HomeMy WebLinkAbout0415 SAMPSONS MILL ROAD - Health 4115 Sampsons Mill Road -
Cotuit
A= 039-153
f TOWN OF BARNSTABLE
LOCATION ' _Cqt1Q( I L SEWAGE# J014 —JI-q-3
of
VILLAGE ( &t LL, ASSESSOR'S MAP&PARCEL 3 - (_ 3
45
0
INSTALLER'S NAME&PHONE NO. j��pr�:-t
SEPTIC TANK CAPACITY
LEACHING FACILITY..(type)`'a���c�t�i.� (size) 4{o W to',t
NO.OF BEDROOMS
OWNER
PERMIT DATE: g (- per_ COMPLIANCE DATE: �- l
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4- � 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) A- Feet
FURNISHED BY J �,/t ��J *�•rrn�
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Town of Barnstable P
Departzmerit of Regulatory Services
• Ala Public Health Division DateMAM
rev h1 200 Main Street,Hyannis MA 02601
Date Scheduled Time Fee Pd.
Soil Suitability Assessment for Sewage lisp®sal
Performed By:
Witnessed By:
Location Addres
5 s LOCATION& GIGt NERAL INFORMATION
Owner's Namc
�/s SA S ono Nt; l / , ' Ile
a�t�.
�'O��^! Address
Assessor's Map/Parcel: 3�/�`�� '1
Engincer'sNamc G�n/� � e
NEW CONSTRUCTION REPAIR Telephone# h o e J b a V
Land Use: 'a WV-2 Slopes M G" Surface Stones //0l_7 e
Distances from: Open Water Body tt Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line ft Other
ft
SIMI TCH:(Street name,dimensions of lot,exact locations of test holes&Pero tests,locate wetlands 1ln proximity to holes)
eK..e C.a
` 41n
cT i'> i
r
201
lj�l CV
Parent material(geologic) G to, 0,I &C,4 VV
Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Pgoe
Estimated Seasonal High Groundwater
Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE
Depth Observed standing in obs.hole: In, Depth to s9II InoUles: Jtt,
Dcpth to weeping from side of obs.hole: In, Clroundwater Adaustment f. V6
Index Well# Reading Date: Index Well loyal _ Adj,&ctor�,,,,,.`.__ Adj.Groundwater level
Observation
PERCOLATION T +'ST Date__�__,�, Tilde
1
Hole# I Tlme at 9"
Depth of Pere Time at G"
Start Pre-soak Time @ Time(9" G")
..End Presoak
Rate Min./Iach C '
Site Suitability Assessment. Site Passed — Sitq Fallcd: Additional Testing Needed(Y/N)
Original: Public Health Dlvisio❑ Observation Hole Data To Be Completed on Back----------
***I£percolation test is to be conducted within 100' of wetland,you]must first notify the. !
Barnstable Conservation Division at Ieast one(1) week prior to beginning.
Q:\S EPTIC\PERCFO RM.D O C
• r
DEEROBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Sdil Color Soil. Other
Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders.
�- LS
3- �o L S 2� • ��/
20-1 y4 C
DEEP OBSERVA�TION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) '(Munsell) Mottling
- g (Structure,Stones,Boulders. -
.� � � � � � ��/ •�S/� Consistency.96 O ave
3 710 L
R
DEEP OBSERVATION ROLE LOG Hole#.
Depth from Soil Horizon Soil Texture Soil Color Soll Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stories,Boulders.
Co i to c e
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders,
Car
sitn
y
Flood Insurance Rate Map:
Above 500 year flood boundary No— Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No._ Yes.,.__y..
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
g
` Certification
ti I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in�10 CNIR 15.017.
Signature Date
Q:1S.BPTIC\PERCPORM.DOC
r
No. d �- r Fee o0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Disposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair(k� Upgrade( ) Abandon( ) ❑Complete System [Individual Components
Location Address or Lot No. 4`5 5, a.rqeS0AS Will Owner's Name,Address,and Tel.No. mUid 4 dixrr t 4
Lod. y/S-SrXM PSot,S A41 it G'oi-u s+-
Assessor'sMap/Parcel 3q r5-3 jW•Sl.;1p- y1g0
rIinstta9ller's Name,Address,and"Tel.No. 5ZA-711)6-93701 signer' Name,Address,and Tel.No.
ixry-e�fo i �rS{72��c35�,?�c =n & t1Aelp-17j Q 1311 V110 tot%f
O
Type of Building:
Dwelling No.of Bedrooms Lot Size oZ 7 °7y/ sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided Y gpd
Plan Date , IlJ, �Ol Number of sheets Revision Date
Title j SSite- S ASMS Ville A
Size of Septic Tank Type of S.A.S.3 %f/p ,�(/ jg�� x
t
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) - U 6Z6 c'
X
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 Environm Code d not to place the system in operation until a Certificate of
Compliance has been issued by this Board of He
Signed Date
Application Approved by Date �-
Application Disapproved by Date
for the following reasons
Permit No. 2-o �- 02 Date Issued z- `
'S ,
F
yNo. d f C.a ` Fee d
.�� �." Entered in computer:
TFfE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION-rOIVN OF BARNSTABLE, MASSACHUSETTS
� I
21pplitatton for Disposal 6pBtem ConBtrUttibn 3permit
t
Application for a Permit to Construct( ) Repair*4 Upgrade( )•Abandon( ) ❑Complete System ['Individual Components
Location Address or Lot No. T 15 (�qpSOh g J i1 j Ad Owner's Name,Address,and Tel.No. ZIL UI-d# Cl @ ] � ,
Assessor's Map/Parcel 3 S C_a4t .:J- VIY54n 'tpSGnS MIl Co Q, #- 74
9,2
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. U • 31F�-Sl55��
&401041 � E.I inear-�'�ryc c 3� jAj i r,Si
Type of Building: t y
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures--
Design Flow(min.required) 330 gpd Design flow provided �� gpd
Plan Date Number of sheets Revision Date / A
Title %tl., 4���n��.r. t/jS S.,v,/nw<
i Size of Septic Tank _ ,� , Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
l?fin KiZA ' �6� S VEj
,
r
Date last inspected:
Agreement:
4 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-Codaa and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health:
Signed ,'�A Date
Application Approved by '` ( Date G
Application Disapproved by Date
for the following reasons
Permit No. 2 a Date Issued G
ti
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired O Upgraded( )
Abandoned( )by
at�/�/ T1�^�T,slc+-i =-�B j �- has been constructed in accordance f
with the provisions of Title 55�and the for Disposal System Construction Permit No.2-ol� -�°13 dated -i
Installed , ' ( �, ✓� % Designer '
#bedrooms Approved desi flow v ?/ d jjgpd
17
The issuance of this pe t all not a onstrued as a guarantee that the system wil tion as�,rll�
4&4d;,
Date Inspector ;�', fi/
l
No. ")O !a - 7 Fee- .l ov ,
THE COMMONWEALTH OF MASSACHUSETTS
-PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal i§pstrm Construction Permit
Permission is hereby granted to Construct( ) Repair(,k-� Upgrade( ) Abandon( )
System located at U/S ✓,cam.., Ail // �_�. rrL..''�
,F I —
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit. r
Date °;J l /,Z. Approvedby
Coo ''----�
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OCT-01-2012 09:32 From:BORTOLOTTI CONST 50842B9399 To:15087906304 P.1/1
FROM :down came engineering inc FAX NO. :1508362SE380 Oct. 01 2012 09:30AM P1
Lo
� e►,►nuaan�t, �
w MAHN Pubilo Health LDivisiumt
100 MAIR tifr'rrf,,,tilyrFsami9,MA Moll
f)ffrr.: 508 862-46+ }
Dote-
12 y.t7
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i9mied a ponmul to isasun a
(cli�tr)� f1 (xz�stellrx) �,/� /
Elept�it.System EEL ,
�,� tJ A Yh�f�'+'� �(ill _U%ged art a design dr8WU by
(lulrS7•e;;h)
1 ( n
Q�yl r .t•! l'�`' r�`�'i,�4;� {J�•�l��,ted
rnwt.il�dolt Tha septic syaltmu ro-fismem-rl Above,"m imiakd yrihatm.tia,lly awording to
Me demri, wbirsh may ia�lc•iial]x.uiiilor oVKaunri -Jta19.F';e� luu�i a:; l�atcral rclncrztinn of tkic
dl rrca hubon bU f3 rlrf/c>r aepdc(uul�.
f- cerlit'y that the se-ptia: Yjstozu idkLea('cri al 0W VPd!4 ilAAe irrf WiTb..1D�jnT QhaPgO (i.e.
gff FatcT lhtazr, 1C IFiTeXa:I-th 64)Tl0J t})4 SAS or ALiy vaLT mfl relo •tim at'ally co1 ipontut
nf the scvfatr aptem)tat iu amoids lace�uitli data&T,oi,-E!Re2,iilat 0rR. I'll-ill rVv'is'ioLt 07
ur`rified e� �,r.j 1t by de,gilp-,er In lulluw
M f}aM,q��`�'n
PANIELA y
OJAI-A
CIVIL.
No 4(9&)7
(Dr'91(y*f1c.r'a 5iptr� u1�+) •(A i 13L r.T`w 'stn.r1,11 T7ucn)
,11/1 914. P`i1,FtiK �'s'� .TiTV4Ta LJ L'i1 ��; T; ' I11.Y15.4tm. i,;,(.Y%'N` TC;AT�
QgA17JANQ4, WXFT, T3i�'Y' L BOTH THIN 1!�Ir ,tip;-�C�I��t aJil dT�F
xa,:Q,�? ,r, .' ,�n ar ' " ,�; Yr r����rr AT�T�r IDIVIS11A jZ.AIUC VOL.,
ASSESSOR'S MAP NO.3-1 PARCEL
1�,,L0. CA'T10N . SEWAGE PERMIT NO.
;�-vILE
LOT SI 5wlsyS 021-L_ ca
�INSTA LL R'S NAME i ADDRESS
e U I L D E R OR OWN ER
O
DATE PERMIT ISSUED 2.
DATE COMPLIANCE ISSUED l� �
/ccv CA
IOGO.4P
f
V.
No�6 r .ram. Fmc............................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Appliration for Diopoiiai Works Tonotrnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
.........................................••------••---------•-...... ....... s�----
- - cation-,Address or Lot No.
..............••---= ... �: --------------....._........----... ---------.....-------------------......---•_..
---
Address
a .................... . c ...... ......._...:. -----------------_-----------------------•••-------
Installer Address
U Type of Building 3 Size Lo4,74____,__�7a ........Sq. feet
�-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther
—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures
W Design Flow____________________S _.._.._____.__gallons per person r day. Total ail flow...._.-3.3........................._ gallons.
WSeptic Tank—Liquid capacity4t2 gallons Length g_.__._ Widthl.l�__-_ Diameter________________ Dept �___.__-
x Disposal Trench—No_____________________ Widt __.___.__._..__.___ Total Length...... ..________ Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter.__.. __.____._. Depth below inlet____.______._._. Total leaching area_!P�e!Vsq. ft.
Z Other Distribution box ( ) Dosing t
a Percolation Test Results Performed by.__._
Test Pit No. I...____ ___minutes per inch Depth of Test Pit__ _ __. _� Depth to ground water............:.%______.
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
•••••••--•-
--•- -..:•--
Description of Soil + ..-•--- .....•• •-_..... _ ...
x :WZ �-------
c, ----------------------- --------.....
x ••---•-----•-------------•--••••------•••-•----•-••--•-•••---•-----••-••••••--- .........••-- •-- ••--- ------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------
--------•-:--••-------•------•-•••---••--••••-•--•-----•••••••••-•-•-•••••-••--••--••------_..•-••-•-•--•_..••••-•---------•-••-•-•••-•----•••--•---•---••-•--.......................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT E 5 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 oar
Signed -•-- . ......-••-•-----•-•----•••••-•-••••-•••-
Date
Application Approved BY j..•--•--•-•-•-•-•...--•--•--••••••._...--••---••-•_-•--- =•--•- . / ��----- -------------
Date
Application Disapproved for the following reasons--------------------------------------------------------------------------------•-------••-••••••--•-•...._-•-•--
.................•-•..........•••---•-••-•••-••---•....•-••..._---•••••••-••--••-----•••••-•-•----•••--••I---•--••-----_....•••••---••----------•-•••-•••-•---------------•---••••---••••••-•---•---_._..
Date
PermitNo.............. �..�_.... Issued-.......................................................
Date
No FRic..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
'c'
OF....................511, 7x&_i 5
.................. .............................. ...................................
7-
lipfiration for Disposal Works Tonstrurtion "Jarrmit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
................................................................................................. ...... ......
a t 1 o n.-,A Address''e,e.� or Lot No.
FT
.............. ....... . .........................................................................................
Address
.......................... ?.......... .......................
Installer Address
Type of Building Size Lof�241-/._17--------Sq. feet
U
Dwelling—No. of Bedrooms...._...._'"..............................Expansion Attic Garbage Grinder
C14 Other—Type of Building ............................ No. of persons....._...................... Showers Cafeteria
Other fixtures
Degign Flow.................... ..__._._...._.gallons per person per day. Total daily flow 9-3 0........................gallons.
WSeptic Tank,--, Liquid capacit/e22(2gallons LengthZ.'��...... Wi&0.::/,�---- Diameter e`te"r................. Dep4 ........
Disposal Trench—,No. Widtp................... Total,Length....___.._.._...... Total leaching area-----------_------sq. f t.
Seepage Pit No........�:�'__c.'Diameter.....A........ ......KZ inlet................. sq. ft.
-------------
Depth below inlet.................... Total leaching area!7
Z Other Distribution box Dosing ta�<,/ 7
Percolation Test Results Performed by....Z44�.6. Date-6411��Ile rj
.................... :;;.......
Test Pit No. I... .....minutes per inch Depth of'Test Pit..,
............... Depth to ground water./�/Vi:_-
.......................
44 Test Pit No. 2................minutes per inch Depth of Test Pit_` ._......._.._.. Depth to ground water......_.._...__......._.
04 ............ .. .. ... .../
— , . ............................. .................... ------ --------------
0 Description of Soil....................o. ...............
.... ............................................... ...... ......*......
U ........................................................................................*...�17/.../............................................................................................
�4W .............................................................
................................. / . .; �Q......................................................................................
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T1T!Lj 5 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....4 D ate
.............
.... ............... .................................... ......
Application Approved By..... ZP4
Date
Application Disapproved for the following reasons:.................................................. ...........................................................
.........................................................................................................................................................................................................
Date
Permit No-------------&157......S�6_0....... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......TONNN...............0 F.....................................................................................
ToWrtifiratr of Toutplitturr
THIS IS TO CERTIFY, That t e Individual Sewage Disposal System constructed or Repaired
by--------------------_--�_),......... gu 4..........L.. -
at......�,u 0 Installer
..................................... - -----------61;0
has been, installed in accordance with the provisions of TITLE. 5 of The State Sanitary Code as described in the
applicatio' n for Disposal Works Construction Permit No----- ...... dated-.....60- .......
I
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM IL FUNCTION SATISFACTORY.
DATE
.�. _2� 9 ---j�ot
A Z.................................................... Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
JN).................OF......&Alci�Qs I
No......................... ..................
FEE...S.b.:,.........
Elispo.oal Works Tomtrurtion ranfit
............
Permission is hereby granted........I . ...........................................................
to Construct Sr Repair an Indivi(4ual Sewjae OS,ystem
atNo....... ...................M........L_.(......
Street
as shown on the application for Disposal Works Construction Permit N'og�tF.'_E�_-IZKZ Dated...C>_ ..............
......... ........
Board o f Health
DATE........ ............. ...................................
FORM 1255 A. M. SULKIN, INC., BOS`r`0_N'_---,
Commonwealth of Massachusetts
Executive Office of Environmental Affairs
Department of• Environmental Protection
William F.Weld . "_ Trudy Cox*
swwry
Gov«row David B.Struhs
Argeo Paul Cslluccl
LL Gowmw e
ee
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Prolerty Add'e+N:
415 Sampsons Mill Road Cotuit Address of owner. 'C 8
Date of Inspe 4ow 3/2 0/9 6 (If different) ��99
Nameoflaspeotor.Joseph P. Macomber Jr. )COACom Nam Ad d Tal hone ber.
J.I�Nracome►ber c Son nc. N ox 66 Centervi�.le ,Mass . 02632
508-775-3338 V�
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below=is=true,acctrrrtte
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
asses
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
pails
Inspector's Siguat
>' Date: ,
The System Inspector shall submit a Copy of this inspection report to the Approving Authority within thirty(�system days co mpleting this shall submit the
inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector
report to the appropriate regional oface of the Department of Environmental Protection. authority'
The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving
INSPECTION SUMMARY:
Check A,B,C,or D:
A) SYSTEM PASSES:
have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
—Z. I
Any failure criteria not evaluated are iudicatod below.
Bl SYSTEM CONDITIONALLY PASSES:
One or more system components need to bereplaced or repaired. The system,upon completion of the replacement or repair►passes
inspection.
Indicate yes ,or not determined(Y,N,'or ND). Describe basis of determination in all instances. If"not determined",explain why not)
The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exflltration,.or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved
J by the Board of Health.
(revised 11/03/95) 1
One Winter Street • Boston,Massachusetts 02108 ! FAX(617)556-10,49 • Telephone(617)292-SM
i'3►,pmtee on Recycled Papa
SUBSURFACE SEWAGE;DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued) '
PropertyAddre" 415 Sampsons Mill Road Cotuit,Mass .
Owner. Paul L. Clark
Date of I=P"40n: 3/20/9 6
B)SYSTEM CONDITIONALLY PASSES(contitMed)
e
Sewage backup or breakout or 0 static water level observed in the distribution boat is die to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of
Health:
broken pipes)are replaced
obstruction is removed
distribution box Is levelled or replaced
The system required Pumper more than four tin a year due to broken or obstructed pipe(s). The system will pass
inspection if(with approval of the Board of Heal ):
broken pipes)are replaced
obstruction is removed
CJ FURTHER EVALUATION 19 REQUIRED BY THE BOARD OF HEALTH:
NO Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health,safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM I9 NOT FUNCTIONING IN A
MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 60 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)
DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND
SAFETY AND THE ENVIRONMENT:
The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and is.within 60 feet of a private water supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 60 feet or more from a private water
supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free
from pollution from that fatuity and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm.
3) OTHER
(revised 11/03/95; g
r, a
• SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(oontinuod)
P:vpertyAddresss 415 Sampsons Mill Road Cotuit,Mass .
Owner. Paul L. Clark
Date of Inspeotion:3/2 0/9 6 •
DI SYSTEM FAILSs •
•
Vj I have determined that the system violates ons or more of the following failure criteria as defined in 310 CMR 16.303. The basis for
this determination is identified below. The Board of Health should be contacted to determine what will be nacessary to correct the
failure.
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesapooL
Disd.arg•or ponding of effluent to the surface of the pound 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 coaspool.
1--44h Ar
Liquid depth in oeaape"leas than 6"below invert or available volume is less than l/2 day flow.
Required pumping more than 4 times in the last year NOT due-to clogged or obstructed pips(s).
Number of times pumped--
Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
Ay Any portion of a 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 I of a public well
Ai Any portion of a cesspool or privy is within 60 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 60 feet&Om a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for
ooliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen.
El LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above:
_Q The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public
health and safety and the environment bebauae one or more of the following conditions exist:
the system L within 400 feet of a surface drinking water supply
A0 the system is within 200 feet of a tributary to a surface drinldag water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone 11 of a public
water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6,00. Please consult the local regional office of the Department for Auther information.•
(revised 11/03/95) 3
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
PropertyAddress: 415 Sampsons Mill Road Cotuit,Mass.
Owner: Paul L. Clark '
Date of Impeotion: 3/2 p/9 6 '
Check If the fo wing have been done: ,
Pumping information was requested of the owner,occupant,and Board of Health.
,,,Koue of the system components have been pumped for at least two weeks and the system has been receiving normal flow sates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
ZAx built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
The system does not receive non-sanitary or industrial waste flow
ZThs site was inspected for signs of breakout.
, Ail system compoaents,h-Juding the Soil Absorption System,have been located on the site.
-4/Ths septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of bames or
tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.
2Ths size and location of the Soil Absorption System on the site has been determined based on existing information or
approzimated by non•iatrusive methods.
,AThe facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub.
Surface Disposal System.
(revised 11/03/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: Paul L. Clark
Owner. 415 Sampsons Mill ,Road Cotuit,Mass .
Date of Inspection:3/2 0/9 6.
FLOW CONDITIONS
RESID MAU,, e
Design flow-.AWD sOons e
Number of bedrooms: ..wI�
Number of current residents:lJAc�
Garbage grinder(yes or no) AD
Laundry conuecte to systeg(yes or no
Seasonal use.(yes or no):ALb— 1 Water meter-readings,if available 4
1 D ,!2
6
Last data of occupancy:
COMMERCIAL/INDUSTRIAL:-
Type of establishment: AM
Design flow: Wday
Grease trap present:(yes or uo),a}A
Industrial Waste Holding Tank present:(yes or no).&,&
Non-sanitary waste discharged to the Title 6 system: (yes or no)jo
Water meter readings,if available: /U
Last date of occupancy:
OTHER:(Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS rmation:
1
System pumped as part of inspection: (yes or no)
If yes,volume pumped:-
Reason for pumping tLi/�/ K'Iy �� �s /W,1°5 0S
TYPE OF SYSTEM
Septic taWdistrib on ba lsoil absorption'system
,V4 Singio spool
VQ Overflow owspool `
_4.)Q Privy
Shared system(yes or io) (if yes,attach previous inspection records,if any)
AM Other(explain)
0 fiE of all components,date installed(if Imown)and source of information:
Sewage odors detected when arriving at the site: (yes or no)_
(revised 11/03/95) 6
ASSE;SOR'S MAP NO.3 I PARCEL l �
0CA'TION _ :.
�'; .. SEWAGE P E It M:.IT:
....Poo.
LACE
TA 11 R'S NAME i ADDRESS
e V-11::DE R OR OWNER
DATE PERMIT ISSUED b . c
DATE COMPLIANCE ISSUED
0
y
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(oontinued)
Property Address: 415 Sampsons Mill Road Cotuit,Mass.
Owner. Pahl L. Clark
Date of Inspeotlon:3/2 0/9 6
BEPTIC TANK:✓l-IOdD�N t4+t)dC• .
(locate on site plan)
Depth below grade: •
Material of construction:Zcoucrets_metal FRPother(explain)
Dimenilons: 7 1 b V 41me 1/6
Distance from top of shulp to bottom of outlet tee or baffle:
Scum thickness:_0
Distance'front top of scum to top of outlet tee or baffle:�_
Distance from bottom of scum to bottom of outlet tee or baffle:,,�_
6
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,
evidence of leakage,etc.)' Pump tank onAP AvAry 9-3 yearsTI—N- -et wata:et tees
are i
sound and shows no signs of r gP
GREASE TRAP:!
(locate on site plan)
Depth below grade:,
Material of construction: concrete metal_FRP_other(esplain)
AM
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or be.Me ja
Distance from bottom of scum to bottom of outlet tee or baflle:A*
Comments:
.
p
(recommendation for puming,condition of inlet and outlet toes or bales,depth of liquid level in relation to outlet invert,structural integrity,
evidence of leakage,etc.) NO y� -
i
(revised 11/03/95) 6
D
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(oontinued)
PropertyAddrem 415 Sampsons Mill Road Cotuit,Mass .
Owner. Paul L. Clarg,.-.
Date of Inspection: 3/2 p/9 6
TIGHT OR HOLDING TANK • .
(locate on site plan) •
Depth below grade:.
Material of construction: concrete metal_FRP other(explain) `
AJA
Dimensions: /A
Capacity: & gallons b
Design flow: ns/day
Alarm level:
Comments: T
(condition of inlet tee,condition of alarm and float switches,etc.)
k)we-
DISTRIBUTION BOX:,
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
PUMP CHAMBER. kw R
(locate on site plan)
Pumps in working orden(yes or no)_d)jQ
Comments:
(note condition
of pump chamber,condition of pumps and appurtenances,etc.)
(revised 11/03/95) 7
� _ e
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
BYSTr:'.: .. :...JN (oontinued)
Propertymdrem 415 Sampsons Mill Road Cotuit
owners Paul L. Clark "
Date of Inspeotioxu 3/2 Q/9 6
SOIL ABSORPTION SYSTEM(SAS):Z e
Cocate on site plant,if possmu;excavation not requ*but may be approximated by uon•intrusive methods)'
If not determined to be proaent,explain:
loarhiag Pits,number:,
leaching chambers,number.0
_D_
leacbIn trenches,utimber,length. .
Web ing gelds,number,dia�enaioas• _
overflow cesspool,number
Co ts:(note conditio ot,�i1, h�uktau a
Solis see page'0A,N"o`1signs of nycLrauli_c�.fMure f or pondin
vegetation is norms i is ry.No repairs neede a mime.
- . ---- ,
CESSPOOLS sAaVe - .. .... ..
(locate on site plan)
Number and configuration: AZA
Depth-top of liquid W inlet invert: MA
Depth of solids Dyer: WO
Depth of scum lspr: FDA
Dimensions of cesspool: 10
jq
Materials of construction: lV A
Indicatiosi of groundwater. 019A
• inflow(oesspool must be pumped as part of inspect;-:0
Comments:(note condition of soil,signs of hydraulic failure, lw,] cr condition of voptatioN•tc.)
PItIVYs/,l ,
Comte on site plan) '
Materials of A�� --- Dimensions:
Depth of solids
Comments:(note condition of Soil,signs of hydraulic Wur .,on of vegetation,etc.)
(revised 11/03/.95)• 8
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I M A�C(, I
DATA
ter.' � 'r y. •_ 'i dS r .. �`+ 4 f '�,4 y r
• _:��. ,,� .x}�,� '. '. r °'•:...::.:.1.;2�:`y,-i I Bel" {��• �..•, + � '�.
.�, ♦ 1�t r`j ':R•1 .`.•. rs,• l�=Ix'� •1.1^ �' yf +qC,
.. .�. t• 1
74
7410
L7 Ord•NF..�•C i t'► ,��' ,�� ;; 1d4"- � .} T if.�''t:�';,
,G/�-I. i r'7 w (T t y Nr , t�t, rZ « .1,•T�lf ":L. +�.
�.. ,/ry .. J �r� •' � 'r '.'wi� r ,•y j-•q•� +Sf t4. � �.'.• w •• j t�''- 1 �. �` ��-'�'�'�rt:A
� �ar�16117jVtyl�r�!",.• � ".•r�'��+ '•N .}4 �: .t.�,.: .�..• '` ,� j ,.•.•t. /ti��Ma 1 I f •%.i.
il
f.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(oontinued)
Property Address: 415- Sampsons Mill Road Cotuit,Mass .
Owner. Paul L. Clark
Date of Inspeotion:3 2 0 9 6
J
SKETCH OF SEWAGE DISPOSAL SYSTEM: e
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100,
Centerville Osterville Marstons Mills
Water Company
428-6691
.'tip V .... •
DEPTH TO GROUND*, Tf?,t� GW/
Depth:to groundwater: .,'1::-F leet
method2of detsnuination ar*p,dmation:
. _...•
.e ge 8A, N. w ter enco tered at 1217 See -
(revtsd� 11/03j9511 _._....._....... . .._ 9
.v• .. .i rr. .
1
I . .. :�r �i•,':Sri: .. •.
•rssnr•:.—n•rr�-rrrnrrr.•nTrrra-e+n rsrrrr.::•rra.zfr:�rrrcrr..nrz•es r.s�s¢r:r.T .. — rs�'crzr.-strr<:.rn-rr:�•r.-.•Tr-�errr.r—••�
'TOWN OF Barnstable BOARD OF HEALTH
4 ( SUBSURFACE SFWACF DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION
t1•••rrt-r••.-:' --.tr.^.r.rrtmrm•n:rvl•r•iirmr+rrrr:r+•.r-c•i-1.--s-•sr+xr'•-rrr.*.t�.:+r rsr:rrns:sr+�sra tsm n•mrr'niav�rrrr�r•rnrnrrr•r.•�r-••••.�
-TYPE OR PRINT CI.EARLY-
PROPERTY INSPECTED
STREET ADDRESS 415 Sampsons Mill Road Cotuit,Mass.
ASSESSORS MAP , BLOCK AND PARCEL # 39-153
OWNER' s NAME Paul L. Clark
PAI?Y' D - CERTIFICATION I
NAME OF INSPECTOR Joseph P. Macomber Jr..
COMPANY NAME J.P.Macomber & Son Inc.
COMPANY ADDRESS Box 66 Centerville, ass . 02632
Street Town or City State LIP
COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 )790 -1578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true , accurate, and
complete as of the ti.rne of :inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems .
. I. ,Il;r �•
Check one:
XXXXXXXXSyste6 PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or the environment as defined in 310 CMR 15 . 303 . Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form.
System FAILED*
The inspection which I have conducted has found that the system fails to
Protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection. form •
•� I
Inspector Signature Date 3/20/96
One copy of this certification must be provided to the OWNER, the BUYER
( where applicable ) and the 130ARD OF 1HEAL7'1I.
* If the inspection FAILED, the owner or"" 'Perator shall upgrade ' the aystem
within one year of the date of the inspection, unless allowed or required
otherwise ad -provided in 310 CMR 15 . 305 .
-
tiw
Lin
THE COMMONWEALTH OF A IASSACHUSETTS..
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BE IT KNOWN THAT
Joseph P. Macomber, Jr.
Has satisfied the Department's qualifications as required and is hereby
authorized to use the title
CERTIFIED TITLE 5 SYSTEM INSPECTOR
as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the
General Laws. Issued by The Department of Environmental Protection. M
June 8, 1995
Acting Director-of the ion of Water Pollution Control
`u Vic.t Jt✓
Ilk
l _ - _ /� Vic, •. 3v
INLET KNOCKOUT !� ,
ray t r rA.
aA . d
1 PI
•`�'.��'l•�"{1" _ _y;.-•�� .. �i ... 1�'. .r�TN77[ i° tY_...,Y'_ "'_""Sw""`..r.°•..^ � a� � %
{+;','� 9 .'k
4
30 00 cl 7"Few RRVA"IL OE rA M 5
10
O v C) 0
O
jr 6
C) C) O C) , •�•-.� v x . 8 U✓ :.r�' L -7�"� 1 49xo
�{-- - -
/2 10 4 m C) :J 0 I Z
r17-0A 4;� 0
37X.'Y' —;� 1 i_i:�.i,�• + :'. t �... .i �r '^wY' .' >: °L V �.i qs •tee # r
\ if 0 t� '1 _ �
♦t SG //�r. /,. I . 1 4 /per - -' jY�� l , : i... R'wl w+i W
C,
0 `�l
t � � 4J o v f{ t*y
-"ewe
. r ■ ! t r� � ri.,wv mww 5
1 t',•;, ,.fit ::
!► ►� 's` �.k X rs-f` ? '� i1/'�'��'t`3't��s�
N �\� `.n� -� _ �f' 1 ��1J9!1: G,•-- '41(r�:' ''"` j I .cam'�t �t��/V t-� !'� f" L✓�C�z�c�.�r�, -_.!� .._
J �_K `tea 4 3,•S s^ ��AG Wl. 3 3+�
427
�'?�� ��fig', � �7��, ,-� )w' � �!.'..7T.'i•-t�,�-' y fir'."� �' ,� . ,, :c/2�, �� h/L o
a ► \\# f�i r _ .l / rry : d.: -:w ' -:fir• ;r/M` AA' 7 - -C 2 AIIN,/ACAI
R�44TIM,-5 9'i J/,tit C c G C_ �' �;�'". �q ` � �, • .__ � � .�?
•• \l p� ' 5'� ''�r*�,t �� � v ,C ry,f� AZ-?.h�
� `� • �,. /� , ALL GAPE sc.tRvE Y
\ �., i-�cj �I�/1 1.. _,rk p A r. l"' •�j", I'�~J'1:'1.. REALY -POST
07-/KJ At�l/ ti. .. ,., �"~�T �:� � ^J� ,��` Z
07
r
-
0,4 f C a 7- Ul
/
�,,./x� �lr.�. �,et..1f.. - —/M. .7o SfQ �.. j '•�,}'eY N:�iR. t w,J}I••✓�I. (. r ,V�
x
j AL
r .
SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES l
MARKED WITH MAGNETIC TAPE OR i �-
COMPARABLE MEANS FOR FUTURE LOCATION. 1.'DATUM IS
(NOT TO SCALE) ASSUMED o
PROVIDE MIN. 20" DIAM. WATERTIGHT �/E"�'j r
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE y o
TOP FOUND. 2" PEASTONE OR GEOTEXTILE 2. MUNICIPAL WATER IS EXISTING
EL. 37.74' FILTER FABRIC OVER STONE a
1\ 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 36.4 Locus
PRECAST H-10 H-10
BLOCKS OR 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO
RISERS (TYP.) MORTAR ALL PRECAST RISERS H- 20 0
2" 33.65' 4"OSCH40 PVC COMPONENTS H-20 INV'S EL.
PIPES LEVEL 1ST 2' 2 5 31.62'
5. PIPE JOINTS TO BE MADE WATERTIGHT.
ENDS BET Hsi6ES 45'10" EXISITNG t4 CCORDANCE WITH
32 6 CONSTRUC110N DETAILS TO BE IN A
.y • p°OO.'.jO cpO cyO Jo oo a°. o eo 00 00
TEE SEPTIC TANK** TEE To--o'o
0 o p o 0 0 0 °o°��° o p o 0 0 MASS. ENVIRONMENTAL CODE TITLE V.
32.25f* ° ° �MM ooao ° °p
®tea®o �a000 ° ° ° ° ° 6" M!N SUMP o°o° MME1 ®�®®� oo°o�� ®a®a®®ao®a >°�°o°o°oo°o°o°o°o°o° o '°°°° 0 0 0 0 °°°°° ° ° ° ° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO
GAS BAFFLE::' °o°o°o°o°o° 12" MIN. INT. DIM. o°o° aa�®®®ao�� 00000° ��®�®®®®0® o0000.o BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE.
o„o N i0000 �0®®®®0®®� oo°o°o ��®�®®��®00000000031.93' 31.76' )°o°o °°0000 o ° ° °
° ° ° ° 29.62
;..: .: :„•..} +•` v': : ;- : ° o 0 0 ° 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
LH-20 500 GAL. LEACHING CHAMBERS BY ACME PRECAST 9. COMPONENTS.NOT TO BE BACKFILLED OR CONCEALED Cotuit
3/4"-1-1/2" DOUBLE WASHED STONE (3) UNITS REQUIRED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSIO
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF'STONE: 40' X 10' OBTAINED FROM BOARD OF HEALTH. DQy
COMPACTION. (15.221 (21) N
10. CONTRACTOR SHALL BE, RESPONSIBLE, FOR CALLING
(6'$ X SLOPE) (-!-X SLOPE) 1" DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION
OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO LOCUS
FOUNDATION EXIST. SEPTIC TANK 32' D' BOX 16' LEACHING COMMENCEMENT OF WORK. L A
24.4' BOTTOM TH-1 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND NOT TO SCALE
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT NO GROUNDWATER FOUND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND.
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 39 PARCEL 153
CONDITIONS IF NOT SUITABLE REMOVED 5' BENEATH AND AROUND THE PROPOSED
LEGENDLEACHING FACILITY. P
VARIANCE REQUESTED UNDER MAX. FEASIBLE COMPLIANCE
99- EXISTING CONTOUR / ■�4.53 k15.405 1 b: SAS TO BE >3' BUT < 6' BELOW FINISH
X 99.1 j I GRADE (VENT AND H-20 PROVIDED)
EXIST. SPOT ELEV. �O
34.58
-[991- PROPOSED CONTOUR
198,4 /
] PROPOSED SPOT EL. � V L 34.68 7.76
v
TH1 SYSTEM DESIGN.
/ � �
TEST HOLE j � �y6 t�3 asi s
SHELL
DRIVE o" SOa
CATCH BASIN 1GARBAGE DISPOSER IS NOT ALLOWED®J y
s
UTILITY POLE `"o .17 Q 5.43
FIRE HYDRANT Q� .67 z�000 'DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD
W WATER LINE 2.P6 537 6.03/ x3 '49 �°\° 35.11 USE A 330 GPD DESIGN FLOW
G GAS LINE 1
OHE -OVERHEAD ELECTRIC ° .37 , MAR RN K- COMER OF SEPTIC TANK: 330 GPD (2) = 660
NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING �° PAVED 86 BRICK PA710 EL 30.3
-�� �-DRIVEUSE iEXISTING 1000 GAL. SEPTIC TANK
4 .;
ED
6
TEST HOLE LOGS \°\ EXISTING 39.3 LEACHING:
36.33 37.67
°�D6.36.48 HOUSE
1936.6 SIDES: 2 (40 + 10) 2 (.74) = 148 GPD
9 6.40 PIT y7.17 BOTTOM 40 X 10 (.74) = 296 GPD
ENGINEER: DANIEL E. GONSALVES, SE #13587 •�'^ 36 � 60TE,
•�' 3, e•OAK 6.95 TOTAL: 600 S.F. 444 GPD
WITNESS: DON DESMARAIS, RS �, p
\•\• / 36.29 OAK ,r PROP.VENT WITH CHARCOAL FlLTER
DATE: 9/10/12 LOT 51 DECK 5 ANDCON RACTORWIT (HOM PLACEMENT By USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
CONTRACTOR WITH HOMEOWNER
PERC. RATE _ < 2 MIN/INCH
27,747±SF r OAK b1D 3 87 CONSULTATION) WITH 2.25' STONE AT ENDS 5' BETWEEN UNITS AND 2.6'
x36.43 •36.25 TM' AT SIDES
CLASS I SOILS p# 13729 � -37.30
■ .25 2 36.29
- 37.74 \ s
■3
ELEV. ELEV. 36
0" 36.4' 0" 36.4' ` 3s.9s G �I 36.
q - q ■35.3C �'�• / °. s TITLE 5 SITE PLAN
3.5
LS LS x 35. x 4.90 OF
1OYR 5/3 1OYR 5/3
3" 36.15' 3" 36.15' x71 36.39
E E \N x3 x3 66 M`O 1 415 SAMPSONS
N
LS Ls .66
31.63-
MILL ROAD
10
2.5Y 5/1 35.56' 10" 2.5Y 5/1 35.56'" 35.00
wa 32.3w COTUIT MA
E E x
LS LS x 32a)6 ° •, PREPARED FOR
��. MgS �^ y
" DANIELA.
2.5Y 5/1 ' 2.5Y 5/1
20 34.73
I�I(:.EL 1'v'IL
20 34.73 �� ORTOLOTTI/RYAN
�� GA G � C ��
A. N '65 2
I LA41
®E55"RC No. 0D �0SJ '� � �°� DATE: SEPTEMBER 10, 2012
M/CS M/CS off 508-362-4541
10YR 7/8 10YR 7/8 CfAPtiIFL A,\tiG� � fax 508 362-9880
Y � DANIEL OJAII,
i A.
144" 24.4' 144" 24.4' OJALA a �v >>�6ho"'
, � ,; down cope engineering, Inc.
Scale: 1"= 30' CIVIL ENGINEERS
NO GROUNDWATER ENCOUNTERED •
LAND SURVEYORS
DCE #12-214 DATE DANIEL A. OJALA, P.E., P.L.S.
0 15 30 45 60 75 FEET 939 Main Street - YARMOUTHPORT° MASS.
12-214 BORTOLOTTI-RYAN.DWG