HomeMy WebLinkAbout0133 RALYN ROAD - Health rC133 RALYN ROAD
OTUIT
I
i
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in compu er:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye
ftpliCation for Disposal *pStem Construction Permit
Application for a Permit to Construct( ) Repair(✓) Upgrade( ) Abandon( ) ❑Complete System [Individual Components
Location Address or Lot No. i 3 3 �a�yn Q�d. (otu�� Owner's Name,Address,and Tel.No. far bo c o. N zed
Assessor'sMap/Parcel 022 - 059 �33 RoJyn iZd (.olv��
Installer's Name,Address,and Tel.No.43(S 'Exr_&A*-Kon I(lc.• Designer's Name,Address,and Tel.No.F.�9�naer��oJ Wows
3a4 0%oak-e, 13o SGndw"o% Sob 449 0(0S3 1t W. erossCkI6 Rd• Foraskdpte, 15'08.4T7•5313
Type of Building:
Dwelling No.of Bedrooms Lot Size Z A,q 06% sq.ft - Garbage Grinder(No)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) y y 0 gpd Design flow provided q$q . q gpd
Plan Date �2� Zl Zo Number of sheets Z Revision Date
Title
Size of Septic Tank toc)o !aNk\ons TypeofS.A.S. (3) SUy 0CMO(N Chambers
Description of Soil SeQ, plans y
Nature of Repairs or Alterations(Answer when applicable) `n4&k\ flea,) -ZO A-4Jox And (3) N-ZO Soo
moo,\1onS GIr,aMhQCS .
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 5 0
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. a 0 91— 0 0`I Date Issued
-------------------------------------------------------------
®0 -t J
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for Zisp9saf 6pstetn Construction i3ermit
Application for a Permit to Construct( ) Repair(f) Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. Qjn�k#f) Pad, (c+v,} Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel O Z- • p S'q
Installer's Name,Address,and Tel.No.�� CS �c cnvc:�;on Inc. Designer's Name,Address,and Tel.No. (.n(,nwe r �� W(,i ;
'S02 4113 tit'<;3 12 W• fcu` f, Ott 1�Ct• �rc,r ',lcin• 5c-a { 7' J313
Type of Building:
Dwelling No.of Bedrooms Lot Size t1, S sq.ftt' Garbage Grinder(t4a)
a Other Type of Building No.of Persons Showers( ) Cafeteria( )
t
Other Fixtures
Design Flow(min.required) 0 gpd Design flow provided K . t gpd
Plan Date 1'Z 2,4 2-9 Number of sheets Revision Date
Title
Size of Septic Tank 000 ag-\\o n� Type of S.A.S. n„ f h rnh�t c
Description of Soils
Nature of Repairs or Alterations(Answer when applicable) �,�c�n it 11., x i �t-2 0 A-boy, W- '_U 00
J
Date last inspected:
"Agreement: t
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system1hi
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
X
Compliance has been issued by this Board of Health.
Signed ,-�'� Date 1 15 i tO
-y AM
Application Approved by S 'j ,.. ya Date
Application Disapproved by~ Y Date
for the following reasons
Permit No. p " bC3 Date Issued
s f
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
t
_ THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(f) Upgraded( )
Abandoned( )by (l ,v
at �_L,3 Pcku, RA C0o,`. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.d'20o�/"V/ dated
Installer ( (z, �.�r�,,e,A,,,� ��t• Designer 'Ena krnon rt n F it,t k.c
#bedrooms t Approved design flow 1(�((1 gpd
The issuance of this permit shall not be construed as a guarantee that the system w�ll f notioh as designed.
Date Inspector
-------
No. ;o f Fee
THE COMMONWEALTH OF MASSACHUSETTS v
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal 6pstem CbstrUction Permit
Permission is hereby granted to Construct( ) Repair(\/) Upgrade( ) Abandon( )
System located at 1 YS 9'A C.o}to:k
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 r
r `
Date I — Approved by t
r -
Town of Barnstable
OFYNE T .
Regulatory Semees
�p 4
Richard V.Scan,Interim Director
�@ Public Health Division
fnt,t °i Thomas.McKean,Director
200 Main:Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508490-6304
Installer&Designer Certification Form
Date: Sewage Perifnit# -00 Assessor's Map\Parcel O-Z-L - b J'°
Fc+ N e C'-A-1-e
Desbner:. c .n ee� n✓ �tci,t l s Ivtr, Installer:
Address: )Z W, C l d P-J Address.
ZtsSc ,� �
F�e-ls li-do.k.MA G Z 641 s+G(e,Le M OZ(v Lt Y
pncG� } was issued a permit to install a
(date) (installei)
septic system at l 3 n f3.i',-.t",
_ 1� based on a design drawn by.
(ad dres
)
�'1cj 1`rt:Q *12 yr Na r-Lts-Jk(• dated i,Z(2.1 k`ZCl
(designer)
'Y- I certify that the septic system referenced above.was installed substantially according.to
the.design, which may include minor approved changes:such as lateral relocation of the .
distribution box and/or septic.tank. Strip out (if required) was inspected: and the soils
were found satisfactory:
L certify that the septic system referenced above was installed with major.changes (i.e.
greater than 10 lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State.&Local Regulations.. Plan revision or
certified as-built by.designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that.the system referenced above was constructed in with the-terms
of the AA approval letters (if applicable)
• t9E't£Rt�
CA
(Instal er's gna ) Vtt.
N0:351i19
O
(Designer' Signature) (Affix D.esigi3 ere)
-PLEASK.-RETM TOBARNSTABLE PUBLIC HEALTH DWISION CERTIFICATE
OF. COMPLIANCE WILL.NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED RV THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:,Sepu;aiesigner Certific e400 Form Rev 8-14-13.doc.
Engineers note:This certification is limited to an-as-built inspection of system components as installed prior to backfiH.The
engineer did not supervise construction-of the system:The iastalier assumes responsibility for all materials;workmanship;backfilling
to specified grades with proper compaodon.and setting rtserstcovers as shown on the design plan.
Town of Barnstable
Inspectional Services Department
RAPNAUM
MASS.A
M ' Public Health Division
1659-y
200 Main Street, Hyannis MA 02601
Office: 508-8624644
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7015 1730 0001 4987 9934
November 30, 2020
REED, BARBARA L TR
133 RALYN ROAD
COTUIT, MA 02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 133 Ralyn Road, Cotuit, MA was inspected on 11/11/2020
by Shawn McElroy, 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
c ean, .5., CHO
ent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\l33 Ralyn Road Cotuit.doc
Town of Barnstable
BARN STABLE
KAM
�A 039. A Inspectional Services Department
tFD MAti
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 o 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 septic tic tank or SAS
P
ONE (1) YEAR DEADLINE CRITERIA
o Static liquid level in the distribution box is above the outlet invert due to an
overloaded or clogged SAS or cesspool
❑ Apo
rtion 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
o Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation
of
a driveway due to H-10 components, etc)
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
I
b as - 055 ^
Commonwealth of Massachusetts - a
,a f. Title 5 Offi-cial Inspection Form".
! ;01 Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments .
133 Ralyn Rd a
Property Address ;.
Barbara Reed �.-
Owner Owner's Nam -
information is Co.... } MA 02635 11-11-2020
required for every
page. City/Town t _ State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the enfd of the form.
A. Inspector Information S 1#. :(5•0�.(.0,
Shawn Mcelroy
Name of Inspector F, T.
'Upper Cape Septic Services
Company Name ty
P.O. Box 73
Company Address
East Falmouth MA 02536
City/Town State Zip Code
508-495-0905 S13971
Telephone Number License Number
B. Certification
I certify that:l 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 aftheproperty 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 properfunction and
maintenance of'on-site sewage disposal systems.After conducting this inspection I have determined that
the system: -;.
1. ❑ Passes
2. ❑ Conditionally Passes, - : , A. ,•, " •.r
1 • ar
3., ❑ Needs Further Evaluation,by the.Local Approving,Authority, J
4. ® Fails
41-11-2020 ,
nspector's Signature Date '
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system 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.7/26/2018 w Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18
R
1
Commonwealth of Massachusetts f' '/ +'+ �' -•
a y Title 5 Official Inspection Form'
N Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments 1
133 Ralyn Rd '
Property Address
Barbara Reed E
Owner Owner's Name
information is ,
required for every Cotuit• MA 02635 11-11-2020
page. City/Town 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:'
❑ 1 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: * '
M .
. ` • _ S i j _ l M1r
1
2) System Conditionally Passes: F .q ,k ,• .
• '
❑ 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):
;r
. 1 �
F fki .•1-- .;ti- jf i.F♦(,.F. 1
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Forums
'; f i-'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020
-
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
r
2) System Conditionally Passes(cont.):
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired:
Y .' * 'i � t' ..,► '� •. , , ,4 ,r .e i f ,+.r. w / : 1r•,. ,•,r t. tr
❑ Observation of sewage backup or breakout or high-,static water,level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ - broken pipe(s)-are replaced F ' ❑ Y :❑N El ND (Explain below):
" ❑ i obstruction is'removed' ❑ Y ❑N- ' ❑ ND (Explain below):
I ❑ distribution box is leveled or replaced " '•❑Y ❑ N; ❑ ND (Explain below):
t
1
❑ 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 ON ❑ 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
°=1-`the"system is failing to protect'public health,,safety or the'environme'nt: :
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: t
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
Commonwealth of Massachusetts
Title 5 Official Inspectoon' F®r'm�'
��I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is Cotuit ' MA 02635 11-11-2020
required for every '
page. City/Town 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,
iafety 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 insp ections:
Yes
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
f
Commonwealth of Massachusetts
f Tile 5 Official Inspection Foy n
' 'i Subsurface Sewage Disposal System Form-Not-for Voluntary.Assessments
133 Ral n Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit 4.A- i MA 02635 11-11-2020 r
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
L
4) System Failure Criteria Applicable to All Systems: (coot.) ,
Yes No
t4
❑ ® ` 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 Wday flow'. -F ' , ., _ . • r .
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped: Y
❑ ®. , -,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
❑ ' ® i` 'tributary to a surface water supply.-%-
Any portion of a cesspool or privy is within a Zone 1 of a public water supply
❑ _ + well.
El [Z ` Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® 'Anyiportion 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.]
❑ ® Y The system is a cesspool serving a facility with a design flow of 2000 gpd-
r 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 16,000*god.- S 1111. ' -
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section C.4. , c
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 P®rion- � }
4;0) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '
133 Ral n Rd
.tip_ •T, � Y
Property Address
Barbara Reed
Owner Owner's Name
information is
required for every Cotuit MA 02635 11-11-2020
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (coat.) 2
If you have answered "yes"to any'question in Section 6.5 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
❑ [E 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?
❑ Z 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 fo`r 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?
® ❑ Wasthe 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.
[E ❑ 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 ;,,:;� . � _ • . , - � , . -,. ,
Tl 4 �.� Title 5 Official Insp"ection foem
y
IQ Subsurface Sewage Disposal System Forth -Not for Voluntary,Assessments , •,
133 Ralyn Rd ,- , :„
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit r-;,. MA 02635 11-11-2020
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): N/A Number.of bedrooms (actual): 4
DESIGN flowbased on 310 CMR 15.203 (for example. 110 gpd.x#of bedrooms): N/A
Description:
Number of current residents: 1
Does residence have a garbage grinder?, Q1 4 ..,� , ,� ,�,,,� ,_ ,; El Yes ® No
Does residence have a water treatment unit? w. ,•� ry t �., ❑ Yes ® No
If yes, discharges to:
Is laundry on a separate sewage system? (Include laundry system inspection
information in this report.) r „r'. ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump? ElYes ® No
11-2020
Last date of occupancy: ,u, ,; F k'°,s"i: •�.t''• c- t �;i —y f Date
t5insp.doc-rev.7/26/2018 J Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
Commonwealth of Massachusetts
Title 5 Official inspection Form,
I Subsurface Sewage•Disposal Sy§tem Form Not for Voluntary'Assessrnents t
s T ` 133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2026
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions: r T
'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
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):
� 1 -
3. Pumping Records:
Source of information: Owner---pumped within last 5 yrs
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons x
How was quantity pumped determined? '
Reason for pumping: Maintenance
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts :j ;:.. - *r ; T ; - ►
j fY Title 5 Official Inspection Forte f
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.,.
133 Ralyn Rd {
Property Address y`
Barbara Reed
Owner Owner's Name
information is required for every Cotuit 'rE MA 02635 11-11-2020
page. City/Town a State Zip Code Date of Inspection
D. System Information (cont.) -, - .,r, .-
4. 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): T,
k•�
Approximate-age of all components, date installed (if known) and source of•information:
1979 r
Were sewage odors detected when arriving at the site?,, ,,It IRI Yes ® No
5. Building Sewer(locate on site.plan): 3 t .,. .,� ,, ..�•.1 .r ,, ,
42"
Depth below grade: ` "feet
Material of construction`:
`r ' 4TI ; t
r . i 'p �:' Orangeburg,,
' '® - ❑ 40-PVC •®'other ex lain .
` ~` cast iron �'' " '='
.? , k. � , .. •T1'i .f1;1 °. _ ,.. 1�,, is .'.:,i • :,a.. � r ',i
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage,,etc.):
Good condition.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
I
Commonwealth of Massachusetts r '
,w Title 5 Official Inspection Form ' . .
i�I Subsutface�sewage Disposal System Form -Not for Voluntary Assessments
133 Ralyn Rd "
Property Address '
Barbara Reed
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) VC
6. Septic Tank (locate on site plan):
Depth below grade: " ' '' 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: s ,• 1000 gal
Sludge depth:
16"
Distance from top of sludge to bottom of outlet tee or baffle' 16"
Scum thickness
8" i
Distance from top scum of to to of outlet tee or"baffle `- 'r , -- 5 '
p
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined? Tape
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 is in good condition with baffles installed and no sign of leakage. Tank very heavy on solids.
Tank also had signs of back-up with scum on top of outlet baffle and stain lines on wall
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
fw; Title 5 Officis0. nspectson form
bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments-
a
133 Ralyn Rd .f
Property Address
Barbara Reed -
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020
page. City/Town - State Zip Code Date of Inspection
D. System Information (cont.) .1 , j j
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.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
Commonwealth of Massachusetts
r� ,,f� Title 5 Official inspection Form
��
,'C.'I Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments
133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit r� MA 02635 11-11-2020 r
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank (cont.)
Alarm present: ❑ Yes ❑P 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 N/A
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
., k.-
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18
Ll� Commonwealth of Massachusetts
Tile 5 Official Inspection Form* ;
' M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r rrr
133 Ralyn Rd
Property Address e
Barbara Reed
Owner Owner's Name
information is required for every Cotuit ,: MA 02635 11-11-2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
•A 4
10. Pump Chamber(locate on site plan): s ` r • r ,
Pumps in working order: - ❑ 'Yes* ❑ No*
Alarms in working order: ' : ``' � ' ' rr ❑ 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: ,
• .E.4 .
p Type: f aid ,ii s
® ' ' leaching pits 'number: `t' ' ' 1-1000 gal
.t �
❑ 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18
I
Commonwealth of Massachusetts
Title 5 Official Inspection, Form.'
0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
sr J T; 133 Ralyn Rd '' r
'
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit x F.: MA 02635 11-11-2020
'
page. City/Town c' 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.):
Leach pit was holding 12" of water at inspection with stain lines above inlet invert.
12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number•and configuration— •" v'
f,
Depth—to of liquid to inlet invert ,
P P q "
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.):
r: ..
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts
f Title 5 Official In-spec$ion Form
i Subsurface Sewage Disposal System Form -' Not for Voluntary Assessments
133 Ralyn Rd "71
Property Address
Barbara Reed
Owner Owner's Name
information is Cotuit f,, MA 02635 11-11-2020 .
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) ff, , r, • ;._f
4 «
13. Privy (locate on site plan): :f?!`'•r• `' -.,,• ' F... , C.
`Materials of construction:,f=
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
8
1
1
T
l� III
4
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts r -
�� y� Title 5 Officia' [ Inspection Form-
�M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wy 133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020'
page. City/Town 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
❑ drawing attached separately
Js
i l
{
r `f
I
.� 3
t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
i
Commonwealth of Massachusetts
Tile 5 Officia[ Inspection -Form
fl Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments
133 Ralyn Rd
Property Address
y
Barbara Reed t
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020
`
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
15. Site Exam: r: •f r . �: r. �.. * , -
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: • ; . ,; 20
r
- feet `
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from systemAesign plans on.record;,r
If checked, date of design plan reviewed:,,: Date -
® Observed site (abutting property/observation hole within.150,feetiof SAS)
® Checked with local Board of Health -explain:
® Checked with local excavators, installers- (attach documentation)
® Accessed USGS database- explain:
You must describe how you established the high ground water elevation:
USGS and town maps show groundwater at greater than 20'.
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
15fl,: Commonwealth of Massachusetts
,'. Title 5 Official I nspectu®n--Form
Subsurface Sewage Disposal System Form :-Not for Voluntary Assessments = '
133 Ralyn Rd
Property Address
Barbara Reed
Owner Owner's Name
information is required for every Cotuit MA 02635 11-11-2020
page. City/Town 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: - I
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
t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
Page 1 of 1
9edroom;, �'
4 81/2"x 12r3" Bedroorr
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https:Hap.rdcpix.com/36a72ed6l cccc l261292b7efd5fl c2cbl-w359920514od-w1024_h768... 1/14/2021
1/14/2021 133 Ralyn Rd,Cotuit,MA,02635 1 realtor.com®
realtorcom® 8
. .. . .....
< Cotuit, MA X
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By Deborah Schilling with William Raveis Real Estate-Osterville
®8
21'3/4 ii'Room tar' i
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x 14'61/2 1_1
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�. Liv{'ng Roam
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Hill; 12•1D114"x1T,IT1/2'
Pending For Sale 23/47
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Veterans:Check Eligibility for a$0 Down VA
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i
$559,900 0$1,892/mo
4 bed 3 bath 2,168 sqft 0.55 acre lot
133 Ralyn Rd, 0 6p
Cotuit, MA,02635 Virtual --- - -
tour
Commute time
DO Noise:Low
S? FEMA Zone X(est.)• Flood Factor96 1 /10 NEW
This property has multiple listings: Listing 1 1 Listing 2
I
t
Property Type Single Family Home Last Sold $219k in 1987
Days on Realtor.com 62 Days Year Built 1979
Price per sgft $258 Garage i 1 Car
Ask a question Share this home
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Property Details v
https://www.realtor.com/realestateandhomes-detail/133-Ralyn-Rd_Cotuit_MA_02635_M90838-75777 1/3
-TOWN OF BARNSTABLE
LOCATION 133 (R*_ILAm R,l. SEWAGE# 2021 - 009
VILLAGE ASSESSOR'S MAP&PARCEL 022 - 06
INSTALLER'S NAME&PHONE NO. Q EXC"A;or, 4-n- 0653
SEPTIC TANK CAPACITY /000
LEACHING FACILITY: (type) 4004cx l L)c, (3) (size) 13A 33 A 2
NO.OF BEDROOMS L4
OWNER Q0.r Smtna- RCCQL-
PERMIT DATE: I- I t4- 21 COMPLIANCE DATE: !-/4-Z d
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
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No.....y��'. ..._. Ficim .................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......OF... ....................................................................................
M
Avoiration for Disposal Works T.nnstrnrtinn Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: I
. ..p. ........ 1..: . G.Y..w. ........ T v T Cove
�� ......... .. ..
dr9ss or Lot No.
...............
..... .... �e �. ....................... ..............Address
. ...... ..............
Own
......
Installer Address
UType of Building [f Size Lot............................Sq. feet
Dwelling—No. of Bedrooms........7.................................Expansion Attic ( ) Garbage Grinder ( )
4 Other—T e of Building ........ No. of persons............................ Showers - Cafeteria
dOther fixtures ------------------•••--•---....----•------- ----•---........--•---....-•-•--•-•••-........................................................
WDesign Flow....... ....:......7e ..gallons per person per day. Total daily flow;...........................................gallons.
WSeptic Tank—Liquid capacity:. ..gallons Length................ Width................ Diameter..........--.... Depth.................
x Disposal Trench—No. .__._.7V-L1&-_W 1t X................. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......� -.1..._. Diameter...=................. Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank (x)
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water---_-------------------
Test Pit No. 2................minutes per inch Depth of Test Pit.............---.... Depth to ground water------------------------
....................................................................................................•-•--•••...............................•------...................••-••.......................................................................................
0 Description of Soil-------------------------------------------------•-•----•--------------------------- ------------------------.....------------------------••--------•--•-•--•..........
v .�. ...
W
----------------- -------------------------------••---- --•---•-----•-----•--------•----•--•-•••-••--------------------------------••----------------•----••-••------•-•-•---•••----
V Nature of Repairs or Alterations----Answer when a plicable.-.--- ../QPO....: _4— :� �T�G - rIlf1k �
........4.oxt..---...,f / C�..-... ...........�.....
............................ ..-.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to•place the system in
operation until a Certificate of Compliance has been sssu by e board of health.
Signed... .- . y�7
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons:.......................................... -•.......•-•-•--••--•--•••----••-••••--........................--....
-------------------------------------•----------------------------•--------------------------------•----........---------•---------------------------------------------------------------•---......_..
Date
PermitNo...... '...:.................................. Issued........................................................
Date
—----------------------
No.--••..�-IAA__ . ............................_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OR HEALTH
H
0F................................
---------------------.._.............................•--
A lilirativu I for Biapvfia1 i0orkii Tonsturtion Veratit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: '- _.....
,gr
' --: F .... -E ','i�r.. a+ �F.'+. `. ..... .. ........., .:�,,fi .�:�i;':..,.. ............................................!'� l .....
Loc tion Address or Lot No.
...........: �.... ` .. :J .. ................................... ....................... ... ....... ......•.........................I..............
Owner Address
(� < F t,-, .............
Installer'7 Address
Type of Building Size Lot............................Sq. feet
-� Dwelling—No. of Bedrooms........ ..............................Expansion Attic ( ) Garbage Grinder ( )
pa, Other—Type of Building
..................:......... No. of persons.............................. Showers ( ) — Cafeteria ( )
Other fixtures ..........................
d
WDesign Flow:........ d.............. ,• ...._gallons per person per day. "Total daily flow............................................gallons.
WSeptic Tank—Liquid capacitj_'! .gallons Length................ Width---------------- Diameter................ Depth.-..........__..
x Disposal Trench=No ��..�Wldth .............. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......a'_ _:1._.' Diameter" ..................... Depth below inlet.................... Total leaching area....:.............sq. ft.
Z Other Distribution box ( ) Dosing tank ( ,A,)
Percolation Test Results Performed b'..•----•--•--•......._.•------••----•----•----•-•------•--•--•--------•--• Date........................................
aTest Pit No. 1................nimutes per inch Depth of Test Pit.................... Depth to ground water-___-___---------_-_---
fi Test Pit No. 2................minutes per inch Depth of Test Pit-................... Depth to ground water------------------------
------------------------------------------
--------------
--...................................................................................................
�0�/ Description of Soil..................................---------=-----------------------------------•--.......................................................................................
W M fr - , :
............................._____........__..__._._._..........................it _..._........_. ......................................................................................................
VJ
W ';.
Nature of.Re airs or Alterations Answer when applicable
U P PP
?
......................
f v'./` 0 f Ye• :fYp.1 .' / `w
----•-- j- s'R''I=;FJ�gy':.•`;�Kp*f.*------- ,y-?r":y,r J-.i .rrt"s�' .+'.. r•• ---•<�'•. f W..... tf t jl''. -----•-''�' l - --'-----._..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article-XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued-by the board of health.
Signed
Date
ApplicationApproved By.........................................-•--- :. •--- ---..._.......--.. .. ..............---------------.....=•----
Date
Application Disapproved for the following reasons:................................................................................................................
--........--•--------•-••-----••---------------------------••••--••------•---------•--•-------------........................---•-------------•---------•------•----•--.........------•------•------•••-
Date
PermitNo.------ ..........................---'--'-• Issued.....................................................
F_ Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........x :. OF.....:. .. `a — ..............
wrdifiratr at .(11impliaatrr
THIS IS TO CERTIFY, That the bdiiv_'dual Sewage Disposal System constructed ( ) or Repaired ( )
by.................................. ;{ - f... cti ........ •--------•----------•---•--...................._........
,r Installer -
at----_- �._te a.-- - . ? .... ---:��A `v�e. ". .-. ~ ;�r�=� �"'�'� F� .............•----------------------------------.
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as desS.ribed in the
application for Disposal Works Construction Permit No---------4i441_________ _______ dated--------- .......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE.
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.. _ . Inspector ` .
� .. ....... .: ..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......... OF.. ,y
NO. ... . '..... FEE... . ....v v
.. ........
• �i�����1 ��•�a� ��n���tr�ilan rraz�i�
Permission is hereby, granted. � ' ............................................................
to Construct (r� ) or Repair ( ) an Individual Sewage Disposal System
at No.................... ... :.. r.. �1.. _�:�. ='
.................
as shown on the application for Disposal Works Construction PermittNo.. .. � Dated-----! .._. '
r r -
Board of Health. t
DATE: r 'fij
FORM 1255 HOBBS & WAP.P.EN. INC.. PUSLMHER$._
r
EXISTING S.A.S. EXISTING SEPTIC TANK Z r`i
TO BE PUMPED, FILLED WITH ' TOP OF TANK, EL.=93.10 J N
SAND AND ABANDONED ' INV.(OUT)=91.85f(VERIFY) O
\ Q
W
\ 91.58 x � N 85°39'10" I Q
W \
178. RE AR A 0
\ q� 21 _ 98,99 o
\ 1.J _ -1
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/ 97.71 -' s}8-- �$0� I .10 0.6 7 0 c
/ x 100.80 0
92.98 O / TP-1 9 x 100.30
ti0 - 0. n S? 98.75
\ C.- 0- (() ar)
99.12
19\� 6 96.9 + LOT Z1 (.� Q)
¢ 34,988f SF �►, i
9� 8 ( 99.4 7 \\ 101.06 ¢ ��� O F Mgss9cyG W J o
a•'. �' 95,95 q,5. j \ x 100.65 0 l o PETER T. V) Q
+ 5. &`'. DECK \ M CIVILEE "' m
VENT 94 4 91 c
�s GARAGE x 9 75 35109 �LLJ M
O 96.0 99,58 ' FSSIO .0
o CB
94,31 99.52 0
(V ... o N PATIO
s❑Nd.�G EX/STING 99. 1 'z�r
CL
� 96,4 3 e HOUSE(#133) ` 40 t-
o / 98.4 4 Z`
DECK FF EL.=101.54f o
��• �� 100.66 � � O o o N
CELLAR FL.=93.44t \ o N z
96. 99,71 99,433 x / ^� o Z I o
06 co w
LEGEND _
\ _-- 99,76 :99.54''DR 102 --EXISTING CONTOUR z Y
E
PROPOSED S.A.S. 98.24 W
x 100.98 EXISTING SPOT GRADE _
3-500 GALLON CHAMBERS / F99,47 ;'::;.:';;.': ` ` ` '`':::• '.., , o CL
SURROUNDED W/ STONE 94,09 9 .31 W EXISTING WATER SERVICE
0
0
1
I x �7,95 !y ''��Y; + -O,H,�!- OVERHEAD WIRES N
.'P ..`. TEST PIT II a
BENCHMARK I \ :R, , .o:""'` o N
_ \ 98.39 :` BENCHMARK �'
0
8. 4. --ay� (V
O
x 98.30 / a ,!_J; ❑ { �. r a
93.68 �W'�
x CB `y4 \ x 94t696_ - - \ 97.08 97,12
TELPED .56 \ /
\ 45 5 , \ .` !� 4 e�� .i(; :� 133,Raly Rd! •j.
9 , �CTuI1,MA02635 y
7 '� ,� r;'_ I� O
\S 6 2¢ 0., \ \ oC B 47 3 po ,( J Qa: I I 1 O
89.90 \ 93.04
'94:93:. '' :'R=� �9 CATCH BASIN .(� :'��`t \ v\ ----1 �` C w
91.62 96.07 Cam •`, 1 �, �' L-
of I Y v O(�.- _I ,3aeecRam.W,aS
OWNER OF RECORD edge j \ � oxas. r \ l 't,..r� c N v
94.20
REED, BARBARA L TR I 3
133 RALYN ROAD00
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MA 026335 PARCEL ID: OZZ-,059 LOCUS MAP W
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NOTE: TO PREVENT JBREAKOUT, THE PROPOSED
EXISTING SEPTIC TANK FINISH GRADE' SHALL NOT BE < EL: 89.5 _
PROVIDE RISERS WITH COVERS OVER INLET & FOR A DISTANCE OF 15' AROUND THE - z L
OUTLET MANHOLES SET TO 6" OG FINISH GRADE. PROPOSED D-BUS PERIMETER OF THE S.A.S. n
PROPOSED SAS
INSTALL RISER & COVER N
SET TO 6" OF GRADE PROVIDE ONE ACCESS' MANHOLE TO WITHIN 3" /EX/STING �-
T.O.F EL.=96.4t(REAR) OF FINISH GRADE FOR INSPECTION PURPOSES GARAGE FGUSE(#133) w g F.G. EL.=96.3t(PATIO) F.G. EL.=95.9t F.G. EL.=95.Ot r EL.=101.54.t � Q
F.G. EL.=95.Ot VENT CELLAR F�:=s3.44t Q
MAINTAIN 2% GRADE (MIN.) OVER S.A.S. (Y 0
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L = 15' L = 23'
@ S=1% (MIN.) @ S=1% (MIN.) I 2" LAYER OF 1/8" TO 1/2" DECK EL ~ p
4"SCH40 PVC DOUBLE WASHED STONE
1 °.
6" 4"SCH40 PVC p
10"I (OR APPROVED FILTER FABRIC)
14' s" as as DECK N W 0 C
EXISTING 4e"'LIQUID E3 im as
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LEVEL qpp GAS aaaaaaa 3/4" TO 1-1/2" DOUBLE i °
BAFFLE INV.=91.17 PROPOSED INV.=91.00 4' 4 8' 4, WASHED STONE c�'� Z w ' Q M
INV.=91.85 Of
DUBOX o': 1A ?1.8' J Q
3 OUTLETS - EFFECTIVE WIDTH = 12.8' T O O
INV.=89.00 � _ T
EXISTING SEPTIr TANK H-2o 3 500 GALLON FACHING CHAMBERS Iv �n�• �, V
-SURROUND D WITH STONEAS SHOWN PROPOSED S.A.S. C F z w
3-500 GALLON CHAMBERS
H-20 RATED SURROUNDED W/ STONE LLl NOTES: TO o
P CONC. ELEV. =90.1 f �- 33.5 -{ Q BREAKOUT ELEV.=89.50
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=89.00 SEPTIC LAYOUT °
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INVERTS, PRIOR TO INSTALLATION. aaaa w
2) D-BOX SHALL BE SET LEVEL AND TRUR TO BOTTOM ELEV.=87.00 aaaaa aaBaa i
We aBaaa � v 0 GRADE ON A MECHANICALLY COMPACTED STABLE �-
BASE OR 6" AGGREGATE BASE, AS SPECIFIED 4' MIN. OF NATURALLY OCCURRING 4' 3 x 8.5' = 25.5' 4' Q °
IN 310 CMR 15.221(2), PERVIOUS MATERIAL EFFECTIVE LENGTH = 33.5' C
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE GROUNDWATER LEACHING YST I� S r� 0 °4) A GAS BAFFLE SHALL BE INSTALLED ON- OUTLET TEE BOTT. OF TP-1, EL.=81.7 FC
NOTES: �'
AS MANUFACTURED BY TUF-TITS, ZABEL OR EQUAL. D_
7EL
S TO THIS PLAN MUST BE APPROVED BY THE LOCAL
EALTH AND THE DESIGN ENGINEER.SEPTIC SYSTEM PROFILE ND MATERIALS SHALL CONFORM TO THE REQUIREMENTS z `i Z 4-
GENERAE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE ao 000S AND REGULATIONS, EXCEPT AS REQUESTED BELOW: w
D M N-310 CMR 15.405(1)(b): LOCAL UPGRADE APPROVAL N
SOILLOG 1) A 3' variance to the 3' maximum cover requirement, for z� Y
for up to 6' of cover over the S.A.S.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE •BACKFILLED PRIOR a
DATE:EVALUATOR:
ER 8, 2020 (,REF#TPT-20-260) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE o
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DESIGN CRITERIA solL EVALUATOR: CHRISTOPH,ER McENTEE SE#14012
WITNESS: DAVID STANTON R.S., HEALTH AGENT DESIGN ENGINEER. - N
NUMBER OF BEDROOMS: 4 ELEV. TP- 1 DEPTH ELEV' TP-2 DEPTH 4 FROM ANY COTHOSE OSH WN NS ENCOUNTERED,
� ALL BE CREPOR EDTIOON DIF ERIN GN z a �
SOIL TEXTURAL CLASS: CLASS I 93.0 0" g4.0 0" ENGINEER BEFORE CONSTRUCTION CONTINUES.DESIGN PERCOLATION RATE: <5 min/inch FILL 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
FILL 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 0
DAILY FLOW: 44p GPD 92.3 Ab 8" 93.3' Ab g" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF o
DESIGN FLOW: 440 GPD LOAMY SAND HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
GARBAGE GRINDER: NO 10YR 7/1 LOAMY SAND a
10YR 7/1 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 2
EXISTINGD SEPTIC TANK: 1000 GALLON CAPACITY 92'1 B 11" 93.1 B 11 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S.
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LEACHING AREA REQUIRED: (440 GPD) 494.6 SF 9• ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
SANDY LOAM SANDY LOAM AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
10YR 5/6 10YR 5/6 DIRECTED BY THE APPROVING AUTHORITIES.
.74 GPD/SF 90:2 0
DISTRIBUTION BOX: 1 INLET, 3 OUTLETS (MINIMUM) H-20 C 34" 89.5`C 54" 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
USE 3-500 GALLON LEACHING CHAMBERS IN SERIES PERC THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
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30"/48' CONSTRUCTION. NNING '�� o
SURROUNDED BY 4' DOUBLE WASHED STONE-ALL SIDES COARSE SAND COOARRE854ND 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE
10YR 8 4 / -SOILS c 2 M
SIDEWALL AREA: 2(12.8 + 33.5') x 2' = 185.2 SF IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
BOTTOM AREA: 12.8' x 33.5' = 428.8 SF REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3) o"L N M
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE rn 0to
OTAL AREA:.................... 614.0 SF 81.7 136' 82.7
136 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
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DESIGN FLOW PROVIDED: 0.74 GPD/SF(614.0 SF) = 454.4 GPD PERC •RATE <2 MIN/IN. 7C" HORIZON 13. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC c On
a NO GROUNDWATER ENCOUNTERED SYSTEM COMPONENTS NOT SHOWN ON THE PLAN. 00
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