HomeMy WebLinkAbout0080 COTUIT BAY DRIVE - Health W96 CofUA.+
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN Of BARNSTABLE, MASSACHUSETTS Yes
01ppliCation for Mispo8al 6pstem Construction Permit
Application for a Permit to Construct( ) Repair(Y Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 90 00'ruf Z-- Bkp�y'Dk V6- Owner's Name,Address,and Tel No
Assessor's Map/Parcel wl�l.r�T' OAI ® C q
Installer's Name,Address,and Tel.No. 1949 7 D Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms �"� Lot Size oZ -73 — sq.ft. Garbage Grinder( )
Other Type of Building PL65[() ,'["! No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 44o gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title go c o—ri a--r 8&4 'MILL E C(-_1_rJ t 1-
Size of Septic Tank 600 GA4"VT Type of S.A.S. C3) �;UD G4Lj..,6 jj e-rfy "
Description of Soil
'
�,N�ature of Repairs or Alterations(Answe�hen appl�le) („k ��c�'C�� ����� ���`a'd�,
v
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mat nance of the afore described on-site sewage disposal system in 1
accordance with the provisions of Title 5 of the Environmental C e d not to pla e the Z/�_ Date
operation until a Certificate of
Compliance has been issued by this Board of al Signed
Application Approved by Date 2 Z Z
Application Disapproved by Date
for the following reasons
Permit No. lt�Z 033 Date Issued L Z
•,,4' ^ � r tip'-- .�Y . 'F..r ''Y{y�.- .. ;J'.s r�..�t~y,..y.r.z F 4 .. •., .,. .. r..�_ ,7„..,,
No.
$ Feee,.
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Entered in computer:
THE COMMONWEALTH'OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - TQW,rN OF BARNSTABLE, MASSACHUSETTS Yes
plication for Disposal 6pstem Construftion 3permit
Application for a Permit to Construct( ) Repair(Y Upgrade( ) Abandon O ❑Complete System ❑'Individual':Componerits
Location Address or Lot No. 40 Cagui r BAy'0;4 u6 Owner's Name,Address,and Tel No w+
A694f , h�11ruSE 7RUw�+
Assessor's Map/Parcel (� d.►/7"" �,t
Installer's Name,Address,and Tel.No. SM_qJ 7,$a$Il Designer's Name,Address,and Tel.No. - ►,,�" *l
Type of Building:
Dwelling No.of Bedrooms Lot Size rr� '.�e ^" sq.ft. Garbage Grinder
Other Type of Building REDS(be,•)TI A L_ No.,of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) - gpd Design flow provided x gpd
Plan Date . : f `kO"?, Number
of sheets � Revision Date
t
Title 90 do-r4.tr-r RAq TAw
Size of Septic Tank , 6tac) tS,AC tyV C Type of S.A.S.
i Description of Soil E- '1 «• C!,rb � if
Natur'e.of Repairs or Alterations(Answer when applicable)
e
! �Z` op-
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maip enance 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
Signed/ / (,• f/i✓✓ / _a Date .' "'
Application Approved by a 1 Date L
Application Disapproved by Date '
for the following reasons
Permit No. Date Issued
- ------------------------------------------------. ----------
THE COMMONWEALTH OF MASSACHUSETTS
°,BARNSTABLE,MASSACHUSETTS
Certificated Compliance ' ..
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired O Upgraded( >)
Abandoned( )by s P- fu 0 do
a
at 'go &-ru r P,4\( Out <4)-roe-r has been constructed in accordance J /
with the provisions of Title 5 and the for Disposal System Construction Permit No. ed
Installer �(»�."� due O QkK fit , Designer W 9 Gild& C_ d.
#bedrooms T Approved design flow gpd
'The issuance of this permi shall not be construed as a guarantee that the system wi igned.
Date ZD Inspector -��
---------------------------
• No. ✓��1 . Fee �� C •• -
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair^{X) Upgrade( ) Abandon( )
System located at 9e) C t�t.� lT.al UjE e\-Y-a I.
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. 1
h�Provided:Constructio (must be completed within three years of the date of this permit. \
Z
Date �'/ 2 1. Approved by
Town of Barnstable
.°� Regulatory Services
Richard V. Scali Interim Director
a�uYerUM �
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 2-8-22 Sewage Permit# ZiX2'033 Assessor's Map\Parcel 56/25
Designer: JC Engineering,Inc. Installer: Robert B. Our Co., Inc. (RBO)
Address: 2854 Cranberry Highway Address: 363 Whites Path
East Wareham,MA 02538 South Yarmouth,MA
i
On Z I Z I ZZ RBp was issued a permit to install a
(date) (installer)
septic system at 80 Cotuit Bay Drive based on a design drawn by
(address)
JC Engineering,Inc. dated 12-28-21
(designer)
X I certify that the septic system referenced above was installed substantially according
to the design, which may include minor approved changes such as lateral relocation of
the distribution box and/or septic tank. Strip out (if required) was ,inspected-and the
soils were found satisfactory.
F certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
y.
I certify that the system referenced above was constructed i Banco with the terms
of the I\A approval letters(if applicable) ;QF ygss 9
r� o�ya 9CyG �
JOHN L E`
Mo , CHURCHILL JR,
"'nstal s ,nature) CIVIL
41
4
0
F
(D 'ner's Signature (Affix De' t p Here)
PL SE RETURN TO ARNSTABLE PUBLIC HEALTH D SION. CERTIFICATE
`OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS "FORM AND AS-
.BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION:
.THANK YOU.
Q:\Septic\Designer Certification Form'Rev 8-14=13.doc
Affidavit
I, Craig Hanson on oath hereby d:epose'and state as.followsc
1. 1 am the Trustee of the Caroline,E;.'Hanson Trust;
2. 1 hold title to the property at.80 Cotuit Bay Drive in.Cotuit, Massachusetts.
3. Attached is a sketch plan of the:home at 80 Cotuit Bay Drive in Cotuit, Massachusetts.
4. Prior to July 4,2008 there were 4 bedrooms in the home at 80 Cotuit Bay Drive inCotuit;
Massachusetts.
Signed under the penalties of perjury.
Craig O. nson,Trustee
Caroline.E.Hanson Trust
COMMONWEALTH OF MASSACHUSETTS.
Barnstable,SS.
On this 26th day ofJanu:ary,.202'2, before me„the undersigned;notary public, personally
appeared Craig 0. Hanson,Trustee and proved to me through satisfactory evidence of
identification,which.was a valid'drivers' license or my own.personal knowledge,to be the
person whose name is signed on the preceding or attached document, and who swore or
affirmed to me that the contents°of the document are truthful and accurate to the best of his
knowledge°and belief,and acknoiNledged to me that he signed it voluntarily for,its'stated
purpose.
NotarVTubuc,'-
My Commission Expires:a �
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TOWN OF BAnRNSTABLE
LOCATION S �i mil/ U/T L.W. SEWAGE# 70ZZ - O3-3
VILLAGE Tjif/ ASSESSOR'S MAP y&1 PARCEL Spar-2j
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) Pg$(size) 12•03 - e33•S
NO.OF BEDROOMS
OWNER L i-I
PERMIT DATE: COMPLIANCE DATE: Z ZZ
Separation Distance Between the: '11
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) *� Feet
FURNISHED BY (� � U• ®�il�
A 3
IS 3z Z
G/
TOWN OF B
ARNSTABLE
LOCATION 17-- 1
SEWAGE#
VILLAGE
ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. •T B �tIL R�
SEPTIC TANK CAPACITY ?
i
LEACHING FACILITY:
(type) /. G► size) _IZ•gL )' S
NO.OF BEDROOMS .4
OWNER
PERMIT DATE:
COMPLIANCE DATE: Z
Separation Distance Between the:
Maximum Adjusted-Groundwater Table to the Bottom of Leaching Facility /� I Private Water Supply Well and Leaching Facility(If any wells exist on Feet
site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist within Feet
300 feet of leaching facility)
FURMSHED BY .� Feet• 4u� i
A �
Z 15- 32 Z
i
Charles M. Sabatt PC
Attorney At Law
'540 Main Street — Suite 8
Telephone Hyannis, MA 02601 Facsimile
508-775-5050 508-778-4600
November 27, 2021
Thomas McKean, RS, CHO
Agent of the Board of Health
Town of Barnstable
Public Health Division
200 Main Street
Hyannis, MA 02601
RE: 80 Cotuit Bay Drive, Cotuit, MA 02635
Dear Mr. McKean:
Please be advised that I represent Craig Hanson who is now the Trustee of the Caroline
E Hanson Trust. Mrs. Hanson°Passed away on August 25, 2021.
The Trustee"has�asked me to-r0spond to your letter of November 17, 2021 ordering him
'to replace the septic system at.the above premises. I am writing to advise you that he
has contracted with Robert B. Our Co., Inc. to perform the replacement of the system. A
copy of the contract is enclosed for your reference. He anticipates that the replacement
will be completed within the next 4 months.
Please contact me in the event'that you have any questions or require further
information.
Thank you very much for your.attention to this matter.
Sincerely,
Charles M. Sabatt
Enclosures..-
CC:,-:Craig,Han§66` r
,ix�•,r t g"t.-,�• 1•.n. + ra f ''„�i.t �.. •-,n_C`'.r .:� yr' 1 ' P•,
A .13,
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, � 2 .
PROPOSAL SUBMI71T.ED M`_. -_._ WORK TO.BEPERFORMEID AT:
NAME. C aig-Hanson ADDRESS,.Same
ALIDRESS:• 10 COtbit-Bay Drive
Cotuit,MA OJ635 _ <� i
BONE .509-428=3 EMAtL cratgharison �hrerizor�.oet
The Roiiert-B Our:Co:prof ises tc�furnish all,materials acid•lat or.necessary to.construct a True V septic
system in,": cco dance vs�fti 32t} R:nepai'crEieei o€E w ronme eta[Prcote+eCon: tie siibjecr i�ropertji;at
go CotuitBay Dr jre:ma flour-bedroom,dwelling:with,design_ tow of4�lt)-gallons:per.day.
wdrtctd.Include-
• 1319Safie'Piope tj asneededt %na1r1<aistuiadergrourrd.tiitriities. :
s Co itluct-a town:moriitbred perctes['and soil,evaluation.
•SuveyproPer#Yas-needed
® Supply'ai?:engineereii-ptanfiay:tfie„solepuipose,df'upgi�adin"gtoaTdle lcompliarrtan-5ite:systerim.
o. . Corn p eCe,ifie--permittingprocws-and.provide a.d'csposal works cousin ctio9.perr nit.
+� Fump:;eiasurig p-tank.art. e:ef construction and suPAly new sanitary tees and:gas,baffle as
neede&--Quote a mmjes e;ds gtank can`tie irrrcirWo.1ed kiW heW de*g2
Abandon existing leading prt p&Tdle V.
Removes4im J asneededmWorkarea.
Trench:from-pasttingseptictankto location-of;new drstribution box.
• Excavatefor instal:a distributizn oox;per.plan-
® Excavate fat and`construct a new leach field'iwaccordance-war engineered plai
e After•inspectio:ts,the i na area will be backfilted,and- raded-with.pritite material.
e .wood chips:vail tiespread overOdshng w000ed/siump area:or:proposed feacf�ing-freld.
• ,:.Loam ar�rl.seesi mill Be spreaii#o aU imp tbM grassy areas ut-spdn as.rivea#fier permiis
Septic Conba�,'80 C-"B.sy D ive Co" 11B/21 -h--.V :...••.
u
s.vrr'[2',iy$frc,'.zi` ,-' ^fir-
I
Work-Notlnduded:
• AnVjrOdep.JarRWn& j
:.
3-
.
• Any upgrades i o eteCtrtcai servio : "° °
•• iVtuve nentofa rgesc s faLe bot tilers •fences,sheds orothet;obtWe'stliatsnay.`ie.ericountered..
e Moveinentofapyurtdergroundv4Tites;iE,water,.el %Mc.gas,phone oriable:
i
• Any.representation-at Board of,H,�aith.or Conservati Ci e.,variance:.m"eetings:-filing)
o emirs
The.material;is=gilaranteed to-We as s�edfied,.and.the above w'oi4e:to be-performed..accordance.with,#he
drawin and cations sul mrtted`for°:abovemork.and_-completed in.a-subs untial.wo k nanfikQ manner,
g . sOcifi
forthe:siim of$15885f1� `
mr payinei m tD be made as-follow
$;SIAO:on signing
$'9�0.810'alr start irf:yrork
t
$1885A0'at,corripletoiort
l
~ imgafion re arir.is needeif trddrtronal costs wr7/arpply.:simple repairs;oreInduded j
4
Caam&seed tavbe:appTiedarice,gtararrtee of grdwth&'mmirtenonce:aretfie;irameownes responsibtifs+
Yjriateassumesperch�sfresrtltSswiltpovk f.'!rO pyorarfteelevatrarris&nvgrourrdaraterencau rent; a
�R���fP�rsmirs rer#�ired,_odaGfi�naf,aoists aPPTy don deFth m►d airtorirrtof Ow'+c.sandregrrMd.
NOTE 'fits proposal may be w idrawn by us if n6t acc pted wrthrn 3o days�4r►v albeiat�on oT ae an from above sperifications
rnrrolvmg extra mst:will be':executery'only►iron written.order and vsnll becorr►e an extra charge over and above We estimate..
Alterabor and dey;atlnns'froin the'.abave p►tsat Y _
be due to unsuctahyeJnnpervrousscd condrtwris or water table elevations.
not; favorable. M. ,� . our control. in the evem-that
aarriu:. t upon stnloes,amderrts,or-delays tieyond
underground utrTrtte! are obstrrrctiirrg the s/�tem,tfie urstotner is espor>srbk for the cost:of resituatiiig,theft We are not
r esprormble fioF arry:rrregateon lines,bees,budres,sh►ubs;or ptautts:untess spered►r►wrrbng.by the Robert S Our Co We are not
resporrsitrle for drnreway;tiarrrage due to the weightofequipment/ fiery tf the desrgn plarfi makes use of
existing optic tank as
Oft of the, rew system,tfie Hobert B_Our Co,is not respoible for the cnridfion of"the sewer line fraire the house to Elie existing
septic tank he a stomar viiwzlE be responsrw for anyadditraisal costs ifirericti'permrtand trenc}i protecEiori ate rie ed,
ACCEPTANCE OF OROPOSAL
The-above:prices;spedficauons and tanftons arO--i st aid cry and Ke:he re byocceotecL You,are authorized
:to do the work`as spedfied.::�'avments-mh tie made as outlined above.
Cistorne"r Signature.
Signature
A►u#toriz" tto 6-Our A., epnesentaitive
Septic;Contraci;86'Cotu Bay DriVdr Cotu"it 1pr
tt$ 9 lrirfFal__ %�
�:;pr•x,..,..4.'� .Y,M`„YE.."a_v?'"z'1�'-..r�'EiC�t`�aµ. . ?`��.:�t,^E°S:z363'ai$o -.. ..
Z
Town of Barnstable �
Inspectional Services Department
(t=�
Bt.L)=
, Public Health Division
��=\Bnftt+rsrn
f 200 Main Street, Hyannis MA 02601
Office: 508-8624644
FAX: 508-790-6304 Thomas A.McKean;CHO
CERTIFIED MAIL#7015 1730 0001 4989 0458
November 17,2021
HANSON, CAROLINE E TR
80 COTUIT BAY DRIVE
COTUIT, MA 02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
S
The septic system located at 80 Cotuit Bay Drive, Cotuit,MA was inspected on
11/03/2021 by Michael Sears, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Fails" under the guidelines
of 1.995 TITLE V (310 CMR 15.00)due to the following:
• Static liquid level in the distribution box is above the outlet invert due to.an
overloaded or clogged SAS or cesspool
You are ordered to repair or replace the septic system within one (1)year from the date
you receive this notification. Failure to repair/replace the septic system within the
deadline period will result in future enforcement action.
i
You may be eligible for a waiver from replacing an onsite sewage disposal system if your
property will be connected to public sewer in the near future. For information regarding
public sewer availability at your property,please go to
httl)s://NN w.townofbarnstable.us/Departments/Asscssinl tPloli�ertv Values/Properly-
Look-Up.asp or telephone the DPW Administration Office at (508) 790-6400. Any
written request for a waiver or extension must be filed in writing to the Board of Health,
200 Main Street, Hyannis MA, 02601
1
PER ORDER OF THE BOARD OF HEALTH
lrolrtas (\lchea i; Z S, CHO,Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report betters Mailing\Failed or Needs Further Evaluation Letters\80 Cotuit Bay Drive Cotuit.doc
No......... ....... .. Fps... '
-r-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...... ........_._.. ....-- --......OF....................._....................... --------------...........--....
Appliratiun for Bi-quiia1 Worko Tunitxnrtiun unfit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: //� ^'l ,Y/) //p`�
LOT- /OC cervir 64V � �r.........l"arv"r )11 i
..............••- . ......................---•-----•.---•- --....----- ---.....---•----------...-----•--•-------------•--•-------...•------------•--............--------•
Lo ation-Address or Lot No.
&BY-01r <S�R�( Sf�><o.'_GS 7 Z e �'ea P�.T Y12tir s
...............-• ................................................ --...---........--------------------------.............---
Owner Address
an. �---------------------------------------------------------------------- --------------------------------------------------------
Installer Address
QType of Building Size Lot___A.7-_110°-......Sq. feet
Dwelling—No. of Bedrooms-----............. .........................� Expansion Attic (� Garbage Grinder
`4 Other—Type of Buildings c « No. of persons...3--------------------- Showers 2- — Cafeteria
t�
Q ....j.�.Other ..................er fixtures -------------------------------------------------------------------------------------------------------------------------------••---------......----
Design Flow ..........gallons per person per day. Total daily flow........ .. .�...-�....._...._----gallons.
W JS
� Septic Tank—Liquid capacity._.____._.bU
..gallons Length................ Width................ Diameter---------------- Depth................
W Disposal Trench—No--------------------- Width.................... Total Length_.................... Total leaching area.................... q. ft.
Seepage Pit No----_--------------- Diameter----/Q----------- Depth below inlet............ ..... Total leaching area.....�U 6...sq. ft.
Z Other Distribution box ( L4 Dosing tank
IZ, // o
Percolation Test Results Performed by........ ._�m. . --------------- Date..... ....._.. .._.. ................
aTest Pit No. 1._.`l......minutes per inch Depth of Test Pit................... Depth to ground water_-___--______-_--_--___.
Test Pit No. 2................minutes per inch Depth of Test Pit________-.--____-_ Depth to ground water._._-._____-_---.._____-
--- •------------•---------------------------•--•---------------•--•-------•--------------••--•--...--••--------•-----
O Description of Soil-----® /L "�` 5.�....S ------------------------------- ------ ---------------------------------
W2 ------•--•-- ------...
------------------------- ------------------------------------------------------------•----------------------------------------------------.--••------------------------------•-----------------------
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 L T i y g g p< y
S of the State Sanitary Code— The undersigned furtl era agrees not to place the system in
operation until a Certificate of Compliance has been ' ued by the board off health.
�°�- '� � 1__,
Dat
Application Approved By..."• �' , �� L/_-------------------
Application ---•..............•-- Date
Disapproved for the following reasons------------------------- ----------------------------------------------------------------Da._.....-----•---
----------------------------••---•----•- ...........--•------•----------...••--•----------•-•---•-------.........................................................................................
Date
PermitNo......................................................... Issued... `11 ...............................
Date
0 ,,l
No........ ....... u Fss... .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
d
.................._.._.......-...........OF..............................
Appliration for Diiip'lial Workii Tomitrurtinm frrmft
Application is hereby made for a Perm#jp,.:Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at• 3 "x
.............................•--•-_... -• ••............................. .......---- •--•--.........--•---....._. ....-••--•---_... --......---......_.
/� L anon Address or Lot No.
....:tir.p vel` f1. A4Z_;f.-•-•- t".................................................r � t9 / ,te• r p ''/T'- �/►Af
............. •-......_..._ - --
Owner Address
T e
� Installer . Address
d YP of Building Size Lot___°�_?_...Q.. ...... feet
Dwelling—No' of Bedrooms_____ f __________Expansion Attic ( Garbage Grinder
Other—Type e of Building �$Y .R� No. of persons.... Showers
Pa YP g --------•=---•-------------- P ('l) — Cafeteria ( )
' a
Other fixtures -----------------------------------------------------.-------------------------------------------------------------------••----------------....------
W Design Flow_____«aT_O_______________________________gallons per person per day. Total daily flow_______ _+ A!._._'......___________..gallons.
WSeptic Tank—Liquid capacity_44tgallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No_____________________ Width_____ ............. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter..._jD-........... Depth below inlet.................... Total leaching area..... ...sq. ft.
Z Other Distribution box ( Dosing tank (
0-4r
Percolation Test Results Performed by- ____r '. ••----
Date....� ��'' 'd................
Test Pit No. l.__"' minutes per inch Depth of Test it...................'_ Depth to ground water________________________
;14 Test Pit No. 2______ w minutes per 'inchq„ Depth of Test Pit____________________ Depth-to ground,water
R+ ?.... ...__ .
Description of Soil-----0- .._ _.�._ ....._.• x ��` '
... __ - - -oaf . � :
--------------------------------------------------------------------•- -•--••--••---•---•••--•------------•---
U Nature of Repairs or Alterations—Answer when applicable._''________________
..---•-------•--_...-•------•---_-•-
.
Agreement:
The undersigned agrees to install the aforedescfibed Individual Sewage Disposal System in accordance with
the provisions of TiT E, 5 of the State Sanitary-'Code—.The undersigned further.aj-•ees not to place the,,;spstem in
operation until a Certificate of Compliance has been " 'ued b fhe Boaid'of health:
Sign a - Z
..................Dat
Application Approved By--"'---i'`rr ._.� ..................-.__: l : �J•*••-•--
., j---•- r•- - -- •-- Date i
Application Disapproved for the following reasons:..............................................................................................................
{ Date ti
Permit No........:.............•-_- - ________ __ Issued.______ YW
-•--•-• -•------------
THE COMMONWEALTH OF MASSACHUSETTS
LL BOARD OF HEAL H
........ �J . ..............oF....... . ......_................................._
Trrtifiratr of ToutpliFattrr
I THIS IS TO CERTIFY, That the Individual Sewage Disposal System construcxed;r('r^ r Repaired ( )
by_ r_� f►J ----••.-. - __ ......................................................
-------------- ---
has been installed in accordance with the rovisions of 'r 5 .f The State Sanitary Code
s des c,�ibgd in the
t"..
application for Disposal Works Construction Permit No. _____________ __ ____ _ aa ed_-:., ___----_�--------------:.............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE....:...............................
............................................. Inspector...................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
F�1J� 7.........OF............. ��' S'.:..... .._..-- �-
__.._._ FEE.",..4�1.'.............
�. �i��r>a�at1 �rk� ��at.�irailaat'� rruti# •.4 .
Permission ids hhereby granted--•----- ''- -�'�6 --- .....
..
( .
to Construe or Repair div ual Sew g Disposal System
at No...
a.
' Street � � � ` ` n i
as shown on the application for.Disposal Works Construction it No f` Dated....I F.Y __._.•e_/]....f.........
..... .__` !...--
Board of Heal't / ��
DATE---•---•---�1_�3 -- •--
r'
. FORM 1255 HOBBS & WARDEN;°'(NC., PUBLISHERS i
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00
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101
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1 S 'X"I1011fAS E.KEL LEY Co: � �. Mc3 t12b0 � Co.
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5 IDS a �
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02664 Fes'►/!LMLce �
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CERTIFIED PLOT 'PLAN.
F CO m
au� .
�hNoN � � � 'LOCATION
26106 SCALE . J v. . . qb.'. DATE .. q/?. .�F
F 4r� r.
PLAN REFERENCE LoT,fQ6.,. . .IAI .. .
.ST.f3 i3L ZCt . "V94, . . : .
CERTIFY THAT THE
SHOWN ON THIS PLAN IS L U D
AS SHOWN HERE THE
SETBACK R T WN OF
-WHEN CONSTRUCTED.
cTi7; /275 J DATE . .
PETITIONER
REGISTERED-LAND SURVEYOR
L 39.op clqT
5-�"4=-D E cJ�3fo��
�OP 0F�70UNICS:
CONCRETE COVER
CONCRETE COVERS
••�; 4"CAST IRON T ��
PIPE (OR 12 MAX. 12"MAX. " ""r'' �� f L
• 4"ORANGEBURG(OR EQUIV)
EQUIV.) — MIN. PIPE- MIN. LEACH
' PITCH 1/4"PER. . PITCH 1/4'PER.FT PIT PRECAST
o J LEACHING
I N V�Fff�jT � a :..,
o EL.. Sw•dQ. INVER {NVE T. i . o PIT OR
SEPTIC TANK DIST. w EQU IV.
EL.. 4?. BOX EL3 r/7 �>x' Q �;% .
INVERTI /SDO I
GAL. IELE�S3 INVERT °'.' to Ww 4Q: ci: 3/4"T011/2'
'' 1
EL,34 9Z �� WASHED
° o w STONE
b •• ...
PROR LE OF GROUND WATER TABLE ,
SEWAGE DISPOSAL SYSTEM ►'`
NO SCALE
Rc
"LIMENARY .
SOIL LOG WITNESSED BY :
DATE I'� .. TIME.��.Q?.!9,/!7 �i9UL-. / !'9 BOARD OF HEALTH �•
TEST HOLE I ,TEST HOLE 2 0244 , ,� / "�►�, ENGINEER
ELEV. 3 7 . . . . ELEV. . . . . . . . l
DESIGN DATA :
8 NUMBER OF BEDROOMS . . .T/��
TOTAL ESTIMATED FLOW . .330 . . GALLONS/DAY
a
vo BOTTOM LEACHING AREA 78 Sty
_ � . S0.FT. /PIT
68 FIVE SIDE LEACHING AREA . , ��� J��. SQ.FT./ PIT
GARBAGE DISPOSAL . y�S. . . (50% AREA INCREASE) F ,
TOTAL LEACHING AREA .S3 .oa. SQ.FT
/ ,� PERCOLATION RATE 4 .��`! +LJ/f!!-':� MIN/INCH
LEACHING AREA PER PERCOLATION RATE SQ.FT.
�VD.WATER ENCOUNTERED
NUMBER OF LEACHING PITS Two �/T.$�. 'h�T4CiL�
APPROVED . . . . . . . . BOARD OF HEALTH
6 piT. . . . . . . . . . . . . . .
DATE . . . . . . . .
C///L
AGENT OR INSPECTOR
k
OF
fH�7,NIAS . K-FLI.7 V CQ.. `4,
1 •.
3EiV T �¢ ,kr
ORAL
PETITIONER 2�ysS1
LO CAT 10
SEWAGE W A 0 E` PERMIT NO.
Q � 6ofe �,� vl000d 3
dILLA6;E
IgSTA L L E 'S A1AE 8 ADDRESS
D UJL0ER` OR WpER
i
DATE PERMIT 15SYE0
Ir
`I
DATE CO1PLIANCE ISSUED J
71
r
i
E C Ivr
.
L o CAT 10
SEWAGE PERMIT pD.
a ui l �ia Y'r 4 3
VILLAGE -
.
IgSTA LLE 'S AC9E � ADDRESS
C O yt �% J
o l� ' Awe 6r e.9 �o
BUILDER OR 6WNEN
DATE PERMIT ISSUED
DATE C 0 M P L I A N C E ISSUED
fZ �"�
�� � � � �
��
c'a � ��
T.O.F. EL.= 39.6'± FINISH GRADE OVER D-BOX= 38.61± FINISH GRADE OVER CHAMBERS= 38.4' - 38.7'
3/4,.TO 1-1/2,. DOUBLE WASHED GENERAL NOTES
0
PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2/o MIN. OVER SYSTEM STONE TO CROWN OF PIPE
WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
OUTLET TO WITHIN 6" OF F.G. 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
FINISH GRADE MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2"OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES.
@ FND. EL.= 38..4 F -F r5" DIA. OUTLET(S) STONE OR GEOTEXTILE FILTER FABRICG. OVER TANK EL. = 38.8'
- -- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
r I DESIGN ENGINEER.
PROPOSED 4" 9" MIN.
TOP OF SAS= 35.83' PLACE RISERS ON ALL
Z-EXISTING 4' 9' MIN. CHAMBERS w/PIPED
SEWER PIPE SCH. 40 PVC 36" MAX. 35.00' 36"MAX. � INLETS TO WITHIN 6" 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
BREAKOUT EL= 35.50 SYSTEM UNLESS OTHERWISE NOTED.
SEWER PIPE OF FINISHED GRADE��
6" 3" 3" DROP MAX 3„ g„ L-27'+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
2" DROP MIN MIN.SLOPE 11% PROVIDE WATERTIGHT o o ELEVATION =35.50' FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE SAS. UNLESS A
13" �, 4" PVC IN FROMR
JOINTS (TYP.) oro- 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
14" *35 5 SEPTIC TANKC OUT TO O 0 0 0 0 O 0 o o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
CONTRACTOR TO PROVIDE ' ING FACILITY o0 0 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
7LSPECIFIED DROP BETWEEN o0INLET AND OUTLET CONTRACTOR � CONTRACTOR SHALL ` OUTLET TEE 35.40' 35.23' 2� � � � � � � � � � 00 00- 0 � � o 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
SHALL VERIFY SIZE 48 VERIFY CONDITION OF \ 00 0 � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
EXIDSTINGDSITION EPTC F EXISTING TEES AND REPLACE AS GAS BAFFLE CRUSHED STONE o 0000 ooFILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
ER MECHANICALLY o o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
TANK NECESSARY COMPACTED BASE
4.0' 8.5' (TYP) 4.0 4.0' 4.0' AND DESIGN ENGINEER.
5 OUTLET DISTRIBUTION BOX TYP 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. SEE BENCHMARK ELEVATION SHOWN
TO BE INSTALLED ON A LEVEL STABLE 33.5' ( .) ON PLAN.
BASE. FIRST TWO FEET OF OUTLET 33.00' GROUND WATER ELEV.= < 27.50'
PIPES TO BE LAID LEVEL. 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 3 - 500 GALLON CHAMBERS 5' M'N� CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
*CONTRACTOR TO VERIFY EXISTING SEPTIC TANK PROFILE DISTRIBUTION BOX Dig l AIL TYPICAL CHAMBER PROFILE CHAMBER DE SAILS TO THE DESIGN ENGINEER.
ELEVATION PRIOR TO ANY WORK& 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE
�+
11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
;J `' t� �� \ ��" U'�' TF ST P I tT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
- , ` ` " ,; PERC NO. TPT-21-306 APPROPRIATE AUTHORITY.
a
y ^ "j
INSPECTOR: Donald Desmarais(BOH) 112. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
\ :� �► EVALUATOR: Michael Pimentel, EtT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
r-` C.S.E. APPROVAL DATE: Oct. 27, 1999
13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
DATE: November 30, 2021
14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
! 1 , ,' G r TEST PIT#: 1
MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
MAP 56 0 '- �'pq •h, ELEV TOP - 38.50 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
LOT 23 �� ti �` r' �` ELEV WATER - < 27.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
,�� _- PERC RATE _ < 2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
MAP 56 Atl( .,
,.�� C DEPTH OF PERC= 36" -54" 16. PROPOSED PROJECT IS LOCATED WITHIN:
19962 � LOT 10 r'' } ASSESSOR'S MAP 56 LOT 25
���"""\"'\\� � TEXTURAL CLASS: I - -
OWNER OF RECORD: CAROLINE E. HANSON TRUSTEE
N V .��a LOCUS
N .{ ,�' 7« 0" 38.50' ADDRESS: 80 COTUIT BAY DRIVE
r-�._3
\ _ r 20
N, m 1a Loam Sand
\ 3$ r'o li \\ `` ".' A y COTUIT, MA 02635
N r 10Yr 3/1
FEMA FLOOD ZONE X
01
-_
--- ,� Loamy Sand COMMUNITY PANEL# 25001C0543J
Benchmark �/ �, B
_ 10Yr 5/6
Corner of Ste _ ,.. 3}
p
Elevation =40.00' �, II %,' ± 36" - 35.50' 17. DEED REFERENCE: BOOK 23093, PAGE 217
t n__ li '
39_ \ __ Approx. M.S.L. 'tl , \\ Perc 18. PLAN REFERENCE. PLAN BOOK 292, PAGE 26
54" J 34.00
LSA 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
\` y STOOP
EXISTING LEACHING �\P' �\ `� ;' / = �\ 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
CATCH-BASIN O�\�� EXISTING MAP 256 � �� \\i , 4 0,1 p� ^.'�r P FOR SEPTIC SYSTEM FOR USES OF THIS PLAN OTHDER THAN ITS NTENDED WILL
PURPOSE.ASSUME ANY LIABILITY
�C 4-BEDROOM II 1\. D 1 r I S Med. to Coarse Sand
0 2.7,734± S.F. '�'° \\Q P r ; (�)1 C 2.5Y 6/6 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
r`O DWELLING \\ `, \\O ; t �/` •
cP -�. MAP 56 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A
o !y -LSA- TOF-39.6'± LOT 11 REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL
0- U, AL.P. 4k STOOP LOCUS PLAN REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
38xT - �•
SCALE: 1" = 1000'
\ i 132" 27.50'
No Mottling, Standing or Weeping Observed LEGEND
� 211 TEST PIT ETA
\ DB M, DESIGN DATA 50x0' EXISTING SPOT GRADE
O \ N S M 38x6 PROPOSED PERC NO. TPT-21-306 - -
O DISTRIBUTION BOX EXISTING 1,000 GALLON INSPECTOR-. Donald Desmarais(BOH)
- 50 - - - EXISTING CONTOUR
o G 13" - SEPTIC TANK TO BE NUMBER OF BEDROOMS (EXISTING) 4
5; -J► \ 5' O UTILIZED IN DESIGN - EVALUATOR: Michael Pimentel, EIT, CSE _50 PROPOSED CONTOUR
O 39 NUMBER OF BEDROOMS (DESIGN) 4 C.S.E. APPROVAL DATE: Oct. 27, 1999
3 DATE: November 30, 2021 LP EIS DESIGN FLOW 110 GAUDAY/BEDROOM 50 PROPOSED SPOT GRADE
O Q E :TEST PIT# 2
EXISTING LEACHING PIT TO TOTAL DESIGN FLOW 440 GAUDAY GAS EXISTING A LINE
8„ a BE PUMPED, FILLED w/ DESIGN FLOW x 200 % = 880 GAUDAY ELEV TOP= 38.50' C C EXISTING UNDERGROUND CABLE LINE
STUMP CLEAN SAND &ABANDONED SWING-TIES SCALE: 1"=20' -
4 BUSH
\ � rr (TYP) DESCRIPTIONHC-2 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER- <27.50' EST EXISTING UNDERGROUND ELECT. &TEL. LINE
DESCRIPTION PERC RATE _
(TYP) 40X' � \ W `^,' EXISTING WATER LINE
-a \ CORNER OF STONE (1) 69.4' S7.8'
yG oo ��\ \ PROPOSED MAP 56 DEPTH OF PERC=
$r�\ �� INSPECTION PORT LOT 26 CORNER OF STONE(2) 38.8' 35.2' INSTALL 3 - 500 GALLON H-10 CHAMBERS w/ STONE % TEST PIT LOCATION
TEXTURAL CLASS: I
CORNER OF STONE(3) 47.0' 47.1' SIDEWALL CAPACITY `
Z� \17o\\ O LENGTH + WIDTH 2 SIDES) 2' HI H 74 / = Lo 9 EXISTING 1,000 GALLON SEPTIC TANK
PROPOSED THREE 3 500 ('�
GALLON LEACHING CORNER OF STONE(4) 74.3' 65.8' ( ) ( S S) ( G ) (0. GPD S.F ) GAUDAY
CHAMBERS w/STONE --- - ----- - -- (33.5 + 12.83) ( 2 ) (2 ) ( 0.74 GPD/S.F.) = 137.1 GAUDAY
- - 0" 38.50' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE
EXISTING� #80 A Loamy Sand
10Yr 3/1
.t, J 4-BEDROOM �� BOTTOM CAPACITY 6 38.00' ® PROPOSED DISTRIBUTION BOX
DWELLING (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY
(33.5' x 12.83') (0.74 GPD/S.F.) = 318.1 GAUDAY B 10Yr 5/6 Loamy Sand
TOF=39.6'± > PROPOSED 500 GALLON LEACHING CHAMBER
36" 35.50'
He-2 TOTALS:
TOTAL NUMBER OF CHAMBERS 3
REV. DATE BY APP'D. DESCRIPTION
� -
0
� --- -_---- -- - -
TOTAL LEACHING AREA 615.1 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE
TOTAL LEACHING CAPACITY 4552 GAL./DAY PREPARED FOR:
Med. to Coarse Sand ROBERT B. OUR CO., INC.
O HC-1 C 2.5Y 6/6
O 2)
NOTES: O LOCATED AT
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 3a5 (4 80 COTUIT BAY DRIVE
EACH SEPTIC SYSTEM COMPONENT. N 3) 6�0 \9 2a COTUIT, MA
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE SCALE: 1 INCH = 20 FT. DATE: DECEMBER 28, 2021
PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT o .0 132" 27.50'
DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF Ln 0 10 20 ao so FEET
HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. o U, No Mottling, Standing or Weeping Observed OF "4ss9c
J0 N L. y�� PREPARED BY:"
3.) PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS ONLY. RESERVED FOR BOARD OF HEALTH USE u CHU (HILL JR. N JC ENGINEERING, INC.
4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY N 418 2854 CRANBERRY HIGHWAY
FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS is EAST WAREHAM, MA 02538
IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL SITE PLAN 508.273.0377
NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. - -- -
SCALE: 1"=20' Drawn By: ATB TDesigned By:ATB Checked By: JLC JOB No.6018