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0068 NICKERSON ROAD - Health
68 Nickerson Road Cotuit /Y1> A= 018-100 --- - --- - �I! I I I j, 7. TOWN O(F�B�ARNSTABLE LOCATION t�U /"` eC�� `d�v SEWAGE# -0 VILLAGE �� ASSESSOR'S MAP&PARCEL01 6-100 INSTALLER'S NAME&PHONE NO. (° o�xs Lxco jm. vAq 5D64770)77 SEPTIC TANK CAPACITY ( 1W LEACHING FACILITY:(type) —00 6a I lo-A C6'��size) :10I x JL 4, NO.OF BEDROOMS I OWNER 2 ko d y s PERMIT DATE: COMPLIANCE DATE: C. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY o ...� 0 � � o 0 4�� � � �. o� ,� T'1 R� �^ `� ` � 'Y` c S �- � � � �. W a1 —• � � � w � s � -� vC �6 (_j)UC1r(V4e_d ?/"fi d 5V No. 10 — 1 v ;- Fee s THE COMMONWEALTH OF MAS ACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplieation for Disposal *pstem Construction Permit Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) LeKniplete System ❑Individual Components Location Address or Lot No. (7 Ac' r s-04 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. � L "N E01ko pe Type of Building: P. 1 Dwelling. No.of Bedrooms Lot Size r sq.ft. Garbage Grinder( ) Other Type of Building ( tYjt No.of Persons Showers( ) Cafeteria( ) Other Fixtures G Design Flow(min.req ired) gpd Design flow provided 0 gpd hK Plan Date y �� umber of sheets Revision Date q Title Size of Septic Tank Type of S.A.S. C4t r. / Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code d not to place the system in operation until a Certificate of Compliance has been issued by this Board of Sit o'Le-�A Date Application Approved by Date ZG Application Disapproved by Date for the following reasons Permit No. — 2-1 Date Issued —,S / — �`�ll)vP�, I//y )-© z .�Ct.f `.rti.�`"'., 4,� F.;„yr# iw•k."-. :w+ l, n 7,n .lnf�.a .n;x1t''x^''•,.+.{? fz*r v . ,Yx ,„dz '!� ... .. +Kxi;f ; .. = ;Y-w.it7 '.•.'. wr:f?"s r No. V �` ( :'P/ /Z'a Fee THE COMMONWEALTH OF MAS ACHUSETTS Entered;ncomputer: Y es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppflrati6n for. IStlO aY pStem Construction Permit, Application for a Permitto Construct( Repair'( ) Upgrade( ) Abandon( ) omplete System ❑Individual Components Location Address or Lot No.' l 1SM l Owner's Name,Address,and Tel.No. 1, Assessor's Map/Parcel lot �► Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.'4 Type�of Building:' u Dwelling No.of Bedrooms 1 t "i io �^w' Lo S ek�, sq.ft. Garbage:Grinder( ) Other w Type of Building O-QaPPI Ir t w No.of Persons F` Showers( ^ ) Cafeteria( ) Other Fixtures Design Flow(min.req •red) j gpd Design flow rovided 0 _1 gpd Plan Date umber of sheets 1 Revision Date q Title tJ ' Size of Septic Tank Type of S.A.S. C Description of Soils ' X,2 Nature of Repairs or Alterations(Answer when'applicable) i Date last inspected: Agreement: A 4y The a agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i >�' g P Y accordance with the provisions of Title 5 of the Environmental Code d not to place the system in operation until a Certificate of `. Compliance has been issued by this Board of Sig Date Application Approved by Date Application Disapproved by t Date for the following reasons R Permit No. f 2 Date Issued —.S_ / `Q i j)v r 1/!'/ ).O THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance v THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( Repaired( ) Upgraded( ) 'Abandoned( )by WoAg at �� Q i has been constructed in accordance with the provisions of Title" and the for Disposal System Construction Permit No. 0Iq*2 dated f// 'I s�0 Installer 1 4 Vu' DesignerE"o Q ('p(Q #.bedrooms Approved design flow U gpd 1" The issuance of t is permit all not be construed as a guarantee that the system will c i esigned. Date 2 0 Inspector !C> No. Fee 47 fi THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Mieposal *pstem Construction 3pefmit Permission is hereby granted to Construct( Repair( ) Upgrade( ) J' Abandon( ) r \ System located at�a�N ICU�e 5`C,4N 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. 3 - Provided:Co structpon must be completed within three years of the date of this:permit. Date I JovPL / S G Approved by ' -huh r rv,jo�P�U^s 1ret,�re (oC r ftvtJ I�wt ll� r Sv' -IRS l�If r �� a f ° S �1 (`^y ► ,S`'/ i Town o f F Barnstable OF THE �0 Regulatory Services Richard V. Soli, Interim Director BARN STABLE, 4 MASS.39 i639• Public Health. Division .,gym , r�ornAta Thomas McKean, Director 200 Main Street,Hyannis, lVlA 0260.1. Office: 508-862-4644 Pax: 508-790-6304 Installer & Designer Certification Forrn Date: �Z � � - , _—L—_� Sewage Permit:(#\ �Pl I Assessor's Map\Parcel Resigner: Installer: ei, Cr - Address: 12 Address: 0( ' �,c. ,Q s lc1 I . MA 6 \ n f n{ �o h s ��caXC nq was issued"a penuit to install a (d te) (installer) septic system at )J,c.LQ 'Sci� � I Wl io' � � __-base;d:on a design drawn by (address) ✓t_` '� r r1 lt,'ci:! �_L-t� dated (designer) I certify that the septic system referenced above was installed substantially accordill) to the design, which may,i:nclude minor approved changes such as lateral relocation of the distribution box and/or septic tank. .Strip otit. (rf required) was inspected and the soils were found satisfactory. t I certify that the septic system referenced above was installed it11 major changes (i.e; (),reater.than 1`0:' latezal relocation of the SAS or any vertical relocrttioii of any coinpozicnt of the septic system) but in.accordance with State & Local Regulations. Plan revision or certified as-built by des gner to follow. Strip out (if required) was inspected and the soils r ei-e found satisfactory. _ , _ I. certify that the system referenced above Nvas constructed in `z with the terms of the RA apliroval letters (if applicable) `a WAss P� r � N`��E -- (Installer's Signature) 1 " MCI 14p.35109 (Designer's Signature) (Affix Designe ere) 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 BARNS-TABLE PUBLIC; HEALTI(DIVISION. T .IANK YOU. Q:'S�t i ll igner Certification tcirm Rev 8-14-13.doc Engineers note:This certification is limited to ar as'-built inspection of system components as installed prior to backfilt.The ' engineer did not supervise construction of the system.The installer assumes responsibility for all materials,workmanship,backfilling to specified grades with proper compaction and setting r;sersicove- ,as shown`or,'the design plan. fi :w No. �`6 1 Fee 5 d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4plication for Misposaf *pstem Construction Permit Application-for a Permit to ConstructK Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot 144 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel I taper's Name,Address,and Tel.No. A( Designer's Name,Address,and Tel.No. nS ExCcv � SaP 737 ?,6lo Fad 1*-,/ Z IX Type of Building: Dwelling No..of Bedrooms Lot Size _sq.ft. Garbage Grinder( ) Other Type of Building No.of Pers Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd sign flow provided_ d gpd Plan Date b ZZ umber of sheets y Revision ate Title Size of Septic Tank e of S.A.S. Description of Soil Nature of Repairs or Alterati ns(Answer when a licab e) C) Date last inspected: Agreement: The undersigned a ees to ensure the construction intenance of the afore described on-site sewage disposal system in accordance with the provisio of Title 5 of the Environme ode and not to place the system in operation until a Certificate of Compliance has been issued b his Board ofHpalt Sign Dated Application Approved by 9.- 1` Date cJ Application Disapproved by Date for the following reasons Permit No. O( Date Issued t 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate Of Compliance THIS IS TO CE TIFY,that the On-site Sewage Disposal system Constructed(A Repaired( ) Upgraded( ) Abandoned( )by at ' has been constructed in accordance with the pro 'sions of Title 5 and the for Disposal System Construction Permit No. %Z 40'acl I dated Installer yL� Oda W&J )J,Tih(ram- Designer Ei_L.61'hludiks 274-tc,, #bedrooms Approved design flow 61j gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector n. No. 9 co ' *� R, Fee )v fi THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yis PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS plication for ]Disposal *pstrm Construction Permit Application for a Permit to Construct ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.r Owner's Name,Address and Tel.No. Assessors Map/Parcel nla Installer's Name,Address,and Tel.No. AfgG 0-1, Designer's Name,Address,and Tel.No. r 1 ,,� cfi[vv�s:fs Sd1737 z6� F :, ,,- < 17 Type of Building: Dwelling No.of Bedrooms e Lot Sized 7 (a sq.ft. Garbage Grinder( ) Other Type of Building l-:�. .,<rF No.of Persons Showers(' ) Cafeteria( ) Other Fixtures Design Flow(min.required) �4 ,1 gpd esgn flow provided / , gpd Plan Date ) r v /N umber of sheets ; Revision ate Title Size of Septic Tank ! / e of S.A.S. Description of Soil Nature of Repairs orAlteratio s(Answer when ap licab ) A Date last inspected: f 1 Agreement: The undersigned a ees to ensure the construction d ntenance of the afore described on-site sewage disposal,system in accordance with the provisio s of Title 5 of the Environmeri• 1 ode and not to place the system in operation until a Certificate of Compliance has been issued b this Board of H//ealth. Sig rf✓t / Date Application Approved by I S Date - —� Application Disapproved by. Date , 4 for the following reasons Permit No. U ( Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CEE,RTIFY,that the On-site Sewage Disposal system Constructed(P Repaired( )" Upgraded( ) Abandoned( )by !/�;;L,, at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ,?���)'2�1 dateds— Installer ;4,r i'C 7 f. Designer 4i #bedrooms Approved design flow ,�� gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date. !i 2 tf Inspector No. 2 c7! Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct(V) Repair( ) Upgrade( ) Abandon( ) System located at �,r { /i Jf J` :4.ti- , r'�7/ l/1�, ` l lb o t IV 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 permit. Date / Approved by I . . . . . ------ - WE &=�Poln�'-N,/umber....... �.l...l.......... > • ABLE, r MA88 Permit Fee.......................................other Fee........................ FD Mfg� TotalFee Paid............................................................... ...... TOWNOF BARNSTABLE Permit Approval by......:..........................On...................... BUILDING PERMIT Map.....P11...................Parcel........:`:. ....................... APPLICATION Section 1 — Owner's Information and Project Location ProjectAddress_�$ /tic 'crscn P,0J Village Cvf'�� Owners Name Owners Legal Address_ City\Ale +cn State zip Owners Cell #_6 lZ cjTa- _E-mail�tl,ue� Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ 'Commercial Structure under 35,0.00 cubic feet L7 Single/Two Family Dwelling Section 3 — Type of Permit ZNNew Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition .❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Easulation Other—Specify Section 4 - Work Description �,r_ine�!) �R-:S-F�i� Y�.«� �. � l-�k�f��� m� r� ►nr 'Y ti�r.lti`rr,, •�-, �►Grrt Town of Barmstah e - y' Departirtent of Regulatory Services ublic Iealth]®><visron nave hq 200 Main Street,Hyannis MA 02601 � t l Date Scheduled Time' Fee PJ Soil silitabil ty SSess ent,fog° S`e va .I)ispa;sal Perhnmed B N r /, Y- Y'tL vi.l�r�i_ Cs y" Wimessed By: 1a LOCATION& G_ 1MIA N GENE INFORTIG Location Address j ie'�i�tatrLl r�r.� , O%vner' ame s N q p p (r)�g�.CbG'.C.�t`�J S tJ S C'✓✓t I , ^•�' t't i{dL�L�Y 1 !t v e ' Address a ,pvZj 4 1 3 _ Assessor's Map/Parcel: �(�1 ioo I- Engineer's Name 4 i1< a.• z Y vw� (rY K. vt�. NEW CONSTRUCTION REPAIR Tele hone'# Land Usc y i v L" .��, :Slopm(%) Surfaee Stones t NC. . Distances from: Opan'�Vater Body ` ft Possible Wet Area ' l` ft' thinkingWaterWell i ft. Dtaiitage ay ft Property Line __� L frp Other ft SKETCH:(Street name,dimensions of lot cxact=location of'test hotel&pere tests, wetlands in proximity to holes) o :._ . .. �H �r1(Scry± ti i Parent material(geologic) ;...t ��5C�.5v, Depth to.Bedrock Depth to Groundwater.,Standing Water in Hole Weeping from Pit pnue /�`yr"4 Estimated Seasonal.High Groundwater DETERNIINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed:standing in ob&hole: in. Deptli to soil mottles: in. Depth to weepingfmm side of obs.hole: in, Groundwater Adjustment Index Vdeti# Reading Date: Index Well level .�,; Adl,`factor _ Adj.Clrowidwater lxvel PERCOLATION,TEST.. ngtp � T1rnd Observation Holek Depth of Pat t Z 'nme at 6" Start,Pre-soak Time @ Mine(9"-6") - End Pic-soak. CA lrt� Rate Min./Inch. Site Suitability Assessment: Site Passed �"�.,. Site.Failed: : Additional Testing Needed(Y/N) original; Public Health:Division Observation Mote 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:\SEPTICT13RCF0RM..D0C DEEP OBSERVATION HOLE LOG Bole## I Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsetp Mottling '(Structure,Stones,Boulders, on istency,%Gravel) -,f,q-4 DEEP OBSERVATION HOLE LOG Mole# � Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency,a ,ravel DEEP OBSERVATION HOLE LOG . Hole## Depth from Soil Horizon Soil Texture> Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling: (Structure,Stones,,Boulders. _-.._-- Consistency,SS,Gravel) DEEP OBSERVATION HOLE LOG. Foie# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) {Munsel)) Mottling (Structure,Stones,Boulders, Cons' ten anvr�l) t 1 _ Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year float boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious matbrW 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 t l Y t&�� (date)I have passed the soil evaluator exairunation approved by the Department of Environmental:Protection and that the above analysis was performed by me consistent with . the required:training,expertise and experience described in 10 CMR 15.017. Signature i 'e--' - Date Q:\S EPTIC�PERCFORM.DOC Town of Barnstable Department of Regulatory Services Public Health Division Bate ' e �uxareSt� i i . mesa i634 tee$ 200 Main Street.Hyannis MA 02601 Date Scheduled iTime -/D #M Fee Pd. 1 U o i oenfop Sewage osalfoil Suitability Assess . t \ l(�'t'i, \ t�i�.l(✓� Witnessed By: '�` LIV � Performed By: � j LOCATION & GENERAL INFORMTION Location Address' 1(��[' - 1E.4 I Owner's Name Address s�UX .1613 Assessor's Map/P4rcel: IK .(�/( I Engineer's Name DO_rq__,) MeA'i�,e•f f NEWCONS1RUtiON REPAIR Telephone �- (� c,L/-' Surface Stones Land Use r\�� I C`�'�`�` Slopes(9'0) '� _ l� Distances from: Open Water Body ��ft Possible Wee Area ft Drinking Water Well !_l © ft i Drainage Way ��' ft. Property Line ft Other ft SKETCH:(Street name,dimensions'of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) i cl) 7" j \ O ° \\ jC�i\ $ \\ \\ �Z 0 N /N ta 25.67'. � \ i iN w.i \\/��� \\ •ate, ---- � j^ '. 0 C �y O 00 O a (� �,.�L 'a;,��; ,�• Depth to Bedrock /t4 Parent material material(geglogic) D 1//o Depth to Groundwaker. Standing Water in Hole:' i✓d am Weeping from Pit Face — Estimated Seasonal Nigh Groundwater �� i DtTERARNATION FOR SEASONAL HIGH WATER TA 3L Method Used: I ! in. Depth to sill mottles: 1n. Depth Cjbperved standing in obs.hole: - , in, proundwnter Adjustment Depth toiweeping from side of obs.hole: Adj.Uroundwaterl evel.,,,,�, Index Well# _ Reading Date: Index Well level __ Acu.faetOC,,,_�. i 'xllttSe PERCOLATION TEST Date Observation j Tune at 9" 1401e# at ! Time at 6" ..�------ Depth of Pere Time(91'41 Start Pre-soak Time.@ End Pre-soak nn I ' � L> I I Rate Min/Inch �( Site Suitability Assessment: Site Passed '` Site Faileds Additional Testing Needed(YIN) Original:.Public x�e$lth Division Observation Hole Data To B e Completed on Bacic— ***If percolaOn test is to be condlucted within 100' of wetland,:you must first notify the Barnstable C41Aservation Division at least one(1)we6k prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface.(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel i I T DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten ra I F Flood Insurance Rate Map: 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? q 1r;5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environlnentiil Protection and that the above analysis was performed by me consistent with the requir imgj expertise and experience described in 3:10 CMR 15.017. Signature Date Q:XSEPTICVERCFORM.DOC Commonwealth of Massachusetts Title 5 official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 68 Nickerson Rd Property Address Bank Owned(Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 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: A. General Information 1. Inspector. [ U Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth R MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section.15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluattiv by the Local Approving Authority 6-28-10 nspector'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. (� IV t5insp official document•03/08 - Title 5 Official inspection Form:Subsurface Sewage Dis sal System•Page 1 of 15 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 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: 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. Answer yes, no or not determined (Y, N, ND)in the ❑ 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'av'ailable. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s),or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts f r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 68 Nickerson Rd Property Address Bank Owned (Contact David Holt.@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10- page. City/Town state Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced t ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed a ND Explain: 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(4),(4)that the system is not functioning in a manner which will protect public health, safety and,the environment: ❑ Cesspool or privy is within50 feet of a surface water ❑ , Cesspool or,privy is within`50 feet of a bordering vegetated wetland or a salt marsh t` 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: El The system'has a septic tank and soil'at sorption.'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. t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Cotuit MA 02635 6-28-10 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 ❑ ® 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. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments _ M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit . MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont): Yes No " f �, fit. C ,❑ ® 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 j ® 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 es" or"no"to each of the following, g y , y "y g, in addition to the questions•in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ .. the system is within 200 feet of`a tributary,to.a surface drinking water supply. ❑ El the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area —IWPA)or a mapped Zone II of a public water supply well If you have answered'`yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the , system in accordance with 31'0 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form`-,Not for Voluntary Assessments M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real'Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 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? t , 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)] t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form`-Not for Voluntary.Assessments M 68 Nickerson Rd z , Property Address Bank Owned (Contact David Holt @ Today Real Estate,1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. CitylTown State Zip Code Date of.lnspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 440 Number of current residents: 0 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)): Sump pump? . ., ❑ Yes ® !No Last date of occupancy: 4-2010 ' Date Commercial/Industrial Flow Conditions: Type of Establishment: r Design flow(based on 310 CM 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: Last date of occupancy/use: Date Other(describe): t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 � F Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection i D. System Information (cont.) General Information Pumping Records: Source of information: N/A 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): Approximate age of all components, date installed (if known) and source of information: 1960's Were sewage odors detected when arriving at the site? Yes No 9 9 ❑ t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 16 Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w,•, �M 68 Nickerson Rd Property Address Address - Bank Owned (Contact David.Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): " Depth below grade: feet 14 4 Material of construction: ® cast iron ❑ 40 PVC Orangeburg ❑ other(explain): , Distance from private water supply well or suction line: tees Comments (on condition of joints,venting,evidence.of leakage, etc.):. Good condition. Septic Tank(locate on site plan): Depth below grade: , feet s - Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: Sludge depth:- < Distance.from top-of sludge to.bottom of outlet tee or baffle Scum thickness x . Distance from top of scum to top,of outlet tee or baffle_ Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? t5insp official document-03108 Title 5 Official Inspection Form,Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts u v w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): • 1 Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness I Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle l Date of last pumping: Date 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): t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts k Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 • page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: + gallons per day Alarm present: t ❑ 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? t ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert r. N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into.or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: t_ El Yes ❑ No t5insp official document•03/08 TrUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 r 4 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: Type. ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 68 Nickerson Rd Property Address Bank Owned (Contact David.Holt @ Today Real Estate 1.800-966-2448) f Owner Owner's Name information is Cotuit. MA _ 02635 6-28-10 required for every ' page. City/Town. State Zip Code Date of Inspection I D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth —top of liquid to inlet invert Empty Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 6'x6' Materials of construction Block r - Indication of groundwater inflow ❑ Yes ® No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspool in good condition and empty at inspection. '' ' 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.): t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 I� ' Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch 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. ' � r 311 I r . � I a t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 h Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage,Disposal System Form -Not for Voluntary Assessments. �M 68 Nickerson Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1:800-966-2448) Owner Owner's Name information is required for every Cotuit MA 02635 6-28-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ,. . t 3 ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet feet Please indicate all methods used to determine the high ground water elevation- ❑ Obtained from system design plans on record If checked, date of design plan reviewed: 'Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database - explain: ' You must describe how you established the high ground water elevation: USGS maps show groundwater at 20'. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TOWN,OB BARNSTABLE LOCATION j5 j N SEWAGE# C®1 D a VILLAGE �'� (, ASSESSOR'S MAP&PARCEL 0 INSTALLER'S NAME&PHONE NO. �j� �-,(gam b/y� SEPTIC TANK CAPACITY 111&U /mod ��L LEACHING FACILITY:(type) ,z 6(size) NO.OF BEDROOMS OWNER J>wr oWI-e PERMIT DATE: ' 11AQ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet FURNISHED BY I-of qo Os. L4 �� �—��/°� ��J✓�� ^ Any � � A pis 93 � . �i TOWN OF Bf 1R7.7S$f1ULE OCA t10N U �`c�C ea��S 1 SEWAGE � t ,ULAGE Co ` ASSESSOR'S MAP& LOT- ........... NSTA.LI,ER'S NAME PHONE NO. EMC TANK,CAPACITY ►ln. �e�� ,EACI-LT G PACIY..M: (tyke). -- - (size) rO.OF BEDROOMS`f itTILDER OR OWNER BRMITDATE: COMPLIANCE DATE: eparation D3ismice Between the: 4aximam Adjusted.Groundwater'Iable to the Bottom of I.eaching Facility eet rivate Water Supply WcU and Leaching Facility (If any wells exist on site or within 200 feet dif leaching facility) feet 4ge of Wcdastd said Leaching Facility(if any wetlands exist wItWn 300 feet leaching facility) f �_eet_ urnishcd b., �l4 c n `' ��/� �cp P5_____�_r.. � . . .. � R "`�_ i ^ �-© �•. A � n 1 � I � � , � � � No. O Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye Application for Diooal 4brac tt COrigtrurtion Vertu Application for a Permit to Construct( ) Repair(r) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No46� ; �. ' � Owner's Name,Address,and Tel.No i' Assessor's Map/Parcel // '� Installer's Name,Address,and Tel.Nd.�jIti,Q 1 n Des ner's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � � gpd Design flow provided ���, gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank "sel/'j bra . Type of S.A.S. L` 3 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved by Q Date Application Disapproved by: Date for the following reasons Permit No. Date Issued ! Of s .`.�'. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r� t PUBLIC-HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPIication for M*Oar *p!6tem CCow5truction Permit Application for a Permit to Construct( ) Repair(4Upgrade O Abandon(' ) ❑ Complete System ❑Individual Components Location Address or Lot No,15�2�/6 /CIC&1'15al? lQ Owner's Name,Address,and Tel.Nof�!'P'/J1�• /, �� GCTZa t7-= Assessor's Map/Parcel P ' f Installer's Name,Address,and Tel.No�J i t 11 lr Designer's Name,Address and Tel No. zW' ® % d 6�6 Type of Building: m Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Ty pe of Building yp d ng ,� _ � No.of Persons Showers e s Cafeteria Other Fixtures Design Flow(min.required)_ /f � gpd Design flow provided_ �/�, gpd Plan Date Number of sheets Revision Date Title I Size of Septic Tank /j G. Tye of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site Y sewage disposal system in P accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. -. ,d� ,%' 6 j w Signe .� ,� ..,.was,, �— , 1.9rJa3 �' Date t �/ Application Approved by j D _ / Date Application Disapproved by: Date for the following reasons r� Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABL E, MA SSACHUSETTS A S CHUSETT S Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( tom) Upgraded ( ) Abandoned( )by /�i`/JCS , at l7) //1 _�l� �/r'j��ha been onstructe in o�dance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer #bedrooms L4 Approved design flow/\ y`'/1) gpd The issuance of his permit shall not be construed as a guarantee that the system will ncti�n/sa designed. Date (j [,d Inspector �V �J No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Mi!9po,5a1 *p!aem CCon!5tructton Permit Permission is hereby granted to Construct ( ) Repair ( ``) Upgrade ( ) Abandon ( ) System located at and as described in the above Application for Disposal System Construction Permit,The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Co t Etion friust be completed within three years of the date of this permit. / . Date Approved by i— f Town of Barnstable �pVE Qi+ Regulatory Services Thomas F. Geiler,Director + BAMSPABEZ MAM Public Health Division ATF16-39.aoil Thomas McKean,Director 200 Main Street,Hyannis,INLk 02601 Office: 603-362-4644 F Fax: 503-790-6304 -Installer & Designer Certification Form Date: l U Sewage Permit# sessWs Map\Parcel Designer: Au - / o g installer: !/ G r Address: 1P0 t� � � Address: pt-,7 L7lG�� i -,On 0 was issued a permit to install a (date) (instal r septic system at ///)9 �1��G�� � 46/7: based on a design drawn by � (address) Da.1 " dated (designer) 1 certify that the septic system referenced above was installed substantially according to the des ign, which may include minor approved changes such as lateral relocation of the distribution box andior 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. O FQqM MAss9�ti(Installer's Si(ynature) No 1140 ; C SSfE l 1�NI IT (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNS ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COiNIPL1ANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. s. Q: Health/Septic/Designer Certification Form 3-264doc f ti i lam, .! ' r - a • - t � .. . c - a • . •. . < Y♦ Jam' NOTE: TO'I PREVENT BREAKOUT, THE PROPOSED NOTE: . MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:23.53 F FOR A DISTANCE OF 15' AROUND THE PERIMETER OF- THE S.A.S. „ SEPTIC TANK PROPOSED,D-BOX PROPOSED S.A.S ' T.O.F. EL.=32:70 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" 'DIAMETER INSPECTION PORT OVER OF 1V4s OUTLET AND SET TO. 6 OF.FINISH GRADE SET TO 6 OF GRADE ONE CHAMBER.(MIN.) AND SET, TO 3" OF'F.G. '!9�y F.G. EL.=29.Of F.G E 27.0- F.G. EL:27.Of' "F.G. �EL: 29.50-26.50(MAX.) 6 D fj R VENT " No. 1140 V1 9" MIN COVER/ L 10'(MAX INSTALL TWO INSPECTION PORTS (MIN.) 0 L 15't 36" MAX,COVER L 15' ) C/ E '® S'17G (MIN.) ® S�1% (MIN.) OS-1 X (MIN•) •. 4"SCH40 PVC 4"SCH40 PVC. 4"SCH40 PVC TAB\�`� �NI 10 10.75" TO • 14 INV. 2 24.5 48"LIQUID,. INVERT ° '• INV.=24.00 . PROPOSED GAS BAFFLE D BOX INV.,,=23.50 4 ROWS OF 6 UNITS AT 5'/UNIT +`1.16' COUPLER.® 31.16'/ROW :. DB-5(H-20) INV.=23.70 INv.= ,23 to SOIL ABSORPTION SYSTEM (PROFILE) PROPOSED 1,500 GALLON SEPTIC TANK „ EXISTING. OUTLETS. RESTORE VEGETATIVE COVER A _ ,EL: '25.50 I BACKFILL WITH CLEAN PERC SAND - 75„ B = EL: :25.25 E -►' f , s TO TOP OF CHAMBERS ` NOTES: > ': - w, •c•. : :, :.,:..•• _ 1) CONTRACTOR SHALL VERIFY ALL EXISTING .PIPE INVERTS PRIOR,TO CONSTRUCTION BREAKOUT=TOP ELEV♦=23.53 2).TANK'AND D-BOX SHALL BE SET. LEVEL•AND TRUE TO INV♦ ELEV.= 23.10 GRADE ON A MECHANICALL COMPACTED SIX BOTTOM ELEV.= 22.20 INCH CRUSHED STONE BASE, AS -SPECIFIED,IN .r .: . .. _ u 2.88 ;� EXMATERIALITA SUITABLE '310 CMR. 15.221(2) 5':MIN.. ABOVE ,BOTTOM ,OF Ir " >' 3).INSTALL INLET &,-OUTLET TEES AS.REQUIRED T.P.:EXCAVATION OR G.W.; EFFECTIVE WIDTH a 41x 2.88 11.52 I 80 s (5.05 PROVIDED) USE .4 ROWS OF B=ADS ARC 36HC'(H20) PROFILE , :» BOTTOM°OF. TESTHOLE EL:=17.15 "= UNITS (NO 'STONE) ,yy/ COUPLER UNITS SEPTIC SYSTEM PROFILE _ TYPICAL SECTION • N.T.S. : PLTA 7. 13" 9 DESIGN CRITERIA SOIL LOG P#: 13005 � DATE: y JULY.28;,201.0 4♦ „• f 3 NUMBER OF BEDROOMS: 4 BR DWELLING - � SOIL EVALUATOR: DARREN M. MEYER, R.S.; CSE #1614., END CAP SOIL TEXTURAL CLASS: CLASS I SECTION WITNESS: DAVID STANTON, BARNSTABLE, B.O.H. DESIGN PERCOLATION .RATE: <2 MIN/IN Elev. TP-1 oe cn 9 °Elev. TP-2 pe`th M _� , -ADS . - ARC 36HC CHAMBER (H20 'LOAD)` DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW:< 440 G.P.D. 27.40 A O" 28.10. A 0" GARBAGE GRINDER: ;NO (NOT: DESIGNED FOR GARBAGE GRINDER) LOAMY SAND # •LOAMY SAND MODEL ARC 36 SEPTIC TANK: 440 gpd x 2 = 880 pd USE NEW 1,500 GALLON SEPTIC TANK 10YR 5/1 1OYR 5/1 9 26.73 8" 27.43 6 8" LENGTH 63" TE; UNIT CONFIGURATION AND AVAILABILITY SUBJECT LEACHING AREA REQUIRED: (440) = 594.59 S.F. EFFECTIVE LENGTH 60" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LOAMY SAND• LOAMY SAND` DIFFER SLIGHTL FROM, E. - FFE Y F M, ACTUAL'PRODUCT APPEARANCE. 74 1oYR 6/a toYR 6/8 SIDE WALL 'HEIGHT. 10.75 ' 24.57 34" i 25.27 34" OVERALL HEIGHT 16„ DISTRIBUTION BOX: 5 OUTLETS (H20) (MINIMUM) C1 ! C1 OVERALL WIDTH 34.5" 4640 TRUEMAN BLVD PRIMARY S.A.S. PERc,®23.05 8.04 CF o H/LL/ARD, OHfO 43026 MED. SAND MED. SAND CAPACITY USE 4 RO S OF 6 - ADS ARC 36HC UNITS (H20 LOADING) -NO STONE 2.5Y 6/6 6.', 2.5Y 6/6 (60.14 GAL) ADVANCED DRAINAGE srsreMs, INC. AND EXTENDED 1.16' W/ COUPLERS. PROPOSED SEPTIC SYSTEM SITE aPLAN BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF BIODUFUSER) (BIODIFFUSERS) 24 UNITS x 5.0 LF x 4.80 SF/LF = 576.00 SF r17.85 123" 68 NICKERSON ROAD, COTUIT, MA (COUPLER) 4 ROWS x 1.16 LF x 4.80 SF/LF = 22.,27 SF 17.15 123" TOTAL AREA 598.27 SF PERC RATE <12 MIN/IN. ("C" HORIZON) Prepared for: Mike Dedecko DESIGN FLOW PROVIDED: 0.74GPD SF 598.27SF = 442.72 GPD > 440 GPD re 'd NO GROUNDWATER OBSERVED / ( ) q Engineering by: Surveying by: SCALE . DRAWN'' DARRENIN.MEYER,R.S. Boo-Teoh Bnvlronmental NTS D.M.M. • 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 981 (508) 364-0894 DATE: to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANDW/CN,MA02537 CHECKED SHEET N0. requirements of 310, CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam In October, 1999. 508382-2822 0712911 O D.M.M. 2 of.- 2 LEGEND BENCH M•ARK PROPOSED CONTOUR / ® PROPOSED SPOT GRADE SHELL LN• / TOP OF CONC DECK — EXISTING CONTOUR 22 i SUPPORT BLOCK 98 —— ELEVATION 29. 95 + 96.52 EXISTING SPOT GRADE � 24 " \ \ , BARNSTABLE GIS DATUM 26 W— EXISTING WATER SERVICE _ :P CEL � 00 ► ►�,359.8 4 TEST-'PIT 96 cc i/ AREA PROP. 1 ,500G SITE CO SON i SEPTIC TANK I I I / , , 30 j Exist. Cesspool - ► j ► % \ (Note 10) / �� / LOCUS MAP N.T.S. o % /• / 20 % i• �/ GENERAL NOTES of - / _ Ff / % / • 32 / 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL / BOARD OF HEALTH AND THE DESIGN ENGINEER, 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF. THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE A LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: - 310 CMR 15.405 (1);(B) 1) A 2.93 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE / / C 5.93 FT BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED) T 20 f O / F p �� - / 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �' TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE SO. 32 �40 \<j�. DESIGN ENGINEER. ms ports / Z �O / /O�`• 4• ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING p p /"' / k j. / FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. >j/. N -' /�/ /%/ // /'y►�•6 0 / �a`// / ' WATER / 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. GATE O 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF o HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. jlN / 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. / /- / 9 v 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED / / // C�. / \� / {.' TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. // / //fH-2 ,S� / a �/ \\ / / 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY <, j�••\ // / // / \� / / THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING , ' 22 // - / �>.� \\ / ;. ;,_ CONSTRUCTION. �.,-� /` // ✓ y , '� '10. EXISTING CESSPOOL TO BE PUMPED, CRUSHED AND FILLED PER TITLE V. 26/{ // // i \ STONE \/ / O . . 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION T-�_ 4y �' \\ DRIVEWAY / \. j 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY - 28 // Nei AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 30 13. NO PRIVATE WELLS WITHIN 100 FT: OF PROPOSED LEACHING ALL PIPING. TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPEC. OTHERWISE), 3 \ \ // — \\ 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW - �� \ FOR THE USE OF A GARBAGE GRINDER OF ,{/qss '' >i/\ . �� \\\ jj �/ / 16. NO WETLANDS WITHIN' 100 FT. OF PROPOSED LEACHING 34 3 17. EXISTING IRRIGATION WELL TO BE REMOVED AND ALL PLUMBING•TO BE D R S •84 ft•�-\ j/ \� CONNECTED TO TOWN WATER SUPPLY. 18. INTERIOR 2" LINE TO BE INCREASED TO 4" TO CONNECT TO MAIN LINE. No. 1140 1 NITAR�a� PROPOSED SEPTIC SYSTEM UPGRADE PLAN 68 NICKERSON ROAD, COTUIT, MA .� MAP:018 Prepared for: Mike Dedecko SURVEY REFERENCE: LOT. 100 Engineering by: Surveying by: SCALE DRAWN DEED BOOK: 21318 DARRENM.MEYER,R.S. Zoo—Tech Adrommemtd 1"=20' DMM CERTIFIED PLOT PLAN: BY BATES & CHELLMAN, ENG. PO BOX 9a1 (508) 364-0894 DATE: CHECKED SHEET NO. PAGE: 017 EAST SANDWICH,MA 02537 DATED: JULY 1, 1926 50"2-2922 07/29/10 DMM 1 Of 2 c tr 100---EXISTING CONTOUR N x 100.98 EXISTING SPOT GRADE OpKeelo Rd Cross St L ��f• 34 PROPOSED CONTOUR WETLAND 'r, 32.2 PROPOSED SPOT GRADE o Pine Ridge Rd m Nickerson Rd � 1N PROPOSED WATER SERVIC TEST PIT Sea St <. _ 4,9 x �� ---- f BENCHMARK • �� LEGEND m 04( Locus z x / L o ` V 15,0 � x 15.5 13 ----- —42—� // x �1 —------ ooI / LOCUS MAP O x 13.0/ ; NOT TO SCALE / x 15.4 PARCEL 100 42,284f S.F. o Ilk rri x 16.8 •X I — o 12,4 1 �A �•� I _ R,43 �ON�•� I .` _! 19.4 ,Q,2.2 & � ����� EXISTING S.A.��� V ,q --TO BE ABANDONED N �el� o w \ � rn 6 EXISTING SEPTIC TANK \ VENT L �,\ , 7 TO BE REM D-- EXISTING N 1 GARAGE TO 34, 10 I EE R,--mot 9 31.1 PROP- \ DODO ROP• DECK — \ 28.3 �- \ 1 1 PROP. SEPTIC PRO�ROSED_ 0 TANK r�\ / % x 29.4 3 .3 1\ i �ID, r' 'HOOSEf - i L�B F.F. EL. 36.0; _ 30 d 33.1-- ; BSMT. S =21.0 i y Q ti 18, i 8 -rn 21 � O 0,7 35.2 -1 I I �� `.'- — 16. PROPOSED 0) 33.6� ,� 34 ��• ��r-- _ ;r PRIMARY S.A.S. O,� 0 2 E ; - EXISTING HO(/SE 10' �F 330 34X-3 .2-r.•`r-t --'� 32, AND DECK TO R-_..r x BE REMOIiEO 34.( - 1 --) �Q r` CB/DH FOUND \ OPOSED N40'07'30"E P �7V i 6.91' OUND M4ss9 o PETER T. C=118 33%� r g McENTEE 1. OWNER OF RECORD CIVIL — RHODES, SUSAN P No. 35109 /�j 449 OLD NORTH ROAD /51 �� �J 33.3 .WESTON, MA 02493 B O1 V ENCHMARK: ROAD PLAN REVISION 11119119 NAIL & CAP S.A.S. TO 5 BEDROOM DESIGN ` EL. 34.01 PARCEL ID: 018-100 Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM DESIGN PLAN Engineering Works, Inc. 1"=20' P.T.M. 145-19 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET No. 68 NICKERSON ROAD, COTUIT, MA (508) 477-5313 3/21/19 P.T.M. 1 of 2 Prepared for: Susan Rhodes, 449 Old North Ave., Weston, MA 02493 I� NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL.=30.5 SEPTIC TANK FOR A DISTANCE OF 15' FROM THE EDGE PROPOSED D-BOX OF THE PROPOSED S.A.S. INSTALL RISERS R IN LET NLET & OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT PROPOSED S.A.S. COVER SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND T.O.F.=35.0f SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT i F.G. EL.=34.2t F.G. EL.=33.6t' F.G. EL.=33.7t F.G. EL.=33.8t VENT MAINTAIN 2% SLOPE OVER S.A.S. L = 10' SET PIPE LEVEL FOR 2' S=1% (MIN.) L = 4. L - 29'(MAX) 4"SCH40 PVC S=1% (MIN.) p S=1% (MIN.) 4'SCH40 PVC 4'SCH40 PVC 2" LAYER OF 1/8" TO 1/2" 6" DOUBLE WASHED STONE 10"1 6 96 $ as (OR APPROVED FILTER FABRIC) 14" BBB BBB It 2' EFF. aaaaaaa 48" LIQUID DEPTH aaBaaaa -3/4" TO 1-1/2" DOUBLE 30.75 �VEL WASHED STONE ADD INV.=30.46 PROPOSED INV.=30.29 2.6' 4.8' 2.6' GAS BAFFLE INV.=30.50 D=BOX EFFECTIVE WIDTH INV.=30.00 PROPOSED SEPTIC TANK 4-500 GALLON LEACHING CHAMBERS WITH STONE AROUND AND BETWEEN CHAMBERS AS SHOWN INSTALL PIPE INV.=31.00 H-10 RATED BETWEEN CHAMBERS TOP CONC. ELEV.= 30.8t BREAKOUT ELEV.= 30.50 a INV. ELEV.= 30.00 as NOTES: aaaaa a6a66 6a a Ba0a aaaaa aaaa 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & BOTTOM ELEV.= 28.00 INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. 4' ENDS 8.5' 4' 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 54.0' TRUE TO GRADE ON A MECHANICALLY COMPACTED PERVIOUS MATERIAL SIX INCH CRUSHED STONE BASE, AS SPECIFIED 5' ABOVE GROUNDWATER IN 310 CMR 15.221(2). LEACHING SYSTEM SECTION 3 INSTALL INLET & OUTLET TEES AS REQUIRED. NO GROUNDWATER, EL.=17.1 - 3/4" TO 1-1/2" DOUBLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE WASHED STONE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 3" LAYER OF 1/8- TO 1/2" DOUBLE WASHED STONE PLAN REVISION 11/19/19 SEPTIC SYSTEM PROFILE (OR APPROVED FILTER FABRIC) S.A.S. TO 5 BEDROOM DESIGN N.T.S. GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOG BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: MARCH 21, 2019 (REF#15,927) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL EVALUATOR: PETER McENTEE PE(SE#1542) OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT LOCAL RULES AND REGULATIONS. ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 34.2 A 0 34.1 A 0" DESIGN ENGINEER. LOAMY SAND LOAMY SAND 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 10YR 4/2 10YR 4/2 FROM THOSE SHOWN-HEREON-SHALL BE REPORTED TO- THE-DESIGN -- - -- _33.7,.er. „ _ _6 33.6, B _6" ENGINEER BEFORE CONSTRUCTION CONTINUES. LOAMY SAND LOAMY SAND 5. ALL ELEVATIONS BASED ON NAVD88f. 10YR 5/6 1OYR 5/6 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 32.0 C1 26" 32.1 C1 24" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF PERC HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 14"/32" 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS MED. SAND MED. SAND AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 2.5Y 7/3 2.5Y 7/3 DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 22.7 138" 22.6 138" IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). PERC RATE <2 MIN/IN. "C" HORIZON 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE NO GROUNDWATER ENCOUNTERED INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND OLD SOIL LOG NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. DESIGN CRITERIA SOIL EVALUATOR DARRENOMEYER#S(SE#1614 WITNESS: DAVID STANTON R.S. HEALTH AGENT NUMBER OF BEDROOMS: 5 BEDROOMS ELEV. TH- 1 DEPTH ELEV. TH-2 DEPTH SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74� GPD/SF) 27.4 A 011 28.1 A 0 11 DESIGN PERCOLATION RATE: <2 MIN/IN LOAMY SAND LOAMY SAND DAILY FLOW: 550 GPD 26.7 B 10YR 5/1 8^ 27.4 B 10YR 5/1 8" DESIGN FLOW: 550 GPD LOAMY SAND LOAMY SAND GARBAGE GRINDER: NO-not allowed with design 24.6 10YR 6/8 34„ 25.3 10YR 6/8 C1 C1 34" LEACHING AREA REQUIRED: (550 GPD) = 743.2 SF 23.0 PERC .74 GPD/SF BOTT/52" PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY PROPOSED D-BOX: 1 INLET, 4 OUTLET (MINIMUM), H-10 RATED MED. SAND MED. SAND USE 4-500 GALLON LEACHING CHAMBERS IN SERIES WITH 2.5Y 6/6 2.5Y 6/6 STONE AROUND AND BETWEEN CHAMBERS (10.0' x 54.0') SIDEWALL AREA: 2(10.0' + 54.0') X 2 = 256.0 SF BOTTOM AREA: 10.0' x 54.0' = 540.0 SF TOTAL AREA:..............................................................796.0 SF 17.1 123" 17.9 123" PERC RATE <2 MIN/IN. "C" HORIZON DESIGN FLOW PROVIDED: 0.74 GPD/SF(796.0 SF) = 589.0 GPD NO GROUNDWATER ENCOUNTERED Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM DESIGN PLAN Engineering Works, Inc. N.T.S. P.T.M. 145-19 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 68 NICKERSON ROAD, COTUIT, MA (508) 477-5313 3/21/19 P.T.M. 2 of 2 Prepared for: Susan Rhodes, 449 Old North Ave., Weston, MA 02493 NOTES: 1.j CONTRACTOR IS TO ALL EXISTING CONDITIONS &DIMENSIONS IN THEE FIELD FIELD 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, DETAILS,&FINISHES IN THE FIELD WTH OWNER - 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT FIRST FLOOR TO BE 6'-11"ABOVE SUBFLOOR - �'1 �j� 4.) ALL CONSTRUCTION TO CONFORM TO.780'CMR MASSACHUSETTS - STATE BUILDING CODE.9TH'EDITION AMEN DEMENT.B IRC2015 5.) 110 MPH EXPOSURE B WIND ZONE A 6.1 ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, OR HORIZONTALLY.W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING - 7J ALL LVL LUMBER/BEAMS TO BE 1.9e U360 LOAD &) SEE CERTIFIED PLOT PLAN DEVELOPED BY SULLIVAN ENGINEERING FORALL TYR AZEK OEC4NG PROPOSED&:EXISTING DETAILS aRAn:Ncc--- 9.) FOLLOWALL MANUFACTURERS SPECIFICATIONS FOR INSTALLATION OF ALL SIMPSON COMPONENTS - 10.)ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS } -- - TO BE 3000 PSI AT 28'DAYS I ' DECK - 11.)VERIFY ALL PLUMBING'&:ELECTRICAL DETAILS W/'OWNERS ON THE SITE DURING FRAMING`CONSTRUCTION I B - 12.)TIMEER FRAMING TO BE SPRUCEIPINE/FIR NO.2 GRADE,900 PSI MIN. 3:)pROVIDE UTILITY INSTALLATIONS FROM STREET TO NEW HOUSE VIA UNDERGROUND.CONNECTIONS TO COMPLY W/ALL LOCAL CODES - B nN={RSEN-nlci?carte p O - 14.)FOLLOW ALL REQUIREMENTS OF THE.IECC2015 RESIDENTIAL ENERGY ❑ SUIGING'D'.>FRD'.'I OOD COi101.E 012 - ' EFFICIENCY REQUIREMENTS&''VERIFYALL DETAILS IMTH THE INSULATION INSTALLER/CONTRACTOR FOR THE STRETCH ENERGY CODE >'^K I�•r r—�� �I �- 15.)ALL VMNDOW AND DOOR HEADERS 4'0"'.OR LESS TO BE 3-2 x.8 W/2K.2J CABINET — 16.)THIS STRUCTURE IS DESIGNED TO THE AFBPA WOOD FRAME CONSTRUCTION KITCHEN BATH ((�� MANUAL FOR.110 MPH EXPOSURE"B"LOCATION PER:SECTION R301.2.1.1 r" RANGE Or =C�ga• I r' - - {V YOUT KITCHEN PKT.t)DOR I LAYOUT rvl OrrNERi ... . FP ROOM ININ �- o, B IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS I aLT.31: ",�, I zfr CLIMATE ZONE 5(USE EITHER PRESCRIPTIVE'VALUES OR RESCHECK CALCULATION ————.——— PANTRY Q' �,: ' TABLE 402.1.2(MINIMUM PRESCRIPTIVE INSULATION&FENESTRATION REQUIREMENTS) q - £': fENESTDA W aKYLKi1 LBLNG' 4fOOJ fRPMEB—III OOR NOaEMENT WALL OAEEMENT SLM f.RPY/.SPM:E WAIT REF L'�fACrpt_ ,.fACTdi R-Y4lL RLALLE R-VA_L•c ih tVE .-.We .e O.iQ AMMEf1 G. Dv5 iR YV Pr I].5 3D 'Yt4 t0(i FT.CEfP: :SLID E ei;R'-:N s+s "r e'-+o• 7,w nc 7-2• s-t7 - _ 1.R-VALUESARE MINIMUMS,&U-FACTORS ARE MAXVAUMS. CABINET /� FIRE RA 2.15/`9NEA:NSR-..15CONTINU USINSUWTEDSHEA7 i':NGONr:4=INTEROR.CREXTERIOP. ©oc - C I � R" =' � � OF THE HOME OR P-5 INSULATION CAVITY AT THE IhTcRICR OF THG flASEMEaIT WALL - iO �,Q 3.REFER TO IEGV:C15 CRAFTER 4 FORALL INSLLATON&ENERGY REQUIREMENTS n I i GARAGE 4.13 5'MEANS R5 CONTINUOUS INSULATEO SHEATHIr4G CN THE WAU EXTERIOR x .: — rS� 7a•x6'a'/ 8 CAVITY NSU - I LDS. 5- t LOS. e . R RT3 CA' LA.TKNJ t b W I HALL � : `BATH c is A LIVING c O -` N.LI z li © , I _ PORCH NAILING SCHEDULE 9TPX i0'CH DOOR C - . A6 7 JP A6 , APRON ( JOINT DESCRIPTION NO.OF COMMON NAILS NO.OFBOX NAILS, NAIL SPACING . I AsRON . ---"--" -- �. I. MASTER - B --- ROOF FRAMING: _.—...---_...._..---'---- -. .__...-'' ---- ---- ------------ ._._......... .----- -----—-_ ..--............ [7.A] - YI. BEDROOM.#1 § ns ` _ BLOCKING TO RAFTER(TOE NAILED) 2 8d - 2-10d EACH END e-r - e•-s. s<• _ RIM BOARD TO RAFTER(END NAILED) 2-16d 3-16d EACH END A IS b COVERED LDS.' y pp�l WALL FRAMING: '' - I E NAIL S - I - T ONS(FAO NAILED) 4-1 vd 5+16d AT JOINTS PORCH D D R ._._ _._..__. TUOA(A� NAILED) 2-16 d 2.16d 24"O.C....: .: v.: I ER(FHA AI.r... - n TOP PLATES HEADER O FIE D L N -- 16d 16d :::n.c.J.Lt�IJi CDGES FLOOR FRAMING: - A; JOIST TO SILL;TOP PLATE OR GIRDER(FOE.NAI LE D) 4i8d - - 4-1 Od PER JOIST - - - BLOCKING TO JOISTS(TOE NAILED) 2-8d - 2.10d EACH END . BLOCKING TO SILL OR TOP PLATE(TOENAILED) 3-16d 4-16d EACH BLOCK ao•. g-C :-!tm I r,r ;'a T:e• s-7 ram• i z'-b d-c- a's. LEDGER STRIP 70 BEAM OR GIRDER(FACE NAILED) 3-16d _ 4.16d EACH JOIST - ---P T.c.x R PG.1Ts va f:ro A JOIST ON LEDGER TO BEAM(TOE NAILED) 3-8d 3.1 Od PER JOIST aslNGa'nHIGN BASE _ - - BAND JOIST TO JOIST(END NAILED) - 3716d - 4.16d PFR JOIST tE-0- BAND J04ST TO SILL OR TOP PLATE(TOE.NAIlEDO 2-16 tl 3-16d - PER FOOT .. .. ,ROOF SHEATHING: T RPLAN WOOD STRUCTURAL PANELS(PLYWOOD) " FIRST FLOOR Q 1 \ I' N RAFTERS OR TRUSSES SPACED OVER 117 o.c,. 8d lod 6'EDGERS'FIELD RAFTERS OR TRUSSES SPACED OVER 16"o:c: 8d tOd 4'EDGEi4".FIELD GABLE END WALL RAKE OR RAKE'TRUSS,W10 OVERHANG Sd 10d 6"EDGEi6"FIELD ------ - ------- - GABLE END WALL RAKE OR RAKE TRUSS >id tOd - 6"EDGE/6"FIELD WI STRUCTURAL OUTLOOKERS - - GABLE END.WALL RAKE OR RAKE TRUSS W:LOOKOUT BLOCKS 8d 10d 4-EDGEW FIELD . OS SMOKE DETECTOR .. CEIUNGSHEA?HIND _ AREA CALCULATIONS WINDOW n, `n/ --- -- - CARBON MONOXIDE DETECTOR, Y Y I N D O Y V SCHEDULE GYPSUM WALLBOARD - --- DG610'FIELD RD '5d COOLERS r E -FIRST FLOOR 1318 S..F. WALLSHEATHING: -@.HEATDETECTOR TYPEMANUFACTURER'S UNIT CITY. ROUGH OPENING REMARKS SECOND FLOOR' 1123S.F. WOOD STRUCTURAL PANELS(PLYWOOD) TOTAL LIVING 2441 S.F. A ANDERSENTV12446 6 30 1/9' 718" DOUBLEHUNG STUDS SPACED UP TO24"o.c. 8d 10d' 6"EDGE712°FIELD B ANDERSENI 2 28 718"x 2B 718" AWNING - t2'&2532"FIBERBOARD PANELS Sd -- 3"EDG&T FIELD GARAGE 418 S.F. AW251 COVERED PORCH 149 S.F. C ANDERSEN A21 3 24 518"x 24 518" AWNING 1 2'GYPSUM WALLBOARD Sd COOLERS — r EDGER 10 FIELD 481S.F. D ANDERSEN C235 1 48 VT'x 41 3/8" CASEMENT FLOOR SHEATHING STORAGE S 00 STR T RA P (PLYWOOD)WOOD UC U. 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