HomeMy WebLinkAbout0012 CRAWFORD ROAD - Health 12 C a`vf(�rd Road
Cotuit
A= 005 - 041
1
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No. �`� �1 IIPf Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftpfieatiou for Disposal *pstrm Coustruttiou 30ermit
4•
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) �omplete System ❑Individual Components
Location Address or Lot No.7- Q �'k Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel tS --p. ,1\��
Installer's Name,Address,and Tel.No. 2��--�-���y �e er's Name,Address,and T No.
--7It OV%V,,, W1
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 2 3, sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 7ji® gpd Design flow provided ?J �� gpd
Plan Date N-(' Number of sheets Revision Date
Title 51� �� ?r-eQSA
Size of Septic Tank @5 saw Type of S.A.S.
Description of Soil 1 —Z�—I B�( p/jA: `tAr4C<_ k 1C,4{ S(Z__ L bIA0.7 SfWi)
1-Z`1 3 CA�ICK lath L1140 Lu4tAl 54-v()
2.7"-- C LAICK— KNK, Sf� ►ft1D SYWp
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance f the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date �O 6)
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
No. r, 1 Fee v
V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
;Yes
PUBLIC HEALTH'DIVISION`- TOWN OF BARNSTABLE, MASSACHUSETTS
applitation'tor Misposai 6pstem Construction 3ofrmit `
^Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(!) 0`Complete System ❑Individual Components
Location Address or'Lot No. 1 'A Owner's Name,Address,and Tel.No.
CA
Assessor's Map/Parcel "4
M
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Sol
Type of Building: ,
Dwelling No.of Bedrooms Lot Size Z 3, 1 sla sq.ft. Garbage Grinder(?A)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
I Other Fixtures '
1
Design Flow{miin.r'erequired) ?j`')® gpd Design flow provided �°`I gpd
Plan Date i`k 7 O?-1 Number of sheets Revision Date '
Title - i kC^ 1?(-P4 J 1r1fh
Size of Septic Tank aj �^ Type of S.A.S. ?—' SC�0 i4 tuft„-- o 1'ja�la F Z
Description of Soil � Z.�"��� � �" 0 ILA t,.Wid- 1(S 4 e,-;S i f L(,,k&rn7 5(Vt5
q-2`1 C4-KK ink till WAVA7 4��Vc)
Nature of Repairs or Alteiations(Answer when applicable)
s �
e'
Date last inspected:
Agreement:
-a
The undersigned agrees to ensure the construction and maintenance.f the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and o't to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
r y
' Signed
L,z, Application Approved by Date
Application Disapproved by r Date
for the following reasons
,
Permit No:t' a1 p�'t' + i Date Issued ? "�
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(,,.4)' Repaired( ) Upgraded
Abandoned( )by
(� l: '`rl-�'""'t'x ""! has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. c �OI dated
Installer Designer
t
~ #bedrooms.. Approved design flow J gpd
The issuance of this permit.shall not be construed as a guarantee that the system wi(ll'fuutt tion as designed. .
Date �/Z -7 b-/ Inspector
r t -- s.
--No.'� 13.�-�"" �l�� __ .. .. Fee 1��
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal *pstem 'ConstrUttion i3ermit
Permission is hereby granted to Construct
oftruct Repair( ) Upgrade( ) Abandon( )
System_located at 1Z C(qWN4-4 R.,k •��4�
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:Construction must be completed within three years of the date of this permit.
Date 'J_6 1 Approved by,
.y t
}
Town of Barnstable
�WEq. Inspectional Services
Public Health Division
BAMRrast.e,
"t 3 Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: l-NOZ 1 Sewage Permit# Assessor's Map\Parcel U5—O
Designer: S�1\���.Cvt��P�,ti, (w�,�1\ Installer: `?')C_
Address: '7 t uthS+- NJ Address: 7�,Y,,
On (3C was issued a permit to install a
(date) (installer)
septic system at (L <y," Ko-.k+ c u\11N_ based on a design drawn by
(address)
dated t-f 27-Z10 \
( esigner
i
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.
0 rA\-(
✓ I certify that the septic system /rerenced above was installed with major changes (i.e.
greater than 10' lateral relocatioe 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. Sew 5Ae-`Wv% As"i,�W Sete` 06/M-Z
I certify that t ys em referenced above was constructed in coinp.iance with the to rms of
the I\A oval tters (if applicable) - �P��H UF,�gq
"cy
NN
OIL
0o C1V'L
nstaller's Signature) No.483
C� FSSiOhf�L i��4r��
Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
\\toaldepts\HEALTHISEWER connecASEPTIODesigner Certification Form Rev 8.14-13.DOC
TOWN OF BARNSTABLE
LOCATION ;*>a b SEWAGE#
VILLAGE ASSESSOR'S MAP&&PARCEL GCSE-®d¢I
INSTALLER'S NAME&PHONE NO. -�.
SEPTIC TANK CAPACITY J'sue .C.,6�-i_
LEACHING FACILITY: (type) f (size) d-�ac 1X•T3n
NO.OF BEDROOMS�� c C+c�-44�y
OWNER t Aj4 Q-4�t�"!Z
PERMIT DATE: °j-6•-44 COMPLIANCE DATE: � Z `7 9 I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -i-49 Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) - ,A Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
-4
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M !6„ .�S 6„
No. 2m O Fee S�
THE COMMONWE*AILTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYicatiou for Misposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) [:]Complete System � hdividual Components
Location Address or Lot No.IZ C` Owner's Name,Address,and Tel.No.
(4 pt,�c
Assessor's Map/Parcel pp
Installer's Name,Address, ndr►S Tel."ti N . 7 p -�j�j Designer's Name,Address*and TeL\w,Io.
�
M ,4AVVS _3
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size M16% sq.ft. Garbage Grinder )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33D gpd Design flow provided gpd
Plan Datemvtv, [to Zal Number of sheets Revision Date
Title S; _ �
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) �e1��_ J R�`c�t.� o �r WWlM
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 not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. /
S' d Date
Application Approved by Date
Application Disapproved y V Date
for the following reasons
Permit No. Date Issued.
• +ram; �4 i��R-- • r�'ray r` - .. f..,.y '�...t k,... 'i`.^'+.:.:, , ��.,.� .v" '"n. ..�+`•-7r.,..... .,. , t. -�, .>n�o.a v.. r"�y�!'ti P
No. 2D?-i 1>{ Fee Jt
THE COMMONWEA1TTH*`0F MASSACHUSETTS Entered in computer: or
PUBLIC.HEALTH DIVISION, TOWN OF BARNSTABLE, MASSACHUSETTS Yes
f
priration for Mis _osat stem Construction Permit -_
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System 91rhdividual Components
Location Address or Lot No. �, ((,t,�cl 1; Owner's Name,Address,and Tel.No. i~"
C u�+` •TAR w R�,tl°'
Assessor's Map/Parcel by „ CO,
Installer's Name,Address,and Tel.No. 3W Designer's Name,Address,and Te No. `' • �"
L4 A-1 GNS'r L;%yv r (. n5U1
1tS' .-i�►0�-SC"`+P.�1 ( M •AA 10.5 il- T -334�1
,Type of Building: -
Dwelling No.of Bedrooms Lot Size 74110 sq.ft. Garbage Grinder, )
Other Type of Building No.of Persons w4`'*'Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 53t gpd Design flow provided .35 o gpd
Plan Date Al"1n I Z, ZOZ 1 Number of sheets Revision Date
Title S`t't ?rw po-'a 1w), tN ey�nd
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ��� c, RC�Iyc Q :b'apX tur AAA 41 ^
Date last inspected:
Agreement: - `
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal systeman
ti:
accordance with theprovi sions 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 ,/"`� .�--•-- Date
Application Approved by Date
Application DisapprovedoFy Date
for the following reasons
Permit No. 9,e)7-t A? '1 Date Issued -3122120VU
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THE COMMONWEALTH OF MASSACHUSETTS
s
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(/) Repaired( ) Upgraded( )
Abandoned( )by ` a/E..c'�}�,G1"1 CA NJ
-at f " Citi has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.2o 1-D dated ?1.12 z d z I
Installer Designer
#bedrooms i Approved design flow gpd
The issuance of this permit shall not beconstr
u
e
d as a:guarrantee that the system\wi11'function as designed.
Date ! r it i► Y Inspector ''
---
No.4 f✓ Fee � 0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS _
Misposal 6pstrm (Construction Permit
Permission is hereby granted to Construct Repair( ) Upgrade( ) Abandon( )
System located at �.Z (� u t��c�. .4 u C�,'•�
A.•
,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.
Provided:Construction must be completed within three years of the date of this permit.
Date- 1,22 2021 Approved by
DATE i 0 t 9/0 6
PROPERTY ADDRESS 12 Crawford Rd
Cotuit
MA 02635 ya �
On the above date, the septic system at the address above was
Inspected.
This system consists of the following:
1. 1-1000 yaiion zepz -ic tank.
2; 1- DistaiRution gox, _
3. 1- 1000 yaiion ieachiny 12it
Based on inspection, I certify the following conditions:
4,- 7h.iz .ins a 7.itee Tice zept,ic .system., (78Code)
5,, Se* 12 .ic .system i.5 .in /2ao/2ea woakiny oade2 at the /zzezeat time.-
SIGNATU iL
Name: Robert A. Paolini
Company: Joseph P. Macomber & Son Inc _
Address: R. O. Box 66 "
Centerville, Mass 02632 -
Phone: 508-775.3338 or 508-775-6412
:v r-
rn
L
P. MACOMBER & SON; INC.
anks-Cesspools-LeachfieldsPumped & InstalledTown Sewer Connections 66 Centerville, MA 02632-0066 ,
775-3338 775.6412
•
i
COMMONWEALTH OF MA.SSACHUSETTS
_. EXECUTIVE OFFICE-0F ENVIRONMENTAL AFFAIRS
G. >, DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM--.N•OTYOR.VOLU.WARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART•A
CERTIFICATION
Property Address: .. 12 Crawford Rd
Cotuit MA 02635
Owner's Name: Christine Greeley
Owner's Address: Same
Date of Inspection: 1 0_-1;0,L-,0_6_
Name of Inspector: (please print) Ra t Ao.1'
Company Name: Z. 1') mar omF.eia .S:o.n Znc.
Mailing Address:
en eay.c e, abb.-02632
Telephone Number: 5 0 8,7 7 5 i 3 3 3 8
CERTIFICATION STATEMENT
I certify that I have personally inspected the.sewage disposal system at this address and that the information reported
below is tale,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in.the-proper function and maintenance of on-site sewage disposal systems.I am a DEP
approved system inspector pursuant tb-Section.15:340 of-Title 5(310 CMR15:000). The system:
X U Passes
-Conditionally Passes 040
.:Needs Further Evaluation by the Local Approving.Authority
ails
Inspector's Signature: Date:
16
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 sy,stem is a shatgd 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.
Notes and Comments
****This•report only describes conditions at the time of inspection and under the conditions of use at that
�. time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Page 2 of I I
OFFICIAL INSPECTION-FORM-NOT FOR VOLUNTARY ASSESSNXNTS .
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORMV.
PART A
CERTIFICATION(continued)
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Greeley
_
Date of Inspection: 1, 011 9.-Dt
Inspection Summary: Cheek ;�;B;C,D or E/ALWAY complete atl of Sectioa.D
A. System Passes: *ES
ND I have not found any information which indiEates;tliat 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:
Se/z.t.i.c *Ztear .is .ia /22ope2 wo/ kina oAdva n.1 fho A,?.e.A¢j?� fimp
B. System-Conditionally Passes:
no One or more system components.as described in the"Conditional:Pass"..sertion.need tote 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.
no The septic tank is metal and,over 20 years old*or the.septictank.(whether metal or.not)is?structurally
unsound,exhibits substantial..infiltration or exfiltration or tank failure:is:imminent. System will pass inspection if:the
existing tank is replaced with a complying septic tank.as approved by.the Board of Health.
'A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank.is less than 20 years old is available.
ND explain:
n o. 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 leyeleo'or replaced
ND explain-
no The system requited 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: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Greeley
Date of Inspection:
C. Further Evaluation is Required by the Board of Health:
NO 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.
A. 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:
no Cesspool or privy is within 50 feet of a surface water
n o Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of.Health(and Public.Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and-environment:
no The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet.ofa
surface water supply or tributary to a.surface water supply.
no The system-has a.s.eptic tank and SAS and the:SAS is within a Zone 1 of a public water-supply.
n o The system has a septic tank and.SAS and the SAS is within 50 feet of a private water supply well.
n oo 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 v izua i.
**This system passes if the well water analysis,performed at a DEP certified laboratory,for colifor m
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 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS'
SUBSURFACE.SEWAGE.DISPOSAL,SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Gree1_Py
Date of Inspection: 1.:0 J 1 9%_n ti
D. System Failure Criteria applicable to all systems:.
You must indicate"yes"-.or"no to each of the.following,for all inspections:
Yes No
_ X Backup of sewage.into facility or-.system-component due:to overloaded.or clogged SAS or.cesspool
_ X Discharge.or:ponding of effluent to the surface of the-.ground or surface waters due to an overloaded or
clogged SAS or cesspool
X Static liquid level in the distribution box.above outlet invert due to an overloaded or clogged SAS or
cesspool
_ X Liquid depth in-cesspool is less'than 6"below invert or available volume is less than'/s,day flow
X Required pumping more than 4 times in the last year NOT due,to clogged or obstructed pipe(s).Number
of times pumped
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply.or tributary to a surface
water:supply.
X Any portion of a cesspool-or privy is within a2bri 1.of a.public well.
_ _T Any portion of a cesspool or privy is within.50 feet of a private water supply well.
_ X 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 forip.]
No (Yes/No)The system fails.I have determined that.one or.moreofthe above.failure,criteria exist as
described in 310 CMR 15.303,therefore-the system.fails.The system owner, ld'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 1.0,00.0 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
X the-system is within 400 feet of a surface drinking-water supply
X the system is within 200 feet of a tributary.to a surface drinking water supply
_ X the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant:threat,or answered
"yes"in Section D above the large system has failed.The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304.The system owner should contact the appropriate regional.office of the Department.
f
Page 5 of 11 ,
OFFICIAL INSPECTION FORM—NOT-.FOR-:VOLUNTARY ASSESSMENTS
SUBSURFACE-SEWAGE DISPOSAL;SYSTEM INSPECTION FORM
PART 8
CHECKLIST
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Greeley
Date of Inspection: l n 4a:a rn 6_
Check if the following have been done.You must indicate-`yes'or"no"W-4o each.of the following:
Yes No
X 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?
X - Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X Were as built plans of the system obtained and examined?(If they were not availablefiote 6 N/A)
X Vas the facility or•dwelling inspected for signs of sewage back up?
X Was the site inspected for signs of break out?
X — Were all system components,excluding the SAS,located on site?
X _ 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?
X _ 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
X Existing information.For example,a plan at.-} a Board of.Health.
X _ Determined in the field(if any of the failure criteria related to Part C is at issue approzimition of distance
is unacceptable)[310 CMR 15. 302(3)(b)]
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSU,RFACE.SEWAGE DISP...OSAL;SY'STEM.INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Gr,.ppl ey
Date of Inspection: 1 0-/.1 A/h 6-
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): :. 3 Number of bedrooms(actual): . ,
DESIGN.flow based on 310 C1NR 15.203(for example:'I 10 gpd x*of bedrooms): 33.0
Number of current residents: 2.
Does residence have a garbage grinder(yes or no):
n
Is laundry on a separate sewage system(yes'•or no)n o [if yes separate inspection required]
Laundry system inspected(yes or no):n o
Seasonal use! (yes orno):n.o 2004 52, 000.gai.2ons G/ D-142. 46
Water meter readings,if available(last 2 years usage(gpd))�0 0 5 4 5, 0 0 0 qa o n.5 D=115 06
Sump pump(yes or no):n° _
Last date of occupancy: l.n e-3 e n t
COMMERCIAL/**' USTRIAL
Type of estab Dent: N I A
Des.ign flow_(l as d on 310 CMR 15.203): gpd
Basis of dbsig0ow(seats/persons/sgft,etc.):,
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):_
Non-sanitary waste discharged to the Title 5 system.(yes or no):_
Water.meter readings,if available:
Last date of occupancy/use: .
OTHER(describe):
GENERAL INFORMATION
Pumping Records
�'�� J✓�r .
Source of information: P
ow
Was system pumped as part of the inspection yes or no):
If yes,volume pumped:_gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
X Septic tank,distiibution 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)
—Tight tank _Attach a copy of the DEP approval
Other(describe):
AppjTc ate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no): 10
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Greeley
Date of Inspection: : fi 0 71916L-
BUILDING SEWER(locate on site plan)
Depth below grade: 2
Materials of construction:_cast iron X_40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
ao.intz appeaa tight , No .22akage oV.ented th1tough house vent
SEPTIC TANK:�-3(locate on site plan) 1000 'ga.2 2 o n z
Depth below grade: 18
Material of construction:X concrete_ metal_fiberglass_polyethylene
_other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate.of Compliance(yes or no):(attach.a copy of
certificate)
Dimensions: 8' 6"X5 ' 8"X4' 10"
Sludge depth: t2 a c e
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
How were dimensions determined:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of.leakage,etc.):
l umI2 tank evezy 2 yeaa-s., In.eet �, out het tees ate . i Qac.e
tank i.3 au.c uaa y zoun
GREASE TRAP: n oo(locate on site plan)
Depth below grade: _
Material of construction:_concrete_metal fiberglass_polyethylene_other
(explain):
Dimensions:.
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
�2ea�e t2CL/? ib not 121te%ent
I .
Page 8of11.
OFFICIAL INSPECTION-F;ORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE OISPOSAL,SYSTEM INSPECTION FORM
PART C
SYSTEM.INFORMATION(continued)
Property Address: 12 Crawford Rd
Cotuit MA 02635
Owner: Christine Greeley
Date of Inspection: 1 Q11-91/0-6
TIGHT or HOLDING TANK:n o (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/day
Alarm present(yes.or no):
Alarm level: Alarm in working order(yes.or no):.
Date of last pumping: .
Comments(condition of alarm and float switches,etc.):
Tighto2 hoid.ing tanks ane no)
DISTRIBUTION BOX:y e (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
le"Pox... r2uetveb.PX'eKa),,: 1 .2a.t'e.¢a e., No zo E.id ca22yoveic o2.eeakage .in oa
PUMP CHAMBER:n o (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition.of pump chamber,condition of pumps and appurtenances,etc.):
Pump cham9ez i3 'no.t /22ezen.t
� I
i
.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: 12 Crawf ord Rd
• Cotuit MA 02635_
Owner: Christine Greeley
Date of Inspection: .`l o/i'g/-0o-6
SOIL ABSORPTION SYSTEM(SAS):_{locate on site plan,excavation not required)
If SAS not located explain why-
Located zee /gage 10
T pe
leaching pits,number:
leaching chambers,.number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions: ,
overflow cesspool,number:
innovative/altemative'system Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
Loamy to enady zo.i-ez.! no Rond.ing oa So.i.2z aae day
vege a .ion iz nozma
CESSPOOLS: no(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-vr no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
ces,3/2oo2.s a.ae not /12e,6ent
PRIVY:n o (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Co ents(note condition of soil,sips of hydraulic failure,level of ponding,condition of vegetation,etc.):
Patvy .c13 not /2aeaen�
9
I
Page 10 of 11
OFFICIAL INSPECTION FORM,NOT FOR VOLUNTARY.:ASSESSMENTS
SUBSURFA:CE.SEWAG -.DISP.OSAL SYSTEM INSPECTION FORM j
PART C
SYSTEM INFORMATION(continued)
Property Address: 12 Crawford Rd.
Cotuit MA 02635
Owner: Christine a r P cz-I a
Date of Inspection:.._ 1-011 A 106
SKETCH OF SEWAGE.DISPOSAL SYSTEM
sal system including ties to at least two permanent reference landmarks or
v cl a sketch of the sewage disposal y g P .
Pro i e, g P .
benchmarks.Locate all wells within 100,feet.Locate where public water supply enters the building. .
J�
MAI
w ;
A •
_
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 12 Crawford Rd
Cotuit MA 0263
Owner:_Christine Greeley
Date of Inspection: 1 013
4.
SITE EXAM .
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate(check)all methods used to determine the high ground water elevation:
WO Obtained from system design plans on record-If checked,date of design plan reviewed:
t1 e s Observed site(abutting property/obse atian hole within 150 feet of SAS)
V_4L6 Checked with local-Board of Health-explain:��h Lary n CI
a o Checked:with local excavators, installers-(attach documentation)
3Accessed USGS database-explainA�-i/2:town:,9ann;6ia�ip- ma. ups
descn be how you established the high ground water elevation:
�.. You must
� u .2
ll�ed. . Capp- Cod Comm.c�.c on !dates 7agie Coritou2s3 And l ugtic Vaten S RR y
ldeii head notecLio.n aneaz ma Sel2t 1995
Oaten ne,60uneez o�P.E.ice cane cod comm.i,640n.l
Top of Oroun
PAW
Leaching
Pit : Beet
Groundwate}" Feet Below Bottom-of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method
Therefore,the vertical.separation distance between the bottom y`
of the leaching pit and the adjusted groundwater table is
feet.
• .r
:r•RIIRTN TRITf1�•TTRf•JlReR7TIlTRlS?.TRr1fR•[T.TS7SrrJ�rT R4!'IL7)f[.�7',O1UT1 T7Yl�T�.1RTiR� i`S�.T'`1•
TOWN OF BARNSTABLE BOARD 07 11EALT11-
SUIISURFACE SEHAGE DISPOSAL SYSTEM INSPECTION FORM PART D •- CERTIFICATION
•••as•t-t•:•:: �rttrt'•�rnr,tr:m•rim►tr+nrms+►rn-tm'r.�s•trtlre'rt:'+t7Rme►*+P�+.lrsavttrrn.�nn�re�ers ttsm vnt•a•7+•sr•�tr•—r•�
—TYPE OR PRINT CLEARIY—
PROPERTY INSPECTED
STREET ADDRESS 12 Caawload Road �
ASSESSORS MAP, BLOCK AND PARCEL # 005-.04
OWN_ ER's NAME Chzis.t"ine gaee2ey
PART D - CERTIFICATION
NAME OF INSPECTOR Ro&eat , ao2.ih-i '
h '% Naeomle2''`� Son Inc
COMPANY NAME aoze/�
COMPANY ADDRESS Box 66 Centezv.L9.9e Ma.6.3' 02632
Stre#V Toxn•cr City LIP
COMPANY TELEPHONE. .( 508 ): 7:75 -. 3338 FAX ( '508 P90 1578
CERTIFICATION STATEMENT
I_ certify that t have personally. inspected the sewage di.sposa'l system at
this address and that the information reported, is true, accurate, and
omplete as of the. time .o.f �inspection, The inspection was performed and any
recommendations regarding upgrade ,. maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems -
Check one:
t -
XXXX System PASSED '
The inspection crhich I have conducted has not found any information
which indicates that. the system fails to adequately protect public
health or the environment as defined in 310 CMR. 15, 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA see.tion of
this form,
System FAILED*
The inspection which I have con t ted has found that the system fails to
Protect the public health and the environment in accordance with Title
6 310 CMR 15 . 30,31 as and specifically noted on PART C - FAILURE
p
CRITERIA of this inspection .form . '
Inspector 5ignatu Date. '29-4
_W==csr�amrr=
ems—f• �
Yne copy of this certification must -be provided -to the QWNER, the. BUYER
where applioable ) and th4 DOARD OF HEALTH, .
* It the inspection FAILED., the owner ox'"'cperator ahall upg-rade ' the eyetem.
within o•ne year of the date of the inspection, unless allowed or required
otherwise as provided in 3;10 CMR 16 , 306 ,
„ THEODALTH OF HEALTH S
BOAITT
/O``J. `J.............. ...OF...... ... s2i'✓S/ /
io n Disposal n Tonstrurtiun rrmit �46�”
. ,���luttt n for � 1 Works � �
Application is hereby made for a Permit to Construct (�r Repair ( ) an Individual Sewage Disposal
Y
A,^....s ...1.2 ..................................'-- ............ ........ ............. --- ......•......<_._..".....- ... .---............... ..
o ati dress r Lot No.
Z. dss
�!a►L.. -. — ..........:........... �.•.° d�. . ................ 1� -.. ,...................
Installer" Address
Type of Building Size Lot. ,�. .............Sq. feet
,.., Dwelling_No, of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder (tip
Other—Type.of Building .. No. of persons............................ Showers — Cafeteria
04 Other"fixtures --..........� Z
W Design Flow......."... �1---:--. �:• gallons per��e�r�d�}c. Total da-lyO4. -.............. 3v---------•-•--
WSeptic Tank—Liquid capacity(-.._..____gallons Length.................Width_,....._..... Diameter................ Depth................
x Disposal Trench—No .................... Width.................... Total Length..................._.Total leaching area....................sq. ft.
Seepage Pit No..._......1...._.... :Diameter..........1 ... Depth below inlet........ Total leaching area..Z�..-.sq. ft.
Other Distribution box (t-� . . Dosing tank ( ) . /
Percolation Test Results Performed by_.:_: � Date...�f..... ....--•--•--. ....... ... ./.
as Test Pit No. 1..L._Z'-.minutes per inch Depth of Test Pit.... ........ Depth to ground water......? Z..,.f:
Test Pit No. 2..!!�:... .minutes per inch Depth of Test Pit......f..Z... Depth to ground water._:.T_f.Z
:---•-:------•....................................
D sc iption Qf Soil 77.11 .... r�U!c!c. L; .... 0 `'n J.........f D_
nJ -----
>�G. ............................ i `'? Sif -7 Tz �` cJ,�!/.�- .... G.�f.�!J.....
1..vi'`�'.�------fit'`' - f�ocKcfTf._ �..-� `�-.?....................``
U Nature of Repairs or Alterations=Answer when applicable...............................................................................................
----•---•-----------------------------------------•----............-----•......-------•------...----•------.....-------------------•-----•--•-----•-.......---.......--------..........•-----.......----
Agreement
• The undersigned agrees to install the- aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITLi- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ee issued e boa I of health.
Signed ran.. G �--�-- a .
1 --� -•------------------- Z D e........ .... .
Application Approved B J C:.: ......... .........................................
Date
Application Disapproved for the following reasons:...............................................................................................................
..............•-•---...................---..............................--- --•---........--•-•------------------•---•...-----------------•----•---------•------.....---•---" ......---....
Date
PermitNo........................•••-...............------------- Issued-.....................................................
Date -
FEB
L
t 8
' F THE COMMONWEALTH OF MASSACHUSETTS
_ f
�' - �---- BOARD O HEALTH {
OF..... .-'...............................................
_ Appliration for Big opal Works Tonstrurtinn Vamit
AP lication is hereby made for a Permit to Construct (L-' or Repair an Individual Sewage Disposal
System .. . .......................................... .�. ............................. . ...
f Location-Address.. ` rl ,,,o"r Lot No. (t
............................d- C ` -• _
Owner ess
i
tt
PrI
�
, -,� •• -- ._.....
- Installer l d/ Address f jrt,
Type of Building Size Lot.._.....!...:.............Sq. feet
Dwelling—No.' of Bedrooms......................:...................:.Expansion Attic ( ) Garbage Grinder (,t-y-)
aOther
Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( )
d Other.fixtures ....................................7r;. .. r�..... ��
«v ----------------------------.....
WW Design Flow.............1f.(::5)...................gallons per perso-pq day,. Total da l.....y flow.............. ..............gallons
WSeptic Tank—Liquid'ca.pacity.��'!�galIons Length.............r. Width..---. .. Diameter................ Depth...----.........
x Disposal Trench—No..................... Width.. ...... Total Length............................ Total leaching area...................sq. ft.
Seepage Pit No.......... ..... Diameter..........!�... Depth below inlet...... lv...... Total leaching area.. L. sq. ft.
Z Other Distribution box ( ��� Dosing tank
,:..,- GC./ � v � ✓F� Date.... / ���5
Percolation Test Results Performed by.......................,s ............, ......
� G "Z j ....5._.... Z
,.a Test Pit No. I..............minutes,per inch . Depth of Test Pit..... -....... Depth to ground water......*...............,
Test Pit No. 2......Z..minutes per inch Depth of Test Pit..._..l.z... Depth to ground water..... z--_
E
t, -'- —..----•- .....- .... 'r-1. - . ..Description of Soil �. - t
p•,JnJ G _^'..-- ,G... �/�Jsr... r/��..�/ %Z.`...�q.... GJ/-// ...... .�.�..�'.....
U
f!¢``'�' `J f oc L s�Tf.:: J r� .9•....! •-•---.� .�•�� .�f
----
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 TITI.S 5 of the State Sanitary Code- The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has6been issued by the bo rd of health a
r Signed.!K , .�...�y�+.. ( <. .�� �71
. - ,e
r. .
,.. .......
� -- Date
Application Approved By........-...?!'?± �.. L��!K ...........................................
< Date
Application Disapproved for the following reasons:.......................................................................................:.._.......----••-----•..
. ....................................................................................... .... Date.............
PermitNo......................................................... Issued.................................................,......
Date
_ I
..�..�..�...�.�k�-....-...�..w..w+#-.....���...�`p>,.-ry,.�..�i,-4��.��-:r..�-�..n-ik+-.�sr-`..�...�.-w-:fr..,P-+e-y':wl�'�.-�.4.....-.ew.e►-iY:w,.:.....w.,Fic-f�.ew�....+.r++�--.�•+s+f- -� ..-...._.!ur.r.r-���
`----_ � THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
... ... .... ........OF............... .................. ..............................:...........
(Irr#ifirate of Tomptiattrr
THIS IS CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
(- ) ( )
by.................... -� " '`----......----------•--- . ...---....----- :.-•---........----....------••--- ...
Installe,r�j;�
at..... Q ... `—0------------•--. .................�=
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described 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 FUNCTIQN SATISFACTORY. ,.. --
/M Inspector.............t":.....---------------------...---•----.......--------.............
DATE..... '7..................................•---
0
THE COMMONWEALTH OF MASSACHUSETTS
BOAI4D OF HEALTH
...........................................O F.................... c�
°0......................... FEE..... �-.............
>� 140pos t ' arks To
union "pamif
4 rmission is hereb ranted------.. ---•-----.... s !.MTh i-a........................................
�s Y g
to Construct ( ) or Repair ( ) adividual Sewa a Disposal System
# .................................................................
at No.li _..... .._C_� t`'�------...._. ....C. �?x.
Street
as shown on the application for Disposal Works Construction Permit ... Dated-- ...! y. S :.....
EF�.. .... ... �......... ..-.Y.L-1._ -__ ...............................
} G d Board of Health
DATE.... /..--=1.a`a.... �_..........
9/11/2020 ShowAsbuilt(1700X2800)
LOCATIO /a SEWAGE PERMIT N0.
5- 7 C)Fri
YILLACE
l
IMST A LLER'S NAME A, ADDRESS
IUILDIR OR OWNEI
DATE PERMIT ISSUED
DATE COMPLIANCE 15SUED fl-aG �S
�Q
qq
z� y/
GC�Ac—+ ero�i0 �o,q�
https://itsgIdb.town.barnstable.ma.us:8431/Home/ShowAsbuiIt?mp=005041&sq=1 1/1
j
LOCATION SEWAGE PERMIT NO.
VILLAGE
I N S T A LLER'S NAME & ADDRESS
II U I L D E R OR OWNER
DATE PERIgIT ISSUED
DAT E - COMPLIANCE ISSUED
1
�-- e x 3
\\O ene ,
1 M ZONE.
RF '4 min k A
�"l• o t
N F Area (min.) 87,120 SF (RPOD)
Z Kevin Smith & Kristen Bryant Frontage (min) ,150'
Width Front,30• -
Side 15'
S52' 32' 10"E CB/DH Rear 15'
Fnd
�. . ll ,�" �o
CB/DH 165 00'
Fnd (Hit) \ OVERLAY DISTRICT: f r o,�f% `i,
a
AP - Aquifer Protection District
15' Bldg. Setback / Resource Overlay Protection District �'� js'- •R ��� o, {�
Saltwater Estuary Protection District
FLOOD ZONE:
r ' Zones X (Min Flood Hazard) Y
/ Community Panel No. LOCATION MAP:
+ #250001 C0752 J 1"=2,000t'
LOT 40
July 16, 2014
II I ASSESSORS REF.:
23,100f SF L ^` �/ r`� c Mop 005 Parcel 041
\, \ V / o
Stone Drive \ I j,Q
REFERENCES:
Slob EL. 39.4' (0 rn U Deed Bk. 21534 Pg. 175
O Patio i o Plan Bk. 223 Pg. 39
c
� o
w— — -_ —w # 12 11.7'* r DIRECTIONS:
_ ` o, 1 Sty w/f
'� -G C "' Dwell in \ p c From Hyannis - Follow Main Street to the West
c 3 9 ROE'OSED o o End Rottary. Take the Second exit onto West
Q) o DD/T/ON O I z V Main Street. Turn left onto Rt. 28. Continue to
t\ - O + Cotuit turn Left onto Main St. turn right onto
K o School Street turn left onto Crocker's Neck O CN Y FF EL. 41.0' x Road turn left onto Sontuit Road follow
M
_ it Cove Road turn
r straight until it becomes Cotu
* _ `
o � � PRO 6.8 � �--• left onto Crawford Road 12 is immediate)
4. L,� FF EL. 41.0' ` ; I _- o # y
rli Ln a) DECK PROPOS m on your left.
rn cn o
O r ,---REPLACEM
ENT.
o
O w J 1 D—KX H-20
m o� MAINTAIN ; 3
T PITCH MIN. F°
O ,,4)
Rinse
CU / 23
Utilities Shown
Are Approximate
E - *310 CMR 15.211 SETBACK COUNTER VARIANCES
10' REQUIRED TO TANK
/ 6.8' PROVIDED
r
15' Bldg. Setback 20' REQUIRED TO S.A.S.
Approximate location of 11.7' PROVIDED
existing Septic System per
Town B.O.H. As Built Card.
S52' 32' 10"E — l
6B DH \ 165.00' �P�-��i OF AggSs9c
Fnd NSF CBn�H g� JOHN C.
O' 'A
Barbara F. Fitton Tr. :U C dIL
48168
TIRE: PREPARED BY., PREPARED FOR. NOTES
Site Plan D 1 The property line information shown was = 9� GIST-
Proposed Improvements Enpeering compiled from available record information.
At SUjjjVa]q ConsulUng,Ina William Danaher '^ SfQNAI-�
2) The topographic information and �
12 Crawford Road t6oeJaaa39u• aaac69•m Main Sbut0dwA11%RtA0205 structures) shown hereon were obtained
.selOm+nti.�d�.oa+,•w«wumraeam from an on the ground survey performed o
Barnstable (cotuit) Mass, ferr Jo0 ne1e, p0 zo o ro Zo on 31312021.
DA 7E: SCALE: RaNew: Jtw Coro.: Joo 3) The datum used is NAVD '88, a fixed "'' '•
March 72, 2021 1" = 20' Pro t: Danaher Pro or : 4roos mean sea level datum.
tO t FyanG y.'•�
N N Kj111 FC4Ve �,yr Y ••�.
ZONE:RF
?
\ N/F Area (min.) 87,120 SF-(RPOD) „
�I, I U t
Kevin Smith & Kristen Bryant Frontage (min) 150' pO / �k�J I'C,
Width (min)
Front 30' \
Side 15' � ° p'
S52' 32' 10"E CB/DH Rear 15' (� - p p ly.• , O
dY
Fnd
165CBIDH .00 q
W.
Fnd (Hit) \ OVERLAY DISTRICT:
d? AP — Aquifer Protection District
Resource Overly Protection District
15' B/d Setback i y 9 Saltwater Estuary Protection District/ FLOOD ZONE: " .. �J l q ? .�4
i Zones X (Min Flood Hazard)
/ Community Panel No. LOCATION MAP:
#250001 C0752 J 1"=2,000t'
July 16, 2014
LOT 40 ASSESSORS REF.:
ai \ 23,100f SF �� �; i Map 005 Parcel 041
Stone Drive � / \ \ � l°- �
REFERENCES:
Deed Bk. 21534 Pg. 175
CU
o Slab EL. 39.4' v
Patio v c Plan Bk. 223 Pg. 39
0 0
W —W I 1 st 12 f 11.7'* g 3 DIRECTIONS:
'� G 6 `� Dwellin/ \ O tL c From Hyannis — Follow Main Street to the West
9 ROPOSED b U \ o End Rottory. Take the Second exit onto West
tv o DDIT/ON O I z V Main Street. Turn left onto Rt. 28. Continue to
<C\. — --_ O t o N Cotuit turn Left onto Main St. turn right onto
School Street turn left onto Crocker's Neck
a It N! ' FF EL. 41.0' .sj Road turn left onto Sontuit Road follow
o 1 V1 c straight until it becomes Cotuit Cove Road turn
CL ° ,�,� -0 FF EL. 41.0' PRO. t 1 6.8'* \ f1.
to N �, DECK PROPOSyD m on 'your toleft�wford Road #12 is immediately
OO v V o REPLACE'MENT , o
+ Ld -KX H-20
o MAINTAIN ; 3
m' /16. PITCH MIN. t°
o
,,b
Rinse
Cz j L3
Utilities Shown
U
Are Approximate OBE/ *310 CMR 15.211 SETBACK COUNTER VARIANCES
10' REQUIRED TO TANK
6.8' PROVIDED
r 15' Bldg. Setback 20' REQUIRED TO S.A.S.
Approximate location of 11.7' PROVIDED
existing Septic System per
Town B.O.H. As Built Card.
S52' 32' 10"E I
Barbara F. Fitton Tr. Fnd JOOHN C. yG
L .
T17�. Site Plan PREPARED BY: PREPARED FOR. NOTES 168
1) The property line information shown was v .o ��O ([_
Proposed Improvements Engineering& compiled from available record information. 'gyp �;$TE �p6
AtWilli Danaher � \
SulfivancomItI.&I.. am 2) The topographic information and F'sSfONAL��G
12 Crawford Road tsoetsaasvu•eo.eole5s•n1 Win sa.w.o WMIW A026M structure(s) shown hereon were obtained
seaOwntr.and,p.00a,,www.mnh�aum from on on the ground survey performed o
Barnstable (cotu;t� Mass. zo o ,o zo an 3/3/2021.
roll: JOD Fleld.• JOD
DATE: March 12, 2021 SCALE: Review: m The datum used is NAVD '88, o fixed
JOD talc.: JOD
1 = 20 Pro et: Danaher Project : 47008 mean sea level datum.
i 20 FT. MIN.
r TOP OF F.uUND.
r EL. _ '. ! f 10 FT MIN.
1 CONCRETE CLEAN SAND
4 SCH. 40 PVC
COVERS
PIPE- MIN. PITCHCO CONCRETE
Tf 1/8 PER FT. COVER
_ 2" LAYER OF
4" CAST IRON
12 MAX. �JB"« t12" WASHED
t PIPE - MIN. PITCHT( RE
1/4 PER FT. ° o
04
-7), P`-I ' o FLOW LINE10 ,
Z
EL.
r. _
-- - �� D I S T EL. ,� Q auj
LOCATION MAP __ ► BOX p17
3/4�- 1 1/2" c p�,�° w a , e
. ; WASHED STONE o ° U. p ` vp
A
W 0 G
r=
GAL... PRECAST LEACHING ° ,---._EL.z
BASIN OR EQUIV.
SEPT I C 6.0'
TANK i.
/ BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE EL. _
' PROFILE OF
GROUND WATER TABLE( / / ) EL. µ `
SEWAGE DISPOSAL. SYSTEM
I NOT TO SCALE
3 �F
DESIGN CALCULATIONS 3=.• " SOIL TEST
NUIU4BER OF BEDROOMS .. .
r
DATE OF SOIL TEST
GARBAGE DISPOSAL UNIT f ? WITNESSED BY
TOTAL ESTIMATED FLOW �- PERCOLATION RATE MEN./INCH
GAL /SR./DAY x ,--._. BR ) � ' __GAL:/04.'+'
REQUIRED SEPTIC TANK CAi✓A;;IT • CAL
OBSERVATION HOLE I OBSERVATION HOLE 2
ACTUAL SiLE 01= SEPTIC TANK `� ____GAL ELEVATION = `fly ELEVATION
LEACHING AREA REQUIREMENTS
S IDEWALL AREA 2- . ;.. GAL /S.F.
1{ BOTTOM AREA _ �' GAL. /S.F.
LEACHING CAPACITY ( BOTTOM + SIDEWAL.L). '"' � ' GAL. •y-
- �.��,?..w• �7�'n,,.r^ / 1. N
RESERVE LEACHING CAPACITY ... ' ` ' GAL.
NOTES
1. ALL WDRKMANSHIP AND MATERIALS SMALL � CONFORM
TO D E.G' E. TITLE 5 AND THE TOWN OF .'.
^t RULES AND REGU A I <�?N_ FOR SUBSURFACE DISPOSAL
14; 2 , r'.r� T OF SANITARY SE NAGE
2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
WITHIN 12" OF FINISHED GRADE.
.t *' 3. EXISTING AND FINAL GRADE "� A!1`'.' ES..ENTI . LY
,- • ,;r. MIN. FRONT SETBACK
' - THE SAME.
MIN. REAR SETBACK
4. NO DE T ErRMINAT ION HAS BEEN MADE BY THIS OFFICE AS TO
MIN. SIDE SETBACK
' COMPLIANCE WITH TOWN ?ONING REGULATIONS. OWNER/APPLICANT APPROVED BOARD OF HEALTH
IS TO OBTAIN SUCH DIET iiNAT'ON FROM APPROPRIATE AUTHORITY.
K ,
..,."^
DATE AGENT
PROJECT LOCATION:
�Pl1µ OF
R1C-IARD �� APPLICANT+
J.
a o O'HEAfi,': A�jVi 0 F
t`!0. 278 /, �!`�\ JG�/ ...l;owt;, _,s�" � td� �.+w wt ���� .p d� ae �i'
r��� ,rS t�� `o g r )Ric
." LEr
GEND H� r� �IJ I/i_OHEgkN SCALE• ) DR. BY- 0ATQ
- ` Na. 691
► �'�` EXISTING SPOT ELEVATIONS 0O 0 }� `r 4
si x -� �ST �, ao® Na' aPa..BY
EXISTING CONTOUR - - - - - 00 - - - - SfP11 a;t
s -
t„ n
I FINAL SPOI E!_EVATIONS 00.0 1 °
f 1 FINAL CONTOUR —__ f t30'�-- r� EARI V 1C. w"
R '
j LAX
t
S I�� �i�A I� SOIL TEST LOCATION fia '� �� RE�i. L�I ND SURVEYORS-1�r� S�4JI►/1ARJ�f11�',�
—""'-,
35 RoIJTE 134 .,.,,. +rJN/1"; Z k
--- soum oENNIS grass. 01F .."!4,
'.W
Iswwms�wo -x...rMw:.:ar ..wvw
��....�...._.._._._..�..-..+.w�-._.-•- _... ... ..._. ..�..-r---.... --____..._. ....-.�.-—_•_•___..�_._— ....._....�.__.�_.T.--...++_.•__._._—�. -.....__,�..... . .-...-._ ....®.--_._.—...n.r.....—� ..r.__.-.+ram..—_.. ._.-..-... _.r«.... ......s...__._
4
U -P •vim
ZONE:
O t n \�. RF
NIF Area (min.) 87,120 SF (RPOD)
Z Kevin Smith & Kristen Bryant Frontage (min) 150' ,` .J °40 �'"
\ Width (min) ---
/ arm_
Front 30'
\ Side 15'
CBIDH Rear 15'
S52' 32 10 E Fnd
165.00'
CB/DH
r
Fnd (Hit) \� OVERLAY DISTRICT:
d AP — Aquifer Protection District
15' Bldg. Setback Resource Overlay Protection District / ,4. y<
- -- - Saltwater Estuary Protection District
9
(0 FLOOD ZONE: - I �a°t^Y A °
Zones X (Min Flood Hazard)
/ Community Panel No. LOCATION MAP:
#250001 C0752 J 1"=2,000t'
July 16, 2014
AD Lor40 / ASSESSORS REF.:
23,100f SF L j l� o Mop 005 Parcel 041
V 'm
i D Stone rve ,o
I / REFERENCES:
�p U Deed Bk. 21534 Pg. 175
Slob EL. 39.4' Patio o c Plan Bk. 223 Pg. 39
CU
`"— — —W-- I 1 Styl w�f \ I 3 DIRECTIONS:
Dwelling ROP 2 0 c From Hyannis — Follow Main Street to the West
$ OSED p U O End Rottary. Take the Second exit onto West
E o 'DD/T/ON \ 1500 Leaching o Z V Main Street. Turn left onto Rt. 28. Continue to
p 'n ` '\ Gal. Whambers O N l a° Cotuit turn Left onto Main St. turn right onto
V p \ \ \ Tankw�Stone 6 School Street turn left onto Cracker's Neck
0- N Y FF EL. 41.0' vj Road turn left onto Sontuit Road follow
v- �' ? c straight until it becomes Cotuit Cove Road turn
O � o .o FF EL. 41.0' PRO. \ a left onto Crawford Road #12 is immediately
�i► a° vj a)! I DECK m on your left.
_.\ o
CU m 3
TH-2
/Rinse / �G
TH-1
Utilities Shown
Are Approximate I
�P\1N OF&I,
C!J a
15 Bldg. Setback o .
v ui
OA�/ ; O.48168
I
S52' 32' 10"E / OFF S/ONAl
�B/DH ` 165.00' LI
Fnd CB/DH
N/F Fn d
Barbara F. Fitton Tr.
TITLE: Site Plan PREPARED BY' PREPARED FOR., NOTES
As Built Septic Engineering& 1) Tpil property line information shown was
SuilivanConsulting,Ina cam heed from available record information.AtWilliam Danaher m
2) The topographic information and �
12 Crawford Road twos>4aax"-MOaM•niwrnat,o4Ost mw MA02 s structure(s) shown hereon were obtained r
from on on the ground survey performed
Barnstable (cottiit) Mass. ow"°wwasuuh""-,nAm 20 0 10 20 on 31312021.
raft JOD IField. JOD 1 3)
DATE: SCALE: Review: JOD calc.: Jo0 m The datum used is NAVD '88, a fixed V
June 15, 2021 1" = 20"A"ro'ct: Danaher Pro or 41008
mean sea level datum.
DIRECTIONS: ZONE: E
From Hyannis - Follow Main Street to the West RF
End Rottary. Take the Second exit onto West Area (min.) 87,120 SF (RPOD) � �
Main Street. Turn left onto Rt. 28. Continue to Frontage (min) 150' Q .
Cotuit turn Left onto Main St. turn right onto Width (min) _ •' ' d
School Street turn left onto Crocker's Neck Front 30'
Road turn left onto Sontuit Road follow Side 15' �. a; ',N,
straight until it becomes Cotuit Cove Road turn Rear 15' �b
s
left onto Crawford Road #12 is immediately
on your left. •.
OVERLAY DISTRICT:
1 AP - Aquifer Protection District
Resource Overlay Protection District •` w? '
Cl�ndH- Saltwater Estuary Protection District
to • 3
N DESIGNDATA SEPTIC NOTES FLOOD ZONE ��' �' �WP
Single Family 1.Location of Utilities Shown on TVs Plan AmApprax.At Least 72Hours Zones X (Min Flood Hazard)
-3 Bedroom Qa IIO GPD Prior to Any Excavation For This Project the Contractor Shall Make LOCATION MAP:
N F Community Panel No.
M / No Garbage Grinder the Required Notification to Dig Safe(1-888-344-7233)and contact �1
2 Kevin Smith & Kristen Bryant Total Daily Flow=330GPD Sullivan Engineering&Consulting Inc.(508-428-3344). 71250001 C0752 J
Use a 1500 Gal Septic Tank 2.The Contractor is Required to Secure Appropriate Permits From Town July 16, 2014 1"=2,O DOf'
Agencies For Construction Defined by This Plan.
CB/DH LEACHING AREA 3.Wherever Sewer Lines Must Cross Water supply Lines Both Lines shall
S52' 32' 10"E
S Fnd 330 GPD/0.74(LTAR)=446 SF Required Be Constructed ofClass 150 Pressure Pipe and Shall be Water Tested to
OO 165.00' Assure Watertightness. In General,Water Lines Shall be constructed in
CB/DH Sidewau=2(I2.83'+2572'=151.3SF ASSESSORS REF
Fnd (Hit) Bottom Area=(12.83'x 259=320.7 SF Coordination With COMM Water,and Shall be in Accordance "
Total Provided=472.0SF(349.3GPD) With imumof1.00-7veriOO&sR Required
1A00. Map 005 Parcel 041
cP 4.A Minimum of9"of Cover is Required for All Components.
5.All Structures Buried Three Feet or More or Subject
15' Bldg. Setback _ _• -•_ _f .___.....: ......... LEACING CHARMER DESIGN to Vehicular Traffic to be H-20 Loading.It is the Engineer's
�_. r0 All Pipes to be Schedule 40. Use Recommendation that H-20 Always be Used.
2-500 Gal.Leaching Chambers in a 6.Install Watertight Risers and Covers to Within 6"offinished Grade REFERENCES:
CB/DH 12.83'x 25'Double Washed Over Septic Tank Inlet and Outlet D-Box,and One Leaching Chamber
Fnd Stone Field as Shown. All covers are to be maximum 18"for concrete or 24"Cast Iron.
l Deed Bk. 21534 Pg. 175
7.Septic System to be Installed in Accordance With 310 CMIt 15.00&
� / 9 248 CMIt 1.00-7.00 Latest Revision and the Town ofBamstable
Plan Bk. 223 Pg. 39
Approximate location of �, LOT40 l Board ofHeatthRegulations.
'\ existing Septic System peg 8.All Piping tobeSch.40PVC.
To yr H. AS Built Card. 23,100f SF �� / 9.D Box Shall Have a Minimum Inside Dimension of 12;and a Minimum
r 5 �i BABANDONED o Sump of6".
OR R MOVED - y 10.The on Distance Between the
Stone Drive �- 4 Separati Septic Tank hiletsand
w E Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend
/'N o
� a Minimum of]0"Below the Flow Linea Outlet Tees Shall Extend 14"
SI ab EL. 39.4' Below the Flow Line,and Shall be Equipped With a Gas Baffle
O Patio o c
f Q o 0
_W_ _ _ i # 12 20,
G._• -w 6 _ � 1 Sty w/f
v D
M/N 3
c 3 welling PPROVED o
3 o DDI T/O 12'-10". o i� Z
U o O ^I � �\ ��t�� N o
CL
FF EL. 41.0' R( SED M
IL ° , l BENCH MAR PRO. � RO• D-B m
O �' FF EL. 41.0' DECK ��O
w �' t r- N : o PERC TEST.21-109
�' m i _ __•1' 3 PERFORMED BY.JOHNODEA,PE- SULUVAN ENGINEERING Finish Grade
TH-2 o & ,
CONSULTIIVG INC
Qt. . �' SOIL,EVALUATOR N0.2911. __ 3 I r -
EX/STING 3' Max.
M CLEANOUT Rinse WITNESSED BY.DONNALDDESMARAIS,R.S.-TOWN OFBARNSTABLE
9" Min
/ -t s Compacted Fill Filter
APRIL 26,2021
Utilities Shown SITE PASSED Fabric
And Or
Are Approximate ( 2" 1/8 - 1/2"
N /U ROPOS D TEST HOLE- 1 EL.37.0 TEST HOLE-2 EL.37.3 Pea Stone 0 .iAYER10YRS/2......... 3.
SEPTIC 3/4'` 1 1/2"
/ / TANK GRAYISIIBRQWN I FILL LEACHING Double Washed
t 9. LOAMY.SAND 36.3 16 ... 35.9 Stone
co 1
,�� BL/kYER.IOYl�4/. .:. ..... ....... o/Az,AYER.I0YR5n..: :: ::: CHAMBER L
_.....�.._. .... ........ � �...... .......... .�.._�.....w. .�.._... ... ..... -__._-..m ....... ._ . ......_.._
............ ........... .. . .
15 Bldg. Setback
'.....:DARK:YEI IAWISHBRQWN :::. .......Ci.. ...BROWN:. .....
LOAMYSAND., : 34.8 21 ... LOAibll'SAND.. 35.6 - 1 "-
O r� CLAYER IOYR5/6
BLAMER 10YR 4 6.......
YELLO fTBROWN �ACLiC:Y}rL�OW#SH 1t4W1?:: :: �- 12'' 10
38" :::::::.::::::L
/ E 2' 32' 10"E - 1 39" SRC TEST 33.8 CLAYER 1 OYR S /6 34.1
CROSS SECTION'- OF CLAMBER
10
25 GALLONS GONE IN I I MIN. YELLOWISH BROWN r
8/�H , 165.00' CB/DH 120 PERC RATE<2 MIM1N(LTAR=0.74) 27.0 132 AMD.SAND 26.3
NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED
Fnd NOT TO SCALE
N/F
Barbara F. Fitton Tr.
1
F.F. D. 4 1.0
See Note 6 (typ.)
F.G. EL. 38.5 F.G. EL. 37.5 F.G. EL. J7 00
Flow Equilizers
EL. 37.00 As Required
Installer To
Confirm Prior EL. 4 7 1500 Gallon
To Any Work Septic Tank EL. 34.50 Too EL. 34.50
(See Note 5) 34. H-20 D-Box EL. 33.83
33.50 Leaching
To Be Installed On Chamber
�:;toble Compacted Bose ot. EL. 31.50
_. Bedding, T"s,
Inspection Port, af:; rrCauritered Rrn eocie Bc Repl ace'.
& Boffels All :Ur7 Uitable::Solls in` 5'.;of....::
.
as Per Title 5 The :04iter,Perimeter ... M.... rem..
. . ... ...::. .
.. .:: .: rn
N
1) The,property line information shown was EL. 26.3 ��P��NOfl1lq�4
compiled from available record information. No Groundwater
Per Test Hole 2 ® H
2) The topographic information and structure(s)
cy
D
shown hereon were obtained from on on the DEVELOPED PROFILE OF SYSTEM EL. 2
round survey performed on 31312021.
i �,
Groundwater 48168
9 y PPer T.O.B. Groundwater Map �? �'� � 'R
LEGEND 3) The datum used is NAVD 88, a fixed mean NOT TO SCALE IST S;
sea level datum.
CDT Cedar Tree
HT Holly Tree
DT Deciduous Tree
CT Coniferous Tree NOTES: PREPARED FOR: PREPARED BY. T1 TLE: }
Utility Pole 1) The property line information shown was • j Site Pian
�Q� Y Q
-E Electric compiled from available record information. Engineering V�L i Proposed Improvements ?�
Wetland Flog 2) The topographic information and structure(s) wllllOm DClnoher ivaii consuiting, Ins. ~`
shown hereon were obtained from an on the ground
# Light Post survey performed on 31312021 & 412612021. (508)428-3344•P.O. Box 659.711 Main Street, Osterville, MA 02655 12 Crawford Road
El CB/DH
oHw- overhead wires seei@sullivanengin.com•wwwsullivanengin.com
3) The datum used is NAVD 88, a fixed mean Barnstable (cotuit) Massa �-
25 Elevation Contour sea level datum.
Draft: JOD Field: JOD CTR
LIJ
20 0 10 20 40 80 � _
Review: JOD Comp.: CTR DATE: SCALE:
Project: Danaher Pro ect#• 41008 April 27, 2021 1 =20�