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HomeMy WebLinkAbout0119 ABBEY GATE - Health 11 I Abbey Gate intuit LA = 021 023 e_ Commonwealth of Massachusetts t bad a�3 r F� Title . Official- Inspection Fibrm. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119 AbbeY_G._ate rd. ........ .. -------- Property ---- — - Address r,r. John and Joan Lynch OwnerOwners ---- ---------M---- Owner s Name ir 0 information is required for every Cotuit Ma 02635 10/18/15. .. Rage. City/Town State Zip Code Date of Inspectiori . .;f . •r Inspection results must be submitted on this form. Inspection forms may not be altered in any' way. Please see completeness checklist at the end of the form. Important:When General4n.forrnation out forms on the an the computer, � use only the tab i inspector: key to move your cursor-do not Michael DiBuono use the return -- ----- ------ -- Name of Inspector key. ❑ Di Buono no ewer and Drain Company ' Cny Nam f.• e ,• . 8 Johns path Company Address " ( .S Yarmouth MA 2664 -------------------- City/Town State Zip Code. r„ , ,508 36-4-9587 S113522 i etephon.e;Numbe,rf.; License Number - -- ------------------------------ B. Certification _ I certify that I'have personally inspected the sewage disposal system at this address and that the inforrnation reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on,icy training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CNIR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the L 1-Ap ling Authority 10120/15 _ .............. _._.. _ . IZspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the some or different conditions of use. z �s 15ins•3113 Title 5 Official Inspection Form.Subsurface Sewage Disposal SyIsof 17 , . Commonwealth of Massachusetts ~ ~�^~��U�� �� �=����~��^�� U ����������*��~���� �������7�N Title �� ��/� � ��~���U Inspection �-��mmmn Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 11SAb — Property Address � ��----�-- — ------ JohnandJoan Lynch OwnerOwner's Name-------- -'----'--------------�---------'---------------------'---------- � inwnnouonis � required for every Cotuit Ma 02635 10/18/1 page. City/Town State Zip Code Date ofInspection B. Certification (cont.) � Inspection Summary� Check A,B.C.D orE/ always complete all of Section D � A) System Passes: i have not found any information which indicates that any of the failure criteria 'described in310CMR 15.303orin310CW1R 15.3U4 exist. Any failure criteria not evaluated are . indicated below. . . Comments: The system contains o 1000 gallon tank aswell an a cononab* Distribution box. All tees and baffles are in place. The Distribution box in level and at normal level. The leaching is made up of several � leachin h��mb����Ddsn�dn���_i��peo ��_|�y��|���oeoredb� navan�ave /���?_a/zabngrmaUave�. _ � ��_ -------------- _____________---__-____--_'-__--_�_-_- - B) System Conditionally Passes: ` El one ormore system components asdescribed in the "Conditional Pass" section need to be replaced or repaired. The aysbam, upon completion of the replacement or repair, as approved by the Board of Health, will pass. ' Check the box for^yes^. ^no^ or"not detennined^ (Y. N. ND) for the following statements. If"not ' determined," please explain. The septic tank is metal and ovor20 years old* or the septic bank (whether metal or not) is structurally unnound, exhibits substantial mO|hadon oroxfihcation or tank failure is imminent. System will pass ' inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. ° A meta septic tank will pass inspection if it is structurally sound, not leaking and if Certificate of Compliance indicating that the tank is less than 20 years old is available. F1 Y �] N ND below): , [ -- F�-- -- } ! - ----- ------------ Form Subsurface Sewage Disposal System-Page zm,r ; Commonwealth of Massachusetts 5---V .—_ Title 5 ffici l Inspection Form — Subsurface Sewage Disposal System Form - Not for Voluntary Assessments /,•" 119 Abbey Gate rd Property Address John and Joan Lynch Owner Owner's Name information is Cotuit Ma 02635 10/18/15 required for every -- ---------- __---------- --------- ----------------------- _. page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): El Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below),- . ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 _ d Commonwealth of Massachusetts _ Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 0 119 Abbey Gate rd Property Address John and Joan Lynch Owner -------- - -----..--------- Owner's Name - ------- ------------ ----------------------- information is Cotuit _ — - Ma __ 026_35 _ 10/18/15 `__ required for every _ — _ page. City/Town State Zip Code Date of Inspection B. Certification (cost.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". 4 Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: _..... - D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due 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 t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 4 of 17 � ' ` . Commonwealth OfMassachusetts ~ ��^.�Q�� �� Official Inspection ����Q�N�� ' Title �� n��UU ��*���0 N: u�� �°���8�.nn �—��oonm Subsurface Sewage Disposal System Form Not for Voluntary Assessments 119Abba Gate d PmpoxyAdd,oao �----'----�----------------------'---------------'--�-----'-- ----- John and Joan L h Owner '--------------------------------'------------------_________-____--. s Name information is required for every C»tuh Ma 02635 10/18/15 page. City/Town ���e-- Z�C��--- --------�---�— Date vfmopection B. Certification (Cont.) Yes No Fl �� Required pumping more than 4 times in the last year NOT due ho clogged or -- .� obstructed pipe(o). Number oftimes pumped: El M Any portion �'the SAS, cesspool or privyis below high gmu rid water elevation. �� �� Any pordonof cesspool orprivy is within 10O feet ofasudace water supply or -- �� tributary hoa surface water supply. ' Any portionofa cesspool or privy is within aZone 1 ofa public well. Any portion of cesspool o/ privy is within 50 feet of private water supply well. Any portion ofa cesspool or privy io less than 1O0 feet but greater than 50feet | from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a:DEPcertified laboratory, for fecal coliform bacteria indicates absent and the presence ' of ammonia nitrogen and nitrate nitrogen ia equal toor less than 5ppmn, provided that no other failure criteria are triggered. /\ copy of the ana|ysip and chain of custody must be attached to this fornn] ` The system is o cesspool serving a facility with a design flow of2O0Ogpd' -- �� 10.000gpd� The system fails. | have determined that one or more of the above failure ,-- _— criteria exist as described in 310 C&lR 15.303. therefore the system fails. The system owner should contact the Board nf Health to determine what will be necessary to correct the failure. ^ E) Large Systems: Tobe considered a large system the system must serve a facility with a design flow of1U.0OOgpdbu15.00Ogpd. ! ` For large systems, you must indicate either^veo or^no^,Io each of thefo|lowing. in addition h) the questions in Section D. Yes No Fl �l the system io within 4O0 feet o[a surface drinking water supply � �1 El the system is within 200 feet ofa tributary to a surface drinking water supply �l F� the system is located in a nitrogen sensitive area (Interim Wellhead Protection -- �� Area — |VVPA) or mapped Zone || of public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section O above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310CyNR15.304. The system owner should contact the appropriate � regional office of the Department. mm -`no °~ Title o Official inspection Form:x *°^=ceSewage h."posa/System Page n*n .�� -- - _ � . Commonwealth ofMassachusetts ^ ~�~~��U�� �� �~����^��^��U B����������4�^���� ����B�0�� � Title �� �"�NU ���K��� Inspection W—�~oxox � m— Subsurfaon Sewage Disposal System Form - Not for Voluntary Assessments 119 Abbey Gate rd Property Address John and Joan Lvnch Owner Owner's Name ----------------------------- ------------� � information � -- � required for every Cotuit Ma 02635 10/1 page. City /own State Zip Code Date ofInspection C' Cxne".k//st Check if the following have been done. You must indicate "yes" or"no" as to each of the following: � Yes No r;� El Pum[�g inlonination was provided by the owner, occupant, or Board of Health � El 0 Were any of the system components pumped out in the previous two weeks? | � 0 El Has the system received normal flows in the previous two week period? 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 asNA\) N El Was the facility or dwelling inspected for signs of sewage back up? N El Was the site inspected for signs of break out? M El Were all system componenhs, excluding the SAS, located on site? ` Were the septic bank manholes un 'veoad. opened, and the io.hahor of the tank` inspected for the condition of the baffles or tees, material of 'construction, ' dimensions, depth of liquid, depth of sludge and depth ofscu(n7 El �� VVasthe fac|hvowner (and occupants ifdi�erenthn h from owner)^~ �� information on the proper maintenance of subsurface sewage disposal systems? The miao and location of the Soil Absorption System (SAS) on the site has been determined based on: Existing information. For example, a plan at the Board of Health. Determined inthe field (if any of t he failure criteria related to Part C is at'issue approximation nf distance is unacceptable) [31UCMR 15302(5)] � D. System Information � | / Residential Flow Conditions: Number of bedrooms (desi n)� 3-------- Number of bedrooms (act 3u�U� ----------- ` . 330 DESIGN flow based on31OC&1R 15.203 (for example: 110gpdx#nfbedrnoms), ---'--'-- � � t5ins'3o3 Title o Official inspection Form Subsurface Sewage Disposal System'Page ow`, all � ^ ' ~ - ' ` Commonwealth ofMassachusetts . ~§�~����� �� �w���~��^�� D U������������~���� ����0°��� Title �� ��/UU ���U��� Inspection N-��mmnv � Subsurface Sewage Disposal System Form ' Not for Voluntary Assessments 119Abb Gate rd � Property Address �����------'----�------'---- --'------ ---------------- John and J )an Lynch Owner ame information is required for every C»tuit Ma 02635 10/18/15 page. City/Town 3mtu Zip Code Date vr Inspection �-------�---- D. System Information Description: The system contains 1000 gallon tank as well as concrete Distribution box. All tees and baffles are in place. The Distribution box is level and at normal level. The leaching is made up of several |eaohin chambers d atti of inspection levels appeared to never have been at abnormal _- Number ofcurrent residents: 2--- -------- ---�- � Does residence have a garbage grinder? Yea M No � Is laundry on a separate sewage system? (Include laundry system inspection � information in this reportJ El Yes [E No Laundry system inspected? M Yes Fl No � � Seaanna| uue? El Yes H No 178GPD Water meter readings, if available (last 2 years usage (gpd)): --------'-�--� Detail: Sump pump? Yes M No . � Last date ofoccupancy: -------- -_-_ � Date � � Commercial/industrial Flow Conditions: Type ofEstablishment: ------ ------- DesignOmw (basadon 31OCyWR 15�2O3)� ----�'-----------'-------------'- Gallons per day(gnd) � . Basis of design flow (neats/persono/sq.h, ehc.)� ---- Grease trap i? ppmsen || Yes R No Industrial waste holding tank present? ' El Yes R No Non-sanitary waste discharged to the Title 5 system? El Yes n No Water meter readings. if available. -------�----------------------' mins'`na Title sOfficial Subsurface Sewage Disposal vpte~-Page rm,, ' | | _ Commonwealth OfMassachusetts ~ ~�^"��0 �� Official H Inspection Form � � 8���� �� �^�� � U��0�� � ������������U���� �—��0~��� . ~~ "��"�w m w�����°�� m��o o ��n xuo Subsurface Sewage Disposal System Form Not for Voluntary Assessments 119Abbo Gate d Property Address -----------'—�----------------�--��—'------�----^---�---��----'-- John and Joan LVnch Owner Owner's Name-------------- --------------------------_—� information is required for every �o�uit _�__ 02635 10/1 City/Town png�� City/TownState Zip Code Date ofInspection -- D. System Information (cont.) Last date of000upanoyuno: Date Other (describe be|ow): | � Goneno| |nfonna1ion Pumping Records: ' Sptember Source ofinformation: Was system pumped as part of the inspection? El Yes E No |f yes, volume pumped: gallons__ How was quantity pumped determined? — — Heaoonfnrpumping: TvpeufSvotenn: ` Septic tank, distribution box, soil absorption system | | Single cesspool � El Overflow cesspool � Privy El Shared system (yes or no) (if yes, attach previous inspection records, if any) | � LJ ` Innovative/Alternative technology. Attach a copy of the current operation and _ maintenance contract (to b* obtained from system owner) and a copy oflatest inspection of the |A\ system by system operator under contract ^ � LJ Tight tank. Attach a copy of the DEPapproval. � El Other (describe): e�-3n3 Title s Official inspection pm�,Subsurface Sewage Disposal System'Page o*o ��' Commonwealth of Massachusetts Title 5 Official Inspection Form '\ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119 Abbey Gate rd Property Address John and Joan-Lynch Owner Owner's Name — ----------- — — -- --------- - information is Cotuit _ _ _ Ma 02635 10/18/15 required for every ---._..--- --------- --------_--- ------- ------------ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 8 ears Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer (locate on site plan): Depth below grade: 28 - feet Material of construction: . ® cast iron ® 40 PVC ❑ other(explain): ------ - ----- -- ---- ------- Distance from private water supply well or suction line: reef - Comments (on condition of joints, venting, evidence of leakage, etc.): System Is vented throught the roof. Septic Tank (locate on site plan): Depth below grade: 2.5 ft feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1000 gallon If tank is metal, list age: ---.__.............. ._----.--_-------------------__ _..-- years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: _....__..__._.. ------ ----..... ------------ - Sludge depth: 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 ` . Commonwealth OfMassachusetts ' ~Q~~��N �� Official 0 Inspection. �� Title U�*��� ���������� U���� ��U�D�� U n ���° �� �^�� � o�� ��� �mo=� � �~ � o ������~m���xo. ��mxmo Subsurface Sewage Disposal System Form ' Not for Voluntary Assessments 18�AbbavGaterd Pr operty � � John and Joan Lynch Owner owners wemo information is � required for every Cotuit _ Ma 02835 10/1 page. CityrFo°n State Zip Code Date ufInspection D. System Information (C0Dt] � Septic Tank (oordj Distance from top of sludge to bottom nf outlet tee orbaffle 24^ Scum thickness ` ------'-'--' | Distance from top of scum to top of outlet tee orbafO 42^e --- | Dis�nce �omb��mofm�mUob�� ou tlet � 1^ S|~dqe tee stick ---' Ta e Measure How were dimensions determined? ------ Comments (on pumping renommendadons, inlet and outlet tee or baffle condition, structural integrity. � � liquid levels au related to outlet invert, evidence of leakage, etuj: ' No evidenceof leakinq,Tees and or baffles �� �d �i �--------- ���� ___-____._-_�--___-_ - ' ���������������---------����`�������� ' ------------- Grease Trap (locate on site plan): � NA Depth below grade: '-----------------�-'------ feet Material cfconstruction: � El concrete El metal El fiberglass El polyethylene El other (explain): | | --'------'-----' --'-----�--- -'-' --' -� �--- -------'--- -------------- '' | / Dimensions: - ----------------��----- Scumthkckness --- --'-------------------- Distancehomtnpcfsoum to top of outlet tee nrbaffle Distance from frombottom of scum ho bottom of outlet tee orbaffle ------�------------ Date of last pumping: - � Date m° -o^u Title n Official inspection Form Subsurface Sewage Disposal System-rage`v*n ` ' Commonwealth of Massachusetts � ~�^^��U�� �� ��`���~�w~�� U U������������^���� ������0�� mo �o�� �� n�mU0 �����«U Inspection �- ��oxxo Subsurface Sewage Disposal System Form ' Not for Voluntary Assessments 119 Abbev Gate d - Property Address ���-------'----'------'-------------------------'-----------------------'----� John and Lvnuh � Owner ----�----�---��----'-'------'--'-------'-----�--'-'-------------------------- ame information|a required for every Cohuh _--__-_------________ _ ��� �02S35 1O/18/15 page. City/TownSm\e Zip Code Date nf Inspection ----�---'--- D. System Information (cont.) I Comments (on pumping neoommendaUons, inlet and outlet tee or baffle condition, structural integrity. liquid levels as related to outlet invert, evidence of leakage, etc.): Tees are in place and levels are normal. -------------�_�������_������ ----------_-_-_-_-__-__ ---------_-___-_--__--_---__-_____-'___---___-_______-_____�_-__�- Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan). Depth below grade: | . � Material ofconstruction: � El concrete El metal 0 fiberglass El polyethylene El other (explain): Dimensions: ---'---'---_� Capacity: gallops Design Flow: —�----'----�---�---�-'--_-_-_____ - 0a|lpms per day ' Alarm present: El Yen El No Alarm level: A|apninv,.,mrkinOOrder: El Yes El No � Oaha of last pumping: �-------�-----'-'--�- ------- '- � Date Comments (condition of alarm and float switches, etc.): --�------�----'------'---------�- -----------�---------- | | . . ----------- Attach copy of current pumping contrac (nyqUinad). |s copy attached? El Yes Fl No � 15ins-pz Title o Official inspection Form:Subsurface Sewage Disposal System-Page``wn � «- Commonwealth of Massachusetts Title 5 Official Inspection Form �ml = Subsurface Sewage Disposal System Form - Not for Voluntary Assessments qrp 119 Abbey Gate rd Property Address John and Joan Lynch Owner — --- ------------------------ Owner's Name ....... information is Cotuit _ _ Ma 02635 10/18/15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert __._....._.__.......__.___At normal level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution Box is level and at normal level with no signs of carryover or decay Pump Chamber (locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.),- If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located,.explain why: t51ns•3n3 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official inspection Form 8 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119 Abbe y Gate rd Property Address John and Joan Lynch Owner Owner s Name information is required for every COtUIt Ma 02635 10/18/15------- --- — -- ---- - City/Town page. y/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: — ------- 13'x25' -- f� leaching.chambers number: ---------- ------ ❑ leaching galleries number: ------------ - ❑ leaching trenches number, length: ---- -- ------ - ❑ leaching fields number, dimensions: ----- -- - - - ❑ overflow cesspool number: - - ❑ innovative/alternative system Type/name of technology: __.__---___.____-__._.__ ._,.__..__..-----......----------_---------_----------.___ _. Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No signs of carry over and no signs of hydraulic failure. _ - ---- — Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration ---------------------------------- Depth -top of liquid to inlet invert - -- ---------------------.----- Depth of solids layer ----------.--..-.-.-______ _ Depth of scum layer Dimensions of cesspool ---------------------------------..----- Materials of construction -------------------------------------- Indication of groundwater inflow ❑ Yes ❑ No 15ins•3113 Mille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 ^ ` Commonwealth -. Massachusetts . ~�^~��W�� �� 6r���^��^�� 0 N����������"�^���� Form� Title �� n�rono��o��o Inspection m ��oomu Subsurface Sewage Disposal System Form ' Not forVo|untaryAssessments 11QAbbe Gate d -- — Property Address ���--�--------'------- ------'—'---------�------'--------�-------------'--- JohnandJoan L h o*no, Owner's -----'--'---------------------------�----------'---- Name information is required for every C«tuit Ma 02�635 10/18/15 page. City/Town State Zip Code Date u/|nooection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic 0ai|una. level ofponding. condition of vegetation, etc.): No sig_g_§_of_pondinqhVdraulic failure. _______�_________ _________ ___ Privy (locate on site p|an): | Materials ofconstruction: ---—-------- ----'------ ------------- � � Dimensions Depth of solids �--- Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, � � Subsurface Sewage Disposal System-rag"wwn ' Commonwealth of Massachusetts ` ~�^~��U�� �� Official � Inspection �� 0 U �U� � ��� � ��U�U ���������0��� ������ ~~.~~ . ==~�=�=�� n��oo ��momv Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119Abbo Gate d Property Address ��--------------------'------------------------------------'---'------ John and Joan L h Owner '------------~--------'----' ---' —- ownernmamu ------'-------'-----------------�----'-------- - information is required for every Cotuit __ Ma _ 02835 10/18/15 u page. 'y /uwn State Zip Code -------- D. System Information ( ' Sketch Of Sewage Disposal System.- Provide o view nfthe sewage disposal system, including des to at least two permanent reference landmarks or benchmarks. Locate all wells within O0 feet. Locate where public water supply enters the building. Check one of the boxes below� ' El hand-sketch in the area below ' drawing attached separately Title o Official msf°cti" Form:Subsurface Sewage Disposal System-Page,,w`, ' . TOWN OfOBARNSTABL E LOCATION / +/ -��/ i _--- _ SEWAGE tl 2MI) -3 6(, + VILLAGE i -_--ASSESSOR'S MAP&.PARCEL INSTALLERS NAME&PHONE NO. QCZ SEPTIC TANK CAPACITY 100 6) LEACHING FACILITY:(type)_LO. 0 -/ ,Zxj (size) NO.OF BEDROOMS OWNER -- PERNIITDAI'E: COMPLIANCE Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feel of leaching facility) _ _ Feet FURNISHED BY 0 V c 0 1 A--c i pay,3 I?-c /9.0 �3�.o �a ir•1 �y�• 6 �3z.s . /�� ��� Commonwealth DfMassachusetts . ~�^~.�U�� �� J������*^�� � k���������*��~���� ����U~0�� ' Title �� Official Inspection�U �- ���=�� �*m w Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119 Abbey Gate d Property Address ��------'------------------------------------------------ John and Joan L h Owner Name information io required for every C»tuit Ma 02635 10/18/15 page. City/Town State__ Zip Code Date of Inspection �----------- 0_ System Information (cont.) Site Exam: Check Slope [� Surface water, El Check cellar ' | El Shallow wells / Estimated depth to high groundwob*r 20 + f feet � Please indicate all methods used to determine the high ground water elevation: Obtained from systemdesignp|annon record 7/2UX}7 |f checked, date of design plan reviewed: -'---'-----------_------------ uam Checked with local Board of Health - explain: El Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local'excavators, installers - (attach documentation) Accessed USGS database -explain: You must describe how you established the high ground water elevation: Test hole data on plan dated 7/20/07 indicates NGE at 10+' Before filing.this Inspection Report, please see Report Completeness Checklist on next page. 15ins-.3/13 1 itle 5 Cfficial Inspocti6ri Form Subsurface Sewage'Qispoial System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 119 Abbey Gate rd — _ --- --- Property Address - John and Joan Lynch Owner --Owner's Name---- -------- ------ — --.... --- — - information is required for every Cotuit Ma 02635 10/18/15 page. City/Town _ State Zip Code Date of Inspection E. Report Completeness Checklist - ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information — Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. 64 ! Fee �aCJ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Rio o aY 6p5tem Cott.5truction Permit Application for a Permit to Construct O Repair( Upgrade O Abandon O ❑Complete System tlndividual Components Location Address or Lot o.///4 46 Owner's Name,Address,and Tel.No. /* Assessor's Map/Parcel ���,s��t; ..2 4� Cv 04 Installer's Name,Address,and Tel.No.&4ATi r COW J' Designer's Name,Address and Tel.No. M �4d SAtAe,.j �4•efjY"!%� !7'1•/l7i//s p'1 5aQ' ' 77/-,1-� ci. �s�eJ�,. �1 q Type of Building: Dwelling No.of Bedrooms Lot Size �Q, d sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 336 gpd Design flow provided 3 70• / gpd Plan Date i-a-11 3, 0672 Number of sheets Revision Date �-- Title S C ire/ fix►&vv <a/ / Size of Septic Tank �i 100 G,L .KQ4"� Type of S.A.S. � ��� Lle,/V_ :;Crre �7 / Description of Soil J 1-r �l 4 ol Nature of Repairs or Alterations(Answer when applicable) 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 B of e h. Sig d Date Application Approved by7—� Date Q Application Disapproved by: Date for the following reasons Permit No. �f r :S 6o Date Issued p ijiA No. < 0C) / '^-� �. �! v oL Fee /Od THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ,application for �Digogal *pgtem Cougtr-uctiou Permit ` F Application for a Permit to Construct O Repair(14upgrade O Abandon O ❑.Complete System ❑�^ndI ividual Components a Location Address or Lot No.I�� �p/j � � Owner's Name,Address;and Tel.No. Assessor's Map/Parcel OQ.c/�d .�2 3&G C-XA nr n Installer's Name,Address,and Tel.No./3;r�/ol�' ��tJ� Designer's Name,Address and Tel.No. &17 sa`�-N7 4 �S�G r�•n�.//i �,ra- ;�t � 77i ra(3 w. y��„d��, ry/q = Type of Building: t Dwelling No.of Bedrooms 3 Lot Size c,20� Q stl sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) ' Other Fixtures !J Design Flow(min.required) .�3Q gpd Design flow provided !o �f gpd Plan Date /&,,-� 3, g0tl 7 Number of sheets / Revision Date Title �r� c uJOs/'4 C�* 0 �0,`"� Size of Septic Tank 4 000 C6 L 5,KtJ/ih5 Type of S.A.S. �3� •� L><roK� 3p}7� Description of Soil �•-s ��rivr Nature of Repairs or Alterations(Answer when applicable) Gar' C- t ,h r 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 a l�h. Sign d�� Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. r � (n Date Issued ? -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by �1,44 A �a✓J� lfiuJ at /�Cj !� �A ,� I} Ca ;�� has been constructed in accordance � o l with the provisions of Title 5 and the for Disposal System Construction Permit No. ��:G 7 —3 6(0 dated p � /G Installer /,� a /`i I C_�yJ A r/o) Designer z"1 - q #bedrooms 3 Approved design flow -'j 1-/6- T gpd The issuance of this permit shpll not be c,�nstrued as a guarantee that the syste�mm w iT �id iigned. . Date y / Inspector\ No. 2007 �3 _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS �i!5pogal *p$tem Cori truction Permit / Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) / System located at /�r/ A94--Z �j� X* ,,,///�c,�' and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction be c mpleted within three years of the d e of this p i .Date 4 7,ust 07 Approved y, a` FROM r FAX NO. Aug. 13 2006 03:03PN P1 Town of Barnstable Regulatory Services o� Thomas F.Geiler,Director • Bnnrsr,,a� Public Health Division 4 � ` Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-79M304 Installer&Designer Certification Form Date: 0 Z 60"7 Sewage Permit`- -3 Assessor's MapTarcel f Designer, Installer: 1� Address: Address: On '?;,2 7 G1 l v im— �. was issued a permit to install a (date) l G (installer)) septic system at [ I � C� based on a design drawn by 'addiess, dated cb ..c� I Certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tame. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 1.0' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State& Local Regulations_ Plan revision or certified as-built by designer to follow. Stripout(if required) was inspected and the soils found satisfactory.. �Z (Installer's Signature - (D tgn tgoa ;,ts31.,$ (Affix ix p Here) i PLEASE RETITRN TO RARNSTARLF PUBLIC RRALTf( )DIVISION. CERTIFICATE OF COMPLIA_NCE WILL NOT BE ISSUED UNTIL BOTH 'X'>E>E[S FORM AND AS- BUILT CARD ARE RECE]i'VED BY THE_BARNSTABLE PUBLIC REALTH DIVISION THANK YOU. QASeptic\Dtsignrr Certification Form Rev 03.09-06.doc _ 1 �f $.3.� 1 T. ............... THE COMMONWEALTH OF MASSACHUSETTS . BOAR® OF HEALTH �, ---.. .............. -.-....... -...OF.................... 3�0 PO' Allp irtation for Mipati al Works- Tioatfurt rrmi# Application is hereby made for a Permit to Construct ( ) or' Repair ( ) an Individual Sewage Disposal System at: • ..... �Z.f..., -----------------••--.. .................................. .............................................................. L t' n- dd ss or Lot No. v s--- Owner Ad ess . `~Q.........--••--•---•..................... ` ----.... ..... ------------- a Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.-... .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....--...........--........ Showers ( ) — Cafeteria ( ) Q, Other fixtures ---------------------------•---• . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity........--..gallons Length................ Width---------------- Diameter.......------.-- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date.........................=.............. aTest Pit No. i................minutes per inch Depth of Test Pit.................... Depth to ground water..---------..---. ----- �, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...--------_---.-------. ------------------------------•---------••-----•-•--------------•---.............................-•---------------•----------•---------------...•-- 0 Description of Soil..........................................................................................................................................----------.................. W V ..........................................................••---••---•--•--•------•------------------------------•--------------------••---------------------------------------------•-----------........ W VNature 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 iITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has brxn issued byy the boar hbar f health. S� ed-.. _.. -----------------------------•- ..... -- Application Approved jBy/ .. . •-• • --=•------- ----• ... .. . Date Application Disapprov the following reasons---------------------------------------------•---------------------....... ..................................... ..-•----------------••---------------------------------•----•-----------......--•-------•--•-••---------------•--•...--••-----=------------------------•---•-----•--••-- ............................... Date PermitNo......................................................... Issued_....................................................... Date i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • ............. ........ -------......--.OF...............-...------..-._.......... Applira#ion for Uispoii al Vorko Tomitrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ......... � .�r..., ..� ? .. .---.....---•-------... �. ............................................... L c t n cl� ss or Lot No ........� ........................................... .•!! --- ---- ................. ................. �;., Owner --•Ad ess Installer Address Uyp� Building Size Lot............................Sq. feet I.W. No. of�B�drooms�_: .__..Expansion Attic ( . ) Garbage Grinder ( ) e o Dwelling . ----•---•-------------- — 11-61er—FF e 'of B�i1"c'itig'�-��`� ........... No. of persons............................ Showers ( ) Cafeteria ( ) Otherfixtures ....................................................................................... .............................................................. Design Flow............................................gallons per person per day. Total daily flow__..........................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter----------*_____ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........._............. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....:-____-____-_.____- P4 •-•••••••-•---------•.............................••••••--•........••.........................------.........................................................0 Description of Soil........................................................................................................................................................................ x • U --•--•-••••--•-••-•---••-••-••......-•---....••••-••--••--•••-•-------------•---•••-------•-•--•••-----...-•--•---•••------•-•----•----••-----•---•---•---•-•-----•-•-----•---••----••••--••-••-••----- w UNature of Repairs or Alterations—Answer when applicable.____________________•.-____------._______-.•-•------__-___-_______._-______-___••-------------- •---•--•••••-•-----••-------•..............••-•-•-••----••-••-•--•••••-•-•-•--••---•--•---•-----•...••••••--•••---••-•--••------•---••••--••----•••...••--•-•----••-•--••••----•••-----•...•-••---•-••-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n ised by the boardoof health. Signed ..,: / - "'' :z' a Application Approved B . ......`-•----......•------•------•--•-------------•-----....--••------------.. -_ . -_- �. Date Application Disapprov f od the following reasons---------------------------------------•---------------------................................................... ......_....•••-•••--•-••••••-•---...•---....••--•••••••••--•--••••-••••••..........-•-•-.......•••--••---I---•••-•--••••••••---•--•--•-----•--•...........-•-•---•-•-•----••-----------------------•--•-- Date PermitNo......................................................... Issued........................................................ Date • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... ^-� C�rr�ifirtt#r ,af f�.�azt��i�aatr�e Isis TO CERTI That the Individual Sewage Disposal System constructed r or Repaired ( ) nstaller � '� ._ ..... ••-r .......I ...-------•-------•-•.................................. •. , ' -.------•--------•---- has been installed in accorda, e w i the provisions of TIT LE ` of The State Sanitary Cod•4`a •cribed in the application for Disposal Works onstruction Permit No.. ................................ da.ted_Jr .__.._.._. THE ISS ANC OF THIS CERTIFICATE SHALL NOT BE CONSTRU ® A GUARANTEE THAT THE SYSTEM qL F CTION SATISFACTORY. DATE_ 7r ._f ._A/---•-•---.......-•---------------------•--......---- Inspector..... ------.; THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH R ...........................................OF..................................................................................... No.. .................... FEE...tf ir 'ttIk urairrn Pr�ti# Permission is eby granted. . _:_ f -----------------------------------------------------•..---- to Construct or a ai n fdlvldua e w D> posal_System at No. - street as shown on the pplicatio for Disposal Torks Construction Permit No --: _'_ Date •.. `� ........................ ..................•..••• --- -•---p-•----- .......`-----.................................. Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - r } &M rl�z* 60" 0/ emm"~X&I *IaiW4 V� ANTHONY D. CORTESE Sc. D /mot .,g/ O Commissioner �uC� �clle, A4�� 0$346' PAUL T. ANDERSON Regional Environmental Engineer, 1 y J L f : 947=1231, 00.C. 6'80-G84 . 't ;J - tee A February 8, 1983 This Departrent is in receipt of the follcr.!in-° application filed in accordance with the Wetlands Protection *xt, �eneral Larrs, Canter 131, Section 01 ("the Act"): Name McShane Construction Co. _Independence Way, Dennis, Massachusetts 02638 R Owner of Land Same City/Town Barnstable Location Lot 9A, Abbey Gate This project has been riven the fol1os,inr '.!etlanus file nurker in accordance wit;, the Act SE 3-950 i The following infomation is missinc. and must he forwarded to this office fora' corlpl ete fi 1 i n<t in accordance t-!i th the .',ct: ( ) Notice of_ Intent (. ) Environmental Data Foni ( ) Locus leap ( ) Plans ( } The plans for - Vie se.!!aCe disposal sister, appear not to meet the requirements of Title. 0 of The State Environr,ental Coae. for the follaiing reasons(s) : l:evievt the Lcard of Health. ( ) Coastal "etlands pe:Mation should be reviei,,ed prior to heari ne 6J A Ulapter 91 License or Pemit is not required h,y the Division of Watewrays. ( ) Application leas been fomlare.ed to the Division of !.later.!3,ys to �-eterr�ine if a Chapter 91 License or ferrli t is renui red. A d.eci sion reo3rdi nc Chapter .91 jurisdiction gill be issue,-' 11,y Vie "ivision of "atemays no later than ( XJ Che.ck. groundwater elevation. Issuance of a file ntrmF;r Jndicates only cor!)1eteness of the` file and net approval of the application. For the Cor.r:7issioner "o. ert�.Taran cc: Conservation Cormission ;�enuty ;'e(innal Cnvironr,Nental Engineer (x Board of I lei 1 th , ( Coastal Zone 4'anagewent Rte 28 TOP OF Raise covers to within 6" of Observation Port FOUNDATION 75 Feet 6" PVC (5' Solid & 2.5' of Perf) EL 20.6 finish grade install risers as needed with Screw Cap To Grade STANDARD NOTES 22.3 GROUND SURFACE EL_ 22.3___ Yent 1) THIS PLAN IS FOR THE INSTALLATION/ REPAIR OF A SEPTIC SYSTEM. ��• 18.5 --------- Propose B x �) ALL INSTALLATION PROCEDURES AND MATERIALS SHALL CONFORM TO 310 CMR 15.000, THE STATE ENVIRONMENTAL CODE, w (rypiI) TITLE 5, AND THE TOWN OF � SUBSURFACE DISPOSAL REGULATIONS. 2'MIN--3'MAX 17.35 TOP EL 3) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE OF AVAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS g ti INVERT EL 17 4 / MIN e' LAYER DOUBLE WASHED OR ZONING REGULATIONS. 4 'gay Existing 10" V17224- 1/2' STONE s 14'" T16.85 ' - - - - - - - - 30" 4 THIS PROPERTY IS SERVICED BY TOWN WATER INVERT EL 14 INSTALL INV EL - - - - - -' T - - - - - EFFECTIVE )OldaGAS 17.05SIDEWALL 5) THERE ARE NO KNOWN WELLS WITHIN 100' OF THE PROPOSED SOIL ABSORPTION SY'Sf4'6) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE BAFFLE INV EL 16.93/4'- 1 i/2' DOUBLE IN EL INV EL Thee 3050 Hzo Maximizers 'b ^b WASHED STONE 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY 6d o it/2'stone on ends & 4'stone on sides �^ P' 6" STONE BASE 51" x 85" x 30" 14.85 BOTTOM EL UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE, ACCESS, INSPECTION Locus Existing (To Remain) 4 PUMPING OR REPAIR. 1,000 Gal Septic Tank o ti s = 0.02 (Typical) S = 0.015 IS 0.011 �;� �;� 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION 10 55, 1 SYSTEM, EXCEPT WHEN VENTING HAS REEN PROVIDED. LOCUS MAP 14 E� 9.7 BOTTOM OF TEST HOLE 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6" STONE BASE UTT,S` TO ENSURE STABILITY AND PREVENT SETTLING. 25.30' x 10) OUTLET.DISTRIBUTION LINES SHALL REMAIN LEVEL FOR A MINIMUM OF THE FIRST TWO FEET OF THEIR LENGTH.12.25' 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' (SAS) OF DRIVEWAYS OR PARKING OR TURNING AREAS, IN WHICH CASE H-20 COMPONENTS SHALL BE USED. Living 12) ALL BUILDING SEWER LINES SHALL HA 1 E AN INNER DIAMETER OF 4" AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC. Bdr #3 Second Floor Garage Rm - 13) THE DEPTH OF THE TOP OF ALL SYST.V'M COMPONENTS SHALL NOT EXCEED 36" UNLESS VENTING HAS BEEN PROVIDED. First Floor 14) IN THE AREAS OF EXCAVATION, EXISTING GRADES SHALL BE REESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS. Utility 15) IF SOILS ARE ENCOUNTERED DURING 77YE EXCAVATION OF THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM Rm R Y THE DEEP OBSERVATIOM HOLE LOG, CONTACT A & M LAND SERVICES AND TOWN BOH BEFORE PROCEEDING. 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO CONSTRUCTION Bath I Bdr #2 Bath Kit Din 17) CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION TO A & M LAND SERVICES AND TOWN BOY FOR REVIEW AND APPROVAL Rm Unf'nis d 18) CONTRACTOR SHALL NOTIFY TOWN AND DESIGN ENGINEER AT LEAST Rm l 24 48 HOURS PRIOR TO INSPECTION(S). Bdr #1 Family Ba th Rm Basement Level 1 DEEP OBSERVATION IV o � . ' 6 4`� �' 149. 00 HOLE LOG ISad � I ELest 22.8 Hole #+ I \ 14 1� Depth le v Soil Soil Soil (in) ft) Horizon Texture Color (USDA) (Munsell)\ DESIGN DA TA o - 18" 21.3 A Fill\ \ 3 .0) ' ,�, 18" - 26" 20. 6 B Loamy Sand 7.5YR5/6 Number of Bedrooms: 26" - 120" 12.8 C Med Coarse Sand 2.5Y7�4 Garbage Grinder: E'xs�ing ter No in e yy,, Design Flow. 330 Deep Obs Hole Date: I I t 0 b e l o ca t e d i tll \ \ `'�I �/27/O7 (110 Gal/BR/1 aF. x Number of BR) . field by con tra(, tor Soil Evaluator: sD STONE Septic Tank: (TO Remain) 1, 000 I I O Witnessed By: <o2 MPI �a48„, ( :' g ) Ga t Pere Rate: (Minimum = Design Flow x 200% 23.8) p1"Ioo col2st. \ - ( Soil Survey Description: CARVER Leaching Area:, 1,�I P� Geologic Material: GLACIAL OUTWASH MORRAINE 6 We t Depth to Standing Water: NA Sidewalk. FlagDepth to Weeping Water: NA (2 Sidewails x _____Ft x ---__Ft) + 1 \ Depth to Mottling(Color): NA (2 Endwalls x --NA 12.25'FT x 2' Est Seasonal High GW: --- -----Ft) 150 USGS Observation Well: NA Bottom: \ ` Dee \ Date of Last Measurement: NA _12.25' 25.3' 309. 9 ( Gravel DEW Garage I Comments: -----Ft x ------Ft> 460.1 \ g Long Term Acceptance Rate (LIAR): Leaching Area Design Capacity: 0. 74 11 I (Sidewail Area + Bottom Area) x LTAR 340. 9 GPD (2C•5) \ 340 _ 330 _ 10 G t. �� ®� DEEP OBSERVATION GPD Provided ____ GPD Required _ Reserve 0C�0 � �®der1.12 ;p- HOLE' LOG 0 S 1, B1 d 11 b ^ Test Hole 2 25 D) r c� J Ga 1 �7 - Ta 1'S \ �e ' �C`� e d (EL = 19. 7 +) 3 Bdr 0 (To �Rerrlal � tp� Elev Septic Upgra de Re a Ir l�la rl j �I D h Soil Soil Soil p 6.3 � �o - We tl t�11 d�' m (ft) Horizon Texture Color ( o (20.2) TCF - 20. 6 0 _- \ Flags set by Hand (USDA) (Mansell) i11 (z Specialist Brad Hall Fill ®p \ o - �o°' 18. 9 A Co t ail, MA 10" - 28" 174 B Loamy Sand 7.51R5/6D-'\ ox- �. 11.o �1. 1 TBM EL = 20. 3 ,' 28 - 120" 9. 7 C Med Coarse Sand 2.5Y714 Located At op Co cre to Ste n Gate � �j l� �( P \ p - / Deep Obs Hole Date: 7/27/079 cJ Abbey (�7 G� e Road �C (l Dt e l ,,� Soil Evaluator. ED STONE , DTH 1 Lo �(� \ V, � � 1' -'0�+ • ,E /�- Witnessed By: Don Desmarais Co t Z..1.1 I, MA � 3 ,( 77\f2b \ \Obs Soil Survey Descript ion: - CA RVERO 106 to A 1jGCj tlQ 0 WjejGeolO is Material: GLACIAL OUTWASH MORRAINEw gr c o 050 * Depth to Standing Water. NA Depth to Weeping Water: NA John & Mary a ry Lynch Depth to Mottling(Color : NA ,,7 26 ExistingLeach Pit Est Seasonal High GW NA 119 Abbey Ga t D e Road OCR U / Date USGS ofbLastaMe Meation surement: NA /�i . ,:.. U,� (2�3) •fi � t0 �7e pumped and \ 18. 6 c Flag \ p P \ , \ ��°' t e °le �� removed as required ��-+ Comments: c� 0 Z 11 , MA 2B. ) Ven ti--, G 5) 1 O ( 7 ` , Title V - \ SCALE.. 1 " - 10 ' DATE. A ub us t 3, 200 gl yyl �2.2) 12 Lot 9A Q� - � � ` 20,050E Sq. Ft. � o Prepared By. 24. 8' Proposed Leaching 1� c111 Deed Reference A & M Land Services w 2 4 \ , , ` Deed Book 10603 w I 28 e 2 Three 3050 H2O Maxim-isers with 2 Stop Page 209 �tr of� � 618 Main Street Suite 3 \ 20 on the ends and 4 Wey stone on the sides , , . Plan Reference WtNSLOW West Yarmouth, MA 02673 22 , Fla PL BK 281 PG 82 I ". „ ; � Ph. 508 771-5263 anmland@comcast.net I \ \ w SPOFFORD ul 26 _ •Z, # 63 0 19` \ 163. 00 30 - S 62 06 48 W 1 ASSESSORS MAP 21 LOT 23 �� AF 00, O .SEoc)T/C Ile J►1/N COVE"iF' 7r0 `T r-r A /2 .BEG OJ•v' G'R'paE� -� M/N. WT. /DO 44615. _... __.__.� t_____._. � " ___..___..-.. �--- vu T.L�`?"' .t-'�raE• t EVEG Y... .97 /900 47'^may r -s • ' f x ' r oLl `® + T.,r E 7 - T,I ©X ° Z-� .' . � /�iQEC�ST CQNC�QETE I 1O 11 . c�on�c E• N e ' ' � . as ;r '�. ,ei,'p-. 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