Loading...
HomeMy WebLinkAbout0026 BUTTERNUT CIRCLE - Health 26 Butternut C*frje Cotut - - - — A= 1) -099 pl it Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owners Name Barnstable ( C.'#-u k k MA 02635 10/18/13 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. A. General Information 1. Inspector: Frank Nunes III (� Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Cityrrown State Zip Code 508.272.6433 Telephone Number B. Certification 1 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 10/18/13 Insp rs Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 201 . 26 Buttemut Cirde•03/O6 Title 5 Official I RnSubsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y� 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 . 10/18/13 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete ail of Section D A) System Passes: ® I 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 26 Buttemut Circle•03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 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. 26 Buttemut Circle•03108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Pape 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 CitylTown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cunt.): ❑ 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 ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 26 Buttemut Circle•03108 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 26 Butternut Circle Property Address Scofield Owners Name Barnstable MA 02635 10/18/13 Cityrrown 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. 26 Buttemut Circle•03/08 Tide 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 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)] 26 Butternut Circle•03/08 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 Cityrrown 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 26 Butternut Circle•03/08 Title 5 Official inspection Forth:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts ugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No pumping 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: 12/26/07 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 26 Buttemut Circle•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 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 12"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: 6"feet Material of construction: ® concrete n 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: 1500g Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle >12' Scum thickness trace Distance from top of scum to top of outlet tee or baffle >2" Distance from bottom of scum to bottom of outlet tee or baffle >2" How were dimensions determined? measured 26 Buttemut Circle-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 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 26 Butternut Circle•03108 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 �y 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 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 0" 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.): No adverse conditions Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 26 Butternut Circle•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yy. 26 Butternut Circle Property Address Scofield Owners Name Barnstable MA 02635 10/18/13 Cityrrown 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: ® leaching chambers number: 2 ❑ 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.): SAS was probed and soils are dry and compact. No indication of backup 26 Butternut Circle•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts ugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Butternut Circle Property Address Scofield Owners Name Barnstable MA 02635 10/18/13 Cityrrown 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 26 Butternut Circle•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE -LOCATION c/!I- SEWAGE# VILLAGE C oTG/T ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO.t�/,1,* SEPTIC TANK CAPACITY /_"�+G' 12zo LEACHING FACILITY:(type) /c�'1> (size) Xa 3'Xe� NO.OF BEDROOMS S OWNER PERMIT DATE: �Z ` "�'� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility o/ Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) R� Feet FURNISHED BY 0 3" �9 f P row Ic a r J http://www.town.bamstable.ma.us/assessing/HMdisplay.asp?mappar-040099&seq=1 10/16/2013 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y� 26 Butternut Circle Property Address Scofield Owner's Name Barnstable MA 02635 10/18/13 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: >12 feet Please indicate all methods used to determine the high ground water elevation: Cl 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: per elevation of home 26 Butternut Circle-03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 15 Town of Barnstable P# op� Department of Regulatory Services : .nawervars, : Public Health Division Date 200 Main Street,Hyannis MA 02601 - Date Scheduled ime Fee Pd. Soil Suitability'As essment for Sewage D'sposal Performed By: ( Witnessed B : LOCATION& GENERAL INFORMATION Location Address �lj �O�N .C//2• . Owner's Name Af,q Aa-A-,4 CoTv r LC 4-8 Address •���!/J'f L��'� Clam, c oT�>r R p Assessor's Map/Parcel:O)pia 10 9 9 Engineer's Name 4EW L NEWCONSTRUCTII�ON REPAIR Telephone#� 9�S'�3e�67 // Land Use ebb •Y'-- Slopes(%) U� �r Surface Stones" Distances from: Open Water Body " ft Possible Wet Area / ft Drinking Water Well / ft Drainage Way �` ft Property Line�L'b ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r ru co Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: / Weeping from Pit Face p 1 Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: 4 in.® Depth to weeping from side of obs.hole: in, Groundwater Adjustment r r i f1.kj% Index Well# Reading Date: Index Well level Adj,factor Adj.Groundwater=Level i 0 PERCOLATION TEST Date„ , Time i — Observation Hole# Ttme at 9" Depth of Perc Vf7 Time at 6" Start Pre-soak Time @ Time(911.6") End Pre-soak Rate MinJlnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) C Original: Public Health Di.Asiou 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:%SEPTI0PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole#7� Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. on isten %Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ns' ten % is DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. .r Flood Insurance Rate May: ., Above 500 year flood boundary No— Yes V__ Within 500 year boundary No Yes Within 100 year flood boundary No^ Yes Depth of Naturally Occurring!Pervious Material _. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil.absorption system? IE ' .4 If not,what is the depth of naturally occurring pery ous material? r Certification . I certify that on y (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection and that the above analysis was pe orm by me consistent with . the required tr ' ' expertise nd xpe 'e c escribed in 110 CMR 15.01 II►-d..n� 1� • Signature Date Q\\EPTIOPERCFORM.DOC TOWN OF BARNSTABLE LOCATION �� .(}�'C/�C�' v c/!�. SEWAGE# c? s r/ VILLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. '­�,4,;' SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER -4 PERMIT DATE: �`� ' "�� COMPLIANCE DATE: k D 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) i Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet FURNISHED BY / .r.4 O ti a, �, ; � �, �; ye �r. No. oqoO J �1 t / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[ppYication for at5ponl *pgtem Con0truction Permit Application for a Permit to Construct(Repair( ) Upgrade( ) Abandon( ) [Komplete System ❑Individual Components Location Address or Lot No. � ` CAP?, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 7 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. /110 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �-�- gpd Design flow provided gpd Plan . Date r "�% "07 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this BVHealth. Signed Date Application Approved by c Date a Application Disapproved by: Date for the following reasons Permit No. Od S Date Issued i No. 0007 - Fee / v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIPPlication for �Biopooal *pgtem Con0truction Permit Application for a Permit to Construct(Repair O Upgrade O Abandon O Zcomplete System ❑Individual Components Location Address or Lot No. —7 46�W~W4,7 C/Ali? Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type gf Building: /Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min..required) 3 ® gpd Design flow provided 3 y0 gpd Plan Date -2-7 —07 Number of sheets / Revision Date 1. Title Size of Septic Tank Type of S.A.S. Description of Soil i- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board Health. Signed Date Application Approved by r Date — 5 Application Disapproved by: Date for the following reasons Permit No. 2-06_:� - Date Issued s. s THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired Upgraded g P Y ( ) P ( ) ( ) Abandoned( )by -C�y��,0 06ewc at � 6- w C4Z/i 1- C/Xf• C' o.� T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ;2 po 7 - S S/ dated Installer J' 17� e C r4?40G�� Designer 4!:�L4!//.O 4r, #bedrooms a. Approved designflow 3 �� gpd The issuance of this permits ll not b construed as a guarantee that the syst m wiill�unc r i n a designed. Date ��� Inspectoor No. U V 7 S/ Fee ,UU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 1=igpo!9at 6p0tem Con0truction Permit -11 Permission is hereby granted to Construct ( Repair ( ) Upgrade ( ) Abandon ( ) System located at Z and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. r-• ,,,oDate f _ �'d Approved by n V Town of Barnstable' ' Regulatory Services Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644. =Fax: 508-7.90-6304 Installer&Designer Certification Form Date: k.-z Z 2 Z 0D Designer: l� V� t'`� Installer: Address: . t&065 Address: On ZZ " 3��'� I Ul)�,bed wF y0%was issued a permit to install a (date) (installer) septic system at , Z49 �;OMZ�JU l OQU4e, based on a design drawn by (address) ,n ' f Lv " _dated (designer) <, ce rtify that the septic system referenced above was installed substantially^accbrdirng'ta tl &e design, which may include minor approved-changes such as latgxal-relocation of the d stcibu*box and/or septic tank. I cerW.4hat the septic system referenced above was inst4;4 with 3rw. c hanges.'(�ee, greater flim10' lateral relocation of the SAS or any vestca-*" iof ayl on component of the.septn'�,system}but im accordance with State&Local Regdialions Plan revisioxk;oil certified as bxt`by designer to follow. --. (installer's Signature)... MASON. m Na toss sAM-AR�Pd er s Signature) (Affix Sfamp Here) ' PLKASE RETURN TO BAMST LE1 PUBLICC,EWALTH.D O 1 FMC. TE OF.: COWL�ANCR MM&N(3 SSUE> SOTD=--.T iFO :. . BUILT CARD ARE RECEVF.D 'Y �.B S`IABLE PUBLIC, _�! TbTANK YOU. Q:Health/Septic/Designer Cer ificAop Form - 6 ' q 15 21�' P cyaration of Plans and Jpe nncanul» n u •+ r• r •. r< "�. r• - r • — T'nd plans and specifications .for every on-site system shall be prepared as follows: (1) •E�vcry system shall be designed by a Massachusetts Rc�gistercd Professional Engineer or a Massachusetts Registered Sanitarian provided that such Sanitarian shall tint-design a. system designed to discharge more than 2,000 gallons per day purrsuiant to 310 CMR 15.103. -e plans for the repair of a system.desi ned to Any other agent of the owner..may prepa. p p y g ;scharge not more.than than 2,000 gallons per day pursuant to 310 CMR IS_263 prodded h..y are reviewed by.'a Massachusetts Registered Sanitarian and•approvcd by tlue.approving t/ authority; tY:r fEvcry,plan_subrrdTted for approval must be dated and bear the stamp and signature of - th'�Cdcsignar, (3J Every plan for a new system or plan for the upgrade or expansion of an =4sdn:g'systcrn'-' which requires a.variance to a property`line setback distaff ce,:must--also reference-a plan �✓ which bears the stamp and signature of ya lvtassachasctu; Licensed Land surveyor in accordance with M.Q.L. c, 112, § 8 I D; Every plan for a system shall be of suitable scale(oat inch=40 feet or fewer for plot plans and one-inch;-=20 feat or fewer for details of,system.components). 4t}d shall include. d�rcnon of: t/ (a) the legal boundaries of the facility to be served: />t-= (b) the holder and location of any easements appurtenant to or which could impact the - - System, �(c) the location of the ill dwelling(s)or building(s)existing and proposed on the facility - L. and idcntifjgaadr of those tc'be served by the system; " j�d) =the''iacarion of existing or, proposed irimper-do as,areas,- including:-ctri-a ays and ✓ p g - c} location an of the Sy stcm (including reserve area); -. (f)• syst;.m design calculations, iiuclading design daily sewage flow, septic rank capacity ulrcd and proyidea); soil absorption. systcm capacity (required and provided); and - - wrhe r system is designed for garbage grinder, - North arrow and existing and proposed contours; (h) lodation'and'log of deep*observation hole tests including the date of test, existing' adc elevations marked on each test, and he names of the representative of the appr ving authority and soil evaluator, location and results of percolation-tests including the aate-of test and the names of a rcpescntadve of the approving authority and soil evaluator, e.!;h .- cs — (j} name and certification numberof-the-Soil-Evaluator of record. (k) location .o£'evcry-Water supply,public and private, 1. within 400 feet of the proposed system location in the case of surface warcr supplies•and gravel packed public water supply wells, 2. within 250 feet of the proposed system location in the case;of tubular public water ripply wells, and 3. within 150 feet of the proposed-system.location in the case of private water U supply wells: -1)-- location cf-any stzrface waters of ha Ccmrnonwealth;rivers, bordering--vegetate wetlands, salr marshes, inland or coastal banks. regulatory floodway, yelocity zone, surface water supplies, tributaries to surface water Supplies,certified vernal pools,private water supplies or•suctinir lines, graycl packed'or tubular public water supply wells, ' .. subsurface drains, leaching catch basins, oz` dry'wells; and She location of any nitrogen .- sensitive area idcnt�ed•in 310 CNS 15.2is within which portions of the proposed ern are located. location of wirer lines and,other subsurface utilities on the-facility; ( obscrYed and adjusted ground-wirer elevation in the vicinity of the system; o) a.cdmpletc profile of the system; (p) -a note an the plan listing all variances to the provisions of 310 CMR 15.000 sought in conjunction witl't the plan; �2w"_� the location and elevation of one bercltrmark.within 50 to 7S feet of the facility ich 1S nOt sLb]cct to dislocation tarlossd:rrg construction•on'the faciL( ) when doss:-rig is'pzeposcd, 'eamplete dcsigz-anii'specificaciorr of the.dosing systc.*n ,��//�opo.sed including.but pot lin-d ed to dosing chamber capacity (required and:provided),' J" 'pump curves and.specifications, number.of d'osizg cycles and depth per Cycle; when a Recirculatisig Sand Filter or equivalent alternative technology is regt�ized or oscd, a complete plan and spccificadon for the system,including a hydraulic profle; t ( locus glan,to show he Location of the facility including the nearest existing street, the sheet nu,'bar. and let number, if any, of he facility; and the rnatcrals of ccnsnvct on.and Lbe specif cations of the system. LO C-AT,10 S_E A G E P IT MQ. d3, Av c I}c e VILLAGE Ga ul 1 INSTALLER'S NA.pF & ADDRESS S©F D ?'fl&o ,1,,9fl1DlS IU1LDEN OR OWNER C�ovvI o n11 DATE -PERMIT ISSUED DAT E CoMPL-IANCE ISSUED 13 3 Q► 3 rim# Lbf 3l i 5T#? E- #z6 L O CAT I0 .76 4�I A G E P IT NO. VILLAGE / G INSTALLER'S ",ME i ADDRESS S0� D TH&0 HY9R1li >s t�y b v 8UILDER OR OWNER &D vsl g D IL DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 6- 2.t-9Y - � -----• � � .. � J � � � Z � � �' ° C W (J.) � '}� �`' �.. N0. :2::..7.1.L y Flzs.... _............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable .....................................O F........................................-------------•------•---...............--•-----.-- OJSI, Appliration for Dispotiaal Works Tonstrartiun Famit Application is hereby made for a Permit to Construct (X ) or Repair ( } an Individual Sewage Disposal System at: Lot 31 Butternut Circle , Cotuit, Ma. ................_........_...................................................................... ------••-•----••----•-•-...-•-•-••-•----••--••......-•--•---•--•-••............................... Location-Address or Lot No. . _Theo Construction__CO._,___Inc.____-___ 24 Great_ Pond_Dr ............................................ Owner Address So. Yarmouth, Ma. Installer Address 2 0 0 UType of Building Size Lot.,2....9.i...................Sq. feet Dwelling—No. of Bedrooms..3.......................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Gt, Other fixtures -----------------•••--•....•-•...........•--•- W Design Flow........55..............................gallons per person per day. Total daily flow........330 ..gallons. WSeptic Tank—Liquid ca.pacity1000 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...Robert E. Raymond Nov. 9 19 8 2 a Date --------. �.. ,.a Test Pit No. 1....... . 1.....minutes per inch Depth of Test Pit. ............ Depth to ground water.._none Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-------••-----------------------------------------•----.........--•-------...................---•--......................................................... 0 Description of Soil....0"-36" subsoil, 36"-144" med. sand & gravel x w UNature of Repairs or,Alterations—Answer when applicable............................................................................................... •-------•-----------------------------------------•--...---....._..........---------•-••--••--•--•-.•---.....---------------------------------•----•------------------------------------------•-•....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT,iE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianc as b en is ed by the, 'oard of 1 ealth. Ithfollowing igne . .....•..... Application Approved By.. . -- --•---.....--•------------•---•-•--•---.... .--- L yDateApplication Disapproved fo reasons:................................................---•---------•----------------•-----------Dat.e.............. -------------------------------------------------------------------------------------------•-----•-•-•---I-••••••••-•---•-•••••-••...........--•-...--------•••---•-•---...----------•---•-••----•------- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ Town Barnstable ........................................._OF..................................... , ppliration for Disposal Works Tonstrurtion f irrutit Application is hereby made for a Permit to Construct 1� or Repair ( ) an Individual Sewage Disposal System at Lot 31 Butternut Circle ................--....-........................................................................ ..•----•••----•---•••--------------•----------.._.._..-----------........._.-----.....---••-_..... Location-Address r Lot o. .... ThTheo Construction Co. Inc. .......24 Great Pond Drive eo _........ . ........ ... .. ......••...... --........ .............. - -........-- Owner Address w .......�0 Yarmouth.. M8a---••...................................... w Installer Address Type of Building Size Lot_29.t 2ao.........Sq. feet U� Dwelling—No. of Bedrooms...3......................................Ex anion Attic ( ) Garbage Grinder ( ) p-, Other—T e yp of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ...............................................................•-•-------••----•---•-••--••------......•••-•••••••-•-•-....-•-•-•----...-•••--....... w Design Flow......... ...•.........................gallons per person per .day. Total daily flow... 33Q _................gallons. 10 W Septic Tank—Liquid capacity 00gallons 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 ( ) Dosin tank ( ) a Percolation Test Results Performed by...giobert.....................E..........Raymond... ... .. Date......NOV......9.__!..__ .1982 Test Pit No. 1.... per inch Depth of Test pit.....'z.................... Depth to ground water----none......... fJ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a „ }... u.... .._ _�....:. O Description of Soil-----d...— �..____3ub80 �, 6 —X4�.__.I�teC . 8an� & CJrBV®� x --------------•-----------• ------.•..•. ••••----••-----•-•--•-•----••--•---•-•••-•................_••••••-•-••......--•--••.-- w U Nature of Repairs or Alterations—Answer when applicable..........................................................................I.............._._._.. ------------------------------------------•-----•----------•---••••--•-••---•---••••-•-•..••---............•---------••--•--•-•...---•----•--•-•---•......•--•--•--•--•-----.....--••-•--••--•• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ' ignede'...••._.........-••••--•...................................•----•-- fi Date Application Approved By....... ...... .^- ---•--.........--•-••......------•...... _. +&ate Application Disapproved f oir the ollowing reasons---------------------------------------------------------------------------------------•-•-- •--•----•-••....._ .................................................---------------•--------------------------------------......--------------------------------------------------------------------------................ 5 Date PermitNo..................................................._.... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF..................................................................................... Tntifiratr of (Sompliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ....:........--•-•••...._•-•.._........-• --• �,'""'-.�._... Y � --•---- --- --•--•. / Installer r....__... _....... ..."En--. ....__ m •-••••••--••••-•-----_-----•............... has been installed in accordance with the provisions of TITLE j of Tie State Sanitary Code as,descriJKd in the application for Disposal Works Construction Permit No.__ PP P . .....=-; . •....•-••--.. dated...._ ........... THE THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANAE THAT THE SYSTEM WILL FUNCTIOI�LSATISFACTORY. DATE............................................ .....-_........... Inspector.,........... ------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OF.. Barnstable ... .................. ................. No.. .'..... � FEE.... .............. Disposal Vorks Tonutrurtion rrutit Theo Construction Co. Permissionis hereby granted.............................................................................................................................................. to Construct (( XX)) Re air ( an In 'vidua Sewa ap ispQsal stem Lbt Sri, Wut'Ce..nut_ `Circlle, �Otu1L, a. as shown on the application for Disposal Works Construction Permit tNo.__.._,� »!D • .. ................ Stree oard of ealth DATE....................•---•--------....-------------•-•-•............•-••--._..... {� FORM 1255 HOBBS & WARREN, INC., PUBLISHERS + 6 �LEV=.•�YZ C�Fa.lE12A.L NOTES 7 ----1 - - -ALL ELC-\/ '5"oW♦j,) A2jW MEAkj SEA►, LEVEL• �`� BP SC D Or.l �j�,9'(��J c;w 9L1.l+I�E t)L)C60 "Y - z PITcI.I A.LL LIES A rat 141 1M L),fj ew- i/a'/FccDFT �( / � � UwiC.Eb`� �T'NE�tsE �p°EGaIF1ED. ALA- PIPES TO AWD !.d THFc SYSTEM SHAI_l_0 i 2d• • I r \\ /� DE' GA ST 12�r.1 c*'P- sL"E D U L.E 40 P C FI�t ALL gEPTK TAA1K$ DISrelgJrloJ mac• A► to O n ^11 � L,E�C!-1t�16, Prs� SHALL �E L"7E•S1GL►JEC� FG]Q N '-- - -- -. lJ © © `� — >ZEr10✓E ALi— E a0 UlJ TA3�.E MA.TE12 AL_ 8 ('S}, t o 000 � c) 00 a z-4+E 1l..1�/Eer ELEVA-rio..iS OF LEAC1-11.� PrrS fo[_ O C 0 A eAa US of (p' A#-J0 �CK-P%L4- w(TH C1_a►y- E \� iT ► ? [� J �1 SAw►O An.ID C�2.ravE� R-P'J _ TI , V - yy ► �E t k7TIF E� WHEN TF+c �ySTE►� IS NEAR F'- I L Q � C�J ®I CLAMPI_ETIO� J A��O P2toQ TO pi►GICFi 1.�u6w I Zo. Z" +-i Imo• f� , , J 'f v► L ESQ OTNEP_�r LSE t�soTE Q, SY51� � A> 1 PQ IJ>E A1T•S y4#A L.L 2 i O lY O Cj O PJE IwISTP.L�tV mj (�! r t AIC�CW C E W 114-t T(T L-E- E M;rgTE TYPIC4l. DIST2tbuT1O1J eyox c) Q c 0:iL y c�o>G AtilD Amy K�L �, � ►J C OT TO SCALE No UA 1L4" � r�✓�l Esc: T �trTE D�STet6VT.o.� Semc ^."t> IaDO <FA TNfP/GAL_ IONOO Gw+l-- .SETf6G TI►l� TY�PI Cd�_ FtACk1 1►.SG IT Q=&,C ✓A T/O A/ P'/r!� ,sy A E-e i c-- J P'eELtiST" ►100T -V0 scdLe MOT,-rc c^L-r- O� 4LJAL k6rsc.: -r^.jIcg QEajFcoc ED TlaeeLr.NoaT vE.t coLA rio N �� = Z/in.., /..�,c h WITH ELErT�IG �L/ELOED WI� Vf!"rH oa3e.ek-A710;v5 P.,, 2A - !/t' FMasEnC)ED STEEL (wS .J h10TE=,d,CGE'.Y9 MAhIHOI„�� C y TOT1'� gGPTIG T;►a.�f A,NA lCw..:HtwIG.. rt7g M6'rA.�.r 60,4tO ao- AeA,LTy bolTo►�1_ CoRIC. 16 �000 pg�- TEST .LT UP TO I W"CS r� > To SSE �V �.n Are,• . =MV�. {� t 9 .�.� TOf' FOLlPLDAT�Owfr SE lGV►J R!!.l 1'SN 6 V'�►y'7�r F-Lev. t NYC Ftr.LlslL �canlL F I►J►SrI aefA oc F 6c^ pc GvsIL /FINISH G[s•sE r [)JEC T�►+CK� C>vE¢.�. :7K_' IE,AGN�Nr �Gsfxp ID-7 Lc�rI - LL _.... •_ _ air _ ,y G O0. 1�OC3 6�►L 1M1/ • © ® O � . r ¢US►dE c) 3To►!t cc W Focl T> CA44C. D►s-r Ysorc O ® 4 m m000 � fir Srenc. TA." �'• m O 0 0 m ; I� • E�>Ev 55rT \ I TYPICAL 2E1 ^GC 3�TEM f FIL.E 8�0' LEACNMI& a I h{oT To SCA L 6 N AL- br J '� S ' S>✓P�Ic mat. � d L,=^C.I4tNG I011' 10 z If-G END �U 1 IEe C C1LC yE��GN C.erTEel-4 ��'' d vkey,157' 4? cawAf PROPO5F-L) DRUCLL I ICIG LOCAT l ON iV!/M B ESP O F dEO.e GL')M S � � EX/'jT ,mar Ec•�v- P R o P o s ED S E.wa G L O l S P o SA L PE,C Sa i,/5 �E.� �v.E'OO M _. �' f Rao .�dl E[�/• i ('; -? � } '�3, � -�-�'r t' t~ �, ?T ^.!t?[L._.�_.. 6vrLLGtc/S /'Et' . CX.N PEPo� r _.� _ - PEeclhw Aa- �fr+cAlinr6 Ae64 zea urtEr, -. Apo o 7- , E5AC kA eSTAR,►---e &0rL) k T MA SS L6Ae-.,IIA 16 Ae.--4 �l FQOPf�SED LLACNIIJG IT .�PPLIGAAIT GILiWL--Q'. a v v►5�o��.�... Zd• G¢.EAST �+o O Q 1�/E 39 Sre.�PIg2 .,o.,..U? 100 °� [ XPAKISION t S�k.1E2 �E.S�G r.J So. YAR"CXJM) MA-. , & Fp�.MUvT1�, M 1�• , 377 Ca P O SCALE. DATE: SHEET 50 G Po AS ►DOTEDTCTXL- DRAWN MY. C HKO BY: A►PO BY: PLAN PLO. 13.S fly 401' ASSESSORS MAP : TEST HOLE LOGS NOTES: PARCEL:I- � �`� r FLOOD ZONE �G'sTr � G/Cq� SO L EVALUATOR _�_.. _. __- ..._ _._._..w WITNESS : -D0Wt4 C) V_ 1) The installation shall comply with Title V and Town of Barnstable Board of r� REFERENCE: )E:CD /� ?!� ZOsovQ T)K /�, DATE: l40 i Health Regulations. u. f,F/277,�'i, Q / /�L PERCOLAT ION RATE: L 2. % 2) The installer shall verify the location of utilities, sewer inverts and septic -- "' components prior to installation and setting base elevations. - lie - _ ` ' 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first / Z/ two feet out of the d-box to the leaching shall be level. g 4) This plan is not to be utilized for property line determination nor any other _1:�O .. � _ 1 ?� 3 a 1MAO 4 Z purpose other than the proposed system installation. LD I Vj 3 Lb � _5) All septic components must meet Title V specifications. [n b��j D �`l * D`J 6) Parking shall not be constructed over H 10 septic components. L 0 CA T I ON MAP ����l�l $� ' 5 7) The property is bounded by property corners and property lines. J f 8) The property owner shall review design considerations to approve of total AAW,, fL4e- Wko design flow and number of bedrooms to be considered for design. Receipt A toly 3 �' �, r✓ �� of payment for the plan and installation based on the plan shall be deemed to r. t -� approval of the design flow by the owner. 9 The existing leaching or cesspools shall be pumped and filled with material i ) g g P P P per Title V abandonment procedures. Those within the proposed SAS shall be removed along with contaminated soil and replaced with clean washed N - sand per Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the ` t " water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if SEPTIC SYSTEM DESIGN applicable. d 11) If a garbage grinder exists it is to be removed and is the responsibility of the � ! owner to ensure such. FLOW ESTIMATE �El 12)The installer is to take caution in excavation around the gas line if -11 applicable. 2 BEDROOMS AT 110 GAL/DAY/BEDROOM -�� GAL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer t0 `l \ lines exiting the dwelling prior to the installation. o SEPTIC TANK o too � L' 14)Access for installation of the proposed septic system will require access M' 0\� 22GAL/DAY x 2 DAYS - '7�q GAL permission from abutters. It is the responsibility of the installer and or Aowner to obtain access permission.- USE MOO GALLON SEPTIC TANK E�I�W(r x-�� S01 L ABSORPTION SYSTEM �5�, F—F�`�;,, r "". .a t)A' ID �-') \ e SIDE AREA: Z>C uI �-} 1 X Z X C7r? ^ /a9, Z �4 T � j \ \ BOTTOM AREA: Z / �. X ., 017 230, j �, 1',^-a e � AA \\ SEPTIC SYSTEM SECTION 4T,5), J _ A'X 7 __ ,Mw•l, tutu, — r q ff� L- 0w a17_ tat( z Tbke o . ...Y O Z O-0 GAL . SEPTIC TANK IN 0 0 . SITE AND SEWAGE PLAN LOCAT I ON �. PREPARED FOR : �I r,';c uf- !�ry • T SCALE: = W :* DAV I D B . MASON RS DATE: DBC ENVIRONMENTAL DESIGNS z \ EAST SANDWICH . -MA 4,."CYO`:tr3 , DATE HEALTH AGENT ( 5O8 ) 833- 2 177 , �A