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0011 BANFIELD DRIVE - Health
11 Banfield ®rive Cotuit P A = 023 031 TOWN OF BARNSTABLE LOCATION it Ale— SEWAGE# t�f-• �-� S� VILLAGE t� t.Lt ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �{� �_ A LEACHING FACILITY.(type) �'-1c�1.eG f l-- (size) c�S' lac NO.OF BEDROOMS :1 iO OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -t' S� Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) P( Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility),n� Feet FURNISHED BY fir Li q i -7r' O 4 ► Fee DV THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppIitation for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I l ° v -Owner's //wwnerr's__N�ame,Address,and Tel.No. � Assessor's Map/Parcel 19D�i�Z'Jy, ap&a� 3 v Installer's Name,Address,and Tel.No. ' Deslgne 's Name,Addre s,and Tel.No. '?Z ' 3.470lo l n l5QkA8a Type of Building: ��yy Dwelling No.of Bedrooms L• Lot Size ���/1) sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z2.0 gpd Design flow provided '3'30 �" ,g/pd Plan Date\ , j I Number of sheets Revision DaZDh/`-�Q,�02 y Title M )_ Size of Sep is Tank 5W����11 Type of S.A.S. cO ` A1.1 Cl 7�LiT1b_ � Description of Soil ., " Ff -"< Nature of Repairs or Alterations(Answer when applicable) 10 S 1 I o Date last inspected: ` Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea . Si ed Dat Application Approved by ate Application Disapproved by Date for the following reasons Permit No. '' � Date Issued ktFee OV II THE COMMONWEALTH , MASSACHUSETTS Entered in computer: Yes u PUBLIC HEALTH DIVISION - TdW_976F BARNSTABLE, MASSACHUSETTS 0(pplication for ]Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon(, ) ❑Complete System ❑Individual Components Location Address or Lot No. �' to (; ��} Owner's Name,Address,and Tel.No.Kj/� ¢.�/fJ loos Assessor's Map/Parcel 0 ' ( 1 7q��U (, (,lv1 �' . �I staller's Name,Address,and Tel.No.�(10(U '11 7' /-jM Design<s Name,Address,and Tel.No. "7 7 T 3.4 7 d 6 ) C��S�r�t��lcy"� • �t. actX�c ait 60j- CIV 6n,5d,1/5 UQQ PY P ( 4a� i� Rlee 03c0 v / Type of Building: .9 Dwelling No.of Bedrooms L. Lot Size o')f Cq sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 0 gpd Design flow provided �� gpd Plan Date�T(,J 0 F(�e �j► � Number of sheets � Revision Date (�/�i Title rr������ �^ Size of Septic Tank 1500 \\Type of S.A.S. � ' ��• U) ro l c_hcs,-n ) j, 5 Description of Soil(Vm-r c�, (40" - ��- FS��G a ILf Z l �_�.i t,Y7�1 �i /z Nature of Repairs or Alterations(Answer when applicable) f')g'(_,v I'c oo rir l -iA s ` t6b N j�4 r Ir(,cJ )r,n f�cx C:�!_ 6-4- 10 -50n_ q1A 1 G(ry J Date last inspected: y Agreement: .. The undersigned agrees to ensure the construction and maintenance of the afore described on-sitesewage 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:-- 7 Si ed /r Date �� �,�ticvx Application Approved by // Date �! Application Disapproved by Date for the following reasons Permit No. � r' Date Issued r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS f Certificate of Compliance THIS IS TO CERTIFY,that the On-site Se//w''a��g__e Disposal system,Constructed( ))-�� Repaired(� Upgraded( ) AbandoneAj )by Bor�_o IUD, C_&,-) ! ruc� ,- Ino • �!..,.I/ (-- at , /�T i r- I C) 1) 1 C. j *�- has been constructed in accordance / with the provisions of Titl 5 and the for Disposal System Construction Permit NeD:V I-a S dated �L Installer,�(�c.Jl(�'f<•�l ()CA�Jj�1UCi1012 ,L'V. Designer Mo(_Oo(joa li 5o,r,4e /Y)y #bedrooms Z- v ApprovedELI' ' w 0 gpd � �111,Al v7The issuance of this permits al n t,be con ed as a guarantee that the systemi as desig ed. �''`Date Inspector } -------------------- No., ) r 5 Fee /Q 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct(` )\ Repair Upgrade( ) Abandon( ) System located at 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 mus be com le)ted ithin three years of the date of this pe it. Date 11 / Approved by SEP-11-2014 03:07 From: To:15087906304 Pa9e:1/1 SEP/10/2014AEb 32: 32 PM FAX No, P, 001 r*,.e (joV 17 93 `J Town of Barnstable Regulatory Services Richard V.Sco,Interim Director Public Health Division iQ79• w� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office; 508-862-4W Fax- 508.790.6304 Installer&Resiguer Celrtilicatioh Form Date: ►t 04 Sewage permit# „ a/4t-2-5S� Assessor's MapTarcel Designer: 1.0 Al 0a Installer: 1Jjfln�T,C Address: Address: On ' S 1 was issued a perrwit to install a e taller) septic system at )ft lZ-W (� ssed on a design drawn by (address) - uYL441 dated (desi Pex) A,,,, I certify that the septic system eefereneed above was installed substantially according to the design, which may include mjxaor 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 (Lie. greater than IQ' lateral relocation of the SAS or any verrical relocation of any component of the septic system)but in accordance with State&Vocal Regulations. Plan revision 4r certified as-built by desiper to follow, Strip out(if required)was inspected and the soils were found satisfactory. I certify that the s referenced above was constru,eted.rn compliance with the terms of the RA vat le rs(if applicable) AR (Inst er°s SianatUle 140 (De,signe s ignature �#PT11RFi`� PLEASE RETURN TO BARN TABLE PUBLIC IiE TH I➢ SXUN. CLItTIFIC OF CON L CE L NOT BE ISSUED UZIT 'D J tl LXU3 JVO $ T ARE RECEIVED BY THE S LE LIC ALT DI ION. T OU. 0A$eP i0 D&§iP&Cv6deaden Forra Rev 8-14-13.doc 31. Town of Barnstable P# Department of Regulatory Services /. ,,,n,.,RE,Br& : Public Health Division MA Date Z� . 8,9. 200.Mam Street,Hyannis MA 02601 , +. r •i r q, �, '. ; ffl,�p1� �; a 'L"�! ,.,,}` �i> .'" tie �_. Date Scheduled_ Time rtl F,ee Pd. 0_ `F .}I; � -°!� � ; :►5a► l Sul ability Assessment for Sew acge Disposal ',Performed.BY: Witnessed By: LOCATION& GENERAL,INFORMATION Location Address Owner's Name ✓e�07V// / IV& Address t' y� ':�rV17 N►l9 , Assessor's Map/Parcel: 1i3 s�a Engineer' Na �� 3� �o� C tj: j}LP DDT 'Vie %�� ;45 NEW CONSTRUCTION REPAIR Telephone# 5D / r (�! ctti C�GL k Land Use:. "Slopes(95) .1 Surface Stones i r rr\» x' -774- ^3 27—a� . Distances from, Open Water Body ft Possible Wet Area ft Drinking Water Well ft f Drainage Way ft Property Line ft Other {t ..-SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) \J la V) m + �1 M. ... �"�- !^mot ��'. �q��/`�♦ r _ � Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_ Weeping from Pit Foce Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: Iu; Depth to soil mottles: In. Depth to weeping from side of obs.hole: ' in, ©roundwater Adjustment f[. Index Well# Reading Date: Index Well level �_ _Adj.factor' Adj..Groundwater Level, a PERCOLATION TEST Date�. .,, Thne Observation Hole# Tine at h" Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6") " End Pre-soak Rate Min./inch Site Suitability Assessment. Site Passed Site Failed: Additional Testing Needed(Y/N) F Original: Public Health Division Observation Hole Data To Be Completed on Back----------- _t ***If percolation test is to be conducted within 100' of wetland,you must first notify the ,Barnstable Conservation Division at least one(1) week prior to beginning. ., Q:\SF-PI'IC\PERCFORM.DOC k DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsigitency.%Oravell "— C S9� Z•5' 7 Ar i , DEEP 013SERVATION HOLE LOG - Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) ( t (USDA) (Mansell) Mottling (Structure,Stones,Boulders. - f onsistency,% ra a A . L /De 417, 7 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horiio Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c O E ' t DEEP OBSEIZ .TIOI�T HOL!.LOG Hole# Depth from Soil Horizon So► xture Soil Color Soll Other Surface(in.) (USDA (Munsell) Mottling (Structure,Stones,Boulders. Consistency, I Flood Insurance Rate Map: Above 500 year flood boundary No/Yes 'Within 500 year boundary No_ /Yes Within 100 year flood boundary No,r_/ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the.soil absorption system? If not,what is the depth of naturally occurring p rvious material? Ceftifiication I certify that on �� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with ; the reguir nine,expertise and experience described in 10 CMR 15.017. Signature ✓ l Dat 2� Q:WEPTICkPERCPORM.DOC I I I R 3CU�S FORM30 &w HOBBSBWARRENTM THE COMMONWEALTH OF MASSACHUSETTS BO D OF H ALTH a TY/TO N F a � EPART ENT iq ^) ollbDl A R SS LX29 TELEPHONE 117F3"e l(�„�l l. �' Address Occupa Floor A artm t No. No.of Occu s No.of Habitable Rooms V' No.Sleeping Rooms No. dwelling or rooming units No.Stories a Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: A Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors. Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 - Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS SPECTI N REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENAL E U " INSPECTO TITLE DATE TIME A) w r•M A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. V v�� ��� � �0.� � 1p�. y� a-�,,,. ` ' Parcel Detail Pagel of 3 Logged In As: Parcel Detail Wednesday, t Parcel Lookup Parcel Info Developer Parcel ID 023-031 Lot LOT 4 Location 11 BANFIELD DRIVE V) Pri Frontage 166 Sec Road MAIN STREET (COTUIT) _ — Sec Frontage_ - - Frontage — village COTUIT �^ Fire District COTUIT Sewer Acct I Road Index 0069 ±-K Interactive Map i - Owner Info owner LOWE, KING & DOLORES K Co-Owner Streetl PO BOX 1790 Street2 I City COTUIT State zip '02635 Country US Land Info Acres 0.49 J use 'Single Fam MDL-01 jI Zoning RF Nghtid I 10 06 Topography Above Street — Road ,Paved utilities Public Water,Gas,Septic Location j - Construction Info Building 1 of 1 Year � � Ext1971 trGable/Hi ---o o-d Shingle— Built sut Wall ---'I Effect 1215 ( RoofjAsph/F GIs/Cmp AC.None —^ Area --- — ------- Cover Asp Type Int — Style Ranch all D wall Rooms 12 Bedroomsnt Bath 9 Model Residential Floor 11 Rooms 1 Full 1 Grade Average Minus I Heat Hot Water Total 14 Rooms - Type`--- Rooms - --- -- http://issql/intranet/propdata/ParcelDetail.aspx?ID=1253 5/2/2007 Parcel Detail Page 2 of 3 I. 7TO- 161 ,4 stories 1 Sto _ JI Heat,Gas r� �'iI Found ry Typical II Fuel BAS, b. 6 BMT PD rib' E Permit History Issue Date Purpose Permit# Amount Insp Date Comments 7/2/1998 New Roof r 32380 $3,175 - Visit History Date Who Purpose 2/23/2005 12:00:00 AM Paul Talbot Meas/Est 2/27/2004 12:00:00 AM Paul Talbot Meas/Est 2/24/1999 12:00:00 AM Frederick Stepanis Meas/Listed Sales History Line Sale Date Owner Book/Page Sale P 1 12/2/2003 LOWE, KING & DOLORES K 17990/079 2 4/5/2002 WHITMARSH, RUTH A 15019/342 3 2/15/1984 WHITMARSH, RUTH A&SPELLMAN, M 4007/309 4 WHITMARSH, RUTH A 1580/22 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2007 $108,800 $2,600 $0 $173,200 2 2006 $95,700 $2,600 $0 $181,000 3 2005 $90,500 $2,500 $0 $144,800 4 2004 $73,200 $2,500 $0 $123,000 5 2003 $66,600 $2,500 $0 $82,100 6 2002 $66,600 $2,500 $0 $82,100 7 2001 $66,600 $2,500 $0 $82,100 8 2000 $57,400 $2,500 $0 $52,500 9 1999 $50,900 $2,200 $0 $52,500 10 1998 $50,900 $2,200 $0 $52,500 11 1997 $52,200 $0 $0 $45,000 12 1996 $52,200 $0 $0 $45,000 II http://issql/Intranet/propdata/PareelDetail.aspx?ID=1253 5/2/2007 i Parcel Detail Page 3 of 3 Al 13- 1995 $52,200 $0 $0 $45,000 14 1994 $51,600 $0 $0 . $33,700 15 1993 $51,600 $0 $0 $33,700 16 1992 $58,800 $0 $0 $37,500 17 1991 $61,900 $0 $0 $67,500 18 1990 $61,900 $0 $0 $67,500 19 1989 $61,900 $0 $0 $67,500 20 1988 $48,100 $0 $0 $28,000 21 1987 $48,100 $0 $0 $28,000 22 1986 $48,100 $0 $0 $28,000 Photos http://issql/intranet/Propdata/ParcelDetail.aspx?ID=1253 5/2/2007 DATE l Z5103_____ ADDRESS 1 Banl ce ecl DIL cve 'ERTY -- --------------------- .ij `. tE NOV 1 3 2003 __Q26-3-1----------------- TOWN OF BARNSTABLE HEALTH DEPT. e above date, I inspected the septic systemat the above address. ,ystem conslsls of the lollowing: ck ce,6, ,with a 6 'XI0' &.cock ce-6-6./2oo.e a-6 an ovea��ow. 0l 13C21dd on my inspection, I certify the lollowing condltlons: d. -- ddIN 7h.i,3 .ins not a t.itte �,ive 6e/2t-ic %h.iz .i.z a zewaye zy,6tem with two ceh,3'/200.e,6 .in '6ea.i.e-: %he sewage by'6.tem i,3 .in /2aopea woakiny oaclea at the ./aezent .t ime- Gla_3te wate2 � 36' geeow the .invent /2.i/2e o� the �ia�t ce��/2o0 �. %he 6'Xi0' ce,3,3/200i i,6 day. The .sewage 'sy'6tem i� in /2ao/2ea woak.ing oaclea at the /2ae ent time. SIGNATUR M a c o m b e J r MAP P . _ - - ---- PARCEL any , �4�€�h per_ M�S4ml2�c d_ Son, Inc . SOT �-- SS : __@Q .__6- ------------ S USE rY.LLLfL,_ Ja . _Q.2.632-0066 _ _508_• 775_ J ) )8 __ _ _ _ _ __ CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY a ( JOSEPH P. MACOMBER & SON, INC. COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:I I Ban)e ie ed Dl2.ive o u.c , Nazz. Owner's Name:E-6 `ale 01 Ruth G Lj_tma2,6h Owner's Address: Cnmv_ Date of Inspection: I I/5/0 3 Name of Inspector: (please print) 10-6e12 %. Nacom e2 a2. Company Name: a• P. Mac om e2 9 Son Inc. Mailing Address-Oo x 66 ('on#ont 1,Uo` NaAA_ 2632 Telephone Number:5 0 8—7 7 5— 3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The,inspection was performed.based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system Inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: �� y 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. Notes and Comments ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 11 Ban e ie-ed D zive o u i ,, Owner: Eetate Ruth GJh.c ma2.6 Date of Inspection: 1 1/5/0 3 Inspection Summary: Check A,B,C,D or E/ALWAY complete all of Section D A. System Passes:. I have not found any.informationly+hich indicates that any of the failure criteria described in 310 CMR �15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below, Comments: The hgwage 6q,3iem jz in /2/toRe2 wo zk.ing o zde2 a.t .the. �a o.s n.t .t.ime B. System Conditionally Passes: Zl)One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND) in the for the following statements. If"not determined"please explain, The septic tank is metal and over 20 years old'* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: zt & 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: 2 i rage.-) or 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAIN A ` CERTIFICATION (continued) Property Address:1 1 Ban,:igid [72.ive r 4",ci�� (,'�a H Owner: tata.te ft — Date of Inspection: 1 C. Further Evaluation is Required by the Board of Health: 42i6 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 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: Z/0 The system has a septic tank and soil absorption system (SAS)and the SAS is within I00 feet of a surface water supply or rrib.utary to a surface water supply. W The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet b�ujSO.feet or more from a private water suppl\•well•'. Method used to determine distance � f� 'This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other, U 7hi, i�3 a .sewage .6y.6.tgm. The hyztem conzi,51—z o� 1-6'X6 ' 9.9ock cez��oo we an ovg2��ow. 3 Page 4 of 1 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address; I I Baneie ed Dlz4-v2 Coa`_u i.t Na,6a, OwnerC_.6.�atz OZ Ruth Nh.i- mat,3h Date of Inspection: 1 1/5/D 3 D. System Failure Criteria applicable to'all systems: You must indicate "yes"or"no" to each of the following for alLinspections: Yes / Backup of sewage into facility or system component due to.overloaded or clogged SAS or cesspool 3Discharge 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 _ ZLiquid depth in cesspool is less than 6"below invert or available volume is less than h•day flow Required pumping more than 4 times in the last year VOT due to clogged or obstructed pipe(s).Number of times pumped . any portion of the SAS, cesspool or privy is below high ground water elevation. c/Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well, any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis, (This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free.from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) Itfe (Yes/No)The system fails, I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems; To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes n"o> i 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 11 of a public water supply well ) pp If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST a Property Address: Banff ie�cl [72 ive Owner: Eztu-te Rut h Glhi.i-m¢2zh. Date of Inspection: 1115153 Check if the following have been done. You must indicate`yes"or"nd"as to each of the.following: Yes Noe. t Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks? — Has the system received normal flows in the previous two week period? 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 a N A Was the facility or dwelling inspected for signs of sewage back up Was the site inspected for signs of break out '/ — Were all system components, cluding the SAS, located'on site? Were the septic tank manholes uncovered,oopened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? — Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Z Existing information.For example,a plan at the Board of Health: Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of I I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:1 1 Banl.ie ed Dlt i.ve o u.i a,6,. Owocr:E,6.tate 0-1 RuLh Nh,77a2.ah Date of Inspectlon: 1 9/5/0 3 FLOW CONDITIONS r... R.ESIDENTLAL Number of bedrooms (design); Number of bedrooms (actual): DESIGN flow bued on 310 CMR 15.203 (for example: 110 gpd x M of bedrooms): �tl� Numbcr of current residents: 0 Does residence have a garbage grinder(yes or no):' Is laundry on a separate sewage system (ycs or no)-;75 (if yes separate inspection required) Laundry system inspected'(yes or no): S Seasonal use: (yes or no): VV' Water meter readings, if available (last 2 years usage (gpd))2002—5 5, 000 ga.e eonz-150. 6 9 G%D Sump pump(yes or no):X.4> 2003-22, 677—gai.Pon.6= 60. 28 Gl D Last date of occupancy: COMM ERCLALA DUSTRIAL Type of establishment: Design now(bued on 310 Civ(R 15,203): gpd Buis of design now(scats/penons/sgft,etc.):1 Grcue alp present(yes or no):/�J3 Industrial waste holding tank present (yes or no):,f//$� Non•sanit.ary waste discharged to the Title 5 sys►e (yes or no):,1 Water meter readings, if available: JU . Last date of occupancy/use: OTHER (describe); A) GENERAL INFORMATION Pumping Records Sourcc of information; None ava i iag ie Wu system pumped as pan of the inspection (yes or no):�L . If yes, volume pumped: _gallons •• How was quantity pumped determined? ,O Rcuon for pumping: T,yPE OF SYSTEM Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy tbSharcd system (yes or no)(if yes, attach previous inspection records, if any) j ,!/D Irnovative/Altemative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank -VV Atucb a copy of the DEP approval ,I�ZL) Other(describe): tZO Ap ximatc aec of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site (yes or no):-vd 6 l_ . Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address.;I I L3an�.ie ed Dl2.ive o 777, 7773h. Owner: ,6tate 1 u mat.6h Date of Inspection: 1715103 7/5%U3 BUILDING SEWER(locate on site plan) rJ Depth below grade:—^/x J �� Materials of construction: cut �ron��,40 PVC v Other(explain): Distance from private water supply well or suction Tine !d= . Comments(on condition of joints, venting, evidence of leakage,etc,): Zhe ao.int.6 appeal t.icrht. No evidence o� .leakage. The zys.tem .cis vented thorough .the 2oo� vent.6. SEPTIC TANK-AMbocate on site plan) Dgth below grade: Material of cons-avction: oncretcleAmcta.IAftberglass olyethylene tLAthcr(cxplain) If tank is'metal list agc:,d is agc confirmed by a Certificate of Compliance(yes or no)-W✓tJ(attach a copy of certificate) Dimensions: AA Sludge depth; Aln Distance from top of siud a to bottom of outlet tee or baffle:_ /W Scum thickness: _ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined; Comments(on pumping recommendations, inlet and outlet ice or bafilc condition, structural integrity, liquid levels as related to outlet invert, evidence of-leakage, etc.): tank .i-s: not /22e,6err GREASE TRAP (locatc on site plan �� t Depth below grade: Material of construction4kconcret9(amcupQfiberglasyt-esolyethylenvLOother (explain): zu Dimensions: j Scum thickness: Distance fTom top of scum to top of outlet(ee.tir baffle: )' /W Distance from bottom of scuts to bottom of outlet tee or baffle; Date of last.pumpi.ag: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc,): Cnv_a.sv f.a-ate i� not R2e�ent 7 Page 8 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued] Property Address: I I Ban�.ie.Pd D,,z.ive Owner: E.s.ta-te U. 1?a.th Oh.i.tmaz.6h Date of Inspection: 1 9/5/0 3 TIGHT or HOLDING TAN L(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: AA Material of construction:1,1114 concrete e&metal X14 fiberglass.f>_ Apolyethylene other(explain): Dimensions: AA Capacity: WA gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: V,4 Al' . in working order(yes or no): e� Date of last pumping: elf�f Comments(condition of alarm and float switches,etc.): Ti.gh.t o2 hoid ing .tanks ate no pnezen . DISTRIBUTION BOX (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box, etc.): —9e,.ate 4e t—'Goa G e n f PUMP CHAMBER '19(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): , Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): P.um.p cham9e2 .ins not R2ezen.t 8 Page 9 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1.1 Dan/.ie ed Dlt.ive Owner:Ezta.te 0, Ruth 0hi.tma2,sh Date of Inspection: 111,5103 SOIL ABSORPTION SYSTEM (SAS): Zoocate on site plan,excavation not required) 1-6 'X6 ' Tn AP-R vti If SAS not located explain why: _Loca.ted: See aaae 10 Type V0 leaching pits, number: Q ,t1t7 leaching chambers, number: j9 leaching galleries, number: _ j leaching trenches,number, length: Q.- leaching fields,number,dimensions: overflow cesspool, number: �OC_? innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Loamy .sand .to /ine coa/tze nand. No 3.iyn6 o� hydzauiic /a.iivae o2 Rondi.ng. So.ies ate cL2y. egeta .ion iz nozmai. CESSPOOLS: Z(Cesspool must be pumpe part of inspection)(locate on site plan) t� Number and configuration: Depth—top of liquid to ihIr invert: Depth of solids layer: Depth of scum laver: Dimensions of cesspoo6 f Materials of construction: 'j� Indication of groundwater inflow(yes or no): � Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Same az agove PRIVY locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): /-),2jmj !ti nnf nno.tonf_ 9 L Page 10 of I I r OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 0` PART C SYSTEM INFORMATION (continued) Property Address: 11 /3unZieid D3 zive Co-tu.i.t, 17a s.6. . Owner: &3ta.te . Oe /2uth Ohi.tmaiczh Date of Inspection: 1115163 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. �Oy 10 I Page I I of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 1 SYSTEM INFORMATION (continued) Property Address: I I BaVie�d DIL-ive Co.tu.i.t, Na,3.6. Owner: cAi h Ohitmait.6h Date or Inspection: 5 2u.t/3 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check) all methods used to determine the high ground water elevation: NO Obtained from system design plans on record • If checked, date of design plan reviewed: NA �ESObscrved site (abutting properry/observation hole with' 150 feet of SAS) NO Checked with local Board of Health-explain: RR YESChecked with local excavators, installers- (attach documentation) 4LSAccesscd USGS database-explain: h.t.612;11 town. ga/tnbtaP. e. ma. ups. You must describe how you established the high ground water elev tion: zed: CahlLply & Ni•i e2 /7odei. 121161 4 Gaound wa�e2 eieva.t.ionz aPove .6ea �eveP. .6ed: IISGS n wei e data. une ,3ed: IISGS e 7ghnir�e� Ou00e in 9z-000- 1 P? g e nnua 2ange wa.te2 eleva.t ionz. '-6 'X6 ' 9 1-6 'X10' .ebb12Oo.e.b .in 6e2.i.e '' o: ,cell Groundwater: erect Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the bosom Of the leaching pit and the adjusted gToundwatcr table is feet. 11 `:."..r...rr.-ni•rz—.-rr-.rT.-sr-•nn-mrr.*r.n,-..r..r.:-.�---rnr:-rr.---rnrrr.-.5-s:r+:-c-r.s.m- ._ .. TOWN OF WARD. OF IIEA.LTII + SUIISUNFACR 9FHA(;F DISfUSAL SYSTF,M INSPRCTION FORM PART D .- CERTIFICATION ••.-••• T••.- .t-�.11•••�T.T..-"rtl'11:TTI T,TC,TS-TT]lT.11'.Tom'.-1 r-lITI1f.�1i19f^TR" R's'fY TSF'�TZ'T+YTL'1•'9 RtT H T1RTT'1tTO�TA'11'TT.•.�r"!"T•T-•�. .�.. -TYPO OR PRINT CUARLY— PROPERTY INSPECTED STREET ADDRESS � � L3cenie�cl [�/2�ve Cotuit, (7a��s, ASSESSORS MAP , BLOCK AND PARCEL # 023-031 OWNER' s NAME EzSta.fe 0;& Ruth b)h,iimagAh PAR7' D - CERTIFICATION I NAME OF INSPECTOR Joseph P. Macomber Jr COMPANY NAME Joseph P. Macomber &won Inc COMPANY ADDRESS Box 66 Centerville Mass 02632 Street Town or City Stat• CIP COMPANY TELEPHONE ( 508 ) 775-33.38 FAX ( 508 ) 790-1-578 CfRTIfICATION STATEMENT I certify that I have personally inspected- the sewage dieposa7 system at AcrmqkLhis address and that the information reported is true., accurate , and omplete as of the time of .- inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of oil- 'site sewage disposal systems , Check one ; ---&/ System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or, the environment as defined in 310 CMR 16 , 303 , Any failure criteria not' evaluated are as stated in the FAILURE CRITERIA section of this form , {' = - System FAILED$ The inspection which I have conucted has found that 'the system fails to protect the j-)ublic health and the environment in accordance with Title 5 , 3.10 CMR 15 . 303 ,. and as specifically noted on PART C - FAILURE CRITERIA of this inspectior. form , J Inspector Signature lateAIML aw ne copy of this c c.ification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF 11BAL'1'H. * If the inspection FAILED , the owner or `operator ehall upgrade ' the eystem within one ,year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 16 . 305 , partd . doc L • COTUIT D P\ E. . ` ------------------------------- - -------------------------------------- 126.02 (CALL ) cv CB 40.00 CB/DH nG z (PLAN) S88.18'20"E V)z ao L_105 88 N �, ,2g4 LOT 4 = v PARCEL ID: --_ _ - 23/31 65.8 s, O POST Q AREA=.5 ACRES o T CB/DISC i 42.8' x ` t� UPOLE Z LOCUS MAP ``\ \0) O ,` ', PLAN REF: 190/31 (n TITLE REF: 21761/27 O PARCEL ID: MAP 23 LOT 31 Ct (_4 ZONING: `RF", `WP" DISTRICT ZONE II BENCHMARK: WIND ZONE 3 EXPOSURE 8 �Y t )3t "� "� PUMP, CRUSH, FILL & ' \ COR BLHD FLOOD ZONE: "C" t G ABANDON LEACHPITS O COMMUNITY PANEL: 250001-21D DATEO:07/02/92 PER \` CB Q EL=67.00 TITLE 5 O \ t t 0 t #11 65.7 z m - ' TOF=68.02 j z / 76.3' 65.7 SEPTIC REPAIR iNV.=65.47 ,,,;;, LOT 5 PLAN PARCEL ID: 23/14 ,; � W ��� GONG• \ ��,—� 1' � �� pp�t0,,,- ✓ �'65.0 go?- LOCATED AT: 11 BANFIELD DRIVE // `;p ; �5• 6 1 ; o \0, C 0 TU I T, M A. h PINES gyp, C� 6 t 65.6 "�,A �,� 64.7 �� o tt -0 `� ----�� og� 't PREPARED FOR: G �� 55.8' �� tt -�,'''i— 25.8 36" Q o o "'�3o KING & DOLORES J A MAPLE PROP ,500 �, L- 0 WE rig \Wy- -SCALE: 1"=203 2I � 28.5 JUNE 6, 2014 oo� ce/DH / 65.5 � REV: JULY 30, 2014 i 65.2 S86.17'30"E 145.91 MacDougall Surveying CB/DH & Associates PARCEL ID: OF 9S P . O. Box 2428 GRAPHIC SCALE 23/15 oPD�R E zo o 10 zo so � Mashpee, Ma. 02649 PH. NOTE' 1 0. 114b fax �508�419-1086 508419-1087 ( IN FEET ) LOT 4 ON PLAN BOOK 190 PAGE 31 DOES NOT R��/ E email: CLOSE MATHEMATICALLY. A NEWER PLAN TO REFLECT QNITAR\a� macdougallsurvey@comcast.net 1 inch = 20 ft. ACTUAL CONDITIONS IS RECOMMENDED TO BE RECORDED AT THE REGISTRY OF DEEDS. SHEET 1 OF 2 J#1553SEP2 TOP OF FOUNDATION EL= 68.02' 4" SCHEDULE 40 P.V.C. I PROFILE OF i/ » / „"$AYER OF. MIN. PITCH 1/8" PER FOOT SEWAGE DISPOSAL SYSTEM DOUBLE WASHED STONE 10' MINIMUM--�►{ , (NOT TO SCALE) ' EL= 66.1' OR FILTER FABRIC EL= 64.7' EL= 65.0' EL= 65.0 ....... EL= 65.0 6 MAX. .......... 6' MAX. 4" SCHEDULE 40 P.V.C. 6" MAX. 6" MAX. CONC. ' INVERT CLEAN SAND FILL „ MIN. PITCH 1/4" PER FOOT RISER & EL= 61.3 ``�Q' PER 310 CMR 15.255 9 MIN./ EL-- 64.0' LEVEL 36" MAX. 40' S=.os COVER FOR 31.5' S= .04 �►1 EL= 62.0 y EXIST. FLOW LINE INVERT '10" 1 4" INVERT INVERT I o 0 0 ° 0 [� o cm o 0 \EL=65.4r EL=63.0. MIN. EL= 62.75 INVERT o EL= 61.54' 6' SUMP EL=61.37' ° °° °o °° ° EXIST. 24 0 0 �p 0 U �.0 �o qp GAS INVERT 4 BAFFLE 6" BASE OF MECHANICALLY ° o o ac COMPACTED SAND 1 ° ° oco EL= 59.3 !! PROP. D83 ' r DISTRIBUTION I 4'0 8.5' L4.0' BOX ' (TYP.) PROPOSED 3/4" TO 1-1/2" 25' 1 ,500 GALLON TANK DOUBLE WASHED STONE 2-500 GAL. (H-10) DRY WELLS (4'-10" X 8'-6" X 3'-0") (H-10) SOIL ABSORBTION (TRENCH FORMATION) ' SYSTEM (S.A.S.) 13' X 25' GENERAL NOTES I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF BOTTOM OF TEST HOLE #1 ELEV.= 54.0' ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT NO GROUND WATER SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY DESIGN DATA FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE ARE ACCURATE AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. NUMBER OF BEDROOMS............ 2_DESIGN FOR 3 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE GARBAGE DISPOSAL.................- NO _- CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE DARREN M. MEYER, R.S., CERTIFIED SOIL EVALUATOR UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. (110 GAL./BR./DAY X 3 BR.) __33_0___ 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION TEST PIT RESULTS- P #1 4368 330GPD X 200% = 660 GAL OF ALL UTILITIES PRIOR TO ANY EXCAVATION. 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE USE PROPOSED 1500 GAL. SEPTIC TANK OR WITHIN 6" of GRADE SHALL BE MORTARED IN PLACE. SOIL TEST DATE: MAY 27,. 2014 INSTALL: 2-500 GAL. DRY WELLS (W/4' CRUSHED STONE 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE OVER THE S.A.S. AND DISTRIBUTION BOX. B.O.H. AGENT: DON DESMARAIS ON THE SIDES, 4' ON THE ENDS) AND BACKFILL 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL EVALUATOR: DARREN M. MEYER, R.S. SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE WITH CLEAN SAND FILL PER 310 CMR 15.255 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND BACKHOE: BORTOLOTTI (MIKE) LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. SOIL CLASSIFICATION................ 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN DESIGN PERCOLATION RATE..... <2 MIN,-/IN. 4 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT �� �� EFFLUENT LOADING RATE.........__74 ELEVATION OF THE OUTLET PIPE. 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. TH#1 EL.= 65.0 (PERC @ 40 -58 <2 MPI) REQUIRED LEACHING CAPACITY.....330 GAL //1DAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS DEPTH HORIZON TEXTURE COLOR MOTTLING OTHER LEACHING CAPACITY PROVIDED..... 352 GAL/DAY ELEV. IN. BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. ( )11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 64.3 0"-8" SIDEWALL: 13' + 25' x2x2 SIDES A LOAMY SAND 10YR4/2 ( ) ( )(.74)= 112 GAL/DAY FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 61.9 8"-37" B LOAMY SAND 10YR6/8 N/A BOTTOM: (13' X 25')(.74)= 240 GAL/DAY BE LEVEL. 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 54.0 37"-132" C I M/C SAND 2.5Y7/3 N/A PERC TOTAL= 352 GAL/DAY TO MACDOUGALL SURVEYING & ASSOC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW AND APPROVAL. NO GROUNDWATER ENCOUNTERED/NO MOTTLES 352 GPD PROVIDED - 330 GPD REQUIRED = 22 GPD RESERVE 13. PROPOSED SEPTIC SYSTEM IS WITHIN STATE APPROVED ZONE II CONSTRUCTION NOTES: TH#2 EL.= 65.1 10 OF MAs SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER ya ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING D R, a,r #11 BANFIELD DRIVE WORK ON THE SITE. 64.4 0"-8" A LOAMY SAND 10YR4/2 �� C^ COTUIT, MA. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 62.0 8"-37" B LOAMY SAND 10YR6/8 N/A o. 1140 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 54.1 37"-132" C M/C SAND 2.5Y7/3 N/A JUNE 6, 2014 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. '�Glsl- REV: JULY 30, 2014 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING NO GROUNDWATER ENCOUNTERED/NO MOTTLES S0IT00a� SHEET 2 OF 2 J# 1553SEP2 TAPE OR A COMPARABLE MEANS. i 11'-8 1/2" 12'-0 1/2" 26400H - - 26400H m W W U) rn wrn cPd � d o X X1 X �1 0 4p' U1 N 2668 2668 2666 5' 6T- rnCp N � A IF 2' > x` o . v� o w _a z 1868 w ,- V\ R3 = lr lT O X r— — W rn 2668 p, A N I N S m � _ a 5 24R ® r B33 U3 o -� - 12' 14' LE 26' pEsicrr BY: .13 Thankful Lane Cotuit, MA 02635 Lowe 11 Barifield Drive Cotuit tel 508-428-4097 fax 508-428-7709 Tuesday,June 17,2014 email lagcon@capecod.net www.LagadinosBuilding.com _ lI