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HomeMy WebLinkAbout0190 CLAMSHELL COVE ROAD - Health 190 Clamshell Cove Road Cotuit F A = 005 050 i i i�, No. . W --I L ;I- s r Fee 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS application for Dig opal bpetem Com5truction Permit Application for a Permit to Construct( )Repair(i, )Upgrade( )Abandon( ) ❑Complete System R4idividual Components Location Address or Lot No. Ow er's Name,Add re s and Tel.No. low Assessor's M�p/�az� 7— Installer's Name,A dress,and Tel.No. ( / U d/ Designer's Name,Address and TelYo. eat z Type of Building: Dwelling No.of Bedrooms Lot Size �-i/ W sq.ft. Garbage Grinder(��Q Other Type of Building ` o.of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow . il 4 © gallons per day. Calculated daily flow 5- gallons. 7_Plan Date / 7.05_ Number of sheets Fevision Date Z Title e ul- e- 1 Size of Septic Tank Zg ©W/ 4! i /�4Y Type of S.A.S. — el 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 Certifi- cate of Compliance has been issued b =thiBd o Health. J> Signed Date `� `v _ Application Approved by Date Application Disapproved for N following reasons Permit No. 2C�S —I Date Issued —5 U a ————— �No. ✓ 1� .Z :ram' A � 4 Fee loo— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: a , Yes _ PUBLIC HEALTH DIVISION - TOWN O�yEy BARNSTABLE, MASSACHUSETTS 01ppYtcation for Mtgpaaf *potem Construction i3erntft Application for a Permit to Construct( )Repair(+' )Upgrade( )Abandon( ..) ❑Complete System U Individual Components Location Address or Lot No. Ow er's Name,Adds and Tel.No.�30� Assessor's Mpp/gpr�eL- Installe's Name,A dress,and Tel.No. Designer's Name,Address and Tel.No. '-7 7/ 3e,,el Type of Building: Dwelling No.of Bedrooms -/ Lot Size Z3i y��sq.ft. Garbage Grinder Other Type of Building /.fs t°eCC_No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7 7 D gallons per day. Calculated daily flow Z gallons. Plan Date 11Z755 Number of sheets / revision Date Title Si* X- .5 e wQ9e 4'yl5Xk��Cam yc% Size of Septic Tank � Type of S.A.S. ? -57�4V 50-eP/ Description of Soil 3 Z 6 ���' �1 �© ii� 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 Certifi- cate of Compliance has been issued o-v this+Bo d of Health. Signed 1 Date 3-4z'le:7_5 Application Approved by �1.r Date o% V Application Disapproved for the following reasons Permit No. S - Date Issued 3 3G 0 S! 71 -----=----------------- --- -------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (fertificate of (Compliance THIS IS TO CERTIFY,that the On-site,Sewage Disposal System Constructed( ) Repaired ( ) Upgraded ( ) Abandoned )by at //`, G.� S CQG� �` �Q�� has been construct d tr./accordance with the provisions-of Title 5and'he or,Disposal System Construction Permit No_._D Cos- I I a dated � 3 G/ S~ Installer Designer J� The issuance of this pef it shall not be construed as a guarantee that e-system(wilil-ft4nction as designed. Date �/ �`! Inspect No. .2 GU _ 1 Fee /UCH THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS xigpogai *pgtem (fongtruction permit Permission is hereby gran ed to Const/act( ) epair Upgrade( )Aband�" ( ) System located at � 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: Co stru tion must be completed within three years of the date of 's pe 't. Date:_ /J U o s APProved by12 f TOWN OF BARNSTABLE LOCATION I9© SEWAGE # •ZGG''J //� VILLAGE ASSESSOR'S MAP &LOT t o INSTALLER'S NAME PHONE,NO. 43, IA, AA Y?p ?�2( SEPTIC TANK CAPACITY. DAD' n_& LEACHING FACILTi'Y: (type)\r 66 C (size) NO.OF BEDROOMS y BUILDER �0 _ /S e i� PERMITDATE: 3"70- COMPLIANCE DATE: 1 V Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) �^ Furnished by 3✓6 y�, y3 s� Town of Barnstable Regulatory Services Thomas F. Geiler,Director + BARNSTABLE, + 9 A 163C9. MASS. Public Health Division rED N1°� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: ?i D S Zpe S 11 005 ©S r / , Designer: �til.tNS�o�.r �p,i-Y`�o,r� Installer: 1�0/1 Address: (A t5- �Ws_0 Address: &L) Ykrrn0\4 On 3,y01��,5— Dr/mg/ was issued a permit to install a (date) (installer)septic system at 1 G l a vvl 5 I l C v,c.. IZJbased on a design drawn by (address) nn r V-s10 W 5 1-�R dated� 'I2 v� 9 to s cam- 2 1 q f v:� (deAignei) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF •-' (Installer's Signature) WINSLOW cyc M. SPOFFORD,.lIe hi . y TEa�o Designer -igna a (Affix Designer' PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BA.RNSTABLE LOCATION CI&1,V,S l,11 SEWAGE # VILLAGE ASSESSOR'S MAP & LOT_ INSTALLER'S NAME&PHONE NO. /�ar ,�d7rtt' CtJ.VaJ�isr�`:�N-� Y-274(92( SEPTIC TANK CAPACITY LEACHING FACILITY: (type) IZO GAL C&VAM)�� (size) 13 NO. OF BEDROOMS y BUILDER "OWNE PERMITDATE: 0 r COMPLIANCE DATE: —1 V Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5 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 //t Feet within 300 feet of leaching facility) Furnished by_. /yl 1r17 4� SS P%Wc-Il 01 COMMONWEALTH OF MASSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS','_:+ 1;'E DEPARTMENT OF ENVIRONMENTAL PROTECT,I.ON } 7JAN � FNIED INSPECTION 00 T OVV N OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: A SAP Owner's Name: Owner's Address: ��L' %,RCEL. _ ®�O Date of Inspection Name of Inspect (pleE�print) t Com p Y an Nam �- , Mailing Address: oQ Ve Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in-the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ,.-' Date: //C�4,q&y Z_ 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 repot to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if.applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I i i Page 2.of.I 1 i t OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A rCEL RTIFI .AyTI.ON (continued). Property dress: /Ad drew Owner Date of I Pection o� Inspection p Summary: A B C D or E./ALWAYS Y , S complete all of Section D A. System Pas ses: sses: I have not foun d an. information-which 'y h 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: 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: Observation of sewage backup or break out or high static water level in.the distribution box due to broken or obstructed.pipe(s)or due to a broken,.settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system.required pumping mo-a than'4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health):. broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A / CERTIFICATION (continued) Property Address: / go / A � Owner: A� i ,/ Date of Inspection:t��� C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board o=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 dete-mines 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 withir a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is withir_ 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100,feet but 50 feet or more.from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a EEP 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: 3 , Page 4 of I 1 OFFICIAL.' FFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: Date.of li?,spection,• (� 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:c'Iogged 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 ''/z 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 groundwater elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ _Lz,, Any portion of a cesspool or privy is within a Zone I of a public well. _ ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well-with no acceptable water quality analysis. [This system passes if tite 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.] (Yes/No)The system,fails. I have determined that.one or more of the above failure criteria exist as described in 310 CvIR 15.303,therefore.the system fails. The system owner should contactthe Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a.large'system:the system must serve a facility with a design flow of 10.,000 gpd to.15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply:to large systems in addition to the criteria above) yes 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.—I WPA)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. 4 Y Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION'FORM PART B f CHECKLIST Property Address: Owner: Date of I spection �: Check if the following have been done. You must indicate"yes"or."no"as to each of the following: Y o r/.. Pumping.information.was provided by the owner,occupant,ar 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.voltmes 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 in.erior 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 owne-)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no Existing information.For example,a plan.at the Board of Health. — Determined in the field(if any of the failure criteria related tc Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 5 Page 6 of 1 l OFFICIAL INSPECTION-FORM_NOT FOR VOLUNTARYASSESS'MENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1)0 Owner: We Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(:design):_a. Number of bedrooms(actual) „ DESIGN flow based on 310,CMR 15,203 (for example: 11.0 gpd x#of bedrooms): Number of current residents: Does residence have.a garbage grinder(yes or no): is laundry on a separate sewage system_:()1es'or no): .[if yes separate inspection required] Laundry system inspected(y s or no):40- Seasonal use:(yes or no.)3 ly ... Water meter read in as ifava'lable(last2 years usage(gpd)):&/)6- ���l1lD O� r DC Sump pump(yes or no): Last date of occupancy: � 9� COMMERCIAL/INDUSTRIALV'-" Type of establishment: Design flow(based on 310 CMR.15.203): gpd Basis of design flow(seats/persons/sgketc,): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the T. -tie 5 system(yes or no):-_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes o no)• If yes, volume pumped: gallons--How was qu nh� 'ty�pumped determined? Reason'for.pumping: TYP OF SYSTEM OF tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system.(yes or no)(if yes,aaach previous inspection records, if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy:of the DER approval _Other(describe): Apr i n to age of all components,date installed(if known)and source of information: 77? Were s . age odors detected when arriv_ng.at the site(yes or no): '� 6 Page 7 of 1 1 ` OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1,96 ( X ��4 Owner: ' Date of Ins "ection:, �✓�/yX�J�P,( . ��(�r� ` BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage, etc.): j SEPTIC TANK: (/'(locate on site plan) j Depth below grade: _ Material of construction: concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: j )((p . K Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: _ Distance from bottom of scum to botto of outlet tee or baffle: How were dimensions determined: Comments(on pumping recomme ations, tnlet and outlet tee or baffle condition,structural integrity, liquid levels s elated to outlet invert, ev WO Bence of leaka , etc.). All GREASE TRAP locate on site plan) , Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I I OFFICIAL.INSPECTION FORM,-,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: d C�e ,C �!� � Owner:. � Date of Inspection 190 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___yolyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallonsiday Alarm.present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: y Comments(condition of alarm and float switches,.etc.): DISTRIBUTION BOX:Zof present must be opened)(locate on site plan) Depth of liquid level above outlet invert. Comments(note.if box is level and distribution to.outlets equal,any evidence of.solids carryover,any evidence of .� age.into or out o box^ PUMP CHAMBER(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note.condition of pump chamber,condition of pumps and appurtenances,etc.): j 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(;--ontinued) Property Address: v Owner:Da O(� te of I pectio pQ SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type Teaching pits,number:L 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 pending; damp soil;condition of vegetation, ): 6L /'o 'Aw P ZI xl/ LA,'J Pi � o (-A > ;, � �-ram e,Z- . 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 or no): Comments(note condition of soil, signs of hydraulic failure,level of pending,condition of vegetation,etc.): PRIV% (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.): 9 Pace.1.0 of 11 j OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C G SYSTEM INFORMATION(continued) Property Address: Abae4a � Owne*specti (� Date oon:: 4D ' � a?r y0� 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. f� (oc o odor) 30tc, a3 1�hpttl 10 Page 11 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of In pection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abuttir_g property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation). VAccessed USGS database=explain: You must describe how you established the high ground water elevation: 19x� � � FZ07/' e 11 Permit Number: Date: Comple,.ed by: � HIGH GROUND-WATER LEVEL COMPUTATION Site Location: /` �C-��/C� Lot No. Owner: �70 ��� /�1i/� Address: Contractor �` � / C� J` Address:. ✓�� Notes: STEP 1 Measure depth to water tEa' le q to nearest 1/10 ft. ............ z` 9/0 < . ................................................................... .Date � month/day/year 7 STEP 2 Using Water-Level Range ?one and Index Well Map locate site and determine: 1 0 Appropriate index we-1........................................., •• OWaterdevel range zone ........... ' STEP 3 Using monthly report "Current Water Resources Conditicns" �y determine current depth to 1plpq 7s� water level for index well ........................... month/year STEP 4 Using Table of WaterdevEA Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3.), and water-level zone (STEP 2B) L determine water-level adjustment .......................................................................................... STEP. 5 Estimate depth co high water by subtracting the water- level adjustment (STEP Q from measured depth to water levelat site (STEP 1) .................................................................................... Figure 11--Reproducible computation form. 15 F j i r i F i i . l i i}- . IE G; i b f ( E f3 --___--� t j C • r ' 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property 110 e�•�wsty�i ccw LOB Owner' s name Date of Inspection ' _ PART A CHECKLIST Check if the following have been done: ✓ Pumping information was requested of the owner, occupant, and Board of Health. ✓ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on . the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS.' i I 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential �i number of bedrooms �- number of current residents 'garbage grinder, yes or no- laundry connect to system, G�) or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: Last date of occupancy GENERAL INFORMATION Pumping records and s urce of information: System pumped as rt of inspection es or no if yes, volume pumped Reason for pumpin Types 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) ' Other (explain) Approximate age of all components. Date installed, if known. Source of information: Sewage odors detected when arriving at the site no Yes o 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) t� depth below grade: material of construction: concrete metal FRP other(explain) dimensions: sludge depth -liedistance from top of sludge to bottom of outlet tee or baffle 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 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) -ty depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments : (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs, etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: . (note condition of soil, signs of hydraulic failure, level of ponding condition of vegetation, recommendations for maintenance or repairs,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, - c ondition. of .vegetation, recommendations for maintenance or repairs,etc. ) 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE i:SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks i locate all wells within 100 ' i 3�I �f f DEPTH TO GROUNDWATER depth .to groundwater method of determination or approximation: 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) Backup of sewage into facility? Discharge or ponding of effluent to the surface of the round or surface waters? g Static liquid level in the distribution box above outlet invert. Liquid depth in cesspool <6" below invert or available v <� olume 1/2 day flow. Required pumping 4 times or more in the last year? number of times pumped �1 Septic tank is metal? cracked? structural) unsound? substan tial ntial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributaryto ` water supply? a surface . within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt mars and h (cesspools privies only, not the SAS) ? within 50 feet of a private water supply pp y well. less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be -acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen = and nitrate nitrogen. !i ICKEY �aneGwu.Gari�a, �'rec SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM CERTIFICATION Name of Inspector: Donald Perkins Company Name. Hickey Construction Company, Inc. Company Address. 38 Rosary Lane, Hyannis, MA 02601 tel : (508) 771--4128 Property address: Certification Statement : I. certify that I have personally inspected the sewage disposal system at this address and 'that the information reported is true, ;:accurate and complete 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. Check One : I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303. Any failure criteria not evaluated are stated :in 'the FAILURE CRITERIA section of this form. I have determined that the system fails as defined in 310 CMR 15., 303. The basis for, this determination is Provided in the FAILURE CRITERIA section of this form. Inspector' s signature\ \ �_,�� �► Date: L�15� 1 Original to system owner: C-0 0-1) t 9 , Copies to. Buyer (if applicable) approving authority 38 Rosary Lane • Hyannis, MA 02601 508-771 -4128 ad No.. Z' Q�... .. Fms.... �................. JTHE COMMONWEALTH OF MASSACHUSETTS BOAR® Off` H EALTIga,FCT ro AP�.i�vl ! �� BARNSTABLE CONSERVATIO) 1 se - 3 ..........................................OF....................--.--.---•----........--------------------------COMMISSION - gf 7 Appliration for Mipatial Works Cnnnitrnrtiun Vanfit Application i her y made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: «R . ..... . .... -------•----------------- ------------ � i.f l��t s S ....... ocatio Addre F Lot N (,lJ IA.Xc.ar..�I .�4............................. .....`5. q�4 Ad r a Installer Address GQ ® S Q Type of Building Size Lot_____...?. .........._.. q. feet U Dwelling—No. of Bedrooms.............3._._..._.._._.....___..__.Expansion At�t}'c (111�) Garbage Grinder A) Other—Type of Building 0 W -+.NCB.. No. of persons....... ........ Showers (1J) — Cafeteria (Nk)) Q' Other xtures Vlir........ A-T.1-H.••-•-- Q ---- -----------------------------•••--------- w Design Flow....... .. ..............................gallons per person per day. Total daily flow............. ....................gallons. WSeptic Tank—Liquid capacity. 0dSO..gallons Length................ Width_............. Diameter................ Depth................ x Disposal Trench—No..................... Width ....... Total Length.................... Total leaching area....................sq. ft. r Seepage Pit No-------/......... Diameter.Zq.......... Depth below inlet.....6.......... Total leaching area..�2.�..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Res`ul!t , r�Performed bY--••••...•••-••------------•------•------•• f= --------------- Date................................ a Test-Pit No. 1.__..._h-____minutes per inch Depth of Test Pit.....f��..._... Depth to ground water-_Ntl•!�-_�lu�4�m N/gTest Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-- --•--- ---- - --------------------------------•-------------------•-•-•-•-•-•-----•---••------•--•-----..-..---- O Description of Soil................. © 'eL / ......... 1 pS0 .......... �4 •-------•-•-•---------------------•-....-•-•-----•-----------....__..._..--•----•---••---•--••-••••----••------------------------...-••••••----------------••-----•-•----•----......•-•--•------•-•-•-•. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ...................................................................................................................•--•••••••--•-•-------•----••••----•-•--••--•-••-•---••---•-••----•---•._......•--. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal n accordance with the provisions of TL l i U 5 of the State Sanitary C ned further a es to place the system 'n operation until a Certificate of Compliance has, een 'ss o alTh. Sig, d•. . ..... .... ......... ----- .................................... --- Dat Application Approved BY •.. �rT%`�� L Date Application Disapproved for the following reasons:......................... ---------------••------•-••---••-------••-•.•---.--------•--...... ................ ..•----••-•-•-•----•-----•••------•----•--•--•-•-----••••-•--•......•-•---•---•-----•••---•-•---------------•-••-•-•----•---•-••----••••••-•-------.................................................... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .--•---. --._ ....._------------------OF................................_..... Applira iun for Disposal Works Tonotruriiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. � ...... ..-k .... COl"U r-T...�..-VV!a� = .... or . Location-Address Lot No AA w, AA ......................_.......................................................................... ..........--................. --....__Aa-r_____.......__________......__---•--.......--• r a �_ .......... ' a• _ F � Installer Address U, Type of Building Size Lot....13______9 .. Sq. feet a ; Dwelling—No. of Bedrooms................. .............. .....Expansion Att'c (A10) Garbage Grinder (N) as Other—Type of Building D '�__ No. of persons...... -.............. Showers (9)) — Cafeteria (1%) dOth xtures •. z 11 --------'1�- +1.-----------••----------------------------------------•-----•-•-�-- w Design Flow.......53..............................gallons per person per day. Total daily flow............ ..................._gallons. WSeptic Tank—Liquid capacityl.OdO..gallons `Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. 4.................. Width__.__ :.._.__._.__. Total Length__:i......�...... Total leaching area..._...._..._..._..sq. ft. Seepage Pit No......,-----_-__- Diameter..�U.......... Depth below inlet.....�4P............. Total leaching area..7_.l�....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by................. ... Date........................ Test Pit No. 1.....rt.t,.....minutes per inch Depth of Test Pit--_--rN..__.._ Depth to ground water... a ._. ------ 44 p41ATest Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------•---•-------------- tf -•--....-•-------.....------...--•---.........._..._....---...-----........--------....-•--------......-----•-- O Description of Soil....................Q--'?.S.rii...•... 5 1.L-.......................................................................................... w U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------•----- ------......----------•---------------•-------•-----------••-••-••--•.....•-•--•-•-••---•-••--•--------•-••-•---•------•-••----................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 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. Signed................=---•-------....---•-------------------•-•-•-•---••---•-------------- ------------------------- _...... Dat Application Approved By._._ -���.;_./7..__ _� � .. -----------------•-----••------••--•--- ?/ Date Application Disapproved for the following reasons:................................................_............................................................... I ---------------------•-------------------....---•--------------•-•-•------•----------•----...----•--------••--•-•••----••--------•-••-•••••-----•-•••-•------•-•-•-••......--•---•--••-................ Date PermitNo......................................................... Issued_=.................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF........................................ �rr�ifirtt�r of (�unt�linnre ' w, ` THIS IS T ERTIFY,,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................. .•. _ ...................................... ................................................................................................. ' has been installed in accordance with the provisions of TITTE r,1.� The State Sanitary Code as described in"the application for Disposal Works Construction Permit No..t..Z: ..... .............. dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector.................................................................................... t f THE COMMONWEALTH OF MASSACHUSETTS 6 BOARD OF HEALTH .........................O F......-----......................._........... '................................... No.. 2... .f7... FEE�f................ Disposal Works Tunstrnrtiott Prrutit Permission is hereby granted------.....! '----------------••-------------•-------...-•----.....----.........--•-•----- to Constru '(_<Ior Repair ( ) an Individual Sewage Disposal System _ at No.•-•-..... A"/.t Street as shown oythea licatio for Disposal Works Construction Permit No..................... Dated....__......_............................. Board of Health DATE--_lZ ............ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS I- v p v �� E 5 s C•77 -3 A v �t�of MN,� /00 y�7}/L _._.. ... . I .�" ,. MO N 298740 o Of 15-7 MAW. -zn _ V v — _ 5' 10 ' _ - _ _ p � 313 45.S(-O-sF .� �= 3® `' i4 �Q ,a; a� U,— I r/+ %.= 5:�,— ,;n �,�P . \� o�.+� cep 1 . 3¢ � - � UtiG�2 A�"r"]i1 , r!ARr _a; tiI/P PAuL J . M IUKuS 29 0 I / 1 68 c_�` Q `vet ;'' d -�J--- - �, � o� P.:!•=:tC c�N us.C.a6S. •. � � Fire T SC F-L• 55.11-7 .�A �•py"� �^� � NYl T--L O= M.S.L. _ C -S2I • 6 _ Ems, .���- 3> 3. o �ir 8 p• � 4 Tbp of C-5 O - . ELF' _.. -- --°- Ufi)Jb -po le LEGEND of CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION CAA EXISTING CONTOUR --- O —— — 02� ALBE G FINISHED- SPOT ELEVATION KN �►! 'i LO7 5R CLAMSHEI-L COVE R`P CDruT► FINCISHED CONTOUR 0rnoRSE p No.10951�O �Q 1 N APPROVED BOARD OF. HEALTHQ' 9o�FSCISTE��;�`` S/O`NAt� y � � 1498rZ DATE AGENT SCALES /" = 1�.0' DATE1�1u1, r i '8Z L®REDGE ENGINEERING CQ 'N CLIE.NT1►'to„x P,„}-+ I CERTIFY THAT THE PROPOSED L ISTERE REGISTI:�q JOg Ito, Zl,1 BUILDING SHOWN ON THIS PLAN CIVIL LAND TJDD CONFORMS TO THE ZONING LAWS GINEER S R Y DR.BY OF BARNSTABLE MASS.4 EXCe-PT 712 MAIN STREET.. CH. BYE HY,ANNIS,. MA�*3. SHEET_— OF DATE ( REG. LAND SURVEYOR 1 20 FT. M/N. n /YOTE /F E/•rNE•4 Ts/E S APT/C TAN-/C OR / _Ef#CH/NG O/T ARE 1%JORE 7-H.9:`/ /2"BELOJV /r`O f7' M/AI. 1.RA10E, A 24 'O/A14E7-.ER CONCRETE COYE.P !�- SHALL BE 3ROU6H7- TO G,qA CO/VCRCTE i 4'PV 4 P P/PE /yEAVY CA ST /RON CO P/ER SNAL L 3E USED EL= SB.S COVERS - /TCN /F//V OR/VEy,V, y �.•:'• �B PER FT. . A :`a Cy AOE CC) ✓E'/z C'L E14N .SAND 7 . 4= 4"C/IST 'LAY ;;b� M/N. P/TC/✓ 1000 GAL. o• o r • • • • • • v •ate yYASHFO STJNE /•T SEPT/C TAN/C D/sT, b r r . . o A g,: a rr $ • . • • rf .•• • • r • r r rEFFECT/VE • • o • 3�4 r- �2., �':�- • • � r • DEPTH • r r � • 0 14�.431•!ED STONE Je''�:i . • r r • . • • r r . ' 40 188•S x I•S - 4-1 1 C.�D i • • . � • • . . p •�o PRECA5 T SEEPAG E IIVV& r &4RV 1T/oNs 7B•S k I.O -78 61 D ° . •� • • • . . •a ar o P/T OR EQ[J/V. _- �= ILI /NYE'RT AT DU/LD/NG 35.5 FT P(TcAPAc!T-( : 549 v 1 D INLET SEP IC- 7-.4N/C' 35.3 FT, 10 FT. D/AM. til C SEE T-041LA77/OV) OUTLET SEPTIC Ti1/VK 35. I ,cT I/VLET o157R/8!/T/ON sox 34-9 FT. SECT/ON OF GROUND WATER TABLE OvTLETD/STR/B[/T/ON BOX 34 -7 FT, //VLET LEACH/Na Fl/T 34.S FT SEWAGE O/SPOSA L SYSTEM LEACH//VG P/T 'TABUL�4T/ON SCALE % ~ _ / - O� D/MENS/ON A DES/G/V CRITER/A D/M.FNs/O/v J3 L FT. NIJMdER 4F BEDROOMS 3 D/HENS/ON C Q- FT. (,\Ai ti) G'AR6AGEO/SPO.SAZ. (JN/T SO/L LOG TOTAL E3T1MfrtTED FLOW -�A a L.1DAY SO1 L TEST */ SOIL TEST*2 SD/L TEST ,(UMBER OF LEACHING P/TS_ I f^ELEK ELEY. DATE OF SOIL TEST MA 31 , I` B I S/OF LEACH/NG PER P/T 168 SQ PT. RESULTS yV/TNESSED BY 1SLA\1ri.rsr�( .90TTOM LFy1GN/NG PER P/T �6 $Q, FT O -14 �L PtRCOL.4T/O/v itATE , / LESS TOTAL LEACH//VG AREA 2loCa Sip. FT. Pe tC0LA�'/ON RATE A&2 F}��`` MIN.�/NCH RESERVE LEAC'.'//NG AREA 2� SQ. FT. oo `,A OF hfq p POD A OF M,4SS o= JOHN r �v� p`' ALQ�R y ��� I-7 •F A, z Ro9€ F 4 o ', M40RSE j 11�2SB74 C S rA , No. 10951 1 \ ��G/S•rE�pQ' I/� 'DO�FG�STEP �c. "0 1��<25,5 c ELOREDGE ENG/NEAR/NG CO,/NG. 111 7/2 MA ST. , VYRNNiS, MASS, / No SURD sslONAI\-� NO GROvNv YYArem ENCOUNTERyOt �-,aT`) CL/ENT: �'G i�Er,; DATE JUL� 13.1�8ti i t GRO UVL> ;-VATE.P A7' EL<v 2 O-m04,- Hl6i I ,L 2 c� rz JOB 8 NO: 21 cl $HEFT_OF (d 2oto 0400 d l �-nu a2 "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." �!;DATE: JAN.10,2 .-- CAPE & ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301C MASHPEE, MA 02649 --------------------- - --- - ----------- -------- ------------ PROPOSED WALL SECTION QO ' VINYL C-LOCK 3"X 6"WHALER HORIZONTAL PILE NOTE:/\\��� �,.,, r BE MACHINERY SHALL ALLOWED IN WORK AREA 36" MHW EL.2.3 SAND/LOAM MIXTURE EL.1.7-EL.3.0 — PLACED BY HAND ONLY =III=1 I=III 10' Ali Of �y Gv, DAVJD CHAR g 08S AL LANOS��a R 12" 0 1' 2' 3' 4' 5' SCALE IN FEET _ WILLIAM PRESCOTT CAPE & ISLANDS ENGINEERING SHEET 2 OF 2 JAN.10,2010 MASHPEE, MA ELEVATIONS ARE BASED ON MLW "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." DATE: JAN ,2010 CAPE & ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301 C MASHPEE, MA 02649 SHOESTRING BAY -2 -1 FLOOD i 8'x 12' FLOAT -2— 3'x 18' RAMP LOCUS EXTSTING \ �t �� COTUIT QUADRANGLE -1 4'x 3 ',P-IEk ANTIS, GERALD A. & CAROL S. E—Lw EL�O S 12 176 CLAMSHELL COVE RD MLW EL•p p,,, .... ,� o��o P� OTUIT,MA 02635 RSH� � SALT MA Lpo MKW EL.2.3 EXISTING 3' WIDE $0��0 STAIRWAYS & LANDINGS EXISTING VERT. 12 LOG WALL TO BE REPLACED WITH C-LOCK VINYL OWNER/APPLICANT: WILLIAM PRESCOTT 190 CLAMSHELL COVE RD y COTUIT,MA 02635 "OF c QAVIQ �f00 �✓ LES M CKI • 2808 MIKUS, P RIC1A L. Q C/O TSIHLIS, MES TR GrstER +° 26 GLENBROO f�bRI IArooS°" ARLINGTON, MA 0 74 . . . . . . . . . . . . . . . 20 10 0 20 40 ELEVATIONS ARE BASED ON MLW SCALE: 1"=20' SHEET 1 OF 2 JAN.10,2010 PLAN TO AMEND LICENSE NO.10203 WILLIAM PRESCOTT TO REPLACE A VERTICAL LOG WALL WITH C-LOCK VINYL IN SHOESTRING BAY, BARNSTABLE, MA CAPE&ISLANDS ENGINEERING MASHPEE,MA TOP of STANDARD, NOTES FOUNDATION - EL �_ Raise �covers to within 6" of , u,p finish grade install` riser as needed _ Q _ R THE INSTALLATION OF A SF.PTI .- N G. GROUND SURFACE EL_ _ ' GROUND SURFACE e ^ 1} THIS PLAN I5 FOR . C SYSTEM RM TO 3i0 CUR 15 0 THE STATE RONMENTAL C MIN _ TITLE 5T ANDT THE TO f.Y OF _. B nstab MATERIALS SHALL SUBSURFACE DISPOSAL REGULAPIONS. ,Z) ENVI ODE t BEEN MADE TO C L NC AVAILABLE MATION H ED DEEDS ' Z' 3) NO DETERMINATION HAS BE AS OMP IAN OF ILABLE PROPERTY INFOR WIT RECORD "y TOP EL OR ZONING REGULAT1011S. N 2''LAYE R nouaLE WASHED 4) T.OWN WATER DOES 4&'SERVICE THIS PROPERTY INVERT EL 10 D-BOX 'lr �1i2' STONE ,: 5 HERE`ARE N0 EXISTING WELLS WITHIN 200' .OF THE PROPOSED SOIL ABSORPTION'SYSTEM. Existing �: ,. 14. _ .. , • 6 OF FINISHED GRADE '� _EFFECTIVE 6 ALL COVERS OF SYSTEh COMPONENTS SHALL 8E BROUGHT TO WITHIN E-ZATT72R7 } W INST SIDE ALL ALL ,j • CTLY INVERT EL ALL LOCATED.DIRE N CTIO . NO STRUCTURES SH BE DR INSPE N a 7 ALL SYSTEM COMPONENTS SHALL REMAIN ACGLSSfBLE F�• B S��-BASE �bAll1'L.L' " y ..INVERT EL �, b UPON-OR ABOVE THE (OMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE' PERFORMANCE, ACCESS INSPECTION Droposed •� 3/4'- 1 D,S ONE DOUBLE '. � � WASHED:STONE � PUMPING OR REPAIR.�; INVERT EL D Box INVEI?T EL ►��,F'tve: Hundred Gallon 3 ' BOTTOM EL - 8) : NO DRIVEWAY, PARKING OR TURNING AREA, VR OTHER IMPERVIOUS AREA SHALL BE:LOCATED ABOVE A SOIL ABSORPTION (Typical) Cohc. Chambers 2. :9c4'-t0'x 8'-6" . Existi SYSTEM, EXCEPT WHEN VENTING HAS BEEN PROVIDED (or similar) %► -!t�'- - . 1000 Gal Septic. 'ank i 9} SEPTIC- TANKS,. GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES' SHALL BE PLACED ON A 6 STONE BASE L-_ ) (Typical) S ENSURE STABILITY .AND PREVENT SETTLING. , �� ' k �- '�' �-• UTION i•.'NES SHALL REMAIN LEVEL FOR A MIMMUM OF THE FIRST TWO FEET OF THEIR LENGTH. EL Z� �� BOTTOM OF TEST ROLE 10) .OUTLET DISTRIB _ . 11) ALL SYSTEM COMPONEA'�S SHALL BE CAPABLE„OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' r j ' OF DRIVEWAYS OR`PAR,�[NG. OR TURNING ARRAS, IN WHICH CASE H-�20 COMPONENTS SHALL BE USED. 12) ALL BUILDWG SEWER L�tEs SHALL HAVE AN INNER DIAMETER OF 4," AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC. ' 13) THE DEPTH OF THE TOP OF ALL SYSTEM COMPONENTS SHALL NOT EXCEED 36" UNLESS VENTING HAS BEEN PROVIDED. 14) IN THE AREAS OF EXC CATION,• EXISTING 'GRADES•SHALL BE 1?EESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS. . i 15) IF,SOILS ARE ENCOUNI pRED DURING THE EXCAVATION OF THE SOIL.ABSORPTION SYSTEM THAT DIFFER NOTABLY FROM THE DEEP OBSERVATI01'.FIOLE LOG, CONTACT THE ENGINEER BEFORE PROCEEDING: . 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. ti NSF Gerald & Carol Antis t F 176 Clamsh ell `Cove Road i Cotuit HA � - 0 E .190 - ` : — 1 .LO�" 58 r.. Top. of Bank t. �. 6170 4' S . Ft. AL -. (--- --1-�-- —' — �-�� a ter L.z.r�e .. I D `SIG.N DATA DEEP OBSERVATION, I EXls tl.n I OOO Ga l g DOLE LOG Se tl c Tank j 3 Test. Hoeg #� I p Number of Bedrooms: (EL 3� a a(° p h Hs oil zti coil , / NO- : - •�� -_ - .._.._ , / ; ._. -. - ._.. �o� onion To ure or Garb _Grinder; D J L �— 110 C Numb r of B — Flit O ! ( / /D R) esxgi.i Ex. t Stairways -- — — — al BR ay e � _ s 3�S` f ;' Sept 1 Sand 10YR3/4 l t ' Lc'2I2dIngS' Existing Fit to .be pumped ,a E2St27L �,:OOO s�'_ a"' A Loamy Send / Eld'Lo'r . 190 I /� P eptic a g' 18 3s 33 B 1oYR,5�- and fill as requlr..d , = Roots{ \ ,: Minim un = Des' n Flog x 2009 GalSr ( ) 36" -1 z,s.� C Medium Sand jjj l • '�� `�> Leaching Area: �2 10YR6/4 3 Bed � D� j 0.� 11_r -- 3? �'' I ' \\ / Side,wall: Deep obe Hole Date: Zan 28. 2005 �• O �/ I •-i `V Soil Evaluator' Ed Stone Ali, �!' ., 2 x ____'t +. _ AI � I I -�� �'� p ( aidewalls � p ). _ Pero Rate: <_ 2 MIN IN /� '• (2 1ndwalls X��'8c3FT X Ft) ° •� soil survey Description CARVER I I _ Geologic D{atertal• OUTFASH Prop, oSed - BOttC•7n: G.� Depth to Standing Water. NA �., �. Depth to Mote ): Depth to Tfee tng Water. NA h 12_83 ,Y t x _Ft) Calor NA �+� Est Seasonal High GW: NA --BoX ry/J Long Term Acceptance Rate (LIAR): O. / `7 CGS observation Well NA Date a Last Measurement NA >\`\ •� r �� Comments: `i Leaching Area -Design -Capacity' �'�'S'`{ �f�j�U - •, / t � (Sidewall Area + Bottom Area) x LTAR G.P. O , , , o CO 334 Gals Required — '�#� Gals Pro vided = Gal s Reserve �Vj q ! Z t 58 P e e -Page- -------- ------ 11 I — — ' '� :;� • , lan R ferenc Pan o0 0 L --- — f Deed Book 12fr37 Page 347 �� 2 q <1� t3,�sj 20 Afini , f= --------------------------- mum ; ••`. Title Reference C , DTH1 Top of Bank to Ie. DC Flood Zone _ csNC_G�= Lat Size 23,414f Sq. Ft. A � i s r f � l SITE AND SEWAGE PLAN I E*I��. � j � _ sanluit Road PROJECT LOCATION 190 Clamshell Cove 1 mad lV I Shed Exist D W �_ o� ( r a1y� Ri g6 Cotul t, MA pe t,. > ASSESSORS AfAP D5 LOT. 50 6. CILIT Y-NG F�A APPLICANT PROPO,S'El) LEA CHl� �. , (` Cctrtit`Goya Rd Bob Kie to ----.� . 190 Clamshell Cove Roa d TAr�ee' .F'.z Ve Hun dre d' Gallon Co-a. a Clamshell - r.: .t Cove Road Co t uz t, MA 006�35 • • - �. _/cam ��� �vf� . � � �C9 , Chambers (or Sim -9x 4 -10x 8 ' 6 PREPARED B.Y. rwith 4 stone around .-• A & M Land Services (To tal •Dimensions 3 —6 x ✓+ 15 Sunset Drive ' k -1 Popponesseat South Yarmouth, MA 09664 Bay E _ 7 t9 h t° 50�394--27,23 / LOCKS AfAP f » 25 t� oR SCALE:' . 1" = 10' DATE:' January 27, 2005 N/F' MVOFFoR ., N� Edmund & Rlemenschneider, saw �ib.�°0R°a REV. 21iy�o tn�� s .i: a� -t�..r �° 204 Clamshell' Cove • Road a y, , Cotuit, ILIA DWG. N0: 300 SHEET i OF 1