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HomeMy WebLinkAbout1135 OLD POST ROAD (CT & MM) - Health 1135 OLD POST RW�COTUIT i l �j COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1135 Old Pose Road Cotuit, MA 02635 Owner's Name:. Jennifer&Kevin Healy Owner's'Address: Date of Inspection: . November 12008 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number:. (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the inforimation reported below is true,accurate and complete.as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340.of Title 5(310 CMR'15,000). The system: ✓ Passes Conditionally Passes Nee s Further Evaluation by the Local Approving Authority Fai Inspector's Signature: Date: November 12. 2008 The system inspector shall)subrtapy 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 copi authority. es sent to the buyer;if applicable,and the approving Notes and Continents ****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. Title 5.Inspection Form 6/15/2000 Page I LA 2 Page 2 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1135 Old Post Road _ Cotuit. MA Owner's Name: Jennifer&Kevin Hedly Date of Inspection: November 1 2008 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 exfiltrationor 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. - ND explain: Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4`times a year,due to.broken or obstructed pipe(s): The system will pass inspection if.(with approval of the Board of Health): broken ppe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date of Inspection: November 1 2008 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. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy,is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland.or,a salt marsh 2. System will fail unless the,Board of Health(and Public.Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface-water supply or.tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has.a septic tank and SAS and the SAS is within 50 feet of a private water supply well. } The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A.copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1135 Old Post Road _ Cotuit. MA Owner's Name: Jennifer&Kevin Hea1y Date of Inspection: November 1 2008 D. System Failure Criteria applicable to all systems: You must indicate either"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 gg 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. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 20.0 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 inapped Zone 11 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 CM R 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date of Inspection: November 1 2008 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 y or as art of this inspection p p tion . ✓ 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 in 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: Yes No ✓ - 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(3)(b)]: 5 I Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date ofInspection: November 1 ,2008 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: 2 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No, Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment:. Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): - Water meter readings,if available: . Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: unavailable Was system pumped as part of the inspection(yes or no): _yes_ If yes, volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: Maintenance TYPE OF SYSTEM ✓ Septic tank, distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance.contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 12123199-as built card Were sewage odors detected when arriving at the site(yes or no): No 6 - Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date of Inspection: November 1 2008 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 12" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirined by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 6" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: - Measuring stick Comments(on pumping recoirunendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present The liquid level was even with the outlet invert There did not appear to be any signs of leakage The tank was pumped for maintenance after inspection GREASE TRAP: None (locate on site.plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness` Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom.of outlet tee or baffle: Date of last pumping: Conunents (on pumping recommendations, inlet and outlet.tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): .7 Page 8 of I l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date of Inspection: November 1 2008 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade:. Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity` gallons Design Flow: gallons/day . Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Commments(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.): The D-box was clean. No solids were present. PUMP CHAMBER : None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Commments(note condition of pump chamber, condition of pumps and appurtenances,etc.): 8 3 Page 9 of 1 I . r OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: . 1135 Old Post Road Cotuit, MA Owner's Name: _ Jennifer&Kevin Healy Date of Inspection: November 1 2008 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: 3 leach chambers-per as-built leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Connnents(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): The chambers were clean. There did not a . ear to be aw si ns o ailure. A camera was used for the ins ection. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert:. Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no):. Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Coin vents(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ` SYSTEM INFORMATION(continued) Property Address: . 1135 Old Post Road Cotuit, MA Owner's Name:` Jennifer&Kevin Healy Date of Inspection: Noveniber 1 2008 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. Cie NK Scram � . G are 10 Page I I of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM:INSPECTION FORM PART C SYSTEM IN FORMATION(continued) Property Address: 1135 Old Post Road Cotuit, MA Owner's Name: Jennifer&Kevin Healy Date of Inspection: November 1 2008 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 1.50 feet of SAS) Checked with local Board of Health-explain: Tonogra>,hic and water contours mans Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable to o rd hic and water contours ma s the mays.were showing olzroximately site. 30'+/-to groundwater at this 5. ,. This report has.been prepare d onlYfor the septic system and components described herein. This septic system l ect P Y has been insp ected ed and passed as of the date of inspection. This report is:not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 TO N OF BARNSTABLE LOCATION 3 Oil Po�-- SEWAGE# VILLAGE CU 1 V r ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(ty e) 3 'Nt4L , C�A (size) NO.OF BEDROOMS OWNER. I-#CA�y 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 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY �r/)sPe.crt on 757 FO f� I I f I O D 4J W uJ W p �� 4� - O W W ' C17 y s 46 QTOWN O,F,fBARNSTABLE �� p LOCATION /I3�D/moo !�`S�`/v`� SEWAGE # VILLAGE - r�J`Lrj'�' ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 8rl-0 64e C.-751- 7?/JP3?R SEPTIC TANK CAPACITY J,5,00 LEACHING FACILITY: (type) .P, t' (size) NO.OF BEDROOMS tl]T.DER R OWNER PERMITDATE: 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 CW t ' No.-� — FEE P 9y t COMMONWEALTH OF MASSAC14US ETTS Board of Health,;R 1tRN S I AB L E,MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair Upgrade( ) Abandon( �mplete System ❑Individual Components r Location 11357 OL I O s—F I Owner's Name Toe VIIU6- -3(1 i ld e,r Map/Parcel# 75 Address Lot# aQ Telephone# Installer's Name 3oln Designer's Name YA P KPH S u v,v eA CUhS V CTi Address K4 vS+! 12 aVS+ 811 N Address YOJ3 j7IU1j>0 K 00!Rf Telephone# � �-7.i(0 Telephone# c—) Type of Building '5iMQ1C Its �t/r(N%� Lot Size 1/3 sq.ft. Dwelling-No.of Bedrooms Garbage g qo) Other-Type of Building No.of persons Showers( ),C'afeteria ( ) Other Fixtures Design Flow (min.required)�r% � gpd Calculated design flow / Design flow provided L/ gpd Plan: Date /0^�� / Number of sheets Revision Date 'Title S i-K + Description of Soil(s) src bit-N Soil Evaluator Form No.4C719f Al- Name of Soil Evalua yy(e ,/1 UfZP4►/Date of Evaluation !Z-:7-C1C DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not t nlare th tem in operation until a Certificate of Compliance Pas been issued by the Board of Health. Signed Date Z 2� Inspections F h' y4. No. i FEE O Cy • 9y t y COMMONWEALTH Of MASSACHUSETTS t Board of Health, B ff K N S I AZ L 67 , MA. APPLICATIO Y FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT F• fi r� Application.for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) - U-Clo'mplete System ❑Individual Components K Location 35- QL Pos—r 12 Owner's Name fog V19u(r - ilodde r Map/Parcel# 7 5 Address Lot# oZ Q Telephone# Installer's Name O r v l� � S�. De "gner's Name #4 N k; 'J u V V e C ons U C7-4 P1 Address -1 K US4 '2 Mav4 ► 11' Address 10/3 =N j;>USTYZ A0o9 Telephone# Telephone# -~ Q S p^- ( 41J 3 �6 a Type of Building 1 (l C f A ,1" tt,. T Vr(C +g/- ! ll'S)ize sq.ft. Dwelling-No.of Bedrooms t =. Garbage g r0 ) Other-Type of Building 4 No.of persons Showers ( ),Cafeteria ( ) Other Fixtures /emu Design Flow(min.required) "I% gpd Calculated design flow 0 Design flow provided Lrs y gpd Plan: Date /0-16' q I Number of sheets Revision Date !.Plan: 5 Sf t4JV`Cje V"/� IAm Description of Soil(s) See- 14 N' -""Soil.—Evaluator Form No. Name of Soil Evalua I'VV �,� Iri.�V rt P Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS ^ F f 1 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and ' further agrees to not lace thesystem in operation until a Certificate of Co pliance as been issued by the Board of Health. Signed Date Inspections /s No.� COMMONWEALTH OF 1` ASSA'l_.HUSETTS t FEE� Y Board of Health, R A'R N STA Q UC MA. CERTIFICATE OF COMPLIANCE l f x Description of Work: ❑Individual Component(s) &�Eomplete System The under • ned here y certifythat he Sewage Disposal System; Con`structei�Repaired ( ),Upgraded}( ),}Abandoned O , Lt at IS S OL17 POSE ROA has been installed in accordance with the provisions fo�ff310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated ? A' Approved Design Flow���7 (gpd) Installer DesigneryWNk�'e S�vu�y CvhS�It�N�Inspector: m '0 ` _ Date: The issuance of this permit shall not be construed as a guarant th t the system will function as designed. No. FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, 1 �4R N STD1.� MA. ➢ ISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct(L4'R-Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system n at S ©('D / y ST A-Y as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three'vears of the date of this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date s - 99 Board of Health �k , BENCHMARK: TE A.M. 56 82.X02 — _ _ _ gEN R � - EL=100.0(ASSUMED) o BAXTER •NECK \ \ \ VACANT / , TOP C.B. V i �192 p OF , , d ROAD F \ \ \ \ 550.24 22 W �- o LOCUS \ _ ti cn t� G B. (fad) OF BAD E . �� NORTH am (BROKEN)11 \ �s �• I I } "1: 'd g ' - r•, ;; °' Ply. .a BAY A. WRITHE th �r1, ti Q a c� Ul \ �. sd, �; 9 5•s' �' LOCUS i o �I � Q, ► \ ,�o o `� �'0 \ rn A.M 75/1.X02 PLAN REF. " I \ � I RES. ZONE. RF Q ► \ \ \ o ti / �� \ s (TOWN WATER) L C. 15593 F SETEA \ \ 4 BEDROOM 0 1�0 ` FRONT 30 I � 74.B \ ,9 0 DWELLING 7916 ASSESSORS MAP 75 SIDE 15'�s I . o �r' ° \ BACK 15' do 1 a, \ \ FLOOD ZONE C II W W GARAGE p \T a I HSE. cg y I �B O' I Gur GRO UND WA TER PROTECTION O 1 POLE \ \ x, .01 �� O VERLA Y DISTRICT AP„ of e?•\ \ � \ �\` \ \ � � . SITE & SE WA GE PLAN R 30.00' i h��,,-lam L = 25.23(CALC.) i OTP` PROJECT L OCA TION - i w L = zs of'(PLAN) .' � I 1135 LOT 20 OLD POST RD. �J r Op- . op05E � R = 52.50', t. / COTUIT, MA. _ �I `93' •' Yg - PART OF — L = 126.62(CALC.) . / `\ ASILOT 1-15 L = 125.88'(PLAN) / \ C i \ S�p6. � / AREA= 0�, z / \ APPLICANT. 5,4e6 SQ. Fr — 93 LOT 20 I VA UGHN HOME BUILDERS 94 —� AS/LOT 1-15 \ 95- - - — AREA- / � 43,562 SQ. .FT. I YANKEE SUR l/EY CONSUL TAN TS 0 ,4 '4 97_ - P. O. BOX 265 43.93 5.��14I f'�-_ ! UNIT 1, 408 INDUSTRY ROAD ti 3p.00, MA. 02648 129.17'� - I MARS TONS MILLS, ROAD �/ N59 48 45 E PH.(508)428-0055 - FAX(508)420-555J . � R = 30.00 � L = 25.23'(CALC.) / (CONSTRUCTION SCALE.• 1 "=30' EDA TE.- 10/16199 L = 26.01"(PLAN) WAIVED) LOT 21 R = 52. 50' ASILOT 1-14 L = 126. 62'(CALC.) VACANT a . REV.• REV.• / � ( - WELL l L 125. 84'(PLAN) JOB NO. 520 73 SHEE T 1 OF 2 EL. = 95.0' i. TOP OF FOUNDATION 20' MIN. - . • 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. V.C. VENT MIN. PITCH 1/8 PER FT. ,2"LA YER OF , 1/8"-112" / / / / / / / / / / �_ CONCRETE CO VER WASHED S71ONE EL=94 EL=95 lip / 8" MAX / / / i i / / / / / / / / .� i i 4* CAST IRON PIPE P17C 114� MINIMUM 36„ CLEAN SAND MAX FLOW LINE EL=91.0 INVERT 110" 14" _ _ _ = O = _ _ _ MIN. �Zp•� o o° = _ _ _ = = _ = = _ = ogo° o EL.= 93.0 -- INVERT LEVEL p 00 CO _ _ _ _ _ _ _ _ _ = o 0 BAFFLE _ 92 25' IN 6 SUM INVERT °°o 0 0 == o 0 0 0 0 == o 0 0 92.25 ' INVERT EL.- _ EL.- EL.= 92.5' EL.= 91.50_ EL.= 91.25_ 4' 4 (717 BE PLACED ON FIRM BASE) DISTRIBUTION (3) 500 GAL LEACHING CHAMBERS MECHANICALLY COMPACTED OR 6" OF S70NE BOX EL.=20-5 __l5Q2_-GALLONS TO BE WATER TESTED 128' X 335' TRENCH MRVA77ON SEPTIC TANK IF MORE THAN ONE OUTLET PLACE ON 6" STONE SOIL ABSORPTION 3/4" DOUBLE WASHED STONE SYSTEM (SAS) PROFILE OF - BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV=_ q-5_' SEWAGE DISPOSAL SYSTEM NO OBSERVED WATER TABLE (9109199) ELEV- =_ 79.5' NOT TO SCALE OBSERVATION HOLE 1 ELEV.=_ 90.5' PERCOLATION RATE S2 MIN./ INCH AT _4�_ OBSERVATION HOLE 2 ELEV.=_93 0' DEPTH HORIZ TEXTURE COLOR M07T OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 0-3" 0 ORGANIC 0-3" 0 ORGANIC 3"--18" A SANDY LOAM 10YR 4-1 3" 18" A SANDY LOAM IOYR 4-1 GENERAL NOTES 18"-36" B LOAMY SAND IOYR 4-6 18"-48" B LOAMY SAND IOYR 4-6 6"-132' Cl MEDIUM SAND IOYR 7-4 PERC 48"-144 ' C MEDIUM SAND lOYR 7-4 1) ALL WORKMANSHIP AND MA TERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN OF _EARN, E____ RULES AND NO, WATER ENCOUNTERED NO WATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BRO UGHT TO SOIL TEST WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 9/09/99 SOIL TEST DONE BY BRUCE G. MURPHY, R.S. 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED BY: DONNA MIORANDI WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE P#9414 DESIGN CAL CULA TIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. NUMBER OF BEDROOMS . . . . . . . . 4 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL - GARBAGE DISPOSAL . . . . . . . . . NO BE MORTERED IN PLACE. TOTAL ESTIMA TED FE0 W 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH LA(STALL- 110GAL/BR./DAY x 4___ BR.) 440 GAL/DAY DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO ( --- OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. (3) 500 GAL LEACHING CHAMBERS REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR WITH 4' STONE ALL AROUND IS TO CALL "DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS 12:8' X 33.5' SOIL CLASSIFICATION . 1 PRIOR TO COMMENCING WORK ON SITE. DESIGN PERCOLATION RATE < 2 74 N.MI /IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS INSTALL LEACHING IN 6 HORIZON EFFLUENT LOADING RATE . . GAL/DAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. LEACHING CAPACITY (AREA X RATE) 454 GAL/DAY 8) PARCEL IS IN FLOOD ZONE___"C"_____ RESERVE LEACHING CAPACITY . 454 GAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP _zd_ AS PARCEL _I=15 _- (33.5XI2.8X 74)+(33.5+33.5+12.8+12.8)MX 74) SHEET 2 OF 2 JOB NUMBER _ 52073 ____-- A.M 56 82.X02 - BENCHMARK: � EL=100.O(ASSUMED) u �t 0� o BARTER NECK \ \ ( VACANT \ 7YJP of c.B �cit p e ROAD ., -� . b \ S50 24 22 W 9e �a 'a - o LOCUS NORTH Nd) V I I ESNOfVo PAuL 9 BA Y .9 w. .: H06 32M LOCUS �I sa C1R1L � G 9 a 0 , f �� { .. �� "�.� \ rn 75/1.X02 PLAN REF. 4, \ (7V WN WATER) RES. ZONE. "RF"L`C. 15593 F r SETBACKS: \ ��4 ' �DRooa�w, - o � FRONT 30 , ' ;r 74.8 9D LLINc'^x<- ' ASSESSORS MAP 75 SIDEBACK115' O H 71 FLOOD ZONE C HSE. I GUY :.r, '�,,�:.:, 1 � � w GROUNDWATER PROTECTION I POLE "A ., I �s o• \ O VERLA Y DISTRICT P .1 a -7 SITE & SEWAGE PLAN L = 25.23'(CALC.) �� �' �, \ I PROJECT L OCA T/ON w r L = Zs.Ol"(PLAN) I I 1135 LOT 20 OLD POST RD. r - / R 52.50' \ COTUIT, MA. hl ��. pRop ' L = 126.62(CALC.) / b I v� PART OF - - 125.88( L PLAN) / \ r _0 4¢��0�' 0 AS/LOT 1-15 / APPLICANT.- S`�o - - AREA- �, z HOME BUILDERS 0A �5,4es se. Fr — 93 TOT �O VA UGHN H cp 9ti AS LOT 1-15 1 I I ' - 9f _ AREA= II 95 43,562 SQ. FT. YANKEE SURVEY CONSUL TAN TS 4431 1 g5 96 — I P. O. BOX 265 _ - 97 � UNIT 1, 40B INDUSTRY ROAD 30.00 / C 634"�` i �� 129.17'� 1 MARSTONS MILLS, MA. 02648 /R = 30.00' . ROAD N59 48 45 E J PH.(508)428-0055 - FAX(508)420_5553 = 25.23(CALC.) (CONSTRUCTION 26.OI'(PLAN) SCALE.' j "=30' IDA TE.' 10/16/99 WAI VED) LOT .21 R = 52.50 As/LOT 1-14 REV- REV.' L = 126. 62 CALC. VACAIV T o / ( � TY/ � J - WELL L - 125. 84 '(PLAN) JOB NO. 520 73 SHEET 1 OF �2=