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Home My WebLink About0756 MAIN STREET (COTUIT) - Health (2) 756 Main Street Cotuit A= 036 - 059 r j _J Commonwealth of Massachusetts 03(p -OS9 Title 5 Official Inspection Form orm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .••'°` 756 Main Street Cotuit Property Address Catherine Berke E. . Owner Owner's Name information is required for every Cotuit ✓ Ma. 02635 05/18/2016 ►�+ 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 f filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere key the return Name of Inspector Y Cape Septic Inspections Company Name 624 Old Barnstable Road Company Address Mashpee Ma. 02649 Cityfrown State Zip Code 508-280-3356 S13938 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 16.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority ;Is�nectors LZ05/22/2016 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 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. ***`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. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 r ' 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: ❑ 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): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey y information is owner's Name required for every Cotuit Ma. 02635 05/18/2016 page, City/Town 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. i 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): t ❑ broken s i e p p ( )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): e i ❑ 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): El broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/18/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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 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: r 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 cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner information is Owners Name required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 feet 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 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. 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 ❑ El 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,•°' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/18/2016 page. Cityrrown 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 N/A) ® ❑ 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: i ® ❑ 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): 8 Number of bedrooms(actual): 7 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 911 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6.of 17 Commonwealth nwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts ME, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner information is Owner's Name required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection D. Sy stem In formation nformation cont. Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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 l/A system by system operator under contract ❑ Tight tank..Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 04/2007 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.): r Septic Tank(locate on site plan): Depth below grade: 12" feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: Standard 2000 Gallon Septic Tank Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwe alth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cot it Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. City/Town 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 39 Scum thickness < 1 Distance from top of scum to top of outlet tee or baffle 4 Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? field instruments Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The septic tank is under the patio 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 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every COtUIt Ma. 02635 05/18/2016 page. Cityrrown 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 06/18/2016 page. City/Town 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.): no signs of leakage or solids carryover. t 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: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwe alth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berke Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8 ❑ 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.): Cesspools(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 ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 I Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,.•'' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/18/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for VoluntaryAssessments sments .•`'' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 page. Cityrrown State Zip Code Date of Inspection 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 within 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,-U m -f4` i,,j 5 —1 l e v,,) +4 e- P t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Assessinu. As-Built Gros, Page 1 of TOWN OF 8AMS1ABLt yr /II t3 L(,CATION 29.._Afr-l" SEWAGE M AeL -Z4j_ �L-LAGE �� i f ASSESSOR S Map&LOT/ • OJ9 L`STALLER'S!IAMB&PHONE NO. - Alr_ a ltT,4.o j lc ' SE7rC TANK CAPACITY Z QOa EACFM�G FACII-ItY:(type) �� SO.OF BEDROOMS 3t2'..DER OWNER � o-�Ca PERN3IT DA;E: COyfPLIA,vCE DATE Sepuwion Dtsance Between the; Max:mart:?d,t;stedGrccrdwa:er Table tothtAummafLeachingFaci:ity �.� Pnvalc Water Supply WcH and LcxItmS FactScy (If any wells exist on Site or wulun 200 fees of leaching facility) � Fat Edge of Wetland and Leaching Facility(If my wetlands exist within 300 feet(4&9 facility) Feet Furrisncd byc�+-- A)l � e si� Z si D 3 a him: ��t��t.to«n. arnst�l�t;.;)ia.u: assess]ngliMdispla� asp?mappar-036059&seq=2 5/13/2014 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-p y Not for Voluntary Assessments s 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/18/2016 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 high ground water: 12 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record 1 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: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database=explain: You must describe how you established the high ground water elevation: I augured a hole at lower elevation and shot it with a transit Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635- 05/18/2016 page. 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 45 or attached in separate file /Z Fe-e i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 w- Commonwealth of Massachusetts w - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >.•'' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every Cotuit Ma. 02635 05/10/2014 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 l n on the computer, JU4 key to move your 1 use only the tab . Inspector: U cursor-do not Michael T Bisienere use the return Name of Inspector key. Cape Septic Inspections 441 Company Name 624 Old Barnstable Road Company Address Mashpee Ma. 02649 City/Town State Zip Code 508-280-3356 S13938 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 05/17/2014 Inspector'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 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. ****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. t5ins•3113 Title 5 Official Inspection or .Subsurface Sewage Disposal System•Page 1 of 17 ' Commonwealth of Massachusetts G W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cityrrown State Zip Code Date of Inspection B. Certification (cost.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: ❑ 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): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is Cotuit Ma. 02635 05/10/2014 required for every page. City/Town 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. t 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 ElY ElN ❑ 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 ❑ ND (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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 f Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 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 cesspool is less than 6" below invert or available volume is less than %day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 i Commonwealth of Massachusetts 4 - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,.' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) 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 feet 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 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. 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 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 i 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form R a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey - Owner Owner's Name information is Cotuit Ma. 02635 05/10/2014 required for every page. CitylTown 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? El ® 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 N/A) ® ❑ 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): 8 Number of bedrooms (actual): 7 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 911 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is Cotuit Ma. 02635 05/10/2014 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: 2 Number of current residents: 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 Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: o2oi3 30 og:; sAir�,�1 �� - aoz z _27 v0Q Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 L Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cityrrown 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: 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments .' 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is Cotuit 1 Ma. 02635 05/10/2014 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 04/2007 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.): Septic Tank(locate on site plan): Depth below grade: 12"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: Standard 2000 Gallon Septic Tank Sludge depth: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is Cotuit Ma. 02635 05/10/2014 required for every page. Cityrrown 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 39" Scum thickness ' Distance from top of scum to top of outlet tee or baffle 4' Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? field instruments Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The septic tank is under the patio 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 I Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cityrrown 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cityrrown 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.): no signs of leakage or solids carryover. 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: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® 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.): Cesspools (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 I Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every COtUIt Ma. 02635 05/10/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •'" 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cityrrown State Zip Code Date of Inspection 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 within 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 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BAMSTABLE ur LGCATION r?St /stc,N gy- SEWAGE M Zt t ' -/33 :VL,LAGE CnMl y— / ASSESSOR'S MAP&LOT�- W9T INSTALLER'S NAME&PHONE NO. H'e b:c�e 1&z-m— SEPTIC TANK CAPACITY d4 6 ap LEACHING FACn=:(type) NO.OF BEDROOMS BUILDER ROWNER -fCa PERMITDATE: 4 C-62 4 COMPLL4NCE 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 f g facility) Feet Furnished by Z a 3 I • Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 756 Main Street Cotuit Property Address Catherine Berkey Owner Owners Name information is required for every COtUIt Ma. 02635 05/10/2014 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 high ground water: 12 plus feet feet 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: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augured a hole at lower elevation and shot it with a transit I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection- Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 756 Main Street Cotuit Property Address Catherine Berkey Owner Owner's Name information is required for every Cotuit Ma. 02635 05/10/2014 page. Cltyrrown State Zip Code Daespection 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 I No.—w-Z0d 8 — d 3 Z Fee---- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVe[[ Con0ruction3permit Ap licati is he �de for permit t 020ruct ( "_,_Alter �), or Repair )an individual Well at: --� ---�`�� -� -- --------��----.sue Location — Address Assessors Map and Parcel — -- /. / Owner Address Installer Driller Address Type of Building Dwelling---------------------------------------------------------- Other - Type of Building —------------------- No. of Persons-------------------------- -----__-___—_____ Type of Well— -C ------------------— -- - Capacity--------/ Purpose of Well----------- - - -- - --------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Pr tection Regulation — The undersigned further agrees not to place the well in operation unt' a erY ' ibito . li as been issued by the Board of Health. � Signed - --- -- -- --------------- -------dace------ �, 645� Application Approved By -- ---- ----------------------- date Application Disapproved for le following reasons:------------------______________—_______—___--------_____—___—__________ -------------------------------- ---------------- ------------------------------------------ date Permit No. ---u�2G O�j -- ---- Issued--- -- -7 -Z T P6 ------------------- date -- -------- ----- -------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f (Compliance THIS I�CERT , That the Individual Well Constructed ( -'), Altered ( ), or Repaired ( ) by- �Bl -----_ ------------------------------------------------------------------— — - - —- / Q / Installer at------ ' — — --------------------------------------------- ------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No wZ-'�----&e__4ZDated-- --- Z ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY.ej DATE---------- rBdl_-------------- --- — -- Inspector---------------------------------------------------------------------------- _ O 3 No.�------------- Fee------- ----------- BOARD OF HEALTH TOWN OF BARNSTABLE i Appricat ion iforMelt ConaructionPermit Ap licat' is her made for permit t� Co�truct ( -), Alter ), or Repair n individual Well at: Location — Address Assessors Map and Parcel ( Owner /S Address Installer — Driller Address Type of Building Dwelling-------------------------------------------------------- Other - Type of Building No. of Persons------------------------------___�_____ Ole Type of Well-C ------------------- ---- Capacity--------/ -`� �f- ------- Purpose of Well - --- ---------- ------— Agreement: The undersigned agrees to install the aforedescribed'individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation untj a C�t' to . f li ? as been issued by the Board of Health. Signed.r---- -- -- --- ------------------------ ----------date ------ 1 ' Application Approved By-- -— —-- -- --- -- -— -— = 2 date Application Disapproved for a following reasons:------------- -- -- -- ' date Permit No. -- Vv G-0 "_ --�,�-�. Issued----- - Z- -- —------------ date ------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate ®f Compliance THIS I�CERT FY, That the Individual Well Constructed (Altered ( ), or Repaired ( ) by- ` ------ ------------------------------------------------------------------------------------------ Installer -- ------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board,of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ------ g PP I.v1�-----,e��__Z.Dated - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATEe � o9scT5----- — - -- Inspector----------------------------------------------------------------------------------------�---- ------------ - -------------------------------------------------------------------------------------------------------- F BOARD OF HEALTH t - TOWN OF BARNSTABLE Vell Congtruct ion Permit - -- - No. --zap-e_z ZFee---------------- Permission is hereby granted -- r � - ------------------------------------------------------- -- - to Construct�/<'Alter ( ,), or Repair ( ) an In ividu Well at: No. - � � i1- -�� -- CO�/� --- - ----------------------------------------------------------------------------------- Street as shown on the application for a Well Construction Permit No. - -— -2 0 d -Z -- - - Dated -- - -� - -------------- - -- - v��,� Board of Health --7 2- �� - DATE-------/-- ------------------- - - 7 y i r - No. ann�1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS s 01pprication for ai5pogal *pgtemc Construction 3permit Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. e7S-� e4�� S Ow s Name,Address,and Tel.No. Assessor's Map/Parcel �3 6 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. - V 17-S SR- d' 77'71 r7&2a- T�pe of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Buildin� G�Zs t No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) (D(00 � gpd Design flow provided �ot�� gpd Plan Date P/ 0 Number of sheets Revision Date Title Size of Septic Tank �&Q-Zo Type of S.A.S. 7'f z&!X Z Description of Soil sod t o C, l S© Nature of Repairs or Alterations(Answer when applicable) 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. 0-7 f35- Date Issued .... .m.r � j r F. Y 'W'�.n.�'�.+*�y^' '•kY.', ..r., a. .... i J• /f-•fi ar 'v ♦ _' �`~ ' +�•�s� No./ 1 .( — Fee TH"OMMONWEALTH OF MASSACHUSETTS Entered in computer: ----PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ' � ' 21pprication-for bigpio5al *.pgtem Construction Permit 00 Application for a Permit to Construct( Repair O Upgrade O Abandon O ❑Complete System ❑Individual Components "Location Address or Lot No. ?_F6 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ^36 t� Installer's Name,Address,and Tel.No, Designer's Name,Address and Tel.No. %�- Type of Building: f' Dwelling._,_-No.of Bedrooms �� Lot Size St14!�o sq. ft. Garbage Grinder (�+� Other Type of Building' 'a S rX, 5 k No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) (a Coo '" gpd Design flow provided /e, t ) gpd Plan Date -/-0 Number of sheets Revision Date v Title ) Size of Septic Tank Ak—&40 Type of S.A.S.I..r� Qy,42--. 7 y x/L/X Z'A Jk'� Description of Soil pfuse sed to P to 1 SO ,+ 11 {. Nature of Repairs or Alterations(Answer when applicable) ;)Iv � o f t f �,1/1 ns-G ,f i a , 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. - Signed T�^^ � c Date —S"'f�I r, ' « Application Approved by ' rf,�� Date �/ 7 Application Disapproved by: Date for the following reasons Permit No. r.3 S Date Issued —=———— ————————— ———————————`—l_——————'—=— — k THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS-IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( W<Repaired ( ) Upgraded ( ) Abandohed( )by �/C V (1A) !/"i/e_PU-) at 7S/, �/," SO' - (142V/!C!0!: has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. '-�Ut)�I (3'$-- date /C?//) Installer /C.Lly Designer � 1 v #bedrooms ; e ha Approved design flow gpd w The issuance of this pe it shall not be construed as a guarantee that the system will-function as designed. Date --__ i 1 �0 Inspector_ /✓r l� �tj . _ � J No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—.BARNSTABLE, MASSACHUSETTS lwigoal Stem Construction Permit Permission is hereby granted to Construct (d° ) Repair ( ) Upgrade ( ) Abandon System located at 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 �/� 0 %� +; Approved by��c_✓F' Town of Barnstable Regulatory Services :.: .. Thomas F.Geiler,Director ELAWWns,.E; S Public Health Division Thomas McKean,Director . 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508=790-6304 Installer&Designer Certification Form Date: ' �/ 2C707 Sewage Permit# Z60-7-13 S. Assessor's Map\Parcel f1�10 3G .h_I S? Designer: S N ld bj;is csa ,Y'_c:. Installer: N t c 1<c Ccnas frvc hv" Address: Gex{-r. tvtiC_ Address: _2B' ►2 sSn 7 4,� 7` hle.rdPn 5+0 1-f�4wnis 1_I�nn,s On -.9 O 7 Ye cicce �ansdrycficV was issued a.permt to install'a (date) (installer) . septic system at based on a design drawn by (address) . e+-p h., 1�. W I son C-' dated (designer) X I certify that the,septic system referenced above was installed substantially according to the design; which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. �M_All _cc.v"(soq Fs _2-0(lb SOO:g4I�WT. GWIG^B�C�GtA6►»�OtVs..aWto6, _�'u�-�X�_ = I certify that the septic.system referenced above was installed with major changes(i.e. greater than 1.0' 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. Of A.YN , nstaller's Signature) NO.SWIG (Designer's Signature) (Affix Desi mp 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. Q:Health/Septic/Designer,Certification Form 3-26-04.doc PROF THE Tp�� DATE: 3 '� / "0 / �OW� O Barnstable REC.BY STAB le '0� Board of�Iealth SCHED. DATE: 6 1 / O RFD MAC A 200 Main Street,_Hyannis MA 02601 Office: 508-862A644 Susan G.Rask,RS. FAX: 508-790 6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. Application to Construct or Expand to Sig (6) or More Bedrooms LOCATION Property Address: Assessor's Map and Parcel Number: jNi_ 3� ��( Sg Size of Lot: 1,73 acres Wetlands Within 300 Ft. Yes Business Name: No�_ Subdivision Name: " APPLICANT'S NAME: D ,,ntc 'D, 'Gerteem. Phone Did the owner of the property authorize you to represent him or her? Yes x No PROPERTY OWNER'S.NAME CONTACT PERSON Name: 'p�hn�s III. i.cr k�H Name: S*r- h,.w A. wt' RjBreJe. � Sv�lower u�l Address: 0" D"„l q,o, Qmrccskr olLocr Address: '1g 00rj-&, g1TTlnLS 024.61 Phone` SOS -831- S2oa Phone:_ ;06 771 --7507' 1 Checklist Please submit copies in 4 separate completed sets. V/ Four(4)copies of this application form co R - ca c-- Four(4)copies of engineered plan submitted(e.g.septic system plans) --I Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans) Q:\Application Forms\SixBedroomForm.doc r C�RoG S- 2/S r J . Op THE Tp� `is Town of Barnstable IIARNSTAE3LE, 1639.. a i6 Board of Health 9� g ,gym plfb MA'I a. i P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. ' FAX: 508-790-6304 Paul Canniff,D.M.D. ,w April 25, 2007 4- Stephen A. Wilson, P.E. Baxter Nye Engineering 78 North Street Hyannis, MA 02601 RE: 756 Main Street, Cotuit A= 036 - 059 Dear Mr. Wilson, You are granted permission, on behalf of your client, Dennis Berkey, to construct an onsite sewage disposal system designed to be connected to six bedrooms at 756 Main Street, Cotuit, Massachusetts. The septic system shall be constructed in accordance with the revised plans dated April 25, 2007. Sin r ly yours, Wayne M.D. Chairm BOAR;iller, OF HEALTH TOWN OF BARNSTABLE Q:\WPFILES\6BedroomsBerkeyMainStCot2OO7.doc ■ Complete items 1,2,and 3.Also complete A. Sign ur item 4 if Restricted Delivery is desired. X a Agent a Print your name and address on the reverse1'.1- & !✓ ❑Addressee so that we can return the card to you. B. Received by(Printed Name) Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes q 1. Article Addressed to: , If YES,enter delivery address below: ❑No I r7 4 s-vT Kathleen Murphy 756NIain Street 3. Service�Ty'pe Cotuit, MA 02635 ❑c0tv.6 Mail press Mail ❑Registered ❑ eturn Receipt for Merchandise ❑Insured . �i �.D 4. Retrict�ed!°'livery?(Ext Fete) ❑Yes 2. Afticle Number (Transfer from service label) PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVI First-Class c-0 o Yag�".�<.Fetes Pai -� pS- n.� �nn o ��,�G 'Permit•�do°'�='1�5`"",,�.o.., ° Sender: Please print`you�name,address, and Z-1P+4 n-thts-box• PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE 200 MAIN STREET HYANNIS,MASSAC HUSETTS 02601 I I j COOS 1{{1{11{{{1111111111{i{{{111{{1111{1{1{ I I ., p Postage $ u7 Certified FeeCO /, P ll II( SE�Post�e' 2005 Return Receipt Fee e e M (Endorsement Required) c S i C3 Restricted Delivery Fee p p (Endorsement Required) USPS� p Total Postage 8 Fees .C� Se To -- ---��t- -----k y--------------------------------- p Street,Apt. o.;or PC Box No. p --75G---- -n he e-�'--------------------------------------------- p Ci"ate„ZIP+4 Certified Mail Provides: t o A mailing receipt o A unique identifier for your mailpiece o A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For j valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is. required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for,postmarking.,If a postmark on`the Certified Mail- receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry.' PS Form 3800,May 2000(Reverse) 102595-99-M-2087 i - � Y S i I r; DATE 9/1In PROPERTY ADDRESS 756 Main .mot cotuit MA 02635 On the above date A, -e septic systemAi the address above was..r Inspected. This system consists of the following: S j/. 1., 2 -.i.rag2.e: . 6X�-_gPock Based on inspection, ) certify the following conditions., 2., 7h ie .i4 no, a.7it is Flue" .3,ePt.ic .5 y.5t em.' 3v--sue ptic .6g s �a tguAe. ..� SIGNATURE _ z _Nam e: Robert k"kaolini Company: Joseph P. Macomber &Son Inc . Addr ess:- se P. 0. Box 66 Centerville. Aass 02632 Phone: 508-775-3338 or 508-775-6412 JOEPtI P. MACOMBER & SON, INC. Tanks-Cesspools-beach#fields Pumped &Installed Town Sewer Connections P.O. Box 66 Centerville, MA 026-32-0066 775.3338 77544t2 COMMONWEALTH OF MASSACHUSETTS lopEXECUTIVE OFFICE OF ENvIRONMEN AL AFAIRs DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM VART A CERTIFICATION property Address: 756 Main St Cotuit MA 02635 Owner's Nadte: Ka h 1 - n Murphy Owuees Address: Datie.vfbapeeE•m 9 1 05. N=wQfjngmtor.fpteasep Robert A Paolini Camp=yNww- J-P-Macomber & Son Inc. MW Address: Rix- A 6 Centerville MA 02632 Te1qdweNamber:508-775-3 38 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information rgmrWd below is true,accurate and complete as of the time of the inspection.The inspection was performed based onmy training and experience in the proper function and maintenance of on site sewage disposal systems.I sm a DEP approved system Inspector Pursuant to Senior 1530 of 1101e 5(310 CMR I5A 4 The system: Passes . Conditionally Passes Needs Further Evaluation by the Local Approving.Authority XF >� s Inspector's Suture: Vie: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Healthor DM within 3()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 ffte DID.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ***w'his report only descsl bes conditions at the thne,of1uspeebou and under the eundOws of use at dim. tmw Thistuspedion.does not adder haw the system win perform'in the future under the same or d0ere* coadttions 6fusco I Tide 51nspection Form 6/IN2000 page I l , Page 2 of 11 l OFFICIAL INSPECTION FORM—:NOT FOR VOLUNTARY ASSESSMENTS .SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM° !' PART A CERTIFICATION(continued) Property Address: 756 Main St Cotuit MA 02635 Owner: Kathleen Murphy Date of Inspection: 9 1 /0 5 Inspection Summary.:. Check A,B,C,D or.E/ALWAYS-complete all of Section.D A. System Passes:NO 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: septic •system .ins .in �aieulte B. System Conditionally'Passes: NO 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. Answer yes,no or not determined(Y,N,ND)in the -for the following statements.If"not determined"please explain. NO The septic tank is metal and.over 20 years old*or the septic tank(whether metal or not)is structurally unsound,.exhibits substantial infiltration or exfiltration ortank failure is.imminent.System will pass inspection if the existing tank is replaced with a.complying septic tank as approved b. y 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: NO 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 756 Main S t Cotuit MA 02635 Owner:. Kathleen Murphy Date of Inspection: 9/1 /0 5 C. Further Evaluation is Required by the Board of Health: NO Conditions.exist which require further evaluation by the Board:of Health in order to determine if the system is failing to protect public health,_safety or the environment. 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: a o Cesspool or privy is within 50 feet of a surface water rz o Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health.(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: a o 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. n o The system has a.septic tank and SAS and the SAS is`within a Zone 1 of a public water-supply. n o The system has a septic tank and.SA&and the SAS is within 50 feet of a private water supply well. n o The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more front a private water supply well**.Method used to determine distance v1-3aa 2 **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: 3 Page 4 of 11 OFFICIAL,INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A CERTIFICATION(continued) . Property Address: 756 Main St Cotuit MA 02635 Owner: Kathleen Murphy Date of Inspection: 9/1 /0 5 D. System Failure Criteria applicable to all systems:. You must indicate"yes"-.or"no"to eitch of the followingfor all inspections: Yes No _ X Backup of sewage.into facility or system component due.to overloaded.or clogged SAS..or cesspool T 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 X of times pumped 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 1.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 forip.] NO (Yes/No)The system fails.I:have determined that one or.morOpf.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 10,00.0 gpd to 15,000. gpd. You must indicate either"yes"or"no"to,each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply ' X the system is located in.a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped - - Zone II of a public water supply well •- If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5.of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECK-LIST Property Address: 7 5 6 -Main St Cotuit MA 02635 Owner: K h by Date of Inspection: 9 1 0 Check if the following have been done.You must indicate"yes"or"no"as4o each.of the following: Yes �o _ 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? NIA 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 Ce,3h/2002 Were the=6"ic lank 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)] M III 5 Page 6 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS .SUBSURFACE.SEWAGE RISP.OSAL:SYSTEM;.INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 756 Main St Cotuit MA 02635 Owner: Kathleen Murphy Date of Inspection: 9/1 /0 5 FLOW CONDITIONS RESIDENTIAL P Number of bedrooms desi 5 ( gn): . ' Number.of bedrooms(actual): 5 5 0 DESIGN flow based on 310 C 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no):2 o Is laundry on a separate sewage system.(yes or.no)n o [.if yes separate inspection required] Laundry system inspected(yes or no):2 0 Seasonal use:(yes or no):n o Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): 2 0. Last date of occupancy: g 2 kn o wn COMMERCIALMODUSTRIAL N/,4 Type of estabo nt: Design flow(l�as'i;d on 310 CMR 15.203): avd Basis of d6iko"flow(seats/persons/sgf,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 NIA Source of information: Was system pumped as part of the inspection(yes or no):_ If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM., _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: Were sewage odors detected when arriving at the site(yes or no):_ y ` 6 i Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM j PART C SYSTEM INFORMATION(continued) Property Address: Cotui . MA 2635 Owner: Ka hl Pen wn,r_nhy Date of Inspection: 9/1 /0 5 BUILDING SEWER(locate on site plan) Depth below grade: . 3 6 Materials of construction: cast iron _40 PVC_other(explain): Distance from private water supply well or suction line:z 0 t cpMj%(og i°e dtgf� d z age,c °n � agl SEPTIC TANK: NG(locate on site plan) . Depth below grade: Material of construction:_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: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Sent.ic .tank iA nnf PlzeAen,t - GREASE TRAPNo(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 � ve /vas related o outlet u ofeakag ec yaea�ezazzntnezn z �� 7 Page 8 of 11 .OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: _ o ui KA-0z635 Owner: Kathleen Mur h Date of Inspection: 9 1 0 5 TIGHT or HOLDING TANK: ND (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.): Tight orz ho-eding tanks aze not /zaesent N0 DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence.of solids carryover,any evidence of leakage into or out of box,etc.): D-Z'6ta.ilut.ion Sox .is not /?2ezent PUMP CHAMBER: ND (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.): l umI2 cham&ea .i-s not •/22eaent 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). Property Address: 756 Main St Cotuit MA 02635 Owner: Kathleen Murphy Date of Inspection: 9/1 /0 5 SOIL ABSORPTION.SYSTEM(SAS): (locate on site plan,excavation not required) If SAS Tt located explain why: ocazed zee page 10., Type leaching pits,number:_ 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.): Loamy .to zandy zo.ii vegeta.t.ion .i.z noamai 2 - z.ingie cezz12ookz CESSPOOLS: yez(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 2 Depth—top of liquid to inlet invert: Depth of solids layer: none_ Depth of scum layer: none_ Dimensions of cesspool: Materials of construction: XX o c z Indication of groundwater inflow(yes nr no): Comments(note condition of soil,signs of hydraulic_failure,level of ponding,condition of vegetation,etc.): zee .2eac4.ing y 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.): It ivy 1,6 not Raezent I ` t 9 Page 10 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOOSAL SYSTEM INSPECTION FORM i PART C7 . SYSTEM INFORMATION(continued)" Property Address: 756 Main St Cotuit MA 02.635 Owner: Kathleen Murphy Date of Inspection: 9/1 /0 5 ° SKETCH OF SEWAGE DISPOSAL SYSTEM Proo e a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmiarks.Locate.all wells within 100 feet.Locate where public water supply enters the building. 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 7 5 F Main s t Cot i.i t MA 02F�5 Owner: Kathleen Murphy Date of Inspection: 9/1 /0 5 SITE EXAM . Slope Surface water Check cellar Shallow wells Estimated depth to ground water Liu feet ` Please indicate(check).all methods used to determine the high groundwater elevation: . •N 0 Obtained from system design plans on record-If checked,date of design plan reviewed: u ez Observed site(abutting p ro abuttin pertY/observation hole within 150,feet of SAS) , Checked with local Board of Health-explain:nz k a i.P t can d no Checked4ith local excavators,installers-(attach documentation) ®ccessedUSGSdatabase=explain: ��/2:�own.,gaani3tal$e.-ma.-u¢ �.. You must describe how you established the high ground.water elevation: llhed. : Ca e Cod Commis.ion 1date/t 7akie CoAtOU/tz And Pugtie UateT Sapp-ey Oe22 head paotection a2ea,6 map., Selt 1995 blatea 4e,30u2ceh o eeice cape cool comm.thion 1 To"f Ground Leaching Pit I: ;eet Groundwate Feet Below Bottom-of Pit High Groundwater Adjustment 1.8 ft per Fnmpter Method Therefore,the vertical separation distance between the bottom of the leaching pit and the adjusted groundwater table is feet, 11 • r1 .Ifo :I•T1RR7•MrRt7TT'T-tTR. J+R.RTPRlTRRiSRiTlfi.•tT.T:7�+fJ'ARORII'T7 TlCR{-Oi TIC'4TlRti'Y'1 Tf'Tf"R�TIRlR!' :�:•.i'-••}• TOWN OF ,RaRNSTART.F HOARD.OF .HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D CERTIFICATION «•ar•ter:•::T--++s.-.-,rnnsr.+n•rtrn+'wses+va+r:rmr.•«zhrn++r++�anrvr-e•n+n+evss nen n•+e-rr•rr-ems+•-•r•� -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 756 : Main St ASSESSORS MAP, BLOCK AND PARCEL # / OWNER's NAME Nathl"eeh Murphy PART` D - CERTIFICATIQN 71 NAME OF INSPECTOR Roge&t P aoiin.i - COMPANY NAME ;oseph P., Nacomle?2' Son Inc COMPANY ADDRESS pox 66 Certteay.iiie glass 02632 Street Town or City. Stag ZIP COMPANY TELEPHONE ( 508 ): 7:75 - 3338 FAX ( 508 )790 1578 m ' CERTIFICATION STATEMENT I certify that I have personally, inspected the sewage diSposa7. system at this address and that the information reported is true , accurate, _and omplete as of the time of .inspection . The inspection was performed and any recommendations regarding upgrade , . maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: System 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 CMR. 15. 303, Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. XXX System FAILED* The inspection which I have con acted has found that the system fails to protect the public health and the environment in accordance with Title 51 310 CMR 15 . 30.3, and as .specifically noted on .PART C - FAILURE CRITERIA of this in ec i -n .fo y - s - Inspector Signature Date ' ne copy of this certification must be provided to the OWNER, the. BUYER where applicable) and the DOARD OP' HEALTH. * If the. inspection FAILED, the owner or•"Q'-perator shall upgrade • the eystem. within one year - of the date of the inspection, unless allowed or required ' otherwise as provided in 3.,10 CMR 15 . 305 , ' 27- APR-5-2007 04:03P FROM:BAXTER NYE ENGINEERI 1-508-771-7622 TO:815087906304 P.2 Town of Barnstable P# Department of Regulatory Services Public Health Division Date $ awttTaOew9t¢g 200 Main Street,liyannls MA 02601 MA69. Date Scheduled_ Time, 1 / Fee Pd. G Soil Suitability Assessment for Sewage Dis osal tom... Witnessed By: Perfon»ed By: LOCATION & GENERAL INFORMATION OwncesNnme 00.nt 9nS tBeN1C6Ltl=le FAssessor'sulaplParccl; Address -716& yyl4tn � �{- p v6v 17ry r^� lr. Address (�D r�� .t iylGngineer's NameA, YIIcs p 76P 1 Yam,i Sg r ,NEW CONSTRUCTION IC REPAIR Telephone N QcOlr 1 '!I 8 91 oa Surface Stones Land Use YG-a 9•C�"�I-nrr+R Slopes(/) Distances tiom: Open Water Body ti Possible Wet Area R Drinking Water Well fl Drainage Way R Property Urictt Other ft SKETCH:(Street nmne,dimensions of jot,exact locations of test holes&pert tests,iocatc wetlands in proximity to holes) 12L- t 19e 1�rlab� djLat 1 Parent ntntcrinl(geologlc) iSJAZUh.l Bu11rv1 c94 Depth to Bedrock Dcpth to Groundwnter: Standing Water in I•Iole: Weeping front Pit Face I Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: ht. Depth to soil mottles: In- Depth to weeping front side of obs.hole: in. Groundwater Adjustment ft. Index Well q Rending Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date Time Observation Hole 9 Thnc at 9" Dcpth of Perc Sy v $1/1 Timc at 6" Start Pre-son:Time cr II:20 AIN 1/:/2 Timc(9"-6") End Pre-sonk u tit.L(a Fto 30r.IG �1:1 yi,F bL m� tY+sk Rnte Min./Inch Site SuitobilityAssessntent: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Sack----------- ***If percolation test is to be conducted within 100' ofwetland,you must first notify the Barnstable Conservation Division at least one (1)weelc prior to beginning. Q:1-I EALTIi/WP/PERCPO RM �40R00IS -Z/S, APR-5-2007 04:04P FROM:BAXTER NYE ENGINEERI 1-508-771-7622 TO:815087906304 P.3 Hole# r OBSERVATION HOLE soil olor soil Soil Texture Mottling (Structure, Depth from Soil Boulders. DEEP Soil Horizon (USDA) (Munsell) e Surface(in.) _ Suti�PyLea� la �Q' 3I3 u = /G ,pv1Z44 ?0t= /20 a Hole#_ - DEEP OBSERVATION HOLE LOG Soil other Soii Texture Soil Color Structure,Stones,Boulders. Depth from Soil Horizon (Munsell) Mottling ( , t o Gr e Surface(in.) (USDA) d�71I A/7 SAna� �,d691 �0 yiQ 3/z, r ,_ � � S��d coo 1� y aJnr+ � I a Yte All, w.kr e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Sln'faee(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. oGravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. Consistency,% 0 Flood Insurance Rate Mttp: ` Above 500 year Hood boundary No_ Yes ✓ Above 500 year flood boundary No_ Yes ✓ Witi1111500 year boundary No ✓ Yes Witldn 100 year flood boundary No ✓ Yes Depth of Naturally Occurrine 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? Yks If not,what is the depth of naturally occurring pervious material? !Certification 1 certify that on YZI9 5 (date)1 have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above er was analysis form Y performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date �/N Q:H EA.LTH/W PM E R C FO RM 2w cm 27111 AWN Mil AWN 37111 AWN 37111 AWN 2m ON 1m/6 ON a o a I I .4 3/111AWN DIIIAWN I 57111AWN g wee g _ am no 0 � I ti g s SOBS A7M SOBS AIM WR 0 g gg O R 8g S S SOBS SOD SOBS SM P P s - i ilO$PIAN mma t� rwr ots WAW"NI WNx COPYRIGHT DALE IffNIBONS FIRST FLOOR PLAN N"M(OM R NORTHSME HORMSWS HEMP POMMY D ' . ` a ErI — DESIGN TIC ARII I �DE�DN MMSQt OF MAY&=M SET. EXISTING CONDITIONS """"e�"WO1ia� NOf 10 w NWRmU® SNFET N0. DATE: °i�° ASSOCIATES „MN °MYpp yOR COM M MY yFp I DMWN m for BERKEY RESIDENCE '"'°"""`°°'�" A.1 10/e5/0e 07 756 MAIN STREET M�'1'1e�100°` omm m RESODR4LL a DOWF ILL oE9cN OaNmv W TYe°w� nWV N" NWIWIW 1N� 1� WIIY66T• w°taf6 AND OONSDIT W NOMHM CHECKED COTUIT, MA. 2 NolN mNM 4& t"1e®eel° eQim pmoA W"Mw°0,NNR.Y1.tW 1.NNA._... I ,i 1 2=oN =0" U IN on w I I 1 > I I I I g � 4 an IN 2=DH > g � >B e 4 g g m Y 4 am 31163 C 9m 0BL snCl CASE 2M ONCE 2M ON MD ON A 9 9CAU:1 4'-V-0' - - tmtaroiaaiusoaman THS PUN ONAIA v�i po r�wr airw rw°ib COPYPoOHT DATE REASONS SECOND FLOOR PLAN NORMIDE NORIIISDE mom E7RRE57Y D i 5 s 9 at A Op1AElE StT OF �" FROMM IB 00UM UW DESIGN EXISTING CONDITIONS ;,m;;"�" 'D(E�SIG/rN��PL� NOT 10 K SHEET NQ DATE: ns e�m bNo ASSOCIATES P�'owW Olt tOW ew�I yat{ I DRAWN dl r� for BERKEY RESIDENCE II A.2 m�ea�as 07 7ss MAIN STREET �m 031NC K FEWINK s MOW � f y COTUITMA. eenuwr ta�ogieo-s+e •r"aw"mntewp of�gR7E p �CEiEq(ED ______1 -- _ - - ----- _ - - 4 ,. i L ` . - " - j i - ��I I - ' _ I . \ . : . -1. I I I. .. X -, ?"w I I .w .1 - 4 Is I , I I : 1. I I 1, . _y . I I _ DH FN[. • . 0fig a . • GENERAL NOTES . ~ y , .4�,. o ~ I - . • ' .e • ; ; _ I SEED f300K 1t►,s95 PAGE 287 - 1.) THE INTENT OF THIS PUN IS TO DETNL PROPOSED NEW CONSTRUCTION - ,•% P •- • c • F, N,,.c. CH'RY,_ K. RYDEP & F41CH,ARD J. V,CRNE3'"UM �, i AND PROPOSED SEPTIC DESIGN AT LOCUS. , _ .. *5' O ' ' - I ---- -- - ti L.C. I'1!I! 31 ty5 _ ' - 1:�'/ }�nr;'r�n it a _ - _ , 2.) LOCUS AREA IS COMPRISED OF : • . . � = 1 - _ a '0 " , Ft/F NICHGLAS C. d' f�.TFIC. 41C►t'i C • I ;' am LOW P• 1 %0 DATE • 1V1014006 P _ _ __-- . ___ -_._ ,�, _ BARNSTABLE ASSESSORS MAP 036 PARCEL 059 : , _ - _ A c� eo r - t I , . I : LOT6 •r ✓.'40 "'_"J • g� •I• �' Timi BARNSTABLE . APRflN `' ) - ,w_• . /, RT I''lJW 31395 C rP o -r,- r _ r /1 =9' TD CERTIFICATE OF TITLE: 176,c: SOtL EVALUATOR: 'a 4_8.._ I r . Y. - -.. 13QARD OF HEiILTH AGENT: 3 _ _ '--_-- _ . . :, . .pt. . ,J', STEPHEN A. WILSON, P.I- 1'?.� 47.5 �7. r C:R DH FND y _ :. DON DESMARAIS t { ..-, x 4 �.S i A ;j - ,: - L.. " - uf' #sC/ _ 4! \ . .�.ea � . 1 DRUB Y�LANEK -, • - y I TEST PR 11 TEST PIT /2 r ,.---► -r--t•v N - . N r '{ I. - °. - : - -, - ---... �, � t _ ,-' WiORCESTER, MA 01609 r •. O S•: . t t G.S.E = 34.5 G.S.E - 35.7 4,._ , rt Y ----Z;.__ 44.e / _ • ) ••. �,•p' r --•0 0'A 0•A ; 3 - - "_ - _ 47;3 � ` 45.hy 45 � �/ - ,e I, Y . 4 - - p P P ` PJw- 'R,, r --e - -q-' - - - 47.4 � ,' , ...• - Sqw LAW SANDY tArW I'- ',' _�E_�. 5t,, p�,,� t rY C ZONING INFORMATION . e • ,: w ?CO�C. C;RQ _'0 x OR"YE �,w "L_,a.� "L>- �n 3') . 0&1..,/*I.I . , . ./ .-,.4V'C.:x_-x/.:.:',C=.5/I, ''I 1/10.',�):�,. . .:,7 I.I . I....,�S!�1.I .,.-1.4 I3,, /- -./ .: pains s 10 Y 3 3 7" 10 Y 3 , _ A � /, S`�Ell X`�� t / ,,i / TONING DISTRICT: RF - f . •. �:; 47 y --- -_.. ._-. - _ _ -5 /,, ., �RIbE�. � it - 'c: / OVERLAY DISTRICTS: RPOD RESOURCE PROTECTION OVERLAY-DISTRICT / /. �tX t ;\�♦ 6 SANDY t�raW 6 sANOY LQW ' < 48X t y - - j ! /1.7.7 BLOCK & STCNI LfJP._L - I / I-' ! 38.4 AP AQUIFER PROTECTION OVERLAY DISTRICT -- 16' 10 Y 4 Q 1!)• 10 Y 3 3 W i� / t > I ( SHEJ 1 / f "*Aa r ,� 1 ,,n / _ tip,' - ti� DPOD DOCK PIER OVERLAY DISTRICT I LOCUS MAP Scale: 1" - 2000' C , ' 7•`A . �` �� U _ I /F - 41 `' 1 �' r �- 4 /' K 4 t F3 ,� I}- � , ' WP WELLHEAD PROTECTION - . . I 1 1 () `Lill REw RAaD \, 1 - X / LAGSTO: 1. r ' _ - / _ t MEDAN SAND MEDIUM SAtVD v a 56 DH \ ci CONCPETE ; r1•rALN� ,1>>' ' .- I /' �, - t W FND I 1 a a I 't / MINIMUM CURRENT ZONING REQUIREMENTS ZONE RF -- ,': t • • 3 . _ -4 ..x .. r ,:' X 4�,3 4 .3 / - . , 29 30 10 Y/R S/6 120 10.Y/R 5/8 ,� # 7��.. . .'t)�,_W r •t , Sax Xl4a.G J/ / / / / / �' I�> r`Htr s� r j 4' / �/� MIN. LOT AREA =:.2 ACRES (RPOD) , - C,: / LEGEND � w { I I t I / LA N. _ t - - - ,E - i ,2 0 i 2 - tL FAPN 1tC.E-.. _ ,, , MEDNM SAND x 4?.SLL 147.b .: c: BRICK t_ _J�._i L HF?ICK V1'ALK t 4Fi,4 ' ' /.'! / p� / J r /, i /, ,) MIN LOT FRONTA �y / .*�,�.; pQ _ WATER GATE/SHUT-OFF 40' 10 Y/R 4/4 { 7 ._ - -(- g.l -i o0- i J _ R YARD = 15 f 4 .. . 4�.2 �, �' / / T 30 SI ARD DE EAR >1.,:. _ MANHOLE - _ X --...f'r I. .I_. ..:'- '� ' ':_ _,..4. , V .... .... I /l _ - _. L- .:' � / '.. . - , .,.... .. •- • ... FR Y x .2 , - ✓ / /.Y g.q , i/ , . f I ° '- EXI.MIJ:; 2 STCRY BRICK PATIO a.R , CO.J ' MEDIW SAND C30L_ D • " m = GAS METER c Re T'r r- I / . ; JI�J PAT. I ,' / / + / �rUGD FRA.1.4 01'rT LUNG y ' / UNI EL MBER. 25=1 0018 D 120• 10 Y/R"6/3 4 7.7 - I. 4.) COMM TY PAN NU ELECTRIC METER _ �, . t I 5.5 x 4 3:9 / ,•' / ,r---t. , �/ ,�� c I Nq• 756 �---- - / �, // . /, / THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C�• O = HYDRANT . . NO WATER AT 120 (ELEV 24.5) NO WATER AT 120 (EL V 25.7� I ,,.0 0I , � ;/ a^„ ; , :' �� GURED AS �, i/ , '_ , .; ; �, / AN AREA OF MINIMAL FLOODING Pore o 54' PERC O 54' 1 4?.3 �. = c I ,: TO 11E RELOCATED 4 I / / ,/' :-. / I J r , . / - •� FINISH FLOOR EIEVAION RATE- t2 Y RATE• t2 M-N�I ' " t r`t\Y� a g REOONFI X 10.0 = SPOT GRADE CLASS I CLASS 13A 113V 7AG [i0 l7[J a •9 t� - - - 44.6/ / ' _, l'��~ / / �7 ! ( �•` 5.) PRIMARY BENCHMARK: MHD STATION 68 N11A MONEL RIVET IN TOP ---'10 --- - CONTOURS I; f L . 50 3t; NC-%/D ° of .t x ap � FLAC O '_ I F.F.E = 48. / / i ,/. / ,' STONE wALL _ L 1 O= . ` _ ' ,-) Y;AL' i I , - �h SOUTH SIDE OF CONCRETE STEPS IN FRONT A HEN AREA RE REMENT 6-' /� 1QT.B OF HOUSE 428 ON MAIN STREET OPPOSITE c :-. 1 )' I -E ' .TR \ 5.7 / / / . / / x ~s�5 w - WATER LINE NITROGEN LOADING LIMITATION: NIA - t ( 48.?) 40.1-A, 1 ,' 41.5 . L.C. PLAN;131395 C ,', R /,� SCREECHAM WAY EL - 62.53' (NVGD 1929) - --G - GAS LINE = � ^,, Y�D`DF C+c v5o��E / / � . : RESIDENTIAL 8 x BEDROOMS . '{ I / 4 .0 I '� .6 / / ,' / _ _ - - x L 1 , ..I / 75,4' -S0. FT. • OJECT ENCHMARKS. �F+w- OVERHEAD WIRES. �_t r .= 4;.r, � _ / / �� I. J x 110 GP BEDROOM z >i ,_ ',. _ j _ ,/ SEE PLAN w _ - I. D/ x 4 •? 1 -1 ' ` �----•-- 46.E K s , TREE LINE E'-+ ti �, a: 3 / /. / II 4i5 -?�. I. /, PR 8 - S !, r � , - e�cT: 1 73t 11CRES'' . :. r, x . - TOTAL DESIGN F10W 880 GPD ', '47.6 ' TREES be SHRUBS x yr . C>!tl91ED 01tNE L �, o:E - = > ) , 4 7.1 W ,. t, - / , / 6. UTILJTY INFORMATION SHOWN HEREIN: GARBAGE GRINDER NOT INCLUDED N A 47. . 7 - _ ,� r s:, _ �'' i :: •-�� - ( / . / .. . I I \•�' . . r'a:� / ,,, ,y X 4C/•1 `1 / - y r ,-- ,- -- -: - (MATE AND : .. UTILITY POLE/GUY WE / /. PPROX 2 -•._ ,•. ,.. / „• LOCATION OF .UNDERGROUND�'UTILIT'IES .ARE A W \ / /i / , ; `."" �� ... : �;• ►• ► .: / ;_ MUST BE VERIFIED IN FIELD E3 THE CONTRACTOR AND , . PERC RATE <2 MIN INCH CLASS 1 .. r /,, 27.9 '/ / BY iII THE . _ _ t-+-1 ,;7, ..E 6 , � , � �,' / , • , APPROPRIATE UTILITY COMPANIES PRIOR TO ANY CONSTRUCTION:" :� LTAR 0.74 GPD/S.F. _ 4 6 _ >; . \ �� - . ,,: / . # A7.2 / TN / , . KEY � -.. �'; : ,. _ SIN. LEACHING AREA OF SAS: REQUIRED..... � � G.7 'y � � '� THIS SI ' ,r JPe�/s y y // ., 7. A►.,TITLE SEARCH HAS NOT.QEEN PERFORMED FOR ;TE. .. . ,, / 6 / / / ,d•RECdNFIGUifATION , / , / r /nI. 880 GPD/ 0.74 GPD/S.F. _ 1190 S.F. MINI �/'� .� < ,. A H . A ?l.E E RCH S / 47.^c BRUSH / Y i /i / OF'Ef(IsnNG Z V S y' , � IF DETERMINED TO BEN RY` Tl S ALL — PROPOSED NEW CONSTRUCTION PROPOSED SYSTEM: , I - - PL 6� 6 l "" / / BE PERFORMED BY OTHE �M i � PLANZIolGS` S �� / / '1� WOAD{'BANE D ELLING , _�. �, / / r 3 I • 11 N PLASTIC LEACHING CHAMBERS - -__ �-� %": 'f`' 8 /TOP OF FND 49.0' . ,' ,' / x �i,3 8.) THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT �j..I-,*x.�'.1�U,.4;x!0,F*_e�"...p.#3.'..0 11".0._I..-.I-t IrI,I l-;f,*I-III--,j,.I,*I,&I i��(�l�1�F-,t WITH 4 OF STONE ON'SIDES do 2' AT-ENDS -Y W, W- ,Yl► - ' e�.t2_,.....c U 1A�17 4l l�bi_.i,'w6:4.1.4'I:,7 _-Ir-_'.-A,6,t-.W--I..�6/_�.-.,-_Li-_�--M_/.,;:I r._--&!:-1;._.--_.*.I;.�/F;.;-:w.I,-.*-;'�.-.;--f,.1.7,I-1 :'."I W , • / . / , N ,�.-._.-.,--.....-_-FI. W/-_-I15E;?i 1ItI�l�i.:II5. .,';..,i"W-..:',-.B"E1.1(I 6 11-��1�mI.I -1T O... II,1.I- i-n_'.,::.;,.'1 r'_p...M 4:._."'/-'.,*w.IL1,f. 4C.:..I....,-,.,0`,'" S....I'1Fu_-G_ ...'1"_I__.._. A-QII I:LW)cl?/- 4,,,b r y H g . AVAILABLE RECORD INFORMATION ,CONSISTING OF PLANS .'I 1_ . .1II.-I 1-. I. I-.I I..S,1. x r. 4�.a �' ES SHOWN HEREON ' :, ; ,__ ./ > ,?> ;,.` - CERTIFICATES AND DEEDS. 'THE EXISTING FEATUR I..I,P_.L.II y ,SIDEWALL AREA. 74 ,+ 12 2 x 2 DEPTH • - 344 SF.: - i - ,. k o - , , w ` 'v J ',: - ..: . ., IN D FR M''•AN'"i0 THE., oUND FIELD SURVEY' ,. EXISTING BUILDING AREA - .. , . / / WERE::OBTA E 0 N GR BOTT01 AREA. 74 .x 12 880 SF -,. ON 4 ,. . ,_F C ) - x / / �: : ; ' � ...,. 3.F3 / .., / ,, : -�• : PERFORMED BY BAXTER=NYE ENGINEfIIING AND .-SURVEYING �! .� TO REMAIN do BE,RECONFIGURED } TOTAL. EFFECTNE LEACHING AREA . 1232 SF r�� - /, /, . 4G.G. / ! �. 2T / L.C. F`L�+N ,t_9S. r . NOVEMBER 3 dt 11. 2005 , s SYSTEM DESIGN CAPACITY = 123 .SF. x 0.74 GPD/SF` 911 GPD s �' ,' .- /,. o T,___- « � / / , ,. , , ^�, r ,.. 4 / _ '' 6. N+'F NIC:HOLA`" C. MCC�F.E�. / / . - I / X %, ,. / , : I 4 n SEPTIC TANK SIZING. 880 GPD x 2 x 1760 GAL: 4f).y , _ r i , ' ,. /' < . _ r_: _ • / I. / . / . _ , .. EXI'STiNG BU G AREA TO BE REMOVED r .. / ., ,. :. � � ;,. ,. . ,, i;, ;. , r USE �000 GAL.ON TANK INi UM): / �... ,.. , ". / . .� .. 3 . ._ ,, APRON _ �: ;: : c r _ b.7 t 1�..� / / . ,„ / 'l r / / , / / �. 3 .. , 3 , ..,. . a __ _ __ . OPOSED , , L , / t _ . / - , .. PATO / �. • .. , , - ,,, re .. 'v , .. , / .. ... .,, ., , .. '7 TOP'OF FOUNDATION 49.0 _. , /_. /. :,, . .. . . I. / aif / / / , /. / / / / / / ,,. _ .l / . , c�. p...Vr R c +t.;..: / F / / - , .' F / , . 4 / � / - c. - ,.4 / / , / / 46.5 8 .. _ / / , 1b v...,..... C , a y �. RAC , / ,� 37.7 ,x a .►, /._ INVERT At fnUNDAlION . / _ .y., r.. � / ;:. , � . �y. SEINER /. /: / .:.. /..: - 13. r. / / / . .• /. / :._ SEWER INVERT KID SEPTIC AW _ / � , . 4('-2 , ' _ - I Y �,0 I :.` �. / / . / ,• / / 27.4 x r.J:7 SEWER INVERT OUT OF SEPTIC TANK 36.7 1k /r 1 (+ , I / , ,/ PIT #1 . / / , . . 0 4 , a. % �/ / w .3fi.l y / . / / , DOSED GARA / <- „ / , F, 36.5 i / r / . t / / / /. / / / ,+ 36,3 / / / . - t , �.. / - 46.3 & / , / , / / , / / / / , t_ ,, . ? _ , SEWE14 INVERT INTD LEACHING CHAMBER 35.1 /_ . ,',.1 ,, • / / . ,,' y _ BOTTOM OF LF�ICHING CHAMBER 34.1 4i••7 - , 1 / I / / / - Y 303/ 0 �, . I 140TTnM OF LEACHING SYSTEM 33.1 ( ' t! / /' ��•' -, /// v / NO GROUNDWATER OBSERVED TO t1EVAT10N 24.5 I -L _ '45.3 1� .��`��; L p / i / : c / / ' ;' ,' ,' ,' ; ?Fit.1: Ml,G tJA!1. .`,rT �' , l.' I! x ni3 / 1- / If - i i / ,'' '! ' ,/ / �'�.A.1"ri/ /• '� .1 r1= _i' _ - y� / / w El_, - 46.0F, NGVD I - i' +, I ( /�( I �J� / .3. ,»• p,- / / , / / / / ,/ / r-ti ..__T._._. ._.. -._.__ •• //J, '�-PRvrV.7c.Y I / .t ti# � - ! / / /i i / ' / , / ,/ . ._ 1r r , / / /I / , / / // / / , k i2• • I 1 --u:e,- ) 4:2 y l 1 I ASPHALT,DRIVE / l ? j / / ,�' / / / , �` r Ci T i n a,'/ : FINISHED GRADE INSERT 4 PERF. PVC 11 46.; " i l ° `/ / -^'`' o i / / ' / y ' COBBLESTT11iE i ..� "! / / / / / (p "' t T APRON t. I / '/ / /� / ,• rr i / r I 1 J. / 1 i . - , / 1 f MAX. 9 I COINPAC �LL 4�. t . I r / t 3 M N TED � . ,:. . , 4 , y r I / /. / 62 F ,h x 4 �: , � 2 LAYER DOUBLE WASHED 1 r :• _ HAMBER .:. , . ., ., .. / .gin . TOP OF C o / - / x �, a w / 4L' K ,. / , , v STONE 1 8 TO 1 2 •.. I / / FABRIC _ .. -ram- :.t , �� I •OR GEOTEXTILE RT I ' PIPE INVE ,,, I r r :• J / i i , J/ l / W f / •� s ;v / i / . Cotu� Massachusetts / 1 / / �. D , . / / }� �__. ii - M t w •„ -r'/- ' 7 - ..s. 1•. /J / / r / ,. _ ray. . II "-'`.1,...",.,./,,I;.1,./_I/,1/C.__�I I:I.I._I,_.,._..I I 3 4 TO 1-1 2 V_ 24 ,.._44- • ,' I.-.J l / / . r / PREPARED FOR _ , DOUBLE WASHED EFFECTIVE I< <� ,o ; ); .n ,7 , ,/ / / / I / /I f l ,/ l �v--i + , // �r { Dennis M & Catherine S Berke .,--.I_*.,.----I.- .I.. ., I1lIw1.i.I 14IIi 1...I.,.,1....-,I.-'._.'I;I,,"16_.,,.r"I,I'_I_-_,4I"-1.__I I,I; IIIii!.;I....I11' '1Wf1I-Vf;_1,(UiDL0-._.r�0UI.V47-9�-1�.4-)I).,I,..1 -.,I - .I. . ,- I..,rI 1.1..- .I1 1:,i__1"1�I..1 '� / \ DEPTH C? r> t !: / / I / / / / I 1 Ix J'9/t- r y STONE + ,�; n �L� ,,`' �c. / ` ` ; I , O i'B OH FND �-`^'„✓ �` x 40. o� / / / I �ti� C x 1 I t I c 0.9 ( x'19.5 I - ,4• 4I ,4• ,.i v � , 1 G9.3..5�.� n,, 37 -�' ,�� Mb �� ^ UX S I r �)i� 1 S Z r> rr •' - .-' N 8Tz7.50- 1y"' ., . ev 1 r•1 I - / / 1 ,. SECTION I c, - ,,- z )II rr I(1 Proposed Septic system Plan H-_I./I,I I_.NA(,./I 1 1 MX ; ' / NOT TO SCALE ./ / ,' ,/ r r' �4 _I.:� �=\ PLASTIC LEACHING CHAMBER DETAIL I `i L-)\V/-\E L.C. P, ': 31395 ' BAXTER NYE ENGINEERING & SURVEYING . i - '!/F F�r,TPICA 1CORE x 19.5 Registered Professional Engineers and Land Surveyors :., 78 North Street-3rd Floor, Hyannis,Massachusetts 02601:' -' ' TY n 0 - - 22 r �* PICAL SYSTEM PROFILE Pho e - (s 8) 77l 7so2 Fax - (SOS) 771 76 - .a r " t., , NOIf .TO ' IT. LINE IN - 4 D N `'o LF1?It1!" TRE" - 39.0-37.5f y , _r +.- o .1 •t PROPOSED T>O.F. SET ALL THREE COVERS TO WITHIN • w` �Se: E 3 ' . EIEV 49.0 [3. OF FINISH GRADE ?��w ,;\ r `, _ p N 1 ., . .;.;. ,. . 3 4 . 1 1 2 .• PROPOSED GItAOE t9.ft � Y�( cow SG ,,.. _ .. 20 0 20 40 T - � All ONE INSPEC110N PORT FN _ _.. arsT -_ �� ►'�M ue WANED -stoN - I- _ " ,., 36;•("cool). '�,w NOCQRDANCE w11H .. _ FNrISHED FLOOR PROPOSED &9" M TANK - 39.Of 2- �l/� llr MANtff•ACIAIRERS SCALE IN FEET � _ • ELEV 39.3 DOUBLE WAM SW RDDOMMa1QAT10NS . . ! ;:� t>io ]�21• 2 74, 2 :• :.- _ . , I Im t�bloE OVER D. BOx - 40.0t oR cmrExllLE FABFitIC t tLFACHING � SCALE:1 =20 �'c ,9fGr6hP` w 6 „ ' 3' MM /O�rfAl .:, SET GONER TO WfTHIN d OF FINISH pW� My v PLAN VIEP,' 4 scH 4o Puc ., . GPtADE R 3•u-fl7 t NOT TO SCALE IMr- 37.7 , 10 PVC N OUT- 3fi.7 I II. I I 0-.-.!I0�.iIII�il!l!I-.,NI-,�ii.M-.l.l1.1..-r-..�-.----.I--".-i_-1--.I!--�-_��1.I�_��A.,..I I-..1 II:f.11I.III I1%1'I7 1s,.I..'I.'I I rl, = MiV N- 37A u FIRST 2' TO BE LE1�EL I+ BOB. ! jo . ., "' A •t N DATE: 03 01 07 . „ MffLE 3/4 TO 1-t/2 OOUEILE i r I4• I, Y ,' Ii NORCED 00NCREIE _ er sIRP . otrr. 363 3 Cr No GROUNDWATER OBSERVED ELEV_ 24.5 6' CRt1SfIED 2400 DALLON ONE-0QIIpAI�ilT SEPTIC TANG Qf�O) s70NE eASF N0. BY DATE REMARKS I - 1O 6E /fSTN1ED ON A LEVEL STABLE BASE DESIGNED EIY: SAW Dww WJLW sEJ•nc TANK m BE FilSPO= ! pFANED ANr1lMILLY «STALLED A LEVEL �„ B FxIS 0: 2005 05-215 sury worksht 2005-215SP.dw . i :, ` 2005-215 _ i ; � /� 1 - . ) - ' . . . i - . _ , 5 . - _ _ - - _ - it � {!• •y,(J/f • ".lip !! 4' ` "J n�,•Y.f�•��' �`�[ •N :„a..e�. � '` .•, �y. �.• Ion l°� f;� ,c'"� O w` !G •� Crsn �t y 0GENERAL NOTES 1 HDo : 0,895 AG 2Q° I 1.) THE INTENT OF THIS PLAN IS TO DETAIL PROPOSED NEW CONSTRUCTION K. R I)I_ RIC,.AR;_� •1. U I' ,x AND PROPOSED SEPTIC DESIGN AT LOCUS. • yy p - d i 2.) LOCUS AREA IS COMPRISED OF " ' ,�� BARNSTABLE ASSESSORS MAP 036 PARCEL 059 c 90L LOOS PIS W50 DATE " fV1s/2006 n,. \ + . I :_A, o• Njo - � LOT 6 N LAND COURT PLAN 31395 C „ BAR STABLE APRON '. CERTIFICATE OF TITLE 178,279 . . t I't'' SOIL EVALUATOR: r, 2;' ti,_8. _+' rD nh I FN :Mandy • BOARD OF HEALTH AGENT: �� - pt STEPHEN A. WILSON, P.E. DON DAIS OWNER: DENNIS D. BERKEY do CATHERINE S. BERKEY ` °hro ' ` �!H 1 1 DRURY LANE - F -- Noisy. TEST 1 TEST 2 � - r-�• (p `�'' •-•' '� s PIT � PIT � :, - - -- - -„t t _ _ WORCES MA 01609 g4 - }•:•t ? G.S.E. - 34.5 G.S.E. 35.7 Q Pt 1y �x '�. ',,.•�'•,. a�lf --,� AP SANDY Law O•AP SANDY LOAM - n -1,7 L - . . ' as.rY�; ~` �i '� ��% ZONINGINFORMATION Y n 'i O ••, • 4 Ub 1t ,y't' '�'; LI• • / I ' colic. c.,RB.� .- QRU " �Eb• �'^ ' L.:. �.• ZONING DISTRICT: RF Y 10 Y �' �- 10 33 7 32 '�� 1 Dom•� • w Landing , 9 9 J Z ' - - - �. - RI oCN F�'STON;4'A.:_Lq - OVERLAY DISTRICTS: RPOD RESOURCE PROTECTION OVERLAY DISTRICT �4tuit 5`,. SANDY Law SANDY Law a 1 r�: '.> <j% • - I _ --- i a � x ,j _ AP AQUIFER PROTECTION OVERLAY DISTRICT 16 10 Y/R 4 6 18 10 Y/R 313 ' it G Y EXISTIN�s I I I fil I. s I�' �?. I S I Tp REMAIN TD E1E _ I �'„ d DP00 DOCK do PIER OVERLAY DISTRICT LOCUS MAP Scale: 1 = 2000 C I C, N -- ;- �_ 41j, _ _ 1MORKSHOP - R"�D ' x /.FLr TO,,F -,� ! , i'� WP WELLHEAD PROTECTION �G-a MEDIUM SAND MEDNM SAND '"1 ''I ' f < { - j v �' `N l.K ✓ q `� ,' ,1 �� _ I ti , n 5 3 I r� ; , ,r MINIMUM CURRENT ZONING REQUIREMENTS N ZONE RF 30' 10 Y/R 5/8 120' 10 Y/R 5/6 i ' % o k'44r3 LAWN! MIN. LOT AREA = 2 ACRES (RPOD) LEGEND a MIN. LOT FRONTAGE 15 I � MEDIUM SAND c 5 L;a7,b l_ - L -L - ! 45.'� /- fin` �I ! � - pQ WATER GATE/SHUT-OFF 400 10 Y/R 4/4 I - -' J �' , t i i !:1 r' ,' /' / '� N FRONT YARD = 30 SIDE & REAR YARD = 15 44.7 MANHOLE Xj - -�- \ t ® = GAS METER MEDIUM SAND �} CQ^ICR Tf` a h`'` ' ._._ •I Eki,`;Trl. .'? STORY ® = ELECTRIC METER t20' 10 Y/R 6/3 j 4 E,: - i �'� r t u_,Nr I _:,5; /' , x 4?.9 ' I,, , -R, 4.) COMMUNITY PANEL NUMBER: 250001 0018 D Ib = HYDRANT NO WATER AT 120"•(EI" 24.5) NO WATER AT 120-•(ELEV 25.7) ! • ' r; r, - -- - - - ' I _ / 4C. C` 13 -� i f•� THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C. - FINISH FLOOR ELEVATION PERC o 54 PERC O 54 ---- -� -' - 1 ,, i RECCMFIQ)U MOM I � f -- '_` AN AREA OF MINIMAL FLOODING - PERC <2 MIN/IN RATE- <2 MNV/M X 10.0 = SPOT GRADE CLASS I SOIL CLASS I SOIL ( i�3N,: -n.r; [3t�._ 10 = CONTOURS EL. - `0.39 NG�iD 1 > �� a.i - 4p � i_!�I; I � - ,i 5.) PRIMARY BENCHMARK: MHD STATION 68 N11A MONEL RIVET IN TOP ti : SOUTH SIDE OF CONCRETE STEPS IN FRONT = STONE WALL LEACHING AREA REQUIREMENTS LOT- - - _� ,�: ,, -- , fz TE \ 6 w = WATER LINE _ a . "�.` / , v OF HOUSE 428 ON MAIN STREET OPPOSITE - NITROGEN LOADIN A77ON: NIA (� \ L.C. PLAN 31395 C ;' SCREECHAM WAY EL - 62.53 (NVGD 1929) GAS LINE RESIDENTIAL: x BEDROOMS 54 `f/4/a� I � Hw = OVERHEAD WIRES ••,_ , ` ` :/ I b. L z _) % 75,470t SQ. FT.. ,,' �_ PROJECT BENCHMARKS: SEE PLAN = TREE LINEx 110 GPD/BEDROOM Co _�r-•;, ` �` 1.73t ACRES , TOTAL DESIGN FLOW = 880 GPD I ; ; ` �-4: F PR -I ^�sr0%E '/ ' 6. UTILITY INFOR ATION SHOWN HEREIN: = TREES do SHRUBS W �. Y i, CRUSHED SHELL DRIVE ) ,IV1 Y, GARBAGE GRINDER (NOT INCLUDED) = N/A I ; 3. t �? t ' - r �-� = UTILITY POLE/GUY WIRE LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND �' ' / ,x 37,9 MUST BE VERIFIED IN FIELD BY THE CONTRACTOR AND PERC RATE = <2 MIN. / INCH (CLASS 1) �: I %.'- ar G` , APPROPRIATE UTILITY COMPANIES PRIOR TO ANY CONSTRUCTION. LIAR - 0.74 GPD/S.F. � �`,'E� � -' ' �' � % KEY MIN. LEACHING AREA OF SAS, REQUIRED: E"-� P ��,�,�, ,'; , ! PROPOSED RELOCATION 7. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE. ! - �. /.l j b RECONFIGURATION ' / 33.E / 880 GPD/ 0.74 GPD/S.F. = 1190 S.F. MIN. „ �: /. IF DETERMINED TO BE NECESSARY A TITLE SEARCH SHALL OF EXISTING 2 STORY ' PROPOSED NEW CONSTRUCTION <`; ,r BE PERFORMED BY OTHERS. PROPOSED SYSTEM: f ,r f WOOD FRAME DWELLING 11 N PLASTIC LEACHING CHAMBERS O TOP OF FND 49.0 x 8.) THE PROPERTY UNE INFORMATION SHOWN IS BASED ON CURRENT WITH 4' OF STONE ON SIDES do 2' AT ENDS > W -- W -- yV W ;' w .;�,., i TEST PIT #t AVAILABLE RECORD INFORMATION CONSISTING OF PLANS, ~ g � CERTIFICATES AND DEEDS. THE EXISTING FEATURES SHOWN HEREON SIDEWALL AREA: (74 + 12)2 x 2 DEPTH 344 SF Q+ > P�Rt�"y'� , �• o. ;' EXISTING BUILDING AREA BOTTOM AREA: (74' x 1 = 880 SF WAS / ��}�!� WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY TO REMAIN do BE RECONFIGURED TOTAL EFFECTNE LEACHING AREA = 1232 SF i r ;; x `; x' !` - % �; PERFORMED BY BAXTER-NYE ENGINEERING AND SURVEYING ON r aF,._ r `` y x<y 27' I_.(_ cCaN t NOVEMBER 3 & 11, 2005. SYSTEM DESIGN CAPACITY = 1232 SF x 0.74 GPD/SF = 911 GPD ! r o O/0 /f '� iJi` NI(:H01_X,3 C. SEPTIC TANK SIZING: 880 GPD x 200% = 1760 GAL EXISTING BUILDING AREA TO BE REMOVED USE 2000' GALLON TANK (MINIMUM) COBBLESTONE,� APRONPIP „ a :,, s. .� •, �, J J ' PROPOSED r PATIO TOP OF FOUNDATION 49.0TO BE R �r SEWER INVERT AT FOUNDATION 37.7 r J QED J :• I �` �/ SEWER INVERT INTO SEPTIC TANK 37.0 - --' ----------5, 1 ,' TEST PIT I�1 SEWER INVERT OUT OF SEPTIC TANK - _ 36.7 PRO"ED r I i ' SEWER INVERT INTO DISTRIBUTION 19OX 36.5 .. ti - GARAGE t -SLAB EL.48.0 SEWER INVERT OUT OF DISTRIBUTION BOX 36.3 SEWER INVERT INTO LEACHING CHAMBER MAI , 6.3 BOTTOM OF LEACHING CHAMBER 34.1 I 29.5 %: �► '� �T P BOTTOM OF LEACHING SYSTEM r �`' " NO GROUNDWATER OBSERVED TO ELEVATION 24.5 PROPOSED 12' I I 5 `ASPHALT DRIVE T _ 5// J�_ !nPUr� " i J� •� ' rY ! ,• .''� ,'� , "' 1 ��^ J'o ohI ,�h[...,/ar,„U/'>^I�t FINISHED GRADE INSERT 4 PERF. PVC /� (J(, .4 rIJ (XaB�.ESTONE /lh� �_' -� /_ •.` 'v'-. / c / /, , /// / �`" / / ✓'J1( I►"'y S,YA.�IJ��, ✓` ,x Mo'd. T !, rt- 36"MAX.-9"MIN. �� COMPACTED FILL/� �� I x 4f,,d rRR{{'�"\ 2" LAYER DOUBLE WASHED �- / / / / = TOP OF CHAMBER * 462 << �• .:� `��t ,' / : / ,' ,� ,' / 756 Main Street STONE 1/8" TO 1/2" ! , OR GEOTEXTILE FABRIC tO PIPE INVERT Cotuit, Massachusetts 3/4" TO 1-1/2- N 24" I --_ ,` ��! ,' f j j! / PREPARED FOR / 1 DOUBLE WASHED EFFECTIVE �' �: Dennis D. & Catherine S. Berkey STONE DEPTH � � r> ..•` ;� / ; �! � ,�,J �.�:, ! �'. �„ ��, I � ■ ■ ram.. x ao. x C4. 5 :1 I r z ',•- '. M'' ,� ' ! I I '' .� I J / TALL LA 4o 41 4' N 3;, Go iJii.'. SECTION - - ,- , CIP , FHD Proposed Septic System Plan NOT TO SCALE r - PLASTIC LEACHING CHAMBER DETAIL F PLAN �c 3'39.`; ' BAXTER NYE ENGINEERING & SURVEYING � v Registered Professional Engineers and Land Surveyors 78 North Street- 3rd Floor, Hyannis, Massachusetts 02601 C'4TYPICAL SYSTEM PROFILE Phone - (508) 771-7502 Fax - (508) 771-7622 4 _ DIST. LINE IN iv NOT TO SCALE "` FMfSHED GRADE OVER LEACHING TRENCH • 39.0-37.5t :'`�,1�t)f 00 PROPOSED T.O.F. = SET ALL THREE COVERS TO wTTHIN 9 min Cover 20 O 20 40 y �TE MEN CN ELEV = 49.0 6 OF FINISH GRADE COMPAC ED FILL ��* 3/4"-1-1/2" PROPOSED GRADE 39.0t ' ( ) INSTALL ONE INSPECTION PORT IN FIH�+ED FLOOR ( MANUFACTURERS SCALE IN FEET y) 0DOUBLE WASHED STON PROPOSED GRADE OVER TANK = 39.Of 2' LAYER t/8"to1/2' Sr �) Cover ACCORDANCE WITH No.xa1e DOUBLE WASHED RECOMMENDATIONS SCALE:1 =20 Y Y ELEV = 39.3 OR Ga07F ALE � 11 - CULTEC [TYPE] p�� GrSTEP 2 70' 2 FINISHED GRADE OVER D. Box = 40.Of LEACHING CHAMBERS �S�ONAL E!� 74' 4' SCIi 40 PVC :y...,..:, 3• MIN. SET COVER TO WITHIN 8" OF FINISH CIWIBER INN PLAN VIEW _ - - GRADE L, NOT TO SCALE INv= 7 s _ W IN- 37.0 10' MN. ? INV OUT 36.7 I R PVC _ a FIRST 2' TO BE LEVEL t •1 o GAS BAFFLE r 3/4 TO 1-1/2 DOUBLE • DATE: 03/01/07 2• WASHED V 148 ~ INV IN=36.5 :• 8. SUMP • OUT 3!f 3 1 8• CRLGM _ _ y RONFORCm STONE BASE - - 1r+ ,.% 5' MIN W t NO GROUNDWATER OBSERVED ELEV. 24.5 SP s' CRUS♦ D NO.I BY DATE REMARKS 2.000 GALLON ONE-CObPARTMW SEPTIC TANG Of-201 8% ABSOFip" SYSTEM (SAS) DESIGNED BY: SAW CHECKED BY: DRAWING NUMBER ' TO BE INSTALLED ON A LEVEL STABLE BASE BOX *20) N SEPTIC TANK TO BE WSPEM CLEANED ANNUALLY TO BE MSTALLED ON A LEVEL STARE BASE NTS 0: 2005 05-215 surve worksht 2005-215SP.dw L 2005-215 o � O z N O �TrT�T�'T'J'9'TYT��7T l?- '110 AREA OF 021760 N DOW00 LOCAUCN CS STUDY / / e ATH ---------- PROPOSED ------ - PROPO RQ ' DECK PNaPCED $i DECK PWOPCaD i F R 11 BEDR ME-JSE ME-AMRE-LOWDRL DOT. ------ 10M. r---------------------------, ' O BTM SECOND FLOOR PLAN ' I �I ON aW rDCAnD -------------- - PROPOS BATH Doors!VOODOO BATH I I TH DECK N10oM„`e um mmwa 0 , ' 0, PROP WD LIVING B1� i ' 1 0Darr. Ma�ISE DSSMrMD ____ _ Dear . BEDROOM ;3 L---_--J PraPCMED ' BATH 1Prd WORMAM Or DrrRa Mwar STMXRM' MEMMOMD To VO DoanOa WORKSHOP BEDROOM /2 I , GUEST BEDRM. - VOOow ON rE-Y! , Dean. Pro-am EMLti. BEDROOM /5 FIRST FLOOR PLAN INS AMA or Drina rrrarraE To ME MGM WALL KEY O EX07M WALLS Barth i e'-i'-0' v'wiesi~s�eawwi M ID WALL KEY WALLS TO NE 10NOcD ��w• ww'w'i. O Drina waa eCN� 1 '�1'-0' '�� iiww� _ ODPYRNil1T DALE REVISIONS A,• �,�wa wiSl H;OIMYIeOHT DATE REVISIDNS �SECONZJLOOR PLAN NORTTHSIDE MMCrHs Mnor OaPar oEsou SON �iA. WORK SHOP NORTHSIDE MrorMMwO Hwl.r DaPMrar rEtoew nS COMMON MArHRCPOED rwLs OF o H. 4 e !e , ,,.,.�,vw, DESIGN IWINVES m�u"� �_____� ""u"°Mr"°M°'o o a a e !e � DESIGN ca•"°°'r.r�s M'�"Ma ARE am"LossPROPOSED ADDITION ASSOCIATES �A! � ® '"'0®'""' *. , ••..mow PROPOSED ADDITION ASSOCIATES SHEET Na DATE. "gWgW �'• aaNrm CVO OOM a ANY DRAWN JH SHEET NO. DATE sy'�.Y' NOT TOD at CQm N AM DRAWN JI � �„« for BERKEY RESIDENCE ,■,,,,,0TNOT�ANNS„E �i Ma,TNETorm.ON„rc in.M ar MHwwMr HMAIIDEMN Or K Y I D N C nm an MAMM"'ATso m A.2 to/oe/oe �.w'�' w��,w 758 MAIN STREET t 001•EIICiv OEM pa,pr VOmd learrrlON A.5 1o/oe/0e """"mod�,r, 756 MAIN STREET Oa1NCI1YE RESODHIML!o010EIKIAL m01M pa,�gym,POSSUM ta, srMMar•wMolouo�ewr•w oSrMS uO CWl1Mr Oi NORM�E ,�,� SSMw•w tat rMMm•,ewle,N,oOwt•w oarMr AND CONENT a'NOWDOI[ Cf1Ef:IfED ewwM w arowwr COTUIT, MA �a�-�O aMMrM See eeMM onMaM w Mlw,orea COTUIT, MA. Maw�waM�ene M•.M a.M�..e oEaa1 TYPICA!LL NOTES: EXISTING FIRST FLOOR LIVING AREA 2601 S.F. EXISTING SECOND FLOOR LIVING AREA 2114 S.F. LA ' EXISTING LIVING AREA TOTAL 4715 S.F. EXISTING GARAGE AREA 736 S.F. XM1fi6�Lo MM 'i 'i wAM o �T%T-M1ew1YT7T7T)�-7/ / T!T 1 �/ \ —— 1 NICK Ca,nNO .m,DMaaN VOA lA M A N / / / / / FIRST FLOOR LIVING AREA 2871 S.F. I r—— I nr�a rorW MT a i // SECOND FLOOR LIVING AREA 2358 S.F. I I I L— / -- --------GUEST LIVING AREA 649 S.F. --------- LIVING I GARAGE [AREA TOTAL 1212 S.F. j I r— — — —J I I HeTAOwa WALL MASTER BEDROOM I I I I I I TMar AKA OF Donna // // / 57ftX M 10 R AAW / // // FIRST FL SCREENED DECK AREA 224 S.F. I N DOW LOCA7M PATIO FL DECK AREA 377 S.F. ePW BREEZEWAY AREA 234 S.F. // II II/// ernes WALL SECOND FL DECK AREA 1147 S F. I ( I I I I 1 I ---------- ------------- PORCH . / // / // DECK PORCH/DECK AREA TOTAL 1982 S.F. — I L------------------------------------------------� �——_—— J i i M vg TH I _1- I DW o o ow I --� I I 1 PATIO PAV r I I POWED 1 l BASEMENT SLAB I I I >y l I FAMILY ROOM l \ fi�t,, L- I r � KITCHEN i PATIO ♦ 1 e I I I 1 oilPROP I BREAKFAST IL �exMDQD) i 1 IA =rA Now aw UNFINISHED EXERCISE ROOM FAMILY ROOM I I I I I I I I 1 STORAGE I L--------------------- I I ; I L I I l -----� _ I -- --J E a zg 0 — o MMraCea I I II BREEZEWAY SLAB PRPE BATH BREEZEWAY ON ——————————————- ------— •aoLe�Hww�°r Tr+ ADO I III GARAGE SLABLn I I <I N DneartAaocrt cvnEMr — 1 I ( I I ProPoeD _= DINING ROOM oil —— —— GARAGE o ODa SELVM! T nomM TV —TAM I I 1 I I I I I STORAGE j 11 ,� • e I I i SWVASE Ohio ,. 1 LO O I I I awl I I ' ; calm I 1 UTILITY ROOM v Mxstaa II 0CIM TO ME Pr.aroeD MrDMaID L-_ rI MEDIA ROOM I 1I II II I I I I I FOYER 11 LIVING ROOM I I I I 1 I I 1 I DEN/STUDY I I I tI I H_ ____-- - M I I I I z lir SR AREA OPEatsna Received L------------------------------J TO SE �x BASEMENT NOTES: I 1 :c> a DrrPaa sPMrMOPrMat I 0 I O C T 0 6 2006 U 1.ALL MMrs�rNICrUIfSMLpAftp SHOW,. roonMorir°E�iS araw'rMOa uww uour L ———————————- � 1. ��a �� ,u! -———— B } i DDLUA RM.merO=0 ALL PARALLEL PANW110 a Baxter Nye ♦CONCER eM Wl SE r POURED Ana ON OMPAC 0 ILL w = alr �A� Engineering 8 Surveying y WALL KEY w AS O DOrINC Maus WALLS TO SE NEAMDYED MMut rwT ALL MMIIaOA,MMN eWD MMAMMMoIa U ® PROPOSED WALLS An,Lon 9CAIA 1 '-1'-0' A,n�i WE aai'Siwcp r w � 1. 8C� 1 e'-i'-O' AeaMa>t awwMMn. w" r.Hare[r SPneeMS ruin AT aeS w srm MMvnM1 TM. a• rwr Q Maw,n•a Ma. 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