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HomeMy WebLinkAbout0278 CLAMSHELL COVE ROAD - Health 78 Clams tell Cove Road ii Cotuit A- 005 -002 I i I No. a010 31O— Fee C• / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppiicatiou for lDigoal �bpgtem Cougtructiou permit Application for a Permit to Construct((Repair(y4pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.279 Owner's Name,Address,and Tel.No. C oral'r Pj_5 r15,r 0,4?( � Assessor's Map/Parcel 0-0,5'__O4,1Z 3/dft4-,6 Installer's Name,Address,and Tel.No.J 09..2 go^ 7�S 2 Designer's Name,Adtlress and Tel.No. ✓o eP4 De /3;opo-vs RAIlAi eePjHy, uloekS6I Mc•' 8/ 1W.W.t � ,*,WeSi' , //6 . C/"O - 1,e, Hof 1 a51IC11Aa' Type of Building:Dwelling No.of Bedrooms y LeJ Lot Size C ' &00 sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) LIL[a gpd Design flow provided 5 3�' gpd Plan Date 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) rW�r,a ll RdLU ®F S" f9® r 036 hf(' / r5 uJ/7' /VO X >Ol9,� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. �] l Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 9 010 31;L— Date Issued ��� 7—/a ;aO — 3Rd— No. t Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Mi5po5al *p5tem Con5truction Permit _ Application for a Permit to Construct((Repair(c4Upgrade( ) Abandon( ) 0 Complete System ❑Individual Components Location Address or Lot No.2,79 Owner's Name,Address,and Tel.No. F Cora%� Prl=r a 14x t--r Assessor's Map/Parcel O��_ Qb2 5p44 Installer's Name,Address,ankel.No.✓Og-z��_ 77'S Z,D� /, Designer's Name,Address and Tel.No. Sag~ y-7- ✓o3cP4r 3,4.-AP5 �hQ��ecl�'�N� wav'kS ZNc• / 6/41wpo.,17 /del /�"jtoes /2 W, C ro.Sl 11ed /gal Type of Building: Dwelling No.of Bedrooms Y Lot Size 15, 8'l) sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures required) remin.Flow Design / g ( 9 ) `7 L(� gpd Design flow provided S 3�"' gpd Plan Date 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) re grAj �� /2ocy I aic e HC Date last inspected: Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. a- \ Signed d Date i } t u Application Approved by ! Date Application Disapproved by: Date for the following reasons Permit No. O�010 —31 2 Date Issued i- ; THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certif iCNte of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired Upgraded ( ) Abandoned( )by /g/^ at ' lf,i _ c9 a alf has been constructed in accordance rU with the provisions of Title 5 and the for Disposal System Construction Permit No. 0-2010 37 2- dated Installer J60�p� %t �fs►!^�o.S Designer #bedrooms Approved desigp flow Ll gpd I The issuance of this permit shall not be construed as a guarantee that the system will fun tign as desi Date �� �� �Q Inspector ' W Fee y�/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1wifspogar *pgtem Construction Permit Permission is hereby granted to Construct ( !.r) Repair (Gi') Upgrade ( ) Abandon ( ) System located at 279 aw"oi S/`i&// �--a �rrvi'1" 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 thi`pe� .U,, (� Date q .9 7—id 1 Approved by 09/29/2010 13:48 5084775313 ENGINEERING WORKS PAGE 01 Town of, le RepWory Services Thomas F.Geller,Director # t Public jjeaith Mieion Thomas Md( aa,Director 200 Main Seat, Hymmls,MA OM1 Fax: 508-7%-M p�a� 30i-$52�644 Date: `L L� Sewage Fermlt# Assessor's►1Viap/Prt" k c. . Installer! Adds 72- fn1. Cre j s : 1 c� Address; �91 C .w� S Awas issued a pormit to install a septic system at O ok v" be" co ore. rZA based on a design drawn by dawd ( ) 1 az I certify that the septic system refcrenced above was installed subsWitially acoordin to io the des° which may include minor approved changes such as latmal roloiaxtian crabs distn'but►on ban and/or septic tank. Stripout (if required) was ttrspected aid the soils were found satisfactory. I certify that the septic MUMrefeterreed above was installed with ms�or vbauge9 (i.e. r then 10, lateral i�elecation of the SAS or any vertical relocation of any cat of tho septic system)but in acca nee with state&Local k0gulShOns. P10 My iaa or ardSed as•budt by daSigner to follow. 5u"ut(if mgdfrvd)was inapoated and tltie soils wore found sa isfwtory. pE"fE:R T. t1ltC McENTEE er CIVIL_ v, No.36149� Q (Designers tgnature �' TOWN OF BARNSTABLE IjOCATION,2 78 4114 r<Ar/�/��/� SEWAGE # 20/0® 392 VILLAGE �aTUI/ ASSESSOR'S MAP &-LOT 605s-002, �NSTALLER'S NAME&PHONE NO. ®S "H2O"�I��� �BS��h-� /�� i�6•y s SEPTIC TANK CAPACITY /000 LEACHING FACILITY: (type) -rPW ®/G 4®"t.36(size) 17 X AS- NO. OF BEDROOMS BUILDER OR OWNER KaX42r PERMITDATE: /0 COMPLIANCE=DATE: . 9..29®/0 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 r 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 f cili Feet a �ty�j Furnished by—., wG�,- { �I r v S In d ff Town of-Barnstable Department':of Regulatory Services ' Public Health;Division, , Hate: to 200 Main Street,Hyannis MA 02601 - Date Scheduled ` Time _ ... ©6. Fee Pd r . Soil Suitability Assessment for Sewage Disposal Performed By. s.2r mac..�'^ e-2. Witnessed By: :V� .. LOCATION&GENERAL INFORMATION Location Address �� `C` Owner's Name co V-e- Address 2?19— CLAwe S he I� '(2 Assessor's"Map/Parcel: QC) M` d2 6 — ®Z Engineer's Name C' NEW CONSTRUCTION REPAII;" x Telephone# Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Wetl Drainage Way ft Property Line ft Other r. ft SKETCH:(Street name;dimensions of lot,exact locations of test holes&perc tests,locate we pdsn:pro'' to'lioles) AUG L b RECD By _---- - C. Parent material 1 i (B��s) r-�t� 1 Depth t0 Bedrock , A' Depth to Groundwater. Standing Water in Hole: Weeping fiom Pit Race Estimated Seasonal High Groundwater ] 2-0 DETERMINATION FOR,SEASONAL HIGH WATER TABLE' Method Used: _ -- Depth Observed standing in obs.hole: In, Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater AdJustment ft. Index.Well.# Reading Date: Index Well level„ Adj.thctor, ,q _ Adj.droutidwaterLevel, Observation PERCOLATION TEST We Time Hole# _ Time at 9" 9 Depth of Pere: M`n Time at 6" Start Pre-soak Time® CLr Time(9".6") End Pre-soak T 9 RateMinJlnchJ\J\C f Site Suitability Assessment: Site Passed ^14— Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPT10PERCFORM.DOC . 1 DEEP.OBSERVATION HOLE LOG' Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones;Boulders:. _ Consiit v �Z� 1 Lt_ Fd 05 g5? Iq DEE ERVATION`HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. . Cons' e 0 12 } �� l..Z. '31- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sail Color ' Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) Lip 22 fr5 16 J2 I/z DEEP OBSERVATION HOLE LOG Hole# Depth from Soil.Horizon Soil Texture Soil Color Soil Other Surface(in) (USDA) (Munseil) Mottling (Structure,Stones,Boulders. Con r t.L / Z f L,,5 to ttz Z 5/7 Flood:Insurance RateMau; i . Above SOQ year flood"Boundary No_ Yes . within`.SOtI year Boundary>; •No Yes Within.j00 year flood boundary No GC Yes Denth of Naturally Occurrme Pervious Material Does at_l'e_ four feet.of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If'not,:wltat.is the depthof naturally occurringpervi malarial? Certification �e. , date I have- assed:.the soil evaluator eitatiunation approved by the; ( ) p Department of Environmental Protection and that the above analysis was.performed by me consistent with. the requed train' g, R`eitise and experience described in LQ C11i1It 15.013. Date AL v Signature; Q\S•BPTIGIPBRCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road _ Property Address Baxter _ Owner Owner's Name information is' Cotuit MA 02635 August 19, 2010 required for — every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor=do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons MIIIs MA 02648 — raun Cityrrown State Zip Code 508.428.1779 S1 12855 _ Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.oe inspection —11 was performed based on my training and experience in the proper function and maintenanpogof cabs site sewage disposal systems. I am a DEP approved system inspector pursuant to Sectiorj=lfi.3of Title 5(310 CMR 15.000). The system: o r ❑ Passes ❑ Conditionally Passes ® Fails s K ❑ Needs Further Evaluation by the Local Approving Authority 3 D fV W August 19, 2010 Job# 10-2 m In ector's S gnatur 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. (A I� J Sawa pot5ins•09108 Title 5 Official Inspection Form.Subsurfa a Dis D..e 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is required for Cotuit MA 02635 August 19, 2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 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: 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is Cotuit MA 02635 August 19, 2010 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .'t 278 Clamshell Cove Road _ Property Address Baxter Owner Owner's Name information is Cotuit MA 02635 August 19, 2010 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *'This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No" to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 278 Clamshell Cove Road Property Address Baxter _ Owner Owner's Name information is 9 required for Cotuit MA 02635 August 19 2010 every page. City/town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® 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 CM 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 CM 15.304. The system owner should contact the appropriate regional office of the Department. 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road Property Address Baxter _ Owner Owner's Name information is g required for Cotuit MA 02635 August 19 2010 every page. CityrTown 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts up Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is Cotuit MA 02635 August 19, 2010 required for g — every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 — 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)): — Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 278 Clamshell Cove Road _ Property Address Baxter Owner Owner's Name information is required for Cotuit MA 02635 August 19, 2010 - every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Tank pumped 9/09 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): t5ins-09f08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is g required for Cotuit MA 02635 August 19 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: compliance date: 7/9/86 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): III Depth below grade: 4'feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): — Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 41 feet —� Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: — years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. — Sludge depth: 2" — 15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 r- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 278 Clamshell Cove Road _ Property Address Baxter Owner Owner's Name information is g required for Cotuit MA 02635 August 19 2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 2" — Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 12" — How were dimensions determined? Measured — Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Baffles were found intact,liquid level was at bottom of outlet invert. Grease Trap (locate on site plan): Depth below grade: feet 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: Date I t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments "< '278 Clamshell Cove Road Property Address Baxter _ Owner Owner's Name information is g required for Cotuit MA 02635 August 19 2010 every page. 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.): 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): Dimensions: — Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•09= Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 278 Clamshell Cove Road _ Property Address Baxter _ Owner Owner's Name information is Cotuit MA 02635 August 19 2010 required for 9 � — every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is COtuit required for MA 02635 August 19, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: One 6x6 pit. ❑ leaching chambers number: — ❑ leaching galleries number: ❑ leaching trenches number, length: — ❑ leaching fields number, dimensions: — ❑ overflow cesspool number: — ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Liquid level was found at top of structure, pit is in hydraulic failure. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert — Depth of solids layer Depth of scum layer ` Dimensions of cesspool — Materials of construction — Indication of groundwater inflow ❑ Yes ❑ No 15ins•OWN Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is Cotuit MA 02635 August 19, 2010 required for 9 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 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.): L15h. 08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts - upTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 278 Clamshell Cove Road — Property Address Baxter _ Owner Owner's Name information is Cotuit MA 02635 August 19, 2010 — required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate water supply enters the building. Check one of the boxes below: where public pp y 9 ❑ hand-sketch in the area below ❑ drawinq attached separately • / / / / r r J r / r r / J ... . 12 \ . \ \ , ♦ \ \ ♦ \ ♦ ♦ \ 61 73 Clamshell Cove Road Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is Cotuit MA 02635 August 19 2010 required for g , every page. City/Town 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: N/A feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•o9/oB Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °( 278 Clamshell Cove Road Property Address Baxter Owner Owner's Name information is required for Cotuit MA 02635 August 19, 2010 - every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins•09f08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 117 of 117 No.. �o.. � ..� THE COMMONWEALTH OF MASSACHUSETTS y �D BOARD OF HEATH --------------------- ,✓ _. . ....................O F_ ..... q I .......... ............... -------.........---------- .� Appliration for Diipoottl Workii Tonotrurtion Vrrmit Application is hereby made for a Permit to Construct k or Repair ( ) an Individual Sewage Disposal Sy.n at 1(�uAaSkI,1.... - ..........................................--..........•...... Location-Address �To. Owner �- II �,,,, 1 Address • ............................... stallerk- s \\\ I � � Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...............Z......................Expansion Attic �D) Garbage Grinder Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .................................. Design Flow........ ---------------------gallons per person �r day. Total daily flow..._...... 0.....................gallons. W Septic Tank—Liquid capacity._lAC�gallons Length__ __ '�._ Width_.`-�_!��� Diameter................ Depth._�_`f. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------I............ Diameter........ ...... Depth below inlet.........6....... Total leaching area.z.4.1.2.....sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .........................•--------•-••••-------------------------------------------------------••••-•-•••-•-------••••-••••--•.................... ._....._. 0 Description of Soil...................................................................-•---•---•-•----------------...------------------------------------------------------.......-•-••---- x U •--•---------•-----••.....................•--•-•........-----------...........................•--------------•-------•--------------•--••------•----••-•..._......------------------•..............._... W --•--•----••-------------- ............................................................................... -----• ............................................................... xyjLc- U Nature of Repairs or Alterations—Answyrwhen icable_.._._. .._.f___.__.. .. ...................................... ................................ -•--;��. ...... .. .......................... Agreement: r--- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of AI'fIE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Complia be oard of health. Si ned �.--F' ` .- . .Application Approved -.�'-----•-•---•............. `7 Date Application Disapproved for the following reasons:.............................................................................................................. ---•-•-•- -•-----•----•-------•--•---------•---------------- --•--•------------------------------•--------•------•---------------•---- � ...---• V Date i r 'Permit No............. .__ Issued----------•----•-------------------•......-••-..._.._... Date .r S. No. .�I&1._. Fps.. THE COMMONWEALTH OF MASSACHUSETTS BOAR_ D OF HEALTH ........ ................OF......... Appliratiun for Disposal Works Tons rur#ion "ami# Application is hereby made for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal System 1 at lt:_.?..._l. .�.�.... �� ----`=--.r.................. -- - ----- -•........................................ Location-Address' _n_ _ _ _ or-I:ot-No. j Owner, Address ••••--.....--••••= r' ...............................•---------------..._....---•-------- ......................'-.......................................................................... Installer' 1 Address d Type of Building t Size Lot............................Sq. feet Dwelling o ooms________________ -__:.__________.________Expansion Attic (J") Garbage Grinder p, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) al Other fixtures ________________ _______________ _ W Design Flow........... `Z?_.__ _.__.___gallons per person per day. Total daily flow................ :_____________________gallons. WSeptic Tank—Liquid capacity..! .,'gallons Length____(____._ Width_._:�_�._..:__. Diameter________________ Depth.__._ __._I_..1 x Disposal Trench—No. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------I _._____--__ Diameter........�...... Depth below inlet......... Total leaching area__ .....sq. ft. Z Other Distribution box O Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I______________'minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lrl Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --••--------------------------------••----.....--•--------...---.....-----------••----------•----•--......................................................... 0 Description of Soil_____________________ x W ----•--------------------•-------------•----•-•-•--••-•-••••--------•---•-•-•••---•--.................... - .............. ....................... U Nature of Repai s or Alterations—Answ whenZi.cable 1! � - ......................................... ,.. - 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 issue by-the.board of health. Signed...... --•• . �------ --•- ---------•.............. .......... .._...--- .._..� Da r Application Approved By_._____ � ,- &� _ __ V ........................................�. Date Application Disapproved for the following reasons-----------------------•---------------------------------------•----------------•------------------•------....-- ---•-•-----•----••----••--------•-----------••-••-...--------•--•-•...................••-_.._...._......-•--.......-----•---•--------•-----•••-----•---------•-•--•-•-----•-----•-------•------- �.. � Date PermitNo..----•-.._....z5K ...................... :... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS --BOARD_ OF HEALTH 1 .......... ...............OF........................aY.• ............................................ Trrfif iratr of Tomplittnrr THISdT sICEfTIFY, That t In vidual Sewage Disposal System constructed ( ) or Repaired ( ) b > :_:. rt Y..................... ..................................... •...................... nstallr at. ..__ _!. C _lam._ " G.._..--I!' ec --.._. -------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as descrihed in the application for Disposal Works Construction Permit No---- __ _:�._�_ .....�,_ dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNC"TIP,, �AT)SFACTORY. � -••1.1............................................... l DATE.---------••--...... =� ............. Inspector......_..............._.........._.......... ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH 4 ' r� r-- - iJ..OF........ ..................•-• •••...... ... .........-__...... FEE No... ......... , ��. �► Permissi( is hereby granted j--- - gin -••-•to Construct or Repair .riwdual Sewage Disposalyst L at No. "= -... -.:..�c�xr�,.t�. ..-t ------�� � {t Street ^.511r`{,. ...... as shown on application for Disposal Works Construction Permit No .�. _ Dated........ .__ ....... ' ij Board of Health DATE__ FORM I A. M. SULKIN, INC., BOSTON ASSESSOR'S MAP NO. oc-) S PARCEL C)o a � L-0 CA T ION S E W A GE PE RMIT NO. XILLAGE i�s� ► z � Q� 0 INSTA LER'S NAIVE i ADDRESS 'i Q UtCW4zl A. i4or- '--A U I L D E R OR OWNER j�nv"f- c�x 4 sS DATE PERMIT ISSUED y&7 DATE COMPLIANCE ISSUED /�/ � �ouS� t �1 ' 5hoe5 trng Bay LEGEND I PoP°e9se � a 0 1 MEAN LOW WATER.{°pprox.) ................ . ... -- gg --EXISTING CONTOUR .off 6 1S a _-_ ................... x ioo.sa EXISTING SPOT GRADE A0 to M TER (°PPrOx•) - - - - -�� .�` o 102 PROPOSED CONTOUR C 'ease tt R _HIGH WATER ___--__8-___-_ ________________ ._- p W EXISTING WATER SERVICE N� `--.s r\,p0 G EXISTING GAS SERVICE ME ---FLOOD-Z_0_NEA'13_-(E_C'- ----- ---12 ------------ -----� _ 14_______________ _ ���`�� --"•- f ��/ U UNDERGROUND WIRES e $ 000-ZONE-C_- _____ g__ __ _ _ _ r �� I''i3 - � _FL _--- --------------------1--}&-----------_- --Fay\ �� �.H.W.-OVERHEAD WIRES - --- ---- -Z< - ,} TEST PIT N v Cr°°k C7 �" _2`�-rL-----. ._---.---_. -.__----'----- '1 � � �\ �� � '�. ar 10.38� t` _-------------- 24----- ,,_�� BEMCHMARK o �� C - 24--=---- _-- - - ---------2.6____--� /2 �q ---2E------__---------------------------- EXISTING SEPTIC TANK �� I 1 '' TAI ��- -2-8- -3fl------ ----- ---=----- _28� ��_� d (TO REMAIN) N I q) 1 I B = 2_--------------- -- TOP OF TANK, EL.=33.7t I I / ' +- �V �/ I I I , 28,69/ TB - - -3zi \ INV.(OUT)=32.35f N 3 '02' 0" / S i i -7-'= � I I i , i 35.08 LOCUS I I I I / TB �_ --- 1�\ 40. I' i i I 1 / L.'OT /J1 APPROVFjS TOP OF COASTAL BANK 36,59 -'�� -_ G� LOCUS TO SMAP CALE EXISTING LEACH PIT 1 / , (DE� FILE N0. SE03-480 TB TO BE PUMPED, FILLED W/, x I I I I / 45,000 S.F.c 36.72 - GENERAL NOTES: SAND AND ABANDONED. y � ,� I I / AP N 0,0 5-0'0 2 ,� / ' 35.1 i 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL �M \4.46} N J ' i / �� i ,' r ' ST E �q4 x 36,99 BOARD OF HEALTH AND THE DESIGN ENGINEER. / / 2f�,11// / 34,64 PA,TI c NAIL SET IN 10" OAK \ , L0 . 1 L L � / 2.18 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS EL.=18.98 (Assumed) � �t 1529+1 t 1 ET. yyALL 30.15�`� 525 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 2 t 1 t . j t 28,77 3 LOCAL RULES AND REGULATIONS. I DECK ?4.31 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR {- 0,84 t t c� 1 t' l 9.49i t 15,87 1 j t f / 30,83� 36,96 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE BEACH �' IJ� 1 p DESIGN ENGINEER. RESERVATIOI�� tt t IP Z x 37,19 DRAINAGE ` i 1 0.l I C` l 30.97 36.10 �EWSTING ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING EASEMENT �\ `+ 1 5� I i t �:i I 1 t z HOUSE (#278) a hp FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN i 1 t m 36, 31,49 x T.O.F.=39.03 `�' �'/ ENGINEER BEFORE CONSTRUCTION CONTINUES. �J t c 2a3,c�6 t N M/ 31,01 0 37,2 5. ALL ELEVATIONS BASED ON MEAN SEA LEVEL DATUM TAKEN FROM 3 t �, 2 Mtn- - _ 1 i li t \ �� < 36.33 ' PROJECT BENCHMARK OF RECORD SITE PLAN BY C.R. SHORT, DATED �z� - - 1 I t ,t ` t m SER + \12/15/85. 1 P tt cn -►II--���� t t� �� n �7,1 v '9 t'IHE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF t 1 _ 25 ���,�- - r Q .GARAGE HE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF. `14- -*-+3µ i i 5 --- _--- T.O.S.=38.54 -NE FOR PROPER INSPECTIONS DURING CONSTRUCTION. t t t TP`4 r i �,_,�t. t t 36,50 36,94 t t tt I 1 1'. t t tt �� 4.56 ` --6. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. tt tt rp�3 _+_��,k- I I '• t t k \ :3zq� 8 39 - - BUFF �100, C 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. t t t ,r" I l I -F\27�0 37,58 ER TO t N' t- �� t 34.57 I OF tom- i I I I I I 37,43 COAST,q� J� 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS . AN \ AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE t t t t ESn t 1 1 1 CONNECT ALL \� tt t� A „�� i� i i l �� 35.45 \ STONE DIRECTED BY THE APPROVING AUTHORITIES. ROWS TO VENT �� 1 DRIVEWAY 36,94 �. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY r, �t t A,13 25J 1 j ob I 4' t It THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 30.20 tt t ` 0 ( t �' I l 90 CONSTRUCTION. 82 OF 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS �� 44ss IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND F 31_ _\ Un I I �� ) 34.96 �� J � 9�yG REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). -32 <�1 - - ni i /' o PETER T. 1 AS REQUIRING STRIPOUT O:FUpNSUR IALS SHALL BE \ p cENTEE w CIVIL NSPECTED BY HEALTH DEPARTME RIO TO BAC . `± 33,91 00 4� __ -'14�. 35,94 t No. 35109 13. THIS FOR SEPTIC SYSTEM PURPOSES ONLY AND 33.50 S 2-7_3.2_ ND I IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 34,48 �3¢edge of pavement 34,40 _w. UP £c/ST PK 32.83T 36,2 3 I PROPOSED SEPTIC SYSTEM UPGRADE PLAN / S N� ��.�6 3,52 :�. 35.2 Site Benchmark 3 278 CLAMSH ELL COVE ROAD, COTU IT, MA - - H: HYDRANT NOTE BOLT Prepared for: Peter Baxter, 278 Clamshell Cove Rd., Cotuit, MA 02635 H.W.- -CLVMSHELL CO VE ROAD EL.=39.14 MSL POLE -- OOD PLAIN DESIGNATION Engineering by: SCALE DRAWN JOB. NO. Community-Panel No. 250001 0022 D Engineering Works, Inc. 1„=30' P.T.M. 205-10 Map Revised: July 2, 1992 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. Zone A13(EL 12) & C (508) 477-5313 9/13/10 P.T.M. 1 Of 2 i t' NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:15.8 NAIL 14.1, FOR A DISTANCE OF 15' AROUND THE IN PERIMETER OF THE S.A.S. TREE SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. CONNECT ALL I >& ROWS TO INSTALL RISER & COVER OVER OUTLET MANHOLE. INSTALL WATERTIGHT RISER & INSTALL INSPECTION ;PORT OVER END UNIT CHARCOAL �,tk �� 4.5� COVER SHALL BE BROUGHT TO FINISH GRADE AND COVER SET TO 6" OF GRADE -1 _25__ , N T.O.F. SECURED TO PREVENT UNAUTHORIZED ACCESS. VENT EXISTING F.G. EL: 18.8(MAX.) �� PROPOSE F.G. EL.=37.7f F.G. EL: 19.Ot S.A.S. MAINTAIN 2% GRADE (MIN.) OVER S.A.S. �!; p SOA SSE INSTALL INSPECTION 1j`32' '`�� L 32' L 10'(MAX.) PORT OVER EACH ® S=1% (MIN.) ® S=1% (MIN.) INV.=16.08 ROW 106•9' 8`3.4 4"SCH40 PVC 4"SCH40 PVC 6" w (TOP LOADED) U-iio"I i a• s 19" TO INV.=32.60 as" uoulo EXISTING INVERT LAYOUT-1 LAMP POST EXISTING LEVEL I _I E%� VEUT � INV.=17.67 PROPOSED 0 6 ROWS OF 5,UNITS AT 5.0'/UNIT 25.0' (TO REMAIN) D-BOX INV.=17.50 INV.=32.35t (6 OUTLETS) SOIL) ABSORPTION SYSTEMTS MUST BE (PROFILE) PROFILE) t EXISTING SEPTIC TANK EXISTING STAB I H VEGETATIVE COVER S.A.S. LAYOUT TIE IN TO EXISTING SEWER PRIOR TO ESTABLISH STABLIBACKFIL WITH CLEAN NATIVE OR LAYOUT LAYOUT-2 EXISTING LEACH PIT, INV.=19.7f PERC SAND TO TOP OF CHAMBERS EFFLUENT FILTER SHALL BE INSTALLED ON OUTLET s-a• POLYSEAL OUTLETS TEE AS MANUFACTURED BY ZABEL (Model No. A1800). INV. ELEV.=16.08 21" FILTER SHALL BE INSPECTED AND CLEANED ANNUALLY. BREAKOUT=TOP ".+'`' 2" 2" i-a• POLYSEAL INLETS TOP ELEV.=15.83 32.50 NOTES: O O 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BOTTOM ELEV.=14.50-~ 2.83 a INVERTS, PRIOR TO INSTALLATION. 5' MIN. ABOVE BOTTOM OF ao 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE EFFECTIVE WIDTH=17.0' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED T.P. EXCAVATION OR G.W. EXISTING SUITABLE i*4 To View STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). NO G.W., EL=7.5 - MATERIAL P D-BOX Section 3) INSTALL INLET & OUTLET TEES AS REQUIRED. SEPTIC SYSTEM PROFILE z USE 6 ROWS OF 5-ADS Arc 36HC UNITS WITH NO SEPARATION BETWEEN EACH ROW & NO STONE 63.25" N.T.S. TYPICAL SECTION 18" SOIL LOG 34.5" DESIGN CRITERIA DATE: SEPTEMBER 13, 2010 (REF.#13,055) SOIL EVALUATOR: PETER McENTEE (SE#1542) A yl NUMBER OF BEDROOMS: 3 EXISTING + 1 FUTURE = 4 TOTAL WITNESS: DAVID STANTON-HEALTH AGENT TOP VIEW SOIL TEXTURAL CLASS: CLASS I Elev. TP- 1 Depth Elev. TP-2 Depth Elev. TP-3 Depth Elev. TP-4 Depth 60" 1 DESIGN PERCOLATION RATE: <2 MIN/IN 19.5 O" 19.0 0" 18.0 0" 17.5 0„ END CAP END CAP FRONT VIEW SIDE VIEW DAILY FLOW: 440 G.P.D. FILL FILL EFILL FILL END CAP 17.5 24" 18.0 12" 16.8 14" 16.5 12" REAR/TOP VIEW DESIGN FLOW: 440 G.P.D. A A LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND NOTE: UNIT CONFIUURA'(IUN AND AVAILABILITY SUBJECT SIDE VIEW GARBAGE GRINDER: NO 10YR 4/2 10YR 4/2 10YR 4/2 10YR 4/2 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 17.0 30" 17.3 20" 16.2 22" 16.0 18" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY B B B i e opm. 4640 TRUEMAN BLVD MED. SAND MED. SAND MED. SAND MED. SAND 11111111 HILLIARD, OHIO 43026 Arc 36HC DETAIL PROPOSED DISTRIBUTION BOX: 6 OUTLETS MINIMUM 10YR 5/8 10YR 5/8 10YR 5/8 10YR 5/8 LEACHING AREA REQUIRED: (440) = 594.6 S.F. 16.0 C 42" 16.0 C 36" 15.0 C 36" 14.5 C E �V�cED DMIRAGE SYSTEMS, INC.PROPOSED SEPTIC UNITS E STAMPED H-20 SYSTEM UPGRADE PLAN .74 USE 6 ROWS OF 5-ADS Arc 36HC UNITS WITH NO MED. SAND MED, SAND MED. SAND MED. SAND 278 CLAMSHELL COVE ROAD, COTUIT, MA SEPARATION BETWEEN EACH ROW & NO STONE 10YR 5/4 1OYR 5/4 10YR 5/4 1OYR 5/4 Prepared for: Peter Baxter, 278 Clamshell Cove Rd., Cotuit, MA 02635 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) - J Engineering by: SCALE DRAWN JOB. NO. (Arc36HC Units) 30 UNITS x 5.0 LF x 4.80 SF/LF = 720.0 SF 8.5 132" 90.3 120" 7.5 a 126" 7.5 120" Engineering Works, Inc. NTS P.T.M. 205-10 NOMINAL BED AREA = 17' x 25' = 425 S.F. TP-4 PERC RATE <2 MIN/IN. ("C" HORIZON) 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. REPERC RATE DESIGN FLOW PROVIDED: 0.74(720 OS.F.) = 532.8 G.P.D. NOD <GROUNDWATER OBSERVED (SAND) D (508) 477-5313 9/13/10 P.T.M. 2 of 2 i r--------------- I I I I I � I I I I I I I I I OD BSI 8 _ s.,6 aeova 0 < 8 D 1 C/) I m M 6v10abova ° O - _A O I I � I 6noaeove _ I I I I I I 88 I I O 1 12'-0' J 0 GABLE DORMERrL- -71 •C �' � 8 PE Inoe. ABove I _ go O �_ g m O � O 0 0 gam 4 js m l $$v ------� 0. 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