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HomeMy WebLinkAbout0050 HOPEWELL LANE - Health 50 HOPEWELL LANE, COTUIT A=040 061 ` it TOWN OF BARNSTABLE Date /o2/ TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF-BUSINESS: JCL l y SG— W ?%S►k f R hN 15("'10G, !_ 6 BUSINESS LOCATION: `O �,QPg U 6, C-C. 1 AlJG— - CCU W I:- INVENTORY MAILING ADDRESS: ---0 %�6 c-we _c L2,a� c�c�TOt TOTAL AMOUNT- TELEPHONE NUMBER: CONTACT PERSON: �1 ©SU, EMERGENCY CONTACT TELEPHONE NUMBER: '>721--531 —G3�4c MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW Q USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Photochemicals (Developer) Miscellaneous petroleum products: grease, lubricants, gear oil ❑ NEW ❑ USED - Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS p icant's Si ure .Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY,REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. f DATE: C q -07- l to ram ' Fill in please: (NZ t APPLICANT'S YOUR NAME/S: C:2Se I"L• r f` BUSINESS YOUR HQME ADDRESS: So NSF W \1 \uyse_ �� TELEPHONE # Home Telephone Number a a5 aWN NAME OF CORPORATION: NAME OF NEW BUSINESS A L L ROL86 wA,511 fPAi NT 11461 TYPE OF BUSINESS V QW6 R2 WjkA 1-F -h 10ki NTI _ IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESSco t\npfiwE LL L1.�E ��T. �� ©7��5 MAP/PARCEL NUMBER UL I (Assessing) C When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Q_ Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth. G Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this,town. 1. BUILDING COMMISSIONER'S OfFICE This individual has been inf m any p equirements that pertain to this type of busines U _ �/IUST COMPLY WITH HOME OCCUPATION ut riz d Signat r RULES AND.REGULATIONS. FAILURE TO COMM TS: Q:s; G.Q.NtpLY MA.Y ����1Lfi IN �I�J�I�: C 2. BOARD OF HEALTH [ MU This individual has been informe t qui ements that pertain to this type of business. .51'COMPLY WITH ALL HAZARDOUS MATERIALS REGULATIONS, Authorized Sign t e** COMMENTS: 3. 'CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: J TOWN OF BARNSTABLE LOCATION SO 14®i3C We-I I )-A . SEWAGE# 2®1,5- 3-7& VILLAGE Co%Q J T ASSESSOR'S MAP&PARCEL LIQ p �p l INSTALLER'S NAME&PHONE NO. "`Y 9,SVC (6;LY► . S@ gr-L/32- 0 SEPTIC TANK CAPACITY /j S®® LEACHING FACILITY:(type) 2 a S-00 0 -5 %3 size) 2S X 0 2,e�X 2 NO.OF BEDROOMS OWNER ,7e)C a4e 10ea-I PERMIT DATE: /® - ZQ-f s COMPLIANCE DATE: 1 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility !J Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) 1,1 A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) t A_ A Feet FURNISHED BY��11 S'n�i 9 'Y .At�*f ( $'AC, ®s A- I._ 2 y ° J3-l = 2 7,9 0 Day- I A-Z 2 P,5' $'?-- 3 Z' c � Rem r Ai A-3 , 2y® i � 9 °� ;y-y k i Rio. Fee f°00+C3f� 611 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYication for Misposai �&pstern Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade N4 Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.S*® 9eXl,4WJ L A (49TV%`T' Owner's Name,Address,and Tel.No.. eq f Al- in �o ' Assessor's Map/Parcel L10 Wef 1 L1, Installer's Name,Address,and Tel.No. 57o5_y 3 z_oS 30 Designer's Name,Address,and Tel.No.S0 -&py- fa�tj F-a 13� e ► ®2GCo,rwc S i3a s(2 h$—f�,P,0a 1163 ,�P.�en+�s,-� Type of Building:Dwelling No.of Bedrooms �7? Lot Size Q, /Z 3 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .330 gpd Design flow provided ,3�/g gpd Plan Date Number of sheets Revision Date Title SQ N&MWI Ln CO 1 U# T' Size of Septic Tank 614r3T^" i epp Type of S.A.S..`Z-�0d 2641at\ C�Qan�5 �i��i���fiAe Description of Soil A-0 1!pEt,wu S � .8 - �r4 L T 6-1 L SG4 w l oll Ls. C-2 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure tAconstructl' maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of tode and not place the system in operation until a Certificate of Compliance has been issued by this Board i d Date �sS Application Approved by / �. Date Application Disapproved by Date for the following reasons Permit No. Date Issued E -------------- ----- 4k �6 1 �NO. r/ r. Fee /06-OQ +_Y THE COMMONWEALtH OP MASSACHUSETTS Entered in computer: Yes - PUBLIC HEALTH DIVISION.-TOWN OF BARNSTABLE, MASSACHUSETTS I01ppYication for Disposal 6psteut Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.5'o HnPOWe CoTV i T Owner'sName,Address,and Tel.No.TeVf .K�n, n / (7 It Ln, Assessor's Map/Parcel go S Ho we ( LA Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.SOX-3(s • fo P.c,�r�,evrco, rrc. 'S°�y3Z•os'3o y Y8 has 12 i �n9,Pot 1163 ,�, nnrS,- OZG y Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other.Fixtures t Design Flow(min.required) 330 gpd Design flow provided 3 W gpd Plan Date Number of sheets / Revision Date Title 50Ogg Size of Septic Tank P Srd A4�� Type of S.A.S. Ae Description of Soil '�fW ,J Q" L r ",� ' S_.N j,- .. (-7 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction d maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmm 1 Code and not t place the system in operation until a Certificate of Compliance has been issued by this Board .('Health/ ig`ed Date Application Approved by C ; / :� OKI— ( . � Date , ,�h 'Application Disapproved 1: % VV Date for the following reasons Permit No. W 1-2 Date Issued / ` / << ----------------- ------ -- ---- ---------- -- - ------- ------ - ----- -.-Z--------_I------------ G COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certifirate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( t Upgraded Abandoned( )by "T &OUr 60 Xim r at ��/41�et,,ow i1 L �- i 6-s has been constructed in accord with the provisions of Title 5 and the for Disposal System Construction Permit t d- U i Installer kolxcr 8,19(2< �( 'one Designer dr #bedrooms -3Approved design flow and, The issuance of t 's permit shall not be construed as a guarantee that the system w{ll--unnccti� as des, ed. f Date I r Inspector ) , ----------------------------------------------------------- ------------- ------------ ---- No. �')-� - Fee 1,., THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal bpstem Construction 3permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(�) Abandon System located at {!I Jao l i 14 r y!r, 'T roc r— a � w 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. J r Provided:Connstructilo')n must be leted within three years of the date of this permit. Date �/ / l%Jr'i l / � Approved by E Town of Barnstable Regulatory Services Richard V. Scali,Interim Director + $AS\'SL9$IF s Public Health Division 1639. ° Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 1 C'30'15 Sewage Permit# 20 15- 3 7b Assessor's Map\Parcel lib (o I Designer: 'T410/nA5 mcUFLL4r", P•E . Installer: )ZO s'eu-C Address: 1F,0. 6ax 111o3 Address: P,0•14& k:3q C_;7 . FIvtil S , !YtA OU,41 i /LA - o Z4`/,5 On /O- Ze-L5- 90&rT 6,E)V-r& was issued a permit to install a (date) (installer) septic system at 50 t40VE IEU—{A&-e GoTU 1 T based on a design drawn by (address) 1 H VMA' M c-t,EUflN P-t. dated �•22-15 / (designer) ✓ 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. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify tat the system referenced above was constructed:incompliance with the terms I!, the I ap ro al letters (if applicable) l'a Eva ft (Insfaller's Signature) W 7i (Designer's igdnature) (Affix Des"i nefls 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. QASeptic\Designer Certification Form Rev 8-14-13.doc Town of Barnstable P# ��B» JIY� Departinent of Regulatory Services s r• Public Health Division ' ' Date ' ' Maas. 200 Main Street,Hyannis MA 02601 Date Scheduled '. ': •, /rD • Tune O d`l Fee Pd. U U Sail SuitaabilitytAssessment for Sewage Disposal Performed-By: 6 GLe(LAN P.F, Pr Witnessed By: 1- bV• f�'G.��p^ LOCATION& GENERAL INFORMATION LocatlonAddress J�r-F OFAU 56 I�oMt�t✓L LlN Owner's Name G OTO-T— -Address SA(r)E Assessor's Map/Parcel: 4-�0%I Engineer's Name 0 M, 4j fftLE NEW CONSTRUCTION ! REPAIR �' a Telephone# ���' 3,6 9`Q Land Use _ 'Slopes(96) 2 Surface Stones�NoNr'� Distancesfrom: Open Water Body IVA ft Possible JWet Area tft Drinking Water Well ft Drainage Way IVA ft Property Line ! • , - r . t D R Other ft SI{CTCH:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands in proximity to holes) Parent material(geologic) 00T(AA,S I Depth to Bedrock, V Depth to Oroundwater. Standing Water in Hole:: Na P - + Weeping fi-oin Pit Face Estimated Seasonal High Oroundwater MA Method DETERMINATION FOR SEASONAL-HIGH WATER TABLE , Used: Depth Observed standing in obs.hole: Ib. Depdi to Boll mottles: De�th to weeping from side of obs.hole! Ill, Oroundwater Adjustment, Index Well# Reading Date: Index Well Leval — T,� A ,factor � dj Adj,ChwundwdterLeval,, _ Observation PERCOLATION TEST bale Hole# Time at 9" • Depth ofPeru ',72,tt, Time at 6" Start Pre-soak Time @ LE,' 1-60 N AT '!5 m IN Timo(9"-6") End Pro-soak Rate Min./Iuch , 2/►'1InJ 1 N. Site Suitability Assessment: Site Passed -Site;Fulled: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back-- --= ***If percolation test is to be conducted within 100' of wetland,you must first notify tile. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC 0 V . DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. isistency %13rityel) 0 A LS 10 3L /uA. 0 G Spw�4 Uh. Z,S1. L 0 G2 n/I S 2.Sy 7 DEEP OBSERVATION HOLE LOG Hole# Depth from Soll Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. a i toGravel) rl L� 10 KfZ 3 IvA 3 C� � 1.S JD �(Z S a • . DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Boll Other Surface(in.) (U$DA) (Munsell) Mottling (Structure,Sloues;Boulders. C In d Flood Insurance hate Map'- Above 500 year f lood boundary No— Yes' Witldn 500 year boundary No Yes ' Within 100 year flood boundary No. Yes r Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material's Certification I certify that on. (date)I have passed the soil evaluator examination approved by the Department of Envi onmental Protection and that the above analysis was performed by me consistent with . the required traini g,expertise and experience described in 110 CUR 15.017. Signature Date U. (5' Q:NSEPT[C\PRRCPORM.DO C TOWN OF BARNSTABLE LOCATION V SEWAGE # VILLAGE ASSESSO MAP & LOT b INSPECTGIAME&PHONE NO. c�6 SEPTIC TANK CAPACITY 1006 71 � e LEACHING FACILITY: (type) �/� �f� (size) 0 NO.OF BEDROOMS BUILDER OR PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 do gt �09 3 { { ��: 'F�+ �', t`.J4 k�°;lo-pt� �t -'-x i} k i � s ,�r�• :,r yn�c `w, , Atp 060/ r BOR'fOLOI'T1 CUNS'1'RUC'1'I1J1�1, 1]dC, s t� p _ c 765 WAKEBY ROAD,MARSTONS MILLS, MA 02648 508-771-9399 .5418428-8926 FAX: 50,8 428 9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION,p'ORM � PART A CER'rmcA'1'10 t Property Address' 'S46 Dale of Inspection: _ Inspector' ame: &M&4z Awner's Nam and Address: , ,4 CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system al this ndi tlress,and that the informa- tion reported below is true,accurate and complete as of the time of inspection, The,inspection was per- formed1based on my training and experience in the proper fturclion.and ma,ii►l€mane of on-site'sewage disposal tems. The System: Passes ' Conditionally Pas ' Needs Further.E alion y , Local Aproving Autho►t F Fails' •r. Inspector's Signature: Date:-- I".7he-Systern Inspector shall submit a copy,of this inspection report to the Ap!proving authority within thir- ty(30);days of completing this insg -lion..if the systein is a shared system ciao has a design now of 10,000 gpd:or,greater,the inspector and the ,�s e n owner shall submit the r(apart ii the appropriate regional office of the Department of Environnienlai Protection:,.The original sho�uRtbe sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: A)SYS PASSES: I have not found any information which indicates that lbu s ys cat violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced w:ri:pa;n d. The system,upon comple- tion of the replacement or repair, passes inspection.. Indicate yes,nor,.or not determined(Y,N,OR ND). Describe basis of .e kennination in all instances. If not determined"„explain why not. t The septic tank is metal,cracked,structurally unsound, I>,ows slit'stantiai infiltration or exfiltration,or tank failure is inuuinent. 'rite system m i-I pads inspection if the existing sep- t tic ta&is replaced wie.h a conforming septic tank as approm by,The Hoard of Health. Sewage backkup or brehkoi•C nr high static water level ollsc mcd in the,distribution box is due to broken or obstructed pipe(s)or due to a broken, setll,.,9 or tunven distribution box. The system will pass inspection if(with approval of The&:and of fl alth): - 1 - t rv0 t�y ifF"3 {wibr drt'�as xis" *� � � s t' 'SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPE�7'i'ION FORM W PART'A CERTIFICATION (continued) Broken pipes)replaced Obstruction is removed Distribution Box.is levelled or replace) The System required pumping more than four times a year due to broken or obstructed pipe(s). The system ill pass inspection if(with approval of The Board of liealth): ' Broke pipe(s)are replaced 3 Obstruction is removed ' C)FURTHER EVALUATION IS REQUIRED BY TIM BOARD OF HEALTH:, Conditions exist which require further evaluation by The Board of Health in order to determine if "system is failing to protect(lie public health, safety and the environment: 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM'IS NOT FUNCTIONING IN A MANNER WHICH WILLIPROTECT THE PUBLIC HEALTH AND 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.IIEALTII (AND PUBLIC WATER SUPPLIER IF'APPROPRIATE)DETERMINES TIIAT T11E SYSTEM IS FUNCTION- .IING IN•AIMA AR THAT PROTECT,THE PUBLIC IIEALTII AND SAFETY'AND THE ENVIRONMENTS , Theusystem'has a septic tank and soil absorption system and.s within 100 Feet to`a surface watei supply or tributary to a surface water supply. The system has a septic tank and,soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. ,. The system has a septic tank and soil absorption system and,is less than 100 Feet but'50 Feet or more from a private water supply well,unless a well.water analysis,for coliform . , bacteria and yolalile.organic compounds indicates that the well is free'fiom pollution from f the facility..and the presence of anunonia.nitrogen and udirate nitrogen is equal to or less (: ,the Win. , D)SYSTEM FAILS: I have determined that the system violates one or more of the fol6owinglfailure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge orponding of effluent to the surface of the ground or.surface waters due to an w' overloaded or clogged SAS or cesspool. Slatic'liquid level in the distribution box above outlet invert due lm an'overloaded or clog- :, ged-64S or cesspool. t' Ltgtiid depth`in cesspool is less than 6"below invert or available^volume is less than 1/2 . rf day flow. Requiredcpumping more than 4 thnes in(lie last year NU, due to clogged or obstructed pipe(s).- Number of times pumped ' m -2 SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public:well. , Any portion of a cesspool or privy is within 50,Feet of a priv,11c 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. if the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen., E)LARGE SYSTEM FAILS: The following criteria.apply to a jarge system in addition to the criterin above: The design flow of a system is t0,000 gpd or greater(Large System)and the system is a significant threat to'.publicheailh and safety and the environment because one or more of the following S conditions exist' 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)of a mapped Zone 11 of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compliance:vriththe groundwater treatment program requirements of 314 CMR 5:(1(1 and G.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B { CHECKLIST Check if the following have been done: } I�Pumping information was requested of the owner,occupant,and Board of Health: _&,"None of the system components have been pumped for atleast two weeks and the systedhas s been receiving normal flow rates during that period. Large volumes of water,have not been introduced into the system recently or as part of this inspection. As-built plans have been obtained and examined. Note if they are not available with N/A. I/The facility,or dwelling was inspected for signs of sewage,back-up. _ the system does'not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _�G , ,r,:H Y: _,CALL system components,excluding the Soil Absorption System;have;been located on site. _ The septic tank manholes were uncovered,opened,and the iriterior-of the septic tank'was3n- spected'for'condition of baffles or tees, material of construction;dintensions,depth of liquid, depth of sludge,depth of scum. The srze'and;location of the Soil Absorptooi►System on the site has ed based on been determin existing information or approximated by non-intrusive mc"Jw s. 3 ;SU;BSURFACE SEWAGE DISPOSAL.SYS'I;EM INSPECTION FORM . A a. s PART B ' „ CHECKLIST(continued) The facilityowner(and occupants, if different from owner)were provides(with information on , the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .:PART'C 3 �+ SYSTEM INFORMATION ' ' FLOW CONDITIONS $]PCiD T A ! V Design Flow: lions Number of Bedrooms: s? Nw r of Current Residents: Garbage Grinder: d Laundry Connected To Sys(em:/� Seasonal QJ ��[�- Water Meter Readings,if a labte: Last Date of Occupancy: - COMMERCLAI JINDtiSTRI_AS•/CCU - Type of Establishment Design Flow: ' 1 :;ttallons/day Grease Trap Present:,(yes or no) Industrial•Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter'Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Dated Occupancy: — GENERAL INFORMATION //ll PUMPING RECORDS aiid source of informs ion: cz System Pumped as part of inspection: '- "if,yes;volume puiupcd:' `' °' gallons Reason for pumping- TYP- E�WSYSTEM:` Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain):.. . PROXIMATE AGE of all mponents, a installed(if lu n)and source of.information: SeAge odors det ted.when arriving at the site - _ _ .....�.. .... -A _ ._.. .... ...-..f .. _ 1 a s SUBSURFACE SEWAGE DISPOSAL'SYSTEI"yt INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: v Depth below grad Material of Construction: concrete inetal FRP_Other (explain) Dimisions: ' Sludge Depth: Scum Thi knes : Distance from top of sludge to bottom of outlet tee or baffle: 3 Distance from bottom of scum to bott61ifof outlet tee or baffle: Comments:(recommendation for pumping,condition of inlet and outlet tees or baIIles�depth of liquid level in relation too tlet invert,structural integrity,evi nce of leakage.etc.) s 0 i� 41 GREASE TRAP: Depth Below Grade: Material of Construction:_concrete__metal FRP_,Other (explain) _. Dimensions: Scum Thickness: _..._ Distance from top of scum to top of outlet tee or baffle: Comments:(recommendation for pumping,condition of inlet and outlet tecs.,ar ba1114,depth of liquid w _ level in'relation to outlet invert,structural integrity,evidence of leakage, TIGHT OR HOLDING TANK; Depth Below Grade: Material of Construction:_concrete_,met.ai._—FRP_Other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm Level: Comments: (condition--of inlet tee,condition of alarm and float switches,etc,:)_ DISTRIBUTION BOX: Depth of liquid level above outlet invert:- Comments:(note if lev and distribution is equal evidenbd ot solids carryover,evidence of 1 ge into 0 out o boxy etc.) PUMP CHAMBER: (f t Pump is in working order: Comments:(note,condition of pump cliamber,condition of pumps and appu;rti'.enances,etc.) -5- _ J ,�''�k'.n3f:^�4,,.;;;h .�+ .rt,4+Y ac ."t'';x -.. 4 �.. x v.rt,N..m c ' w•:-, .R Ix. a3*. r w..,:f�,�- a::."'n .;4 w -+r s ? s y.:::dl�" ,r ... ? ii..",1 ,ar ...,: S' v f6}',;', ,.,:,`+u M) .,.s'9iJ,A .d•v Wr, .`.:... : :,:., �.:`�...�,t',gg ifs+;. i *'Fa+�'% " M'7• 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(conlinucd) 4 SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits,number:-Leaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Co nts: (note condition of soil,si Is of hydraulic figure level f ponding, ndi on of vegeta on, etc. CESSPOOLS: 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,groundlyatpr: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soilk,signs of hydraulic failure, level of ponding4condition of vegetation, . P V 1RIVY.,� Materials'of construction: Dimensions: Depth of Solids: - Comments:(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -r SYS p SUBSURFACE SEWAGE D1SPOSAL: 1 NA. INSP9 C,TION FORM _ PART C SYSTEM INFORMA110N (cmi6imcd) SKETCH OF SEWAGE DISPOSAL SYSTEMS Include ties to adeasl two permanent references, landmarks or I)en hmarks. Locate all wells.within 100 Feet. ��r t ;a° p'�O CY ✓`✓ DEPTH TO GROUNDWATER: Depth to groundwater: Feel 1 Method of Determinatiop or AP roxi aliou: -7- IfZ No.. ................. FEB............................_ THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEALTH mown......................O F.............Barnstable . ................................................. Appliration for Disposal Works Toustrurtion 11truat Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Lot #27 - Boxberry load, Cotuit, Mass-' ..........-.............:.............•-----•----.......---•-----------.........--•........ Location-Address or Lot No. •---•--•-.Elle'll..JI......Haxnaby...........................................: Ma.in_. t...3 -CAt�zi ............................ Owner Address aa ere...bebe1.......................................................... ._..--•-------------••-----•---•----.......................-•------•......--------........-•••--- Installer Address Type of Building Size Lot............................S �., Dwelling—No. of Bedrooms.......3..................................Expansion Attic ( ) Garbage Grin er ' Other—T e of Building .......ranch No. of persons............................ Showers 2 — Cafete a YP g P ( ) dOther fixtures -----------••-•----------------•----.....-----------._.....------------------------------......---------------------------••- W Design Flow..........5-5.............................gallons per person per day. Total daily flow..................330..................gallons. WSeptic Tank—Liquid capacitPQ.0.0---gallons Length..82-6''_. Width4.'I.Q."._ Diameter................ Depth5.'.8"_.__. x Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area.............:._ __sq. ft. 3 Seepage Pit No....1.............. Diameter......(a........... Depth below inlet.....6............ Total leaching area...266......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....-._jdr.ed-&e...Eng.1-ne_er-i-ng--------- Date....8/2/a.3................... Q.._..minutes per inch Depth of Test Pit-__-__12':_ Depth to ground water--none....ene ounterell Test Pit No. 1.__2._ --.. (i Test Pit No. 2....N/A....minutes per inch Depth of Test Pit......N/A..... Depth to ground water........................ P+ ---•----•••-•------•-------...•---...•-------•-•--------------------•......-----•---•---••---------.._.......-•-•--------------..............-•---•-•-•.--•-- 0 Description of Soil------..Q.1....---.2-1---------Laam--&..taps odl----------------•--------•---------•-------------------------- •-•-•---- •-------------- -_-. v .........................................2'....-...1Q........Me_dium...yell.air...sand-------------------------------------------------------------------------•----. W ....................................1Q.'__._-_._.12-'------Me.d.-_--white---sand/tra_ces---of---gra.vel/mo...water...at...12 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 TITLL 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 ealth. ®R" - _ enT�tS�.x �/1- _�.�.• 1�-- .' . .._..._ Application Approved B D to Application Disapproved for asons:_...--•-------------------------•----------------------•------------------------------------------•--••-------•- ••------.....-•-----•.............•••--------•--•••--•••-----•••----•-----•-----•-•-•---••---•----------•--------------------------------••••--•----------•------------------•------••-------....------. Date PermitNo.......................................................- Issued............................ ............ Date FnE...J-*'! ......._.....- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 2 own......................O F............Bar..................s tabl e ---- - ------------------------•-................•--- Appliratilan for Dispntial Worko Tnntrnrtion rrntit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: Lot rr27 - boxberry Road, Cotuit, Klass. ........... _.............................. -•--•--------------•--•-----•----.... ............................................... ._.............. ........_............... Location-Address e•r Lot No. Ellen..J. Barnaby......--•..................... ....Main St-.-,_... ............................ Owner Address W Steve Lebel Installer Address dType of Building Size Lot............................S U ,., Dwelling—No. of Bedrooms......3...................................Expansion Attic ( ) Garbage Gri e�� Other—Type of Buildingranch....... No. of persons............................ Showers 2 — Cafe enj Otherfixtures ------------------------------••. ------------------------------------------•--------........................._...._.....•---- Design Flow.........�r5.............................gallons per person?er day. Total daily flow....................................gallons. WSeptic Tank—Liquid capacit�000___gallons Length..v-..6��__. Width._1�..... Diameter________________ Deptl1.._$.._..__- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No 1_______________ Diameter.....6............ Depth below inlet....6.'_._._..-.. Total leaching area..2 .......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed by-------Lldr..e.d�;e..Eiki in-e mn............ Date...8f 2/83.................... Test Pit No. 1._2.0. minutes per inch Depth of Test Pit.....12`�...._. Depth to ground water.nOYle--- ?Ilepv�lf�"� Test Pit No. 2._N�ti.....minutes per inch Depth of Test Pit-__•.N/-h-..... Depth to ground water........................ a' ------------------------------------•---•--•----.....-----..........----..........•......---................------....------------....-•••••......•.......... O Description of Soil........ -' 21 Loam &..topsoil =-------------------- x 2' - 10' l�iedium yellow sand ---..•---------------------------------------------------------------------------------- ------------- 10' - 12' Nled. white sand traces of rave . 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 TITLZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu&d by the board of health. ,. ri Pres. 1 1. /84- Signed_0 -..:.....e...Ltd. .... / 7_- .------ s rt _ ate Application Approved By.......... -------------•--•------•-•---------------------------------- Application Disapproved for fn" i reasons:..................................... ------------------------•-•-•-------------••••---••--•--•-•-----••--.........-•---•----••---•----------•---•----------------•-------•••-•••-•---••------••----•-------•---•-----•--' -----•----•--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF-MASSACHUSETTS BOARD OF HEALTH .........2own....................O F.Larrs ta-b .................................................. vErrfifiratr of Tomplianrr THIS IS TO CUTIFie t�at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by -------- X.el X._..._.. Lot #27 - Boyberry Road, Cotu T,"'41ass. at..-•------------------------------------------------------------------------•------•-----------------------------------•------------------------------------------•--•-------•----------------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Co a>s Acribed in the application for Disposal Works Construction Permit ................ dated__ ._.._ r^r�''� ___............._.. THE ISSUANCE OF THIS CERTIFICATE SHA_ NOT B CONSTRUED AS G ARANTEE THAT THE SYSTEM WILL FUNCTIOVATISFACTORY. DATE.............•••--............------ .......H.. ....................... Inspector................... -------------._...••-•••....--.--•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �~ 2oWn.........................OF...Barne-table..................-._...............:............. N ..........J.......... FEE. Dioposal nr1 Tnndr ion rrnti# Permission is hereby granted`.---�-•-eve..-1,2.--e1----•..................••••---••--------•---------------•...............---••-•............_•-••-._.... to Cons ct ( ' or Repa>r, ) an Ind'vt ua1,.Seg�a Dis ystem `b #2�7 - o.x�e�ry Roa , kjotiu t, $� . atNo.............•--••-•--•------•...-----...................._.....••.....-----•--•....••-•••......-----•--------------•--••••----••••-••-••-•----•--•-•-----•---•-- Street ,. as shown on the application for Disposal Works Construction Permit-No.._... Dated.._. _ _... ..--•- .................................................. '/`> � Board of Health ....................._. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS /` ti L C . 27 2- p . o T z7 co47 M ! IN b3i o,, s 10 •, 1 OVA OF sEf119 (� m^ N F\4b _ I Q�g-TE���Q- �S� • �O L Q ^` £ p !+ zoaE 'IF F y� 3 v /�sr j', Pam•'' ' � —oo —�A YES�,�r�o -r.1 3. LEGEND � � 9q '�, �D Iz� CERTIFIED ~PLOT PLAN EXISTING SPOT ELEVATION Ox0' (NOF.q�1 EXISTING CONTOUR --- 0 - - - ���` , ss� Lo> Z7 13 u 13 L FINISHED SPOT ELEVATION ( ] o / a G0 -�y / 7 FINISHED CONTOUR 0 o ORSE IN APPROVED - BOARD OF HEALTH�rk pNo. 10951�0 �� AGENT SCALE, / "= 40 DATE DATE ► ��?��� AIA e L DREDGE ENGINEERING CO. IN EA � y CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO? .�3 vS BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING - LAW9 . '�•'�'M ' ENGINEER S RVEY DR. BY' - OF BARNS TAB E , MASS. 712 MAIN STREET CN. BYE _ H YA N N 1 S, MASS. / z •Io•Q'3 ___ _______- SHEET-- OF DATE REG. LAND SURVEYOR _ _ x r THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A , m / �C(�J IL DATA r NOTE : ,/F E17-lYeR TNE.SEPr/C TAN.< G, f{i\ O D -p z : L.E�9CW1,,VG P/r AAre MORE TA -1,41 /Z '�BEL. w '„` !Z rn -i cn G /a f7: M/� 1RAv oE, A 24 "O1AM E7-1fR CONC"RE7•"Ertl C'C9v. IO nN O m < m 4'PVL' o/PC ''NAILL BF BROUGHT TO GRADE. `.c,V EXT..P/+ z -{ G� (Tl p CON�L'7 E _ Nf/A/. P/TCN J,+EAVy. Cif ST /RON CD✓ER Sf�.q L L .3E USj_EJ rn r rn r?l 0 E6 L= 1 a l, o CO YEI!'S D 3 m r O 2 , M Zini. CO/WC.e£ T� O A _ „v- G ,1.oE Ca ✓ER CL E,4,V S',4,V J N z ------- rTl m v _ - _ L/�U/O LEVEL 4'z 1 '• a ^i O ~` 4"CJ13T (�- ti�E_� �z� S— 2•LAYER fe1PL•' ! OO O • • o cr4,rAUM • e 1 J v 10 cn GAL. D 2 MIN.vrrc.�I � 1 , � . ..• ► t. . e cn r^ rn -1 - I SEPT/G TA/Vft . , , a • WA SH,=O ST2�NE CAS p � m is;_ BDX w• • 1 � • • • • / .•• �• _ 1-- :-Y 1, 1 Et-fEcrlvc 314 - 1 /a` p I L ,%a_. �,pyo� ! • 1 • DL'PTN • • 1 • o W�4Sl/ED STD,YE n O C- 0 115o, 8 x 2,g 3-(-I V /D • O• • r • • • • • • • p •,,.p PRECA5 r SE.EPAG E 2 7C � O r IjVVCAT CLEVA770,VS of ► a • • • • • • • • 1' . o P/T OR "U/V, m p — COM - ( I',). 1 x 1 , O 1 3 3 G / 0 ' o r -J -C -C z Z ,o�� � INYE.4T AT QUJLD/NG �f 9.o FT_ � 3� G f r D/f1M. � EH = 9 Y �= ` �� o INLET .SEPTIC 7. AlK 99.8 Fr, PT.GL�PAcIre - 49a 6/D L� l2 FT O/�41+f. ` oQ. z ti o OUTLET SEPTIC TAN.K 98•Cn F7. 4 C SEETABULATIaN> 9 m I/VL.ET DISTR/DUTION. BOX 9g 4 FT- GROUND J TE�t.T/�DLE yc F O CITLG`T D1 STR/B U7'/OlY BOX 9 8-.2 F7 SECT/ON O F Iv rn 3 el? I/VLFY L£ACN/NG P1T -T4.o FT. SEWAGE D/SP'4SA L SYST�/'►1 LEACf�II/YG PiT 7ABULATIDN O0m D.ESPGIV CRITERIA SCALE DIMENSION A 3 'rr y p -no C — to J, D 1,&f4-)v51 a N a 4- FT. � w z v D NUMBER Of DEDRa4AlS _ D/HENS/ON C 4- F7: (AAI 1 m C° D O _ m r ti, GARQAGED/5PO-5A.L UNIT WCQEE7 SO/L LOG w TOTAL- ES FLDK/ 33o GA4.1OAY SOIL. TEST *,' SO/4 Tl--S?-1*2 6WI- TEST 2 N w '--- NUMdE.R of LeACX/NG P/pZ_I fLCy 98.5 A-. f D = -< Cft C SIDE LLACPIVCr PER P/T i50'e SQ -;r f 'OATE O� SolL TEST �5T .9 19 a3 o O �� ' 307�-0/-t L,6.�C'///NG PER P/T T�'�• 1 $Q, �tT. LoAtit •c RESULTS jNJTNESSED dY J� JAsal3 6 3 9 0-4 i co,.oncrcD P�,t COLAT/ON RATE / LASS a/ m -i Z y=, �� TOTAL LEACHING ARE^ SD. FT. T�P'�"- ><COL.AT/ONRA7E �q� M!"IINCK rI� _ 1i — 4�s�RVEGEACfI/N6ARE/� �3 9 SQ. FT. 2 MJN.�INCN m O O �� Z y. '� o D z -+ ��- 50 - P_ 22 B I Z 1 D O 2 OF !��' i F i r c o cn lO W -0 o� y� 'S G) T. C I rn CDT L ) I � �I,� b N� 5� 1 p MORSE y D D c°o ✓ p�o. 10951�o EL DREDGE ENG/N,EFR/NG CO /NC. p� � z m \ C./t Q►BTE� oQ, 'flog c'/s-r �� _/ �L= 05.S 7/2 M/1/ [� N ST. NYRVNIS, MgSJ. u' Sum£` ``S���N,��E�� ND GROfJN[7 YVi4rtrt ENCO(JNTEREO CL/Elv7-,- 3„p���,� ,�RTE � 3 • � o • 8 2 GR O UND ;-VA TER A r- - J O B No. 3 3 2 0 5 514 Eis-r o,- ir— .�LOCATION r. �.. P L.L. L t NO Z2- VILLAGE Gry aT DATE 8,8. 83 , APPLICANT `S FEE 461 L.S20 -" ADDRESS . I X Cc-7Lj I TELEPHONE NO. 4-29-9p 13 (Non-refundable'f , ENGINEER Fes.D A[�� C.1 ksr��i kre- . TELEPHO1;12M ZZl1•¢ DATE SCHEDULED' Ayr.L)ST a1 19 fry Applicant' s signature . . . . . . .-. . . . .:. • . • • • O O e • • . • • • • • O . ._. • .... •.• • • O • • • . • 0.0 O • • • .O O_• • . • • • • • ..O 0.0.0 . •. • • O,.• • 0.0..0 j SOIL LOG:.: SUB-DIVISION NAME CaTT-JIT Ce>MMIon'-& :"DATE i q • 13'3 TIME 11 EXPANSION AREA:- YES ✓NO .,em► l-+1-d ELL.aa ENGINEER TOWN WATER ✓PRIVATE WELL :J�� u .� ®t`�I BOARD .OF HEALTH EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of ' test holes and percolation tests, locate wetlands in proximity to test holes) NOTES _P I ' ul o • c�anaPA-+J�/ � � � H . jb PERCOLATION RATE: 2. nit! t-A� TEST HOLE NO.: ELEVATION: TEST HOLE NO: ELEVATION: 1 1 . 2 Low , 2 3 �' `�' v ��nrt PP�Te.0 3 5 T. 5 6 6 7 r 7 8 M 8 9 9 4i' _ �3/ �' 10 I 10 12 12 ' 13 f 13 14 w2 14 15 15 16 ' F 16 ,.S•UITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITSt_- LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: t' NOTE: ENGINEERING PLANS ;MUST•;SHOW NUMBER ASSIGNED ON PERC" TEST PL 7'ION 4 ORIGINAL: COMPLETED IN ENTIRETY BY` P. E. AND RETURNED TO BOARD O EALTH COPY. , RETAINED: BY APPLICANT;<F I LOCUS �2sTwccoNTouR: ---- SEPTIC SYSTEM DESIGN SEPTIC SYSTEM SECTION 2 O PROPOSED CONTOUR: ••••••••• ... EXISTING SPOT ELEVATION: 25.5 2"PEASTONE PROPOSED SPOT ELEVATION: 5.5 FLOW ESTIMATE: 104.04 COVERS WITHIN 6" 3/4"-1 1/2" © 3 BEDROOMS AT 110 GAL/DAY= 330 GAL/DAY OF FINISHED GRADE WASHED STONE NC y TEST HOLE: a TOP OF �' NEE O.p N UTILITY POLE: -p- FOUNDATION �^ INSPECTION PORT GO Q 'L SEPTIC TANK: n , .„_,, �p.N to!Z FENCE LINE: - - m-- m. m ELEV.=97.0 f� HYDRANT: 330 GAL/DAY x 2 DAYS= 660 GAL 3'MAX m' - < RETAINING WALL: ® 101.29 COVER USE 1500 GALLON SEPTIC TANK �\ ELEV. a (1'MIN) LEACHING AREA: a (EXISTING) ELEV. 98.55 98.38 � USE 2-500 GALLON CHAMBERS(8.5'x 4.8'x 2'EFF.DEPTH)WITH 99.3 ELEV. ELEV. " 94.0 LOCATION MAP a ELEV. D-BOX H H ELEV. LOT 27 (69,123 SF) 4'OF STONE ALL AROUND (25'x 12.8'x 2'DEEP) 1000 GAL (6"STONE UNDER) 4' 4' ASSESSORS MAP:40 PARCEL:61 NE 25'x 12.8' LAND COURT CASE 22824D SIDE AREA: (25'+12.81 x 2 x 2=151 SF (0.74)=112 PAL/DAY SEPTIC TANK TEE SIZES:(TO BE CONFIRMED) 96.0 2-500 GALLON CHAMBERS WITH BOTTOM AREA: 25'x 12.8'=320 SF (0.74)=237 GAL/DAY INLET-6"UP,13"DOWN 4'OF STONE ALL AROUND OUTLET:6"UP, 14"DOWN ELEV. (25'x 12.8'x 2'DEEP) CAPACITY=349 GAL/DAY GAS BAFFLE (H-20) AT OUTLET TEE (TO BE VENTED) TH-1 101.0 TH-2 101.0 deck BENCHMARK AT O/A HORIZON ELEV. 6„ FILL ELEV. RIGHT CORNER TEST HOLE LOGS LOAMY SAND O/AHORIZON 10YR 3/2 kitchen [bah �� OF CONC.PAD ENGINEER: THOMAS McLELLAN,P.E. 6" 100.5 LOAMY SAND dining bed ELEVATION=102.25 B HORIZON 12" 10YR 3/2 100.0 room % WITNESS: DAVE STANTON,R.S. LOAMY SAND B HORIZON bed DATE: 9 21-15 24" 10YR 5/8 99.0 LOAMY SAND room ` a PERCOLATION RATE: a 2 MIN/IN C1 HORIZON 3p° 10YR 5/8 98.5 t� ��. SANDY LOAM 97.0 SANDY LOAM room y o w C1 HORIZON %mo o-� 48" 2.5Y 8!6 1st floorC2 HORIZON 54" 2.5Y 8/6 t� MEDIUM SAND 96.5 ``• 2.5Y 7/4 -perc at 72" C2 HORIZON ^ MEDIUM SAND (, 1 *�, \0 138-1 89.5 132"l 2.5Y 7/4 90.0 10 basement �p� %'o- 7 NO GROUND WATER ENCOUNTERED office NOTES: ` •�A L 1.VERTICAL DATUM: ASSUMED 00S, 2.MUNICAPAL WATER IS AVAILABLE. �97 EXISTING FLOOR PLAN 98; 3.SCHEDULE 40-4"PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. 97 /99 4.ALL PRECAST UNITS SUBJECT TO TRAFFIC LOADS TO CONFORM WITH AASHTO H-20 SPECIFICATIONS. N 5.PIPE PITCH= 1/4" PER FOOT(UNLESS NOTED OTHERWISE). 98-- _ _ ; r 00 �jJ �O 6.FIRST 2'OF PIPE OUT OF D-BOX TO BE SET LEVEL. 12" 7.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE USE OF A GARBAGE DISPOSAL. 99----- -,�� oak / ; /101 �jI 8.ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE STATE OF MASS.ENVIRONMENTAL CODE(TITLE FIVE)AND LOCAL HEALTH REGULATIONS. oak 9.CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR TO CONSTRUCTION. 4 ,12" oak th 2% 10.GROUND COVER OVER ALL SEPTIC SYSTEM COMPONENTS NOT TO EXCEED 3'. eo /, `•� th-1 11.FIELD SURVEY PROVIDED BY TERRY A.WARNER,P.L.S.,HARWICH,MA. _`.� OFc� sywc� � 12.THIS PLAN REQUIRES THE REVIEW AND APPROVAL OF ONE OR MORE TOWN DEPARTMENTS AND IS SUBJECT TO CHANGE UNTIL SUCH TIME. °��� �� 5�0 20 ; 13.EXISTING LEACH PIT IS TO BE PUMPED AND FILLED WITH SAND OR REMOVED. E T 66V&">r�ti �eig`.bh ,�~ 1 14.D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. � ROc oC tij �` 15.THIS DESIGN REQUIRES A VARIANCE FROM TITLE 5,SECTION 15.221 (7) PROPOSED LEACH AREA TO BE GREATER THAN T BELOW GRADE,(VARIANCE OF 1.5'). 101 �, \ `` r 4R i \ -14 �-w 102 ,` C, SITE PLAN ,Q9O 7`r0 J103" O JI LOCATION: °• `� F 50 HOPEWELL LN., COTUIT, MA 14yr ` PREPARED FOR: O,o 102 W EUNI102 r JEFF & KATE NEAL DATE:9-22-15 SCALE: V=30' A -102~` - BASS RIVER ENGINEERING 00�� \ µ '46MAS J. McLEL N, P.E. P.O.BOX 1163, EAST DENNIS,MA 02641 M15-46 508-385-3426 OR 508-364-9048