HomeMy WebLinkAbout1691 MAIN STREET (COTUIT) - Health 1591 Main Street (Cotuit)
C)tuit
------ - - - ---- - - A = '017 001
R-
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IME Town of Barnstable Barnstable
Regulatory Services Department 1 edca�j
BAANSTA13M
b 9 � ` Public Health Division
200 Main Street, Hyannis MA 02601 2007
t
Office: 508-862-4644 S"2'n f / I 2' Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Elisa Entine
77 Chestnut St.
Boston, MA 02108
Re: Oregon Beach
Dear Elisa Entine:
In response to your letter, received September 29, 2012, the Health Division staff has
investigated your concern about pollution from sewage at the north end of Oregon beach.
A thorough review of the septic systems in the area, and a beach inspection took place
October 1, 2012. An examination of the new culvert and the area of the old pipe
connecting Rushy Marsh was included in the inspection.
On October 1, 2012, we found no evidence of violations, or pollution discharge. In the
vicinity described in your letter, there was no odor at the time of inspection. There was
several species of macro-algae washed up on the shore dominated by codium seaweed,
which can become quite malodorous, when significant quantities collect on the beach and
decays. There were also several horseshoe crab shells along the whole section of beach,
in front of the Oregon Way properties. Most the horseshoe crab shells were shed
carapace, but when there are heavy winds and many creatures wash ashore the dead
animals can be very smelly.
J
r�.
Near the new culvert, newly planted beach grass and enrichment soil had a slight earthy
odor, but did not suggest any sewage concern. The beach and culvert water clarity was
excellent. There was significant waterfowl in the pond, and large schools of small fish in
the shallow waters, suggesting healthy habitat.
Consequently, we were unable to find any source, or evidence of contamination.
If you have future experiences of the disturbing odor, please telephone our Coastal
Health Resource Coordinator Karen Malkus, at(508) 862-4641.
Thomas McKean, R.S., CHO
Agent of the Board of Health
Barnstable Health Division
200 Main St.
Hyannis, MA 02601
(508) 862-4644
Elisa Entine
77 Chestnut St.
Boston,Ma 02108
617 227 6377
eentine@aol.com
Town of Barnstable
Health Division
200 Main St.
Hyannis, Ma 02601
Dear Mr. Thomas A. McKean:
As a resident of Cotuit, I'm writing to you to report a health concern I encountered while
walking along Oregon beach north of the new, currently abandoned, culvert.
To be more precise, a disturbing fowl septic odor was detected while walking along the
edge of the water at the northern end of the recently built house next to 60 Oregon way
the Gretchen Reilly compound). The disturbing odor, was distinctively septic sewer odor
as supposed to odor derived from decomposed algae that accumulates adjacent to beach
groins or from exposed and decomposed vines around the edges of depleted ponds, as it
happened to Rushy Marsh pond during the failed drain project construction, last April.
I should add;'that the day of my stroll was September 2,2012 and while the detected foul
odor was in close vicinity to where the old pipe connecting Rushy Marsh Pond to the
ocean once existed, such pipe had been removed as part of the failed drain project and
hadn't been yet re installed
On behalf of the residents of Cotuit,hope the contamination source can be found and
corrected so no further discharges of that nature continue to offend our beach.
Appreciatively,
Elisa Entine
1691 Main St. °.
0. :.
Cotuit, Ma 02635
61`7 227`6377
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Elisa Entine
77 Chestnut St.
Boston,Ma 02108 �
617 227 6377
eentine@aol.com i
Town of Barnstable
Health Division
5
2-00 Main Str
�Hyanrus,Ma 02601
-:Dear Mr Thomas A McJKean.
r As a resident of Cotuit, I'm writing to you to report a health concern I encountered while
' walking along Oregon beach north of the new, currently abandoned, culvert.
To be more precise, a disturbing fowl septic odor was detected while walking along the
edge of the water at the northern end of the recently built house next to 60 Oregon way
the,Gretchen Reilly compound). The disturbing odor,was distinctively septic sewer odor
as supposed-to odor derived from decomposed algae that accumulates adjacent to beach
F , grouis of from exposed and decomposed vines around the edges of depleted ponds, as it
happened to Rushy Marsh pond during the failed drain project construction, last April.
k m11,
s I should adds that the day of my stroll was September 2, 2012 and while the detected foul
_ odor was in close vicinity to where the old pipe connecting Rushy Marsh Pond to the
'� ;ocean once existed,such pipe had been removed as part of the failed drain project and
hadn't been yet re installed-
a
R .On behalf of the residents of Cotuit,hope the contamination source can be found and
corrected so no further discharges of that nature continue to offend our beach.
er
Appreciatively,
Elisa Entine
1691 Main St. a
Cotuit, Ma 02635 v
617 227 6377
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T
ti
'Rushy 1Vlarsh Pond'--` WAtiZA
EIEr 11 i
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Site 3
.n K � ; Site 2
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} 1 � Nantucket Sound
150 ft
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Figure 19. The shore at Rushy Marsh Pond showing proposed site
options to reconnect the Pond to Nantucket Sound. Site
1 is the location of the 1956 wooden sluiceway; site 2
is the location of the present 12" pipe. (Base map from
Town of Barnstable, 2001 a.)
E
34
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Map Page 1 of 1
Town of Barnstable Geographic Information System New Search Home I Help
Parcel Viewer Custom Map Abutters Map Size ® El Zoom Out I fl a M j,I j In
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Property
Location: 130 OREGON WAY Info
017014 Owner: BRAGDON,DALE D TR
4 A 1524
Location Information
Map&Parcel 017018
Location 130 OREGON WAY
(`P Acreage 2.50 acres
Av1f,dfarshPond 0�� Current Owner
rti I Mailing Address BRAGDON,DALE D TR
%BRAGDON,DALE D
017016 C/O LESLIE W VIETH
N 130 - 3 LANDMARK ROAD
WESTFORD,MA 01886
Value(FY 2012) 0
Extra Features $28,300
/Vauckef Sound Out Buildings $3,700
Land $3,351,700 °•,.,'_
t Ote012 ',. Buildings $267,100 w
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d'• 1n91 E 2t Extra Features $28,300
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w —.. Land $3,351,700 s
Set Scale 1° = 191 ,,..j I Aerial Photos MAP DISCLAIMER Buildings $267,100 _
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Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS
BarnstableMA v1.2.4379[Production]
http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=017018 9/28/2012
As.Built Page 1 of 1
TOWN OF BARNSTABLE
LOCATION D p 5 (:,Om EWAGE # t,83_
VILLAGE tow.c T- ASSESSOR'S MAP & LOT Ot( WT /1
INSTALLER'S NAME & PHONE NO._L7 L t4 0 36 2 - 3t,6 S
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NO.OF BEDROOMS_? PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER P,C{C rLci:S I`
DATE PERMIT ISSUED: 10 f lT
DATE COLiPLIANCE ISSUED; 3� "-
VARIANCE GRANTED: Yes No
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http://issgl2/intranet/propdata/prebuilt.aspx?mappar=016011&seq=1 9/28/2012
Map _..__..._._.._.__ Page 1 of 1
Town of Barnstable Geographic Information Sy em - New Search Home I Help
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Full
^- {� ;� ry tr''j Q _,��_N •y ® (9 :c JPG Map: 016 Parcel: 011 Property
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i 018012 Location: 60 OREGON WAY Info
' g100 Owner: REILLY,GRETHCEN A
018008.
snae, Y' Location Information `•
Map&Parcel 016011
Location 60 OREGON WAY
a Acreage 2.55 acres
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\ 4 � aao Current Owner
j Arsfiy,60�rshFond 4 i
Mailing Address REILLY,GRETHCEN A
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-`•, P 0 BOX 587
COTUIT,MA 02635
Appraised Value(FY 2012) y h
< - Extra Features $202,700
oiegge Out Buildings $29,300
NapErcRef Sovrrd
11782.. ( Land $3,504,500 ;
Buildings $1,698,400 S
Total Appraised $5,434,900
N1780 ,a„
\� Assessed Value(FY 2012)
__ ___..._—_�� ...._.___..._._..�......__......._.._ 4t
4. Extra Features $202,700 ti
gs�d� ���•�2 � otaol Out Buildings $29,300
e q0 Land $3,504,500
J Buildings $1,698,400
>' Total Assessed $5,434,900
Set Scale 1" = 127 \ A rlaYPhotos- ' I\ AP DISCLAIMER
pyright 200 10 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS
BarnstabieMA v1.2.4379(Production)
http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=016011 9/28/2012
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Elisa Entine
77 Chestnut St.
Boston,Ma 02108
617 227 6377
eentine@aol.com
Town of Barnstable
Health Division
200 Main St.
Hyannis, Ma 02601
Dear Mr. Thomas A. Mc-Kean:
As a resident of Cotuit, I'm writing to you to report a health concern I encountered while
walking along Oregon beach north of the new, currently abandoned,.culvert.
To be more precise, a disturbing fowl septic odor was detected while walking along the
edge of the water at the northern end of the recently built house next to 60 Oregon way
the®Gretchen Reilly compound).'The disturbing odor, was distinctively septic sewer odor
as sup os"ed to odor derived from decomposed algae that accumulates adjacent to beach
groins or from exposed and decomposed vines around the edges of depleted ponds, as it
happened to Rushy Marsh pond during the failed drain project construction, last April.
should add,that e day. my stroll w Septe er 2, 2012 and while the detected foul
odor was in close vicinf{y-to-where_the old pipe co g- ashy Marsh Pond to the
cean once existed such pipe had been removed as part of the failed drain"project and
a 't been yet re installed
On behalf of the residents of Cotuit, hope the contamination source can be found and
corrected so no further discharges of that nature continue to offend our beach.
Appreciatively,
Ehsa Entine
1691 Main St. ,
Cotuit, Ma 02635
617 227 6377
Town of Barnstable Barnstable
Regulatory Services Department AHMWMCRV
iAPN9rA8LL '
.
MA
1e39. Public Health Division
�'
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 T v Thomas A.McKean,CHO
�t�
Elisa Entine L
77 Chestnut St.
Boston, MA 02108
Re: Oregon Beach
Dear Elisa Entine:
;? z �'z
�3°�. M ref zAp_
In response to your letter, received 9f2 t , the Health Division staff h o your
concern about pollution from sewage at the north end of Oregon beach. A thorough
review of the septic systems in the area, and a beach inspection took place 1,'G=. An
examination of the new culvert and the area of the old pipe connecting Rushy Marsh was
included in the inspection.
On L08-T2 we found no evidence of violations, or pollution discharge. In the vicinity
described in your letter, there was no odor at the time of inspection. There was several
species of macro-algae washed up on the shore dominated by codium seaweed, which can
become quite malodorous, when significant quantities collect on the beach and decays.
There were also several horseshoe crab shells along the whole section of beach, in front
of the Oregon Way properties. Most the horseshoe crab shells were shed carapace, but
when there are heavy winds and many creatures wash ashore the dead animals can be
very smelly.
Near the new culvert, newly planted beach grass and enrichment soil had a slight earthy
odor, but did not suggest any sewage concern. The beach and culvert water clarity was
excellent. There was significant waterfowl in the pond, and large schools of small fish in
the shallow waters, suggesting healthy habitat.
Consequently, we were unable to find any source, or evidence of contamination.
If you have future experiences of the disturbing odor, please lot- s-la7 .
Cr r C o O5'jXj I2d'-aurae Ga�r�,•�r i
4G 51 Lf 9CO, y�
omas Mc ean, R.S., CHO '
Agent of the Board of Health
Barnstable Health Division
200 Main St.
Hyannis, MA 02601
(508) 862-4644
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635 November 15, 2010
every 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,
out
Whennfilling A. General Information
forms the ( I
computer,
r,use 1. Inspector: ►l1/n"I IVl
only the tab key
to move your Patrick M. O'Connell
cursor-do not Name of Inspector
use the return p
key. Septic Inspection Services Co
Company Name
'°' 189 Cammett Road
Company Address
Marstons Mills MA 02648
City/Town State Zip Code
508.428.1779 SI 12855
Telephone Number License Number
- � i -0
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and thatath';e
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 ofon 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: 1.
® Passes
❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
November 15, 2010 Job# 10-277
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.
V
t5ins•09/08 �J�
Title 5 Official Inspection Form:Subsurface Sewage sposal Syste •fudge 1 of 17
Commonwealth of Massachus
etts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635
every page. Cityrrown November 15, 2010
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:
® 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:
Tank is not in need of pumping at this time, leaching system shows no signs of saturation or
surcharge.
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 co
mplying omplying 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-09108
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
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635 November 15, 2010
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ 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•09108 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
>••''• 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUIt
required for MA 02635 November 15, 2010
every page. Cltyrrown 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 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•09108 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
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUIt
required for MA 02635 November 15, 2010
every 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
❑ ❑ 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•09/08 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
M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is Cotuit
required for MA 02635 November 15, 2010
every page. Cltyrrown 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:
® ❑ 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): 5 Number of bedrooms (actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635 November 15, 2010
every page. Cltyrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 1
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on.a separate sewage system? [if yes separate inspection required] ❑ 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: Currently
Occupied.
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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
aS Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635
every page. City/Town November 15, 2010
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: Tank pumped 18 months prior to inspection
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):
l5ins•09108
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
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUIt
required for MA 02635 November 15, 2010
every page. Cltyrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Leaching system installed
s ailed 2005
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 3'
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.):
I
Septic Tank (locate on site plan):
Depth below grade: 2'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: 10.5' long x 5.8'wide- 1500 gal.
Sludge depth: 2"
I
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
u Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is Cotuit
required for MA 02635 November 15, 2010
every page. Cltyrrown 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
30"
Scum thickness Trace
Distance from top of scum to top of outlet tee or baffle 6
Distance from bottom of scum to bottom of outlet tee or baffle
14"
How were dimensions determined? Measured
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is not in need of pumping at this time. Liquid level was found at bottom of outlet invert and tees
were intact and clear.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
l5ins•09/08 Title 5 Official Inspection Form:Subsur!ace Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
wM 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is Cotuit
required for MA 02635 November 15, 2010
every page. Cltylrown 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'
I
t5ins•09/08 Title 5 Official Inspection Form:Subsur'ace Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635
every page. CitylTown November 15, 2010
State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box resent if
( p 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 solids or high stains present.
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.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-09/08
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
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635 November 15, 2010
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: Five
Flowdifussors.
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching system was probed with no signs of saturation found
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
15ins-09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
w 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is
required for Cotuit MA 02635
every page. City/Town November 15, 2010
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.):
15ins-09/08
Title 6 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
1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUit
required for _ MA 02635 _ November 15, 2010
every page. City/Town 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
• / r f r r + r f / / / / / / / / / / / / / / /
f f r f r f f f f J J f / f / / ♦ J /%♦%/%/ / /%/
'r\ri r .`:•\f\r r r / f f J / r J r ! / • f r r / J
6
/ f
19
24 19
, .44
Front Yard
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUit
required for MA 02635 November 15, 2010
every page. Cityrrown 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: 8+
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:
Area of SAS is 7-8 feet higher than marsh on opposite side of road
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
Commonwealth of Massachusetts
,W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 1691 Main Street
Property Address
Stern
Owner Owner's Name
information is COtUIt
required for MA 02635 November 15, 2010
every page. Cltyrrown 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)y )completed p eted
® System Information— Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
TOWN OF BARNSTABLE `
LOCATION I Uri 1 / G►+S St. 5P 1
VILLAGE o wm.4,fi ASSESSOR'S MAP&PARCELL
IN€r'fik+45,F_WS NAME&PHONE NO."1;�tl r-,'C k 00►'u!
SEPTIC TANK CAPACITY (500 c
LEACHING FACILITY: (type) Fw:.uG :. 'u° Gf 5 (size)
NO.OF BEDROOMS
OWNER f porn II
PERMIT DATE: C> IVfI DATEr�` 1 5 I�(�
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 wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY M
r
r./ / / J !'J J 4 f f / f ✓ f ! f J J
fi J f f f f f f J
4 4 4 t ♦ h t t ♦ 4 \ h h \ \., t t'\ h k \ \ h t-\ ♦ l
f / f f / f / f F f / / f f f / f / / f F f / f • d
h t \ 4 ♦ 4 4 4 \ \ 4 h t 4 h \ h t t 4 4 t t 4 4 t \ t
�e�.xm: / f r J f r f / J J s • r • / f r J / .f f f r r / r / f / r r • f • /
,� h 4 4 \ \ ♦ h h \ t t t \ h.h h ♦ ♦ ♦ t \ \ \ h;4 4 4 \ \ ♦ \ ♦ \ \ ♦ \
f f / / f f f / J f f'F J / / J f f / f / J / f / f / f'f"f J / F • /
� h \ 4 h k h h h \ \ t 4 h ♦ \ t \ \ h t 4 t h t h 4 4 \ \ 4 4 \ 4 t ♦ 4
4 4 4 h \ t
� 19
24 19
34
r
Front Yard
TOWN OF BARNSTABLE
_ LOCATION %ll9% /yla�+� S1L SEWAGE # A:7a!`-e77S
VILL AGE �� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. .CcraKt/1414eti ,f0?-7?V4
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) �=/ate�. �rav1 t/�� (size) /t X 5/p�4x
.NO. OF BEDROOMS S
.'BUILDER 0�
PERMTTDATE: 3/ 4f 0/Z COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �f Feet
Private Water Supply Well Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) `loci t Feet
Furnished by
�-�y�/
��� �
� - ,, �_.
��'.
���
f
O
rr
P,
No.t rJ Fee 0
THE COMMONWEALTH OF MASSACHUSET7S Entered in computer:
t Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for �igpozal 6pgtem Construction Permit
Application for a Permit to Construct( )Repair(-)()Upgrade( )Abandon( ) El Complete System 04jndividual Components
Location Address or Lot No. (Co�( (h 4 i n s�-. [C�}u l f Owner's Name,Address and Tel.No.
1 Andnw � Sinn
Assessor's Map/Parcel mC.12
17 Pc( �� IrlG�ri s�J Co%v�✓ /79l1 d263 S
Install 's Name,Address,and Tel. Designer's Name,Address and Tel.No.l;�c>8j yZS-913/cxt 13
y.
u `- S1� main sfi. D �r�,Ile /!I/f o2l,ss
Type of Building:
Dwelling No.of Bedrooms F,V-c Lot Size &6 914 sq.ft. Garbage Grinder(A'o
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow d el r gallons per day. Calculated daily flow 5_50 gallons.
Plan Date ;2 2 Yj s Number of sheets o ne Revision Date
T
Title
Size of Septic Tank (Ay -Type of S.A.S. l..c&cV,,nti &ig m bees 1/9 1 K l al x
Description of Soil �6 go`,I lass u-+ plGns
Nature of Repairs or Alterations(Answer when applicable) fry spi I r�D Lack Pi}- (4)(4, Icack-nq
C�wi lacc^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 Certifi-
cate of Compliance has been issued B of Valth.
Signed ' Date �r�l®�
Application Approved b Date 36110 S
Application Disapproved for the following reasons
Permit No. r9co 5 ® Date Issued 70
No:r�rJ Fee D O
.� m
THE COMMONWEALTH OF MASSACHUSETTS � l Entered in computer: Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpprication for jX6pogal *pgtem Contruction Permit
Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System XIndividual Components
Location Address or Lot No. 1(oi l 54-,j [n}v l f Owner's Name,Address and Tel.No.
1 Andre,d 1, Sltrn
VAssessor's Map/Parcel /L�./ Na"? SS . �o tvi� f9 d O Z 43 S
T n'1� n ; PSI 1 , ,
Installg's r1 Name,Address,and Tel. r Designer's Name,Address and Tel.No.CScl8j5/Z9--9/3/ext/3
GD/'
I�
3 s l i m �h S r. DS kr�,/lc h7A o 2G ss
Type of Building:
Dwelling No.of Bedrooms F,v-r- Lot Size Colo,ITSq sq. ft. Garbage Grinder(Alct
Other Type of Building - No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow jr/27 a //6 X 5 gallons per day. Calculated daily flow gallons.
Plan Date��, c Number of sheets 0 r CC Revision Date
Title pyz,p�s�c� o hga. S,,g1-cn, (2e12c.'W"
Size of Septic Tank ('. rtwr4,n ) Type of S.A.S. LA&cti,n3 C ham lo-ers q&1x 1Z1XZ 1 At
Description of Soil 12c ., Ir soi 1 103S c— c darns .'
J
Nature of Repairs or Alterations(Answer when applicable) jZ , (a,.r- �M i I cj I ca c 17 eotl-. (4ji"� I c.oc k-fy
C 4-M w,kaeer.
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued pb�
t ' B of Valth. l
Signe — Date �S
Application Approved b Date 3 y 0 S
Application Disapproved for the following reasons
Permit No. `J "'0 5 Date Issued O 5
---------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY, that thepit-sit; ewa isposal System Constructed(i )Repaired( Upgraded( )
Abandoned( )by /� On C� Z�I`/S i
at t IONA 1 5>+ ^ Q �?� has been constructed in accordance
with the provisi s of Title 5 and a for Disposal System Construction PermitNo. 9a'S'�-7 5 dated 3
Installer Designer Sf �,Qr% Q SU-N
The issuance of thi pe 't shall not be construed as a guarantee that the sys,e w' u lion as designed.
Date c3 U 5 Inspector
——rram� ————--——————————————————————————————
No. Q00 5 —0-7-5 Fee /U�7
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
MigosW *p! tem Contruction Permit
Permission is hereby granted to Construct( )R pair( gr1ade( )Abandon( )
System located at �� i1 / r 1Gt?Irk S - . �►
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: Constructions/must be completed within three years of the da of this
7 /
Date: / I0 Approved
30/0�-
Wei / 4
TOWN OF BARNSTABLE
LOCATION %6, t9/ SEWAGE # Oaf-�7s'
VILLAGE L�iri>� ASSESSOR'S MAP & LOT
INSTALLER'S NAME.&PHONE NO.
SEPnC TANK CAPACITY /1ZD GEC
LEACHING FACILITY: (type) /eri c&9'Ta-J (size) 1X X S/r X4x r
NO. OF BEDROOMS 3
BUILDER 0 O
PERMITDATE: 3�fs' COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) r Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) 076 Feet
Furnished by
a0
4-0
101-
I
Town of Barnstable P# ?
ppTNE Tp�
ti�P� ti� Department of Regulatory Services
RA ABLE, : - Public Health Division DateC a uLov
y MASS.
039. 200 Main Street,Hyannis MA 02601
�AJFD MA't a i
Date Scheduled 1 .2 11 O t' Time--F Fee Pd. AQ
Soil Suitability Assessment for Sewage .Disposal
SegeA �ty y. e Q
Performed By: �u l.i�(��,� Witnessed B ���r U/• � :/�� .
LOCATION & GENERAL INFORMATION
Location Address 1 i VyIoM S11t+e4./` Co►vtt Owner's Name AnJ cw 5I6111
Address
�olvif
b Assessor's Map/Parcel: Wtap 17 Pe) i Engineer's Name 6'/#hoq 4. 41ihwr Ar
NEW CONSTRUCTION REPAIR X Telephone#(Sai) s,{Z g-9/3 7• esfi 13
� d
Land Use Slopes(%) 0 ~alD Surface Stones dMe
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line tt Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes)
Parent material(geologic) q_&Z Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:tW� �1S1�1�; Weeping from Pit Face .IVOnf
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
PERCOLATION TEST Date la I Time
F Observation r
Hole# _ Time at 9"
Depth of Perc 30 '1q9 rime at 6"
Start Pre-soak Time a Time(9"-6")
End Pre-soak /0
l( _ '�n"
Rate Min./Inch 0 1 Y�
Site Suitability Assessment: Site Passed /K Site Failed: Additional Testing Needed(Y/N)
Original: Ptiblic Health Division "Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one (1)week prior to beginning.
Q:HEALTH/W P/PERCFORM
s
DEEP OBSERVATION HOLE LOG Hole #�_
Depth from Soil Horizmi Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Grave)
3 O a w � Ake S
Lv doU 570d ,�Yk Y -10yle
t�_( u Lvatbl Sawa 6Y/z '516, r g
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel
Flood Insurance Rate Man:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No— Yes
Within 100„year flood boundary No_ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on 06q (date)1 have passed the soil evaluator examination approved by the
Department of Enviromnental Protection and that the above analysis was performed by me consistent with
the required tra ing,expert'se and experience described in 310 CMR 15.017.
h e Sig Datenature /
Q:HEALTH/WP/PERCFORM .
N
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As /
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O
F F 1
j
ci
. I !.k-a' Tau.,nr.anaauoe O
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Pl
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Town of Barnstable
Regulatory Services
' jl� Thomas F.Geiler,Director
I 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: 3 Sewage Permit# 2065®7 d Assessor's Map\Parcel Yh l07 1`1-
Designer: !Six-- .0n A 1.li`J s n 1?.O. Installer: '130,r±6 GCrAS+.
Address: )3ci�e hr My jc--,L krA rc v, Address: 'P.O. Oc,,c 764
Ir_ mauskms M J15
On 3 jq 65' 13ce-61 e5 1+� Com; hOn was issued a permit to install a
-�—( ated ) (installer)
septic system at 1/O c f f &w MSG F t1l i t based on a design drawn by
(address)
5Ar9hc.n A Ws`Isc" , f�at=a dated a12cIZ6S
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
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.
IN OF 4?40.►
STEPHEN tiG
ALLYN v'n
L.---(Installer's Signature) o WILSON
No'3021 e y
'9'G'ST;
NAL
esigner's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/SepticJDesigner Certification Form 3-26-04.doc
(4200/•.!&z>
TOWN OF BARNSTABLE
LOCATION J ,9 / /"'1 N i N S T. SEWAGE # - /
VILLAGE co T" u Y ASSESSOR'S MAP & LOT Q l 7 —0 f
INSTALLER'S NAME & PHONE NO. CoY Co7\7S- 3 Gp,
.N
SEPTIC TANK CAPACITY /Soo G-L
LT-a.CHING FACILITY:(type) S' t T (size)
NO. OF BEDROOMS-PRIVATE WELL OR PUBLIC WATER Pu Sc,c
BUILDER OR OWNER Q-T" Co rf !!—i
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
r
- I
Na7.1-,7OA41 fN0, QNH %IV /NC
No.12............ . FEE.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........OF............ .....................
Apptiration for Uhiposal Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct �r Repair an Individual Sewage Disposal
System at:
A Lo F
j ------------..............---
Location ss t
.............A0 ............................ Lbasa�...PC I
Owner :4 dres
...JJAC....... �L,
installer Address
Type of Building Size Lot...4;S3.40-----Sq. feet
U .5----------_----------Expansion Attic ( )Dwelling—No. of Bedrooms................. Garbage Grinder (44—
'_l
P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria
A4 Other fixtures -------_--------_---- ...... -----------------------------------------------------------------
!4 '------**............***----------------------
Design Flow........._.__56.......................gallons per person per day. Total daily flow.... ......4_(6,15...................g-41ons.
W 31
9 Septic Tank—Liquid*capacity.1.0.0gallons Length..W.'-k". Width_--:,7)! ... Diameter________________ Depth...6.1........
Disposal Trench—'No. .................... Width.._.._....._..._._.. Total Length___......._........ Total leaching area...................Sq. ft.
Seepage Pit No---------f---------- Diameter..161::.4...... Depth below imlet..6 L Total leaching area...54.9----etf)
Other Distribution box Dosin tank
Percolation Test Results Performed 41W.W... Date..(/_X_j.!J(-)................
Test Pit No. I....._ per inch Depth of Test Pit___ Depth to ground water.W)X_.CeYG20-0?6KW
44 Test Pit No. 2...... ...minutes per inch Depth of Test Pit-__ Depth to ground watert)0&)6-QC0U0Wdt44
P4 1 .. ....i....................................
----------- -----------------------------------------------------
........ !.Set
0 Description of Sol. —Z
0
JSAD.......=........
........0....r:=IJ.............
................................................................................................................................................ ...............................
U Nature of Repairs or Alterations—Answer when applicable...............................................................:...............................
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aioredescribed Individual Sewage Disposal System in accordance with
Z,
the provisions of TAITHE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of-Compliance has been issued by the board 'healt
1-4-
e�
i�...........
Sign ........... .. . ..................................... ....................... _�W!V�..........
MUST .
..........'Application Approved By...... ... ..... rION AND UARt, �'�z;
,?AjtjG El GIN
............. CF:R
�,,STALLA7 INSTALLED IN
Application Disapproved for the followin, r asons:.... ...........................................
91' ----------------- ,Y I
TO PLAN.
.........................................................................................................................................................................................................
Date
Permit No...........a-.7---- 9/ -------- Issued....................Date................................ lr�i
001
No.._... _....... Fps............._............
j
• 4
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......... .........OF..............�/F�"\��:k�: .:.✓-- .¢ A4�,.........................
Alip iration for Dispoal Works Tonstrnr#inn Errant
Application is hereby made for a Permit to Construct ( j,)-or Repair ( ) an Individual Sewage Disposal
System at:
.................N........................ �.Rj�� ��� :. ��Sr7sr.�._i�..!!��(� ...�i . 1---•--- ----------------.....
Location dress or,Lot No
................. ....... .......................... .....a�..l.=_-? .:.:. ;v:,l_d_..d...._....: �.Y._.! ".............._..
Owner � -... J
Installer Address
Type of Building Size Lot__ `?. `r'....Sq. feet
U Dwelling—No. of Bedrooms................... �.....................Expansion Attic ( ) Garbage Grinder
a`LI Other—T e of Building No. of ersons__________________________ Showers
YP g ---------------------------- P -- ( ) — Cafeteria ( )
Otherfixtures -------------------------------------------•-•--....--•---------------•-------•--------- -----------....---•--....--•---. ------
W Design Flow.............`3.t__......_.__._.._____.gallons per person per day. Total daily flow...........4_ '......_.__________.___._gallons.
WSeptic Tank—Liquid capacity..!l .f-gallons Length--.� Width..'D."_�'._ Diameter________________ Depth...<�..::�.
x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area.................... . ft.
Seepage Pit No_________ __________ Diameter_._�� .__��__._._ Depth below inlet___::: ?..... Total leaching
Z Other Distribution box ( `-r DosiTJ tank ( )t,. ?1� ti.. ' 1 �
Percolation Test Results Performed by i 1' ` ._._1�- ! _� 1" _ '►_ �__ !?___ Date._. +.
Test Pit No. I_______r,-:____minutes per inch Depth of Test Pit _ _ Depth to ground water L1 r t'{._!. Kj:�- r�
44 Test Pit No. 2........'_::...minutes per inch Depth of Test Pit.... Depth to ground water_ )::_.�.7___.76 ✓il'Ce-C 19
Fit�/ sy(( --;--------- •••.................
�•1 .. ,i_ ---- ............. t ..._.F..._..A .-•------...-----•-----•-•-- ---
O Description of Soil E . �r :_� �a !Jr°J`01{ ' ._._l_i_� ._':_�_a +�_.__i E is 6di_�:�_.._E _. i P/`1 t
x _
U i
_.2. �J. -••-•-------•-•------•-•--•----•- --------•----••----------•------------------------------------•--•------•-------•..................................
U Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________
----------------------------•----............------------------------------......__.._....--••_....._..........----•----------------...•---...--•••--------------...._..__.._....--•--•-------•••••_.._.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIL- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the boar�f f health.
Signefl,4L''...� - '_ti--�e.-•r "
�v\,
Application Approved BY .._.. ...• - ---------------•--------•-•----------------•• ----------: -- ............
Date
Application Disapproved for the f ollowin r asons:-•••--------•-------------•-------------•--•----••----------••----••--•---------..__•--••-...._••---..:-•••••--
---------------------•-----------•-----•----------------•-•--------------•••--•-----...•••-••-------•••••------------------------------._...----...-•----•--•-----------•--••--------- .................
Date
Permit No.........t ............................................q/
....__-••••-•-•••••••------•-•-----_. Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........4.. ° .r ............OF..............t.�?. Gn� .� �1.�.�.1 .....................
Tnrfifirate of faompliaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by.................................................:- .._...........T. ------------------------------......--•--...........•-•-----.......-•----------..................--•-••--•••-
6 � Installer
has been installed in accordance with the provisions of TITI s1 0f le State Sanitary Gr&-a6desgv jd in the
application for Disposal Works Construction Permit No_________________________________________ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...............�. .._- G. (� ........................ Inspector........... _....-•----•---........
ov ,THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
% • ,.................OF._..._.._... MJ. Q?"_! C- .r.-•---..._.... S�
No......................... FEE........................
Uispnnul arks VOLUMMudinn- rrutit
Permissioi hereby granted..............................................•--_P.....••-•-Y----•.........__...._.......................................................
to Construct (c I or "tLIA,) a nd id Disposal System
at No.. ....... --•-
._.... �•----•-•-•••......-•--.._...•••-•------••-- .
treet ��
as shown on the application for Disposal Works Construction P r t N _______________ ted__.___.__.___cc__..._.._.___....____........
....-------•••••............... .... .............................................
Board of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
\ f
f
engineering inc.
civil engineers & land surveyors
October 15 , 1987
Barnstable Board of Health .
Barnstable Town Hall
Hyannis, Ma.
Re: Lot 3A
Main Street, Cotuit
Dear Members of the Board--in
The purpose of this letter is to inform the Board that we have
inspected the septic system installed in the ground.
The components were installed according to our design plan with
the following exceptions;
1 - The septic tank and distribution box are approximately
4 ' farther away from the foundation than shown on the
a _ plan, as a result of the addition of a wood deck.
In that the leaching pit is located per plan, the"D" box and septic
tank location variance is of minimal impact .
I hereby certify that the system is installed in compliance with
S.E.C. Title V and Barnstable Board of Health rules and regulations ,
as well as , noting the above exception, the approved design plan.
If you have any questions in this matter do not hesitate to call
US .
Very truly yours,
ARROW ENGINEE ING INC.
Robe t E. Raymond, P. . & R.P.L. S.
10 cape drive, suite B, mashpee, ma 02649 (617) 540-0354 • (617) 477-2120
"# , , b •;a� , Bt LEGEND /ABBREVIATIONS
o �• ',+ ✓' %" 9 M: HYD. SPIN SPIND 4110W
. �/ , " .•• •' \ x _ ` LOT 3 B w EL s 10.0T NGVD I -
f ••• i,b ` `I' CB DH FND 8 LC. PLAN 16194E Y 5;3 I = UTILITY POLE
N/F'DAVID R. WEINSTEIN 0 = WATER GATE/SHUT-OFF
Y' 'J• WF B- - -
�! 3 • „ t �. = ELECTRIC ER
m
to
IRRIGATION CONTROL BOX
• ?
� " .. „`p' ,' �•, Sn � ' • 1 1 � J � � ( � ® MET
AIR CONDITIONING UNIT
ohs• ,; a o� � �' - � AL �p _ _..�, r' S 7e•2e1pp. -= � I Z cnr: cnr: = UNDERGROUND CAN WIRES
1 r ra� ,�,,P E I a w w = WATER LINE
3 OVERHEAD WIRES
c " o *7 (r' � , ` i/ �\\ WF B-Z :1: �••�. 'I 1 = I �j -0"W_an.-am =
J
Alt
I
AL
TREE LINE
CONCRETE BOUND
op 1\ !; \\\ BORDERING VEGETATED ✓ •`0 ,1 � I r• 100.0 I I � A-6 B
r` -� :�` �xl ; JI IL WETLAND Ni- ` :'`y LOT 4 = STAKE SET FOUND
L.C. PLAN 16194 B /
•wry �' y o / � ` 9 1;:'. ' �• \ 1 i ` i I N/F DAVID R. WEINSTEIN = MAG NAIL/SPIKE SET
1 nd '
�nkn •' ° ELEVATION
t , `N o T 1 'a ; ° � Y,;` // I � t t � 1 ` I � CB = CONCRETE BOUND
WF B-3 / \ wboDED i i n DH = DRILL HOLE
i' ne \�� , zQ • //� t t, , \ TEST PIT / I ! 65 f - FND = FOUND
• n - t AL / 13 t�.a - ,�� WF = WETLAND
LOCUS MAP Scale. 1 - 2000 - I D FLAG
LOCUS AREA IS COMPRISED OF . / / !
• I TBM• MAG NAIL I z F.F.E. FINISH FLOOR ELEVATION
,g' , (: , LAWN ` I / EL = s.2T NG I EP = EDGE OF PAVEMENT
ASSESSOR'S MAP 017 PARCEL 001 N LOT 3A SITE & 4 A- LC. PLAN 16194 B ^; ry 1 / / I Z
CERTIFICATE OF TITLE: 157,820 N/F DAVID G. MUGAR er ,� : 14 - - ; �-� , z _ 0 I
? l i'S v► S
O JAMIE K. STERN CERT.# 160,338
R WL. II BORDERING VEGETATED GENERAL NOTES
1691 MAIN STREET c� c�W--�'.c�W=-C CA I I ` .
COTUIT, MA 02635 g- i. o • AL WETLAND
t.a O- ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE
� WOODED � i ��cA}�� tr
ZONING INFORMATION �' i j; '�'` �+n I AL WITH TITLE V OF THE STATE SANITARY CODE DATED
' CA
1 WF A-4 MARCH 31, 1995 ANY LOCAL RULES APPLICABLE.
ZONING DISTRICTS: RF , ' j CA '
RPOD RESOURCE PROTECTION OVERLAY DISTRICT o o / , , , ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING
/ `• t J It' �, ` OP a BY DESIGNING ENGINEER
AP AQUIFER PROTECTION OVERLAY DISTRICT Cd FNb !' "
/ A ® �' % %� `'� TEST`PIT } I CA U Alk AL CA�92/80 0
MINIMUM CURRENT ZONING REQUIREMENTS N ZONE RF / j /' ' L,\ r i .°� i x AL WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
MIN. LOT AREA = 2 ACRES (RPOD) ,� %' i �� °} LOW BRUSH NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT
�*+ 6 SCRUB Y .; 1 RUSHY MARSH FOR INSPECTION.
MIN. LOT FRONTAGE = 150' 15
/ / /.2 STORY, Wo00` A -, I �. AL
%FRAME DWELLING N+vG wq ; tC,:� 1 \ $ AL POND ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC., SCH 40
FRONT YARD = 30' SIDE & REAR YARD - 15' _ No. 1691,. / - _ 1
W F.F.E. s 17.37 / � 1� ✓ '�'� 1 EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING
COMMUNITY PANEL NUMBER: 250001 0022 D ' B-5 y / j RE OVE IPE TO - - - - o SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER
THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS / - 0 400'PVC tr. ? LEACH � IT !� t A-3 310 CMR 15.255.
ZONES B, C & A11 (EL. 11.0) BASE FLOOD ELEVATION = 11.0' m� / INV,/OUT 13 4;' ; -+ � J, �,,..J1 °D ^, WF
STONE DRIVEAL r
SHO R j 3� r j . �" (' PRIMARY BENCHMARK: RM 46 FIRM MAP CP# 250001 0021 D
/ z
/ t ENCLOSURE / ; / /J j` ' LANIDSC�PED ,. ', r-`;= - - -'�%. 0 ` FLANGE BOLT ON HYDRANT NEAR
ACH PITI AREAI ' / 7 ' C 1 LOT 4A INTERSECTION OF MAIN ST. & OCEAN VIEW
SOIL LOGS DATE: DECEMBER 10,2004 �' ' ,� %; �• D-Bo r , _
I B AVE. ELEVATION 25.82 NVGD 1929
P#=P 10,878 A m ' 106.0' L.C. PLAN 16194 ( )
LOT 3 4, ',/ / / / _ ,�• N/F ANDREW L do JAMIE K. STERN PROJECT BENCHMARK: MAG SET IN PAVEMENT
/ 8 �g*p/,GE '; �c.0 /- / p' 11 NEAR NORTH EASTERLY PROPERTY
SOIL EVALUATOR: STEPHEN VENTRESCA, EIT � L.C. PLAN 16194 J �;�`, 1„
BOARD OF HEALTH AGENT: DAVID STANTON / l :AL
TOTAL PARCEL AREA ;c I t•1.r 1-1 ■ k CORNER OF LOCUS EL. = 6.27' (NGVD 1929)
WF B-6 66,884t SO. FT. z oy 1 EXI TING L CH PIT TO �8
TEST PIT 1 BORDERING VEGETATED f 1.54f ACRES I •. BE LIMPED & FILLED o 1 UTILITY INFORMATION SHOWN HEREIN:
G.S.E. = 8.8't WETLAND I • I i / W - LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND
on 0 IL W:F A-2 MUST BE VERIFIED IN FIELD BY THE CONTRACTOR AND
t1Cn �p�cn !• �uFs & NEEDLES a' __/ YSTEM ,. ANYCONSTRUCTION.
tr 1<ING ,? c� \ , APPROPRIATE UTILITY COMPANIES PRIOR TO
t. I r ST E DRIVE L.EAC,;t.:, !�
3• � _ 1 r I `b 7 \ , EXISTING SEPTIC SYSTEM LOCATION PER INSTALLER'S TIE CARD
A I \` PERMIT- # 7 91 CONSTRUCTION., ATED 1 /1 /
PE T- 8 - B�' ARCHD 0 - 5 87
LOAMY SAND \
__ �� Z
" y-� m \< o .j t BORDERING VEGETATED WETLAND FLAGGING AND DELINEATION PERFORMED BY SAMUEL
6 7.5 YR 4/3 WF B-7 a i WOODED $ � ���� x�J ,1 •J , WETLAND
HAINES OF ENSR INTERNATIONAL ON NOVEMBER 30, 2004.
,
BW i _ o°D �, \ O`�� O��` \ �I ` o A. TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE.
LOAMY SAND 0 �� �'�OPOF o ~ �, _ AL i IF DETERMINED TO BE NECESSARY A TITLE SEARCH SHALL
12" 7.5 YR 4/2 1 BE PERFORMED BY OTHERS.
IL
C z �' rn O d t \ 1 00 O• WF A-1 THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT
LOAMY SAND 50• \ 0 AVAILABLE RECORD INFORMATION CONSISTING OF PLANS AND
Aik �,E7 1 r 1 x 7 r, .,
�. 0 1 LJ. ! .S.J •� I 1 1
120" 10 YR 5/6 1 I ►� CS FND �� Ai DEEDS. THE EXISTING FEATURES SHOWN HEREON WERE OBTAINED
WF B-8 ; WOODED (BRKN) �''' ,�92/81 FROM AN ON THE GROUND FIELD SURVEY PERFORMED BY BAXTER,
PERC O 48 I 1
r
NYE & HOLMGREN INC. ON FEBRUARY 11, 2005
NO WATER ENCOUNTERED RATE= <2 MIN/IN'
v
UNABLE TO SONIC PLAN REFERENCES:
! i000• 1 I I I ` �' L.C. PLAN 16194 B
CP
47,97D co �' N "v►
/ -
CB FND
K 1691 Main Street
Leaching Area Requirements Cotuit, Massachusetts
fA p N
5 BEDROOMS AT 110 GPO/BEDROOM = 550 GPD N 7g.�. $ m PREPARED FOR
°° w z 0.� Andrew L. Stern
ADDITIONAL 50% FOR GARBAGE DISPOSAL _NA_GPD •�r 0.
PERC RATE = S2 MIN. / INCH (CLASS 1 )
+ TITLE
DESIGN SCHEDULE ELEVATION POLLY E. BEHRENS
LIAR = 0.74 GPD/S.F. N/F BRUCE E. Proposed Septic System Repair
FINISHED FLOOR ELEVATION 17,37 do �
PLAN BOOK 39 PAGE 43
MIN. LEACHING AREA OF S.A.S. : EXISTING SEWER INVERT AT FOUNDATION 13.4
SEWER INVERT INTO SEPTIC TANK -13.1 550 GPD/ 0.74 GPD/S.F.= 743 S.F. MIN. SEWER INVERT OUT OF SEPTIC TANK -12.8 BAXTER, NYE & HOLMGREN, INC.
SEWER INVERT INTO DISTRIBUTION BOX -12.6
SEWER INVERT OUT OF DISTRIBUTION BOX N12.4 �, Registered Professional
PROPOSED SYSTEM: SIDEWALL (48'+12') x 2 x 2' = 240 S.F.BOTTOM 48' x 12' = 576 S.F. SEWER INVERT INTO LEACHING SYSTEM N10.0 N/F BRUCE E do POLLY E. BEHRENS t Engineers and Land Surveyors
BOTTOM OF LEACHING TRENCH -8.0 PLAN BOOK 39 PAGE 43 812 Main Street, O Massachusetts 02655 sterville,
FINISH 816 S.F. WATER TABLE: NONE OBSERVED AT ELEV. 0.0 Phone - (508)428-9131 Fax - (508) 428-3750 STEPHENFLOM EL,
N
17.4 TYPICAL SYSTEM PROFILE 9 �-
FINISHED GRADE = 15.0t NOT TO SCALE MANHOLE FRAME AND COVER TO GRADE (IF UNDER PAVEMENT). 9°�,��is rtA�o\
t OTHERWISE CONCRETE COVER AJUSTED TO 6 BELOW FINISHED GRADE. NAL E '
- OVER D. Box TANK = 15.O
FINISHED GRADE OVER t J/4w - 1 !" 20 0 20 40
FINISHED GRIDS = 13.8t FIN►SNE� WASHED STONE 40'
OVER LEACHING SYSTEM = 14.0 - 12.0
8'MIN. 3• (mi FIRST 2' (TO BE LEVEL)
_ _ _ 4' SCALE IN FEET
4" SCH. 40 PVC 4' SCH. 40 PVC then O(TYPICAL) 2.Ox
O 2.Ox 9' (min) Cover 2"PEASTON
w ,:><• :-•, 'r<"'�'-'., �.�:. - t, ,e:;' :'•'' ' • 20 DATE: 02/24/05
2 min a Cover CONNECTION w
0 2.ox L 1 1�1 36 (max) 1 , .•�_.;
1O lfl IGG$ w w 24 12 ,e. -a... ' a..'.Y: 4.i -
GAS BAFFLE 6 SUMP _ 3 4 -1 1 2 EFFECTIVE = "��''•1; = :i:�s!:`; `,rY? 4 r
c��NsrRucr ACCESS _
4 SCH. 40 PVC o 0 0 0 0 o WASHED ,r ; N iT e...-,. r .ri r.y r
MANHOLE OVER INLET _ " +_" AS ED STONE DEPTH %. s t. �.�.''�J,•;. .','i'`;.�- 1iLL r•:Y. ..; �.., ,,.••,'��, 4 12
r0 TANK TO AT LEAST .r :�'. -r'` ,; t;�.t: , ,...,;• ,-
_ F: r r r WITHIN F1NI ::6 SH G
• 1 2
REINFORCED CONCR 6 CRUSHED 4 4 4 co
FOOr►NG STONE BASE 5' MIN EL 8.0 r 12'
• INV= 10.0 No Groundwater Observed O Elev. 0.0 NGVD NO. BY DATE REMARKS ORAN7NG NUMBER
ADJ. GROUNDWATER EL = 2.0 NM (-MHW) CONCRETE FLOW DIFFUSOR DETAIL PLAN OF PRECAST LEACHING CHAMBERS
20 LOADING)
EXISTING 1500 GALLON SEPTIC TANK EXISTING DISTRIBUTION BOX PROPOSED CONCRETE FLOW DIFFUSERS (H No SCALE No SCALE 0: 2004 04-160 SURV wrksht 2004-160ec.dwg
H-20 2004-160
TEST PIT -*I TEST PIT -*2 GENERAL NOTES
ELEV.:: IS+ '
ALL ELEVATIONS SHOWN ARE BASED UPON
�_s DA"I'llifV11 Us"
2, PITCH ALL LINES A MINIMUM OF 1/8" /FT. UNLESS
OTHERWISE SPECIFIED.
o0coo j 0 @ 0 f cc 000
000000 @ 0 000000 3. ALL PIPES TO AND IN THE SYSTEM SHALL BE CAST
7�
0000101) @ 0 000000 IRON OR SCHEDULE 40 PVC.
000 0 () 0 0 @ 0 000000
o 000003 (D @ c00000
4. ALL SEPTIC TANKS, DISTRIBUTION BOXES, AND
(D
000000 0 @ 0 000000 LEACHING PITS SHALL BE DESIGNED FOR H-20 WHEEL
000000 @ 0 000000 LOADINGS WHEN UNDER PAVING.
110 3 14" 000 0 0 g @) o 000000 5. REMOVE ALL UNSUITABLE MATERIAL BENEATH THE
000 0 0 13 0 @ 0 000000 INVERT ELEVATIONS OF THE LEACHING PIT FOR
1
TYPICAL DISTRIPIUTON BOX 000000 (D @ 0 CID 0 0 A DISTANCE OF 10FT. AND BACKFILL WITH CLAY-
4-01
UQUID LEVEL NOT 7-0 05'64 zc' FREE SAND 8 GRAVEL HAVING A PERCOLATION RATE
��',' I , _ , 1 ! ! 6 0 -1 OF 2 MINUTES PER INCH OR LESS.
IVOrF.' DISTRIBUTION BOX AND tSoo B. THE ;3ARN1TP,`= BOARD OF HEALTH MUST
N(,
GAL. REINFORCED SEPTIC TANK BY BE NOTIFIED WHEN THE SYSTEM IS NEAR COMPLETION
OBSERVATION PIT TYPICAL GAL. SEPTIC TANK ACME PRECAST OR FIQUAL. TYPICAL LEACHING PIT AND PRIOR TO BACKFILLING.
7. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS
PERCOLATION.RATE= < 2 MN ,`NCH, NOT TO SCALE NOT TO SCALE SHALL BE INSTALLED IN ACCORDANCE WITH TITLE '-Y
OBSERVATIONS BY: T01,1" McKE'AIN NOTE TANKS REINFORCED THROUGHOUT WITH OF THE STATE SANITARY CODE AND ANY LOCAL
3 BOARD OF HEALTH ELECTRIC WELDED WIRE WITH 24-1/2 RULES WHICH MAY APPLY.
ENGINEER: ARROW ENGINEERING INC. EMBEDDED STEEL RODS IN TOP & BOT- 8. CONTRACTOR IS TO NOTIFY ENGINEER, PRIOR TO THE
DATE: TOM. CONCRETE. IS 4,000 PS.I. TEST, INSTALLATION OF SEPTIC SYSTEM, OF ANY DISCREP-
ANCIES BETWEEN TEST PIT RESULTS AND FIELD
CONDITIONS.
To 9. ACCESS MANHOLES TO SEPTIC TANKS AND LEACHING
PITS TO BE BUILT UP TO 12 INCHES BELOW FINISH
GRADE.
TOP OF
FOUNDATION
ELEV.
GRADE PIN I'C'H GRADE FINISH GRADE FINISH GRADE OVER LEACHING
OVER T NK F OVER "D" BOX AREA ELEV. = 4415)
LLEV ELEV ELEV.
- ----_ _ _ '
EXIST GROUND
t 7
;lXl 41
A
WASHED STONE
INV.=
t,
0 T I NV. Dt
0 INV.
I NV, 0 G A L
BOX DIS1
D REINFORCED TO BE LEVEL_
CONCRETE r 'A'ASHED STONE
B STA AB' E)
)EPTIC, TANK
BOTTOM OF PIT
_iF LE-EL 5 STABI_F ) ELEV.=
INV.=
11A PRECAST LEACHING PIT
TYPICAL SEWAGE SYSTEM PROFILE LE
10 BE LEVEL 8 STAB' E)
NOT TO SCALE
05%
t LEG E N D
-1-0 _15A_
MAP ��ECT N F RCEC� LOT ADDRESS
EXIST CONTOUR
PROPOSED CONTOUR ,
7Z M Ptl�-'JA:"'Y`
cz; EXIST SPOT ELEVATION 8 X 0
PROPOSED SPOT ELEVATION 8 + 0
PERCOLATION TEST x ZONING DISTRICT FLOOD HAZARD ZONE
OBSERVATION PIT
-'DE" t( ,N " RITE IA
_ .__ ty_ PROPOSED LOCATION OF DWELLING
gp�
NUMBER 0: v{f
PERSON PER KDROOM
Ek SEWAGE DISPOSAL SYSTEM
.Ml.t.t."�'l- T 6ALLONS PEP PERSON PER DAY
T `54, V,/t
LEACHING R EQU I R E D)
IT
EACHING PPOVIDED c tj
DISPOSAL.
APPLICANTi ENGINEER:
GELA 0 N N, f\3 ARROW ENGINEERING INC.
SEWER DESIGN OSTON PLAC. 10 CAPE DRIVE SUITE B
ISHPEE MA 02649MA
Rr . 50TW MA
SIDEWALLs a V 9 14 4, r
BOTTOM SCALE DATE SHEET
e7l f
AS SHOWN
TOTAL
PLAN SCALE 40' DRAWN BY= CHECKED BY APPD. BY PLAN NO.
P F R
A