HomeMy WebLinkAbout0567 MARINER CIRCLE - Health 567 Mariner Circle a
Cotuit I
—- -- -- - ------ A = 024 — 082 I ----- - - -
No. G- Fee 1
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
e
F
01pplitatioii for Misposar *pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade'Abandon( ) ❑Complete System Individual Components
Location Address or Lot No.vrfo;(_� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Desi ner's Name,Addr ss,and Tel.No.
Type of Building: �nbb-5
Dwelling No.of Bedrooms,?j e Lot Size _ sq.ft. Garbage Grinder( )
Other Type of Building �A 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. .C' \ \�
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 YQironmental Code and not to e the system in operation until a Certificate of
Compliance has been issued by t ' d of ea h.
Signed Date
Application Approved by Date
Application Disapproved b Date
for the following reasons
Permit No. �,, b?i Z I Date Issued 3t 2o2
'`'' ��a i'�'1�,+'4.,.+,t'y-t ...!+ ..� ,_.r',. ,�T.,.�.r'n. , K� „r�..,;..r^ •,` �r,.i''. y+ic 4... _ ._ .k.r: ti r ..+ -�
No gb 4 Fee �W
" THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
r�
* pplicatlon for Disposal 6pstem Construction Aerinct
Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System ' Individual Components
Location Address or Lot No.�15( Owner's Name,Address,and Tel,No.
Assessor's Map/Parcel COC
Installer's Name,Address,and Tel.No. Desi er's Name,Address,and Tel.No.
CN
Type of Building:
Dwelling NoW Bedroo`'ms ` ��� ![` '`�Lot Size 1,�-- �. sq.ft. . Garbage Grinder( )
Other � of Bui �p. No.of Persons� .T ype ldin� Wig` Showerrs( ) Cafeteria( )
Other Fixtures
Design Flow(min.required .-.`ak gpd Design flow provided "" gp
k
� d
Elan Date�. *, :Number of sheets Revision Date
Title
Size of Septic CType Of S.A.S.
A. f �,� v, t
Description of Soil ZS_
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:-
Agreement: z,
The undersigned agrees t_ensu etll construction and maintenance of the afore descr'b y.tem in ed ion-,site sewage dis"osal system M
- � g P
accordance with the provisions of Title 5?of the En ironmental Code and not to place the system_in operation until a Certificate of
Compliance has been issued by this-Board of/ ealh.
Signedi
Z7 Date ,
Application Approved by Date
Application Disapproved by 2 Date
for the following reasons +% "8 ,.,4
Permit No. —. j Z) Date IssuedZ.
- - - _
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired(� Upgraded
( ) '
Abandoned( )by C AY0 5 A eiXG A tJ&M )6J
at 56� MAIL, , Cto-to Co- l-T has been constructed in accordance
with the provisions�o^f+Title 5 and the for Disposal System Construction Permit NoZ0,I 32( dated B J31 1 ZO 2
e.,
Installer a V'18 S&A- Designer
#bedrooms 13 Approved design flow gpd
The issuance of this permi)shall not be construed as a guarantee that the system will�funfctiojas�de�lgned�. ��,DateL r Inspector
t
w
No. 7,0Z _. Fee lw•
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
s Disposal Opstrm Construction Permit i
Permission is.hereby granted to Construct( ) Repair(�Q) Upgrade( ) Abandon( )
System located at 7 AA Agige& np c".q.,' OD-DA 1 7
tr -
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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 completed within three years of the date of this perm'.t!
Date P �1 1202 I Approved by � r
- _ -TOWN OF BARNSTABLE
LOCATION; SR!� �,�� SEWAGE#A�,;:�
VILLAGE ASSESSOR'S MAP&PARCEL��_
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITYdo
LEACHING FACILITY.(type pN�S'g—N (size)
NO.OF BEDROOM -
OWNER
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 f facility) �`� —Feet
Edge of Wetland Leaching Facility(I y wetlands exist within /
300 feet o eaching facility) Feet
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FURNISHED B
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CARL G.
CAVOSS
"7
INC.
210 NATHAN ELLIS HIGHWAY EAST FALMOUTH,MA 02536 ;1
PHONE:508-563-5530 FAX:508-563-5028
9/8/21
Town of Barnstable
Barnstable Health Department
c/o:Thomas A McKean, R.S.
200 Main Street
Hyannis, MA 02601
RE: Certificate of Compliance Release
Mr. Thomas A. McKean, R.S.
I herby authorize David Hendrick to/take possession of the original COC for 567 Mariner
Circle, Cotuit MA on behalf of Carl F. Cavossa Jr. Excavating, Inc.
Mr. Hendrick has a scheduled closing today at 4pm. This is a one time transaction given
the circumstances. Mr. Hendrick will release the original document to Cavossa
Excavation subsequent to the closing.
If you have any questions, or require any additional information or documentation, feel
free to contact me. earl 2cavossa.com Cell: 508-274-8010.
Respectfully,
/arl Cavossa Jr.
President/Owner
Town of Barnstable
Regulatory Services
Richard V. Scali,Interim DirectorRAM
t
Public Health Division QU
a Thomas McKean,Director ,
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-740-6304
(_J)
Installer& Desi ner Certification Form
Date: _ �l Sewage Permit# � _�Assessor's Map\Parcel 0
Designer: '- �'�` 5. Installer:
-._Address: q L , & ► � _ Address:
114 itvw�, rVIlLeYfP&V
On ? � �• was issued a permit to install a
(date) siesta er)
septic system at 510 �&A, O -based on a design drawn by
(address)
r`r e -�'�'« JO,. dated ... __.
-- ------- (designer) ...
certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation.of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major. changes (i.e.
greater than. 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State& Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in compliance with the terms
of the M ap . val letters(if pplicable)
.� �.
W.._ (Instal 's ,ignature) 14ARRINGTON �
NO.1070
(Designer s.' i'nature) {Affix p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUYLT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification Form Rev 8-14-13.doc
f
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address,
t.4
Ruth A. Salvucci 1.
Owner Owner's Name
information is /
- required for every Cotuit ✓ t1 MA 02635 October 30, 2015
page. City/Town State Zip Code`- Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When r
filling out forms A. General Information. 61�
on the computer, A c�
use only the tab 1. Inspector: /Y'
key to move your
cursor-do not David D. Coughanowr; RS f �
use the return key. Name of Inspector
...
Eco-Tech Rapid Response
r� Company Name
155 George Ryder Road South
Company Address,'-,,-,.
Chatham MA 6. 02633
City/Town State. ' Zip Code
508 364-0894 ` 1328
Telephone Number License Number
B. Certification
I certify that 1 have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete a§ 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:
E Passes ❑ Conditionally Passes •❑ .Fails
❑ Needs Further Evaluation by the Local Approving Authority
October 30,2015
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.
�D rS
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is required for every Cotuit MA 02635 October 30 2015
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® 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:
Inspector's Notes==> The septic system described herein is deemed to pass this Real Estate
Transfer Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4-
5, or specified by local regulations. The scope of this inspection is limited to health and environmental,
compliance and the septic system has been evaluated according to the conditions observed on the
day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing
determination.
Removal of garbage grinder is recommended
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available
❑ Y ❑ N ❑ ND (Explain below):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
y
Commonwealth of Massachusetts.
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner,,. Owner's Name'.. _
information i5 Cotult ` MA 02635 October 30 2015
required for every t
page. Cityrrown State Zip Code Date of Inspection ,
B. Certification (cont.) ,
❑ Pump Chamber pumps/alarms not operational. System will pass vMli Board of Health approval if
pumps/alarms are repaired.
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):
El 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:
.r.
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
F
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is required for every Cotuit MA 02635 October 30 2015
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate Yes" or No 9 p
to each of the following for all inspections:
_Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than %day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
I�
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
' Owner Owner's Name
,information i
required for every� Cotuit j' MA 02635 October 30, 2015
.
page. City/Town State Zip Code. Date of Inspection
B. Certification (cont.) t'
v Yes, No
El ® 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 160 feet of a surface water supply or
tributary to a surface water supply.
❑_ ® ' Any portion of a cesspool or privy is within 6 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.]
El
® ;The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
M1 ❑ ® The system fails. I have determined that one or more of the above failure
�t 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
' r
y
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is Cotuit MA 02635 October 30 2015
required for every ,
page. City/Town 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): 3 Number of bedrooms (actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd
t5ins-3/13 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
f
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci.
Owner Owner's Name - s
- information is Cotuit = MA 02635 October 30, 2015
required for every.
page. City/Town State - Zip Code Date of Inspection
D. System Information
Description: .
Asystem sized•for-three bedrooms was:installed by Spero Theoharides in 1980. .
Number of current residents: 1
Does,residence have a garbage grinder? ® Yes ❑ No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonal use?` ❑ Yes ® No
Water meter readings, if available last 2 ears usage(gpd)): 38 gpd
9 ( Y 9
Detail: 1
' 2013: 13,000 gallons 2014: 15,000 gallons
Sump pump? El Yes ® No
current
Last date.of occupancy: . Date
Commercial/Industrial Flow Conditions:
Type of Establishment`
Design flow(based:on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc:):
Grease trap present?: ❑ Yes El No
,Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged.to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
__ I
f 1
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is Cotuit MA 02635 October 30 2015
required for every
page. City/Town 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: Owner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
H w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name '
information is required for every Cotuit MA 02635 October 30 2015
page. Cltyrrown• State- Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installeflif known) and.source of information:
Age: 35+ years. Certificate of Compliance for a new system was issued 8/5/1980 (Permit#80-405 at
Health Department).
Were sewage odors detected when arriving at the.site? r ❑ Yes ® No
Building Sewer.(locate on site plan): s y
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.):
Sewer line appears structurally sound with no evidence of leakage or backup into dwelling.
Septic Tank(locate on site plan):
1
Depth below grade: feet
Material of construction:
® concrete ❑ metal;, A ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: a x years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 8.5 x 5 x 6-1000 gallon
Sludge depth: 6 in
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
• i
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is required for every Cotuit MA 02635 October 30 2015
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 28 in
Scum thickness 1 in
Distance from top of scum to top of outlet tee or baffle 9 in
Distance from bottom of scum to bottom of outlet tee or baffle 14 in
How were dimensions determined? Design Plan
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pumping not required at this time. Maintenance pumping is recommended next summer and every 2-
4 years thereafter with year round occupation. Tank and tees appear structurally sound and
functioning as intended. No evidence of leakage in or out was observed.
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
W Title 5 official Inspection Form
h Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
^M 567 Mariner Circle-Assessor's Map 24 Parcel 82
a
Property Address
Ruth`A. Salvucci 1 ;
Owner: Owner's Name
information isn 'R _ L 6'
- required for every '
Cotuit' MA 02635 October W 2015
`page:" . . _ CltylTown State ' `Zip Code Date of Inspection; t,
D. System,Information (cont:)
F
• .. i ''q';_. _ ''. .ei+ a ..
Comments,(on pumping recommendations,:inlet and outleftee ocbaffle condition, structural integrity,
liquid levels'as related'to outlet invert, evidence of,leakage,�etc:):
Yf
t
M
- .. .•'
. t 3'
Wa
a
•
Tight or Holding Tank(tank must be pumped`at time of inspection) (locate on.site plan):
Deptfi'below.grade
Material of construction:
Ps _ ,$ _ •, _ _ _
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
w
s
„ q
Dimensions:
Capacity• -
o .
gallons
s b6sigrl Flow: +`Z gallons per day * v,
Alarm present.N Yes No
ti Alarm IeveL Alarm in working order: ❑ Yes ❑ No
Date of last-"pumping ,
�.. Date
k Comments (condition of alarm and float switches, etc.):
y
rcw
a c
* e - - � 1. � •t n ,. • '
•,y ? _ *'
*Attach copy,ofcurrent pumping contract(required), Is copy attached? ❑ Yes ❑ No
t5ins•3/13 x Title'5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
567 Mariner Circle -Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is Cotuit MA 02635 October 30 2015
required for every
page. City/Town State Zip Code Date of Inspection
.D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert at outlet invert
Comments (note if box is level and distribution to outlets equal, an evidence of solids carryover, an
q Y Y Y
evidence of leakage into or out of box, etc.):
No adverse conditions observed.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
i
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci n
Owner Owner's Name A
information is COtult MA 02635 October 30, 2015
required for every
page. City/Town State Zip Code Date of Inspection
D. System Informatiom(cont.) ;
Type: ,,
® leaching pits r number: .
El leaching chambers number:
leaching galleries number:
❑ , leaching trenches number, length:
leaching fields - number, dimensions:
❑ overflow cesspool. r number.
❑ innovative/alternative system
Type/name of technology:
Comments (note conditiomof soil, signs of hydraulic failure, level of,ponding, damp soil, condition of
vegetation, etc.):
No evidence of surface ponding;breakout, lush vegetation,''ornther evidence of hydraulic failure was
observed. A hole was dug into leaching pit stone and no effluent contact staining was observed in the
stone or overlying soils. No standing effluent was observed,to a depth of 24 inches below the top of
the stone layer.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
s
Number and configuration
i
Depth-top of liquid to inlet invert
Depth of solids layer
Depth of scum.layer
Dimensions of.cesspool
Materials of construction
Indication of-groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is Cotuit MA 02635 October 30 2015
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Com
ments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
^M 567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner = Owner's Name
information is required for every, .:�
Cotuit . MA . 02635 October 30, 2015: '
"
page. _ Cdylrown 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
LOCATIONS
-OF SEPTIC COMPONENTS
LEACH DISTANCES IN DECIMAL FEET
P►T A B
�4 3' DISTRIBUTION,BOX 1 26 16
2 2 29.5 17
rM►000 GALLON3 34 20
SEPTIC TANK 4 27 29
B
1 SCREEN
PORCH
A ri
NOT
EXISTli1lG TO
SCALE
®WELLING
567.
THIS SKETCH IS w
BEST VIEWED IN J o
COLOR FORMAT
508 .364-0894
MARINER CIRCLE
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
;M 567 Mariner Circle-Assessor's Map 24 Parcel 82
Property Address
Ruth A. Salvucci
Owner Owner's Name
information is required for every Cotuit MA 02635 October 30 2015
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 35+
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: 8/5/1980
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:
Barnstable GIS Department records
You must describe how you established the high ground water elevation:
Town of Barnstable GIS Department records indicate that the property is over 35 feet above
groundwater table. Approved design plan on file with the Board of Health shows bottom of system is
4.3 feet above the bottom of a test pit in which no groundwater was encountered.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
a a Subsurface Sewage Disposal System Form Not for Voluntary Assessments
wM 567 Mariner Circle Assessor's Map 24 Parcel 82
Property.Address
Ruth A. Salvucci
Owner Owner's'Name
information is
required for every Cotuit x MA' 02635 October.30, 2015
._:.
page. ,_' Citylrown State, Zip Code Date of Inspection,
E. Report Completeness Checklist .
Z. Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure.Criteria Applicable to AlkSystems) completed
® System Information_ Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
GEOHYDROLOGICAL PROFILE
— NOT TO SCALE
z
a
a PRECAST Z
LEACH W
PIT
z
� p
ch �
¢ LPERDESIGN
OF a
LEACHING IS
ABOVE HIGH
GROUNDWATER
M
V
GROUNDWATER NO
ELEVATION GROUNDWATER
PER GIS MAPS ENCOUNTERED
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
L A T ION SEWAGE PERMIT NO.
aW
1 ccr.�,N� Sa- yas=
VILLAGE
INSTA TIER' AME A ADDRESS
� UIL ER OR 9WNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED S 5-8I
v '
w
h '�
w
���
�,
v THE COMMONWEALTH.OF"MASSACHUSETTS
BOARD OF HEALTH
-------------0F......�r�.... .... ..............................................
01 Appliration for Disposal Works Tonstrnrtiun rumit
�1 Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
on
SysG at:
...--- ... . .. .
�\ t
lion- ess, r or Lot No.
....7 ................... ...... ............'....----..--..-.-._..----------•-•-•-_ .........._•--------_-JM._.. .. .. ..............................._....
Owner Ad ress
W .............
Installer Address .
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms. ........•......_._._._...___...Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building . ................. ..... No. of persons............................ Showers ( ) — Cafeteria
Q' Other fixtures .................... _
W Design Flow.........3,30....................gallons per person per day. Total Qdail kow____--..._.�>......................_gallons.
WSeptic Tank—Liquid capacity,�Mgallons Length_.)_.. .... Width-_...-- ..... Diameter________________ Depth.................
x Disposal Trench— o...................... Width___._T--------_-_-. Total Length____._.____r------"Total leaching area....................sq. ft.
Seepage Pit No...._.a(............. Diameter......A......... Depth below i et.... ------------ Total leaching area........... .....sq. ft.
Other Distribution box Dosing
z ) g ( )
y
Percolation Test Results Performed by---r1 "' ---•----••------ Date.... � ......----
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to grou d water------------------------
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Q+' •-••••-•--•-•. ......
•------------•------------------------------------------------•-- -----------------.... ----------
0 Description of Soil... .... ..-- •------•...-•---------------------•--------•-----...._._......•••-----•----------------------------•--•-------.------
x ?. .
w -! ..--
- - - -
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 iITi 114, 5 of the State Sanitary Code—The undersi ed further agrees not to place thr sysketn in
operation until a Certificate of Compliance has�isuedy the d of alth.`
Signed. -- -- - -- ------------------•----- .............. V�� D?te .�--
ApplicationApproved By.............. .... ....`... . . .............................................................. -------- ..........
Date
Application Disapproved for the following reasons:................................................................................................................
-----------------------••--••----•-----•----------------.......--•--•----••---•--...................-----I•-----------••--------•----••-••------•----------•--•-•-----•----••----•---------••-------.....
Date
PermitNo..........................................._......._.... Issued-.......................................................
Date
r 4 _ I
No........��Y..... FEs.............r>.. ....
THE COMMONWEALTH OF MASSACHUSETTS
�- BOARD OF HEALTH
.,/r .............OF....... .
Appliration for Disposal Works Tons rurtiun Permit
Application is hereby made for a Permit to Construct (, or Repair ( ) an Individual Sewage Disposal
syt at:
,
....- + 7.._. .�u�. ..... .. . _....... ' --.......-- .........................0.........................
.L..lion es;; ,.n or Lot No. --------------•--------
..........-- •-----._.._.....- -••-•--•-- ......... ................. ,�
Ovwper�. Address
r a •---•• ........ .................................{ •-•----.............................. --••••--------•----•-•--•......._...---•--••---...................................................
Installer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.;.......... . .....:.....................Expansion Attic ( ) f' Garbage Grinder ( )
aOther—Type of Building - "---�- J---. No. of persons---------------------------- Showers ( ) — Cafeteria ( )
P4 Other fixtures -------•--------•----- ----------•--•••--..........
..... ......---•---------------•---•
WDesign Flow.......... 30....................gallons per person pgr day. Total_dajiy;ow.............r= ..................gallons.
W ,�Septic Tank—Liquid capacity/ Length...Y..... Width...t�_ _..... Diameter................ Depth................
x Disposal Trench—N,o.................... Width•.-__T.._.._._._... Total Length........... ....... Total leaching area....................sq. ft.
Seepage Pit No____________________ Diameter.._.._......... Depth below i et..__ _.....______ Total leaching area..........- .....sq. ft.
Z Other Distribution box ) Dosing ( )
'" Percolation Test Results Performed by ................ Date_. ......................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f14 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water..............`.........
------•---•---•---•-------------------••----------•......---------•••......-••.........................-..................................
O Description of Soil....
.-to---... : ...:................•-----•---......-•--------
x
U -- --- •-- . ----•-------•--------------------------------•----•---•-•----- ..._
W �------------- , a .....-••------..............
----- -- - -- - -
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
-•------------------------------------------------•--------------------•------------.....-•--•----------------•------------------------------------------------------•------.
Agreement:
1
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The undersi ed further agrees not to place th sy em in
operation until a..Certificate of Compliance has been - sued b th d of 1 alth.'
Signed----- --•- . .......................... .............. �_ ; �..... >7
Application Approved By..... -•------ .. + '
-- _.. ......................
Date
Application Disapproved for the following reasons_...................................__........................................................................
_
............................................................... .................................-------------------------------•-•--------------•-----•------------•-------.._Date --------•--- t
PermitNo.......................................................... Issued.......................................................
i. Date
THE COMMONWEALTH OF MASSACHUSETTS
^ BOARD OF HE LTtxl
.........� ........OF..... ..✓.... �.!..
uprrtifirFatr of f ompliFanrr
TV S TO IFY That th Lndividual Sewage Disposal System constructed O or Repaired
. 1j
by-------- ......_..... •----
aril
at.......... --... ;;,1►. -------- ---- --------------
has been installed in accordance with the provisions of TI �rj of���State Sanitary C e as described m the
application for Disposal Works Construction Permit No._ __.. ----�� -•-__-_----_- dated__..._ '.+7_:... ...._.._..._�.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE u
SYSTEM WILL FUNCTION SATISFACTORY
r � I�Pe�Ctor__��u.Y`^
DATE ............................
...... ......... ......... ns
-•--.---
,,..i„,r,...r„�h _.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F H . T
..
No:............ . .�a� FEE........................
i to9'�!
nr tr ion
rrmit
Permission is hereby granted---- --•--. .-------•-•-- ----------------------•--•---------------•-•- .......................................
to Construct ( or Re y
air ( ) an.Individual . wagq Pisposal
at No.----1 � .. ,/ !'I _ ...........................................
Street _j
as shown on the appli tion for-Disposal Works Construction rmit .___ Dated..___.. ' �/
I. .� of Aealt
DATE......... .O .......................................... -Board
FORM 1255 HOBBS & WARREN. INC:. PUBLISHERS -
l `
N SITE PLAN
ROUTE 28
SCALE: 1 " = 20'
z
B.M.= 100.00 (ASSUMED) ON #555 MARINER CIRCLE Co
CORNER OF BULKHEAD town w81 � � 5- S E M s
water
2 01 .9 3' b 95.72' oorin Or
�k septic,setback ed-e- f 2fl'------- ------
lan
-
----I- w ------
o
X 99.73' 99.15' x---------
Mariner cir
LOT 24 I "COTUIT"
........L........ LOCUS
N AREA=20,404±SF /' I 96
z scren 919.26' I NO SCALE
-,
ooc PROPOSED SAS porchr _ 1
2 H-10 500—gal chambers ' '`
�oz with 4' stone all around in �. ,:;:•`� '
w :PAVED_::
25 x 13 x 2 leach trench.
� I �rn ���� •':,'•;DRIVE;:;"` ;..;,<°�• ,� .
Z O
;� m �� 11 — I
°' v T.H. #2 r;. : O H-20 ?Z 96.28
N o o D-Box 92 1 U LEGEND
3% W 1 Q
Test Hole Location
99. X O � GAS GAS GA O I 5
� � F :':-:.::> `.:?z` T.H. #1 I —GAs— Approximate location
� N
°j � gas line
ii
3';: 1 3
O Z —w_ Approximate location
w rT� ` o • water line
o
��� X 99.83 20 _ �, p X 98.95 �I
0 \ 99.83' _ v �I L-Ij O • •••.. ...... Existing contour 10 loading
p n A ..�8•-
7- 11SHED B, IVI , N �I ° O sept000ogkal. H- ding
l
A 99.40'
° \
Existing Leach Pit
99.08 -0 1 `/ (to be pumped & backfilled)
° \
Septic setback opprOX eqr `e^he G�ae^ I.....97 a--0---o- 6' stockade fence
9e of fan, oar%9,°��a
o ,
- p Percolation Test
161.06 a�. ��� 1 Location
'--X-J8._18' o0 1
-6 - 1 PROPOSED SEPTIC SYSTEM REPAIR
#581 MARINER CIRCLE 7 PREPARED FOR
town water Cb 9I/.30' CAVOSSA EXCAVATION, INC.
rn 96.82'
• AT
GENERAL NOTES #567 MARINER CIRCLE
1. ADDRESS: #567 MARINER CIRCLE, COTUIT, BARNSTABLE OF (COTUIT), BARNSTABLE, MA
2. ASSESSOR'S NUMBER: MAP 024 PARCEL 082
3. DEVELOPER'S LOT: LOT #24
4. TOPOGRAPHIC INFORMATION WAS COMPILED FROM AN ON THE OWNER: MICHAEL D. DICESARE
GROUND INSTRUMENT SURVEY. PREPARED BY:
5. TOWN WATER IS PROVIDED TO THE SITE & SURROUNDING PROPERTIES. Glen E. Harrington, R.S.
6. NO WETLANDS ARE LOCATED WITHIN 150 FEET OF PROPOSED SAS. •1 70 0 9 Leda Rose ton
7. REFERENCE PLAN: TUBE #167 SHEET 1
ane
8. UTILITIES LOCATED IN THE FIELD AND ARE APPROXIMATE. �3'f�4� Marstons Mills, MA 02648
9. THIS DESIGN PLAN IS TO BE UTILIZED FOR SEPTIC REPAIR PURPOSES ONLY. ITAR�P Tel: 774-238-1813
10. THE PROPERTY IS LOCATED WITHIN A WP WELL PROTECTION ZONE/ZONE IL _ Email: ghorr880hotmail.com
11. THE PROPERTY IS NOT LOCATED IN A FLOOD HAZARD ZONE. SCALE: 1"=20' DRAWN BY: GEHRS DATE: 14 AUG 2021
12. THE PROPERTY IS LOCATED IN THE SALTWATER ESTUARIES PROTECTION ZONE. i
DATUM: ASSUMED FILENAME: 567Moriner SHEET 1 OF 2
Existing Dwelling SYSTEM PROFILE
Not to Scale
First FI. Elev.=101.79 PROPOSED
3 HOLE H-20
DIST. BOX
Existing Grade = 99.5't Finished grade over system=2% slope away Existing Grade = 99.5't
CELLAR Septic tank covers must be D-Box cover shall be One chamber cover shall be Min 2"-1/8"-1/2" Double-Washed Stone .
WALL S within 6" of finished grade within 6" of finished grade within 6" of finished grade or geo-textile filter cloth
0.02'/ft.
S=0.01'/FT To of Peastone Elev.=96.6't
13' EXISTING Level for 2' S=0.01 ft/ft
1000 GAL. 15' Invert EI v.=96.1 '
SEPTIC TANK P=s6.23' 13' ® In ® ® ® CM 24" `'(NOF
Ex. Invert H-10 = 0' ® ® ® ® ® ® ® Invert Elev.=94.10'
Install Gas Paffle 4' 20 8'-6" = 17' 4'
or aqua P=96.40'
Ex. = 96.85' 25
3/4"-1%" Double-Washed, Crushed Stone 5' Min. (5.6' PROVIDED)
6" OF 3/4"-11/2" STONE H - 1 O
.10 0
6" OF 3/4"-11/2" STONE Bottom of Test Hole #1 Elev.=88.50' O
LEACHING CHAMBERS :91R � -
Design Calculations
ALL OUTLET PIPES FROM THE
Number of Bedrooms: 3 EXISTING (per 1980 Permit) DISTRIBUTION BOX SHALL BE
Garbage Disposal: Not allowed with this design SET LEVEL FOR AT LEAST 2 FT. t2" CONCRETE COVER
Septic Tank Capacity Required: 1,500 gallons (min, per Title V) 3 - 5" OUTLET 3"
Septic Tank Capacity Provided: Existing 1,000-gal H-10 septic Tank KNOCKOUTS
CONSTRUCTION NOTES
Leaching Capacity Required: 330 gpd x LTAR= 446 SF Req'd Area - 18" 12" INLET
Lon Term Application Rate for <2 min. inch = 0.74 al s ft. OUTLET
1 . Contractor is responsible for Digsafe notification g pP / 9 / q•
6" 8" .::
and protection of all underground utilities and pipes. Proposed Leaching Structure: 1-25 x13 x2 Leaching Trench z"Bottom Leaching Area Provided, = 325 Sq.Ft.,.
.. :•
2. The septic tank and distribution box shall be set .
level on 6„ of 3/4 -1 1/2 stone. Side Leaching Area Provided = ,152 sq. ft. 3"
Total Leaching Area Provided 477 sq. ft. > 446 sq. ft req'd. PLAN-SECTION CROSS SECTION
3. Backfill should be clean sand or gravel with no Leaching Capacity Provided =477 sq. ft X 0.74 gal/sq.ft.=353 gpd.
stones over 3" in size. 3 HOLE H-20 DISTRIBUTION BOX
4. This system is subject to inspection during installation NOT TO SCALE
by Glen E. Harrington, R.S. SOIL EVALUATION & PERK TEST
. 5. The contractor shall install this system in accordance Date of SOIL EVALUATION & PERK TEST: August 3, 2021
with Title V of the Massachusetts Environmental Code Evaluation Performed By: Glen E. Harrington, R.S.
and local Board of Health Rules and Regulations. Witness: David Stanton, R.S., BOH Agent
6. If, during -installation the contractor encounters any Excavator:Zack, Cavosso Excavation, Inc.
soil conditions or site conditions that are different Percolation Rate:< 2 mpi in C1 & c2
from those shown on the soil log or in the design, Test Hole Test Hole
the installer shall halt installation and immediately notify No. 1 No. 2 42-60 DEPTH
Glen E. Harrington, R.S. DEPTH SOILS ELEV. DEPTH SOILSSOILS ELEV. EN RT"SOAK 40:00 PROPOSED SEETHERED FOR
REPAIR
7. No vehicle or heavy machinery shall drive over the D SOAK 6. 0
3" 10YR4/2 99.25 4" 10-R4 2 99.17 24 GALS APPLIED CAVOSSA EXCAVATION, INC.
septic system unless noted as H-20 septic components. Bw Bw Use <2 mpi for AT
loamy sandloamy sand #567 MARINER CIRCLE
8. Install Tuf-Tits gas baffle or equal on septic tank outlet tee. 36" 10YR6/6 96.50 34" 10YR6 s 96.67 design purposes.
9. All piping shall be SCH 40 PVC. C1 C1
10. No potable wells or wetlands are located within 150' of proposed SAS. "' 15zand m-15%sand 42" (COTULT), BARNSTABLE, MA
gravel gravel Per
11 . Provide 1 H-20 DB-3 distribution box and 2 H-10 500-gal. 91" 2.5Y6/4 91.92 93" 2.5Y6/4 91.75 OWNER: MICHAEL D. DICESARE
chambers by Wiggin Precast or equal. C2 C2 so" PREPARED BY:
m-c sand m-c sand Glen E. Har rin ton, R.S.
2.5Y7/4 2.5Y7/4 9 Leda Rose L
12. The existing leach pit shall be pumped and backfilled. 1-3%gravel 1-3%gravel g
ane
13. Removal of trees for SAS installation shall be determined by 132" 88.50 126" ss.00 Marstons Mills, MA 02648
Installer, and Owner. 10' around SAS recommended. No Observed Ground Water Tel: 774-238-1813
14. Provide magnetic marking tape over components one-foot below Soil Evaluation Certification Email: ghorr88®hotmail.com
1, Glen E. Harrington, hereby certify that on October, 1995. 1 passed the soil evaluator
grade t0 facilitate relocation of components. examination approved by the;DEP and that the analysts was performed by SCALE: 1"=20' DRAWN BY: GEHRS DATE: 14 AUG 2021
me consistent with the required training, expertise and experience described
in 310 CMR 15.017. DATUM: ASSUMED FILENAME: 567Moriner SHEET 2 OF 2
� xE..
r
F FL ELEV = 76)(5
-- --- -- FINISH GRADE -FINISH GRADE FINISH GRADE---
TOP OF FOUND. OVER TANK = _ ' '`7 '_ OVER PIT _ —jam
E LEV. IK f
4' C.I. —I- - 4" p WH REENEE EU BACKFi� ASTONE
DWELLING -- V.C. -- 4 V..C//a:- ;,
f7
CELLAR FLOOR _ GALLON \ ' ' ' " � °' 0 O C r' O 3/4' TO 1-1/2"
ELEV. = c�XS ' ' REINFORCED GONG. I . •1 O C) O O i ���_ CRUSHED STOKE
o
O C O 0
oa ° o • • • • • o ' oeo' e • DIST. BOX v9 0 � tOtiV�O o
oa 0 ° 0 7 n O o
�- (TO BE LEVEL a • o 0 o O o (•: � � � X- BOTTOM OF PIT
SEPTIC TANK ° a J a o 0 0 o i oa 4 1.
AND STABLE ) /�� ��j ELEV.
SYSTEM PROFILE iQ- -
( NOT TO SCALE) ----, - - -�
LEACHING PIT a I F
DESIGN CRITERIA �k
kllMBER OF BEDROOMS
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GARBAGE GRINDER c
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