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1019 MAIN STREET (COTUIT) - Health
1019 Main Street Cotuir A= 034- 023 i II I '� II j I i i TOWN OF BARNSTABLE (dARR1AQc- 1 LOCATION I01c( (` Ato. :5 i 110056' / SEWAGE# VILLAGE C p-G 0 1 T ASSESSOR'S MAP&PARCEL 34 2. INSTALLER'S NAME&PHONE NO. �czuD� �3TER��Qli.SFS (-L C `f 77 SEPTIC TANK CAPACITY 1 500 CAAe,wlj . LEACHING FACILITY.(type)(a) " (size) dbt Y I NO.OF BEDROOMS S OWNER_DAYIP f, 3-oAQ CAASe PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NIA Feet Private Water Supply Well and Leaching Facility(If any wells exist on /A� site or within 200 feet of leaching facility) H Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) // NIA Feet FURNISHED BY T rA `p A-3= 0Ulm t �La _ A-42 29.4 A -S-- 32° 35' A-1 � 3z g° 14. 1 a 2o•g� 0 �'� 29 A l� No. � � A/�/`�' Fee THE CO ONWEALTH OF MASSACHUSETTS)I E compu r: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSA TTS I4plitation for bisposal 6pstem Const uttlon i3Prtnit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) AComplete System ❑Individual Components Location Address or Lot No. i OICJ MAW ST <vTO LT Owner's Name,Address,and Tel.No. ziRtA Assessor's Map/Parcel 3T/oA� (641 - ✓ po Aap . 1(;,(. �► Ty,-t mA In�st�1 er's Name Address and Tel.No. 5o2'4-17-,99T7 Designer's Name,Address,and Tel.No. 012-�-?3-0 3-1'� C�tMw"be L-i-c- aC. GNere.1�ZZt&d6-, :TMC 15 CO AC-Sr n5; 6kAtj8b- Type of Building: Dwelling No.of Bedrooms Lot Size �(�� sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) vZa® gpd Design flow provided oZv2 5.7 gpd Plan Date q— 13-,9L0 16 Number of sheets � Revision Date Title 1®1 A1V S°Tkk;&-,' Cb- u Cr Size of Septic Tank I g Oo c9-L, Type of S.A.S. �D k l <I- tAaa* Description of Soil Nature of Repairs or Alterations(Answer when applicable) aVST44_L, Q&k) [ q] G--FLEW 59?< TXvL-Ix-- To weto 1.4-aC? 0,-6pX -rb C A� L 42 —(, C"wA W iTL-4 75 ' o�- Qc- p6 Vobp2 4fjiD 3,S` ON 5ope2 MJ 4-` ©tj �7•P�S 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"is Board of Heao,.N ° Date b Application Approved by Date Application Disapproved by Date If for the following reasons t Permit No. Date Issued Iry No. to �!/Y �(Y!/ Fee ` THE COONWEALTH OF MASSACHUSETTS� E to d' �comput'er: Yes PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSA TTS . application for MispoSal 6pstem Construction Permit Application for a Perit to Construct( ) Repair(X Upgrade( ) Abandon( ) PSComplete System ❑Individual Components Location Address or Lot No.i 019 MAW Sr c CoTo eT Owner's Name,Address,and Tel.No. `L �CAWi�S� DAv(D * 3OAjo C fA5c Assessor'sMap/Parcel 3T/p� PO s® 166 <rtDrv(i /"A Inst�.1 er's Name Address,and Tel.No. 503-417-.981-7 Designer's Name,Address,and Tel.No. 5026-a-73-O 5-1 la L�iv"rERPr415ES L�I_C- Jc- -We t 3 C o ,+L sr 046 aS 5 GlL4�8� w �. G✓ fF�4�( Type of Building: Dwelling No.of Bedrooms 01 Lot Size 4k+E a.0 4± sq.ft. Garbage Grinder( ) Other Type of Building R63(bGX/1-14L. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) off'a0 gpd Design flow provided OL;2 $,7 gpd Plan Date 4~ 13-;L016 Number of sheets Revision Date Title I D 19 MA I U t5 Tt26&-r C!aTV (-r Size of Septic Tank 1,500 6&g-L, Type of S.A.S._) W G{,L.oN.j <1i4Aw4a S Description of Soil i Nature of Repairs or Alterations(Answer when applicable) :370$-[4u ��i (5 44) &.A-uo&) $ep•Z 1 G T?+i,K- TO N OLO 14-90 ?y �A) LC --6, C.H*,a AC w 1 Tf-4 r •1$ o .�C-�bQOtt u 1•JD Gk 400 3.'S1 ON St)G& Atip 4 om G705; 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 b is Board of Heal Date 4 (5iplo tb Application Approved by _ Date Application Disapproved'by Date I for the following reasons \` _ A Permit No. Date Issued -----.---------------------------------------- ----------- ----------------------------- ---------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS } Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired('O Upgraded( ) +. Abandoned( )by 0_ P[-,l.oi ' at 10 t 14 i 1J SZ" �z 1`t�(T �Ci4�tk1 AGE H E�has been cons cte i acc rUd e with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer QAPG-4OttDE &JT-m_ .A4SFS LLC Designer �C /W rgML,&- to<- #bedrooms �,. Approved design flo �,.�.Q gpd The issuance bf trrh' permit shall not be construed as a guarantee that the system wi fun o as desi ed. -'Date "1 b Inspector Q -----No.-----------------------------.--- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction �ermit Permission is hereby granted to Construct( ) Repair( x) Upgrade( ) Abandon( ) System located at ( O 19 M A I IJ STet�`C C.0_rO IT ,YCAP..,RI Gcs HDoss and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons io mast a co pleted within three years of the date of this permit. Date �� Approved by lip/ks ■■E041120/2016 10 A3 5082730367 44 qua r'. U11 !! i ■; Town of Barnstable. �oE r Regulatory Services Thomas F. Geiler, Director BARNSPABLE, Public Health Division J o t670• s�� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: F08-862-4644 Fax: 508-790-63c4 Date: 9 �� _ Sewage Permit# aZD Assessor's Map/Parcel .1 la,3 Installer& Designer Certification Form ncsigner: C E')-k �Cti n�, Tvn C Installer: C- Address: Address: 155 Gc)vY1merc.t'13I Easi w�r2.h�m M A cz�.3F K Q , On .4- ( 5 - ao(� CaQew;.cke- CnterPns-1S was issued a permit to install a ,, (date) (installer) 1 septic system at i019 M&Lfj rcj based on a design drawn by (address) dated A ri 1-3 a; 616 (designer) 1 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. Stripout (if required) was inspected and the soils k cre found satisfactory. I certify that the septic system referenced above was installed with- major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if req nspeeted and the soils were found satisfactory- OF Id u J r7. St311e1' q 1,10 tune) NAt. esigner's Signatur (Affix esi e s mp Here)' PLEASE RETURN O BA.RNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE 'WILT, NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BOILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION, THANK YOh. q'al'll:c i'arnu.J,s�mrccrul'icali n lbnn.doc Town of Barnstable . P# Departiment of Regulatory Services S MUNHUMA a Public Health Division DateMAM ' � Ia39. 200 Main Street,Hyannis MA 02601 plEl1 Mltt� ••, IV (� Q r Date Scheduled J Time M Fee Pd._ /�1" Soil Suitability Assessment for Sew ge Disposal N Performed By: tG�luZ( Cdtmer>�� , BT^I� C"St✓ Witnessed B : � Iv.. — y , LOCATION&.GENERAL INFORMATION Location Address 1 C� d•Y U t T Owner's Name QAtv to £ _ToAsl 60<4_(E l n�G4>ziLt C t�OJS6) Address,10tct C,1 4W 5"r .e—olrw I i C=AP6 Le_Ab Cpd7C�2�R1S�S [.fir; Assessor's Map/Parcel.• O3`T/Q.-3 En ineer s Name y Engineer's TG E�(�t�2fAJ� NEW CONSTRUCTION..' ' REPAIR '\ Telephone# 509—47-1 -Is$17. SU$-Z 7 3-0 37 7 Land Use 1?ES!DfiJrl9L Slopes(96)Y ^J'8% Surface Stones__N - Distances from: Open Water Body S,#So ft Possible We -Area ft Drinking Water Well �o ft Drnl'nage Way Ip ft •Property Line /0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) y i Parent material(geologic) 0 rAj4sN 091,44 Depth to Bedrock > iZ�♦ Depth to Groundwater. Standing Water in Hole: S Iu' Weeping from Pit Face > 124 Estimated Seasonal High Oroundwater IIra" DETERMINATION FOR SEASONAL•HIGH WATER TABLE Method Used:'D412 ' 06SY_V4Ttdn) Depth Observed standing in obs.hole: > I24 in, Depth to soil mottles: > Depth to weeping from side of obs.hole: > We ln, Groundwater Adjustment _„_,�f. Index Well-# Reading Date: Index Well level Adj,factor,,,�_ Adj.drnundwater Leval PERCOLATION TEST Data m o� Time fd!60 Observation Hole# t Time at 9" Depth of Pere Time at 6" , Start Pre-soak Time @ /0: 401 _ Time(911•611) End Pre-soak /0%i9 AM 4 Rate Mim/Inch L 2 Site Suitability Assessment Site Passed �- Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observtition Hole Data To Be Completed orrBack--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTICIPERCFORM.DOC ±` DEEP-OBSERVATION HOLE LOG Hole# e Depth from Soil Horizon Soil Texture Sdil Color Sol]. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucturc,Stones;Boulders. — Consistency,%'drayell O-1Z� Iru Cee—IM61p-5rd0e 1.041n-1 sw to .Yoe Sib WOeu �- 05 30- e2L' C Men zs y ��re DEEP OBSERVATION HOLE LOG Hole# 2— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munseli) Mottling (Structure,Stones,Boulders. i'et.e-- CtauSNu�O S/earu6 ' t2"-3o" � Eo9rn'� SAnrp IoYK Sib .- '"` meoevm SQn rU DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture rSoll Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth fivm Soil Horizon Soil Texture Sall Color Sall Other Surface(in.) (USDA) (Munseli) Mottling (Structure,Slopes;Boulders, Consistency, QMYCD l • Flood Insurance Rate Map: Above 500 year flood boundary No— Yes .. Within 500 year boundary No Yes Within 100 year flood boundary No.✓ Yes _._ Dej)th of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious mtitorial exist in all areas observed throughout the area proposed for the soil absorption system? fS If not,what is the depth of naturally occurring pervious material? Certification I certify that on 17^ (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and perience described in�10 CMR 15.017. Date Signature Q:WEPTiCU?BRCFORM.DOC r I Wal In h+ Clos CJi 7i.7"x V-10" Master Bedroom ----- 20'-0"x j 3'-2" Ceiling Height=14'-6" Walk ND CIO et 7-7"x5- Master B th Walk-in 10'-2"x 8'- Closet 6'-4".x 6'-9" o w Patio Breakfast 24'-0":x 28'4' Room Laund 12'4"x 7,-2 5-8"x -2" i i op b Kitchen , 19'-10"x'1V-1" _ i Closet i. _ I i ® Dining Room 12'-6"x-14'-9" Mudroom 9'-0"x 8'-13" � I i -I r _Rel- Sunroom ------ 264"x 10'-7" Study ; T-T'x 14'-1 V ; Living Room 13'-6°x 13'-10" Foyer x UP 6.-i^ UP 1019 Main Street First Floor Piar, Cotuit, MA 02635 Ceiling Height=T-10". 1 V 2' 4' Scale 1"=10',0" Bet 0 h I Bedroom Bedroom 7- O 8'-$"x 1014' Bath 12'-2"x 8'-8" --- 12'-0"x - ---- T-i1" Closet— } j _Closet - I —Closet- —Closet— 4'-8" Closet Bedroom 1'T-F x,1?'-7" DN 1 Closet — I I Second Floor Plan Ceiling Height=T-10" 1019 Main Street 2' -4 8. CoWit, MA 02635 Scale i . r ' V ♦Wr�� Patio 14'-01,x 9-9 o' s � Living Area 13'-8"x 15'-3" DIN 11'-o'veudee CelGng. � t j 1 4'.10;. - Hall � BED#1 ii 9'6"x 9'-6"x 11'-3''i 5`4" I ; � I Garage i '16'-5"x 17'-6" BED#2 9!-4"x,17'-0; ,i Carriage House-First Floor Plan Carriage House-Second Fioor Plan Ceiling Height=T-O." Ceiling Height= 1 Q'-Ti 1019 Main Street Cotuit 'MA 02635 "Scale r ,r ti Completed:October 2015 Note:.Dimensions are not NEWFINrG i.AND guaranteed and are provided `,PHO u a7 PI-IN' 9 t�PNt)ICsi1;a�Fi1' S F for informational purposes only. (600)328-0217 No. J / Fee G V—o THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zippl Latlon for Misposal *pBtem Construction permit Application for a Permit to Construct( ) Repair(*l Upgrade( ) Abandon( ) ❑Complete System 14 Individual Components Location Address or Lot No. 10 14j MAI V :57- 6 i J a Owner's Name,Address,and Tel.No. DAv i n 4- :r6A'N cl:fA5C— Assessor's Map/Parcel pat -bas )e l 6(o" CD'"Ev e i Installer's Name,Address,,aand�Tel.No.6709—477—ES 77 Designer's Name,Address,and Tel.No. Type of Building: F Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Date Application Approved by Date Application Disapproved by Date for the following reasons ^- Permit No. / Date Issued No. / /w Fee w V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,"MASSACHUSETTS 01pplication for Misposar 6pstetn Construction 3permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System `K Individual Components Location Address or Lot No. 101(i MA1 V $ 40' O i T Owner's Name,Address,and Tel.No. DAB 11) {- 10 /l1J<kA545 Assessor's Map/Parcel 03W Oa3 Po SOK I h(. C-)-r V t`r Installer's Name,Address,and Tel.No. 5708.-4*2-.92 77 Designer's Name,Address,and Tel.No. IPw A Type of Building: i Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd 1 Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank { , it Type of S.A.S.. i Description of Soil &Y i V '"e Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenanc o `the afore described on-site sewage disposal system in accordance with theprovisions of Titie,5 of the Env1ironment4.l-C©d'i lacehe system in`operation until a Certificate of" M- Compliance has been issued by this Board of Health. G Signed Date Application Approved by q: Date / Application Disapproved by '' Date for the following reasons ' �5. IUD Permit No. Date Issued 6 --------------------------------------------------------------------------------------------------------------------------- ----------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS e � Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(,X) Upgraded( ) Abandoned( )by C kP&4)(b-&. %VT&.1f&_<0S U.C, at 1019 kA(10 $'jam e dT Q i "f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.c�'6 176 dated Installer dAPAW 0 DE W Z3g f j ,r (.LC— Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will nc on esigned. �_ Date (D// /� Inspector No. J ,'?o Feed— `� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS C Q Misposal 9sipstrin Construction j3Prmit Permission is hereby granted to Construct( ) Repair(X Upgrade( ) Abandon( ) System located at ( (9 t2 t T' and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co l(eted within three years of the date of this Gb Date > t Approved un 23 15 08:13p p.1 Commonwealth of Massachusetts 03 Y 0,-7 Title 5 Official Inspection Form a` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every COtuit MA 02635 6-19-15 page. Cityrrown State Zip Code Date of Inspection Inspection resattS 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 forts ��m1i1111tr1rrrrr�r on the computer, �l# OF r41rz���� use only the tab f 1a I /,/qS l key to move your 1 Inspector. cursor-do not James D.Sears =��:;...JAI�AE-- use the return Name of Inspector -d— bUH key. co) CapewideEnterprises LLC •� Company Name 153 Commercial Street y'4i 5 I N SPEW Company Address ��r'��rn►►m1nN11r��� J{ Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification 1 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 6-19-15 06spector'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. 15ins•3113 ?0� Title 5 Qrricial Inspection Form-SUDSurtaoe Sewage DigpoSal System•page 1 of 17 I . 7 Jun 23 15 08:13p p.2 Commonwealth of Massachusetl;ts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r' 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Cotuit MA 02635 6-19-15 page- City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/alwayscomplete 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: The system is two c pool's and a pit. 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): LSms-3113 Title 5 Official Inspection Form Sib"ace Sewage Disposal Syslem•Page 2 of 17 Jun 23 15 08:13p p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments UIV 1019 Main Street Property Address David Chase Owner Owner's Name information required for every Cotuit MA 02635 6-19-15 _ page. Cityrrown state Zip Code Date of Inspection B. Certification (cunt.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cunt.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ IUD (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 mannerwhich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspoo(or privy is within 50 feet of a bordering vegetated wetiand or a salt marsh 151ns.3/13 Title 5 Ofridal Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Jun 23 15 08:14p p.4 Commonwealth of Massachusetts -- Title 5 Official Inspection Form Al Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Cotuit MA 02635 6-19-15 page. CitylTown 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. Q The system has a septic tank and SAS and the SAS is less than 1000 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 6 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 N�❑ Q Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ E& Liquid depth in enaqmmit is less than 6" below invert or available volume is less than%2 day flow R/,r- tam•3M3 This 5 official Inspection Forth:Subsurface Sewago Disposal System-Page 4 of 17 Jun 23 15 08:14p p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Cotuit VA 02635 6-19-15 page. Cityrrown state Zip Code Date of Inspection B. Certification (cont.) Yes No ® Required pumping more than 4 times in the last year!UQTdue 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 tharr 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 tfie 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 addrtron to the questions in Section 0. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Orfidel Inspedion Form:Subsurface Sewage Disposal System•Page 5 at 17 Jun 23 15 08:14p p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner owner's Name information uefor every Cotuit required for eve MA 02635 6-19-13 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 AEPOMUM manholes uncovered, opened, and the interior inspected for the condition of the 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)] C. System Information Residential Flow Conditions: Number of bedrooms(design): NA Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 15ins alt 3 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Page s of 17 Jun 23 1508:15p p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is Cotuit MA 02635 6-'15'-15 required for every +. -_ page_ City/Town State Zip Code Date of Inspection D. System Information Description: The system is two c pools and a pit- Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes 0 No Water meter readings, if available last 2 ears usage 2013-317,000Gal g ( y g (gpd))' 2014-256,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present. Date Commercialllndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/personsftq.ft,etc_): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes Q 'No Water meter readings, if available; t5ins-3113 Idle 5 Official Inspection Form.Srbsurtara Sewage Osposa System-Page 7 or V i Jun 23 15 08:15p p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase _ Owner Owner's Name information is required for every Cotuit AAA 02635 page. citylroe+n State Zip Code. Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes M No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® 111111111110111111111111M, soil absorption system ® ZWWcesspool ® 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 ❑ Fight tank.Attach a copy of the DEP approval. ❑ Other(describe): 151ns-3n3 Title 5 Official Inspection Form:Subsuftoe Sewage Disposal System-Page 8 of 17 Jun 23 15 08:15p P.9 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Cotuit MA 02635 6-la-45 page_ CitylTown State Zip Code Date.of Inspection D. System Information (cont.) Approximate age of all components,date installed (if known)and source of information: NA 6-2015 New line over flow pool to pit. Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): 16" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is PVC. Septic Tank(locate on site plan): Depth below grade: 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: Sludge depth: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of t 7 I Jun 23 1508:16p p.10 Commonwealth of Massachusetts - Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments mpm 1019 Main Street Property Address David Chase Owner Owners Name information required for every Cotuit MA 02635 6-19-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) 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.): Y_ 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 6 Official Impaction Form:Subsurface Sewage Disposal System-Page 10 d 17 Jun 23 1508:16p p.11 Commonwealth of Massachusetts t Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Coturt MA 02635 6-19-15 page. Cky[Town 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): i 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 4 Comments (condition of alarm and float switches,etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 TWe 5 Official trispect an Fomt Subsurface Sewage Dispcsal System•Page 11 or 17 Jun 2315 08:16p p.12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is required for every Cotuit MA 02635 6-19-15 page_ CltyfTown 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 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.): 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: 15ins•3113 Title 50Rdal Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Jun 23 1508:17p p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information required for every Cotuit MA 02635 6-19-15 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: ❑ leaching chambers number. ❑ leaching galleries number: I ❑ leaching trenches number, length: 3 - ❑ leaching fields number, dimensions: 1 overflow cesspool number: ❑ innovative/alternative system Typelname of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is a c pool and pit. C pool is 5' deep w/cover steel at 10". Pit is 5'deep. Pit at 43"below grade. I'water in pit_ Clean walls. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert 16" Depth of solids layer — 211 . 1n Depth of scum layer — Dimensions of cesspool - 5' Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ine 3r13 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 13 0117 Jun 23 15 08:17p p.14 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information is MA 02635 6-f 15 required for every Cotuit - 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.): Main goof is 6'btock w/steer cover at 8"PVC inlet wftee. 3 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.): l5ins•3/13 Title 5 Orfidal Inspection Form:Subsurface Sewage Disposal System•Page 14 cr 17 Jun 2315 08:17p p.15 Commonwealth of Massachusetts Title S official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �w2w,,__$ 1019 Main Street Property Address ---- --- ---_�_ —_ —. David Chase owner owner's Name informationis required for every Cotuit MA 02635 6-19-15 _—_ __. page. CGtyffown State Zip Code Date of Inspection D. System Information (cons.) 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 Wens within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: hand-skatch in the area below C! c ! f / r r l45 i9 l . i t Mims•W13 INe 5 afhoal hVecOm Form.Subsurface s,""'Diz,11 SYslaro-Page 1S or-. Jun 23 15 08:18p p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1019 Main Street Property Address David Chase Owner Owner's Name information required for every Cotuit MA 02635 6-19-15 page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar r ❑ Shallow wells "10 Estimated depth to high groundwater: 20' r 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: Abutting area drop's off a cross st. No G.W. at 20'+. Before filing this Inspection Report, please see Report.Completeness Checklist on next page. 15ins•3f13 Title 5 Official Inspection Form Subsurtace sewage Disposal system•page%of 17 Jun 23 15 08:18p p.17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1019 Main Street _ Property Address David Chase Owner Owner's Name information is required for every Cotuit MA 02635 6-19-13 page. CAyff wn State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D,or E checked ® inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate fife 15ins r 3713 Title 5 041c1at inspection Form:SUDSUrfdoe Sewage Disposal Sysrern• age 17 of 17 No. 8 ` Fee OU — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es ftpYication for Noposai *pstem Construction 3permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System Vndividual Components Location Address or Lot No. <� a`+.,� S Owner's Name,Address and Tel.No.'�Da`„ C4\,4SC c c�U 1 cc�� vr.^�. sQ g-5'*6- k Assessors Map/Parcel O 3, >/ p�3 Cn) C)63S` Installer's Name,Address,and Tel.No. -c ,:! 68igner's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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. Si Date Application Approved by `/W Date j~ Application Disapproved by Date for the following reasons Permit No. I -� �f Date Issued 2� / No. �d ' ! t- Fee `Oc, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es A " ZfppliCatlon for 0sposal Opstem (Construction permit 9 i Application for a Permit to Construct( ) Repair(t�Upgrade( ) Abandon( ) El Complete System 1 `Individual Components Location Address or Lot No. >; `� ��4, S Owner's Name,Address and Tel.No.00 tj,cA C1n�S'C cam; coti:1, �•��� s Q�-ya - s�y Assessor's Map/Parcel O 3 Installer's Name,Address,and Tel.No. --:5\ 15e'signer's Name,Address,and Tel.No. p.Cb• pox 37 5::-,Nc�R t--"-�, ,vn,A c�a sG Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title S Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) T`� L(CD �� V�C� s0..� n�.sar- �0c�--,C-3 s" b-xz , f� + V 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. _ . Si Date S f - Application Approved by MV A, Date ` t i Application Disapprpved by Date for the following reasons Permit No. / - / Date Issued (f- 2 f' f, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance A)� THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(t/� Upgraded( ) Abandoned( )by:R,1C.p�V oc c 1—",��I.G at k CO\� 1/,1wA'�y\ �r �0 L�� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ) °11 -•?°� dated f 1.2 S / Installer���G�-1 =,+- . Designer #bedrooms �, 1'�. Approved design flow V gpd The issuance of this permit shall//notlbe`construed as a guarantee that the systenrwill-fquncti'o\n asrddesigned._ Date / tP )) Inspectorti, No. d"8 t I ' a."1 f Fee �UU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Vsposal *pstrm Construction permit Permission is hereby granted to Construct( ) Repair(� Upgrade( ) Abandon( ) System located at y" and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio Pmust a completed within three years of the date of this permit. n Date (/ Approved by ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■m■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■ , ■ ■■■■M■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■G■ ■A ■■■■■■■■■■■■■■■■■■■■■■■■■I■■■■ ■■■■■■■■��, ,� � ■■■■■■■■■■■■■■■■■■mm■■■■■■■■■ ■■■■■■■ ■ ■■■■■■■■■■■■■raffl■w�.■■■■■■■■■ ■■■■■■I ■■ ■■■■■■■■■■■■■■■■■■■■■ ■M■■■■■ ■■■■■ iiw■ . ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■■■■■■ ■ '!- ■■■■■■m■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■ ` �1■■■ �■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■l ■■■■I■■■■■■■■■■�..n ■■■■■ ■■ ■■■■■■ mmmmm Ommmmmm ■ ■ .■ �■■ ■ ■■■■ .. ■■■■■■ ■■■■■■■■ ■�■ ■■ ii■� Immmm ' e ■■■ ■■■■■■■ ■ l■■■■ ■■■■■■■■ ■■■■■■■ ■■IlmllMMMMMMMMMMMMMM■■1■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■ � ■■�■ ■■■ ■■■■■■■■■■■ Now— � ■® SWMMMMMMMMMMMMMMMMM ■■■■■■■■■■■■■■ ■ MMMIIMMMMMMMMMMMMMMMMMMMMI ■■■■■M■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■ ■�■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■ y: ■ ., ■ ■■■ ■■ ■■■■■■■■■■ ■■■■■■■■ ; . `'1■i ■■■ ■■ x it■■■■■■■■ ■■■■■■■■ ■ i _ IMMMEE' MMMMMMMMMMMMM ■■■■■■■ M■ �= F ■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■r■■ ■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■m■■■■■■■■■t ■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ �., r ,t� '�'' r �� � C� f :r. �--- �� Y '� Afib N SEWAGE PERMIT NO•% LO C VILLAGE I N S T A LLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A I m / � L DATA f� Y✓rye s �� F 1 t i e No .:. 6....... Fps.. ._............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............ ......................OF..................I..,................. Appliratiou for Utopos al Works C onstrurtion amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �. L cation-Address or Lot No. ----••-•--•(`�1 ._..s.l,.� L.... .................................................. .........•----•............-----••---••....... Ow r Address _m. .......A. r_ .1.�^_ ...............:..... .............. 51_........ Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............................. .. .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures ----=---------------------------------------- ------------- •------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width........---..--- Diameter--------------.. Depth................ x Disposal Trench,—No. .................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No..........:.......... Diameter.....---.---........ Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.-----.............. Depth to ground water...................----. �r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.........--.----........ a -•••-------•......=--•--•----•...:..........•-•------•-----•--••----------•-•......-----•---••-••--•-•----•---•-••-----•---•--........•--........-•••••--•- 0 Description of Soil..............................................:.....•-••---•-----•-•---•---•---------------------------------•----------•-•---------------------............------.-•-•- W --•-------••-••---•--------•••-------•-----------------------•---------------------••....•---••......•....-----••-•-•••••••.....--------•--••--•-----••••.............................................. .............. -----------------------------------------------------------------------------------• -- U Nature of Repairs or Alterations—Answer when applicable...---.� ._\0AI-Y--.--.:1� ®-n...... -•-------------------•---•---------------••------•--•-----..........................................................;........ ------------------•------------•--- Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TA!HL 5 of the State Sanitary C de—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo o health. Signe .............. ---....---•...... ------- --------- ------------ Application Approved . . -•-•• ---- . ....7 . � ------ ate Application Disap ove or a following reasons-------------------•----------------------•------•-••-------•-----•---------•-----------•-•.................... ...................................... ----•-•••--------------.........----------....-----•-••---------....---------------•-•-••--•--......-•.......••--••-----•-------•------•-•-••••--...----_---••- Date PermitNo......................................................... Issued....................................................... Date Alf— Noo. /.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH k ............. ....... ...............OF......................................................................................... Appliraation for Dispniiaai Works Tonstrnrtion rrmit Application is hereby made for a Permit to Construct ( ) or'Repair ( ) an Individual Sewage Disposal 'System at: ' ................_/..o!. ..-== ...... ''....--=s ---------.Ca ' -----.... ------.-----.•-------------------.----.....------------------------------------------------------- L cation-Address or Lot No. ........... 5'__ .....•L-...:`S ..---•................ ....----••••-•-.... ..---........---•---•---•--............... --.........---•--------...........---...-•---- OW r ddress 1.4 «� LA.�l'1-' D---- re ±^-'4"..................... ........ ...........Ml..................................................... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No of Bedrooms.........................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons_________________-•-__-__-- Showers — Cafeteria al Other fixtures .._....-•---•---•------•---•---• . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.-___-____-__-_---.____. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------------------------------•-------•------------•-•----•-•••-.---•-•......................................................... ODescription of Soil........................................................................................................................................................................ W •-•••-•---••----------------•••-•••------•••--•-•--------•---•••-••••---•••••---•....•-•-•••••••-•••-•---...... '. ------------•---•----•-••----•••••••--•-•-•••••--•••-•......••-•-._......-•-..... U Nature of Repairs or Alterations—Answer when applicable _. .r- =!-1`--- o� C" G ___ U P PP ) � ---------------- -----------------•-----•-----------------------------------------=--•---------------------------------------. f - r..----•-------------....---••------- Agreement: The undersigned agrees to install the aforedescrbed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary C de— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo o health. R 1 Signe ..:C.ZI r�--:....�..... ....... ...I.�.�......------•-----. 4 _---- Xa / Application Approved - •... 4�`w 0.1 ------ Date Application Disap rove or a following reasons:-------....................................................................................................... _ ...................................... ---•-••••--•-••••-••-••---•--•••-••--•--•----••--•••••-----••••. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS -� BOAR :OF HEA 01rdifiraatr of Tompiiatnr T IS IS TO CTIFY,-That the Individual Sewage Disposal System constructed ( ) or Repaired j at t..- as been installed in accordance with the provisions of TI ~' j� T e State Sanitary Coe a des ribed in the application for Disposal Works Construction Permit No....It.<_.'" . ... .......... dated .}}� ____-____--_--------•--- {f THE ISSgANCE OF THIS. CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO STISFACTORY. 9/ t✓ DATE.-----.•--..? ............P --1/9---------------------------•-----. Inspector.�--�..-----------------------•---------••---------------•-•-----•--•-•--•-•-- x . � t THE COMMONWEALTH OF MASSACHUSETTS BOAR F HEAL '' .....................OF:....- ..... f :�. ......... ....... L No................. ..... FEE................------ D. Y _ 'I nrk nrn #r uan lermi Permission is hereby gran -- ...................... ...-----•... •• .......................................................... to Constru t or R an In ' Id Sewa a Di s alp' tem� — Street f Cam' as shown on the application for Disposal Works Construction Permit No.�_..._.........�Dated....,�-�.............. ....... ...-•--------------•......_...........--------------------------------......-••••................_....._ DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LOC&TION ' 5EW6,C4E PERMIT UO. VILLAGE - LrLi' LLA 5 - - - IWST&LLERS U&NlE e, ADDRESS - &U+L-D.E R S 1.1 A/l f7 &D D R E SS DNTE PER"VT ISSUED DATE COMPLI &MCE ISSUED ; ;��. �� S .� ��Y ,_ ap'� ,- ' v ---------- -------- ----------- --------------- FINISH GRADE OVER D-BOX= 37.6'± FINISH GRADE OVER CHAMBERS= 38.1' - 36.91 GENERAL NOTES SLAB EL.=-40.2'± 3/4"TO 1-1/2" DOUBLE WASHED PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2%MIN.OVER SYSTEM STONE TO CROWN OF PIPE I. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE OUTLET TO WITHIN 6'OF F.G. 4"SCHEDULE 40 PVC MIN SLOPE 1% INSPECTION PORT w/ACCESS BOX WITH 2"OF 1/8"TO I/2"DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. Z@ FOUNDATION= 40.0'± 38.0' - 38.5' 511 DIA. OUTLET(S) COVER TO GRADE (SEE NOTE#20) STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.A DESIGN ENG CESS INEER. 9"MIN. I COVEROTYP) 36'MAX. I I I PLACE RISERS ON PROP. SCH.40 9"MIN. 9"MIN. As= 35.23' CHAMBERS W/PIPED 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER-\ ROP. SCH.40 3TMAX. 34.40' 39' MAX. BREAKOUT EL= 34.90' INLETS TO&'OF SYSTEM UNLESS OTHERWISE NOTED. VC SEWER FINISHED GRADE 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN.SLOPE @ 1% 6-f 3" 2" DROP MIN. I I j 00 ELEVATION = 34.90' FOR A DISTANCE OF 1 VAROUND THE PERIMETER OF THE SAS. UNLESS A 311 9' L=8'± 3"DROP MAX MIN.SLOPE@j% PROVIDE WATERTIGHT 00; ES-4 IN FROM JOINTS(TYP.) cl, 0 C) 00 0 THE LINER IS NOT LESS THAN THE BREAKOUT ELE ION. " PVC EPTIC TANK 00 7 `4 1 4" PVC OUT TO c1c> 35.75' C> 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. LEACHING FACILITY 1.00, C> L__j Coo 36.00' 12" 1 C 00 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. C> CD C C> I OUTLET TE C> CD C> C�o C> C)C> Ck: C 00>1 CXD C> (D <D C>C> 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 4811 1 1 0.75' C)C>c>6c> cD c>:> c> c:> <D <�kD c:Ao c> c>c> cD C>CXD C)C:> C C> C>C)C>C> CXD C)C> E 35.17 MIN. 35.00' CX:> CX:> C> C�o �> 0 0, CX:>CDC> (Do cx:�, <=CD FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS '-GAS BAFFLE 6"CRUSHED STONE CXD C!:)C� CXD I NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH OVER MECHANICALLY 4_0' 1 1 4.0' 3.5,_ 1 3.5' AND DESIGN ENGINEER. 10.2'OFFSET TO FISID-00- COMPACTED BASE 6.0' - - I -__1 IN (TYP.) 3.0' 3 OUTLET DISTRIBUTION BOX -20.0' V (TYP.) 8. ELEVATIONS BASED ON APPROXIMATE MEAN SEA LEVEL DATUM. BENCHMARK ELEVATION 6"CRUSHED STONE TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 26.50' 10.01- OF 40.00' ESTABLISHED ON A NAIL SET IN A FENCE POST AS SHOWN ON PLAN. OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET 1 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE PIPES TO BE LAID LEVEL. 32.65' TMIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT PROPOSED 1,500 GALLON H-10 CONCRETE SEPTIC TANK LC-6 CHAMBERS CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES LENGTH 10'-6' WIDTH 5'-8" DEPTH 5'-8" (Dimensions per Wiggin CROSS SECTION VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. 0NTRA'C'T0f',, TC-) VE'RIF'Y EXISTPINC', Precast Corp.,Pocasset,MA) r"i"J", _1111111'", H-10 SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL CHAMBER DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. EVATiON p�, �Tn N 0 T I E N!G�N E E'R D,17-FE R E T, NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 7 �7 TEST PIT DATA APPROPRIATE AUTHORITY. NOTES: 14998 PERC NO. k �l,IL 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED INSPECTOR: David W. Stanton, R.S. UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR SEPTIC SYSTEM COMPONENT. J, 0 EVALUATOR: Michael Pimentel, EIT, C E TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. C.S.E. APPROVAL DATE: . .-Oct. 1999 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE a N a 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA 'N April 5, 2016 'I v, ^"A DATE: 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TY SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF 7 SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. TEST PIT#: MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILI REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, !0 LOd ELEV TOP 37.70' 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS ONLY. FINESIOR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ELEV WATER <27.20' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN %A L SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. CO PERC RATE 2 min./inch 16. PROPOSED PROJECT IS LOCATED WITHIN: PROPOSED INSPECTION PORT J '-48 DEPTH OF PERC 30' a. LOC USr oti 1N co d PROPOSED H-20 DISTRIBUTION BOX 34 BLOCK PARCEL 23 ASSESSOR'S MAP OWNER OF RECORD: DAVID W. &JOAN W. CHASE, TRUSTEES TEXTURAL CLASS: I C1 L PROPOSED 4" PVC VENT; EXACT LOCATION PER OWNER -LSA -61 EXISTING CRUSHED STONE U Off 37.70' ADDRESS: P.O. BOX 1665 DRIVE TO BE REMOVED AND COTU Fill-Crushed Stone REPLACED WITH VEGETATION 7 IT, MA 02635 PROPOSED 1,500 GALLON -LSA- 12" 36.70' -10 SEPTIC TANK X FEMA FLOOD ZONE H CE-,SS�-P�OVDL, TO, E',"E PU1,0,9�-_r,,) COMMUNITYPANEL# 25001CO756J SPRUC vf'), PF R T It 7 L E_� :5 Loamy Sand -LSA- B 1 OYr 5/6 17. DEED REFERENCE: BOOK 10203, PAGE 299 PROPOSED CLEANOUT AP 30" 35.20' FA% PLAN REFERENCE: PLAN BOOK 401, PAGE 48 35. 18. EX. SHRUB (TYP) 5"HOLLY TIONS SHOWN ON PLAN WERE BASED ON A FIELD INSTRUMENT SURVEY. Perc 19. EXISTING CC;NDI CY) 48" 33.70' 2 WALK 37.0' E,K S T 1 N G C'.,-E P�,N OU 20. A 4"PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A 3"OF FINISH GRADE XIST,,; DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN A-, TP1 TIONS. ON THE TOP TO ALLOW FOR 1"196 -LSA- 4 HED -4 REMOVABLE THREADED CAP SHALL BE PLACED f 7.7' 37.7' Medium Sand 3"TREE ,5"HOLLY C 2.5Y 6f6 21. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. > % -LSA- To 22. PROPERTY LINE INFORMATION IS APPROXIMATE ONLY. THIS PLAN JS TO BE USED ONLY FOR 24'PINE SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY FOR USES OF NY- THIS PLAN OTHER THAN ITS INTENDED PUPOSE. RHODY LOCUS PLAN " PROPOSED TWO LC-6 r 23. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL SCALE: 1" 1000' REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. LEACHING CHAMBERS 4'SPRUGE WITH AGGREGATE MAP 34 126" 1 27.20' J MAP 34 �,P No Mottling, Standing or Weeping Observed PARCEL26 -LSA- PARCEL24 DESIGN DATA TEST PIT DATA LEGEND APPROX, LOCATION OF PERC NO. 14998 GAS LINE PER OWNER,--\\ 504' EXISTING SPOT GRADE NUMBER OF BEDROOMS-CARRIAGE HOUSE(EXISTING) 2 INSPECTOR: David W. Stanton, R.S. 50 EXISTING CONTOUR NUMBER OF BEDROOMS-CARRIAGE HOUSE(DESIGN) 2 EVALUATOR: Michael�Pimentel, EIT, C E C`l? APPROX, LOCATION OF WATER LINE PER OWNER DESIGN FLOW 110 GAUDAYIBEDROOM C.S.E. APPROVAL DATE: Oct. 1999 r_50-1 PROPOSED SPOT GRADE DATE: Ap il 5, 2016 TOTAL DESIGN FLOW 220 50 PROPOSED CONTOUR 2 20 DESIGN FLOW X 010 % 0 GAUD TEST PIT#: GAS EXISTING GAS LINE 137.00' ELEV TOP Benchmark USE PROPOSED 1,500 GA N SEPTIC TANK #1019 <26.50' EXISTING OVERHEAD UTILITIES Nail in Fence Post ELEV WATER Elev. =40.00' EXISTING PERC RATE W W EXISTING WATER LINE Approx. M.S.L. 4-BEDROOM MAP 34 SWING-TIES SCALE: 1 20' DV�(ELLING PARCEL23 INSTALL TWO (2) LC-6 LEACHING CHAMBERS DEPTH OF PERC TEST PIT LOCATION 46,204 S.F.± HCA HC-2 4z W/AGGREGATE TEXTURALCLASS: DESCRIPTION 0 01 PROPOSED 1,500 GALLON H-10 SEPTIC TANK SIDEWALL CAPACITY 10 TANK INLET COVER(1) 13.5' 14.5' APPRQX!,%!ATE LOCA'P�r_)�i%4 OF FIER BOAR' (LENGTH + WIDTH) (2SIDES) (1.75' HIGH) (0.74 GPD/S.F.) GAUDAY PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE TANK OUTLET COVER(2) 20.8' 21.4' (20.0'+ 10.0') (2 ) ( 1.75' ) (0.74 GPD/S.F.) 77.7 GAUDAY Oil 37.00' ()F 1,1-E-ALTH, AS-13"JiLT`-'A RD 17.5' 24.2' Fill-Crushed Stone CORNER OF STONE(3) 13 PROPOSED H-20 DISTRIBUTION BOX BOTTOM CAPACITY 12" 36.00' CORNER OF STONE(4) 24.0' 33.8' p, (LENGTH x WIDTH) (0.74 GPD/S.F.) GAUDAY PROPOSED LC-6 LEACHING CHAMBER (20.0'x 10.0') (0.74 GPD/S.F.) 148.0 GAUDAY Loamy Sand CORNER OF STONE(5) 39.8' 43.1' 1 1 . 1� A� B I OYr 5/6 36.2' 36.1' CORNER OF STONE(6) 30" 34.50' (0 REV. DATE BY DESCRIPTION TOTALS: MAP 34 TOTAL NUMBER OF CHAMBE PARCEL25 60, TOTAL LEACHING AREA 305.0 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE Co 4 225.7 (6) TOTAL LEACHING CAPACITY GALJDAY 7 PREPARED FOR: Medium Sand CAPEWIDE ENTERPRISES C; (5) 7 C 2.5Y 6/6 (2) P) LOCATED AT 1019 MAIN STREET 0 MA 02635 COTUIT, (3) HC-2 SCALE: 1 INCH 20 FT. DATE: APRIL 13, 2016 126" 1 26.50' 0 10 20 40 80 FEET (4) Q No Mottling, Standing or Weeping Observed HCA ------ PREPARED BY: >, /yc) 41 JOHN RESERVED FOR BOARD OF HEALTH USE CHUYHIILL JR. -Z� JC ENGINEERING, INC. 'Vj L 2854 CRANBERRY HIGHWAY 41 07 EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 Drawn BY: BsM Designed By:BSM Checked By:JLC B 0 3431 [_........... ------ SCALE. 1 20' 0, L 'J'lc I v"'r"v""'jr" '_'r_Fj r 'D UBLE A HED 2' 0 W S T E TER FAB��C N D ,F Ej 9 9 4 �114" 7735.-, C) '0 ---------------- ----------- ---------- ------ -------