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HomeMy WebLinkAbout0059 PUTNAM AVENUE - Health 59 PUTNAM AVE. t/ C- COTUIT -- - A = 036 041 ol&t" r i b LTOWN OF BARNSTABLE LOCATIONI eC/T �y/9 o'ft V'L� SEWAGE# �3 �! WLLLAGE Gyf-vi ASSESSOR'S MAP & LOTt'' D �Y INSTALLER'S NAME&PHONE NO. Go.�'/nc �iY" SEPTIC TANK CAPACITY I id V C �,.l 6�,c•� LEACHING FACILrTY: (type) ze) t NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: �Tc/ f�C_��'; COMPLIANCE DATE: 7 a -d Separation Distance Between fhe: 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 - •J IDr.., TOWN OF BARNSTABLE LOCATION S S 2,/17a nv 4vt" L.v7 e Fq,,n//C-)I SEWAGE # —C�000-34 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)�DO�/�j Cffg��c2S (size) /,.a X 3 NO. OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: .T C 1-0 COMPLIANCE DATE: 3) �g I©� Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 C l� as � `�• p�i le`� 3? � � �_ sa ` � 53t a S 9 c cam., TOWN OF BARNSTABLE i �J LOCATION �T&4 Ayt Cl`!!/�i� SEWAGE # 000 VILLAGE 00`7 o% ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. y` SEPTIC TANK CAPACITY _/.5 00 6,e/ LEACHING FACILITY: (type) ,SRO G11(.074,11ke-f (size) 13L i `t8 NO.OF BEDROOMS BUILDER OR OWNE_�E PERMTT DATE: Dec'- - /D I A o" COMPLIANCE DATE: 3 9 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 A ` o�-�-�<< fig' e C�aal Vic` LA r Corr monweaith of assach se . . I , Subsurface Sewage Disposal System Fort -:Not for U.pluntary Assessments 59 Putnam µ....,.. __.._...__ _....._ ... ...................Property Address Donald Emery --_ Owner Owners Name infom atton is Cot .it' Ma 02635 11/,4/2043 required for every _� _ —-- _ page.',' Gtty(fown State Zlp Code Date of.lnspeetton lnspectioh,results must be:submitted on:this form. Inspectio forms may not W.altered in any Way. Please see completeness,checklist,?at.the;end of the.fdrm. I-portant:When flling.outforms ®r o �r�, �n i1 111 on the computer, use only the tab 1: Inspector: key to-move your cursor do not Seatr M -�loheS use the return; ....; .... key.. Name of Inspector _ __ .. . Capewide Enterprises - — --- Company NameVO 153 Cor6rhercial St: Mastee Ma 02fi49 _. _.. .. ..- - _.._ _.._..._. Gityfrown State Zip.Code 50.8-477=8877 SI 4.._._ . .....- ---- Telephone Number: License Number t. f'tlflci41 - I eertify that 1 have personally inspected the sewage disposal system atfhis.address and thatthe information reported below is trine, accurate and complete as of the timeof the inspection;The inspection. was perforrned based on my.training and experience in.th'e proper function.and maintenance of on site sewage disposal systems. I am a DEP approved systems inspector ptarstaarl#;to Se toon �5'340 m Title 5 (3j® cMR '1 000).The system: ® Passes, ❑ Conditionally Passes ❑ Fails ❑. Needs Further Evaluation by the Local Approving.Authority . 11/4/2013 _. .._ __ .. _.... ._. .... _.� Inspectors Signature; :_Date. : - The systerra inspector shah submit a.copy of this Inspec#Ion report to the Approvrng:Authorlty (Soard of Health or DEP} within 30 days of eornpleting: hls.inspectlon:1f ttie: ysteni is a shared"system or has a design flow of 10 000 god or greater, the inspector and the system owner shall submi#the: report to the appropriate regional office of the.DEP. The original should bib 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:ot rase at l;hat tkM "This ihspectiora does not address-how'the system mill pe esrrri:i ra the.f tt re under tf?e.satne or;different conditioris of use t5ins•3/13 T106 5 Official Iris;iedz F Subsurface Sewage.Disposal,System-Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Putnam Ave. Property Address Donald Emer y Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 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: The dwellings located at 59 Putnam Ave Cotuit are served by a Title V septic system consisting of 2 1500 gallon septic tanks, 2 distribution boxes and 4500 gallon precast leaching chambers. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. `City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"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 Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityfrown 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 the were not Y ( Y ® available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for 566 gpd 5 03 ( o example. 110 gpd x#of bedrooms): provided t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments uM 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2013 = 94,000 total 2012= 88,000 total Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes Z No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type.of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 7/2000 per town records. 1 leaching chamber added 7/2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: tank#1=3' tank#2= 2' feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: tank#1 = 2' tank#2=1.5' 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: both tanks are 1500 gallons Sludge depth: #1= 5" #2=4" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle #1= 3' #2= 3' Scum thickness #1= 1" #2= 1" Distance from top of scum to top of outlet tee or baffle #1= 6" #2= 6" Distance from bottom of scum to bottom of outlet tee or baffle #1= 10" #2= 10" How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank#1 Water,level was even with outlet invert, tank was not leaking and was structurally sound. Outlet tee was intact. Tank#2 Covers are on risers, tank was not leaking, outlet tee present. Both tanks should be cleaned soon and again every 2 years for proper maintenance. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 II Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert #1 = 0" #2= 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Both distribution boxes were video inspected from the septic tanks and found to be in good condition. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/,3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number. 4500 gallons ❑ 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.): s.a.s. consists of 4 500 gallon precast leaching chambers in a 13'x42'x2' trench with 4' of crushed stone. Leaching facility was video inspected and found to have approx. 4" of standing water with a stain line only a few inches higher. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 59 Putnam Ave. GSM Sye Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition'of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 L ..:.Cqmmonwea,Ith ® a sachusetts ti n: F We _ Off ........ ,64E urface Sewage Disposal Systetvt Foam -IVot far Voluntary Assessmenfs :- 59 Putnam Ave; - -----___.�-... ---- __,..._. -. ..., Property Address Owner Owner's'Name . . information is Cotult Ma 02635 11l4/2013 required for every ... ... ......: .... .... ...... - _.:.. _ ..-. page:. Clfyffown State Zip t✓:ode. Date of Inspection e ysfd' of af� n {cant.} Sketch Of Sewage;Disposal System: Provide a'view of the sewa9e disposal system, including ties to at least two permanent re€erence.la`ndrnarks,ar benchmarks:Locate all wells within �.00..feet Locate where publicwater°supply enti r the building ,Check one af't# e.boXes below: ® hand-sketch in;the area below ❑ d`rawirig;attached separately _ r `I TAB' _ 2= S'Z S-f - a A-z; 2b'a� SAS 73 A A3 3Z Y6 Q Y 52,E i t5ins•1"13 Title 5`Otfictal'lnspeclion Form:Subsurface sewaga.. sposal System Page+tb of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 59 Putnam Ave. Property,Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 11 + 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: 7/27/2000Date ❑ 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: design plan dated 7/27/2000 indicates that no groundwater was encountered at 132"and system is designed to have 5'+ seperation between bottom of s.a.s. and adjusted groundwater elevation level. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Putnam Ave. Property Address Donald Emery Owner Owner's Name information is required for every Cotuit Ma 02635 11/4/2013 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. Fee---- BOARD OF HEALTH be TOWN OF BARNSTABLE vvv ApplicationArVell Con0ruct ion Permit Application is hereby made for a permit to Construct ✓7, Alter or Repair ( )an individual Well at: k4DC. L-4aA!�lt— o 3(o—_Oqi___ Location Address Assessors Map and Parcel Owner Address -------------—— ----—---------—---------------—------ Installer — Driller Address Type of Building Dwelling Other - Type of Building No. of Persons---------------------------- Type of Well - Ll Purpose of Well Agreement: The undersigned agrees to install the aforidescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certific f ompliance has been issued by the Board of Health. 3 Signed- --------- gt/c, , ate Application Approved By date Application Disapproved for the following reasons: date Permit No. __iz_ z Issued date —-—------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed Altered or Repaired by-------- —------------—--------- Installer at -- ----- ------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Pro)ection Regulation as described in the application for Well Construction Permit NoWN03:L411C Dated-910fo-Ji- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector ZUU 3 Fee--_ BOARD OF HEALTH TOWN OF BARNSTABLE AppiicationjorlVeli Con0ruction3permit Application is hereby made for a permit to Co struct ( 01, Alter ( ), or Repair ( )an individual Well at: 10,4 r"o H.. AU c' LO(�-c;� O 3(0 - Location— Address Assessors Map and Parcel . --- — I Owner Address --------------------—-----— ----_----------------- —— ---------------—------------- — — ———---- — — — — Installer Driller Address Type of Building Dwelling -— --- - -- ------------------ Other - Type of Building----------------- No. of Persons------------------------ Type of Well Capacity------------------ — /i� �a Purpose of Well-----�----��---"""--------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certifica of ompliance has been issued by the Board of Health. Signed �.tsrd - - -- ------------------- - ------- ate Application Approved date Application Disapproved for the following reasons: --------- -- ------ e date Permit No.--�" � 'V � 3 ---------- Issued -- -©"date--------------�----------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of ComPhance 'I THIS IS TO CERTIFY, Th t the Individual Well Constructed ( "S, Altered ( ), or Repaired ( ) Q f _ by Installer at- - SS --L�s,t.�iva Lc.u C has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Pro•ection I,V&AA)0_-n 3g �� G Regulation as described in the application for Well Construction Permit No. ----- ----------Dated� -THE ISSUANCE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- -- -- — - ---- Inspector------ - - ------------- k ' C I � BOARD OF HEALTH TOWN OF BARNSTABLE Ive[1 Con5truction3permit No. w-2�3� Fee- � in,NP Permission is hereby granted ---- - ------------ --to Construct Alter ( ), or Repair ( ) an Individual Well at: No. /L7— a w u r -- ------------------- ---------------------------- Street as shown on� �the application for a Well Construction Permit No.-- -- -`-OC) C�3 8 ----- - Dated-- _4�_ � 3 -------- ,. �-- Board of Health--------- -- ------------ ---...__ _54.5�1 DATE— — i * No. ?.pD3 33 / k Feetoo s— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Rprication for &5polar *pftem Con5truction Permit Application for a Permit to Construct( )Repair()()Upgrade( )Abandon( ) ❑Complete System %Individual Components Location Address or Lot No. 55 Po. vj c.,,% A ut �v i Owner's Name,Address and Tel.No. 'Do"i k Q ieWiC Assessor's Map/Parcel IRn, (3c 4 -I 7 S Map 3& (:.1 */ Cr- iv, Wl 62-63 s Installer's Name,Address,and T l.Xco. Designer's Name,Address and Tel.No. !h "deuce /lacy-�/'�/cf j G$-�j}� Sicpwa-% A. Wi l svn Polo S 1- S502S Q,,trctzr Nr ko(c+.2 , nc Z5 -"-I1 JlA- BIZ 1'Yla►y S� S�zVv' (¢ 11A A d2,f0 SS t n Type of Building: _ `7q Dwelling No.of Bedrooms Lot Size l Z it 61Zt-sq.ft. Garbage Grinder(44) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow S 50!�%PJ/61e� gallons per day. Calculated daily flow 5S o gallons. Plan Date 7/L3/O3 Number of sheets e,,e- Revision Date Title s 1 un S4 c S 4 5 h_", Size of Septic Tank Type of S.A.S. �eac4,!!y 6',4a01hors Description of Soil R 4�_ 4- PO-IS (;tz x /.3 'x 2 IA-A , Nature of Repairs or Alterations(Answer when applicable) Add c cQcQ,i-tvrta f l e_&C_�i nA cm %2C_c i+n d rs C'XL5hV1!1 ScrSfc►h � PCr&%,,t' t- 2cX70 -.'a3ciZ v- cvrisfvuchca /CGbl12l^StCit oT e U ticlinq +-o resicfei4-1al c(wtcll,�q Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuo by this Boar of Healt Signed ' Date y)3 ,2oa- Application Approved by Date 7- ZY-03 Application Disapproved for the following reasons Permit No. 2Z0 3— 33 Date Issued Noy t. 31 Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: !-, . Yes ` ! PUBLICrHE" LTH'DIVI•,SION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[pprtcatton for �Dtgoml *pgtem Congtructton Vermtt Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System Individual Components Location Address or Lot No. 51 Poti.1 a», A vc �� + Owner's Name,Address and Tel.No. ` � t 17ohxtdP £vhc�.,. Assessor'sMap/Parcel P.O. t34iK °i 7S I'Acp 3!v �l 4�/ Cot., 6263 s Installer's Name,Address,and Tel..No. Designer's Name,Address and Tel.No. S•katWr A. Wi ISw, Q `) P0•!0 S ! L ;�o i3c�.ctzr, N r.lC_ r` l�^ /r> r $I2 Y►'la+�,- ()S 1Zevj to rA tA OZ 6 SS„ 0 Typeof Building: _ ` 4 Dwelling No.of Bedrooms r r yc Lot Size I Z l r&7Zt sq.ft. Garbage Grinder 'Other + Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures z Design Flow 550���� �''� gallons per day. Calculated daily flow SS o gallons. i Plan Date 7/2-3/o3 Number of sheets csh e- Revision Date r Title 4 a. -P SWHc- S4skv,, Size of Septic Tank o l/4,z Type of S.A.S. Lae k i Clio wr hsr s Description of Soil IQ J2 - -Fo F-C011 S t;SrZ�x /.3 I x 2 z A� Nature of Repairs or Alterations(Answer when applicable) AdcQ gzcQd,hvna 1 C'KtShnc, swsizYr► ( Pcrr„r '� 2c.�00 -335� -�w Ct�nst�ruc.ilw �GGyrt2Y-Sr['yt G� 5 ext s-h n., b t i c t+Y.a 4-0 r e s+clue n 4-l a l ej w e 11, Cj Date last inspected: 1 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu by this Boar of HealtV Signed `: G� � Date J-I, )3 -J oa- Application Approved by Date 17 !2 c/-G 3 Application Disapproved for the following reasons i _ Permit No. 2-GU 3' 33 Date Issued '7- 2 q G 3 — — -- —------ --- ————————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certtf tcate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired Qom )Upgraded( ) Abandoned( )by cl fx 1 t^ at : i - �%,�,�„! H)�-c ry i % has been constructed in accordance with the provisions j lL'cc_�(.itc(of Title 5 and the for Disposal System Construction Permit No. 200 3'?31 dated 72 y-03 Installer . Designer The issuance of,this .ermit shall not be construed as a guarantee that the syste fcfn n Date 7 1.3o DS^' Inspector t No. Z_CiCJ�i 1----------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwt.�Poar *pgtem Con.5tructton 3permtt 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. r Provided:Construction must be completed within three years of the date of this permit!r Date: ' 2 `ir U 3 Approved by r TOWN OF BARNSTABLE LOCATION oy T 11v A �'t� l�'1�' SEWAGE # � VILLAGE C.0 f vi" ASSESSOR'S MAP & LOT Qi ` INSTALLER'S NAME&PHONE NO. AAoj2.Q J FS.1L�,- SEPTIC TANK CAPACITY ` �U C�u-d`o�c•N LEACHING FACILITY: (type) �ay ate/ C' - (size) NO.OF BEDROOMS BUILDER OR OWNER �� PERMTTDATE: e� `TIC P(' COMPLIANCE DATE: 7 d � Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Waier 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 1 I I 34 D46 yV "o,6 No. Z-8A �� �003 _11q�� r rw Fee THE COMMONWEALTH OF MASSAC� E S En- twed in omputer: W Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MA S C USE S Zipprication for Digpogal *pgteut Congtruction Permit Application for a Permit to Construct( , )Repair( )Upgrade( )Abandon ) ❑Complete System ❑Individual Components Location Address or Lot No. pulwkw Owner's Name,Address and Tel.No. S1�B• �2S 8g " u�u4i�t u'�.t•k 'EwtgP�{ Assessor's Map/Parcel 636 04 fox tbo ot't'ERV j L oF� w44 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 2.. Lot Size 2•?4 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations( nswer,,when applicable) Date last inspected: %'��� l✓ v�� . Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue y is B of alth. z Signed KI 1E A4F Date S 6 Application Approved by Date Application Disapproved for the following reason Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by at ha constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N led Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector ---- — — _ ------- "------------- �- -No. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Digpogal *pgtem Com9tructiott Vymit 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:Construction must be completed within three years of the date of this permit. Date:_ Approved by _ No. `Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS_,� T I ZIPPrtcatton for Mtgogal *patent Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon ) ❑Complete System El Individual Components Location Address or Lot No. ,T9 F,(;1 /Q tM._ Av E Owner's Name,Address and Tel.No. 8 z g g VXA#a N %X%t-4 r V14 F 9' �( Assessor's Map/Parcel v 3 6 b 4 �, pX k G O O rF v t F vVl Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: " DwellingNo.of Bedrooms 2- Lot Size 2.7 s ft. Garbage Grinder 9� g ( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. \ Description of Soil t Nature of Repairs or Alterations( nswer„when applicable) f a ql Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been � issue y this BoVofalth. Signed � G£ S $ 1'Lt Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) d Abandoned( )by at ha constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N ted Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector _ _ • No. � - f.. THE COMMONWEALTH OF MASSACHUSETTS 1 PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS �Dtgooal *pgtem -Construction 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:Construction must be completed within three years of the date of this permit. 1 Date:_ Approved by ASSESSORS MAP NO: !l" �D � PARCEL NO, r)'A l `'J ---- - --- NO. --------- Fee- BOARD OF HEALTH TOWN OF BARNSTABLE 0(ppYication,forlei[ Con0ruction3permit Application is hereby made for a permit to Construct 0-1, Alter ( ), or Repair ( )an individual Well at-, a. -,t Co 7'-<trte Location — Address Assessors Map and Parcel Owner Address r q vn�e �7 /JB 768 Mu[h _ /Lt.A Oj6 �// Installer — Driller Address Type of Building Dwelling ----- -- --—- -- Other - Type of Building-- ---- No. of Persons-----_____—__—________ Type of Well-- f ✓C ----- --- Capacity--------- Purpose of Well--�P/` �� r'^-- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificat of Compliance has been issued by the Board of Health. Signed date Application Approved (--- Application Disapproved for the following reasons: ----- --- ------------------ date Permit No.--�1��`��—�""---o�`� -- Issued-- -- ---------- ------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance E THIS IS TO C ITIFY, That e Individual Well Constructed (9j,'Altered ( ), or Repaired ( ) by--- -- - - --_-- -- ---- - ----— __ -------- Installer at—_ S-7 . lqut`r-j c� Gt' e CD JIZA <7 /kA has been installed in accordance with the provisions of the Town of Barnstable Board of Health hPrivate � Well Protection Regulation as described in the application for Well Construction Perm�tVdr'- "C -= �'Date&_x7----`-L---=--��D� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--- - -- Inspector No. Fee- -- D OF 77 TOWN, OFARBARNSTABLEL r ; TH � .. ppCuat ion_�bf'* Ytonotrurt ion Permit r { Application is hereby made for a permit to Construct er ( ), or Repair ( )an individual Well at: Location - Address Assessors Map and Parcel A -7- Owner— Address i— �pp — — • _�4�_L��lr�.ti�r �/ !.�. /� 6 K �6_b M u:� •.-c /t.0 a aJ 6-�� Installer - Driller Address Type of Building Dwelling -- i Other - Type of Building No. of _ T e of Well p YP ---4---4��____----- Capacity------------------------ Purpose of Well--//"r 6. Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to ,place the well in operation until a Certificat .of Compliance has been issued by the Board of Heart . a� J I Si ned ✓ S w�° —_—g — — ate Application,.Approved ate Application Disapproved for the following reasons: - - —- -------—__----_-_ - ! i date Permit No. Issued date BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate ®f Compliance 1 THIS IS TO CF,�RTIFY, That t the Individual Well Constructed ( 4-r Altered ( ), or Repaired ( ) by— -1-� --- - _- ---- - — - __ n y- Installer at___S? /_u/ Nu wl Gt 1IC �O �•1 r�r �lA ' has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permo°--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- Inspector------------_ —_—_—�____ 1, BOARD OF HEALTH { TOWN OF BARNSTABLE . 1 Yell Con5truct ion Permit No. �`' ��--f Fee Permission is hereby granted �A to Construct ( 4, Alter ( ), or Repair ( ) an I`/ntgv�— 'e id ual Well at:: — ------- - ------------------------------------- street as shown on the application for a Well Construction Permit No.-Nli e ;Wz<—_ Dated ' __�_ _' 6 b 1- ------------- Board of Health DATE t, I I , 1 r 1 i b 1 No. & Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ice/ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migpooar *potem Con!5truction Permit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) l Complete System ❑Individual Components Location Address or Lot �u ,,,i Avc Co Fu,I Owner's Name,Address and Tel.No. po v,e.kCQ f_r %Ar-d Assessor's Map/Parcel 6O YV►R p 3 G �cc+�-a� Pe_L �� �.�Fzrdi/lG /,W/v O 2l�SS Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4Z$ Go.riz, Nec €. Holi—a— , 2(L Wlc,,.1 St O S d-z r LQ MA 5 Type of Building: Dwelling No.of Bedrooms 1 i vz Lot Size 21 S, 31 sq.ft. Garbage Grinder(A,6 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow I Lo c -,eM -g4Uoa&pe-P&y. Calculated daily flow 5-.4-0 gallons. Plan Date Z7 [m Number of sheets !>"_ Revision Date Title /:- S Size of Septic Tank IS Type of S.A.S.L&,,eL C6—to,,,,s 1Z°x4-t XZ Description of Soil I _­�j 1 o 4a g4p Lk, t/_�S 1 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 Certifi- cate of Compliance has been iss#by this B and of al . Signed Date 1,-2 0® Application Approved by Date Ze 1d71D Application Disapproved for the following reasons Permit No. ZCt ^ `/ Date Issued No Fee THE�COMMONWEALTH OF MASSACHUSETTS Entered in computer: • Yes PUBLIC HEALTH DIVISION,-TVWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for �Dizpaal *pgtem Construction Permit Application for a Permit to Construct(X Repair( TLJpgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot Nyo�y pu Naw� we �o(-v� Owner's Name,Address and Tel.No. "fit aL PG Vic.1CQ G LYV�FY� Assessor's Map/Parcel A O,a.0AC^ l 60 MAP p 3G (�ar� PCL ~51 O"SS Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. e I Z Os1rv��I(a , MIA OZ ,55 Type of Building: Dwelling No.of Bedrooms I"t Vr- Lot Size 21 S Y 5�sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 to 9pd 6cd--w, ti ma4errsTerlduy. Calculated daily flow Sid gallons. Plan Date Z7 CASw ��e Number of sheets 0�. Revision Date Title �v�ra se �° s "o- Sys/ia, Size of Septic Tank 1500 3c.It'n6 Type of S.A.S. -=-,� Ck —12-,cs IZ`xJ*4-*t xt� Description of Soil cam"- . +� �I o go �+�► 1�lGit� (P- `I74 5) 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 Certifi- cate of Compliance has been iss ed by this and pf al ft. �/ Q Signed Date Application Approved by Date 7 Z Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- s THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Or Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( Repaired( )Upgraded( ) Abandoned( )by at G '' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ' yy"( dated 7 Z' V Installer Designer The issuance of this pe it shall not be construed as a guarantee that the system will function as designed. Date 3/6 l 0 Inspector 3 b --------------------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS , 1wigpoga[ em Construction Permit Permission is hereby gr nted CC nstruc Repair( Up rade( )Aband ( ) System located atd ��"/ `� 7 �'16 'i 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:Construction must be completed within three years of the date of this permit. Date: �` I �� /w Approved by A? TOWN OF BARNSTABLE LOCATION J` �/JHM Svc l LI�,;j SEWAGE # 0i.0 i y 41 VILLAGE CO—r,, % ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: - - _ •9ms3c2 /'S /01_ (type) 500 NO. OF BEDROOMS BUILDER OR,OWNBR. PERMITDATE:' -4 ALV COMPLIANCE DATE: I Separation Distance Between the: -, Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private.Water Supply Well and Leaching Facility (If:any wells exist.. on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of:leaching facility) Feet Furnished by A L( j a c �a' �a�• �k 3 CHao1 Z No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 01pplication for Mtopo al *p!Aem Comarurtton VCrmtt Application fora Permit to Construct( )Repair(PlUpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7�yym Ave.- Owner's Name,Address and Tel.No. �ot�A\O Cv►1Cn � �o� Assessor's Map/Parcel t{�8 dt••: Pr� S e l-j �C "�"� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 16t-uCe (ACe.I(:Slc� Type of Building: Dwelling No.of Bedrooms :3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) V P Sf' $�00 G ft l iw^ <t�sT4ncsz�••c o.�.i o Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuo by this B d of H Signth,/, e� Date cif e 7—00 Application Approved by Date Application Disapproved for the following reaso s -el 49 Permit No. Date Issued Fee —THE='C;OMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVII ION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migogal *pztem Construction Permit Application for a Permit to Construct( )Repair(KUpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. s9. w 7AI"Ij"I f1 ve Owner's Namem,AddieJ.s and Tel.No. Assessor's Map/Parcel 14 t C3 Gl n Ps S e lT( k C �As�• � .�ia 4d.�-8S� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. "�t^Uc.P �'IC.Cc,I� • S�t� 8�( one ST_ "k OsTc t, ,�;n. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building r No. of Persons Shovers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date / Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when (applicable) V p t n�Y o ; 1 5 yU G,�i(� rol c\A� 1Z 3C� \�cy .33UCNArvNbc l t.�.,l �3' 0� � �a Sicnc — '�� S-kC"C o..+ kop Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuo by this BD, d of e t Sig d L a Date":J, e 7-0 0 Application Approved by Date Application Disapproved for the following reas s t Permit No. "' Date Issued —————'——————,—————————————————— ———————THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(✓)Upgraded( ) Abandoned( )by a%\o,\c V N e , _ at S R, IV\ la e . cov, has be constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer-33 c-, c e �A c CC,`�, s l e(' Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. � Date C>> Inspector 4 L 4, --- ,--------------------------------- No. ✓' Fee _ THE COMMONWEALTH OF MASSACHUSETTS - PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi,0001 *pgtem Construction Permit Permission is hereby granted to Construct( . )Repair( ✓)Upgrade( )Abandon( ) System located at S ,i 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 ujtion ust be completed within three years of the date of&spet l Date: r Approved by 1� .36 . 10/9/97 NOTICE: This Form Is To. Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) 1, , hereby certify that the application for disposal works construction permit signed by me dated MJC >-O 0 , concerning the property located at Ol i t\AVM ��c e�l v meets all of the following criteria: j • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED DATE: J,,x l t 7—d O LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert e. ' o vc: C� \iec33o tab r �w AD SOO 0 i' If r sc fn —��Y BAXTER, NYE & HQLMGREN, INC. Registered Professional Engineers and Land Surveyors 812 Main Street,Osterville,MA 02655 (508)428-9131 FAX:(508)428-3750 December 14, 2000 Board of Health Town Hall 367 Main Street Hyannis, Ma. 02601 Re: Septic Repair Permit#2000-339 Donald Emery, Putnam Ave, Cotuit Members of the Board: - A repair permit has been granted to upgrade the existing cottage, currently being refurbished at the above noted location. The proposed system consists of a 1500 gallon septic tank and 3 cultec leaching galleys with 4 ft. of stone. The system has the capacity to handle 3 bedrooms (330 gpd) but the existing cottage has only 2 bedrooms. Near the cottage our client has re-built an old accessory building and converted it into a hobby workshop/gardening shed. It will contain a small bathroom consisting of a sink and toilet. We are proposing to install a second septic tank for this bathroom and add an addition cultec to the proposed leaching system. If you have any questions or comments please do not hesitate to call me. Very truly yours, Baxter, . ye & Holmgren Inc. S phen A. Wilson, P.E. #2000-33 Land Surveys .• Subdivisions Septic Design Wetland Filings Site Design --- --- ---— - -- /� �o r 1 wood ,Ua 3c �- I �.oa7.i OrNrrre � 'K\x/T/f I U W F� #59 b r a � W A (168.15') SHAPE FACTOR = 17.2 B— 52,705 sq. ft. U 1 drive 8' wide LJ HEDGE 27.05' ..... W #1 /I. � W 30.0' 3j0, / PROPOSED I RESERVE 10' 3 ; Mlht' w J ' � W , / I 31' 1 W Ld 4 M MAN o N 6 her" 39' cy C 4 �3M 4 1 �! .' +qco . p e MT TOWN OF BARNSTABLE LOCATION 11e JSEWAGE # C;bc )-•-�39 VILLAGE �'�`T,�/ ASSESSOR'S MAP & LOT 1 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /S6'0 Cog- LEACHING FACILITY: (type)�G'O��r C'fi`�}i91 i�e2S (size) 1,.9-X 3 i NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: -, C 7 -0 G COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet. Private Water Supply.Well and Leaching Facili { g ty (If;any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist withtn 300 feet of leaching facility) Feet 4 .. .Furnished by '�k �W�.� Sd 0 �J-- o i C � �� i ca•.�„.�l<< W6 4��6` �.�1 •EGA 55��•• c0c 0 • TOWN OF BARNSTABLE .. LOCATION SS/v%i)n�r�rF�u— Lv j C �/= %irr =•�� SEWAGE#Q000—33q I VILLAGE Cow;/ ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY A 0 4 LEACHING FACILITY: (type) S0 0 6 q/. Pry t-,-Ilf' (size) i NO.OF BEDROOMS 3 I BUILDER OR OW�Ea —Fm E PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist j 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 1 A a8� ;s;,3�. tia' o 101 y y yE <118,6 ���,.3•x b3"6� 0 a �t Al F EB 2 U [uud , MC-u te ------------------------ -, A6 61dk 1 ler lq e��-` f � i TOWN OF BARNSTABLE LOCATION SEW Lvj C' �r�%irrk=•�1SEWAGE#,�oyo-33� VILLAGE Co-7�;I i ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY' /SO D G/h/r i I LEACHING FACILITY: (type) Dr71-d/!' (size) I I NO.OF BEDROOMS 3 BUILDER OR 9MIT2 EM 51, PERMITDATE: _Tic:y 7-{'o COMPLIANCE DATE: i Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 { q i avTleT 3� � T5; y3-' C 5a' S3101 LiLf 0 a —f4l - ......_.__...........:............._._..._...... ..........._...- - - ao� FEB 2 U [uu 7D --------------- ---------- I I 1 t At 1 tb-o' zo'- b' t ' 0 SECTION ~ ' .SCALE: 3/y'� 1'.. , a0 �, � - l I��$•• Etiart+E Ee.EO 3a1 .e_• ' R-R 1 _ nt I � EXISTING STORAGE susPeNOe� teuNs 'e ' •D 4 To I 2Y4__Sr+os_ ' i u P .Q n -i- 00 a I 1 _ 1 vwAl-L F LIST)N6_...ZB.1,7_ II 10 I• Ge w.R wwoowS • ID i PPOPOS ED !_XEPCISE ----- ' •...:9 9 .. _ .------ ---, � ' � -. 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OLD POST RD. �P N QJ 6 PAGE 20 PLAN BOOK La'1 LOCUS • d COOL ST. r • '�� WE � COTUIT BAY 0� v S80.0; 396,; LOCUS MAP �°� CV `try� ASSESSORS MAP 36 ((SUBDIVISION OF PARCEL 41 � 44-1 0 # ZONES 10-7 N a k 2.79 Acres RF-1 & AP a 3 121,672 S. F. Upidnc 15.9 MINIMUMS O AREA = 43.560 S.F. 0 �� CB FND shape factor FRONTAGE = 20 o, WIDTH - ,w Q VC0 CB FND (DETAIL LEFT) FRONT SETBACK = 30 O —j 0 K SETBACKSr 0) SIDE U) N REAR SETBACK = 15' rn p s' M 0 � o0n euILDiNc HEIGHT' = 30' CV 2 ^ i 5=6, �5 ry LOTS E AND F CREATED ON A.N.R. PLAN N ;? o "CV 2�8 ,`E 3 �ry SIGNED BY PLANNING BOARD ON AUGUST 7, 2000 3 O S 58 � 22. ii� N soi C w , 59 Putnam Avenue PROPOSED CONSERVATION RESTRICTION — — o ��� Cotult, Massachusetts I�, " J " W 1 no PREPARED FOR k QUi�p/N p� N �I - Donald Emery CV 159•55' � '^� _ Z O N 8 01 4'077 Z r_ •5'�5. .W 4 g �S/' J00 W ` 3.. TITLE o ,� ---� ` �� Plan of Land Iry SA' •� HOUSE O. � � � ln� s a , S BAXTER, NYE & HOLMGREN INC. Registered Professional 88 00 27 W " 1� C � ° w S r� N77.4',5. „ tiy' ,� 11i fir( � � ,,��. �,� ��j �: � Engineers and Land Surveyors 4 0 p _...". 812 Main Street,Osterville Ma. 02655 `n 2.6g .A v� S 80.19' �``` - Phone - (508)428-9131 Fax - (508)428-3750 PIITNA.�Ll � 1438" E � � 2.16 27.05 c 16 . - AKA ,iG4PM.41 ' r S88'05'37"W 0 315.23 "N -- SB FND S81 N 04 03"E 34 SB FND 35.56 2.28' 40 0 40 80 3 O " , SCALE IN FEET 0 - SCALE.-I"-40' DATE: 12/27102 C4o 0 V PLAN BOOK 551 PAGE 31 S V� . �N or M REV. DATE. REMARKS .. ;s N `' 11 'ZO77C) -, Col N C.4 ^ `3 � O ... ;� o o Z077 NG NUMBER O N d• DRAWING a, 00 H:\2000\2000-33\survey\wrksht\00-033—rev.dw k � Cn JOB # 2000--033 ,.W;,y it ♦♦ Oy ._ .',:.. wz as L.RlJIIIYV t .✓ r, ; ,� L •'_" t, 7 •.Ay�a.3-7 'S a 4. _K~7 _ ,� Stake & Tac Set/Found _- r ,� r r� �o�� ,4 ;;r-0� ��► - _ PK Nail Set/Found _ y b i. �e�•.'+ ': , ` *rs��° -1 �. 1 VElConcrete Bound ® Gas Gate c� 'Ire Electric Meter s Catch Basin F. •r .o� :; (i(sjio S� r r f 04 Water Gate } ,, ;?::• �Y .. 3�, .. -b o i ® TV/Cable Box • . . . ••. c'iwl 'e`'r�'..!! pug -�. x. .Q C;� - • ® Telephone Riser Yp 4;Y' .L-. i�'L'Ba NY3' -°r•r� F ;;3; _ -O- Utility Pole O 20 Contours . ♦ r y�. s ,.r, ..z `�r or M¢ Q Q n 20OX00 Spot Grade 4, +♦,. 1 y r r°t tx u }9 a"t+t-a'1,a�i } K '� L • ,, :t� w � .; >. t•, i �.. Test Pit CISI .• • jj y .•: `;,. �; t`* +7,�1J' rtt3�yya,*� tt K t OMT ♦ P t it . i �1.�k 1' I� 4�1'S;.�J Ytl�ei;i'l♦ r :s 2,L'..+..}.'.rFf i iMil A p' ! �� �••• :rY"„S�kc4 -t~..sa• 'ti �'i.�.."•�. 't ��` 'r r fit.-.,�1,. I � .T� .. LOCUS MAP o 1" 2000' 2 -►.T F ZONING DISTRICT: RF O n EL AREA ` OVERLAY DISTRICTS: A AND — 2.79 ACRES' (AP) AQUIFER PROTECTION ��' 121,1 (RPOD) RESOURCE PROTECTION OVERLAY DISTRICT (DPOD) DOCKS & PIERS OVERLAY DISTRICT C9 FND (DETAIL LEFT) GENERAL NOTES Z ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH t, MINIMUM LOT AREA: 2 ACRES , 4 ; I , f T17 LE V OF THE.STATE SANITARY CODE DATED MARCH 31,1995 ANY LOCAL RULES APPLICABLE. MINIMUM FRONTAGE: 150' FRONT YARD = 30' SIDE YARD = 15' REAR YARD = 15' ; o, r ► -•` j,�, ( 1 :r �\ ,� BLxf ,3 ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING LOCUS PROPERTY IS SHOWN AS: ,r- I , �u BY DESIGNING ENGINEER ASSESSOR'S MAP 36 PARCEL 41 s 7 `�;`�\ err �XIS�NC �► WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, +� , 1 stj LOCUS DEED: 4 " LDiHC �► DEED BOOK 12,934 PAGE 41 ^ �� �� - �� '�:. < _ NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT . w cr .\ �\ �. :��, - 1`� 32 FOR INSPECTION. PLAN REFERENCE: 3 s>�l �� I `gyp. `�� �� �o ., \ B00 562 PAGE 77 N I �\ ,�. .: 1,500 GAL THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN `�• PR6RPSED AC APPROVAL BY DESIGNING ENGINEER • SEPTIC TANK COMMUNITY PANEL NUMBER 250001 0018 D rl r F .� A00 GAL`L€ACHIN t t VATH *k4w ` THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C, —BOX AN AREA OF MINIMAL FLOODING. M y �� �� �� `` GA �` ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 40 PVC., SCH .40 r ` \ —500 LEACHING CHA c VATH^4 OF S ! r CO `2g EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING �. \ 1,500 GAS. � �I!a 'OS71NG I 4' SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5' PER cv I fay PTIc TANK w 1 i FOUL r h , l \ �► ao jWAIIV naY r 310 CMR 15.255. jy�+ 8,,04or w , ,� -•-.. 1 \ , PROJECT BENCHMARK . DATUM - NGVD (. ••,, 34.63' 1 i :TBM CONCRETE BOUND 0 ELEV.= 42.94, ,t LOCATION OF UNDERGROUND UTILITIES 0E'APPROXIMATE 1� (� , • a r r SkOUL,D BE VERIFIED IN THE FIELD BY THE APPROPRATE EXISTING , ' w "UTJL I Y""COMPANY PRIOR TO ANY CONSTRUCTION: COTTAGE • LOCATION OF EXISTING SEPTIC SYSTEM IS APPROXIMA7'E. r r r + PER INSTALLER'S .CARD: PERMIT 12000=339 r.. EXISTING CONTOURS PER TOWN OF BARNSTABLE GIS p,6 6g ' , AND DO NOT REFLECT FIELD LOCATED DATA. `.' PROJECT BEN MARK �/ � r -- / D T!M t SB.FND Z + EL. — -42.94 blGV6 :y 27•Cli SB FND N co ct ,- ' � . 7 r L f . � i , HARRIET R. CABOT 59 Putnam Avenue _ c% FIDUCIARY TRUST CO. LOT Z , C 0 3 0 Cotuit, Massachusetts O II 41rr - _ 'PREFAB® FOR r . n 3 9 Donald Erne rY 74. sPro ued Expansion of Septic System 4' STONE 4' STONE 4. 5, 4' 13' 4' S� 8.5' S' 8.5' 4' 13' AMR, NYE & HOLMGREN, INC. 8.5 4' STONE Registered Professional 4' STONE °� Engineers and Land Surveyors I"36 of� s' MIN, " MfU 42 812 Main Street, Osterville, Massachusetts 02655 �� ` �o s 33. ' STEPHEN2 PEASTONE Phone- (508)428-9131 Fax - (508)428-3750 PROPOSED LEACHING CHAMBER CAPACITY NO.3o2,a y EXISTING LEACHING CHAMBER CAPACITY ,f ',_� ; '' WASHED STONE 40 0 40 80 •�.�cis240 `� 4 500 GALLON LEACHING CHAMBERS (ONE ADDITIONAL CHAMBER) 3 — 500 GALLON LEACHING CHAMBERS SCALE IN FEET` SIDE: 13' + 33.5' X 2' X 2' 186 S.F. 4.• 5• 4' SIDE: (13 + 42 ) X 2' X 2' _ 220 S.F. BOTTOM: 13' X 33.5' = 4 5 S.F. r` , BOTTOM: 13' X 42' — 546 S.F. SCALE:i"=40' DATE: 7123103 13 • 766 S.F. REV. DATE: REMARKS 621 S.F. z 766 S.F. X 0.74 GPD/S.F. = 566 S.F. (5 BEDROOMS) 621 S.F. X 0.74 GPD/S.F. = 440 S.F. (4 BEDROOMS) Cal PLAN OF PROPOSED ADDITION TO LEACHING- SYSTEM LM *= NUMBER PLAN OF EXISTING LEACH CHAMBERS CONCRETE LEACHING CHAMBER DETAIL No SCALE NO SCALE - NO SCALE H:\00\00-033\surve worksht 00-033SP.dw { 2000-033 _ - 77777777777 - - , L s LEGEND LD POST Leaching Area Requirements EXISTING PROPOSED RD. #1017�N 4 - Edge of Pavement - N J Q 5 BEDROOMS AT 110 GPD/BEDROOM = 550 GPD "` _ Water Pipe w - Q' _ tj Leach Pit ADDITIONAL 50Y FOR GARBAGE DISPOSAL N.A. J --- I ! wood meadow � Leach Field PERC RATE = 2 /1 MIN. / INCH (CLASS 1 ) fence Catch Basins QQ grass J Septic Tank Q LTAR = 0.74 GPD/S.F. U ❑ - Distribution Box o LOCUS Li Water Gate MIN. LEACHING AREA OF S.A.S. C.B. ems' Light Pole SCHOOL ST s -p- Utility Pole i #59 Contours COTUI 2 = 744 S.F. MIN. 50 so Q � T BAY 550 GPD/ 0.74 GPD/S.F. s \ v J sao Spot Grade ® PROPOSED SYSTEM SIDEWALL (12+44)(2)(2) = 224 S.F. Test Pit N LOCUS MAP BOTTOM 12' X 44' = 528 S.F. �. W � Brush Line C.B. �j 9 in (168.15') SCALE 1 = 2,000, SHAPE FACTOR = 17.2 ASSESSORS MAP 36 52,705 sq. ft. Tree Line _ TOTAL = 752 S.F. P�•4� 11 Y1 I (SL' DIYISION OF ) PARCEL 44 & 44 1 i LdL Jf/Ari Jt 8' wide Ld If ZONES GENERAL NOTES: --mac H 3 _ RF & AP \ Enc, -27 0 -"'� MINIMUMS ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH r 'j' ' i .� ne• , b' •'� ,�; TITLE V OF THE STATE SANITARY CODE DATED \ ': N - AREA = 43,560 S.F. MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE. q/" ' +, FRONTAGE = 150' C. / 3 I '; �' PROPOSED `\ 30.o FRONT SETBACK = 30' ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING 1 co Q � RESERVE 10 1-1.5" WASHED STONE .SIDE SETBACKS = 15' BY THE DESIGNING ENGINEER. N®r �.,5�.✓' Mlp- W REAR SETBACK = 15' 36.8# W _ BUILDING HEIGHT = 30' WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILUNG, NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT V FOR INSPECTION. 11 #49 W C4 w I, THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN 44' APPROVAL BY THE DESIGNING ENGINEER. % AO' MIN F PLAN OF LEACH CHAMBERS ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC: zar'd ;' 39' #N�� NO SCALE EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING / I 12' SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER FINISHED GRADE 310 CMR 15.255. OMP/------ 36"MAX.- 12"MIN. ACTED FILL 2„ PRIMARY BENCHMARK : N.G.V.D. PEASTONE a ' PROJECT BENCHMARK : SEE PLAN C*j_ \�rqs a 3/4" TO 1 1/2 ' 30 5" g O F a DOUBLE LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND wasHED sTONE SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. SECTION VIEW EASEMENT --26----- 3Q\� N0 SCALE 215,318 eq.ft.uplal�d N 4.94 A( fir / 24506-egfl;wetland -'04,3 ACRES�� , ------- ' ---- - 5.0'7-acxee totd oq,Lu R.. NOTE: LOT B WAS SUBDIVVIlDED INTO LOTS C & D PY'PLAN rvvgtsc.r s SAC z v IF1Y d 1 • +r r. • LEACH SYSTEM `COASTAL BANK \ \ it ALL PIPES TO BE SCHEDULE 40 PVC o€ STATE DEFlNI71ON USE 1 - 4 DISTRIBUTION LINE IN 5 RECHARGER 1NITSNX `,,10H y� P A of MAss IN A 12'X 44' WASHED STONE TRENCH AS SHOW4 N s N ��' STEPHEN ALLY O IST ivtc, .� d► C.B.SET o ���F01 STER� ASTug�K o I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THE PROPOSED IIWELLING SHOWN IS ��ss/DNAL T�VM DEFlNI71ON w.,._ IN COMPUANCE WITH LOCAL ZONING BY-LAWS (WITH RESPECT TO SI T BACK REQUIREMENTS --�_ Z� -2_oo Q ONLY)` AND DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD AREA. a `9 & AL flagged wetland ,, & & aoAL *� THIS PLAN IS NOT TO BE RECORDED OR USED TO ESTABLISH PR P��cTY LINES. AL A AL � & � %etland A, .. .�AL ,� ; '` Septic System Design A • � Ak A` AL `i, & * &�� AL eea 9�� REGIST ED PR ESSIONAL LAND SURVEYOR DATE PUTNAM AVENUES COTUIT PREPARED FOR CO °� DONALD EMERY _� TITLE TYPICAL SYSTEM PROFILE Design Schedule ELEVATION BAXTER, NYE & HOLMGREN INC., Proposed House & Septic System Finished Grade = 35,0'f SOIL LOGS )ATE: 5-23-00 #P-9745 TOP OF FOUNDATION 36.0' ENGINEER: BOAR)OF HEALTH AGENT FINISHED BASEMENT FLOOR 28.2' Steve Wilson,P.E. Donna Mora nd�, Barns. Health De t CONSTRUCT ACCESS NOT TO SCALE FINISHED GARAGE FLOOR 35.0' P , p D Proposed M TAW OVER INLET SEWER INVERT AT FOUNDATION 33.1' TEST PIT 1 TEST PIT 2 BA 1 R NYE & HOLMGREN I Top o� TO TANK TO AT LEAST Foundgtion = 360 WITHIN 61 FINISH GRADE g SEWER INVERT INTO SEPTIC TANK 32.9' G.S.E. = 3 7.8' G.S.E. = 35.7' Registered Professional Proposed FINISHED GRADE OVER TANK = 35.01t FINISHED GRADE DIVER A BOX = 350t SEWER INVERT OUT OF SEPTIC TANK 32.6' Finished } FINISHED GRADE DYER LEACHING TRENCH = 35.0't 0 ry » Engineers and Land Surveyors Basement z8.p' _ SEWER INVERT INTO DISTRIBUTION BOX 32.4' 0 "Ap" SANDY LOAM Ap SANDY LOAM FOOTING :. .::.;, 4' SCH. 40 PVC . ';. .... FIRST a (TO BE LEVEL) SEWER INVERT OUT OF DISTRIBUTION BOX 32.2' 6" 10YR 4�2 6° 812 Main Street, Osterville, Ma. 02655 (TYPICAL) - 4' SCH. 40 PVC 12' (Min) Cover SEWER INVERT INTO LEACHING SYSTEM 32.0' Phone - (508)428-9131 Fax - (508)428-3750 s'or OLD' 36' (Max) Cover BOTTOM OF LEACHING SYSTEM 30.o' "B" SANDY LOAM "B" SANDY LOAM tees s BAFFLE sum 4' SCH .40 PVC p 10YR 4 4 b 10YR 7/2 2'Layer 1/8'tol/2' WATER TABLE N/A 20 � 2t) Peastone LEACHING CHAMBERS "C MEDIUM SAND "C" MEDIUM SAND R inforced Concrete 6' CRUSHED Slope = 0,005 (Min ) 10YR. 416 10YR. 6�4 ' TONE aA 4• Pvc� O O O O O • O O O O 132" (El. 26.8) 1;2" (El. 24.7) DATE: 07/27/00 •;: • O • O • • _. _ O • O • O O O O NO WATER ENCOUNTERED AT EL. - 32.3 PERC ® - 60" @ T.H. #2 REV. DATE: REMARKS BOTTUM ELEV, = 30.0' RATE= < 2 MIN/IN 1500 GALLON SEPTIC TANK DISTRIBUTION BOX 5,3' TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE DRAWING NUMBER SEPTIC TANK TU BE INSPECTED & CLEANED ANNUALLY Nei (:�rc,�,, ':er� t1u<;��r�,r�:� Elevation = 24,7' �- LEACHING SYSTEM H.\2000\2000-33\SURVEY\WORKSI�';I \ 20033ec7-27.dw