The URL can be used to link to this page

Home My WebLink About0160 OXFORD DRIVE - Health LCotuiI�2 Oxford Drive t 21-074 - - -- ---- - ---- - TOWN OF BARNSTABLE LOCATION U b x f lJ r-i Drive, SEWAGE# VILLAGE (`�,�hA ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. '��ih�g SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (/ (size) NO.OF BEDROOMS 3 OWNER PERMIT DATE: COMPLIANCE DATE: (o Separation Distance Between th 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 le hi facili ) .`Feet FURNISHED BY �1 �. ► 6� _ _ _� cJ1 \ . � � \ '� - �/� � � — -� s .o 0 P T � �j�p No. 0�'o .. Fee � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppficatiou for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade X Abandon( ) ❑Complete System Individual Components Location Address or Lot No. U a Xft rA b v e 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. 11_ Ty e of Building: Dwelling No.of Bedrooms Lot Size Size2b,MD sq.ft. Garbage-Grinder( ) Other Type of Building � �hn No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �� gpd Design flow provided gpd Plan Date Number of sheets 2 Revision Date Title .t& hxftd , C Size of Septic Tank Type of S.A.S. Description of Soil ha � i ium Nature of Repairs or Alterations(Answer when applicable) 2SY)tied 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 f H Signed Date Application Approved by Date 19^ '� J Application Disapproved by Date for the following reasons Permit No. ,2U O " (o jO Date Issued 6'�r No. i 0 r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for -Misposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System kZndividual Components Location Address or Lot No. I � b xfv f A hr V e Owner's Name,Address,and Tel.No. Assessor's Map/Parcel _ 4 n Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size 2 h O(, ) sq.ft. Garbage Grinder( ) Other Type of Building }1/t No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 48 1 gpd Plan Date�40�0 / Number of sheets_ 2 ,{ Revision Date -- Title��6fl�P(� ��v1 \E �1/1 fY/ - R � ir !��{ )d�(� rIlt 1 1' " Size of Septic Tank Type of S.A.S. Description of Soil A" ,L,(1 hA(j < l Wk w d lam qt+d Nature of Repairs or Alterations(Answer when applicable)T bg? (, k X 12)SUi/6_11 611 (k[1W1JYj,f J Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed \' Date b ,a D20 /r G Application Approved by Date (p^6 �� Jµ �.• 'Application Disapproved by Date ':• for the following reasons z Permit No. ;C) d — (0 fo Date Issued -- b f; --- r 1!__ �. 1? t t+ 9--- - { ----:---- - - - - HE Cd�MMO�TWEALT , OF*S§ACHU4SETTS BARNSTABLE;WkSSACHUSETTS Certifuate of Compliance" THIS IS TO CERTIFY. that'yl e On-site'Sq ge Disposal system Constructed(� {)1�� 4.Repaired( ) Upgraded ( ) iih1 ; t t Abandoned `6y at l(G() }X ft)�� j�, has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No.a°2 0 dated 0 Installer { n?< (i Wbpi Designer � ) t, #bedrooms Approved design flow 3 c� gpd The issuance of this p remit shaynot be construed as a guarantee that the system will ctifGn own 'de d. Date Inspector --------------------—D r--------------------------------------- ---------------------------------Fee------------------- No. y �'P 10 �C/ ,__ ) . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(A) Abandon( ) System located at i 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. 15 os Date CO Approved by / V Town of Barnstable 0� Regulatory Services BAMSTABLE, Richard V. Scah,Interim Director MASS. 39. Public Health Division M Thomas IMcKean, Director 200 I'Maill Street,Hyannis,MA 026,01, Off-tee: 5OS-862-4644 Fax: 508-790-6304 Installer& Desi ner..Certiricati.on Form Date: _zq) 241 Sewage Permit-# Assessor's Ma,p\'Parcel �7 Designer: ,V_Ekl "n-e_t LdA tic, Installer: Cx c,OkQ C>,+ A Address: �ru�sAddress: Le M A 1 6 7— On U 4A(5 a permit to instill a (Cl, (ins taller) Septic system at c) _X�C64 VP Cz based on a design drawn by _7 "I--eer % dated.---,q 3(5 '(designer) Ll_ I._Certify that the septic system..referenced above was,i'ristalled sO*stantiafly according to the design, which may include.ininor app,roved changes such as lateral relocation. of thedistribution box and./or septic tank. Strip out (If required) Nvas:inspected and he soils Nyere.found satisractory. I certify that the septic system referenced above was installed with major changes (Le. -ctooatlon of SAS or an vertical relocation of any component greater than 10' lateral I 1� Y .pone .t Of the Septic system) but in accordance with State 8,, Local Re-utat,ons. plan revision or certified as-built by designer to folloVY. Strip out (if reql.lired) xas inspected and the soils were found satisfactory. I certify that the system referenced above was constructed I'll with the terms h 'A approval letters Of'appli(;able) Alk (Installer's _iii-tur (Dcsign_er's (Affix De,I si I gne ere)_ PLEASE RETURNNSTABLE PUBLIC HEALTH.DIVISION— CERTIFICATE OF COMPLIANCE NIVILL NOT,BE.ISSUED ]UNTIL BOTH. ORIM AND AS- BUILT CARD ARE, RECEIVED BY THE BARNSTABLE PUB.L.I.0 HEALTH.DIVISION, 111AINK W&Pfic!Desi.gner Certification Forn,Rev 8-14-11doe Z�A S Engineers note,This certification is limited to an as-built inspection of system components as insialled prior to backiiii.The engineer did not supervise '�'s responsibi construction o,;the system.The installer assumes J tily for all materials.workmanship,backfilling to specified grades with proper compaction and selling risers;Qovers as sirown on the design plan. Town of Barnstable SINE Tg,. " Inspectional Services Department SARNSLUIM °Public Health Division MASS. 1639. �m 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 , FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 2095 May 14, 2020 BLACKMAN, BRUCE D& DONNA M TRS 160 OXFORD DRIVE COTUIT, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 160 Oxford Drive, Cotuit,MA was inspected on 04/14/2020 by Michael T. Bisienere, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20 h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH o s c ean;*&,-CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\160 Oxford Drive Cotuit.doc Town of Barnstable BARN LE, .. Inspectional Services Department AtfD MA'S A .• Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code§360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline' 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA :` ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the.well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) Zaching- facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form �- .i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ; 160 Oxford Drive € F Property Address t;7 Bruce Blackman ii w Owner Owner's Na information is required for every Cotuit 1/ MA 02635 04-14-2020 page. City/Town State Zip Code Date of Inspection •= �a Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information S�# (��9 on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road Co � Company Address Teaticket Ma. 02536 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the,property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑. Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 04-18-2020 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 I� t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The.system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r Commonwealth of Massachusetts p Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Offcial Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal : to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® ❑ 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 '/2 day flow 0 ® 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 water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Rio Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 . 04-14-2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Z ❑ 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.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form '~ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection Do System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 plus GPD Description: 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Detail: a Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): i Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: 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 below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .•, 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: J ® 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: 09-28-1992 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 16"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: standard H-10 1000 gallon Sludge depth: 2° Distance from top of sludge to bottom of outlet tee or baffle 34" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home. At the time of inspection the liquid level was at working level. The H-10 1000 gallon septic tank seems to be structuraly sound. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 I Commonwealth of Massachusetts �n Title 5 Official Inspection Form 'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owners Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 'Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 160 Oxford Drive V Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 2" 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.): At the time of the inspection there were no visible signs of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form tI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No` Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: one ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 160 Oxford Drive V Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) ' 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the leaching pit was full. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil; signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 IL_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): a t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts ,.9 Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !% 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is Cotuit MA 02635 04-14-2020 required for every page. Cityrrown State Zip Code Date of Inspection. D. System Information (cont.) 14. Sketch Of Sewage Disposal System: . Provide a view of the sewage disposal system, including ties.to at least two permanent reference landmarks or benchmarks. Locate all wells within,100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below (Ekdrawing attached separately Aj t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 I b TOWN,OF BARNSTABLE LOCATION/o�, � wcof nr SEa!AGE / : PYILLAGE_ i, ASSESSOR'S MAP& LOT 6�l 0 b-INSTALLER'S NAME& PHONE NO. 'SEPTIC TANK CAPACITY cb LEACHING FACILITY:(tnm) ' (size)� NO.OF BEDROOMS__�j _PRIVATE WELL OR UBL1C WATE UILDE OR OWNERR�h DATE PERMIT ISSUED: - DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No i l7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 160 Oxford Drive V Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 14 plus 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: I augered a hole at a lower elevation and I shot it with a transit to show 4 plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 160 Oxford Drive Property Address Bruce Blackman Owner Owner's Name information is required for every Cotuit MA 02635 04-14-2020 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed &Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank-Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included i 13,3T'ToM j L e-r-0i k)S L S Fee, l� t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Fi$ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Diopooal Workii Tomitxnrtion ramit Application is hereby made for a Permit.to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .............. ra..�... � o L`�.k.1..a Z .2 ...Wf...fi ......._ .... ...__••-••-••-•-•- -•• .................................................................................................. Location.Address or Lot No. - ...............................•......... •---------••-•••-•--•---.............................. Owner Address --------------------f�!`ka_ ....... ................................... •------•-•-----------...!/ ! .��M ...f/f�l s.�L:f..............-•--------- Installer Address Type of Building Size Lot................ q. feet � Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( } Other—T e of Building ........ No. of persons............................ Showers 2— — Cafeteria Otherfixtures ---------------------------------------------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.l 2��4P.gallons Length................ Width................ Diameter---------------- Depth.........._..... x Disposal Trench—No. .................... Width......-_......._.... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter...__ ........ Depth below inlet.._..�a............ Total leaching area......�a0....sq. ft. Z Other Distribution box ( t) Dosing tank ( ) Percolation Test Results Performed by.. '------------------------------------•---------- Date a Test Pit No. I........ _._minutes per inch Depth of Test Pit.................... Depth to ground water......................... fZ4 Test Pit No. 2................minutes per inch Depth of.Test Pit---................. Depth to ground water........................ a . Descriptionof Soil Ss, ----••-----•-•-••---•--•-•---•----------------------------------------------------------------•------- V .--------------------------------------------- -----------------------------•-------------•-------------------------------------------------------------------....--•---------------•------------------- W x ------------------------------------------------------------------------------------ -----------------------------------------------------------------------------------------------------------•-••---- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------------------------•---------------•-----------------------------------..........------......------.....a---------------------------------------------------------------........_....------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha-,-begn issued by the board f health. �' ..----.g Signed.-�`------ -- -- .......... --- --- ----- - ............................... Application Approved By ........ .:... � e -- --- ------- - - °�.� . Date Application Disapproved for the following reasons- ................................ ------------------------------------------.......................................... ------------------------------------- -- ------------ -- -- -- --- ----------- ------------------------ -------------------------- ------------ ----------------------------------------- ........................................ Permit No. ..-- ........... Issued --------- ---- ' Date k / t� THE COMMONWEALTH OF MASSACHUSETTS. r BOARD OF HEALTH TOWN OF BARNSTABLE App iratinn for Disposal Works Cfnnstrnlrtion thrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -• .................... -•-••--•-•--•-••----•----•.....---•--•----------------------•-•--••-------•--..................... n Location-Address or Lot No. Owner ^ Address .^9...... t-(...........................^-- • ......................... Installer Address UType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms............. ..7 HQ ...:.---.--.Expansion Attic ( ) Garbage Grinder ( ) 4 Other—T e of Building a yp g ............................ No. of persons............................ Showers (Z) — Cafeteria ( ) Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid"capacity__Lej Ugallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.....4F6........ Depth below inlet.......G............ Total leaching area.......&D_....sq. ft. Z Other Distribution box ( I) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I.......2,----minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••••- --- ----------------------------------------- -------- ----------------- ------------ ----------------------------------------- .....----------- D Description of Soil..................5+ U -----------------------------------•-------------------------------------------------------•--•---------•------------------------------•-•-W ---------------------------------------------------------------------------------- •--•••••------••-•----••-------•...--••------•-••------ •••------•-••-•••-•----•------•-•••-......• ................ V Nature of Repairs or Alterations—Answer when applicable.................................................................................._.....__...... ------------------------------------................................................................................................................................................................. Agreement: 1 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the `of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha be issued by the board f health. Signed - ---- ------ ---------------- _ y S � �y ---------------------------------------- Dated- ApplicatioN-Approved By .,�----- - - ---- -- - --- ------- ------ ---- ...... - -- -- ................................-............... Due Application Disapproved for the following reasons: .......................... .. ................ . ..-----.I...........................-..................................................... .... ............ .. .............. ........................................................... .......--....--Date....------------ Permit No. , -- (� Issued - . '" ,T r* ..... ...... - ............. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Terttftrahe of QuIontylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System const-ucted or Repaired ( ) by -------------a................................... 1`I- -----...------------..........--------- ---- --................---- ------------------.-- ......----. .----------.......------------------------... Installer at ......................... b SO 1-6.a. . Co_ --�:._..--✓ .�1 has been installed in accordance with the provisions of TITLE of The State Environmental Code a's described in the application for Disposal Works Construction Permit No. �...... ----- dated .----- .-.--r-.., -..----- PP PQ-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. '' 4 DATE............................... .. --` --- ------......------------- Inspector .................. i 1/ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... r�� FEE. ' Disposal Works Tuans#rnr#imin. rrntit Permission is hereby granted................... -----A!-Mt?--v-----••----------------------•---------•-----------•-....--•--------------•---...._ ._.. to Construct (44 or Repair ( ) an Individual Sewa e Disposal System T l 50 o rc� 2 � ' at No---------------------------------------•at-•••-•-a--•••-.0...---•l 6•--• Orm•-••--• ----- Street ` �- as shown on the application for Disposal Works Construction Permit No. ...!... , Board of Health DATE............. ----•-•-----------••---•---•-------...._...-------= FORM 3850E HOBBS&WARREN.INC..PUBLISHERS f AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION CC SEWAGE #T -A/13(1 ^ VILLAGE ASSESSOR'S MAP & LOT t`-INSTALLER'S NAME.& PHONE NO. � T "SEPTIC TANK CAPACITY s rt LEACHING FACILITY:(type) (sue) 4x?® �NO. OF BEDROOMS _PRIVATE WELL OR UBLIC WATE UILDE OR OWNER DATE PERMIT ISSUED:_y . DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 I http://issgl2/intranet/propdata/prebuilt.a,spx?mappar=021074&seq=1 9/27/2013 COVAW .. . � op 1.04.,2 GROOM) EL- 104f. CO VCRa�a C»�s M S7M PInW 1/4' SO==40 P.Y.G .�.. Jul Ofi LIIw pww 1,�e P=PZ• a?z 3 1O? EL.= Bean _ ° ` 101.8EL Fes: 101 O o � rw�a� a. EL..=.1�� ° a° 1 1-000 ALLONS10 . PJT a f' t;BOTTdO�' :OF':, TZ�S'T.SOLE OR; Iy5'GS' PROBARLE A'A?MX MARL s • .LET • + FRaFILE OF ss - EWAGE I�iSPf7SAL S S YSTEM .. r 'N OT" ;TO SCALE - S :wI S BY .,TER1?P .1, THE 5'ED` r HEAL Th1 of DA R R -TA LE' t . 0, BILL LIEBER P E. r w Y.. _.- rn 21f -TICtN-.ROTS::.-- -__—� �I11 /.'INCI r. 1' - ••ram.• - - Lo - _.; FiLiE= 'OF~ - •6a- .F' v V- '•i: - N? a -r X s _ a a - E3II�A E •I3iS S' s- :s = - S Y r.• �1 - 3J �y -1- �' O O_ N T� S�T r :. D- SCALE. . , r r',"-.•i Y- I.Y. `, _.:�,i- -o - Jw) - , .<(tr••y' ✓• Ila + �'•.. ,�. -- / _ - . .,:-- -.� _ ALL VA?IQNs <��t.SS'UME'A , } t. • r <• -� -•�.�' '�_ t:;'' is • t' _ t MG • �'} ems.N:._... •.�D= .' .,•. ..- .n�.. '�C .. - .. ., ,.. �o� .�i� 6 16. t: 6 6 1 9,2. / / DAB- ��. < qG G _ s'T-HOL..,�.. , " ARA ' TEST 80LE 102.2 0� a F fi • �."-S'ti;:•.•.a•" n :,:` i�r}'c.,:a,a„ _ �,t7r .;Sa� �, -' - '' - 2. - - s•i'� is �i>. "1 �,tsw-` - �' .'.�•_ ��p�. - r i.- - p� �R�ypr%�;; t �C�`'s� i. ♦. �- � ��''L.i. itt ".ter- ,>,sn -i:i't`.� , �/'� _ "5. 4. yy;Tv• - 'iC 1, .3 y ..r ,•'-�' `,.• y Syr .a:i`` ,Z.-.a- .x. J'' r Xt -sk5 � - -y ,:�r -.:yK' .�y�. -_s �1J'� _ ._�. _ � �Y'`.�y • F vi^�-.%R�^yrse`. �=.�7•LL�- _ t�= �3. it �•T* �•"�• �?� c ..t' 1 yr' ;.-�•a Jr �.. r-- - sti ::: ' `c`V � —:•'a`.'%�I�} '�"'•�,.5.. -:a•.. -1=.. :.-•-1: y�(� ?� .,� 'y,^ _ y< •',�,_� _ -�� .,, =.ant '� �+.:�.'_ _ .:fir.. �5- jt 4 air, - �1•'•E>:'" _;}: .�� . - ' . , � _.. . . a :,.. �•�-r -I ,:off r.y tcyo"""�_.TS� �,'�.�.... �r ,.a:•L._ ,� _ f ,i(f J' _ R_ .:M'�e i.,w .;' Y �' •d'. :.Sri �-'S,�y�,� L. _ y. -..`-. _ _ ,:,'!t" ,�•. - `� �:•;�"'.-.. .'@ '�y .? ,.rri'.. 'ems s 'y:+�►. .>4w•'".�.�..•: Ss ar .�.,y,.r,� f,� "r 5. - k :+d.t -*� �.•.R•. <.'• �BYs-. .;a=^�- .t nF sue. r`/` •�"' '�v ��.1fZV�✓V'l• - � .a' �.. � i.r- �R•, - ' .e•�-``r'. -yam _ �! _:x..%!• ?t.,J �� •••1 � - 1_ s.-P+.��. ��'•f' �p ;'_ ._:.<y'.. ;�.k.r �.: 'S �� 'r ••id �:_ y ..Safi, P •/ .A D ;A �:}. Y'��..� i{:1•j.. ".7 '� h.A-t ?..•.,•.r r-. ��a. �.• �'-�--+. °.«v 7c- :y"y+a ,i-_ : ,. :� �•� _:aj1'. � � � �1-> � :•1 f,, - ', <�,•y�<"'.`.• 3,. .s•.r. r•., 2 y.��'',�� ''�- -A Wt '•i;'tY•'s.�'t`W=:�" ,. - _ •S _ s.,,A'a�._x' �::et':. �C,.<`?,�„'_ ;��'-+',r'�r.,r-'x'r'•=4'' �- "� _:'K+,aS? � ��`r-a_t."4� .,sr4.:"•!'^r 1'_:_."�• -'w':?it . � ,i: 3:. -_ -> -�' � - .tat J"?� s�• .<•-'aa9T+7'-�r [..�t:•�• .d.a JN ... - ^,V' '•a:, t ,� i^+4e .-�• - 7.� iT•.rf-`- e..-^.,ram .. > �p..; - _ _ _ :��: r 'a- '-- - .p-'i"`:�x.-:,.. i.�.►�-�r�:.n,7.r,� /�� r'x.'� ��_ fA" -41 . ,t•. ..s:., -- _ - .sib► ••� z. -.�•F _ `C '.r'-• -a••f .J -��i ��.. it. �� :is ,!!• �.r`.� - <.L�•ak .�•�-\ � t y Y�� .. r r :., .. //may�y`��J1�JT � /T_ N //�/�/_�C .�., 2 �-. �,•� , E 1 jj}''''''�� t 3iJ i r O1 lJRJ, '{-. •' ,:xr i-,1 �::. - �'•, :'r '�,t�'.r `*? V6,:. .- �.. i,,,,� - - 1J -�t � "�' r� r i 6' �� //)) 1 TOWN OF BARNSTABLE ~' LOCATION rf` SEWAGE # e+/ `S'�tt Ic•4n7 VILLAGE ASSESSOR'S MAP & LOT 0d-I �7y INSTALLER'S NAME & PHONE NO. `;)SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 40, (size) X ENO. OF BEDROOMS _ PRIVATE WELL OR UBLIC WATE BUILDS OR OWNER, DATE PERMIT ISSUED: .�,%�-' DATE COMPLIANCE ISSUED: VARIANCE GRANTED: 'Yes No �� '°\ GIN I � .1 -- 98 -- EXISTING CONTOUR l :'` tq x 100.98 EXISTING SPOT GRADE ' i o 57 y W PROPOSED WATER SVC. ' \ <n\ r--- e L- I--•- o r'r G EXISTING GAS SERVICE �� . ^"�- r_7 < ---dGVy-- UNDERGROUND WIRES / �° E� pJ t �; i 56 TEST PIT ' 44 a booz:r«eorne ��O✓ LPG BENCHMARK S < _., I jv P� LEGEND I ' f w N LOCUS MAP NOT TO SCALE N 31`53'20" E 125.00' 101.23 X 102.14 \, INSTALL BULL RUN VALVE TO TO ALLOW FOR THE PIT TO REMAIN CONNECTED "'". .... ........... .. 101,97 GARDEN \, 12 8' x 101,6 _ x 102.73 Y� SHED EXISTING S.A.S. SHED 1.. .: _1 TO REMAIN CONNECTED f. O 0 WITH �TH BULL RUN VALVE, .. ........ ......... . 102.19+ F 110 FOR FUTURE USE cv 102,55 TP-1 TP-2 0 1 1 103.02 ► 102,86 1 : EXISTING SEPTIC TANK --- (TO REMAIN) TOP OF TANK, EL.=101.9f x 10 2.8 9 O 103.03 INV.(OUT)=100.57± 3 103.23 N 0 w 102.30 o _ 103.32 0 DECK - — x - P + 103.13 WALK BH x C p LO 103.97 102.85 0 Z G� N d 102.60 102,89.: ' 103.30 �Ex14ZriNc BENCHMARK ' :PAVED';.'` ;'`: :•.`, HOUSE(#160) COR./BULKHEAD ;DRIVEWAY...`.': ; :. GARAGE TO.F.=104.4f/ EL.=103.38 i 103,07 x 10 2.3 2 .'102.24, 103.41 LOT 50 103.02 / 20,000 SF / w. 81 102, 5 x 02.50 . ; 1OL39 � - 102.01 f 4 + o 4 p � CB 101.39 �G� - 101.27 3 100,8.5 CB '`:.UGW.::. 125.00' 99.56 bO N 31°53'20» 100.64 100.28 99.89 99.21 98.73 98,23 OXFORD DRIVE O F ,ygss9cy - o PETER T. PARCEL ID 21 74 M TE rEE C IL N PROPOSED SEPTIC SYSTEM UPGRADE PLAN Na. 351009 160 OXFORD ' DR, 1COTUIT, MA 02635 fcis�� p E� Prepared'for: Bruce Blackman, 160 Oxford Dr, Cotuit, MA 02635 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. I BLACKMAN, BRUCE D Engineering Works, Inc. 1"=20' P.T.M. 133-20 160 OXFORD DR 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. COTUIT, MA 02635 (508) 477-5313 4/30/20 P.T.M. 1 Of 2 4 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL.100.0 FOR A DISTANCE OF 15' AROUND THE EXISTING SEPTIC TANK PERIMETER OF THE S.A.S. PROPOSED D-BOX PROVIDE RISERS WITH COVERS OVER INLET & INSTALL RISER & COVER PROPOSED S.A.S. SET TO 6" OUTLET MANHOLES SET TO 6" OG FINISH GRADE. OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND T.O.F=104.4t SET TO 3 OF F.G. TO SERVE AS INSPECTION PORT F.G. EL.=103.3t F.G. EL.=103.2t F.G. EL.=102.7f F.G. EL.=102.2t INSTALL BULL ' RUN VALVE MAINTAIN 2% SLOPE OVER S.A.S. L = 30' L = 13' ® 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 t0"i g aaa�aaa (OR APPROVED FILTER FABRIC) " 14" 2' EFF. aaa0aaa EXISTING 48' LIQUID DEPTH aaaaaaa --3/4" To 1-1/2" DOUBLE LEVEL ADD GAS WASHED STONE PROPOSED 4' 4.8' 4' BAFFLE INV.=99.80 D BOX INV.= 99.63 INV.=100.57f EFFECTIVE WIDTH = 12.8' (VERIFY) 3 OUTLETS INV.= 99.50 EXISTING SEPTIC TANK H-10 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED *25.0*' OF 1/8" TO 1/2" WASHED STONE TOP CONC. ELEV.=100.3t VED FILTER FABRIC) NOTES: BREAKOUT ELEV.=100.00 INV. ELEV.= 99.50 Bac 1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & ease INVERTS EXITING HOUSE, PRIOR TO INSTALLATION.2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM ELEV.= 97.50 4' 2 x 8.5' = 17.0ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 4' OF NATURALLY OCCURRINGEFFECTIVE LENGTH = STONE BASE, AS SPECIFIED 310 CMR 15.221(2). PERVIOUS MATERIAL 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION 4) A GAS BAFFLE SHALL BE INSTALLED ON OUTLET TEE BOTTOM OF TEST PIT, EL.=91.1 3/4" TO 1-1/2" DOUBLE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. WASHED STONE SEPTIC SYSTEM PROFILE GARAGE/ EXISTING GENERAL NOTES: HOUSE(#160) 1, ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL back of house BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS BH OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DECK 3. THE SEWAGE. DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE O' 605 p�9� DESIGN ENGINEER. "� cv 47ANY CONDITIONS- ENCOUNTERED'DURING -CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. ___!�_ pc 5. ALL ELEVATIONS BASED ON AN ASSIGNED DATUM. 1 hN j '�N cad 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 1 a 1 (n 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. N 1 1 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED. S.A.S. 1 1 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. �-12 8'-I SEPTIC LAYOUT 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 SOIL LOG 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). DATE: APRIL 20, 2020 (REF#TPT-20-61) 12. AREAS REQUIRING STRIPOUT"OF UNSUITABLE MATERIALS SHALL BE SOIL EVALUATOR: PETER McENTEE PE(SE#1542) INSPECTED BY DESIGN ENGINEER PRIOR'TO BACKFILL. WITNESS: DAVID STANTON R.S. HEALTH AGENT 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 102.6 q 0" 102.6 q 0" 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC LOAMY SAND LOAMY SAND SYSTEM COMPONENTS NOT SHOWN ON THE PLAN 101 g e 10YR 4/2 8., 101 g e 10YR 4/2 8„ LOAMY SAND LOAMY SAND DESIGN CRITERIA 100.3 10YR 5/8 28" 100.1 10YR 5/8 30" C C NUMBER OF BEDROOMS: 3 BEDROOMS SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) DESIGN PERCOLATION RATE: <2 MIN/IN MED. SAND MED. SAND DAILY FLOW: 330 GPD 2.5Y 6/6 2.5Y 6/6 DESIGN FLOW: 330 GPD GARBAGE .GRINDER: NO-not allowed with design LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 91.1 138" 91.1 138" .74 GPD/SF PERC RATE <2 MIN/IN. "C" HORIZON EXISTING SEPTIC TANK: 1000 GALLON CAPACITY NO GROUNDWATER ENCOUNTERED PROPOSED D-BOX: 1 INLET, 1 OUTLET (MINIMUM), H-20 RATED REFERENCE PERC PERFORMED 6/16/92 (P#7908) USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 160 OXFORD DR, COTUIT, MA 02635 SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: Bruce Blackman, 160 Oxford Dr,'Cotuit, MA 02635 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: T SCALE DRAWN JOB. NO. ............................. 471.2 S.F. Engineering Works, Inc. 1"=20' P.T.M. 133-20 TOTAL AREA:................................. l 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD (508) 477-5313 4/30/20 P.T.M. 2 Of 2