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HomeMy WebLinkAbout0215 LEWIS POND ROAD - Health 215 Lewis Pond Road Cot uit tP A = 020 014 r. k -� TO)&'N OF BA�RN�ISTABLE 3 3 y� LOCATION /� Zr'WII�' P�� IV f SEWAGE # 2,002- ' VILL•AGE��TJI� ASSESSOR'S MAP & LOT .21)—/ _ INSTALLER'S NAME&PHONE NO. ,�a$' � �� 9�-���JQ5�f'���9,4rtV3 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) NO.OFBEDROOMS_ BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: 0Z Separation Distance Between the:- s . Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet o leaching facility) Feet Furnished by �- ✓-� .-- ��, , � .5 .� �-a' �. ,j� � � _ ' �'6p'�v �n'-N -, e � . t °� � •1� ., � � i ,� . No. 2co3 — 3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS Zip pfication for 33igaal 6pgtemc Cottgtructiou Permit , Application for a Permit to Construct( )Repair Grade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �/=6(11 ps9 p Owner's Name,Address and Tel.No. c �brrr' Assessor's Map/Parcel BrU� . , Installer's Name,Address,and Tel.No. f-bg_ S/9 U— q75$ Designer's Aame,Add res and el.No. ' s�g—39y-2 7 9 3 , 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 gallons per day. Calculated daily flow gallons. 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) �9>'�� 4MO, 6M/ ,J, /, !/' dex 4 S'DO l,ug Z C/ !" y`5roeiz diav� 2 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 Certifi- cate of Compliance has been issued by this Board of ealth. Signed Date Application Approved by .� Date - u`03 Application Disapproved for the following reasons Permit No. 2UQ 3—33q Date Issued 7— Z t— 0 ——————————————————————————————————————— " Y No. 33 1 *�. Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS . 01ppYication for �Digaal *potem Construction Permit Application for a Permit to Construct( )Repair(4,<rade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. js & U115 RpAa,:;;( Owner's Name,Address and Tel.No. C�T�f Assessor's Map/Parcel f A / aRLir4 Installer's Name,Address,and Tel.No. 3—o a— W 2 9_ g7.39 Designer's ame,Address and Tel.No. ' SDI—f Q'�_ /�-7 Z 3 ' v� sp� -� 1✓'�rrr�s /4 Type of Building: Dwelling No.of Bedrooms !V Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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)L�-)t011 /04261. (/1Z4 . 1. 1, //' 6A 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 h operation until a Certifi- cate of Compliance has been issued by this Boar of Health. Signed Date Application Approved by Date-?- Application Disapproved for the following reasons Permit No. 1003-33q Date Issued '7- 11- 0 --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (torupriance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(e;_)+Jpgraded ( ) Abandoned( )by a ct s c lid; /.�, f d"110S. at E�. �-quo f r,�i rP/ r arair has been constructedyin accordance with the pro isions of Title 5 and the for Disposal System Construction Permit No. ?bQ3 3� dated 7- 2( 'C.� Installer ,o 5,-_04i 0 13.0,oW_5 Designer G r� )1-",'V _ ' S The iss ance of this perraiit shall not be construed as a guarantee that the system w' afd si n Date 2 . !) Inspector r No. �—W3` ----�—f —------------------- Fee ,IV THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigozar *pgtem Congtructton Permit Permission is hereby granted to Construct( )Repair(,�..)-tfpgrade( )Ab ndon( ) System located at Pa a ra f'r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit Date:_ �- 2 ( Approved by THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M /A�C(� I DATA ITOWN OF BARNSTABLEe LOCATION '' SEWAGE # VILLAGE ASSESSOR'S MAP & LOT iL- f;- INSTALLER'S NAME&PHONE NO. " e"':11,0- SEPTIC TANK CAPACITY j LEACHING FACII.TTY: (hype) NO.OF BEDROOMS r1 BUILDER OR OWNERh�Ff T PERMITDATE: COMPLIANCE DATE: 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 o leaching facility . Feet Furnished by o d j /-0..ss —r _d V1 0ATE;_ 00 PROPERTY ADDRESS; '21'5 Lewis Pond_Road .._&& ury Cotuit: Ma_- 02635- On the above date, I Inspected the 6eptlo system at the above address. This system conslsts of the following; 1 . 1 -1000 gallon septic tank 2. . 1 -1000 gallon leaching pit Based on my Inspection, I certify the following conditions: 3. This is a title five septic system. ( 78 Code 4. The present septic system is in working order at the present time. 5. This is a three bedroom desiVgn. ' 6. There are actually 4-bedrooms. SIGNATURE;,./ Name:_,LJ ,--eisa[at .C.,L�____-- -2 O 0 Company: Joai.ph_P _ Hacomber_& Son , Inc . Address :_ Box----66------------- Centerville L. Ha�_:_02632-0066 Phone:___ 508_775_3328_______ THIS CERTIFICATION ooes NOT CONSTITUTE A QVARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. T�nks•C1i>;Pools•LI"hfloldf Pumpod Z, Instsllid Town sswor Connsoflons P.O. Box 66 C{nllrvl114, Mil 02632.0066 775.3338 776,6412 gyp,.�'yy5p f COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.6600 TRUDY CORE Secret&ry ARGEO PAUL CELLUCCI DAVM B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION Property Addrew: 21 5 Lewis Pond Road N,rrsa of O,wrsar John McGarrahan COtuit Address of Owrwr: same D.taoflnspactlort: 9/26/Ogoseph P. Macomber Jr. Nassw of trsapacm: (Ptaasa Print) I am a DEP approved systwn 4upectw Pursuarrt to Seddon 16.W of This 6(310 CMR 15.000) Co"VmryNifT1e: Jose h P. Macomber & Son Inc. µ&TwVAddresi: ox bb , CenE—er-ville, Ma . 02632-0066 Taiephorse Nurnbar — CERTUiG1TION STATEMENT i certify that I have personally Inspected the sewage disposal system at this address and that the Information reported balow Is true, accurate and complete as of the time of Inspectlon. The Inspectlon was performed based on my training and experience In the proper function and mainisnance of on-site sew a disposal systems. The system: Passes _ Conditionally Passes _ Needs Further'Eval tlon By the Local Approving Authority _ Fail Vupector's Sigruture• � Dow The Systsm Inspe r shal submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)whNn thirty (30) days of completing this Inspsctlon. If the system Is a shared system or has a design flow of 10,000 gpd or greater,the Inspector and the system owner "ll submit the report to the appropriate regional ofiica of the Department oKinvironmenttd f rotectlon. The original shouid'be sent to Vw system owner and copies sent to the buyer, If applicable, and the approving authority. NOTES AND COMMENTS 1 . Three bedroom design under the 78 code. 2. In actuality the house has four bedrooms. revised 9/2/98 PagtIorii " Primed on R"kd Pipe( SU93UFJAC9 SEWAGE OtSPOZ LL SYSTEM MPEC'TtON FORI.I. PART A > C£RTIRCA 10N (00ntinu00 Property Addraaa: 215 Lewis Pond Road, Cotuit Owner. John McGarrahan Dww of kupeadon: 9/2 6/0 0 oN3reCTtoN SUltrtAAY: check A. B, C, a P. r A SYSTE]1►ASSES: 4)16 1 hay+not found ►ny Informadon wNch McColl that any of the faAuro condtdons described Ln 310 CMR 4.303 exist. Any ta: crhoris not ove.1vated us Indicated below. Three. be o 78 Code a nouse hag 4 b drnnm Y. SYSTIU CONOfnONA LY PASSES: _l On• or more system sompononu u dosoribod In the 'Cor► %;IwW Puo•socdon rood to be replaced ot repalred. Tha oyatam. v compladon of the replacement w ropalr, u approved by the hoard of Health, wW pass. . "cat@ yss, no, or not determined(Y. N. w NO). Ooaertbe bash of datormLation In all 4wtaneod. If*not dotermined% oxplakt why rwt. The septic tank la metal, "068 the owner w oparstw has provided the system Uwpoctor with c copy of a Cee"Cste Compusnce (attached) Indlcating that the tank wu tuW*d wlthln twenty(20)Yew prig to the data of tho tnapacoc the septic tank, whether or not metal, Is stacked, avueturaJJy unsound, shows oubstantlal InMU41don of exTtivadon, o. fallvro Is Imrnlnent. The system wW pass Irapection If the ssJotino septic tank la replaced whh a eomplytno septic tan approved by the board of Health. _Sewage backup or.breakout or high stado water loyal observed in the dlsvibudon box Is due to broken of obsvucUd p or due to a broken, sonisd or uneven dlsvibutlon box. The system will pass Inapsot)on II(wtth approval of%N Board Ha alth). broken plpo(s) are replaced obswcdon Is removed dlsvlbution box la levelled w replaced • The sytrtem(squired pumpbto-tnon dun'lour-dmos,o'yearduo to bcoilonwobetpvotad plps(s). TAetry>rtsrm wiryasr Inspection If(with approval of the hoard al Health): broken pipe(j) uo rspiacsd obswcdon Is removed h�alarti revised 9/2/98 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �. PART A CERTIRCATION (contirxred) Property Ada*": 215 Lewis Pond Road, COtuit . OWTW: John McGarrahan D+ts of lnsp.ctJor+: 9/2 6/0 0 'C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Condldons exist which require further evaluadon by the Board of Health In order to determine if the system Is taMA9 to protect the public health, safety and the onvironmont. 1) SYSTEM Will PAS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CW 16.303(1)(b)THAT THE SYSTEM 1�3��NppOT FUNCTIONING IN A MANNER WFUCKYALl.PAaIECT THE PUBLIC dEA1LTV"ND"FM&1dD THE DCZ3OkM`6 R: /VD Cesspool or privy Is within 60 fuel of surface water Cesspool or privy Is within 60 foot of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUppUER,IF ANY)DETIER3 AIM THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE EIlVt 0NM8iT: The system has a septic tank and soil absorption system($AS) and the SAS Is within 10o feet of a surface wear supply or tributary to a surface water supply. The system hes a septic tank and soil absorption system and the SAS Is wlthln a Zone I of a public water supply wou. The system he$ a septic tank and poll absorption system end the SAS Is wlthin 60 test of a private water sup;WY wou. The system has a septic tank and soil absorption system and the SAS Is Isss than 100 feet but 60 foot or mao from a private water supply well, unless a well water analysis for collform bacteria and volatile org"c compounds Indcates tMat tNo well Is, free hom pollution from that facility and the �p'('o�s tr nco of ammonla n1trogon and nitreto r% ogen Is equal to or less than 6 ppm. Method used to determine distance (approximation not vaUd).- 7) OTHER A)j revised sed 9 2/98 Page 3of11 r r - SUBSURFACE SEWAGE DISPOSAL SY'STDM WSPECTiON FORM PART A CER-nMATION (continued) vrav«ty Aches+: 215 Lewis Pond Road,- Cotuit Owrrr: John McGarrahan °iti l`"°"tiOfL 9/2 6/0 0 D. SYSTDA FAILS: ns exist as Y /t Indicate either 'Yes' or 'No' to each of the following: I have determined that one or more the following Healthiure nbed ibed The Board of should contacted to detorrnin 1 what will be n•auuY to cortact Vw fbilu determination Is IdentlAed below, T Yes No/ oomponertt doeto ert overloaded y Backup°F**wage Inw 4+clWtY'a•� ^ ed SAS or Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged cesspool. rloaded or clogged SAS or eeaspool• Static liquid level In tq• dlstrl �1onblo�r Bove outlet Invert due to an ove -- - E.Kr � r flow. Liquid depth'In-ce••• Is lose than 6' below Invert or available volume Is leas than 112 day Required pumping more than 4 times In the last Year NOT due to clogged or obstructed pipe(•). Number of tlmes pumped Any portion of the Soli Absorption System, cesspool or privy Is below the high groundwater elevation. Any portion of a cesspool or privy Is within 100 felt of a surface water supply or tributary to a surface water supply Any Portion of a cesspool or privy Is•wlthln a Zone I of a public wall. Any portion of • cesspool or privy Is within 60 feet of a private water supply well. / Is less than 100 teat but greater then 60 feet from a private water wpplY well wiV�r / Any portion of a cesspool or privy of well wets( analysis f( - r acceptable bacteria,quality the well has been,anitr gennalyzed tanderjtrats ntrogen.ach copy mmonl E. LARGE SYSTEM FAILS: You must Indicate lithe( 'Yes' or 'No" to each systemso el f ollowiadditnn to the criteria above: The following criteria apply to large The system serves a facility with a design flow of 10.000 gpd or greater(Large Syatsm) and the sYltsm Is a slgniAc&m tivsst to ronment because one or more of the following conditions exist health and safety and the envi :Yes N?/ (/ the system Is within 400 foot of a surface drinking water BupPIY / er �e�wrlew�rk+klw4'w'eNr'w►fIY•.•• ' f/the system Is'located In a nitrogen sensitive area(interim Wellhead Protection Area IWPA) Or a mapped Zone it —' wets( supply Well The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult tf» low rs ofAce of the Department for turther Inforpstion. or if revised 9/2/98 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �r PART B r CHECKLIST Prey Aloes&: 215 Lewis Pond Road, Cotuit Own«: John McGarrahan Deu of Inspection: 9/2 6/0 0 „ Check If the following have been done. You must Indicate either 'Yes' or 'No' as to each of the following: Yes No _ v I Pumping Information was provided by the owner, occupant, or Board of Health. Nona of the systsmcort+po&ants wa.w:baart pow+ *d+EOPOtJeut!two•weeJ4&%A W-WY4`t6m h"Aw"woelasp...ol A rates during that period. Large volumes of water have not been Introduced Into the system recently or as pan of ws Inspection. As built plans have been obtained and examined. Note If they are not available with NIA. _ The facility or dwelling was Inspected for signs of sewage backup. The system does not receive non•a"tary or Industrial waste flow. _ The she was Inspected for signs of breakout. _ All system components, *eluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the Interior of the septic tank was Inspected for condition of bat or tees, material of construction, dlmenslons, depth of liquid, depth of sludge, depth of scum. The slit and location of the Soil Absorption System orr the ►ire has been determined based on:- Existing Information. For example, Plan at B.O.H. _ Determined In the field (If any of the failure criteria related to Part C Is at lsous, approximation of distance Is unacceptao, / 116.302(3)(b)l The faclUty ownu l+r+d.^^—pr=—".Jf dLdarant froar.oLcaarl.+scarapcauidad.wlth fmLagXa *foaorl7�•p=;••�^�^}-^.^r_ SubSurface Disposal Systems. revised 9/2/98 P►iesof11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM %. PART C SYSTEM INFORMATION P,opw y Addr*": 215 Lewis Pond Road, Cotuit ownw: John McGarrahan Dou of iewpactJon: 9/2 6/0 0 FLOW CONDITIONS REST OMAL; Design flow: atl _g•p•d•roedro M. Number of bedrooms $$I Number of bedrooms(actual): Total DESIGN flow Number of current residents: Garbage grinder(Yee or no): Laundry(separate system) es or o If yes, •epasus.1 spaction.required —. Laundry system Inspected s r no) / _///10 Do qct!lM6 :G/P D=3J Seasonal use (Yes or ree): /S I�00c,-rya �6-yj5 U-.� J—7��•�� Water meter readings,If avaiable (last two year'$usage(gpd): Sump Pump )yes or no): Ali Lost date of occupancy: COMMERCtALV4OUSTRIAL; Type of eetsbJlshment: Design now: d ( Ba ad on 15.203) Basis of design flow Gresse trap present: (yes or no) Industrial Waste Holding Tank present: (Yes or no)-AO �/� Non•senitary waste discharged to the Tide 6 system: (yes or no)" Water meter readings.If available: Lost date of occupancy: AM OTHER:(Describe) Lost data of occuponcy: ' GENERAL INFORMATION PUMPING REGARDS and $ urce of In' motion: 1 System p mped a part of Insp ctio (yes or no) If yes,volume pumped: .;iloni+ Reason for pumping: TYPE 0 YSTEM Sepdc unkld4*Abv#oft-b0*4%oll absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes, ottach previous Inspection records.If any) IIA Technology sic. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, dote Installediif known)-and souroe of iwfomtadoet: �I<O Sewage odors detected when-arriving at the site: (yes or no)e revised 9/2/98 Pose 6 of 11 I SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM �r PART C SYSTEM INFORMATION twee** d) Progeny Address: 215 Lewis Pond Road, Cotuit own«: John McGarrahan Data of In'°'c`6°"` 9/2 6/0 0 BUILDING SEWER: ILouts on she plan) Depth below grade. 1Q Material of construction:a1 cast Iron -1 40 PVCdother (explain) Distance hoMR(ivate water supply well or auction line Diameter Comments: (condltion of Joints, venting, evidence of feakags,♦tc•) Joints a No evidence of 1paka4a. s em is ven r . SEPTIC TANK: Vocals on she plan) Depth below grade/_1Z Material of construction:-L/,oncrete g,(lnetd1/QFib•rglassA/APolyethylene400ther(explaln) H tank Is instal. list age && ls.ag•.conArmed by Certificate of Compliance A49 (Yes/No) Dimensions: Sludge depth: Distance tram top of dge to bottom of outlet tee or befflc Scum tNckneas: Q Distance from top of scum to top of outlet tee or battle: Distance tram bottom of scum to botto of outlet e or baffle: How dimensions were deterrnlnid: Comments: uecommend+tion for pumpl condition of Inlet and outlet tees or�baffles, depth of IlauldCJleavel in relation to outlet Invert. etructureFintegrity. tvidence of leakage:s�srii1ump the et t T e t is presents an sh c tars - GREASE TRAP: Iloc+te on slit plan) Depth below grad•: Material of cons trucdon{Acoricret•,VAmet&I4&8Fib•rglaaaAXPolyethy)•ne4,kother(explaln) Dimensions: Scum thickness: Distance tram top of scum to top of outlet too or baMr� Distance hom bottom of scum to bottom of outlet tee or battle: Date of lost pumping: Comments: ►grttY Irecornmendation for pumping, condition of•Inlet and outlet ts•+ or baffles, depth of liquid level In relation to outlet Invert, a mctural Inc evidence o}leakage, etc.) rease revised 9/2/98 Psee 7 or 11 SUBSURYACL SEWAGE DUP'03AL SYSTEM WMCMW F0PJA FART C SYSTDA WFORIAtAMN (con*-*411 hopwry Ado o": 215 Lewis Pond Road, Cotuit OWTMr: John McGarrahan Dow of h&Pocd-: 9/2 6/0 0 TIOKT OA HOLDING TANX/Y4A'(t! IT&nk must be pumped prior to, or &t time of, Inspection) llocete on she plan) Depth below gradouf if MetorW of con&wction:l/sfcen�retel metal Flber91ss4 ,►0lyelhylen6'1qLother(expisln) Dimension s: C&p&clry:Design flollonslday Alum preAlum lov Inw o(king order:Y*Wh NoM Osto •I previous pumpin0: Comments: Icondldon of Inlet toe, condition of &form and float switches,eta.) g rccc - OtSTRISVTION SOX:�I✓ Ilocste on site plan) Depth of liquid level above outlet Invert:_ Comments: Ino&e If level &nd distr!bution Is equ&), evidono* of solids carryover, evidence of le&ltage Into or out of"a. etc. D 1 pVlAp CMIABFA:A�Ve' Ilocsis on site pl&nl pump&In working order,(Yes or No) Alums In working ordor IYo& of No) Comments: mote condition of pump chombor, condition of pumps end appurtenances, etc.) --TT0t preGPnt hIr 1 of II - - revised 9/2/98 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPEC ION FORM , PART C SYSTEM WFORMATION(condrxiod) PropertyAddreu: 215 Lewis Pond Road, Cotuit Own«: John McGarrahan Dav of Inspection: 9/2 6/0 0 SOIL ABSORPTION SYSTEM(SAS):�j (locate on site plan, If possible;excavation not required,location may be approximated by nondntruslve mer0tods) If not located, explain: Type: Isaching pits, number: leeching chambers, number: leaching gallerles, number: leaching trenches, number, length: D leaching fields, number, dim *Ion overflow cesspool,number: O Alternative system: /J Name of Technology: f �i Comments: (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation. etc.) Loamy sand to dead sand- No si gns or hydraulic failure or ponding. soils are dry- Vegetation is normal. CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to Wet Invert; Depth of solids layer: Depth of scum layer, Jm Dimensions of cesspool: J,f Materials of construction: Indication of groundwater: Inflow (cesspool must be pumped as part of Inspection) -Cesspools are note resent Comments: Inots condition of soli, signs of hydraulic failure, level of ponding,condition of,vegetatJon, etc.) --Cesspools are not present PRIVY:d'bve- (locate on site plan) Materials of construction: Dlmenaions: Depth of sollda:� Commenu: Inots condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) -Privy is not present, revised 9/2/98 Psgc9or11 SU53UR►ACL SE!WAOC D13POSA1 9Y5TDA W3►ECT10N,IL0" PART C iYSTOA tN1F0R]dATI0N (**n*w*4 propeMAd&*": 215 Lewis Pond Road, Cotuit 0~: John McGarrahan 9/26/00 SX TCH Of SEWAGE DISPOSAL SYSTEM: Includo do$ to it 10411 two Wm"nt r�l�r�nc•lu►dmuki or b�nchmuk� loch@ Nl wells wltNn 100' Ilocato wh#lt publlo watof wpplY COMO$tnto houA�1 O I \ I 4. '� �\ \ h��10o(11 revised 9/2/98 . • SUISURFACE SEWAGE D(3P93AL SY3TEA1 11413►ECTION FORM PART C 5 s SY3TVA 11�1FORIAAMN (con %)*4l PropwTy A"".&: 215 Lewis Pond !Road, Cotuit owner: John McGarrahan Dual of lnsp.ctfon: 9/2 6/0 0 MRCS. Repon Rome Sop Type_ Typical depth to groundwater uSOS Date webslte visited Observation Was checked Oroundwster depth: Shallow Moderate Deep _ SITE EXAM Slope Surface wets( Check Collar Shallow wells (stimsu4 Depth to Oroundweter,612--'root /teens Indicate ell the methods used to dstermine High Oroundwater ElevatJon: _OtoWned from Design Ilan# on record �0.1.,�mjn.d MndlJ.n. observation hole, basameot sump etc.) om local Chocked with local Solid of health Checked fEMA Maps ,1 Chscksd pumpinq recoids Chocked local excavators. Installers used USOS Data Describe how yov estsblisf»d the High Oroundwater Elovotlon. QjyjJ be completed) Used; Water contours map. Gahrety & Miller Model 1 2/1 6/94 ' hcellorll revised 9/2/98 .•,wgr+�wt�Tr,swr w�•wrwl�-.w,,•ww,wwnl.+ww�I+wrR�.,anv.w�.r.v„.'.. +rwe�-�..�~. .- I'Ui(N OP BARNSTABLE BOARD OF HEALTH � '^^ .••.-•'.-3UIlSUfIFACF. 9EW (;P, DI f'U,9ALA SYSTEM INS C1'I08 FORM -' PART D •- CERTIPI CATION S -TYFC OA FAINT CLCAILY— 1 PROPERTY INSPECTED STREET ADDRCSS 215 Lewis Pond Road, Cotuit ASSESSORS HAP , BLOCK AND PARCEL # OWNER' s NAME John Mcuarrahan PAIiT D - CERTIFICAV10H NAME OF INSPECTOR Joseph P. Macomber Jr, COMPANY NAHE Joseph P. Macomber &, Son, Inc. COMPANY ADDRESS Box 66 Centerville MA. 02632-0066 Street Tovn or City state t COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( ) - CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposei`1 system at ®rlecommendat' lons his address and that the information reported is. true , accurate , and omplete as of the time of �inspection , The inspection was performed and any regarding upgrade , maintenance , and repair are consistent With my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : i Systecn PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CHR 16 . 303 . Any failure criteria not evaluated are as stated .in the FAILURE CRITERIA section of this form . System FAILED# The inspection whIch I have con licted has found that the system fails to protect the F)ublic health and the environment in accordance with Title 5 , 310 CHR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this Inspection form , V - Inspector Signature Date Dn e copy of this rtlfication must be provided to the OWNER,' the BUYER there applloable ) and the BOARD OF HEALTII, e Ir the Inspection FAILED , the owner or operator shall upgrade the system within one ,year or the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 , 306 , partd . doc TOWN OF BAMSTABLE LOCATION 215 Lewis Pond Road SEWAGE # VILLAGE Cotuit ASSESSOR'S MAP& LOT rNSPECTED BY: J.P.Macomber & Son Inc 775-3338 048200MMNAME,&PHONE NO. SEPTIC TANK CAPACITY 1 000 gallon LEACHING FACILITY: (type) leaching pit (size) 1 000 gallon NO.OF BEDROOMS OWNER John McGarrahan PERMITDATE: COMPLIANCE DATE: 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 Wedand and Leaching Facility(If any wetlands exist within 1P Zofac ' facility Feet Furnished �y • 4yl • TOWN OF BARNSTABLE LOCATION �� �-�i� �^�� � SEWAGE # VILLAGE rvru t--r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /5 `0 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER ot�� � C9 "A^) PERMPTDATE: COMPLIANCE DATE: 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 'Pt "f , e r * r v1 i _ __LOCATION -EWD,C,E_ PER UO. STALLER- 5 1J�►P/lE _�_ ADDRESS.__-_ __ - _ _ _ _ _bUILDER S . _1.1-d1.IlE_ -�AD_DR.E DIQTE PERMIT --DATE COMPLI AI`10E _ISSUED_:f -i3—�� 33� a� Sc. ►� 0 40 y�3 �VG 1000 y"p,j e PAD a G4 Fzws....F.: .. THE COMMONWEALTH OF MASSACHUSETTS BOARD PF HEA TH ..OF......... ... ... App ir6tiun -fur hipviial lVorkii Tunuitrurtiun Permit V Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � _ �5.:..1P e c� . ...................................r�i i .' ..._....-•---- + Loc atio e Ad ss- e ,r or Lot No. f�l lE__ P7 -------------------•----------------------------------- ----------------------- ,p Owner :-" Address � ---------------- ----- Installer Address U Type of Building, Size Lot---..:......................Sq."fe et r✓ ; —� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) `Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.._......III.............. Showers (/ ) — Cafeteria ( ) f4 Other fixtures ................................ Design Flow............ .. . . .............gallons per person per day. Total daily flow...............40 0---__-_--_--_-..gallons. W Septic Tank L Liquid capacitvIC00gallons Length---------------- Width............._.. Diameter_---_---.-__-- Depth---------- ...... x Disposal Trench—No. .................... Width-----------------._�-�otal Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No....._.�_._..__.._._ Diameter. >Tepth below i let.................... Total chin area......----.-.--___sq. ft. Z Other Distribution box ( ) DOsin tank ) � %' a Percolation Test Results Performed by..._ l4gt._. ___ _________________ Date........................................ Test Pit No. 1................minutes per inch Depth of T st Pit.....___......_..... Depth to ground water.._.-.___._....-_..__.. ral Test Pit No. 2----------------minutes per inch . Depth of Test Pit.. ........ ..... Depth to ground water--_--._.-_-...._---.____ x --------------------------------------- ------- _ .._ O ------ Description --- --- --- ------ ---------------------------------------------------------------- W -------------------------- ------------------------------------------------------------------------------------------------------------------•.---_.---------------------------------------------------- VNature 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 Article \I 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 Qhe�alth. �j Si d << - -------------------- ���F 17�� � A lication Approved B -- - ..-----•.. ..............................---`----- PP PP y------A Date: Application Disapproved for the following reasons------------------------------•---•--------------•-•-••-•-------------------------------••---------------•------- •---.......-•-------------------•-•-•-------------------------............---------...------•--------.--- Date PermitNo....3��k......................................... Issued........................................................ Date /o No ..'- = FEs............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I � t,-a1,/1!-'tl "...:.......,9................... ApptirFation -fur Ii,4puutt1 urko Towitrurtioat Vanift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: . ` f / f. oj.j / �.......................................................f.......................................... --.......------------------------- ..... ------......-------------------------------------- ..� f0L Lot No. ........................... . .. Own Address ------------- ........ u_s f. _ p Installer Address U Type of Building Size Lot............................Sq. feet IJ— �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons.--------�-_-............ Showers (/ ) — Cafeteria ( ) Q' Other fixtures ------------------------------------------------------ W Design Flow-- -._-..--,.15 ...........................gallons per person per day. Total daily flow............. ga...................gallons. WSeptic Tank- Liquid capacity/000-gallons Length---------------- Width..----.--....... Diameter----- ---------- Depth..___.-_...... x Disposal Trench—No--------------------- Width------------- ---,T otal Length-----------......... Total leaching area...----------_.--_-.sq. ft. Seepage Pit No...... ------------- Diameter-100.01d Depth below inlet.................... Total cliin area.-.-..._-----__--sq. ft. z Other Distribution box ( ) Dosing tank (/ ) ° �' 7� ��` ��� � a Percolation Test Results Performed by---- W-�. -- —------------------ Date---------------......................... Test Pit No. 1................minutes per inch Depth of TKt Pit.....:.----__-.--- Depth to ground water..---.-.---..-.----.-._. rXq Test Pit No. 2................minutes per inch Depth of Test Pit. -- _.---- Depth to ground water---------------------_- 9 _V-. f ....-.._..O Description of Soil-------------------- - - - --------------------------------------------- ---- --- --' -�---�------ v ----------------------------------------------------------------X-J)-•------w m------.0.2.: .� w x -•-••-------------------- ---------- ------------ ------------------------------------------------------------------------------------------------------------------------------------------------------ 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 Article XI 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. V Date Application Approved By----- ; . ,e. Date Application Disapproved for the following reasons:......................................................................... .......-•-------.. ............•- ...................-................................................................................................................................................................................... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD �OF HEALTH /` _............OF......t J!. r �z - .........1...� �- `-r .................. Trrtifirute of 0.1,11mphaaurr �-- TNIS I• TO CERTWY, That;the Individual Sewage Disposal System constructed ( ) or Repaired ( ) I t I/ r Instal-e� has been installed in accordance with the provisions of Art�cle XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--.t---.-.---- --------------- dated-_-..> :.:.1 :'.. T.. ................ THE ISSUANCE OF THIS CERTIFICATE SHALE. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �3 '/L o U . l 7 -----•------•..... Inspector----7.-AeDATE---------- ---------------- -----------------------� ------ -------------------------.....---•------- THE COMMONWEALTH OF MASSACHUSETTS BOARD4F HEALTH .............1/....C�.. s/.L-i....OF - ............. ' ' 't---...............----------.................. l �l No......................... FEEl-- ...---........ Dispo, rark-q t Tiu . rurtiott errant Permission is ereb ranted.-.( to Cons tr et,,('�) or l'epair (, ) n Indly 1 Sewa e,D sposal Sy, f' at No.-ff_ �`-1_...ff.. t=�aZc..`_fx..�: _l _ ..................r_,/...t&...................................................... Street n _ as shown on the application for Disposal Works Construction Pee�rmit No.--'/- /-/_:` .iDated..-�77 ............... -----•----.--•.------..._ Board of Health DATE---------/�-'--�-�-v-------?=�--- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' I WIv ' ' I i I i. L ! � � , ' _ ) .. _: ._i I--�\� - -- i I ' I f_ i. I_ i- ;-- -- I- -�--i-• • I • I � I I I r3p I r i 4 _ , , , Y : - -- � j 1 1 j ! j �4,t�ll I 1 I �` - j - ���VI I I __-i __. -I - __ - .-� i-_• _ 1 I i , 1 , AA llzavl Zi 74//7- WYU'`s"• I A r pJ?J�� NSA ' ��SuG�W6 ��[""��1� �"•�"' 1 `n'r�' cJSTFt��a��'� � ; `"�cWfl..�W/j`rr�: �v/J"�r.S'�� 1 I �'►pR�O'�'AL�`'',.�u I I , , I I , , L I I I IFI-- i I � i u ;. + I I r L., I • -- - f 1 , I I i. I IQI I -- I I I ! 1 , GW I I I : I 1 ' ; I I I ( •.;-� I I `. i �`; LOT � i _ , � � �___� __r_ { - I_ t IL. A ! I _ I _L._ , ,a�.,•.•� I I , � I I I. I , I I '\1�i I -) I � I , I— I I__.i I , I /L- _� ' / ,�� Lam^`-.� -Y�_' �/-:✓_ ' '' I - I I ' I , i 1- - , � I 1 I" /�- wa • I I A ::::a,/�- cY i c I i i11 i COh�S�/GTy�Y t/ If < c orsAV 114CP It �I4+ OI!I'^��'Y G•fir/ I •� I . `n a 19 a s I I IQ 4' �— i ---•1.7:/„Ex/sr__t__ -L:EK(5r Tv I Ex/I � a r s�„ !J t 1 L I ylq � w rt r , LA LIZ M"Lo (l a L h e rn, ax ,a 519 ,e ip- c n2>„a> oy a /a IV _> at � L ru,lt a;L — r— 4 01 CA ---� TOP OF F FOUNDATION ' EL F STANDARD NOTES GROUND SURFACE EL-_fC— O__ GROUND SURFACL ELL 3 _ " MIN 1) THIS PLAN IS FOR THE INSTALLATION OF A SEPTIC SYSTEM. OUTLET PIPE LEVEL 2) ALL INSTALLATION PROCEDURES AND MATERIALS SHALL CONFORM TO 310 CMR 15,000, TM 574r CM97WOMMENTAL CODE, __._:.-... TEV FIRST TWO 1,E'E_' 3 N� VENT REQUIRED ' ''> j, TITLE 5, AND THE TO AN OF 2319 2a 15 7" 1 C. __ SUBSURFACE DISPOSAL REG ULA TIOR TOP EL _�_—_� LIQUID I,FWl 3 ND DETERMINATION HAS BEEN MADE' AS TD COMPLIANCL; OF AVAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS MIN 2' LAYEP I)MMLE WASHED ) 3 ,g -BOx 1✓91- 1/21 STONE OR ZONING REGULATIONS. 10" �"� 4) TOWN WATER SERVICES THIS PROPERTY INVERT EL 14" c r EFFECTIVE f / 33' : -- -- - •- SIPENALL 5) THERE ARE NO KNOWN PRIVATE' WELLS' ON THIS PROPERTY OR WITHINOF THE PROPOSED SOIL ABSORPTION SYSTEM. GAS BAFFLE AT OUTLET INVERT EL B' SMNE PAS INVERT EL 6) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 12" OF FINISHED GRADE, WITH O_NE COVER OF THE INVERT EL 3 , b D,E G. 3 - f"Qv/ 2� � 3/4 - 1 i/2 DOUBLE SEPTIC TANK BROUGHT WITHIN 6" OF GRADE. D Box 'aj 3. - INVERT EL (Typical) « +t S GJ f WASHED STONE 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR EVEPECTION. NO STRUCTURES' SHALL BE LOCATED DIRECTLY 6" STONE BASE INVERT EL ,� UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS WHICH WOULD INTERFERE WITH THE PERFORMANCE ACCESS INSPECTION 1,500 Gal Septic Tank w t7 B077t7M EL ' P PUMPING OR REPAIR r (Typical) 50 P /2 ! `ZS',o 8) ND DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION - —� EL BOTTOM OF TEST HOLE SYSTEM, EXCEPT WHEN VENTING HAS BEEN PROVIDED. 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6" STONE BASE '2. � - --_ � TO ENSURE STABILITY.AND PREVENT SETTLING. 10) OUTLET DIS'TRLBU770N LINES SHALL REMAIN LEVEL FOR A MINIMUM OF THE FIRST TWO .FEET OF THEIR LENGTH. 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE' OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' OF DRIVEWAYS OR PARKING OR TURMNG AREAS, IN UWCU CASE H-20 COMPONENTS' SHALL BE USED. 12) ALL BUILDING SEWER LINES SHALL HAVE AN INNER DIAMETER OF 4" AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC: LE97S' POND ROAD 13) THE DEPTH OF THE TOP OF ALL SYSTEM COMPONENTS SHALL NOT EXCEED 36" UNLESS VENTING HAS BEEN PROVIDED. 14) IN THE AREAS, OF EXCAVATION," EXLS'TING GRADES SHALL BE REESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS: - - - - - - - - - _ - - - - - - 15) lF SOILS ARE ENCOUNTERED DURING THE EXCA NATION OF 77IE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM _ _ _ _ _ _ _ 1 "40 THE DEEP OBSERVATION HOLE LOG, CONTACT THE ENGINEER BEFORE PROCEEDING. - - - - _ L - - 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. S 68 02'50" E 203.40' 1 / Exist / - - - - Dliv 46 ! Foundation / - x �" Proposed 48 - Exist i - ` Water D-Box l _ PROPOSED LEACHING FACILITY �-t T Lind 38 Four 4. 6' x 12. 5' x ,2' D1 i S1 GN DATA . �`6 deep concrete chambers DEEP OBSERVATION a¢� eb ,��' (or similar with �4' stone Number of Bedrooms: HOLE LOG ' (Total Area 42 x 12. 6) Garbage Grinder: NO Test Hole #f (EL = f i f' / i / o ; _ _ Design Flow. _ / ' D� ev Soil Soi] SoII � � 34 g `� `� � pth (�1 �it) Aorizon Texture Color 1 0 .► (110 Gal/BR/Day x Number of BR) (USDA) (Mansell) DA) 5 2 - r` U _ Sir ?jtj,3 �VA/"�`-( d 10"R`F l Septic Tank: 15"ap 5 /� N �"'• 1 � oo :�/ Test Pit ! o � f 2'o,r 3y t,oAM `1R`�'t Ex / , / Locetion o Yo (Minimum = Design Flow x 200%� G �. ,ca1,l el - ' �� Leaching Area: 2.0 2 5 D C CoAA-6 � �Shedd / s/a Pump and Fill / 30 - Sidewall: Proposed existing leach pit 42 1500 Gal i as required ( Sidewalls x 4 Z _Ft x —Ft + : .. p 1 l� , / r Z ) Dee Obs Hole Date: to 1�t ? _ Soil Evaluator. er.� 5 fo N e S—Tank , - - - -- -- _ _ -� `0� 6A,o (:•Z Endwalls x r Z' Ft x ___Ft) 2 I Witnessed Hy: SA e^ wi-1 i- t " r �g• 83 Pero Rate: z M P! 2 /, Soil Survey Description: CARVER Geologic Material- I Bottom: Lot 19B _ — - V1 `-f 7- x /Z • �Ft Depth to Standing Water. NATIPASH / ,'/ r� �r ) Depth to Weeping Water. NA 43,2cJO� sq. Ft. — — _ _ d� Depth to Mottling(Color): NA O P Est Seasonal High GW: NA Lon Term Acceptance Rate LTAR 0. 74 O ,' USGS Observation Well: NA 20 0, 50 Leaching Area Design Capacity: 55 J Date of last Measurement NA '��� G Comments. (Sidewall Area + Bottom Area) x LTAR G P L7 131a 00 30 / - .- - - _ -- -- - - - - - - / ca CD 20 - � - - - -- - - - " - Cranberry Bog (Abandon) ' PROJECT LOCATION Z 1 5 (C w) S `�o N.O )20 p any GvTo t,T, M ASSESSORS MAP 2© LOT APPLICANT. �>' ) 5 , Locvs PREPARED, BY taw r S Po.l� A & M Land Services 15 Sunset Drive South Yarmouth, MA 02664 (.Ea►► o :; 1 (508) 394-2723 • --'' ) SCALE l ZOO DATE.- r7l!Yle"l REV. LOCUS MAP 2.15 L5W15-TU IT D WG. NO, 3 0(, Co SHEET' 1 OF / - '. - - .a.- _. ._ ..w r..s+.-.�+ra:w+I-•m.rrarrn*:.....�,..w:s..s....,...e+r«..i�.......-.:.e.^A,^.uuM.ti+s^,yd,,.••.;-- - -..-.....-rw:rr.nrr..-wrw..+w..sew...n, f++.:..e+a...aw•,..awwnu'.w4Y J^'.oa.+srve.x..M'.-...,:+:._a,P*: -.r � +....._..•-_.w_...-.-.........--� _ ..-._�_.-....+.�.�-.....�-.r�.�....................._....._.«.. ...-..... .w.,u +R,«a.:r rswrw•+ww..+.t»r+. u. .. w-r..w...suF•a�..+sr u.-.�.+»wwr.. w...+. - ,.�.r ..»._..,w+.. w. _ _ - --_-