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HomeMy WebLinkAbout0093 CONSTANT LANE - Health ,j 93 Constant Lane Cotuit i' :4�039 061 I No. �- "� Fee ,t>' 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 0 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplitation for Misposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(114pgrade( ) Abandon( ) ❑Complete System O/ndividual Components Location Address or Lot No.y3 Cop q s¢aas¢ L�, Owner's Name Address,and Tel.No. 7,91 A'9*4"- /6 31 Assessor'sMap/Parcel dr 3 jp—G ®a/ o Installer's Name,A�dress,and Tel.No. �"�- Zz-� 2d'z3 Designer's Name,Address,and Tel.No. �� Y77— yJ X i��t�r�i� cY�� Fns+�tiB�r s�JJ tcio✓45' 3 S- r w aiesoci�LV2GvSf se/ o esf Qifes Type of Building: Dwelling No.of Bedrooms Lot Size 2� 0,.V sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '��3Q gpd Design flow provided gpd Plan Date z—zh, 0�/x Number of sheets 2 Revision Date Title /�_r,.z ��� ` .4, Size of Septic Tank /62,n?G Type of S.A.S. G'�lr ors cr t2c� S r Description of Soil Nature of Repairs or Alterations(Answer when applicable) lif fe j Zr 5-e o Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued b this Board of Health. P Y Signed Date Application Approved by Date r Application Disapproved by Date for the following reasons Permit No.1 q,:jL Date Issued E/ No. l ! T Fee / O' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpf ration for disposal 6pstem ConBtrUttion 3permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System 0/ndividual Components Location Address or Lot No.73 wn S f�rti f G�s, Owner's >Name jAddress,and Tel.No. 7 81 x 4.41' /a 3/ (-Oflrs� - ��Q6 /7•ea9eY� Assessor's Map/Parcel Installer's Name,Address,and Tel.No.✓ram- >T 3' %t�'2�_ Designer's Name,Address,and Tel.No.,rc,a'— y7'7— S3J 3 m"vr�rS .G'/��r iV Pl�r"I f f L.t�a✓�S �i 33-� �.� �1 6� I/oirrov�� /� 1�4f�' fS�'�P�� o% �G•c's'f��Fi' Type of Building: Dwelling No.of Bedrooms Lot Size ,'Z4' 045V sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date �.7�Zo�//r� Number of sheets _. Revision Date Title ice sp•./ J o .r f S Si s/r-i.s / ice s�/ • .. y Size of Septic Tank y/ln42 V Type of S.A.S. Try�rrs srr� Sr�in.��r Description of Soil Nature of Repairs or Alterations(Answer when applicable) a S2 .ONr.S,� ' .:-.../�,s,.S-/�sf� ./Ja/r,✓�� /��/�cs�. �- . S�dQ ��� l"�r_r�-�s�.,D.•,S /iir� 5�.�� 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. / Signe °� �_ �. _ Date �/Z////9 Application Approved e /by / f ""r "' "�+� Dat Application Disapproved by Date for the following reasons Permit No. ;In! L/ - Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compfiante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�/)/ Upgraded( ) Abandoned( )by� at 3 l"odr ,Goyt� Lei. Ca,cu,'t has been constructed in accordance with the provisions of T ie 5 and the for Disposal System Construction Permit No201 I— q-1_ dated 1`I Installer Designer #bedrooms Approved de�ignn floe 3 7fcQ 7' gpd The issuance of this permit shall not be construed as a guarantee that the system w Il c�o,{on as desiggned. Date -i( � �. Inspector �/� No. I Fee'. /(A_J1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS disposal *pste Construction 3permit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cj)nstyuction must be completed within three years of the date of this permit Date I1 Approved by ' r / x i T�w n of Barnstable Regudato>ry services Richard B.ARNbTABLE V. Scal ;'In#erim Director R, , - - , Pubd c I�"eaith v�si®"n z. 9 ,MASS. - - �p 163.9 �0 ll hatnas TVlcKean,,]Director. _ x 20Q Ma"in"Street;Hyannis,MA 026QI 1 i Office; 508-862-4644 Fay:, 50$-790-6304 1 Installer&Designer Certification Form " P Date: .4 � �t t �! Sewage Permit##2419.-®r/TAssessor7sMIap\P�rcel 0 �i"� 4 Desig"ner. t_= a 1.n�ee-!n Wad .x s `lac Installer: --�J— ��_ e�� �- Address: 1,2 Vih C" L (c/" R ,�Sr •e> Address: ? Cl= (date +�-On �'��%issued,a permit to i"nstall a (insta er) 1 t septic system at `�" �ar►S -J�- C ie„ .�y 6,.,Ati , based'on�a design� ravvii�by (address). € dated' y h 6'Ucs✓LCs f� 1 ! . (designer) I certify.that the septic system.refetenced above was installed substantially"a'ccording"to the design, which play include minor approved.cl Ian such as lateral relocation Qf the distribution.box,and/or septic,tank: Str1p"out.(if equirzd),was "insp.ected"and the soils, were found satisfactory: 1 •`'' I certify, that the septic system referenced above. was installed w,itli major changes ( .e. § greater than,l0' lateral relocation ofthe SAS or any vertical relocation of any com,oriont of"the septic system)"but in,accord with State &"i�ocaY.Regulations 'Plan reNdsion:or t eer-tifed-as built by designer to•follow. Strip out(if reguit-ed)was'inspected,and the snits" ' were foundsatisfac�toty". ) I��eertif, that the.system referenced Abovey ivas constructed inry- with the ter ms. of the 11A approval letters(if applicable) w PEtE�S. ��E Installer's Si nature C�Vtt_ ( g ) gip.359C19 ( . g " ) (Affix"Designe " y. Deer er's" i nature PLEASE'RETURN `i'O BARNSTABLE"PUBLIC;HEA�.LT13 DIVISION: CEI2"I` FICATE . OF COMPLIANCE WILL NOT-" BE ISSUED UNTIL BOTH THIS FORM 'AND AS-, " :- BUILT CARD:ARE RECEIVED"BY THE..BARNSTABLE PUBLIC.HEEALTII DIVISION. rq T 4ANVK YUU l ; (Z:Sept ueaigner.Certification,6orm'Rev 8-1 t-i3.doc Engineers note:This certification is limited to an as-built inspection:of system"components as-installed prior to backfill.The i engineer,did not supervise construction of,the system The it staller,assumes responsibility f6r all materials,:workmanst p,6ackfiliing to specified grades with proper compaction"and setting risers,covers as shown on the design TOWN OF BARNSTABLE LOCATION !.3 SEWAGE# 2O/9— Uy7 VILLAGE �'���L� �' ASSESSOR'S MAP&LOTQ,3,9- Qd INSTALLER'S NAME&PHONE NO.,/�Zg, SEPTIC TANK CAPACITY 106 LEACHING FACILITY:(type)Crps (size) NO.OF BEDROOMS 1-3 BUILDER OR OWNER ?074e� eK ra PERMIT DATE: �;Z/�-11 9' COMPLIANCE DATE: Separation Distance Between the: ' Maximum Adjusted Groundwater Table and Bottom of Leaching Facility A Feet Private Water Supply well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by t 4 o ° ° ved�' - o r f 7 i 93 G,n Town of Barnstable r# 1 ly l> Departinent of Regulatory Services. eUwsrest$ Public Health Division Date �< — `t' f- 117 a 16.. � 200 Main Street,Hyannis MA 02601 fD µp't Date Sclieduled ( ( (00 QC) Time Fee Pd. Soil Suitability assessment for ►5ewa e �z�p®sal Performed By: J C I �r '•t G Gj 1ti�e �lLi 15'�' —Iitnessed.By. LOCATION& GENERAL INFORMATION Location Address C//7`��'_17r• �O' 5 �� Owner's Name (Za Ct Address O ZC.UeS4--S `¢.2. f _ Assessor's Map/Parcel: 8-3q —Q(o t Engineer's Name,��� fJ�Ju t NEW CONSTRUCTION REPAIR Telephone':# Land Use:% 1- G—1 Slopes(Ro) Surface Stones Distances from: Open Water Body �7� ft Possible Wet Area ft Drinking Water Well �S Drainage Way ^�r//-17 ft Property Line �,— h Other ft SIMTCH:(Street name,dimensions of jot,exact locations of test holes&pere tests;locate wetlands tin proximity to holes) IV&Tn /T CA-+v� I Patent material(geologic) Depth to Bedrock. NJ P_1A Depth to Groundwater. Standing Water in Hole:, Weeping from Pit PnCe -` Estimated Seasonal High Groundwater t Z ` ' DETERMINATION FOR SEASONAL HIGI WATER TABLE Method Used: Depth Observed standing in obs.hole: _ -___ in, Depth 113 Soil mottles. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level , AdJ,factor Adj.Oroutidwnter level PERCOLATION TEST We_ Ttme Observation Hole# C Time at V . . Depth of PercO 7 Time at 6" Start Pre-soak Time Q 2 y End Pre-soak ` t r"� .► ' Rate Min:/Inch / Site Suitability Assessment: Site Passed �/ Site Failed: Additional Testing Needed(Y/N) Original; Public Health Division Observation Bole Data To Be Completed On.Back----------- *0.1f 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:\SEPTICIPERCFb.Rm.DOC DEEP OBSERVATION BOLE LOG Hole#. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling '(Structure,Stones.Boulders. Consistency,% ravel i 5-tw1 ZC5-y DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture, Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,.Boulders. Consistency.% rave o d s (6YOJz DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil tither Surface(in.) (USDA) (Munscli) Mottling (Structure;Stones,.Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. ons' ten m i Flood Insurance.Rate Map: Above 500 year flood boundary No— Yes ._ Within 500 year boundary No.f Yes Within 100 year flood boundary No Yes. Depth of Naturally Uceurrint=.Pervious MaWrlal Does at least four feet of naturally occurring pervious matey ial exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occumng pervious material? Certification C' , g CL� I certify that on (date)I have passed the soil evaluator examination.approyed by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required tr ' 'ng,expertise and experience descr'tbed:in 110 CMR 15.017. -s- ,. l22 Signature Date _ Q:CSEPTIC�PERCFDRM.DOC C/ RECEIVED JUL 0 2 2004 TOWN H OF T BARNSTABLE H DEPT DATE__ 6/24/04 PROPERTY ADDRESS:_A3 CQnst-.an± r anP eotuit 060 l MA 02635 On the above date, the septic system at the above address was Inspected. This system consists of the following: 1.- 1-1000 ga.P2on zeptic tank ' 2. 1-dizt2.i9ut.ion gox.. 3. 1-100D gaieon �eeach.irtg 12.it.. Based on Inspection, I certify the following conditions: 4. 7hiz tz ¢ t.i.t;ee :�iye :septic !system. ('T8 code) . 5. The Ze/2t is ..system ins in '%120/?e'z wo.2k.ing o/.de z at the P'Sea.ent time. SIGNATURE:z� Com pa n.y: .-ra— c z t, g_�acOmber-4_san . , Inc. Address:__p__Q__.B.nx_6.----------- . le-,--MA 02632 66 Phone: THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY CH P. MACOMBER & SON, INC. Tanks=Cesspools-Leachfields Pumped & Installed Town Sewer Connections x 66 Centerville, MA 02632-0066 775.3338 775.6412 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE-OF ENVYRGvNMtNTAL AFFAIRS DEPARTMENT'OF ENVIltOl4MtNTAL pROTICTION. a y .H TITLE 5 OFFICIAL INSPECTION FORM—NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART•A CERTIFICATION Property Address:�- f'_mn-stant_Lan,- Cor tut,. MA 02635 Owner's Name: Owner's Address: Date of Inspection Name of Inspector: (please print) .. rlrY,.�,aUaoaal4ster Company Name: , --1laaomAz_,t & .S�n AO. Mailing'Address: Cen e�tvt e, 4's.a.•02632 Telephone Number: 5 0 8—7 7 :3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system,at this address and thatthe.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 tbe proper function and maintenance of on:site sewage disposal systems.I am a DEP approved system inspector pursuant tasection.15:340.of'Fitle 5(314 Cr4R,15.,000). The system: XX. Passes -Conditionally Passes Needs Further Evaluation.by the Local Approvin&Authority, Fails Inspector's Signature: Date: `T�►�t The system inspector shall submit a copy of this inspection reporrto the-Approving Authority,(Board of Health or DEP)within 30 days of completing this inspection.If the$yste 'b a.she o4 system or has a design flow of 10,000 gpd or greater,the inspector and the system'owner.shaall'submit the.report to the appropriate regional•offiee ofthe 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 inspectior-and under the conditions of use at-that tune:This inspection does not address how the system will perform in the future under the same or different conditions of use. _... _. ..__. 411 cnnnn. Daae 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM' !' PART A CERTIFICATION(continued) Property Address: 93 Conct-ant- Lant- Cotuit Owner: Char be en Date of Inspection: Inspection Summary: Check A,BC;D or.E/ALWAYS-.complete-all of SectionD 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: Thv AP.12iir 3y,3tem i,s /22oRez woicking o2dea a.t the 12e2,6en.t 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 eexplain: I I! 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: U- The system required pumping-more than 4 times a year due to broken or obstructed pipe(s),The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 93 Constant Lane Cntuit Owner•. Charles Madden Date of Inspection: 6/2 4/o 4 C. Further Evaluation is Required by the Board of Health: Conditions.exist whichrequire f u-ther:evaluation.by.the Board::.of Health,in order.to.determine if:the system !s faLling 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: { 5 Cesspool or privy is within 50 feet of a.surface water i 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 tbel 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. kThe system has aseptic tank and SAS and the:.SAS iswithin a Zone 1 of a public water-supply. Y� The system has aseptic tank and.SA&and the SAS is within50 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 fronl 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 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 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A , CERTIFICATION(continued) Property Address: 93 Constant Lane cotuit Owner: Charles Madd n Date of Inspection: 612 4 (fi 4 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the.following;for all inspections: Yes Np _ 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 Zclogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than %.day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number / of times pumped , Any portion of the SAS,cesspool or privy is below high ground water elevation. _ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface / water supply. 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 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 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the:system must serve a facility with a design flow of 10,000 gpd to 15,000. gpd• You must indicate either"yes"or"no"to,each of the following: (The following criteria apply to large systems in addition to the criteria above) yes 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 Q If you have answered"yes" y yes to any question in Section E the system is considered a significant threat,or answered � "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or.failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 93 Cnn G i a n t T.ane . �'otuit Owner: r ba,-1 es Ma.d.den Date of Inspection: ti �2 n 4 n n Check if the following have been done.You must indicate"yes"or"no"'as to each.of the following: Yet No Pumping information was provided by the owner,occupant,or Board of Health _ X"Were any of the system components pumped out in the previous two weeks? y 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: Yes no Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance .. is unacceptable)[310 CMR 15.302(3)(b)] 5 i Page 6 of 11 OFFICIAL INSPECTION FORM`-NOT FOR VOLUNTARY ASSESSMENTS .SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 93 �'^p��ant Lane (Intuit Owner: rharl p,Madden Date of Inspection: r,j 9 4 j 0 4 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):: _. Number of bedrooms(actual): DESIGN flow based on-310 Ch1R.15.203 (for example:110 gpd x#of bedrooms): Number of current residents: Doesresidence have a garbage der(yes or no): Is laundry on a separate sewage system(yes or no):k [if yes separate inspection required] Laundry system inspected(yes or no): $'Q o Seasonal use:(yes or no): :zOfl� Water meter readings, if available(last 2 years usage(gpd)): �0 003 Sump pump(yes or no):M Last date of occupancy:- COMMERCIAL ITOb STRIAL Type of estabMAnitnt: Des+gn flow(based on 310 CMR I5.203): d Basis.of desi�i''flow(seats/persons/sgft,etc.). Grease trap`present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to a Title 5 system(yes or no): Water.meter readings,if available: Last date of occupancy/use:�-i -- OTHER(describ.e):. GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): `tD If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system - tPo Single cesspool CO Overflow cesspool Privy W Shared system(yes or no)(if yes,attach previous inspection records,if any) tW Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) 11�Tight tank M Attach a.copy of the DEP.approval _Other(describe): Approximate��e of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 Page7ofII OFFICIAL INSPECTION-FOR,M.-NOT FOR VOLUNTARY ASSESSMENTS SUBS- } LFACE SE'VVAGE I3ISPOSA Sy$TEM TNS.I'EC'TION FORM PART C " SYSTEM INFORMATION(continued) Property Address: 91-4•�ws�v�t-,3�31=----0 owner: lCh:r 1 in ��auen Datt of I•nsocetlorsi ti 19 a ;� r„•, BUILDING SEWER{tocate-on site plan) Depth bclow.grade: Materials or construction" cut iron ,r_40 PVC/other(cxplatn); Distance frflm private wsvFr`suppty well or svctlon line'; 0+ Comments(on condhion of joints,Yent'ing,t.vidcttee of le age,e c) em vented thorough .the houlse vent13. SEPTIC TANK:( (Locate on site plan) D4p.th Wow grade:Miterifl-or construction:Lconcrcte_„ rnotal ft-bugla. olyethylcne. ocher(cxp.lain) If uc is mccai If'st ag,r; Vlo is of conlvmcii t;y a Ccrkficaie ofCor�pl{aec(yas or no): T„(attach a copy of Dtmcnslons:� � lovla, U t© u�c�o � � ��{�, • Qistx t depth: Dis.tancc from top of sludge to tionobi o75uttci tcc or baffler Scum thie+kness:S94L Distance from top of scum to top of outlet tee or baffle: C� Distance fom.bottom of sctun to bottom of outlet tee or bafflc:T,A H.ow w.e.rc dimensions determined; rYloNNI Lgd Comments(:on.pumpin.g reco.mmcndations, inlet and o�et tee or baffle condition,structural integrity, liquid levels as relate4a0'ou11e.1 Inxc►t,evidence o.f.leakage.,etc), eaa�. Zn�et and outlet teen nnn in n-Pnry -7h /�t�LLLC Ll-/La G/yboun . �. GREASE TRAP:` gvlocate on site plank Dcpth b.ctow gradc:�p Material of construction: 1�p,conc.rctc k�Lmet&1\&,fibcrglass�lpolyethylcne other (explain.. D tmen:lonx; Scum th.i*ncss: Distance horn too of scum to top of outiet(6 yr baffle: Disuncc from bottom of scum to bottom of outlet tee or bafflo: Dace of Lut pum.ping:P( Comments(on pumping rccomrtton0silons,.inlet and outlet tee or baffle condition, structural integrity,liquid ICYCLs as related toou'tict invert, evidence of:Ieaka:gc,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 93 Constant 7.ane ('ntn i t Owner: C'harl ac Madden Date of Inspection: r,/9 a /n a A TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: 1k concrete Ametal fiberglass polyethylene other(explain): Dimensions: Capacity: J 1A gallons Design Flow:ft gallons/day Alarm present(yes or no): Alarm level:_ Al in working order(yes.or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): 7.igh.t o2 hoiding .tank,6" not p2e6ent DISTRIBUTION BOX:�=—(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:, Comments(note if box is level and distribution to outlets equal,any evidence.of solids carryover,any evidence of leakage into or out of box,etc.): u ion Sox ha, one ia.tezzai. No evidence o� .eo.i'edz roRRU n„no No Uiclence o e iedkage into 02 out o ox-� PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no):1U\ Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 10jImP rhnmOvn nol ;2no%en.t 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 9-4 ( nnetant: Lane Owner: E�r.1efr-14 en Date of Inspection: "4;04 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) 1- 7000 gallon R2ecast ee¢ching 12.it If SAS not located explain why: Lo cap ed .see aqe 10 Type ✓ leaching pits,number: Ncj leaching chambers,number:"' J leaching galleries,number: leaching trenches,number,length: _ IW leaching fields,number,dime ions: 1rv% 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.): L So -;44 c47 9Pr49 F),P ,,, 11e9e4644ef� aS 1-9454Cf0 /ill? Oq -O))Op JA �7 3n �nnro the inUe2t 12iRe. CESSPOOLS:(a(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: WA Depth of scum layer: Dimensions of cesspool: Materials of construction: rM Indication of groundwater inflow(yes.or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): r0AAnnn PA nal naea42n� PRIVY: (locate on site plan) Materials of cons ction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc): 2.i.vy no# a�p.spn#.. 9 Page 10 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY-,ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(.continued)- Property-Address: U Lane ('ntn i t Owner: charl2S Madden Date of Inspection. 6 2 a /9 4 14r-o U(7) SKETCH OF SEWAGE,DISPOSAL SYSTEM Provide a sketch of the se ermanent reference landmarks or benchmarks.Locate all we is within 100 feet.Locate where public water sul ply enters the building. i \ I iA- 79 10 0 r .Page I I of I I OFFICIAL INSPECTION FORM — NOT FOR 'VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C , SYSTEM INFORMATION (continued) Property Address: 93 ('nncl-anf- T.a,Tne C Qt u it Owner: ni.M=1 . 4adeleri Date of lnspecttoa: 6,-241454 i • SITE EXAM Slope . Surface water Check cellar Shallow wells Estimated depth to ground wale Meet Plcasc 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 (abuning property/observation hole within 150 feet.of SAS) Checked with local Board of Health-explain: _ Checked with local excavators, installers. (anach documentation) _Accessed USGS database-explain: You must describe how you established the high ground water elevation: Leaching Pit :cc( Groundwater: Feet Bclow Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Thercfore,(he vertical.separation distance between the bonom �� ' Of the leaching pit and the adjusted groundwater table is t 11 rrnr,^ni'r+r-•r••^��•nsr•nn.rna--n.s+s.+•r�*fn•R+N'orTr+A*R+R+ Wr^-W,VV I IRS A-M-M-r- "-..,..,. TOWN OF Barnstable WARY OF .HEA.LTII SIAISURFACE SEWAGE JMSPOaAL SYSTEM IN811ECTION FORM - PART D•- CERTIFICATION .+-ti,.- rtnrrm+'� 'namer.rn���st' inn•nr.r+rr.n+tennnay.-rr+•••r•• • •• s, .T„,.; —T,,r.-.-,, .s.,�•rrarnneRefre.r-ten+ ..TYPO OR PRINT CLEARLY- P/IOPERT y T NSPCCTED STREET ADDRESS 93 Conziant Lane ASSESSORS MAP , .p3 QCK AND PARCEL # � Oki OWNER' S NAME -Chaake6 rladden PART D - CEfiTXFXCATXQN NAME OF INSPECTOR Bauce Raca.�lizte2 COMPANY NAME Joseph P. Macomber & 'Son Inc COMPANY ADDRESS B._. x 60, Centerville Mass 02832 Street Tolm Qr C ty 9tat• GIP COMPANY TELEPHONE ( 508 ) 775-33.38 FAX ( 508 ) 790-1-578 CUTII'ICA-VON. STATEMENT I certify that ,"I have personally inspected the sewage 'disposal system this nddr.ess and that the information reported is true., accurate, and complete as of. the time of ,inspection, The inspection was performed and any 'recoinmendatioils regarding upgrade', maintenance , and repair are consistent with my training and experience in the proper function and maintenance of o. site sewage d i sposa.i systems . Check one ; Systegi PASSED _ The inspection which I have condu.c.ted has not found any information which indicates tKat th.e system fails to adequately protect public. health or, the environment as defined i:n 310 CMR 16 . 303 , Any. failttre criteria not evaluated are as stated in the FAILURE CRITERIA section o ,this form . System FAILED* The inspection which I -have oonalticted has found that the system fails protect the jiub.lic health and. the environment in accordance with Title 5 , 3.10 CMR 15r3Q3 , and as%spevifically noted on PART C - FAILURE CRITERIA of this inspection form., Inspector Signature ate Ins P f --r--.ter-•,�,�--srs-rvT---r't�s�tict�*�*� - . ;ine copy' of this ,pwrc.i-fication.. must be provided to the OWNER, the DUYER '( where epplicabler ) and the 130ARLY OF r{SAlr'1`I{, * If the inspection FAILED, Elms- ow-nor or operator. ehal-1 upgra�de ' the ayetem. within one year oP the dnte of ,the inspection , unless allowed or required otherNise as provided in 3.10 CMR 15:r3.06 , partd .d . 6` 1ti34 F.Ef S t. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................................".......OF......................................---------.......................................... Appliration for Uiupuual Works Tuuutrurtion Punfit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: Location- ddress or Lot No. �1........C�-f ._13.0�Lp . ®.. �e _ A .-. � .._... �R----•--9AAW4 B�Ry M On � Address t --------------------------- --- ----- . Installer Address U Type of Building Size Lot_a-,,.OQ!P_.....Sq. feet Dwelling—No. of Bedrooms................I.......................Expansion Attic (M) Garbage Grinder (Ala) '4 Other—Type of Building No. of persons.......... Showers — Cafeteria a g P (v� ( ) dOther fixtures ------------------------------------------------------•-•••-•••-•-•••-•--••----------------••----•---•-----•••••••-•-•---•-••-......-•••••----•-----• W Design Flow........./,eZ?........................gallons per person per day. Total daily flow..........................................__gallons. 04 Septic Tank—Liquid capacityJV P._gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No. .................... Width...___ __....___._.. Total Length..........._-_ Total leaching area....................sq. ft. x ' .. Seepage Pit No--------------------- Diameter_._._ra_ Depth below inlet.....------------ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....----------------------------------------------- :� __ Date---------------------------------------- �T . Test Pit o. 1................minutes per inch Depth of Test Pit___-__1Z-_.._.__.. Depth to ground water... _ ... fT4 Test Pit No. 2.... ......minutes per inch Depth of Test Pit...../.Z....._.. Depth to ground water.-A/0-_. 0 Description of Soil--��f-••-----•••-••••----•-----•------...•---.....•--••••-----•••---•---------•--••••-•-•••-...-• --.--••--------------------•......_...... W ------------------------- ..................................................... •-•-•---•--•---•-------•---------•---------------•••-•-•-••-•••-•-•-•---•-•-•--•••-•-•--------------------..........•... UNature of Repairs or Alterations—Answer when applicable................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T'=i.i�p of the state Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Corrpliance has been issued by the boa d o health. � l " Signed n / 30 � Application Approved By.............................................. ... -�-r---� er_--------------- ......................... ate Application Disapproved for the following reasons-------------------------------------•---------------------------------- -------------------------------•-------- ..............•--••-••-•-----•--•....-•••-•••••---------••-•--•--••••-•-••-••••••-••..........-----•------•••-•••-----•-•--•------••----•••-•--•-••---•••-------••••••••••...-•----------------•--•-••-- Date PermitNo....................................................... Issued-....................................................... Date ,No......................... Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' J .... ........ .................O F.........-..-..........-.....--.......---------------------...-.. Appliratioai for. Bi"asFal Works Tomunrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: ................_--...._........................................................................ ....... Location- ddress or Lot No. 4•_ St fS1._1f1.5. ., _ 2__l t�c�j?rSI2.. �' t'���f'�F" ..�f)! O r Address Installer Address Q Type of Building Size Lot_ &.,._p a____._Sq. feet Dwelling—No. of Bedrooms................. .......................Expansion Attic (ND) Garbage Grinder (No) aOther—Type of Building ____________________________ No. of persons......... _________.____ Showers (�) — Cafeteria ( ) QOther fixtures _-------•---------------------------------------•-------•------------------------------._--------------------------------------....---••-••.._..•--•- W Design Flow......... 7?........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/ov-0_gallons Length................ Width.........._..... Diameter---------------- Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter...... a _�_.___ Depth below inlet_____.6______.____ Total leaching area.. ................ ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.................... -----------------------------....................... Date........................................ ,a Test Pit No. 1__..__ -:_.__..minutesperinch Depth of Test Pit..._.1. _.__._.____ Depth to ground water._��d___ -° rZ4 Test Pit No. 2...... ........minutes per inch Depth of Test Pit.....!_2__`.______. Depth to ground water.-A!�P___ • - ODescription of Soil....-�---•�l --•----•--------------------------•-•----•-•-----•----------------------------•-------------------•--------•--............................ W V •••-•-•----••--••------••••-------••----••---•---•--••-•-•----•••--••-•---•-•••----•-•--•------•---•-•----•---------•••••-•••--••-•-•-••-•--•--•-••-•----••••••--••••••••-••-•••-------••-•••••••-••••-- W UNature of Repairs or Alterations—Answer when applicable................................................................................................ •------------------------------------------------------------------------------------•--•----...-------------------------------------------------------•------------•-----•--••---•---••..._•--•---•-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i,TIE ; of the State Sanitai ''Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by thkb.oad " health. Signed. . _e...... �:,..--•- 1rJ- '� " /------30.--•Y•17Date A lication A roved B !.. .- ---:----3- 86 PP PP y-------••--•-------•-•-•••----••-- i_ ....--•__•-•-- ------ Date Application Disapproved for the following reasons---------------------------------•----------------.............................................................. ............................................................-•--••••--•------•-•-•••--•-------......•---••--------_.._..-•-•--•----•-------•-••--------•••--•-•-•-••••--•---•------•-................ Date PermitNo......................................................... Issued----------------------................................ w Date THE COMMONWEALTH OF MASSACHUSETTS --' BOARD OF HEALTH Tatifirtttp of TompfiFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal S"t9j,, istructed ( or Repaired Instu , I .1,";, at--•----••---..._..--••- �. 7 :�r_�_.. �`{. k'�}-----------------LSD-t'\ C..' ''` has been installed in accordance with the provisions of i.i t t j of The State Sanitary Code as,describf d in the Works � application for Disposal orks Constriction Permit .__ ........ dated_.-.___ -_-- .�-��--1--�:6•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NQT'.,BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEIi WILL FUNCTION SATISFACTORY. DATE.........-•'•...................................................................... Insp tor.................................................................................... A = THE COMMONWEALTH OF MASSACHUSETTS �__--- BOARD OF HEALTH ' .:�/ /� 1. ma N o..----- FEE................ �i��o�at� ork� ��no-#pion rani# Permission is hereby granted..............__:.. .__ .. ................. �.. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System `O--� at No................ ........... ---.�•---- r --- rZ.v�: �.A xl�.-------`-�•_- --------- - -------------------- --------------- Street /U?4 as shown on the application for Disposal Works Construction Permit No..................... Dated......... q_18_o ................................................ ....V. -- -= Boar f Health DATE...................................•--•-g-!_____=- FORM 1255 HOBBS & WARREN, NNC.. PUBLISHERS - no ° L.o T 3? 0 o° N 210, 000 � N h IVDA►,, Pir f r-T•EFF.D&Pr�1 V e J #ti gok �?1 'S��Q�C j000UA���oNc. SePTti c TAMII- P.V.c. - P0 SL� :N A 12s' 3 6Eu -0"M {lv u 5 f ( `2.4 ' 5 N y 5° h sr+AJ r Z-AAJE r^n ��,� C�1' c�'� 20 C�REtN I,EA� FARMS CR' S+�Rom' • r S/ . S I 10 C O I sT.g� Z �S—�t wasti�d sna 14 eoc CoFr• D!p►A4. o Fr LE 4g.4 0 0 0 lOo C-�al. core-. Q o ea Go►.1c•Lr-Ac"lmcn P,r SeP�t�. Ton k 48 S p 4a d AAA A 0 0AA 3 t=r• 42 0 I&A I A e .' /¢-1 �t kta5/lcd s-t ne Bor. P�-r Env r�Psor9" �� v pEs IC, DA-r-A Svbs RCoLATI�t�! RATIr: AIIAI C Ro P �►av � D TEST PER F'O RM ED S e P-r t o ,31I 6P-PROOMS K ItO G%PD = 3SO CPD LEACNIN(j I�10 GARBAC-4e DISPOI AL USEJooa GAL.SEPrItT�K MEDIUM eoly 80-r CAN PAG IT y FR,0V 10 E D : M M 4�v Pic. 48 `730T r.bM -IF e.z-K 1 , o S� oEs I13 GPD K 2.5 = 56 S C P D SAUD SAMD TOT-41 CA PAC ITy F 0v1DeD (,.7 c-e C — D v5 PO—<A L_ 5V..sssn, " s�:y'�/v . c:•t r ♦ I ?vim. v � r� A c C'_o R D^"r-S v`t ) T" PROVISIONS O.F T'cT>~er 5 0 TAS MA55 . G-NV IROlJME:NTA� Cote . Co�3 sT>F.wr Lm . r,J o 6PouND W,4-T-P TOWN OF BARNSTABLE LOCATIO�t�'Y I7 Lwe SEWAGE # �' 'VILLAGE eol � �55. ASSESSOR'S MAP & LOT M 39 L' I C M INSTALLER'S NAME & PHONE NO. CA.)v-tr�zaL , SEPTIC TANK CAPACITY t d O C,! !) H-1ltz►Z LEACHING FACILITY: t L `ll size �NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER C-Cz,"_ e— �- `C'ZO� CAS DATE PERMIT ISSUED: ,. @� 1 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No /` j �.pr�$Tc��1 ��_III � ,'', i . . , � � .i �w 1`... `j ty„�� i4- ��. � ,; �� ��'� �® 5���� I , TOWN OF BARNS TABLE LOCATIO 1tc SEWAGE # t 4 VILLAGE a �� C ASSESSOR'S MAP & LOT ! �.- 6/ INSTALLER'S NAME& PHONE No SEPTIC TANK CAPACITY O 8(y p"11c j EACHING FACIL�TY:(type) ',, iZ kNO. OF BEDROOMS PRIVATE.WELL OR PUBLIC WATER BUILDER OR OWNER;,. DATE PERMIT ISSUED: Lo DATE COMPLIANCE ISSUED: � 7 VARIANCE GRANTED: Yes N0{ 4. y i 3r r i SEW GE INSPECTIONS DATE �6CA�ON„ _L {ASSESSOR'S MAP k LOT VC.LAGE CJ�� � -INSPECTOR t� SEPTIC TANK CAPACI'I"Y Q�,� �(size) LEACKNO YACILM: (type) No.OF BEDROOM SUII.DER OR OWNER OWNER MAILING ADDRESS n4-oo sg� I WI o ,. o� ll '' �X 0 t , k 3 � -44 lo N CNlu 3 4M LEGEND � N EXISTING CONTOUR Q �OVte le x 100.98 EXISTING SPOT GRADE Z82A Go° e P® —W EXISTING WATER SERVICE P 2 Q�� c °� G —G EXISTING GAS SERVICE IS TEST PIT BENCHMARK �a LOCUS SomPso" LOCUS MAP N 30'37'05" E NOT TO SCALE 130.00' 4 4 U � W LAj \\ LOT 37 W 101,48 x 100,25 26,000±S.F. Q r 0 -- ------ , Li-A Q) �i 9S 51 o E Q EXISTING LEACH PIT x 10245 (approximate) 00 l TO BE LOCATED, PUMPED, FILLED WITH SAND and i i ABANDONED w \\\ +•101,27 + 10 \ W 1�n o \ O \ I O 1 N p \ \ I l W N O \ �� i� N LO �t 99.30 0 Ln cn 1OL99 CO- • cv ' — EXISTING SEPTIC TANK a� l::si�R7P:=7 - (A (TO N (TO REMAIN) \ f` •' :..� TP-15 TOP OF TANK, EL.=100.92 O 1:= O C i INV.(OUT)=99.57f �\ 102,52 + . 011 + 102.66 �� O x BENCHMARK 101.86 CORNER/A.C. PAD 99 48 EL.—102.88 DECK N 102.54 \ 102.75 �� rins AC I x \t\ PERGOLA 101,95 P 100.870 � I i /EXISTING r o HOUSE(193) GARAGE Q T.0.F.=104.5f x 10 2.8 8 i 162,64 . x y, 102.70 + WALK �0 ,•. /� 102.74 1112,04:`. o PETER T. ���'LAMP 99.98 McENTEE CIVIL "' c9 �� - �02,1 Q ,•:.:' No. 35109 mp I i 130.00' ''' x l0 ,25 N 303705 E - '1 J FENCE 101.53 CATCH BASIN EDGE OF PAVEMENT 99.14 98.46 'P61 97.51 100,80 OWNER OF RECORD CONSTANT LANE REGAN, ROBERT F & LORRAINE S TRS 82 WEST STREET PARCEL ID: 039-061 SOUTH WEYMOUTH, MA 02190 Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 1"=20' P.T.M. 290-18 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 93 CONSTANT LANE COTUIT MA (508) 477-5313 12/20/18 P.T.M. 1 Of 2 Prepared for: Cape Cod Septic Services, 350 Main St., W. Yarmouth, MA 02673 \.F NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL=98.0 SEPTIC TANK PROPOSED D-BOX FOR A DISTANCE OF 15' FROM THE EDGE OF THE PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT PROPOSED S.A.S. OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE INSTALL. RISER & COVER OVER ONE CHAMBER AND' T.O.F.=104.5t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT F.G. EL.=102.5t F.G. EL.=102.1 t 'ENT F.G. EL. F.G. EL.=102.1 t to 100.5t MAINTAIN 2% SLOPE OVER S.A.S. - SET PIPE LEVEL FOR 2' L = 20' L = 5' S=1% (MIN.) ® S=1% (MIN.) 2" LAYER OF 1/8` TO 1/2" 4"SCH40 PVC 4"SCH40 PVC a" DOUBLE WASHED STONE 10"I as $ as (OR APPROVED FILTER FABRIC) 14" s' 2' EFF. eaaaaaB DEPTH aBaBaBa --3/4- TO 1-1/2" DOUBLE EXISTING 4a' WASHED STONE LEVEL ADD 4' 4.8' 4' GAS BAFFLE INV.=98.17 PROPOSED INV.=98.00 INV.=99.57t D-BOX EFFECTIVE WIDTH = 12.8' EXISTING INV.=97.50 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN NOTES: H-20 RATED 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP CONC. ELEV.=97.8t INVERTS, PRIOR TO INSTALLATION. BREAKOUT ELEV.=98.00 INV. ELEV.=97.50 E3 2) D-BOX SHALL BE SET LEVEL AND TRUE TO aaaaaaaaaaa GRADE ON A MECHANICALLY COMPACTED SIX Im aaaaaaaaaaa INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=95.50 310 CMR 15.221(2). 4' OF NATURALLY OCCURRING 4' 2 x 8.5' = 17.0 4- 3) INSTALL INLET & OUTLET TEES AS REQUIRED. PERVIOUS MATERIAL EFFECTIVE LENGTH = 25.0' 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W., EL=89.0 _ LEACHING SYSTEM SECTION SEPTIC SYSTEM PROFILE N.T.S. GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: X STING -310 CMR 15.405(1)(b): HOUSE(#93) 1) A 3' variance to the 3' maximum cover requirement, for up to GARAGE o.F.=�o�.3f 6' of max. cover. S.A.S. shall be H-20 and vented. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR / TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4.-ANY- CONDITIONS ENCOUNTERED DURING-CONSTRUCTION DIFFERING -- v -_- - - -_ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN DECK ENGINEER BEFORE CONSTRUCTION CONTINUES. p o 2 5. ALL ELEVATIONS BASED ON AN ASSIGNED DATUM. �N N o 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF I v THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF r1 26 irn HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. , PROPOSED 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. ao S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS OD J AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. -25.0'-�I 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SEPTIC EPTIC LAYOUT 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE SOIL LOG INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND DATE: DECEMBER 20, 2018 (REF#15,863) NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. SOIL EVALUATOR: PETER McENTEE PE(SE#1542) WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT ELEV. T P- 1 DEPTH ELEV. T P-2 DEPTH DESIGN CRITERIA 100.0 A 01, 100.1 A D" LOAMY SAND LOAMY SAND NUMBER OF BEDROOMS: 3 BEDROOMS 1OYR 4/2 1OYR 4/2 SOIL TEXTURAL CLASS: CLASS 1 99.3 B 8" 100.0 B 8" DESIGN PERCOLATION RATE: <2 MIN/IN LOAMY SAND LOAMY SAND DAILY FLOW: 330 G.P.D. IOYR 5/a 10YR 5/8 97.7 9�.6 30" DESIGN FLOW: 330 G.P.D. C P$RC C GARBAGE GRINDER: NO-not allowed with design 28"/46" LEACHING AREA REQUIRED: (330) = 445.9 S.F. .74 EXISTING SEPTIC TANK: 1000 GALLON CAPACITY MED. SAND MED. SAND PROPOSED D-BOX: 1 INLET, 3 OUTLETS, H-10 RATED 2.5Y s/s 2.5Y 6/6 USE 2-500 GALLON LEACHING CHAMBERS IN SERIES SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. 89_0 132" 89.1 132" BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. PERC RATE <2 MIN/IN. "C" HORIZON TOTAL AREA:.............................................................. 471.2 S.F. NO GROUNDWATER ENCOUNTERED DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD Engineering by: SCALE DRAWN JOB. N0. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 290-18 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET No. 93 CONSTANT LANE COTUIT MA (508) 477-5313 12/20/18 P.T.M. 2 Of 2 Prepared for: Cape Cod Septic Services, 350 Main St., W. Yarmouth, MA 02673