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HomeMy WebLinkAbout0038 ABBEY GATE - Health A -b Gza;fe- Co fw t TOWN OF BARNSTABLE :,CX ATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOTOZ IJI A INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY .1po® LEACHING FACILITY: (type) �!%�' (size) 00L NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I� ,qq IL �� 60 4G TOWN OF BARNSTABLE AA LOCATION 33 Qb E q �TC SEWAGE#_ O-Z) - VILLAGE C OTUI 1 t ASSESSOR'S MAP&PARCEL 4 INSTALLER'S NAME&PHONE NO. P-D CO. So$ 411 SS�1 SEPTIC TANK CAPACITY,. 1000 LEACHING FACILITY: (type)5 . C 6i0tMg&'0_5 (size) 12.E33 1-0 NO.OF BEDROOMS 3 OWNER W k LJ—I P!M PERMIT DATE: -A I u., 'ZI COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .S 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 rAp+ Lh t p� 3 36. 1 32,5 J e 4 lo.Z ✓Ti3 q 30 " No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4plitation for ]Disposal 6pBtrin Construction i3Prm.it Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. G+TiE Owner's Name,Address,and Tel./No. Assessor's Map/Parcel d f d �,APE Ag��cPAAxy Dupes Installer's Name,Address,and Tel.No. 56?-e4 7'7- 9T 77 Designer's Name,Address,and Tel.No. R000tT Q:� Ova- c® Type of Building: PCR-7L?Le v) Dwelling No.of Bedrooms Lot Size ® ± sq.ft. Garbage Grinder( ) Other Type of Building RESt7a&jJ 1#1A, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) dz_;L0 gpd Design flow provided 345 , gpd Plan Date 4 i i -2O:L i Number of sheets Revision Date Title 39 C4-?'ETCd a�— Size of Septic Tank Y 60 C-AuzAk$ Type of S.A.S.�Aj 5oa mod. 064n 3-S Description of Soil k Ep L b&4 SA-Ad'o R Nature of Repairs orAlterations(Answer when applicable) USC t2 47-i P j O Q8 Gvk.L01J Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Signe Date " Application Approved by Date Application Disapproved by Date for the following reasons Permit No. / ''� Date Issued C € No. / ~ ,.t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes i- r PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS ftpYication for Mis,p seal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components Location Address or Lot No., A G �'� (�,..�' Owner's Name,Address,and Tel.No. Assessor's Map/Parcel a.a 3 d 0 Tu t 1 l-(. /!�"t G � CN©T fir- Installer's Name,Address,and Tel.No. j 6'R-4 77- n 7 7 Designer's Name,Address,and Tel.No. Ro T f�, 00p_ co Type of Building: M I N,3 Pc1L-t rT«V) Dwelling No.of Bedrooms g Lot Size pv— sq.ft. Garbage Grinder( ) Other Type of Building (E.St D&VTlA4_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) oZ�Q gpd Design flow provided 3 1 a� gpd Plan Date 4-0 9 -:.O 11 Number of sheets ( Revision Date Title 39 AN399e G.4 re cibTC1 t`Z"."' Size of Septic Tank ( g 4 06 G4,LewUS Type of S.A.S. 60 5 e ri 6?k- Cd 4,tt a6a Description of Soil Nature of Repairs or Alterations(Answer when applicable) USC- t�)QXTt .O G-- C.G[12t) SC5P77 G., 'tb ��v N-�►� r) n30u Tr,(� 'San C-.tct_<)?q v L .c-btu a Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been.issued by this Board of Health. ^y 1 �. Signed l _ Date 14- A, Application Approved by \,\�. Date. Application Disapproved by Date 4 for the following reasons Permit No. --}l l/ �`� Date Issued -� --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X Upgraded( ) Abandoned( )by P_ C'b at 3 8 /4-dj5EY GA-7-r- C'67 u t'T has been constructed in accordance ) L with the provisions of Title 5 and the for Disposal System Construction Permit No,, )'/ ! dated Installer Rp6cx( UAL (::�® Designer 3C. 8X)C 1A.)E!-Z1 0 �iUC #bedrooms Approved design flo/rR �Z� gpd r The issuance of this permit shall not be construed as a guarantee that the system 1 ill function as designed. Date S 112 Inspector \( / , 4� (, 121 Gr V_/L. No. 1 / �'I1 t Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstrm Construction permit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) System located at _35F A 6V C OT v a - and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this p'hermit ` Date f/1� / ' Approved bye` Town of Barnstable ,.o Regulatory Services ' .�. , Richard V. Scali,Interim Director. , • snnrtsr�ete, ' �. 9 MAM i639• Public Health Division �� r nrua� Thomas McKean, Director 4r 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 5-20-21 ` Sewage Permit# Assessor's Map\Parcel 22/113 Designer: _�(✓ Er��ti.neerin5. xvic. Installer: Robert B. Our Co.,Inc. (REI Address: 2 8 5`l CroAkoe.rry ll(kH w o y Address: 363 Whites Path ra5k ware,�%am 6253$ South Yarmouth,MA On �l1_ RBO was issued a permit to install a (date (installer) septic system at_38 Abbey Gate Road based n a design drawn by , (address) —Sc EV1 Sides e_eXt )9 , TnG, dated 4-19-2.1 (designer) X I certify that'the septic system referenced above was installed substantially according j to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component ' of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed 1 lance with the terms of the I\A approval,letters(if applicable) "OF J4HN L r✓� U CHilRCHILL JR. (Ins ller s nature) CML N 41 r t i (D ner's Signature (Affix De 1 p Here) PL SE RETURN TO ARNSTABLE PUBLIC HEALTH D11ISION. 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:\Septic\Designer Certification Form Rev 8-14-13.doc i . r V t VE8 tol I*gAY 3 2000 COMMONWEALTH OF MASACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION i Property Address: 38 ABBY GATE COTUIT, MA 02635 OD� Name of Owner MARTIN Address of Owner: 468 SEMINOLE AV.ATLANTA GEORGIA 30307 Date of Inspection: 4/13/00 Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 608-664-6813 FAX 608-664-7270 ° CERTIFICATION STATEMENT I certify that I have personally Inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes - _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date:4/20/00 The System Inspector shall sui4it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable;and the approving authority. NOTES AND COMMENTS i "The Inspection is based on criteria defined In Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.My inspection does not imply any warranty or...guarantee of the longevity of the septic system and any of its component's useful life." THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS FOR PROPER MAINTENANCE. RECOMMEND RAISING THE COVER TO THE PIT. revised 9/2198 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A 1 CERTIFICATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02636 Name of Owner MARTIN Date of Inspection: 4/13/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: i X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are Indicated below: B. SYSTEM CONDITIONALLY PASSES: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair i as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination In all instances.If"not determined",explain why not. nta The septic tank is metal,unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,Is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass Inspection If the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. nla Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due .to a broken,settled or uneven distribution box.The system will pass Inspection if(with approval of the Board of Health). _broken pipe(s)are replaced + obstruction is removed _distribution box is levelled or replaced t ' The system required pumping more than four 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 1 _obstruction Is removed i i t • s " i p r t 1 i i • revised 9/2/98 Page 2 of 11. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A i CERTIFICATION(continued) A Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4/13/00 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC.HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. i i f . 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: I The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. i _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, i i t _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nLa(approximation not valid). 3) OTHER n/a i f f i revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4113/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. - X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. - X Liquid depth in cesspool is less than 6"below invert or available volume Is less than 1/2 day flow, - X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped 0. - X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. - X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, - X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No - X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply - X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 38 ABBY GATE COTUIT, MA 02636 Name of Owner: MARTIN Date of Inspection: 4/13/00 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health. X _ None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ X As built plans have been obtained and examined.Note if they are not available with N/A. X _ The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. i X _ The site was inspected for signs of breakout. X _ All system components,excluding the Soil Absorption System,have been located on the site. X _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X _ Existing information,For example,Plan at B4O,H, X _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)) X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2198 Page 5 of 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 38 ABBY GATE COTUIT MA 02635 P Y Name of Owner MARTIN Date of Inspection: 4/13/00 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d.lbedroom Number of bedrooms(design): 2 Number of bedrooms(actual): Total DESIGN flow: 220 gpd Number of current residents:1 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required - Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): Na gpd Sump Pump(yes or no): NO; Last date of occupancy: Na COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) n/a GENERAL INFORMATION PUMPING RECORDS and source of information: Na System pumped as part of inspection:(Yes or no):NO If yes,volume pumped n/a gallons Reason for pumping:n/a TYPE OF SYSTEM X 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) _ I/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval i Other:n/a APPROXIMATE AGE of all components,date installed(if known)and source of information: 1975 §@Wdgg 6116M deter:!@d WIN @ffiuiho @t th@ @it@:(Y@@ of no): NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4/13100 BUILDING SEWER:X (Locate on site plan) Depth below grade: 64" Material of construction: _ cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of Joints,venting,evidence of leakage,etc.) THE SYSTEM HAS TOWN WATER. SEPTIC TANK: X (locate on site plan) Depth below grade: 48" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a i If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 8'6"H 5'7"W 4'10"" Sludge depth: 2" j Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of Inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) I THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS. F GREASE TRAP: _ (locate on site plan) Depth below grade: n/a s Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a i Dimensions:n/a i Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) x n/a k i revised 9/2198 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) j Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4113100 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: Na Material of construction: concrete metal Fiberglass _Polyethylene other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:N/A Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a f , DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Na c - Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) n/a PUMP CHAMBER: _ s (locate on site plan) j Pumps in working order:(Yes,or No): NO Alarms in working order(Yes or No): NO Comments: i (note condition of pump chamber,condition of pumps and appurtenances.etc.)_ n/a r - I i i revised 9/2/98 Page 8 of 11 l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4113/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(1)1000 GAL 6 X 6 leaching chambers,number: (n/a)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system:;n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAD V OF WATER IN IT AT THE TIME OF THE INSPECTION.RECOMMEND RAISING THE COVER TO PIT BECAUSE THE COVER IS 48"DEEP. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: nla - Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of Inspection)NO Comments: (note,condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a , Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Page 9 of 11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4113100 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent reference landmarks or benchmarks locate all wells within I (Locate where public water supply comes into house) Beet AA 6 FA 0� f revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 38 ABBY GATE COTUIT, MA 02635 Name of Owner MARTIN Date of Inspection: 4/13/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep— SITE EXAM _ Slope; - _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record X Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions _ Checked with local Board of health Checked FEMA Maps I ' Checked pumping records Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2/98 Page 11 of 11 r - Ax . Commonwealth of MassachusettsOr Executive Office of Environmental Affairs De artment of Environmental Protection 1 WAGow�ia F.Weld � gVy e Argo*Paul Cellucci David 0: 116 U.Governor Comtnitaloeer SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: Address of Owner.. 11 3'��7`ti Date of Inspection: q' L7 (If different) Name of Inspector. W.E. Robinson SR Company Name,Address and Telephone Number. ( 5 0 8) 7 7 5-8 7 7 6 W.E. Robinson Septic Service P.O. Box 1089 Centerville MA CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: f/Passes Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: 1!�"CX l 4r The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A,B, C,or D: A) SYS PASSES: I have not found information which indicates that the m violates an of the failure criteria as defined in 310 CMR 15.303. �y system Y Any failure criteria not evaluated are indicated below. B) TEM CONDITIONALLY PASSES: . One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indica yes,no,or not determined.(Y, N,or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked,structurally unsound,shows substantial infiltration or exfltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (re sed 11/03/95) 1 h One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 , l i Printed on Recycled Paper r i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . Property Address: 36 Owner. Date of Inspection: B] TEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will peas inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed C] THER 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. Z) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 8) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: ✓� 4S 02r-y 6Z^i4 tE C©7l//r r.Owne S/ Date of Inspection: / c� D] STEM FAILS: have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for his determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for . coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El E SYSTEM FAILS: e following criteria apply to large systems in addition to the criteria above: Tie system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public 1 and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone H of a public water supply well) The owns or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirem nts of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information., (revised 11/03/95) 3 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Owner. Date of Inspeetlom Check if the fo have been done: pig information was requested of the owner,occupant, and Board of Health. —LM/One of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. barge volumes of water have not been introduced into the system recently or as part of this inspection. F�As t plans have been obtained and examined. Note if they are not available with N/Acility or dwelling was inspected for signs of sewage back-up. m does not receive non-sanitary or industrial waste flow J �e site was inspected for signs of breakout: V m components,excluding the Soil Absorption System,have been located on the site. The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or zmaterial of construction,dimensions,depth of liquid,depth of sludge,depth of scum. Thesize and location of the Soil Absorption System on the site has been determined based on existing information or ap/pr�ximated by non-intrusive methods. Lfacility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C -� SYSTEM INFORMATION Property Address: Owner. Date of Inspection: nspeot / FLOW CONDITIONS RESIDENTIAL: Design flow:-13-_gallons Number of bedrooms: Number of current residents: Garbage grinder(yes or no):A- Laundry connected to system(yes or no):4 Seasonal use(yes or no):lam✓O Water meter readings,if available: Last date of occupancy: CO MERCIAL NDUSTRIA U Type establishment: Design ow:_ pions/day Grease p present: (yes or no)_ Indust ' Waste Holding Tank present: (yes or no)_ Non-sari waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: - Lest&4 of occupancy: - OTBER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)_ If yes,volume pumped: ¢allons Reason for pumping: TYPE OF TEM Septic twWdistribution box/soil absorption system single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: /.�-a &A. Sewage odors detected when arriving at the site: (yes or no)�i Q (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C �i SYSTEM INFORMATION(continued) Property Address: d >l �/�h� .f3 'y �(f &l t Owner. Date of Inspection: Z -,2 y SEPTIC TANG: (locate on site plea) Depth below grade: 3l Zwncrete Material of construction: _metal_FRP_other(explain) Dimensions:-6 Shulge depth: is Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: L 0 Distance from top of scum to top of outlet tee or baffle: , Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) A_it� - D S G li � x-i:s r i�i�� � y a Coe,, . AL ko s �i Z�-✓2 G E TRAP:_ (loca on site plan) Depth low grade: Mate ' of construction:_concrete_metal_FRP_other(e:plain) Dime ' ne: Scum ass: from top of scum to top of outlet tee or baffle: from bottom of scum to bottom of outlet tee or baffle: Co nts: ( endation for pumping,condition of inlet and outlet tees.or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) v (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . r/ SYSTEM INFORMATION(continued) Property Address Owner. Date of Inspection: TIG OR HOLDING TANK: (locate site plan) Depth be grade: Material of n: concrete_metal_FRP_other(explain) ' Capacity: ons Iksign w: gallons/day Alarm eve Common . (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, 'dense of solids carryover,evidence of leakage into or out of box,etc.) PUMBER_ (locatplan) Ljc ing order-(yes or no) (note of pump chamber,condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 9 3 k� � �iS�7`� Owner. ,L/'•��S Date of Inspection: SOIL ABSORPTION SYSTEM(SAS}:_ (locate on site plan,if posable;excavation not required,but may PP be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits,number: leaching chambers, number: leeching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool, number: Co GtZs (nom condition of soil,signs of hydraulic failure,level of ponding,condition of vegetatjon,etc.) 16 o 6 Fizz c 3 L l� ' ! '' rtJ aE d L JL »�n, l CESSPOOLS:_ (locate site plan) Number d configuration: Depth-top liquid to inlet invert: Depth of so layer. Depth of layer: Dimensions o cesspool: Materials of nstruction: Indication of water: w(cesspool must be pumped as part of inspection) Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY: (locate on plan) Materials f construction: Dimensions: Depth of lids: Commen :(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) (revised 11/03/95) 8 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM IINjFORMATION(continued) Property Address: Owner. /�ft/ �L7 rvJi/7�.5 Date of Inspection: SICMH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' �y Lh 1 � us 0 t l DEPTH TO GROUNDWATER Depth to groundwaterj.�4 feet method of determination or approximation: (revised 11/03/95) 9 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Appliration -fur Bi,ivuiitt1 Works Towitrurtion Vrruift Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewagq Disposal System at: b g '/` t J am✓ ............ .t..........` l Location-Address or Lot No. .^ -c.---•---------------------------•--------- �-�- f� 1e----- � ....... .......... Own e Address Installer A dress Q Type of Building Size Lot...._._ A.6_.Sq. feet U g— -Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms.-.._.___. __________________________ — P4 Other—Type of Building ............................ No. of persons----____.-_____--___-__..._. Showers ( ) Cafeteria ( ) W Other fixtures ----------------------------------------------------- W Design Flow_______,rE Q___._". J� gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid Cci ..........gallons Length-------------_- Width.......... Diameter----------...... Depth-------.----- x Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------- Total leaching area--------------.-----sq. ft. Seepage Pit No.....&Aq.... Diameter____________________ Depth below inlet.................... Total leaching area-------.-------.--sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--.-.-.-:---.-.-..--_ 44 Test Pit No. 2....._----------minutes per inch Depth of Test Pit.................... Depth to ground water......_-_-_--...____.--. ►4 --------------•--•---•---- ----------------------------------------------------------------------------••------------------------------------------------..-. Description of Soil .�1 -✓..C?( ----•------------------•----�- - -------- ------- —---------------- x �--e---=�-j--------� ��--------� ------©-�-sF, ---------------- x ---•---------- ........-------------------------------------------------------------------------------A.=c--�--------------------------------------------------------------------------------- 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 Article XI of the-State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ued by the board of health. --------� Signe d.--� ------------------- 1"!�---------C-�----------'----- -----------�1�----��--- Application Approved B __l...................................................... .........../Z.4 -2 ... Date Application Disapproved for )iefollowing reasons-------------------------------------------------------------------------------------- --------------------- --- -----------------•-------------------•-------•-----------------------•----•-•----•------•-----•----------I------------------------------------------ ate PermitNo.------. ................................... Issued--------- =---- ----- r ................ Date ---.--..--.------------------------•--------------- r 1 " e-,;�� N No......-7.-'3------• _._ Fps. - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration -for lliopoiial Works Ton.fi#rurtiou 1jrruiif. Application is hereby made for a Permit to Construct ( or Repair ( ) -an Individual Sewage Disposal System at: o / ? %c s .� ' C------------ ------------- -- - --( : -------------As--- -a-.---,-- Lo{cation-Address or Lot No. / / Owney- Address Installer A dress U Type of Building. Size Lot_ ......... .............. feet Dwelling—No. of Bedrooms,---------A=—�-------------------------------Expansion Attic (. ) Garbage Grinder ( ) Other—Type of Building .._..'-------"_.- p ( ) ( ) - __.."-__. No. of ersons___________________________ Showers — Cafeteria G4Other fixtures --•--------------------------------•------------------------------ W Design Flow......... U------- ------------------gallons per,person per day. Total daily flow-------------------------------------------- WSeptic Tank—Liquid capacity------------gallons ' Length................ Width------.......... Diameter................ Depth.___.__._..... x Disposal Trench—No..................... Width-------------------- Total Length__.---_.--.-_..__... Total leaching area--------------------Sq. ft. Seepage Pit No..--- 1 --.-_ Diameter-------------------- Depth below inlet-------------------- Total leaching area-----------.------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.-------------------------------------------------------------------------- Date-------------------------------•------- a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water.._................__ (� Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water...--------------------- ----------------------------------------------------------------------------------------------------.__..---------•--• ------- --------------------•-------- D Description of Soil---------57A_,�!--- _ _____________ ...4------------------------- --------- ----- x V m x ------------------------------------------- ------------------------------------------------------- ---- ------ V 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed---i-- .4;� •---5r le� _ -- :I ------ ----1 ---- D to Application Approved By.-----�- -- -----------------•--------------------------•--------------------------------- _ ✓...._/1, Date Application Disapproved'for the following reasons-----------------------------------=---------------------------------------------------------------------------- - -_...----•-------------------------------------------------------------------------------------------•--..._-----------------------------------------------------------------------.-......------------- Permit No. / • Date -F> ---------•-............. Issued...........--/A ---.l 3....... J Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / 1J....?. /- ............OF....... ...� ..^s:. ... � .. '....�... --........ Trrtifiratr of flampliaurr THIS IS TO CERTIFY,"That the Individual Sewage Disposal System constructed ( or Repaired ( ) by--.._C-.. _� .. _.`.. �� -- �- .....--•---------• �j/�`°.'`" ' --------------------------------•------•• ----------- Installer .. ` -^ at.....A--�----r-•-••--._9..._2. ... ��' �--------- __�-.---__ ...................... ? = .o L /�`' r has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal-Works Construction Permit No------ 1.._.A...................... dated--------------------------------------- THE ISSUANCE OF THIS CERTIFICATE-SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL .FUNCTION SATISFACTORY. DATE ' Inspector - --------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH- No � ...................... .-•----•--------------••- FEE------------------•---- %ripn ittl rrrk ( �a� r�tr i>�at rani Permission is h .eby granted•_-__ -+.�'.�.__./.___-✓ +A___f �__ _ *_ ------------- ----------------------•--..----- to Construct ( or Repair ( ) an Individual Sewage Disposal System — t_ Street as shown on the application for Disposal Works Construction Permit No..................... Dated--------..__----------._-..-.------_-_--•. -----------------------•-----------------....---•-------.............................................. Board of Health DATE..............................................................I................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y i 1 �txt e seaarr�m, ma r� ,era C. MURRAY HEALTH-INSPECTOR "4 yr 7BOARD OF HEALTH ,• 3 TOWN OF BARNSTABLE f OFFICE HOURS: 8:00 - 9:30 A.M. TELEPHONE 1:00 - 2:00 P.M. 778-1120 EX. 38 e . i. e s r_ h I - f� f MARCH INC. BOX 316 WAQUOIT. MAt6, 02530 TEL. 617-477.0440 o • ti h t b � 9 t� r 5�± PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE _T FINISH GRADE OVER CHAMBERS = 35.4 - 36.8 GENERAL NOTES T.O.F. EL.= 38.74 FINISH GRADE OVER D-BOX= 36. PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED WITH COVER OVER INLET& STONE TO CROWN OF PIPE RISER TO WITHIN 6" OF FINISHED GRADE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OUTLET TO WITHIN 6" OF F.G. 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 38.3'± = 37.54 5" DIA. OUTLE.T(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. - - - --- -F.G. OVER TANK EL. STONE OR GEOTEXTILE FILTER FABRIC i , 1 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE } DESIGN ENGINEER. 4" PROPOSED 4„ 3.4� I ' PLACE RISERS ON ALL SCH. 40 PVC SEE NOTE 23 4.0' MAX. CHAMBERS w/PIPED 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE SEWER PIPE 31 .80 _ --------- -- EXISTING MAX. TOP OF SAS = 32.80 --�r' / SEE NOTE 23 BREAKOUT EL= 32.30� INLETS TO WITHIN 6" SYSTEM UNLESS OTHERWISE NOTED. OF FINISHED GRADE 6" 3" 3 DROP MAX L=15'± 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN - ---- 2" DROP MIN 3„ 9�� MIN.SLOPE ,r f ,j PROVIDE WATERTIGHT I ELEVATION = 32.30 FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM JOINTS (TYP.) II 14" SEPTIC TANK 4" PVC OUT TO O 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF O o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE O LEACHING FACILITY o 0 0 � SPECIFIED DROP BETWEEN Too 0 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL , o OUTLET TEE 32.10 MIN. 6 31 .93' 2' oo � 0 0 g. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF o 0 0 00 AND CONDITION OF EXISTING TEES GAS BAFFLE 00 0 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK EXISTING SEPTIC AND REPLACE AS 6 CRUSHED STONE o 0 0 00 0 0 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS TANK NECESSARY OVER MECHANICALLY o o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 5 COMPACTED BASE 8.5 4 0' - (TYP) 4 0 I . 4 0, AND DESIGN ENGINEER. OUTLET DISTRIBUTION BOX 4.83' 4.0 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 35.00, TO BE INSTALLED ON A LEVEL STABLE 25.0' (TYP') ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.- < 24.501 PIPES TO BE LAID LEVEL. 29.80 12.83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON H-20 CHAMBERS 5' MIN. CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES ELOEVATIONPOR TO PRIOR OAIFY NYWORKI &G SEPTIC TANK PROFILE H-20 DI ��RI � � SON SOX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS TO THE DESIGN ENGINEER. NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING T ,� ✓ l;f • %=' // " F ST P I T " 'n ATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM PERC NO. TPT-21-74 APPROPRIATE AUTHORITY. INSPECTOR: Donald Desmarais (BOH) 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED • �� UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR QUEEN ANNE LANE S EVALUATOR: Michael Pimentel, EIT, CSE • ' � �/� -` K TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. (40'WIDE LAYOUT ' ` �. .•" C.S.E. APPROVAL DATE: Oct. 27, 1999 >' .• �- - 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. DATE: March 26, 2021 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE 62 TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. 21 _ S82° 13'S5" E ELEV TOP = 36.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, 35.00' _ L=67.47 j 1i4, «-�' f � J) FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). Q- R=186.11 .__ ;�� 11 ELEV WATER = < 24.50' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN �d C' ~` • ' s� , OZONE 2 PERC RATE _ < 2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. / _00 \� O t II / • 0� '4 TM� + DEPTH OF PERC = 36"-54" 16. PROPOSED PROJECT IS LOCATED WITHIN: n - o �� ��' � TEXTURAL CLASS: I I ' ASSESSOR'S MAP 22 LOT 113 , r �, - • ' N �� �; 's Cs /4 • •. - OWNER OF RECORD: WILLIAM R. ABBOTT& NANCY A. DUBE n , ADDRESS: 38 ABBEY GATE 0" 36.00' COTUIT, MA 02635 LOCUS f \� ! Fill FEMA FLOOD ZONE X Lij _ 18" 34.50' !L � `� � 2�+ �Il1% . Loam Sand COMMUNITY PANEL# 25001 C0539J Q o o ��Y = __ j �p ' r / " Vt/ B 10Yr 5/6 17. DEED REFERENCE.- BOOK 12976, PAGE 294 (� I� < Q w CO `� // '3 yy , 36 - 33.00' 18. PLAN REFERENCE: PLAN BOOK 280, PAGE 18 >' w o o MAP 22 4 : t Ll� LOT 113 36" z MAP 22 ,} �� � 1 PI '�, f _ 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 1{ m - 20,200± S.F. a LOT 114 J j 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 0 o Z / DECK II j �� / ,' I� ��- FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY / �� • •' • FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. Z I / / �°� 'Ff ��I j /�1 ' ' ` ' • • • Medium Sand 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Uj / ~ / ��•-, I j / 8 = a C 2.5Y 6/6 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A w Y / FFE=42.4'± i / BUSH 7i l In .' y�� `�. REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. > w -LSA- i `�w / #38 S� (TYP) 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL p pw �o \w / EXISTING DECK i Benchmark LOCUS PLAN REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. UJI C0 = 2-BEDROOM Nail in Tree 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE SCALE: 1 1000' p' \ DWELLING = J / 0� Elev. = 35.00' APPROVALS ARE REQUESTED FROM 310 CMR 15.221 7 : ' = (1.) A 1.0'WAIVER (3.0'-4.0') FOR THE MAXIMUM COVER OVER THE H-20 SAS. � TOF=38.7'± '� s DTP 1 / i Approx. M.S.L. 138" 24.50' (2.) A 0.4'WAIVER (3.0'-34) FOR THE MAXIMUM COVER OVER THE H-20 DISTRIBUTION BOX. 36xg, ��' _ No Mottling, Standing or Weeping Observed PROP. // ,' DESIGN DATA TFS' PIT DATA LEGEND - - - - - -40-� H-20 D-BOA/1 0 / a �,� PERC NO. TPT-21-74 PROPOSED TWO (2) 500 GALLON I NUMBER OF BEDROOMS (EXISTING) 2 INSPECTOR: Donald Desmarais (BOH) 50x0 EXISTING SPOT GRADE H-20 LEACHING CHAMBERS W/ -39- �/ SURROUNDING AGGREGATE EVALUATOR: Michael Pimentel, EIT, CSE -- - - 50 -- - - EXISTING CONTOUR T 2 � SAP�.ING NUMBER OF BEDROOMS (DESIGN) 3 (MIN. PER TITLE 5) Oct. 27, 1999 C.S.E. APPROVAL DATE: `�' 36 DESIGN FLOW 110 GAL/DAY/BEDROOM 50 PROPOSED CONTOUR CABLE BOX ` --- __ _ - - - -39- ` 15 0' 4 2 DATE: March 26, 2021 ELECTRIC BOX h 1 14" TOTAL DESIGN FLOW 220 GAUDAY 50 PROPOSED SPOT GRADE S82° co a ' TEST PIT#: 2 I 13'55 E \ LP ` PROPOSED INSPECTION PORT DESIGN FLOW x 200 % = 440 GAUDAY ti. 126.00, ® / SWING-TIES SCALE: 1"=20' ELEV TOP= 36.00' T �� EXISTING UNDERGROUND UTILITIES USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER - <24.50' EXISTINu i,UUU Oi-�L.L UN Ocr-i i�, i r1wr: , DESCRIPTION HC-1 HC-2 WN W EXISTING WATER LINE TO BE UTILIZED IN THIS DESIGN PERC RATE = PROPOSED 4" PVC VENT PIPE; 1 CORNER OF STONE (1) 37.4' 21.1' % TEST PIT LOCATION EXACT LOCATION PER OWNER MAP 21 f MAP 21 CORNER OF STONE (2) 49.4' 33.3' INSTALL 2 - 500 GAL. H-20 CHAMBERS W/ STONE DEPTH OF PERC = EXISTING LEACHING PIT 1 U BE PUMPED, FILLED LOT 60 ( LOT 61 TEXTURAL CLASS: I O O EXISTING 1,000 GALLON SEPTIC TANK WITH CLEAN COARSE SAND, AND ABANDONED CORNER OF STONE (3) 47.9' 46.2' SIDEWALL CAPACITY - CORNER OF STONE (4) 35.5' 38.4' (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE - - (25.0' + 12.83') (2 ) ( 2' ) ( 0.74 GPD/S.F.) =112.0 GAL/DAY 0.1 36.00' O PROPOSED H-20 DISTRIBUTION BOX BOTTOM CAPACITY Fill 18" 34.50' Q PROPOSED 500 GALLON H-20 LEACHING CHAMBER (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAL/DAY w (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAL/DAY B Loamy Sand #38 Cn 10Yr 5/6 EXISTING zo 'T 36" 33.00' 2-BEDROOM V- ► TOTALS: DWELLING o REV. DATE BY APP'D. DESCRIPTION I 20 Z TOTAL NUMBER OF CHAMBERS 2 - - - ----- - C-2 A TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE (1 (2 TOTAL LEACHING CAPACITY 349.4 GAL./DAY PREPARED FOR: 10.0' c Medium Sand ROBERT B. OUR CO., INC. 2.5Y 6/6 NOTES: - O Ld LOCATED AT 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF C-1 "' EACH SEPTIC SYSTEM COMPONENT. MAP 22 « 38 ABBEY GATE LOT 113 COTUIT, MA 02635 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE 20,200± S.F. MAP 22 _ PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT (4 12.8-� 3) LOT 114 SCALE: 1 INCH = 20 FT. DATE: APRIL 19, 2021 DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF " 24.50' pp� 0 10 20 40 80 FEET HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. N No Mottling, Standing or Weeping Observed 0-Atk S82 of ° 13'55"E - JOHN L. G�� PREPARED BY: 3.) PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. 126.00' / RESERVED FOR BOARD OF HEALTH USE I CHU CHIILL JR. N JC ENGINEERING, INC. CIV 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY - No. 41807 2854 CRANBERRY HIGHWAY FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS SITE PLAN MAP 21 MAP 21 ,�� EAST WAREHAM, MA 02538 IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. SCALE: 1"= 20' LOT 60 LOT 61 508.273.0377 Drawn By: SJI Designed By:SJI F&ecked By: MCP JOB No.5645