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HomeMy WebLinkAbout0155 BAY ROAD - Health 155 BAY ROAD aka-�4-a-S�w�xa��.�' - A- 007-630 Road. _ -- Cotuit J , TOWN OF BARNSTABLE LoJATIO-1 SEWAGE #.-Zo 13`Z rJ(I AGE C.A V ASSESSOR'S MAP & LOT C07 o30 TALLER'S NAME&PHONE NO. d2o*i s•Fk CGu/q+t nQ SEPTIC TANK CAPACITY f AJ-00 14 Lo 2 LEACHING FACILITY: (type) n(yo0 (size) 1�/�2(3311 NO. OF BEDROOMS _ BUILDER OR.OWN R .;r> �rt (`ACID PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility. (If any wells exist on site or within 200 feet of leaching facility) ,c/ Li/ eet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility J�pb t Feet Furnished by G -daw r a ' " 91 ® ' o " " Message Page 1 of 1 Miorandi, Donna From: Schlegel, Frank Sent: Thursday, December 11, 2014 10:30 AM To: Miorandi, Donna Subject: RE: 007-030 Map & Parcel Hi Donna, Happy Holidays! _) This address was changed. I hate when this happens because they never tell me there is an open permit with the town. I would have sent you this notice (encl.) if the owner warned me! Sorry! Thanx, Frank -----Original Message----- From: Miorandi, Donna Sent: Wednesday, December 10, 2014 9:15 AM To: Schlegel, Frank Subject: 007-030 Map &Parcel Hi Frank: Trying to keep records straight and recently I did a perc and septic inspection for 541 Santuit Road with a Map & Parcel of 007-030 and the computer shows up a 155 Bay Road, Cotuit. Is this correct? Thanks! Donna 12/11/2014 Message Page 1 of 1 Miorandi, Donna From: John O'Dea (John@sullivanengin.com] Sent: Thursday, December 11, 2014 9:59 AM To: Miorandi, Donna Subject: RE: 541 Santuit Road, Cotuit Donna, agree. Thanks. John O'Dea, PE Sullivan Engineering Inc. 7 Parker Road/ P.O. Box 659 Osterville, MA 02655 508-428-3344 508-428-9617 (fax) From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Wednesday, December 10, 2014 9:20 AM To: john@sullivanengin.com Subject: 541 Santuit Road, Cotuit Hi John: Just trying to keep records straight that the recent inspection we did for Manny Cabral (Ron's Excavating) known as parcel 007-030 is now known as 155 Bay Road, Cotuit. Formerly known as 541 Santuit road, Cotuit. Are we in agreement? I am also checking with the town's engineering dept. Donna 12/11/2014 oil. 7 �( � Fee 51). THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PU LIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 165 T Rypw plitation for Misposal *psteut Construction Permit Application W:�4rmi Construct 44 Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 'EX2 Y&W®30j ,9'rX� A at, Al v} Qd O ,46 Installer's Name,Address,and Tel.No. �oo�4 q776,177 Designer's Name,Add,Wean o J<7-XC6t V(2 ,vl 7 Fk_r .r Rd, Os,krv)Yl6 mp 6AA_,!6 Type of Building: Dwelling No.of Bedrooms Lot Size o�� sq.fr. Garbage Grinder(�0 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 7 gpd Design flow provided V 5 gpd Plan Date -Tuj Y -3 01 IQ® 1 Number of sheets / Revision Date Title54_ )0I044-7 PA0P sed_ -TM,0 fZ YQT) Size of Septic Tank 45,00 Qd-line2 Type of S.A.S.A,14 I' l `8 Description of Soil tSi' me. — �o� f'1's'� — i� � ��„iou 3�1s aqaU IF 7 AF r4 e Ya M 6t/rc yn -3dAk no jrduhAVK&r enC°.piw4 ex 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 not to place the system in operation until a Certificate of Compliance has been issued by this Board o igne Date / Application Approved by Date -7/3 d//3 '• Application Disapproved by Date for the following reasons Permit No. DO l -Z) e7`7'� Date Issued 3 /3 ._. , No. C/'�' � a\/ 7 �� � ���W Fee THE COMMONWEALTH OF MASSACHUSETTSEntered in computer: PU LIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes IUD Wora � plication for Disposal pstem CConstruction Permit v, �toConstructApplicat onmit (l/S Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address.or Lot N O"*4* �,2, 't� Owner's Name,Add ess,and Tel.No. n 0, arX&' Assessor'sMap/Parcel �(// rr030 rcw..�kr 44 ,O/wls64, A OdO Installer's Name,Address,and Tel.No. `j�j�j C Designer's Name, dd es a d o yr/y p�• SCvv�.s F-Ym vrw4I vi '" xfKcr Fed, Os +crv�ll�, /!'!Iq dolA Type of Building: Dwelling No.of Bedrooms J Lot Size g ` o?® sq.ft. Garbage Grinder(NO Y Other Type of Building No.of Persons Showers( ) Cafeteria( ) ' Other Fixtures Design Flow(min.required) 7 2� gpd Design flow provided "T�� gpd Plan Date Tu l y 3 0/ 7�,4r 0 1 ;.] Number of sheets � Revision Date Tit1e.5► ¢C I�/ao /"/0�4SC� �/'»f'JrOVC.h►�11� Size of Septic Tank 150 0 AQ,11Oo Type of S.A.S. &4b 1'Af ehdl'31AY N �QrG l Description of Soi176S-t' /r/c. O "'Ivy -A, 1 efl�� �aY /: �o7gJ 1d=33" Jui er /0Yi? �/e aaii III oa 33 4 7 16 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: t K 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 d not to place the system in operation until a Certificate of Compliance has been issued by this Board o s ned r Date -Application Approved by Date 3 a�j3 Application Disapproved by Date ' for the following reasons t �Permit No. DOI d ---------------------------------------------=-=-_=------------------ ----------• - a,� TH E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CBRTIFY,iji4 the On-site Se a e D's sal ®t /Constructed( � Repaired( ) Upgraded(. ) Abandoned`-( )by S 4 l at ,,5 emaLffTMV Aeen construct d in accordance with the p�av'sions of Title 5 and the for Dis osal System Construction Permit No�d)3 a 7 dated ? Installer ` h �( Designer #bedrooms Approved design flow �/C) i gpd cop Inspector The issuance of this ermit s all not a co strued as a guarantee that the system anv as designed �' Date Ins _ �YJ f/ Y ---------------------------------------------------------------------------------------------------------------------------------------- No. Q13 -7 -7 Fee J jd '- _ THE COMMONWEALTH OF MASSACHUSETTS' PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 33is sai 6pstrm Construction Permit Permission is hereby granted to Construct( ✓) Repair(,1Q) a Upgrade( ) Abandon( ) System located at �� ,a f•t 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 of be co pleted within three years of the date of this permit. Date (�� �� Approved by r'� Doc t)6 14 08:45a manny 5084770177 p.1 Town of Barnstable Regulatory Services Thormas F, Gitiker,Director AM26106 � ]Public Health Division o Tboxnas McKean,Director 200 Malin Street, Hyannis,MA 02601 t Mice: 509-962.464a ' FAx: 508-7W6304 Date: '' Sewage Permit# ZQi3^ Z1z Assessor's MopMaitrcel ` Ttasteiler&DC3t f eFtfficntRgn form Designer, .'�`ur .� ,mot ,—T Installer: 4vi .Address: ?-U. . Address: 7 (date) "� installer) w2�s is ae a e�trtli to instalJ 0 �9 A l SOptiC SyStGIr! a based orn a design drawn by a e5S) dated certify that the septic system referenced above; was installed substantially a=rdirtg to the design, Which may include minor approved changes such as lateral relocation of the disttibution box and/or septic taz*. stripout (if required) was inspected and the sons were found s4stactory. I certify that the septic system referenced above was installed with major ch=ges (i.e. greater than 10' 19-teral zelocatioxi of the SAS Or any vertical relocationi of any component Of the septic system) but in accoxdanec with State Laval tions. Plan revision or CCVT'ed as-bWt by designer to follow. Stripout (if re ected and the soils were 1'a d satisfaC ry. � �lcr s Sisnature fiF $TG 9qk 4(Dggner's ignature (Affix earner's Stamp Hcre P1�EAS TO )3ARNO.TA►B F PC�`BT Tr 17V.s*1 xzl T7wV1SI011. CE12T'IFCCATE t]1F COIvII�LJA,NC : NOTE' BE ISS UN HIS FORM X? AS- BUILT C RE C IVE)E1 PYJB E ( vIS O TH.,A�NK Y(7r_,f. q:bllite feMWInisneree tifieaei-rcy—4q0 J �a-0'•. ,ire,. . Y .. ^r,• it . ' _0. .. _ .. a .�. .. . .'. . INA Z PROGRESS .c P. R- INTS _ RESIDENCE FOR a� ROYAL BARRY WILLS ASSOCIATES, INC. A R C - H.. I T E C T S C L:A R K'E S M I T H C 0 H A 5 S E T M A - 8*.bmySftd-BWMMA a17a66-5m axeaaw,m,AJA , pNCB S79r •E ZONE: BENCWMARK RF . iI is FN BNA FNC , Mt e7,12 0 s-' CONC. HIT Ill(m''EL J4.00 FENE2ft. ----------- :_----__ ---- ------ •Y PROP ` ,. ' \ j y/\ 1il 6rm ta-OVERLAY DIISTRICT" V� O Ar�a '48,'9TANR �itaA,:.i%M: a.01 °6S: o FOOD ;1 �^b ppSED ASSESSORS W REF.:BOX• \ - r: REFERENCES: rw troz Peer om cc •V l P ``• \ '\ I pm'BeoY 262 yy $1 W 15 '- -'� I _ ./ ono .�• S�p +\ - BUILDING 'J, i�ymr"°ia.c::.wdrrr4 .r+Marnsro. JETBA I��� �ae.e.r..u.x.a�Mn.ewbu.mts.m ©' C \\\ _ DNCB rn..v.erw.twtr�wry.ro°wvrr..ec o� FND �.a+.eeo.vt�..u�orrev..r°r � �1 awoewtmarwrdtaawarw.e O:. / r r "'1 waaaontm_,m.twonum V.-� ♦A16Ysrf ttYArYl4wltr.°0°gawd. IF . �� ..�Y�• \ - '.�D ��r�"'�1 ..°'Yw°MwR+1YYOdtlna Y111°YIrMYfYea► 01� ABUTTERS I� 1..�i.sbw�iiYd.m, w�i o°uum�e SHED wautm.rmtrr.w.rrn..rrreY pft ORS r,. o S79'48'00•E- 1pm.m irtoe.�`rurp, m°�i,.s2rra - IRON • 12489' ; wtmvrtvrY.trrY.u.onwn.mt°aw PIPE • we.rrY.trrteuwe„Y.evle.a.ra. FND Vi N_ I •W.v°i°y�vrgvm F ! irvOe•i,r-IvNiri 150.00' 1 to - �.;. m�P•e�•aea r__ ' DNp N79'48'00'W pHCB- M _ FND I I + rn,P.wi,.w.a.swerw M CROSS SECTION OF CHAMBER PBRC fli4T:I" -, NOT 796411E wuoavomae.oww.aurvua®meo I W , '. pLNAYLAlOta, 1 rr.Ib,/ m,�m°vw>m oau,wsararuu I� , 19Rf17o18•i „A nA w m e.. �•"C.�...' COL. ,.:. uowa m�va..w. n mw..ma aauuiav'�vv.wa D041LOPED PROFILE OF SYSTEM NOTTDBCAtE ""'• 9CTB PASSED SANTUIT ROAD Site Plan TITLE. PREPARED Br PREPARED FOR'. NOTES ' . Proposed Improvements Sullivan Engineering,Inc. . `�°ta § 13 B STE1/E CLARKE t^e°""°°Y cemm tfono.�.7 1 °llne.'on e.Y.tN,a as/APR/ta p F'O Box 659 �id t0/APR/11 =i At /J r 9A'L/R� Osterville, MA 02655 41 Brewster Rd zl rn.w wb lx.Y amine .^oN r 541 -q�d (808)428-3344(508)428-9817 for CoNOSSBt, MA 02025. Barnstable (cDtun) Mass. 20 0 1b 20 40 so J IDe eotow e..e b an eavmM avfl: CTR 'fold: J0D N��,�Ealn� DATEt SCREE' r ReNew: PS C .:B1f July 26,2013 Pro cf: JJ002_perke Orowlnp: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M ' 541 Santuit Rd Property Address Lorantos Owners Name —Batabite l/01 U MA 02635 1/29/13 City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. t A. General Information 1. Inspector. Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 Telephone Number B. Certification 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 1/29/13 Inspecto ignature 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 fixture under the same or different conditions of use. 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,•�' 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Pumping suggested every 3 yrs to prolong the life of the system B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, 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: n/a ❑ 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 541 Santuit Rd 2013-03(06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y` 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ 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: n/a 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 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. 541 Santuit Rd 2013.03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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: n/a 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 D ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Citylrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 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 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a 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 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. 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ 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 as 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, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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: ® ❑ 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(5)] 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 or 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityfrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220 Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: n/a Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): n/a 541 Santuit Rd 2013.03108 Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .. 541 Santuit Rd Property Address Lorantos Owners Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Pumped 3 yrs ago per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool . ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 7/5/88 per compliance on file Were sewage odors detected when arriving at the site? ❑ Yes S . No 541 Santuit Rd 2013.03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 City[rown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): . Depth below grade: 18"feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: >10'feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000g 2"' Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle >12" Scum thickness 1/2' Distance from top of scum to top of outlet tee or baffle >211 >211 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? measured 541 Santuit Rd 2013.03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong the life of the system Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): n/a Dimensions: 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 Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments N 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons � Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): n/a "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level w/the bottom of the pipe 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.): D-Box is 3' below grade and in average condition for its age Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 541 Santuit Rd 2013.03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 CitylTown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ 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.): Leach Pit 4' below grade,cover to 12"of grade, there is 2'of effluent in pit at this time, no obvious stain line above current level 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M y 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Citylrown State Zip Code Date of Inspection D. System Information (cont.) 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): n/a 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Him Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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. I� C C� 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorantos Owner's Name Barnstable MA 02635 1/29/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: GW>20' based on elevation of home in relation to nearby surface water 541 Santuit Rd 2013.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 r: Town of Barn stable P# O`THE : Department of Regulatory Services ' Public Health Division ? wwarnsrx Date+ 2016 Main Street,Hyannis MA 62601 tl Date.Sc eduled Fee Pd. q Ile ., S61 Surtabr�t Assessment or Se a e Dos os r l t f p `. "Performed B J`�, 1�4 ✓\ '� f V / Witnessed By: LOCATION&GENERAL INFORMATION' Location Address'61 sq,,1y!( 2��� �.. Owner's NameS�epl�ei���`�f iVr�{�c�:�,"( (K� Address Assessor's Ma /Parcel: 60 —(33 ` f , P Engineer's Name S'.(,�/i l�G i? £'is(ABC/, NEW CONSTRUCTION. t/ REPAIR Telephone# 3"� -'1293-33 V Land Use 310 es. 'Yo Gfb A 4 \ P ( ) 'S P Surface Stones F Distances from:• Open Water Body�� tt-�Possible Wet Area 5to f ft Drinking Water Well Drainage Way i ft '`Property Line ft `Other ft SKETCH:.(Street name,dimensions of lot exact locations of test holes&pere tests,locate wetlands in proximity to holes) 41111W,1111 yyIf y} f as.+a. r..e.am..l .m.ewm++.rdm ,aav<e ®�maa X 33105, —) •4.,, ,q �X 10 9� P. � C , , ,�rs�l t iiy wtttfµeEl a y : s 1, f r �5e 41.13 Parent material.(geologic)`0- "� Depth to Bedrock Depth to Groundwater Standing Watei in Hole: 1`rV^� Weeping from PL. it.Faye 1�[cr __� ,T• Estimated Seasonal High Groundwater ��•� ��l_z ��T.U.3 (oRck3 tii ` \�5 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: /1/A- . •' as Depth Observed standing in obs.hole -:— In.' Deptli to 50II mottles; in, Depth to weeping from side of obs.`hole. - In, ©rnundwater Adjughfient ft. pl y Index Well# Reading Date: Index Well level ..a Adh factor AdJ dfnundwater Leval PERCOLATION''L+'S`1'.,. . bate?? , 'xttue .I o , Observation { Hole# Z Time at 4" Depth of.Pere �V_ _1 r Time ut 6 Start Pre-soak Time @ End Pre-soaks Rate Min./Inch Site Suitability Assessment: Site Passed = — Site Fatled�. Additional Testing (Y/N) --- Original: Public Health Division ' Observation Hole Data To Be Completed on Back----------= ***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:\SEPTIC\PERCFORM,DOC I .DEEP OBSERVATION HOLE LOG Hole# � Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) t (USDA) (Munsell). Mottling (Stnucture,Stones;Boulders: Pt<` o isistencv 96'Oravel) Lowy 1i3-33.`r Cet � i �1.3Z t��� 7 40. DEEP OBSERVATION HOLE LOG Hole# Z : Depth from Soil.Horizon Soil Texture Soil Color -Soil Other. Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten %Gravel) 0 7A 7 L A c DEEP OBSERVATION HOLE LOG Hole# 3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in:) (USDA) (Munsell) _ ' Mottling (Structure,Stones,Boulders: Co i to c Gravel) c� • 3 0 3_ a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil �rner P Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co . ten V_3 2o�i m I+lood Insurance Rate Man: Above 500 year flood boundary: No Yes VJithin 500 year boundary No Yes Within 100 year flood boundary No:/ Yes Deptli of Naturally Occurring Pervious Material :Does at leastfour 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 pervious material's ...,. w . Certification I certify that (date}I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by ma consistent with in 1t)CMR.15.017.. the required training, xpertise and experience described Signature Date �7 ZS� Q . . • BP'I'IC\PERCF ORM.DOC J Page 1 of 1 Wadlington, Ellen From: Schlegel, Frank Sent: Friday, February 21, 2014 3:29 PM To: Barrows, Debi; 'mmacneely@commfiredistrict.com' Cc: Heath DeptMailbox Subject: Address Chnage for Map 007 Parcel 030 Hi Debi, Th a ner contacted a to request an address change for this property. They indicated that the old house was demolished at 541 ntuit Road Cotuit and the new house would face and take access from Bay Road. I have effectively changed the address to#155 Bay Road for the new construction. You may want to update any hard copies you have on file for this property. Please contact me if you need more help with this notice. Frank Schlegel E911 Data Liaison Engineering Records Manager 2/24/2014 f Barnstable F.MFr�`yr 'Town of Barnstable ° mD-America cmr 1)epartmen"t of Public Works p, 382 Falmouth Road,,Hyannis MA 02601 r 60 MPS A http://www.town.bamstable.m_a.us w 2007 Daniel Santos,Director Office; 508 790-6400 Fax: 508-79M406 Stephen J. Clarke 41 Brewster Road Cohasset,MA. 02025 Date: February 21, 2014 Re: Address reassignment for Map 007 Parcel 030,# 541 SantuitRoad, Cotuit., Dear.Mr. Clarice, I am in receipt of your letter requesting a change of address for the property:identified above. I have reviewed your proposed site plan and concur that a change of the address is necessary to provide properidentification of your new building on Bay Road, Cotuit: Even though your property is not a corner lot, it does have frontage on two roads and the section of the Town of Barnstable's Ordinance-for Numbering of Buildings (encl)for corner lot number assignment is used to determine the correct number for your type of property: Evaluating the records in this office;reveals that.#155 Bay Road was.reserved. for your property. This has.been identified.as an effective number to reassign your property for the new construction. Therefore, acting under the direction of the Town of Barnstable"&Ordinance for: Numbering of Buildings,the address for this property has been reassigned to#155 Bay Road, Cotuit. This new address has been updated in town records. I will notify the Building Department and the Board of Health of this,change because of the open permits; This new address will need to_be posted in accordance with the enclosed ordinance:on your new building. Please contact me if you require further assistance with this notice. Sin sly Frank Schlegel E91I Data Liaison Engineering Records:Manager DPW/Technical.Support 382 Falmouth Rd./Rte:28 Hyannis, MA.,02601: (508) 790-6400 x-4942` frank.schlegel@towribarnstable.nia.us Town of Barnstable. SS.A Department of Public Works s� fo 39. 382 Falmouth Road; Hyannis MA 02601 http://www.town.bamstable'.ma.us Office: 5.08-790-6400 Daniel Santos,Director Fax: 508-790-6406 Roger Parsons,PE.Town Engineer SUBJECT:Numbering of Buildings Map No..00 7 Parcel No. 0 3 0 Date:-'PL-�ewvantt a,l�f� Dear Property Owner, Notice is hereby given in accordance with the General Ordinances of the Town of Barnstable, Chapter III,Article V, Numbering of Buildings,,adopted March 3,1931,revised July 21,1994, public convenience and necessity requires the assignment of number t S-:5- for your property located on-RA STREET NAME VILLAGE I This number should be affixed to your:building so that it is visible from the street as outlined in Exhibit"E", Town of Barnstable Rules.and Regulations for Numbering of Buildings. Please contact Mr.Frank Schlegel at the Engineering Division at(5W.790-6,400 x-4942 and be prepared to provide all telephone numbers at this.location so that your E-911.account records can be:confirmed when the correct building number,is posted. Roger Parsons, P.�ri Town Engineer encl: ""T.O.B.. Rules & Regs. "Common Questions Site Map Assessors Change Form ParcelEdit Page 1 of 1 71",4/;�--� If ro; � a J a Logged In As: ���;��� .Friday,'February:2112014 Frank Schlegel Application Center Road System Reports Road System The record has been updated. Parcel Detail Parcel ID: rC07030 Sewer Acct: � TAR. Fj Update Devel Lot: ILOTS C & D. Owner: CLARKE, STEPHE'N J& NANCY J Co Owner: �.. Street: 141 BREWSTER ROAD f City: COHASSF State: MA Zip 52025 .m --------------- Location: ; __ 155 1 BAY ROADVillage. Cotuit I. ., Road Index: 0085 Pri Frontage: 19 To set road, you can also enter road index and tab Out of field. Secondary Road: ISANTUIT ROAD I � Sec Index; 1426 ? Sec Frontage 0015 Visions Location: 1541 SANTUIT ROAD Last Updated: 2/21/2014 2 38 57 PIVI --------------- No, Bldgs: I ' Account;No: 1900 v Lot:Slze(acres); 1 119cJ9541� State Class: 1010 j Year Added: 1940 Fire.Dist: I ._ . Deed Date: 4/12/2013 Deed Ref: 27286/333 Land Value: 203900 Bldgs Value: 38300 Extra Features: 20200 1 --------------- Condo Complex; ( Building F-7-7 -i Unit:�� Update hitp:/tissgl2/intrane,t/propdata/ParcelEdit.aspx?ID=191. 2/21/2014 Town of Barnstable Department of Public works Technical Support Division 362 Falmouth Roach Hyannis, MA 02601 I— Qo � N�o ��s oho # I! { 41�C)D CA A V r 01 J k C7 CO -lit \ ! v C)� CD w F� t base.maps.dgn. 2/21/2014 3:`11::58 PM _property grt s shown on thle plan are for assessing purposes only and do not.represent actin relationships to physical obl -QU7R�.3fl 41 Brewster Rd Cohasset, MA 02025 781 383 0682 siccoh@gmail.com i Roger Parsons Town Engineer Dear Mr. Parsons: 1 am writing to request a change of address. The current address.is 541 Santuit Rd.. Cotuit, MA 02635. The existing home has been demolished and a new home is being constructed. The new home is to be fronted on Bay Rd. with driveway access on Bay Rd. as well. The only frontage on Santuit Rd is limited to the existing driveway. Please .see the attached site plan and memorandum from Attorney Bernard Kilroy. Thank you for your time and I look forward to hearing from you. Sincerely, Stephen Clarke z MEMORANDUM TO:Stephen Clarks DATE:February 4,2013 FROM:Bernard T.Klroy RE: LOTS C and D(541)Santuit Road,Cotuit,MA(the"Locus )shown on Plan filed in plan book 260, page 70(the"Plan")and frontage requirement underthe Barnstable Zoning Bylaw. Locus is shown on the plan as having 15.68 feet of frontage on Santuit Road,a public way,and 188.S3 feet of frontage on Bay Road,a private way. At the time the Locus was created by the Plan(1972)Locus was in an RF zone requiring 150 feet of frontage. Locus is a portion of LOTS 35 and 37 as shown on the Cotuit Highground Plan filed in Plan Book 19,Page 143(1926)for Robert T.Fowler. The Cotuit Highground Plan is a resubdivision,in part,of the land shown on the Plan of Building Lots at Cotuit prepared for Charles L Gifford in 1902 filed in Plan Book 15,Page 67(the"Gifford Plan"). Said LOTS 3S and 37 area redivision of LOTS 72,73,78,79 and 80 on the Gifford Plan. LOT C,to a depth of 200 feet from Bay Road(also known as Bay View Road on the Gifford Plan),includes all of LOT 78 and the major portion of LOT 79 on the Gifford Plan_ The remainder of LOT C is a portion of LOTS 92 and 93 on the Gifford Plan. LOT D is a portion of LOTS 79 and 80 on the Gifford Plan. When Fowler acquired title to the lots on the Gifford Plan by deed recorded in Book 435,page 202(Parcel 2),LOTS 81-87 on the Gifford Plan(all of the lots on the west side of Bay View Road)had been conveyed by Gifford to third parties(Fowler did acquired LOT 82 on the Gifford Plan in that deed and is shown as LOT 17 on the Cotuit Highground Plan. In my opinion,LOTS 78,79 and 80 on the Gifford Plan had the right to use Bay View Road and Mashpee Road for all purposes including access to Santuit Road for the installation of utilities. Except for the Easterly 90.89 feet of LOT C,LOTS C and Dare derived from LOTS 78,79 and 80 all of which front on Bay View Road on the Gifford Plan(Bay Road on the Locus Plan)and each of which or any portion thereof have the right to said use of Bay View Road and Mashpee Road. My opinion is based on the fact that all three lots are shown on the Gifford Plan as fronting on Bay View Road leading to the unnamed way(shown as Mashpee Road on the Cotuit Highground Plan)and to Santuit Road,that the deeds out from Gifford of LOTS 81-87 were silent as to any express grants to the use of Bay View Road and or Mashpee Road and that the use of Bay View Road and Mashpee Road,being the only access roads to Santuit Road for the three lots,for such access is part of the common scheme of development of the land. It appears from the aerial photographs available on the Town Website that Bay Road Is constructed and used by a number of homes thereon,including LOT 17 on the Cotuit Highground Plan and based solely on that fad,should be sufficient to obtain a building permit for LOTS C and D. According to the Barnstable Assessors'records Locus is presently improved by a single family dwelling built in 1940. Based solely on that information,the property is not governed by Chapter 112(Historic Properties)of the Town Ordinances and the dwelling may be razed with an appropriate building permit. Chapter 240,section 91H of the zoning bylaw(developed lot protection)would allow the razing and rebuilding as of right subject to the lot coverage(20%of the lot area)and conformity to current setbacks and sideline requirements. r �,. -_,CC Op o MAYYCgM;cr, /<� ` c I 1 t/ •I / I ' l ` yy AEFEflENC¢mM, i lk e..+ mm.o r^E. Site Plan Existing Conditions Sulltvan Engineering,Inc. At 0 8ox 6c9 STBr ter R os;�.»rn.MA 02655 4f Brewster Rd 541 Santuit Rd COhnsset, MA 02025 Bamstable rcowio Mass. - rc. April 10,2013 zr ur. 1. rm-oo�-ono 6- DNCB S79.46' "E ZONE: J ` FND 1 BENCH,MARK 290:69 DHCB J/ - f-HaiT RF CONC. BND: FND:. / ,FND t Aieo.(„w1.)87.120t EL 34.00 \� - it F£NCE RSA __,__.____--___._ � ___.__.__._HIT-_. _-_\___ :____,_-_ , A.BUTTEsF Sro tr. PROPOSED R ts' SEPrc _-- LOt C&D I OVERLAY DISTRICT: I TANK \.: _ - _ \ I/} AP- I ^ l Area:`,489d S F.to , Eat"o+be Wbt,Med I F Oi FLOOD ZONE: LOCA770NMAP z c m D 1 i JJY 1992 PROP' _ l -` ` ryroom ' ft'�zoaDr) 7.. 1 a . , ASSESSORS REF.: •_tti"1 — FERENCES: +0a007:Parror030 4 0 _ RE crig _ `\�Y .,�" .`.\ y y Pi.e mor<xD/a0 22 ze SEPTIC M e�gx�gvni.rwmm.tx�.m.m.ewe o l<�_ I '� O. 011 �Y .�` OA y \• �y \ BUiLOfNC M ,' ilDeCmmru�o�6�eNPW+�,�.PvmlbP®Tm O. . Otn Sp ill `� •., . \ J - z.. SETBACKS\ --�' wx �emc.w�warr;�mmu®dtiw CB aeecmm=wewa.,.isbv,�.rw®aswje.w.mrffiaw O n.,a.w .mmm+. um,s nm�m.mera l � pN FN O. ' •� A/�./' - mar af'mvbbegWW fmAn •....,,t ON r�, acw.aa, IR g vmamr�Au.xso�mor. e�,e. 7PE vsaeWwNbmdmtl-]O Arw mum - - '�` '° FNO y'ti 20� � o �sw�w,m°.ea� v wneama..e bW p,.� i Ss ZO\ ABUTTERS: �� rm wwamar n. x+. ® uwnso,�.ee. 1 r p v�p J .SHED, p kaa<>� m meaa,a a ou um• t _ PROD, 579'4600"E J I. IRON. S 125.89' 1;. a.aiw�d tme:o:no.ta..om«m.u.b edmiM PIPE . FND _ DFSTGNDATA m to LF ictttrva I. '/.:DFiOg' N79'4fi'OO'w f ' LEAHING CHAMDX DON - a ..:-.-_.•, oN�B � I I .�C�� CROSS SECTION OF CHAMBER' PBRuc TEST:14,678 NOTTD SCALE a � TEST ROLE-t TIQLU a Mo. AST HOU3JUT HQLf,4m . .. u n malam du x �a - -taAvbFaMS ..: : faviva I.e..ui'"fir - e °aw�ox. n,matreu.o: a.tisama ,vawa�a N.� T � DEVELOPED.PROFILE OF SYSTEM .. NOT TO SCALE , SITE PASSEO SANTUI T ROAD 7l TLE... Site Plan PREPARED BY PREPARED FOR. NDTES Proposed Improvements Sullivan Engineerin Inc. "fi . U .. m so,.,�a ey waew�,ar sv�wy . At C STEPHEN CLARK,E N d b t .4 Doi PRn� PO Box fi59 d to/aPR/x 'Osterville, MA 02655 41 Brewster Rd 541 Santuit Rd c r ),9-9E17 x COnasset, MA 0202 508 a28-J344 508 42 h��mwmio�rl.d M1wn'. dove' J. O Barnstable (CotUit) Mass. d 20 0 20 ��w t Id:1 to n, Of R: CTR -Field• JOD/YM'/CTR BvmsmMe 4Y5 map.. DATE July 36,2013 5 1"_20` Ravtcw:P(6je66 M0 02_foke ora w;6g: y wf y2oposc-� a Page 1 of 1 Wadlington, Ellen From: Schlegel, Frank Sent: Friday, February 21, 2014 3:29 PM To: Barrows, Debi; 'mmacneely@commfiredistrict.com' Cc: Heath DeptMai[box Subject: Address Chnage for Map 007 Parcel 030 Hi Debi, The owner contacted me to request an address change for this property. They indicated that the old house was demolished at#541 Santuit Road, Cotuit and the new house would face and take access from Bay Road. I have effectively changed the address to#155 Bay Road for the new construction. You may want to update any hard copies you have on file for this property. Please contact me if you need more help with this notice. Frank Schlegel E911 Data Liaison Engineering Records Manager 2/24/2014 No?e-"a�? 9 THE COMMONWEALTH OF MASSACHUSETTS AR® F H A T ......... v---------------•------OF...-. d�'v.. - > . Appliratiun for Bi_qpuiiai Works Tongtrurtialn thrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: ..... •------ - Locati -Addre or t Non Owner Address 1.4 � Installer Address Type of Building Size Lot____________________ _____Sq. feet U Dwelling—No. of Bedrooms___________ ______________ ___ _____Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building No. of ersons____________________________ Showers YP g ---------------------------- P ( ) — Cafeteria ( ) Other fixtures ---------•--------------------------•-•-------•--------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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_______-_______________. Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water______-___..___________- Descriptionof Soil........................ 4•---._ '...---•-------------------------------------------------------------•------------------------------------•---- x x -----•-----•-------•-•-------------------••-•-•-•-•-----•--------------------•-•--- ---- V Nature of Repairs or.Alterations—Answer when applicable._______ - .��___-__� _C1 :___�,5_.----- j5 , Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI':E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b e issued by the board of health. Signed------ _- ........... 1........5.... ........... ; Application Approved By.. : --- --•---- ---•-• -• ....... ---•-••-•--•...... ... .............• ---••-•-� ate Application Disapproved for the following reasons:----••--=--------•----------------------------------------•---•---------------•--------------•---•-------------- ----------------- --------- ----------------- _---_-_------•---------------------- --------•----------------------------•-----------•------------ Date Permit No..- ._..s✓'1..................•----._. Issued....---- .... Date L D ( � `3 No. ... _. ; Fss.... ........... o � �p 7 THE COMMONWEALTH OF MMASSACHUSETTS ' ! � 1V.-..fie R® �—��/ � T I—f 1- O F...... ................ Appliration for Dispas al Workii Tomitrnrfinrt Ilumit Application is hereby made for a Permit to Construct ( ) or Repair�an Individual Sewage Disposal System at: .........................a y_ . ------ " ... ur ... r o --- ..._... Locatio -Addres `"" or t No.- -- -•-- \ Owner �j Address i a Installer Address UType of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms............•.•.............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P-I � Other fixtures -----------------------------------------•-•--------...--------•-------------..._.._..------------•---•-----------------••-------••--------...-------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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........... a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--------------.......... Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_._____.___.-___-.-.___. DDescription of Soil......................... . ............. ----------------------------------------------.------ ---•-----------------------.._----------- x ` V ••-----•-•----------•------••-•----•-•----•-----•--••••--...-•-------•-•--•---•••--•••••-••••----••-•-••-•-••----------•••--•-•••-•-----------••-------•-----•••--•-•••-------•---•--•----••--•--•---- UNature of Repairs or Alterations—Answer when applicable.______-,AZµ-_Se=`CR_`� ....._� --�_.... 1'V, , -----------------� `� `�----------S�-•-=•---•-••......--------•-••.(.�-J v .......................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT12 y g g p y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has b issued by the board of health. Signed---- 1 0 C� gb D Application Approved By... • •-• ••........ ....... ................. --- -•--••••----- -•-- .... ate Application Disapproved for the following reasons-----------------------•-------••----•--...------------------•-•-----------------------------------------••_...-- .................................•-------- --- _••...•••-•-•• •--•----•----•---••--•...-•-••-•--••-••--••• ---•---•-••---••---•-----•----••--•--------••-•-•----••••••-•- Date PermitNo. •-•-•-�•• •-- .......................... Issued._....---•-----------------------------••-•------•••-•- Date THE COMMONWEALTH OF MASSACHUSETTS O A R D HEALTH '....................OF......c Cj1 / _.... Tlertifiratr laf Tuntpliatta THIS TO CERTIFY, That he Individual Sewage Disposal System constructed ( ) or RepairedZA bY------------- ....... µ- ............................................................. .. .................................. lr has been installed in accordance with the provisions of TTS 5 of The State Sanitary Cod as d in the application for Disposal Works Construction Permit No... C� .� /�._ dated-_. __ -..� ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... -- 7-- - �-•--...--.....-----••-----•-•---. p - Inspector --•------------••-•----•-------•------•-•--- � - - ':THE COMMONWEALTH OF MASSACHUSETTS B ARD OF HEALTK NO. "..'' /Ltd/, ..... 1-7 ............1...!/. .......OF... .L� .1.. '^'`-::............ FEE....... S.1 r v /// .-aYrk� �nn��r irrn rrntit Permission is hereby granted......__6C.A. '5:...i_. "- . f. `� c ----•••• ••--•-••-•--•---••••••••.......-•••••...............•-••-•••- to Construct ( ) or Repair (•-,d-an Individual Sewage Disposal stem -_----- Street as shown on the ap lication for Disposal Works Constructi rmit Nd X1__~ 'Dated... . 1.... .................. ................... ...................................................... Boar of Health FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS d3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not-be altered in any way. A. General Information 1. Inspector: Frank Nunes III Name of Inspector saa Company Name 25 Deer Ridge Rd Company Address Mashpee MA 02649 City/Town State Zip Code 508.272.6433 Telephone Number B. Certification 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 16.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 03 O 10/23/09 �m+d �4 -n Inspecto Signat Date c co P The system inspector shall submit a copy of this inspection report to the Approving Aut�erity and of Health or DEP)within 30 days of completing this inspection. If the system is-a shared_syst for has a design flow of 10,000 gpd or greater, the inspector and the system own r shall m%hri t tre report to the appropriate regional office of the DEP. The original should be se to the stem Ewyner 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 same or different conditions of use. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s � 541 Santuit Rd Property Address Lorrantos Owners Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: 1 have not found any information which indicates that any of the failure.criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Pumping suggested every 3 yrs to prolong the life of the system B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, 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. Svstem will pass inspection if the existina tank is reDlaced with a complvinq septic tank as Commonwealth of Massachusetts Title 5 Official. Inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 't 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 Y2 day flow ❑ 0 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) D) System Failure Criteria Applicable to All Systems(cunt.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 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 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 and chain of custody must be attached to this form.) ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface 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 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. i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no°as to each of the following: Yes No ® ❑ 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 as 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, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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: ® ❑ 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(5)] Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M ' 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual) unk DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes E No Water meter readings, if available(last 2 years usage(gpd)): - - Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑' No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Pumped 2 yrs ago per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): r Approximate age of all components, date installed(if known)and source of information: 7/5/88 per as built ` Were sewage odors detected when arriving at the site? ❑ Yes ® No 4 Commonwealth of Massachusetts Title 5 official Inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: >10' feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1� feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000g Sludge depth: 21,. Distance from top of sludge to bottom of outlet tee or baffle >12' Scum thickness 0 - Distance from top of scum to top of outlet tee or baffle n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a How were dimensions determined? measured. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cunt.) Dimensions: - Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level.' Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened)(locate on site plan):- Depth of liquid level above outlet invert level w/the bottom of the pipe 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.): D-Box is 3' below grade. No adverse conditions Pump Chamber(locate on site plan): Pumps in working order: ❑. Yes ❑ No Alarms in working order: ❑ Yes ❑ No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ Teaching 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.):. Pit is 6x6 and of precast construction,it is 4'below grade,it has 2'of liquid in it at this time, riser to 12" of grade, no stain lines above current level Commonwealth of Massachusetts Title 5 Official Inspection. Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M z 541 Santuit Rd Property Address Lorrantos Owner's Name Cotuit MA 02635 10/23/09 CitylTown State Zip Code Date of Inspection D. System Information (cont.) 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 p blic water supply enters the building. 5 1 c C >3 t. a, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 541 Santuit Rd Property Address l-orrantos Owner's Name Cotuit MA 02635 10/23/09 City/Town State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >40' feet' Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: pate ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: per phone conversation ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USES database-explain: You must describe how you established the high ground water elevation: see above DATE 6/6/02 PROPERTY ADDRESS:541. Santuit -Road _ - -----Cot -- , Mass ------- i- .- z - �Q2 02635 4 -- -- _-_--+ - --- � On the above date, I Inspected the septic system at the a ove uV ress This system consists of the following: Tod 'v� 1 . 1000 gallon septic tank, tiFgk 46 2 . 1-Distribution box . 3 . 1-1000 gallon g p 1 g precast leaching it . Packed in stone: ( 6 X10 T ��F Based on my Inspection, I certify t'he following conditions: 4 . This is, a title five septic system. ( 78 Code ) 5 . The septic system is in proper working order ,` at the present time . 6 . Waste water is 60" below the invert pipe. of -the leaching pit ;, 7 . Pumped septic tank at time - of inspection . Heavy .scum & solids layers were present . - SIGNATURE: ; _ Name :_1_p,_ Macomber _jr------ Company; Joseph_P _-Macomber-& ' Son , ,,In"c Address : Box 66 -------------------- Centerville, Ma . 02632-0066 Phone:--- 508_775-3338 - -- . THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 1 JOSEPH P. MACOMBER & SON, INC, `Tan ks•C'ess pool s•LeachfIeIds °Pumped & Installed Town 'Sewer Connectlons P.O. Box 66 Centerville, MA 02632.0066, 775.3338 775.6412 9 . COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION I ,.Y TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 541 San tuit Road Cotuit , Mass . Owner's Name: John Gilmore Owner's Address:106Y s in a e ,Mass . 02131 Date of Inspection: 6 6 h 0 2 Name of Inspector: (please print)Joseph P.Macomber Jr . Company Name: J. P.Macomber" & Son Inc . Mailing Address: Box 66 Centerville .Mass . 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that 1 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 ection 15.340 of Title 5(310 CMR 15.000). The system: ' Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fai Inspector'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. 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 conditionsof use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued). Property Address: 541 S a n t u i t Road Cotuit,Mass . Owner:John Gilmore , Date of Inspection: 6/6/0 2 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. stem Passes: did have not found an informatio hich indicates that any of the failure criteria described in 310 CMR 15.303 or m 5.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time . B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, 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: y0 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: WThe 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 E ND explain: 2 Page 3 of I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 541 Santuit Road otuit , ass . Owner: John Gilmore Date of Inspection: 6/6/0 2 C. Further Evaluation is Required by the Board of Health: A16 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. I. System will pass unless Board of Health determines in accordance with 310 CM 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: rt/0 Cesspool or privy is within 50 feet of a surface water 40 Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh ,f 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: Na The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or rributary to a surface water supply. A)D The system has a septic tank and SAS and the SAS is within a Zone I of a public water supple. 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 I 0 feet b�J50 feet or more from a private water supply yell". Method used to determine distance --� 'This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility,and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: �9 3 Page 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Properly Address541 Santuit Road Cotuit ,Mass . Owner: John Gilmore Date of Inspection: 6 6 02 D. System Failure Criteria applicable to all systems: You must indicate "yes" or"no" to each of the following for all inspections: Yes i�c ackup of sewage into facilityor system component due to overloaded or clogged SAS or cesspool ischarge 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 L, X 10 2&o .4-'.A>a ' 7 _ j Liquid depth in.zc4spool is less than 6"below invert or available volume is less than ''A day flow Required pumping more than 4 times in the last year NOT due to clogged or obsrmctedpipc(s). Numbcr of times pumped— �. . �y ponion of the SAS, cesspool or privy is below high ground water elevation. y portion of cesspool or privy is within 100 feet of a surface water supply or tributary tc a surface JrGater supply. �ny ponion of a cesspool or privy is within a Zone I of a public well. _ �/ y ponion of a cesspool or privy is within 50 feet of a private water supply well. iy ponion 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. ITbis 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 trust be attached to this forma dd (YesNo)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 o' 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 now of 10,000 gpd to 15,000 gpd• You must indicate either'yes"or"no" to each of the following: (T'hc following criteria apply to large systems in addition to the criteria above) e s n-o/ 4 he system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributaryto a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat,-or answered es" in Section D above the large system has failed. The owner or operator of any large system considered a s!enificant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 5 304 The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 I s' OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 541 Santuit Road 4 Cotuit ,Mass . Owner: John Gilmore Date of Inspection: 6/6/0 2 Check if the following have been done. You must indicate`yes"or"no" as to each of the following: Yes No/ i/ 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 ? —u-111 as the system received normal flows in the previous two week period Have large volumes of water been introduced to the system recently or as pan of this inspection.? Were as built plans of the system obtained and examined? (if they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out ? ZWere all system components,'ewluding the SAS, located on site ? Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction,dimensions, depth of liquid, depth of sludge and depth of scum ? 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' n� 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 I5.302(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:541 Santuit Road otuit , ass . Owner: John Gi more Date of Inspection: 6 6 02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): t-3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x 4 of bedrooms): 00 a Number of current residents: _ Does residence have a garbage grinder(yes or no): .6/p Is laundry on a separate sewage system es or no):.6'D [if yes separate inspection required] Laundry.system inspected ( es or no): S ' Seasonal use: (yes or no): Water meter readings, if available(last 2 years usage(gpd)): 2000-46 , 000 gallons-126 . 03 GPD Sump pump(yes or no): Nd 00 — 0 , gallons-136 . 99 GPD Last date of occupancy:dOA& /f7 COMM ERCIAUINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): 41A gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present (yes or no):414 Non-sanitary waste discharged to the Title 5 system (yes or no):/1,6* Water meter readings, if available: Last date of occupancy/use: OTHER(describe): WX GENERAL INFORMATION Pumping Records ' Source of information: 8- /�jfj Was system pumped as part of the inspection (yes or no) If yes, volume pumpedl alIons -- How was quantity pumped determined? Reason for pumping: Pumped septic tank Heavy scum & so i s ayers were present . TYP,R OF SYSTEM - 4- Septic tank, distribution box, soil absorption system Single cesspool . Overflow cesspool Privy IW Shared system (yes or no)(if yes, attach previous inspection records, if any) innovative/Altemative technology. Attach a copy of the current operation and maintenance contract (to be obtained from syste owner) Tight tank /(/ Attach a copy of the DEP approval 00 Other(describe): Approximate age of all con on�e , date installed (if known) and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 541 Santuit Road » otuit , ass . OwnerJohn Gilmore Date of Inspection: 6 22 BUILDING SEWER(locate on site plan) 1! Depth below grade: f' Materials of construction:,j&cast iron -,el4o PVC 4y other(explain): XO „ Distance from private water supply well or suction line: Id P Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tiQht . No evidence of leakage The svtem is - vented through the house vents . SEPTIC TANK: Zoocate on site plan) /mod 'Vj j Depth below grade: 1 "— � Material of construction: /Oconcrete.gmetaW.0 fiberglass jppolyethylene /Uyother(explain) If tank is metal list age:All Is age confirmed by a Certificate of Compliance(yes or no):,J (attach a copy of certificate) Dimensions: Sludge deptho� Distance from top of sludge to bottom of outlet tee or baffle: . d 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:P u m p e d tank at time of inspection . Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of.leakage,etc.): k _ Pump the sPntir tank PVPry 2-1 yenrg ` nlPr & n„rlAr tee2 arg in P1ace .The tank is structurally sound and -Ghnws nn PvirlPnrP of leakage . Pumped the tank at time of inspection . Heavy scum & solids laiyers were present . GREASE TRAPlocate on site plan) Depth below grade:Ay Material of construct'on:,Vl concrete&metaWAfiberg lass4polyethylenef*other (explain): Dimensions: 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: Date of last pumping: ley Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Grease trap is not present 7 Page 8 of 1 I R OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 541 Santuit Road Uotuit , Mass . Owner:John Gilmore Date of Inspection: 6 $ 02 TIGHT or HOLDING TANYAlj ye(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:*concrete&metal A4 fiberglass polyethylene 4/,4other(explain): Dimensions: A64 Capacity: '4>.4 gallons Design Flow: .U1I gallons/day Alarm present (yes or no): Ufa Alarm level: AIR Alarm in working order(yes or no): Date of last pumping: N!) Comments (condition of alarm and float switches, etc.): Tight or holding tanks are not present x DISTRIBUTION BOX: Z' (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: ti/J 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 has one lateral . No evidence of leakage into or out of the box .No evidence of solids carry over . PUMP CHAMBER (locate on site plan) Pumps in working order(yes or no): Ad Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances, etc): Pump chamber is -not present . 8 Pace 9 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropertyAddress:541 Dantuit Road Cotuit , Mass . Owner: John Gilmore Date of Inspectioo: 6/6/o 2 SOIL ABSORPTION SYSTEM (SAS):pe"', (locate on site plan, excavation not requiredc�) 1-1000 gallon precast leaching pit packed in stone .E�6 ' X10 ' ) If SAS not located explain why: Locate see page 10 Type }leaching pits. number: 11)6 leaching chambers, number.' ,00 leaching galleries, number: Alb leaching trenches, number, length: 0 Zb leaching fields, number, dimensions: �Hoverflow cesspool, number: innovative/alternative system Type/name of technology: J'�� Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Loamy sand to medium fine sand No signs of hydraulic failure or _ponding . Soils are dry Vegetation is n—o-rmal .Waste water is 60" below the invert pipe . .. CESSPOOLS(cesspool must be pumped as pan of inspection)(locate on site plan) Number and configuration: Depth — top of liquid to inlet invert: Depth of solids layer. Depth of scum laver Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): ' Cesspools are not present . PRIVY (locate on site plan)' Materials of construction: i� Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): . Privy is not present . 9 iL Page 10 of I I OFFICLAL TNSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWACE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM TNFORMATION (cminucd) Properry Address: 541 Santuit Road Cotuit ass. Owocr: John Gi more Dilc of Inipcoi0o: 6 6 SKETCH OF SEWACE DISPOSAL SYSTEM y Pioioc s ikc(ch of the Icwcgc dispoIII system including Ilcs t ocnc o of Icast rwp permencnt rc(crcncc InnCmarks o Nnuki. Locuc ill wclli withi n 100 fcci. LQciic whcrt pvblic whir supply mcm the bvilding. -Ch 10 Page I 1 of I l OFFICIAL INSPECTION „S ECTION FORM — NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART G SYSTEM INFORMATION (continued) Property Address: 541 Santuit Road i 3. Cotuit . Mass , Owner: John Gilmore Date of Inspection: 6/6/0 2 t SITE EXAM Slope Surface water Check cellar r �; Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: a , NO Obtained from system design plans on record - If checked, date of design plan reviewed: NA YES Observed site(abutting property/observation hole within 150 feet of SAS).: NO Checked with local Board of Health-explain: na YES Checked with local excavators, installers-(attach documentation) YES Accessed USG Sdatabase-explain: hHp ; 1rtown .Barnstable .tn'a.u'. s . You must describe how you established the high ground water elevation:. used ; Gahrety & Miller Model . 12/16/994 Grond water levels above sea level '. Used ; USG ; 0 nervation well data June 1992 Used ; USGS ; Technical bulletin — — Plate_ 2 January 1992 Annual. ran es of group water elevations . Top of Ground Leaching Pit /Fy ,eet e Groundwater: t eet Below Bottom of Pit High Groundwater Adjustment 1'.$ ft per Frimpter Method Therefore, the vertical separation distance between'the bottom rof the-leaching pit and the,adjusted groundwater table is 27 ' 20" feet: 1} f {{ "rA rT*-M1t'ra�'n-♦st'r1rr.•nmrT+n ITTSTT:`.T'•r!1VIf:�flf•C'1"111TiCrl�S1RaTTR • •v 1• •T'irfTl�Ti'T^..�• r•..,1 it TOWN OF Barnstable BOARD OF HEALTH SUI)SURFACR SFHA(;F DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION .•••�••t�T"".'. -T.t t�^.�.�T1 T T.T1'tt.'T TT.T.'CTI}yTT'�!'I r•tRTf T•RAT^TmRCVi�RTSRR1��TfCTf lfR.RT1tTTTITt -TYPE OR PRINT CLEARLY PROPERTY INSPECTED STREET ADDRESS 541 Santuit Road Cotuit ,Mass . ASSESSORS MAP, BLOCK AND PARCEL # 007-030 OWNER' s NAME John Gilmo-re PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr .' COMPANY NAME J. P.Macomber & Son Ino-! ' COMPANY ADDRESS Box 66 Centerville ,Mass,. 02632 Street Town or CSty State L!P COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX (508- ) 790 _ `1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at this 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 on- site sewage disposal systems , Cher one : System PASSED The inspection tghich I have conducted has not found any information which indicates that the system fails - to adequately protect public health or Lhe environment ae defined in 310 CMR 15 - 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* \ t \ The inspection which I have conducted has found that the system fails• to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - • FAILURE CRITERIA of this inspection form , Ile Inspector Signatur 14Date Xcopy of this certification must be provided to the OWNER, the BUYER re aPpl icable ) and the BOARD OF HEAL711. * If the inspection FAILED, the owner or.."operator shall u d within one year of the date of the inspection , unless allowed ortrequiredm otherwise as provided in 3.10 CHR 16 . 305 . partd .doc twit TOWN OF BARNSTABLE &10 d—®.x LOCAT'-ON SEWAGE # Z-VILLAGE /�i� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 � LEACHING FACILITY: (type) 6"XAP (size) NO. OF BEDROOMS 1Z BUILDER OR OWNER y®40�0 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: 6 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 an ng Fa ility(If we ds exist within 300 feet f 1 hi ility) Feet Furnished y ' I y 1 '5MnR Af r• TOWN OF BARNSTABLE LOCATION 54 R- Jdji A SEWAGE # VILLAGE ASSESSOR'S MAP & LOTR O INSTALLER'S NAME & PHONE Njgttl�la &m\e-'c-vs . q17 A SEPTIC TANK CAPACITY LEACHING FACILITY:(type){.� �� (size) / T4`I�v NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER'/ .BUILDER OR OWNER K ' . `; ��- -ObeiN DATE PERMIT'ISSUED: 19 8 DATE COMPLIANCE ISSUED: ? - VARIANCE GRANTED: Yes No �-� ,� -� ., j._,. 2 � � , i �� ® � � .. �V r r� CB . DO S79"46'O "E % ZONE: ,z FIN BENCH`MARK 290.89 pH03 / / / HgcT / RF (RPOD) , CONC. END. FND ! % f ND/ / ABUTTERS Area (min.) 87,120 SF Fronts a in 150' '''• EL. 34.�0 ' HIT \ \ \ �` / j FENCE Width min) )25' - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - \ - - - - - - - - / Setbac�s: \ Front 30' r ' p \ \ \ \ -� % ` I Side 75' -ta `-- \ 1'� \ \ i \o_ \ \ / f i ! Rear 15 \ PROPOS G! .\ ` L 6� a\, l t I i t I SEPTIC --- \ \ I OVERLAY DISTRICT. 1\ \ \ I `,� + AP - Aquifer Protection District\ TANK �\ I �.•- � ____ �>, • � � Estuarine Watershed x •: s Tll- O 0 \. w FLOOD ZONE: �. . _ o (A \ ` O / �`` .` \ \ \ \ + + Zone B / / I o a' #250001`ozinol No. LOCATION MAP'.. H ( < July Z 1992 (1N-2000f) «� I o-BOX `� \ \ \\a \ \\\ 7\ ASSESSORS REF.. " 2'_10 \ �\ \ \\ \�`� REFERENCES: Map 007, Parcel 030 i �'`---' \ \\`'m �'\ \ �\ \ \ \\i` Deed Book 153211043 Plan Book 260/70 ( 257/28 , <\ /'� w 4$� , .� ---�� SEPTIC NOTES 1J O TM_2 TH / \� q t"� -,^/_� `` \ 1 Prior WIIA yUExcavahson For Ibis This Projectthe Contractor AMM At Lem M7akel - I / j� 4 �� 0 J s JJ \ \ \ \ \ \ the Required Notification to Dig Safe(1-888-344-7233). • 40 � \ \ \ 2.The Contractor is Required to Sayre Appropriate Permits From Town o ` O o _ O \ r- m `1 \ o \ SBA CiS \ Agencies For Construction Defined by This Plan. Z , I /� m ��'C O �,.1 m \ 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall / m Z (N+rn / \ \ �� ' ` 0 H CB Be Constructed of class 150 Pressure Pipe and shall be water Tested to l? \ \ \ EN 0 Aastma Watertightness. In General,Water Lines Shall be Constructed in w ocMR 00 00&�31'O MtIS oinAccoraanco 2 t -{ i -- 4.A Minimum of 9"of Cover is Required for All Components. � C_ = ' i` - � � --' j \ ' s.All strttenma Burial Three Feet or Mtn or Subject E \ 1 to Vehicular Traffic to be H 20 Loading.It is the Engine's „ Recommendation that H-20 Always be Used y \ 4t \F `l� (V p 6.Install Watertight Risers and Covers to Within 6"of Finished Grade ABUTTERS r` Over Septic Tank Inlet and outlet,D-Box,and One Leaching Chamber 7 . 0; .Septic System to be Installed in Accordance with 310 CMR 15.00& SHED V 249 CMR 1.00-7.00 Latest Revision and the Town of Barnstable Board of Health Regulations. 8.Ali Piping to be Sch.40 PVC. Q9.D-Box Shall Have a hfmimum Inside Dimension of 12",and a Minimum S79'46'00"E ! 10.The ep of6". tance and IRON 125.89' and ash ll u No Lea than Between the. q id DDeptth�Inleett Tees Shall Extend ?� a Minimum of IV Below the Flow Line.Outlet Tars Shall Extend 14" Pi aE Below the Flow Line,and Shall be Equiped With a Gas Baffle. i -to OR d n _ I DESIGN DATA 00 Single Fsn* -411edroom011oo D - -�'� NoOalbap(lriader N Finish Grade [l J Total DailyFlaw m440OPD Una IS00(id Septic Tank - - - - - - - - - - - - - - -- jI _ Compacted FI71 FBter f \ LEACHING AREA Fawn And/Or 440 GPD10.74(LTAR)-595 SF Required 1/8'- 112" Sidewall-2(1T 10"+33'1-185 SF Pea Stone � 150.00 ' � I BottomAreas(12'-10•x33'-6')=430SF 3/4'- f 1/2' r Total Provided-615 SF LEACHING Double Washed i DH CB N 79'46'00"W \ 'i O I / / LEACHING CHAMBER DESIGN CHAMBER scone �- FND \ Q4C'B I AllftestobeSchedole40.Use \ FND I I 3-500set.LeaddogChambers in a 12-1D' 121-10"x 3Y-6"Washed Stae Fleld as Shown. \ I I CROSS SECTION OF CHAMBER PERC TEST: 14,078 '-1 I ' NOT TO SCALE PERFORMED BY:JOHN O'DEA,PE-SUUUVAN ENGB4BBRING 11U I SOIL EVALUATOR NO.2911 F.G. EL. 32.00 WITNBSSED BY:DONNA MIORANDI,RS.-TOWN OF BARNSTABLE I � � I See Note 6(qp.) JULY25,2013 W F.G. EL. J3.00•- •nna Foundation Grading To Be 'PEST HOLE-1 at N Coordinated With Landscape Prop EL.31.2 TEST HOLE-2 EL.311 T QLE-3 EL.32.2 TES HOLE-4 BL.32.2 " Flow EquUizers EL 29.7 As Required f qu f� In ! T •:.�•.FI[:[.'::•:.•.i�:r:•. �r.. ::::•O.i':r�:r err�:-::•:.•rri :�:�::'Or:•r •.•.i:•:':.•:rr::•.:• steer o t500 Ca! " .:.:.::rr.r.. . ::::::::.•.:•:. Confirm Prior EL. on .......................................... .......................................... 12 .......... .2 1 :'. .'::::.:::. :::::'. :.:':.:..:':::. ::::.2 7 .:..'.:.:.................................. 20 ......... ,0 �di��/yg To Any Work S20 Tank 73 IQR EL- 29.00 ........... H- Required :.•:,AB1atYER•10YR3p::•:::.�:: ...kB'LitiYER•It)Z R.3t1' :.•:1CB'LBi.YER.103CR3A'::•:::::: ..............� B'LX.YER.103t1C3f1'::::•�.::• �t�' S �+ ... ... .......,....•.. � See Note 5 33 . .1�tMMUkRICG"y::.:`.'::'. 'YIIkY'DA6tlEARBY:'::.'::::: ::::Y8127G'DA1t1CGR6Y:: :: •:: YBRYDA121@ARHY:::::::::. 9C' ( ) :::::. ....... ......... O : 7 ::::LOAMYSAND:::::::::::' 2 :::•LOAM�FSAbID:. ::. ::: 1.6 " .:. :::. :::::LOAMYSAND.':.'. :.: :.: 1 s �q. JOOH yN ro Be eau on I Leaching !ns ed Charm:. ...... SR10Y1tb/8:::::.:::. :::Bi:AYBItIAYJt6J8...... ... ::BLA7CIDt10YR6B. :::. :. :::BiA7C8k1AYR r�+ bar ........ 6ig::. :::::. 0 LLJ .. .................................. ::::::::.................................. :::::::.:...... . s ore oc e ':i•::-:::•:.:BROw.IB3ILY1H3.OW.:•::.•i:.:{ •:r.-::�r: iBROAYb1fSH.YELLOVi!:•::.:•::{: :':::::.,BRQwNISH.YEtb(IlW.• ::: .:::{:•::•r:.BRQwNL4[i.YBL•LOtW......... e o I L � P _ 33"'::::::.'.:'.: :JAAMiL$A3iDr:.: :. :.'. . S 40"'.: .::.::.:r:.LQ 9A1D'::::.':.':::.'. .9 18"'.':.::'::.:'::::.WAb1I!$ .'rr:'.::r::r:30.7 0"':.::'. ::::::..I OAMY$ifD': .':'::.'rr:.30.5 o O.4 1 8 .. Bedding.'T's, a Inspection Part, C LAYER IOYR716 C LAYER lOYR 7/6 C LAYffit LOYR 7/6 C LAYER 10YR 7/6 fl sands . m YBLLOW YELLOW YELLow YEUDW d I STER�� k,Q as Per Titre 5 c ii it7k AiYiziliBttiF(ti•,•;Y a;'SstCe rr. Ml3D.SAND PERC TEST PERC TEST SAND O S'/O ENG��� Wi NALEL 20.2 25 GALLONS GONE IN 4 MIN. 25 GALLONS GM IN 4 MIN. P Groundwate rest Hole r 13 .2 1 " PBRCRATE<2MINlIN TAR-0.74 .2 1 " PERCRATB<2MBUEI(LTAR_0.74 27.2 120" i DEVELOPED PROFILE OF SYSTEM N OUMWATBRENCOUlTOW R WAMMIN NO A A Groundwater �• NOT TO SCALE Per T.O.B. Standard SITE PASSED CANI'VIT ROAM T/TLE. Site -P-lan PREPARED BY. PREPARED FOR: NOTES: 1.) The structures shown were located Proposed Improvements Sullivan Engineering, Inc. on the ground by conventional survey PO Box 6�)9 STEPHEN CLARKE methods on or between 05/APR/13 A n1 A + y Osterville, MA (02655 41 Brewster Rd and 10/APR/13. 2. line ormation I a hereon wproperty s c piled from m available own 541 Santuit Rd (508)428-3344 (508)428-9617 fax COh ease t, MA 02025 record information. Barnstable (ceu-tuit) Mass. 20 0 10 20 40 80 3.) The datum used is on assumed Draft: CTR Field: JOD/WK/CTR NGVD 1929, from the town of ..j Barnstable CIS map. DATE: duly 30, 2013 SCALE: 1 �►_20r' Review: PS Comp.: wK Project: 33002_CI arke Drawing: