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HomeMy WebLinkAbout4339 FALMOUTH ROAD/RTE 28 - Health IC 4339 FALMOUTH �ZOAP COTUIT I i �I , oay_a�� Commonwealth of Massachusetts Title 5 Official Inspection Form rt t.� Subsurface Sewage Disposal System Form• Not for Voluntary Assessments kvi- m3 4339 Falmouth Road a=, Property Address ..�; Michelle Booth ­0 Owner Owner's Name w, q n isrewired for every Cotuit / t.g MA 02635 9-19-17 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms �# a 9 �titHueWNrpi on the computer, A use only the tab 1. Inspector: ````�� �tK of key to move your 9�►;• . y� cursor-do not �: JAMES �' :ms use the return James D.Sears Name of Inspector key. =mot EARS Capewide Enterprises Company Name 3�t�cRT�F ��rO 153 Commercial Street ,y s IN BPS, Company Address Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system Inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 9-19-17 spectot's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. *""*This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 1 I 15km.doc•rev.6/13 Title 5 OfRdel Inspection Farm'Subsurface Sewage Disposal System•page 7 or 77 a6ed xed dH 99:ZZ L 60Z SZ &S r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. cityrrown State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A.B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system is a 1500 Gal.Tank D Box and two pits. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon.completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a.complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below). 15ins.doc•rev.611e Title 5 Official Inspection Form:Subsurface Sewa Oe Disposal system Pape 2 of 17 Z a5ed xe� .dH 99:ZZ L 60Z SZ daS I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments E " 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection If(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ No(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health,in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc-row.6116 Title 5 Official Inspection Form,Subsudare Sewage Disposal System-Page 3 of 17 £ a6ed xed dH 99:ZZ L 40Z 5Z d8S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fall unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning In a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in JIM=is less than 6" below invert or available volume is less than %day flow Ff'3 t6ins.doc•rev.6N6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 b a6ed xeJ dH 99:ZZ L 60Z SZ daS i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ° 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. City/Town State Zip Code Date of Inspection B. Certification (cant.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 f®et of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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, t5ins.doc-rev.6116 Title 5 01Ticial Inspection Form:subsurface Sewage Diaposal System-Page 5 of 17 g a6ed xed dH 95ZZ L 60Z gZ daS Commonwealth of Massachusetts Title 5 Official Inspection Form um Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth owner Owner's Name 1 information is required for every Cotuit MA 02635 9-19-17 page. Cityffown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on; ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): NA Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 lsins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 9 abed xe:1 dH 95:ZZ L i3OZ SZ daS i Commonwealth of Massachusetts Title 5 Official Inspection Form d Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner owner's Name information is required for every Cotuit MA 02635 9-19-17 Page City/Town State Zip Code Date of Inspection D. System Information Description: 1500 Gal.Tank D Box and two pits. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): 2015,69,00OGaIs2016-77,O0OGals Detail: Sump pump? ❑ Yes ® No Present Last date of occupancy: Date CommerciaUlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seatslpersons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes. ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doe•rev.6116 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 7 of 17 L a5ed xed dH LS:ZZ L l,0Z 5Z daS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name itlon is Cotuit MA 02635 9-19-17 required for every per. City/town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use'. Date Other(describe below): General Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5insdoo rev.WO Tile 5 Official Inspection Form:Subsurface Sewage Disposal System Page B of 17 9 abed xed dH LS:ZZ L 60Z SZ daS i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1969 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): , Depth below grade: 20"feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH -40. Septic Tank(locate on site plan): Depth below grade: a"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal. Precast H-10 Sludge depth: 2" ISin%doo-rev.6!16 Tills 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 6 a6ed xed dH 99:ZZ L 60Z SZ d@S h I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. CltylTDwr1 State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 1 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 1 7 How were dimensions determined? Asbuilt-Tape Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and covers at 8" below grade. In and outlet Tee's, No sign of Leakage or over loading Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date l5ins.doo rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page ID of 17 o l, abed xeJ dH 9S:ZZ L l•02 SZ daS Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner owner's Name information is required for every Cotuit MA 02635 9-19-17 page. CityfTown State Zip Code Date of Inspection D. System Information.(cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No &ns.doc•rev.6116 Title 5 Official Inspeclon Form:Subsurface Sewage Disposal System-Page 11 of 17 6 abed xed dH KEE L WE 2 CIBS i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box, etc.): D Box is 16"x 16% 18" below grade w/two lines out. Box is clean and solid. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No` Alarms in working order: ❑ Yes ❑ No' Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): `If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: ISins.doc-rev.6116 Title 5 Official brspedon Form:Subsurfaoe Sewage Disposal System•Page 12 or 17 Z abed xed dH 9S:ZZ L 60Z 5Z daS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments F 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name Information is required for every Cotuit MA 02635 9-19-17 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: IN leaching pits number: 2 ❑ leaching chambers number: - ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is two 1 b00 Gal. precast pits. Pit#1 in grass, Pit and cover at 21" below grade H-10 w16" water. Stain line at V above water line. Pit#2 H-20 in driveway. Pit at 27" below grade w/steel cover at grade. 6"water wl stain line at 1'above water line. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Stain line at 1' Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc•rev.6113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 E� abed xeJ dH 85ZZ L60Z 92 d@S Commonwealth of Massachusetts o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name nform requir on is Cotuit MA 02635 9-19-17 • requiredd for every page. city(rown State Zip Code Data of Inspection D. System Information (cunt.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan).- Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.wills Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 17 6 a5ed xed .dH 65:22 L WE 92 d85 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments F 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name Information Is Cotuit MA 02635 9-19-17 required for every page. City/Town State Zip Code Date of Inspectlon D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells wlthin 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately F/p vivT r � 0 2 r ✓7`� - JOr �`�= tr�0• YY" C -s= ,,2 3 t5.ins.doa•rev.U16 Title 5 Official Inspecticn Form:Subsurface sewage Disposal system•Page 15 of 17 5 abed Xed dH 65:22 L 60Z 5Z d@S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 page. City[Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to h gh ground water: 2 + feett Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: G.W. on file ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: G.W. on file w/B.O.H.. Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15ins.doc•rev.6/16 tale 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 91, a5ed xed dH 69:ZZ L 602 2 d8S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4339 Falmouth Road Property Address Michelle Booth Owner Owner's Name information is required for every Cotuit MA 02635 9-19-17 pie. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file tSins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface SewaGe Disposal System•Page 17 of 17 L 6 abed xed dH 00:£Z L L02 SZ daS r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION yA� ` T L re -14 S `) 7 Vv TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 4339 Falmouth Road Cotuit MA 02635 ®� Owner's Name: Frank Twyeffort Owner's Address: Same Date of Inspection: June 26,2007 Job#07-139 ti Name of Inspector: PATRICK M.O CONNELL � Company Name: SEPTIC INSPECTION SERVICES CO. � ""'` Mailing Address: 189 CAMMETT ROAD 00 MARSTONS MILLS MA 02648 1 '" Telephone Number: 508-428-1779 C) CERTIFICATION STATEMENT ct I certify that I have personally inspected the sewage disposal system at this address and that the information eported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes _X_ Conditionally Passes Needs Further Evaluation by the Local A roving Authority Fails .• Inspector's Signature: Date: 6/27/07 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments: Distribution box is deteriorated and collapsing,recommend pumping tank. ****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 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: XX _XX_ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Distribution box is decayed and leaking,needs to be replaced. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping 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: Page 3 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 4339 Falmouth Road Cotuit P Owner: Frank Twyeffort Date of Inspection: June 27,2007 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria 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: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 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_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 a Zone I of a public well. _X_ 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 forma _No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well 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. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 Check if the following have been done.You must indicate"yes"or"no"as to 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 available note as N/A) _X_ _ Was 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 the Board of Health. _X_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)) Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):440 Number of current residents:2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Two years total:93,000 gal.=127 gpd. Sump pump(yes or no): No Last date of occupancy: Currently Occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,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: Tank had never been pumped Source of information: Owner Was system pumped as part of the inspection(yes or no): No If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool. _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1989 Were sewage odors detected when arriving at the site(yes or no): No Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: ,Tune 27,2007 BUILDING SEWER: XX (locate on site plan) Depth below grade: V 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.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 6" 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: 10.5'long x 5.8'wide—1500 gal. Sludge depth: 8" Distance from top of sludge to bottom of outlet tee or baffle:26" Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle:6" Distance from bottom of scum to bottom of outlet tee or baffle:6" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees are intact,liquid level is at bottom of outlet invert Recommend numyina tank GREASE TRAP: No (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.): Page 8 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSME NTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 TIGHT or HOLDING TANK: No (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.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): Box is leakine and collaasine. PUMP CHAMBER: No (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.): Page 9 of I 1 OFFICIAL INSPECTION FOR M—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: Two 6x6 pits. 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.): Both pits have one foot of standing water with no high stains 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. Falmouth Road Water Service 39 31 3 2 48 42 Page I 1 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4339 Falmouth Road,Cotuit Owner: Frank Twyeffort Date of Inspection: June 27,2007 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 20 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: _X_Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: _Checked with local excavators, installers-(attach documentation) _X_Accessed USGS database-explain: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water at el.35 and topo map shows property at el.60. oFt�r� Town of Barnstable . Regulatory Services snxrsrna Thomas F. Geiler, Director 21 6 9 A,Eo �A Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 REGARDING.SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS DISCLAIMER A septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original or copy of the report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observations and interpretations contained within this report. In addition, by receiving the report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved: at a particular property would be listed on the Disposal Works Construction Permit. Q:\SEPTIC\Disclaimer Private Septic Inspections.DOC Ec--Imovfl-}, TOWN OF 8ARNSTABLE LOCATION A33q qcq SEWAGE#�5� V LLAGE ASJESSOR'S MAP&PARCEL IN*TfiffEBWS NAME&PHONE NO. p AY01 L &R7 r SEPTIC TANK CAPACITY 11500 LEACHING FACILITY:(type (size) OCr-) NO.OF BEDROOMS OWNER �'/ter►IC -Twyaor f PERMIT DATE: C - DATE:-,I?r,SP. CD lad l6'� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist 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 17 I Falmouth Road t Water �. Service 39 3Q 31 2 42 48 No. . '• Fee _ 2-- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: v PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Ztppltratton for �Dis;paar *pltem Con.5trurtton Vermtt 65P1 .. - aox Application for a Permit to Construct( ) Repair Upgrade Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.Y33Q !"l�lllt0!/Td! XWa Owner's Name,Address,and Tel.No. G'a t T Assessor's Map/Parcel �"� 3 fit v C//JJ©?Ul.� In taller's Name,Address,and Tel.No.P - 16 'S2 Designer's Name,Address and Tel.No. aSt:P1 9-e- 181. j3, oS e eat e r-1 ees Type of Building: Dwelling No.of Bedrooms. Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) sTi�L% aG�aTi�y .. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved by Date Application Disapproved by: ` Date for the following reasons Permit No. Date Issued F No. A00 Fee 1�. _v� F i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zfppltcation for Oigpool *p5tem Congtruction Permit 3ox Application for a Permit to Construct(") Repair( ) Upgrade( ) Abandon( ) El Complete System-I0 Individual Components Location Addressor Lot No.1j(.1`,3Q f!¢/!NI(;1 4�NA PI Owner's Name,Address,and Tel.No. cd !j r00,4 1"tvtf earl" Assessor's Map/Parcel �^'� In taller's Name,Address,and Tel.No.5-d ' 280' Designer's Name,Address and Tel.No. 77. Type of Building: Dwelling t No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title 1 -� Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) r05i l4o1/ Date last inspected: J, Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved by Date Application Disapproved by: Date for the following reasons i i Permit No. Date Issued -;�- �' - - fi � THE COMMONWEALTH OF MASSACHUSETTS j U BARNSTABLE, MASSACHUSETTS (fertificate of Compliance THIS IS TO CERTIF Y,that the On-site a e Disposal System Constructed ( ) Repaired Y Sw Upgraded ( ) Abandoned ,by P 2 icjo at 7 #-i ( ) ha been co s ru`Wedi cordance with the provisions of Title 5 and the for Disposal System Constructi4 dated Installer Designer #bedrooms Approved design flow , A gpd The issuance of this permit shaA not Pe construed as a guarantee that the system ill unction as designe4. Date �/ Inspector /� ————————————————————————— ————— ———————————— 921��� No. 1; Fee ..�--- THE COMMONWEALTH OF MASSACHUSETTS _. PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Oigpont *p5tem Congtructton Permit a Permission is hereby gra e�o Construct ( ) ReRai ( �) yUp rade ) Abann, n. ( ) S System located at VA / and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must Ve comp eted vy'thin three years of the date of thi Date / Approved by W'y0*t H[T0�e The Town of Barnstable ,AL rur. q Inspection Department W��'� 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D.WLuz Building Commissioner June 5, 1992 Frank and Patricia Twyeffort 4339 Falmouth Road Cotuit, MA 02635 Re: Site Plan Review Number 15-89 i 4339 Falmouth Road, Cotuit, MA y change of Home occupation use Dear Mr. and Mrs. Twyeffort: I The above referenced site plan is approved with the following conditions: 1. The parking area shall be screened in accordance with Section 4-2.5 of the Town of Barnstable Zoning ordinance. Enclosed please find a copy of the conditionally approved plan and a certificate of Review. Please be informed that you must comply with any requirements the Zoning Board of Appeals may impose in addition to the above. a } should you have any questions, please feel free to call. a Peace, r J h h D. Da uz Building Commissioner JDD/km cc All Site Plan Review Staff enclosures (2) i S920605A a `lr S The Town of Barnstable Inspection Department s619.Mid d 367 Main Street, Hyannis, MA 02601 �C M. 508 790 6227 Joseph D.DaLuz Building Commissioner SITE PLAN REVIEW CERTIFICATE OF REVIEW I certify that Frank and Patricia Twyeffort has submitted an amended site plan (see file SP-15-89 for previous review of this site) pursuant to Barnstable Zoning ordinance, section 4-7, and that such site plan has been reviewed and Conditionally Approved by the site Plan Review staff. Bui in , ommiss' n or his designee date f ction 125.00 LOT 9 25,000;SF 0 N/F o Fcx SOARE.S C] N 7e' 14' ry `. N STRUCTURE 5 3 ' STEPS y x/I I ' Y 125,00- v � ati s Col yl9a O P.%kk'` GARAGE 7 ' PARKING AREA) ( PRESENT DRIVEWAY ) -,— TURN—AROUND o G' co SCALE: 1/8" = 1 FT. ROUTE 28 Jr RNSTABLE , LQCATION U( SEWAGE #=u 0b VILLAGE ASSESSOR'S MAP 6z LOT INSTALLER'S NAME PHONE NO. PY•� (} /(� SEPTIC TANK CAPACITY �Jl LEACHING FACILITYAtype) f (size) NO. OF BEDROOMS-PRIVATE WELL OR UBLIC WATER BUILDER OR OWNERneO /. �d• yInolj DATE PERMIT ISSUED: /e ' / DATE COMPLIANCE ISSUED �' -r IS - r 7 VARIANCE GRANTED: Yes No (�yy� M �.1 _v �: s �r�N ____�/ � p `/ �� :�. /Q 74 i THE COMMONWEALTH OF MASSACHUSETTS- J, 6 BOAR® HEALTH OF... ............... . ..... ... .............-- Applira#ion for Disposal Works Tonstrnrtion rutuit Application is hereby made for a Permit to Construct ( t.�or Repair ( ) an Individual Sewage Disposal Systemat: -- ----•-•--- v I ........... ..• -•---- •----- Lo -on-Address Addresser -0-------. .... ---e= Address Type of Building Size Lot _©U4..t......Sq. feet � Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) a . —Type of Building ......................:..... No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .-----•--•-•-•---------•-----•------------------------•....-------•-•••-••--••----------.._.......•---•------•-----•-••••------•-•-••---------------- W Design Flow.............. ._gallons per person per day. Total daily flow.._........-_...� gallons. WSeptic Tank—Liquid capacity/ . .p..gallons Length/_a..-.6__ Width ":iQ". Diameter................ Depth. -.--.3.`.�. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area---___d sq. ft. Seepage Pit No--------I........... Diameter-__�..-_Q.: Depth below inlet..�'.6 Total leaching area..d_ .._ ._...s�,Ktdf Z Other Distribution box ( ✓Y Dosin k ( ) � ) / `-' Percolation Test Result Performed b L? ..._ ..... /. 6 Date. W Y r Test Pit No. 1................minutes per inch Depth of Te it_..../ _�.._.__ Depth to ground water. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------.................. --------------------=---------------------------------------------- ............--------------------................................ Description of Soil /- `qq� ........... --------------------------------------------- -----•-----------------------�-/---../Z..... U � -' W --------------------- --------------------------------•-•----------•---•--.._...-•----•------_.....---------••------------•-••...-----•......--•--•................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........................................-............................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the o dZofhylt�h.Signe -- -----... --- - . . Date Application Approved BY ..... ' ------------------- Date Application Disapproved for the following reasons:..............•---------------------•---•-----•-------------------------------------------------------------••- --------------------•-------•------------..........--•--••••-----------•-•-------•--•--•---•----•---•---•-•---•---•------•-•.._..------•----•---•-•------•-•-----•••------••--•-•--•---•---•-••-------- Date Permit No........ .�... ---------------- Issued-..........................................D ate....._ . Date 7A �� _ -7 _ FRim THE COMMONWEALTH OF MASSACHUSETTS J BOARD HEALTH G?7e1'dt:...............OF....:r =;;-•f� =r-:: `:r '',>.. Wiration for Disposal Works Tonstrur#iun rrrmit Application is hereby made for a Permit to Construct ( wr or Repair ( ) an Individual Sewage Disposal System at: .. . . ... .. --•-- - •- --- •- - -------. Lo`a ion-Address •• t�1 Ct� c� r� a 7 __E�: . irk— - _-- - - - -- .�' No Owner ................................. W �� Address ,-� .......... Installer Address Type of Building Size Lotlf__ ......Sq. feet U Dwelling No, of Bedrooms.............----_•------_� g— ______________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures. ••--••-••------•--------•------•--•-----------••--•-...----•-•--------------• -•--•-•---••--•--••--------.....---•-•-------•-••------•........_-•---- W Design Flow............. _.......................gallons per person per day. Total daily flow...._.... '- ........ ................gallons. WSeptic Tank—Liquid capacityS092-.gallons Length/ __1,__- Width:_.?-._-r._.. Diameter................ Depth 6'. _:"- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......!----------- Diameter:__+.a..:.. ?.___ Depth below inlet___.::_ .:_. Total leaching area..1�r%�"�_._S Zt. Z Other Distribution box Dosing tank ( ) J / `" Percolation Test Results Performed by.."�_ <'.-_ 'il _y::_._ :_ f �` �" Date.6`�:F�!.! f________________ Test Pit No. 1................minutes per inch Depth of Tesi Pit..... ......... Depth to ground water.AVr, 1_ ...... (Z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil - :^�%..-=�..... .. x.. e~-..--•----•----------•---•-----•-------.. W UNature of Repairs or Alterations—Answer when applicable.-.............................................................................................. .........................................-.............................................................................................................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed....................................................................................... ................................ ?J Date Application Approved BY - . ---------- ..::`_"`" .�. Date Application Disapproved for the following reasons-----------------------•----.....----•---••--•----------•------------------------..._...-•-•---•---•------....._ ..................•-•-----.............--•---------------•--••------------...---------.......------•-----•...........-•-•--------------------•......-•-----•------•-----••-------•--•••••----••---•-•--- Date b PermitNo-----------------�-•-----�•--._..�............ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD PF HEALTH f �r (Irdif iratr of Toutplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at-------•-•------••-------------------•-•---•-----------------•-••---•-------------------•--••---•----------------------•---------------------••-•-•--------------•---•------------------------------- has been installed in accordance with the provisions of TITIE 5of T t Sanitary Code as described in the application for Disposal Works Construction Permit No......_._..SS ------------------- dated_............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. . ....�_ _'• ...................... Inspector.................... ............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �- 6 D ......................................OF..................................................................................... �S No................. FEE........................ Disposal Works Tnn#r ion rrutit Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo........................................................................................................................... Street /, -- -Go as shown on the application for Disposal Works Construction Permit N ._----(----. ._ Dated------------------------------------------ , - ------------------ ----- C / Board of Health l DATE.......-•------•----- -• -- ......................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS A Nd- FEic.............................. THE COMMONWEALTH OF MAb;SACHUSETTS BOARDYF HEALT....OF. . . . ...1�I-� .. ...... ... Appliration for Uhiposal Works Tomitrurtion rumit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System ...........a .J. ................2 /............... ..eZ. .......... ..2F ... .t ................ L,c Add,e, or Lot No. ................. .......... .rA4,-V....... . ........... Owner Address ..... .. ... . .... .. .................... !;i�r ��X._44c� ............ . . . ......... Installer Address Type of Building Size Lot...�j6Y_W.Sq. feet U Dwelling—No. of Bedrooms.... ............. ... . .........................Expansion Attic Garbage Grinder a Other—Type of Building No. of persons............6............ Showers (e) — Cafeteria Otherfixtutps .--...........................v....................I................................................. ----------------------- Desi n Flow.................. .............gallons per person per/da,V- Total daily flow........... 9 Septic Tank—Liquid capacityf W.gallons Length___149_4.... Width................ Diameter__.__r------- Depth_,6.3,_ Disposal Trench—No..................... Width.........,o......... Total Length................../. Total leaching area....................sq. f t. Seepage Pit No-----------I---------- Diameter.......... ------- Depth below inlet...__...--.-. Total leaching area.—'IJ.V..7.sq. ft. ZOther Distribution box Dosing tank 7 Percolation Test Results Performed by....A.A elx Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit....../.y.4... Depth to ground water---IAVO.Jt4Vi 7- 40 Test Pit No. 2................minutes per inch Depth of Test Pit...___._............ Depth to ground water____....._..._.......... 04 ......................................................... A ---- ----- ------------------------"-----------*................*----------- --------- ---- 0 Description of Soil................. ...........I ._Jv.�)............................................................................... �4 MZ ---------------------- ------------- -----------------------*......... -----------------------*--------------------------------------------------*--------**-------------- I ...............--------------------------------....................................................................................................................................................... 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 T I TI14, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bDee issued by the board o health. - Signed--- ... ------------------------------ Date ApplicationApproved By................................................................................................. ........................................ Date Application Disapproved for the following reasons:............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo.................................................I------- Issued----------------------------------------------......--- Date 0 80466696 00 0*0000 too d.&A000*0004.*00*0000 0000002,000*0000 606000-004,a 00 e.-Ses.06M.9090960064 094*66 as 6066*4 600 00000*.60 0.0*60 0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........r(MA-.-V.)......OF..... . . Ve ..... . ... (9rdifirate of Tontphatta THIS JS TO CERTIFY, at.... - ..... Tha,h Individu l Sewage er Dispys I System constructed---(-1------- --o--r---R---e--p--a--i-r--e--d by---------------Z... ......... 4,-Zdd�- ------------------------ 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. FUNCTION SATISFACTORY. DATE..............0................................................................. Inspector..................................................................0................. .............................. - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for lioposal Works Tontrur#ion rrruat Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System t Loc ion-Addres - ;��� �* y� �f or Lot Lot�No. Owner ress .................../.._f,.f.... \.�•.____''�"�'-�' L-wN-P • Q v .ivw yc•_LS{f'j". ---r4'4' eed1-- ----------- Installer Address Q Type of Building Size Lot_ J'"__2.Sq. feet Dwelling—No. of Bedrooms.............. ------------_____.._.....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _4&1 No. of persons........... Showers ) — Cafeteria Other fixtu s ....................... ------------------•---.----•-••----------------------------------...w Design Flow.................. ..... ................gallons per person peiyd�y. Total daily flow.._.......__ i.1-0..................- WSeptic Tank—Liquid ca.pacityf f gallons Length._/ZV..'..... Width................ Diameter.._;,_____. Depth..-.�''�..... x Disposal Trench—No..................... Width........f.......... Total Length.................A. Total leaching area....................sq. ft. Seepage Pit No---------I---------- Diameter.........% ......... Depth below inlet........ ......... Total leaching area,. Xs . ft. Z Other Distribution box (.11) Dosing tank ( ) aPercolation Test Results Performed by... ..11 ----AZ.C/..... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit_____�.��_ ____ Depth to ground water__-2L�J.hGrY.�' f 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ......................... ............................. ,. O Description of Soil................ 1 ! ......L' x c, w UNature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------•-----••----....._..----------•----•---------------••--••-•--•-••-_.....----•-----------------------------•------...----•----•-------•-----------------------•------•---•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha/bDe issued by the boa d health,,Signe fixn- Date ,Application Approved By....................................................••--•---••-•----------•-...........-•-•---•--- Date Application Disapproved for the following reasons-------------------------•---•-•-------------•---------------------------•------•--------------------------.----- Date �> Permit No.................................................- •:--, Issued....................................................... Date - THE COMMONWEALTH OF MASSACHUSETTS' BOARD OF HEALTH (,Q' V' .......oF..... ..d... ,..... Trr#ifirate of Tong hattrr ,r THIS IS TO CERTIFY, That the Individu 1 Sewage Di oaal System constructe4 ( ) or Repaired ( ) by.. .�,�. ...... -------------•--••---•--------------- -------_------------.._.--..----_.-.-.-_- a ` { _._ _ �_Inst 11 .!�?:_ t., -----•------------------ at. rg" 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 SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM,WILL'FUNCTION. SATISEACTORY. DATE............................................................................... inspector--------............................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . _.� . Noy......... .. FEE........................ Disposal Vorkv 'Tonstrurtion ramit . Permission is hereby granted. k __s _ ?... ..... Y` ..................... to Construct (. ) or�Repair ) an Individual S wage D' posal System .... Street as shown on the a plica ' n for Disposal Works Construction Permit No.._- ••_...,., Dated.......................................... 4 / 1 t Board of Health DATE..... :....... .............................................. •--••-. ' FORM 1255 A. M. SULKIN, INC., BOSTON a _ . A2c 1 ..._"� �_. _ �A��t.� c�:• s U ,.a � � G _., cae:Tv r..�. L''+.....a.,...! E. ,lowt I' , - — --- �� �. �i TG 1 p,L t , ._1 E S p� !�.l i+�5 I M ►r'� O F 7115 cam. LE '� 4 AN - L.� � �.� �>�F'T, " T�����5 L�tST 2tB.Jz ��►.� �x , Ai-AU LEA.Cu�,1G-i Pr-S SNA,, ° FI ALA--Ing ��n15J�T�1c�bL,� MAT"Ei2!4i_ � ► �E�T14 ,-'= ► F r;= %'. O (,\D ® � ! �1 ' t►.�.iEe-i Et-Et/A r-�c��� c F l e.A.Ct+l!-ram, F7 f�'�J Fti .. 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AGC:E 5r5 TO rOG } L`C�To►✓{, c�or.A �� -d000 Pr TEST SEPTIC ��.SE A� S� 1.C1 -µ,►_SG > � n Tt's >� Tait)►L.T i �O Tt�. 1 Z{A�'N ti�� - LoT to IZS�o�► � 1 — �F-�►�..��SN G�rZ�.or� )rl.���51a 6,,�,� F= ,r..,,s�-: E,e•�+.nE o�� Lo /F1►..SI SN C�Q..AA9E_�2`SO 1 <1v'E� �+AF.�ti:_• 1 Ix0 �,�E"�''t"��x�. 70_�C$� l..Eac w,uC-� Q►�_��xs T ,lU _toi 25 i"4�48,((e7 .� • I f SAS } CIEX- c `ay 4 ►Nv �-& N0 A .01-+- STC.w.Lir �-` 0 �•� c 10 0 T © . 00 Iv X .� t .,s 1 d d • �— ��'..� �- �J /� .__-". - `Ili C,� {,,,�sVr�►.- ' �jl-r�.ESI-k -ii Vtr' - /.� 1 vv„ a CjN L ttJC_ U�--� k-O , -14-1 I oP. Diu RI t"� -r 3x�� - ��. �)A T = J Z,a.i 2 � I C I L ►J a I" .'.� O'S l N f ' � I y _ -' - - / �-� \fit �a �- t ,� _r��s� e- PROP05ED, 15 IGe-1AG%E I SPOSJs► -- S*q'SiTE M FA L K,-f OLD`' l-i Cl- ._l3 t_ '7Qx / y°►� \ ,, \ 0,7 i '7 a �E+� e,ET.�� �1 �Z -7 ax A LL O. J S PWEFZ PE32SOIJ P€r L>AY T F' c�F�SE t�✓A."�'t c� 1 T .ST E-}t : � '1.. � ). '�.. i_.6, u ' ASS, A f°GS41�. �i AC-c�P�3EL tr.EA.C-N4 ,.SC-r p;�-. `5 C A,L F- 5 i,3cr `EO GATE ,( ", I, _ �6: w. Ott _.._ �' ? � ��1C/E.�2AAG E �E 5 I �,/J • - �., nlU�C1 E 1�: �"+--�"£.C7 3►.if �i'TQ_U GTt D G , 1J G -� SI>,��,e,Lt, Q2Ea = Qt'1CZ)�� )CG � C 5) 37� G- 1 1� '9A,5.S ' P L O r �L��,� �a T'! C� �! �v�,,�s = �`�`��i �4 )�act i•6� - 5G 6 t�l� _ ,� _ -- ._....�... 1 G'� 4 Z -7 G p r tz.t t C.-x ..;t<E POP, ►r) � !2 TEST PIT #1 TEST PIT #2 10._6' GENERAL NOTES p, ELEV.= 70x3 ELEV= ri 1. ALL ELEVATIONS SHOWN ARE BASED UPON THE I I USC a GS DATUM SUBSOIL o I - I 2. PITCH ALL LINES A MINIMUM OF 1/811 /FT. UNLESS I "' r OTHERWISE SPECIFIED. J � �� 00000 3 D @ 0 6_' 0 c 000 000000 O 0 000000 3. ALL PIPES TO AND IN THE SYSTEM SHALL BE CAST N 1- - - - - - - - - - - - I N o_ 00000 O O o 000000 IRON OR SCHEDULE 40 PVC. 000 0 0 O O 0 O O 0 0 0 000 _1 4. ALL SEPTIC TANKS, DISTRIBUTION BOXES, AND 1 000000 � O () 0 0 0 000 ,� LEACHING PITS SHALL BE DESIGNED FOR H-20 WHEEL \ / 000003 0 0 0 000000 LOADINGS WHEN UNDER PAVING. MEDIUM � � 000003 0 O0 000000 - - �-SAND 00 0 0 0 0 O 0 000000 5. REMOVE ALL UNSUITABLE MATERIAL BENEATH THE 0 3 1� 00 0 0 0 0 O 0 6) 0 0 000 INVERT ELEVATIONS OF THE LEACHING PIT FOR ° TYPICAL DISTRIBUTION BOX 0000 0 (� O O 0 0 0 0 oco A DISTANCE OF 1OFT. AND BACKFILL WITH CLAY- 4 -uQu LEVEL FREE SAND a GRAVEL HAVING A PERCOLATION RATE 12' � NOT TO SCALE 6'-0'. OF 2 MINUTES PER INCH OR LESS. -- NOTE' DISTRIBUTION BOX AND 1500 6. THE BARNSTABLE BOARD OF HEALTH MUST NO l ,47ERENCOUVTEREO GAL. REINFORCED SEPTIC TANK BY BE NOTIFIED WHEN THE SYSTEM IS NEAR COMPLETION OBSERVATION PIT TYPICAL 1500 GAL, SEPTIC TANK ACME PRECAST OR EQUAL. TYPICAL LEACHING PIT AND PRIOR TO BACKFILLING. 7. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS PERCOLATION RATE= 2 MIN/INCH NOT TO SCALE NOT TO SCALE SHALL BE INSTALLED IN ACCORDANCE WITH TITLE Y OBSERVATIONS BY, RONALD GIFFORD NOTE' TANKS REINFORCED THROUGHOUT WITH OF THE STATE SANITARY CODE AND ANY LOCAL BARNSTABLE BOARD OF HEALTH ELECTRIC WELDED WIRE WITH 24-1/211 RULES WHICH MAY APPLY. ENGINEER: NORMAN GROSSMAN, P.E. EMBEDDED STEEL RODS IN TOP a BOT- 8. CONTRACTOR IS TO NOTIFY ENGINEER, PRIOR TO THE DATE! JUNE 26, 1981 TOM. CONCRETE IS 4,000 PS.i. TEST. INSTALLATION OF SEPTIC SYSTEM, OF ANY DISCREP- ANCIES BETWEEN TEST PIT RESULTS AND FIELD CONDITIONS. 9. ACCESS MANHOLES TO SEPTIC TANKS AND LEACHING PITS TO BE BUILT UP TO 12 INCHES BELOW FINISH GRADE. LOT /0 TOP OF FOUNDATION ELEV= 72+50 FINISH GRADE FINISH GRADE FINISH GRADE OVER LEACHING FINISH GRADE OVER TANK OVER "D" BOX AREA ELEV.= 70+5 7 ELEV= 72+ EXIST. GROUND 70+8 125.00 0 ELEV. = 71+0 ELEV.- 69+25 -- -- 3"X 1�8"X 3/4 LOT 9 INV= - INV.= 68+67 `""'' " o' . o' WASHED STONE 25000± SF INV.= 69+0 1500 GAL INV.= 68+83 INV.= 68+5 T DIST. BOX a°^ �' .'::. :. . : :. :::' ° 12 " 3/4 x 11/2" REINFORCED f (TO RE �EVEL X CONCRETE 8, STABLE) . • °°° WASHED STONE SEPTIC TANK °� '••'•'• • " ••"••• ° ., (1-0 BE LEVEL a STABLE) INV.= 68+3 ' BOTTOM OF PIT _ 62+3 �o �2'_o � 6'NIF CLAYTONSOARES rR� \ L TYPICAL SEWAGE SYSTEM PROFILE PRECAST LEACHING PIT o (TO BE LEVEL a STABLE) o NOT TO SCAL E O �� LEACH. � N PIT 6968 � ,� �R LEGEND 2g' �� EXIST. CONTOUR -- — — MAP SECTION PARCEL LOT ADDRESS 6� � EACH. ,,, — 8 IS O GAL JPIT PROPOSED CONTOUR 8ti 9 66 SE TIC 6 TA D" BOX + EXIST SPOT ELEVATION 8 X 0 / PROPOSED SPOT ELEVATION 8 +0 ZONING DISTRICT FLOOD HAZARD ZONE PERCOLATION TEST x 6e I 14 OBSERVATION PIT m l EXII 70 3 /N 1 DWELLIN GAR.N 45. 4 20 � PROPOSED LOCATION OF DWELLING 64 I DESIGN CRITERIA ,��� - �,�� ., 'I _ 4_ ���� `�.� & SEWAGE DISPOSAL SYSTEM NUMBER of BEDROOMS o ,o PERSON PER BEDROOM __2 _-_ ��Y �N� LOT 9 FA L M 0 U T H ROAD \ \ z, , . GALLONS PER PERSON PER DAY __55_ �I►a �a 12 LEACHING REQUIRED 440 BARNSTABLE M A LEACHING PROVIDED _854 EDGE � OF PAV ENT J DISPOSAL NO '_ J 69 ;. ,;� APPLICANT : ENGINEER 65 67 / f THEO CONST. CO ARROW ENGINEERING INC. 6'6 6B SEWER DESIGN • I" ak � 24 GREAT POND DR 10 CAPE DRIVE SUITE B Rodt-RI 'y S. YARMOUTH, MA MASHPEE MA 02649 FALMOUTH ROAD SIDEWALL- -T x 2 x4 x 6 x 2.5 = 377 GPD \ , BOTTOM - -rr x 4 2 x 1.0 = 50 GPD RA"MJNt) ^I SCALE : DATE: SHEET: "° `'�'s' AS SHOWN I OF I TOTAL= 427 x 2 = 854 GPD �f. AUGUST I, 1981 SEWAGE APPLICATION NO.#512 PLAN SCALE : I''=30' DRAWN 8Y: CHECKED BY: JAPPD. BY: PLAN N0.�N�� '' SEE/SEM JTH RER REVISED: 9/11/87