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0181 SANDALWOOD DRIVE - Health
181 Sandalwood Drive Cotuit A 010 - 034 i sse/fo 48420 30®/® M _ __ - �` � � � � � � � � , 1 � 1 .'I I I ^ ^ � \ ��, ��V � - _ q: t -_ t : . . . � �• _ - _ .t _ i � ... - _ �. .. r .' � .... 4' .� .� � � - - y � Y - .. Y .... .. ' .,_ � _ r �� ... i � .. ry .� r _ �. r. � ... r ., � _ _ � •, ._.., u _ _ TOWN OF BARNSTABLE , LOCATION (.�� �o� \.t;o6 i.�2• SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL 145 INSTALLER'S NAME&PHONE NO. 4— � SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ��' L C(� C S(size) NO.OF BEDROOMS OWNER c» Qr ASS PERMIT DATE:, -( �, 1 �. COMPLIANCE DATE: I a I J Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5 t + 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) �" J Feet FURNISHED BY CL Pf 43 0 — o T�►' 22 ID Tos 13 �, (�� 3 f No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pphCation for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. $, � ��fya��� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. SO Type of Building: Dwelling No.of Bedrooms Lot Size c>10�V)CSCj sq.ft. Garbage Grinder(/J Y A Other Type of Building No.of Persons Showers( )cafeteria r Other Fixtures Design Flow(min.required) 2�!2yo gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic.Tank �� C�� Type of S.A.S. j'—4.e!!� ghcoL, - j & Description of Soil )CC!!!, Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction d mai nance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Enviro ental od t to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea Signed Date Application Approved by - Date Application Disapproved by Date for the following reasons Permit No. �7''7� 4f� Date Issued �—/ No. Gam'/ / Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered;ncomputer: �. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplitation for Bioppsal'6pstem Construttlon Verm t Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. o t, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ( �'� Q ` �t jai ( a-)c,C)S C, to Installer's Name,Address,and Tel.No. Desi er"s Name,Address,and Tel.No. Type of Building: - U Dwelling No.of Bedrooms Lot Sizex c-;?C), Z6CJ sq.ft. Garbage Grinder(JJ Other Type of Building No.of Persons c.:P1 Showers( Cafeteria r Other Fixtures p '�GC v�. R ••C�- 6 S i C��= L C'�. `��;`k u Design Flow(min.required) ) gpd Design flow provided �t� , cZ (. gpd Plan Date '� �In 1 �� ._ Number of sheets ... "- -- Revision Date Title C� �-C&9 _ Size of Septic Tank ��00 Type of S.A.S. Description of Soil t f ;'Ll C \C, . v Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envir ental od'a'nd1 not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ,'Signed F ' Date Application Approved by _ Date 7 / f Application Disapproved by Date for the following reasons Permit No. !DateF4ssued C,'-/�! THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Qtertifitate of Conmiiante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded.() Abandoned( )by G C'A:r —,,Q2 Sv,cvu at ""�Gh�'ir:\i.Zne i_l " has been constructed in-accordance with the provisions ofyTitle 5 and the foorr�Disposal System Construction Permit No.,—;Z/7 '�`*A*ated ��A Installer Gvlcl '_C_` J� -,. Designer #bedrooms Approved design flow z �+,,> gpd Y,N The issuance of this permit shall not be'construed as a guarantee that the system willfunction as designed. Date Zi / - ! :;' Inspectorell --------------�------�--------,-.--^-�------------------------------------------------------------------------------------------- ------ oul No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS disposal &pstem Construction j3ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade,(K) Abandon( ) System located at ,iCs�l C�����JCS?S('' �� • 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 b'completed within three years of the date of this permit. Date f APpro eV&by-.. Town of Barnstable Regulatory Services Richard V. Scali,Interim Director * snaxsTna[.e, MAS& Public Health Division i639• ♦� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form • Date: 29 1 Sewage Permit# 901-1--2.q-o Assessor's Map\Parcel ,( 1 31- Designer: 0 'Installer: Address: Address: c�S�C �I A Ctecl ; p Cow On a-1 v� was issued a permit to install a (date) (installer) septic system at, based on a design drawn by (address) 5� dated (designer) XI 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. I 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 compliance with the terms n&approval letters (if applicable) .�a Or Eh•4ggs� + .. 4Y_`yS� i�. C �zr, (Installer's Signatur o S 'r„ (Designer' Sign e) (Affix:z es Me;40 p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. 'Q:\SepticTesigner Certification Form Rev 8-14-13.doc Town of Barnstable P o 1 S 3 8 Department of Regulatory Services •Baer = Public Health Division Date 5 3U 1+ .M9. 200 in Street,Hyannis MA 02601 atilt . Date Scheduled_ t. ��, 1� Time—A� l I "— Fee Pd. l 0 6 Soil Suitabili �Assessment for Sewage Disposal r Performed By: C��cY Qx i ' � Witnessed By: \ Q l t, �th cam �� It,`'`� LOCATION&.;GENERAL INFORMATION Location Address` - - Scr, a�.Talc 6 Ci Owner's Name Address 1 tE3 `�C.c\6 V,l w tF 3>n Assessor's Map/Parcel: 1 Engineer's Name Cam , NEW CONSTRUCTION REP— Telephone# 'J( � —ail'LA Land Use ` CAP-Clt 1 OL\� Sli es(%) 1 9 ) Surface Stones tj �P+�Distances from: Open Water Body�ft ft osaible Wet Area�ft Drinking Water Well /J/A$ �}'� Drainage Way ft Property Line _ft Other "7 '�ft SKETCH:(Street name,dimensions offl lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) k { Z� Parent material(geologic) r, ��5�'r. Depth to Bedrock .tJ J lA Depth to Groundwater:Standing Water in Hole: /�ti I c� t t �+'B g` ill Weeping from Pit Face �p'ne ®\!�,S Estimated Seasonal High Groundwater N fN DETERMINATION FOR SEASONAL HIGH WATER TABLE: Method Used: I - th Observed standing m obs.hole: D� B' in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in Groundwater Adjustment ft Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level observat;on' PERCOLATION TEST ` Date :` Time Hole# i Time at 9" �1 •1 Depth of Petc �j O r L{�y j: Time at 6" Start Pre-soak Time @ 1.-3 Time(9"-6') t n End Pre-soak 1 fi 1 RateMinllnch ►��\ L Site SuitabilityAssessment: Site Passed `Site Failed: Additional Testing Needed(Y/N) iJ Original:Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:VSEPTTCIPERCFORMDOC i I DEEP.OBSERVATION HOLE LOG' Hole# f Depth from Soil Horizon Soil Texture Sod Color Soil OtherSurface(in.) (USDA) (Mvnsell) Mottling (Structure,Stones,Boulders. C r o G ^� Iao S L ld 231; r I L_. (V L�'re-S l 3a ^13a- 1 MSS, zrs DEEP OBSERVATIO HOLE LOG` Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mmsell) Mottling (Structure,Stones,Boulders. J - Consistent %Gravel DEEP OBSERVATI.ON HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) { (USDA) I (Mansell) Mottling (Structure,Stones,Boulders. GMSigtengy,% I « I i i - I i DEEP OBSERVATION HOLE.LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling c (Structure,Stones,Boulders. Consistency.%Gravel) I r i i Flood Insurance Rate Map: t Above 500 year flood boundary No_ Yes Within 500 year boundary No�YI Within 100 year flood boundary No_/ Y I ea - - Denth ofNaturally Occurring Pervious Material Does at least four feet of naturally occurring pervious atecal exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring irvions material? Certification I certify that on t C�l (date)I have passed the soil evaluator examination approved by the Department of Errvir ental o on and that'the above analysis was performed by me consistent with the required tr ' e se an e e i scribed in 310 CMR 15.017. Signature Date Q:VSEPI•MERCFORNMOC . r i TOWN OF.BARNSTABLE 1 LOCATION IV P-AJA -L t,000 6,1L., SEWAGE # VILLAGE C61,1 v iT ASSESSOR'S MAP 6z LOT INSTALLER'S NAME St PHONE NO.sPcr/E7—t/o 7' C(/),J S7— SEPTIC TANK CAPACITY /Oo0 6xc� LEACHING FACILITY:(type) (size) 9�/a NO. OF BEDROOMS 'PRIVATE WELL O BLIC WATER BUILDER OWNE /'1�1�-nj2f DATE PERMIT ISSUED: y/Y,9y DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �' � #/8'1 QG r �i . �.9 yb, �� y3' c7 6 4 � No.. ••---.' Fmc :t2a. THE COMMONWEALTH OF MASSACHUSETTS ; APPROVED BOARD OF HEALTH nsta Conservati Depart enSTOWN OF BARNSTABLE ned pplirati efnr Ui�pn�tt1 ork,i Towitrnrthin Famit Application is hereby made for a Permit to Coristruct ( ) or Repair ) an Individual Sewage Disposal System at: ��'�)/� ��f�,Lwccati�on-Address ....Y.. .� .................................................... .. "--- ' ... z` ......... ...........................................or W VbYt '/,cb77 ' o e t Al j�e_T"7cJ�! "71.1 3/ Add ✓M 1 44 jUS Installer Address PQ UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms................—7---------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures ----------------•--------------------_-----•-------------------_------- -•------------- ----------------.........•-••-•......--••••......---•--•..... W Design Flow................ .............gallons per person per day. Total daily flow-------------- ...............gallons. Septic Tank—Liquid capacity_ OoO.gallons Length---------------- Width---------------- Diameter_..-.--_--_--- Depth................ �rllW Disposal Trench—No. .................... Width.................... Total Length-----_......._�.__. Total leaching area....................sq. ft. 3 Seepage Pit No..___--_�--. Diameter------ .D..-..... Depth below inlet___-_-_-4......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ------------------ ----•----------------------------------••--------------------------•...---••-••-•...........................-......7--- O Description of Soil....................... a' C r --- U •••-••••••••-•---•------••....---••••••-••-------••-••-•••-•-••••-•••••-•••-••---•--•-•••••••-•---••--•••---------•••-•-•••••--•----•---•--------•--•-•-•---•--•----------•-•--••-••......-•-•••......•- W x --------------- ----------- ----------------------------------------------------------------------------------------------------------------------------------------- U Nature of Rep irs or Alterations—Answer when applicable.___.__/�'Q Q_....___ `......._ D�1 _._._1_�!T........... •- f''► ! `` ---•••-• ........................................s ;..r _ ....SY ------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has e ssue b he rd of h Signed ------ -. - ® . a .. ......... Date Application Approved By -- ------ -- ------ --- ---- .. --- Dare Application Disapproved for the following reasons- -----------------------------------__------------._----------....--- _...... ................ .................. . ......................... ------------------- ............................----..._......---------------------- ....................................... - Date -owl PermitNo. 3_�.. .....-. .,.-/--------------------- Issued ----------- ........................... / ate r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applira tuft for Biripw3al lVnrkw Tomitrurtiun 1rrmit v . Application is hereby made for a Permit to Construct or Repair -�/,) an Individual Sewage Disposal System at: - -----...-••---•-•••----••----------------------------------------------------------- ............................................................. -� Location-i\ddress or Lot No. _ __I�UC ........................................� tl/ZG:�� / i1�.10L_� t^iLu� 0V464JZ. U�b.3�... ------...... _ Owner Address a J`- (J f,a'� lGV v,�cl r�I V 71p !�l•�h L l`� � ✓_M r✓L�1 I(c S - --------------------------- ------------------------------------•-•-•-------------•--•------------------------------••-.-•---- PQ Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms--------------,..T-------------------.-Expansion Attic ( ) Garbage Grinder ( ) p-, Other—Type of Building ---------------------------- No. of persons=_______-----_-___..._..--- Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- - W Design Flow................ ............. per person per day. Total daily flow.............-33G_.__........._gallons. WSeptic Tank—Liquid capacity_�OoO gallons Length---------------- Width---------------- Diameter.--------------- Depth................ x Disposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... :._.. Diameter.._.../0-------- Depth below inlet........ ...... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water.........'.......... .. 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water....._.................. a ----••-•---•.......................•---------------•--------•-•-•----•-•-•--••-------•-•---..._....._.............-----------•---------...._........--•••-. O Description of Soil......................` - -------f '�''` ' ..e..---- - S--�I ',��ct� ------......_ . � cis' -_-.mot'j�q x ----.......................... V ............................................. ••--------------•-•-•----•-•---•-•-----•------•-••---•----•-----------------------------•••-------••------•-----------•------•-------••----•---------••... W UNature of Repaairs or Alterations—Answer when applicable.---.-.�'n p..._.._4__........._l�%.Q•f_1�_.C............./ 1............... ----•---•----------t�..... �---'•--•r=s-.f U�......................�:`'.. . `i:..1 � . -•-'� `S•......`--�.. v ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has(been 'ssue bey the board �of`health . �J Signed ------- /`o/...g1..y... Application Approved BY _. >l/)_/ c 1- _ �-t , �?.'!?/lt-'.,:._r ..----------------. .---..._...._-.------------------------------ -----------------�----------.------- te Application Disapproved for the following reasons- ---------------------------------------------------------------- ---- ----------.................................................. .......... . ....... .. ------------------------------ _ ........................Dare.....Permit No. .(��....--... .�.....+.... .-� Issued �..I.(.a.(...` r r -.... f l Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE .F TErttft.rate of (famplia re THIS IS TO CERTIFY, That the.Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ---------------------------------------------------------- �5�©�j-�'GLc--i� Lv v_c --- ....... . at ............... .<�. --------- _svt L- .( Jam..........0 --:----------------C 1. 7_u.�'F......-- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......................_.------ --------------- dated ---------------------------------------...__ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -�-r- DATE ...../.:._..... .� ---- ----------- Inspector ..... `.1` .� ....... 7. --------------------_,---------------------------- -=S=-------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No........... -•-......�. FEE.--•.....6........... ' � �i�ttusttl �rk� �u�t��r�r#iun �rrmi� Permission is hereby granted......................:: ) .!'.&_I 0c_ �'.�_._..._._.� v:� --------------------•---------------••---........•-- to Construct ( ) or Repair (-<), an Individual Sewage Disposal System Street C y as shown on the application for Disposal Works Construction Permit\No___________________'`Dated....._._........._..:!!......_............ , .......` `� %� �l?........................................- ' t �. DATE-----•--- r ------•---------------------------•--•---- v Board of Health FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS Tom O BARNS :J. /� Lt�CA'TiOI�t _ ct d a/ bird o 4 ®r SEWAGE'# VILLAGE ASSESSOIZS'ivfAP di Lt?T ss�rrc T"- K CA crrY /bClo y Cl o'. LTGACfIING FACT€—7$ •{ty ) r 7 -S PERRIhTDATB - OMFLI ►A1t `DATE; Sepatatlon Di ne..Ebc Min Adjusters Gmandwaier Table to the Bottom of Leactteng Fatil;ty Feet PnYate�►ater Supply WeBI andLng Facihry (If any walls exist atsits or w-11 xtiva 20Qft oflehing facny) t Edge of V'IEt#and end Leachl ig Fat ty{if any wetlands exist withea 3a(}feet¢f luag fac�ry Feet::' Famished by`` i ParGL- 1 D a � f f f 0 6-3 " a3b � LISPS TRACKING# First-Class Mail Postage&'Fees Paid USPS Permit No.G-10 9590 94021, A B %306 7765 51 United States •Sender:Please print your name,address,and ZIP+4®in this box• PoSWI Service I Town of Barnstable y Health Division 200 Main Street Hyannis, MA 02601 I I � {h.I,l, iii:•si: i :4�.#({ :::;j} :� tlil i.ij L;:.°�F�'Iiii{� II • p Complete items 1,2,and 3. TSignature 0i Print your name and address on the reverse ❑Agent so that we can return the card to you. A�s 11 ❑Addressee 0 Attnh.this card to the back of the mailpiecey;"r Received 6y(Printed'Name) C. D Deli ry or on the front if space permits: 1. Article Addressed to: D. s delivery address different from item 1? Ye If YES;enter delivery address below- [l N - �t F MANROSS, BRUCE, ,kGWENIDOLYN Y,81 SANDALWOOD DRIVE COTUIT, MA 02635 III�III�II�III��IIIIIIIIIIIIII�IIIIIIII�IIIII ❑AdultSignature 0 e SgntureRestricted Delivery 0Regste l redMail Restricted 9590 9402 2480 6306 7765 51 certified Mail® sv Certified Mail Restricted Oellvery 4etliary urn Receipt for ❑Collect on Delivery erchandise 2;_Artirle Number=CTraosfer from.service.lahell� Collect on Delivery'Restricted Delivery p Signature ConfirmationTM + s . a I ❑Signature Confirmation 1I , ,7015 1730 0001 4990 15 6`7 l Restricted Delivery Restricted Delivery PS Form 3811,•July 2015 PSN 7530-02,000-9053 Domestic Return Receipt. r` •P •. • Ln r� C3 0 f&, --,, Qom' Certified Mail Fee bra Services&Fees(check box,add fee as appropriate) r=1 ❑Return Receipt(hardcopy) $ 01 0 r ❑Retum Reoeipt(electronic) $ �Postmark 0 ❑Certified Mall Restricted Delivery $ Here 0 []Adult Signature Required $ V ❑AduR Signature Restricted Delivery$ O Postage m $ Total Postage and Fees se. MANROSS, BRUCE A & GWENDOLYN 0 ---! r� 181 SANDALWOOD DRIVE C'ty COTUIT, MA 02635 ., ,., Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the •A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides _. for a specified period. delivery to the addressee specified b�name,or to the addressee's authorized agent •You lay Reminders.CB: Adult signature service,which requires the t ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mails,First-Class Package Service®, available at retail). _ or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age,{ international mail. and provides delivery to the addressee specified f ■Insurance coverage is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a I certain Priority Mail items. USPS postmark.If you would like a postmark on,-, ■For an additional fee,and with a proper this Certified Mail receipt,please present your -1 endorsement on the maiipiece,you may request Certified Mail Item at a Post office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion.: of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. , electronic version:For a hardeopy return receipt, complete PS Form 3811,Domestic Return Receipt,attach PS Form 3811 to your mailpiece; IMPORPAIM Save this receipt for your records. PS Form 3800,April 2ois(Reverse)PSN 7530.02-000.9047 r VE Town of Barnstable Barnstable Regulatory Services Department °'eudicaU� snxivsrABM I � ' 7 639. ,m Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 1567 May 9, 2017 MANROSS, BRUCE A& GWENDOLYN 181 SANDALWOOD DRIVE COTUIT, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 181 Sandalwood Drive, Cotuit, MA was inspected on 05/03/2017 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 Cod 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 BO 10F HEALTH Ehomas�McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\181 Sandalwood Dr Cotuit.doc Town of Barnstable ' Regulatory Services Department - Public Health Division 200 Main Street,Hyannis MA-02601 Office: 508-862-4644 Richard Scali,DirectorFAX: 508-790-6304 Thomas A McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15,000) _ An``x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground w . ❑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 ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no ac a er is. (This syste asses if the water analysis indicates the well is free from po u ' 6Single WO 2 YEAR DEADLINE CRITE Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation . of a driveway due to H-10 components, etc) ❑ Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) Kde eaching facility with standing liquid level at or above the invert pipe (per Town §360-20 h) OTHER Repair deadline: WSEPTIMDEADLINES TO REPAIR FAILED SYSTEMS.doc <, Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form ; �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr , Property Address ^ Bruce Manross Owner Owner's Name information is Cotuit ✓ MA 02635 5-3-17 required for every t page. City/Town State Zip Code Date of I ection Dh Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information S4 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 5-3-17 1 spector'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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions 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. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 r Commonwealth of Massachusetts .azl Title 5 Official Inspection Form � ��I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a.Ji!✓ 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is Cotuit MA 02635 5-3-17 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in"310 CMR 15.304 exist. Any failure'criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ one or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts .7 l Title 5 Official Inspection Form, I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _ a, 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required.for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped- ❑ 0 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 E]_ ' ® tributary to a surface water supply. ❑ ® Any-portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.], ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection `❑ Area— IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of'17 Commonwealth of Massachusetts z�l f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr 1 Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? '® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan'at the Board-of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts .a=1 Title 5 Official Inspection Form �;, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City[Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a.separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? n ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage,(gpd)): - Detail Sump pump? ❑ Yes ® No Last date of occupancy: 5-2017Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203):, Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present?. f•• . El Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No. Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments a% 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--pumped 2yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ' ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 8 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form I f� i:.,. ' 'il Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `�`�Jf!✓ 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. Cityrrown . State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed'(if known) and source of information: Tank and pit 1970's with second pit added in 1994 Were sewage odors detected when arriving at the site? ❑. Yes ® No Building Sewer(locate on site plan): Depth below grade: 30"feet Material of construction: ® cast iron 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 24"feet - Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) z. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach>a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal Sludge depth: 12" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form ' ,.��A Subsurface Sewage Disposal System Form Not for Voluntary Assessments 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness V. Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" 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. 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 Y t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr L J" Property Address Bruce Manross Owner Owner's Name information is Cotuit MA 02635 5-3-17 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: - gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts la=i Title 5 Official I nspectioh Form f� ' �1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is Cotuit MA 02635 5-3-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 1" 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.): D-box shows signs of decay and crumbling. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts ' (@p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr — Property Address ,Bruce Manross s Owner Owner's Name ` information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Type . ® ,leaching pits number: •2-1000 gal ❑ leaching chambers number: a. , ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system 1 Type/name of technology: Comments (note condition of soil, signs of-hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit"4" has signs of failure domented from 1994. Pit"5"was filled to inlet invert at inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to,inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts IaRI Title 5 Official Inspection Form �'i?,.'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a_J; 181 Sandalwood Dr Property Address Bruce Manross w Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): a .a, Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts" f Title 5 Official Inspection Form -1;A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name z information is Cotuit MA 02635 5-3-17 required for every - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 C 1 45C fe e*A go f Y I A$` YYYY IY�6®ililifi�W41i�®� t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts ' +I Title 5 Official Inspection Form �'1,�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181 Sandalwood Dr Property Address Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water r, ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts lay a Title 5 Official Inspection Form IL; �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments b, !„ 181 Sandalwood Dr Property Address —— ---- n.. Bruce Manross Owner Owner's Name information is required for every Cotuit MA 02635 5-3-17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: f l Fill in please: 5 s APPLICANT'S YOUR NAME/ S: .r BUSINESS YOUR HOME ADDRESS L z515 V/� z y R TELEPHONE # Home Telephone NumberD O D C� NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS55 IS THIS A HOME OCCUPATION? YES NO y"F"r.� gzj bc',5�.,7 (3e-- r\Z ADDRESS OF BUSINESS-AK zs —C Z) ��MAP/PARCEL NUMBER ,� ~V J (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the.Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OF CE PLY WITH HOME OCCUPATION This individual has b d of an p rmit requirements that pertain to this type � ir� RULES AND REGULATIONS. FAILURE TO Authorize Signature**; COMPLY MAY RESULT IN FINES. COMMENTS: 2. BOARD OF HEALTH . This individual ha e inform �Pte er it q it nts that pertain to this type of business. _..Authorized Si ture* COMMENTS: 3. CONSUMER AFFAIRS (LICE ING AUTHORITY) This individual ha en ' r of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: GENERAL NOTES Bedroom Bath 1. Contractor is responsible for Digsafe notification, Verification of Utilities TEST HOLE #2 125.00' o and protection of all underground utilities and pipes. SHED o 2. The septic tank o q, distri gtion box shall be set 1 ELEV.= 48.00 aV level on 6 of 3 4'-1 1 2 stone. 4' 7.00' m 3. Backfill should be clean sand or gravel with no Bedroom stones over 3�� in size. 4. This system is subject to inspection during installation j t•; f FAILED by Carmen E. Shay - Environmental Services, Inc. LEACH PIT 5. The contractor shall install this s FAILED Second Floor system in accordance Y LEACH PIT with T414 V of�_the Massachusetts state code, the approved plan OX and Local Regulations. 99 6. If, during installation the controcto� encounters any TEST HOLE #1 i'' soil conditions or site conditions that are •different E LE .= 48.00 _ J from those shown on the soil log or in our design 2 _ 0_0 installation must halt & immediate notification be �-=-- g a made to Carmen E. Shay - Environmental Services, Inc. PATIO 7. No vehicle or heavy machinery shall drive over the O septic system unless noted as H-20 septic components. f r I on II outlet toends.8. Install Tuf Tite as ba fles o e ua s a e 9 q . Bath Kitchen EXIST. Dining 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. eptic Tank 10. All solid piping, tees & fittings shall be 4" diameter -J Schedule 40 NSF PVC pipes with water tight joints. 0-0 Living Roo Office 11. Municipal Water is Connected to ALL OF The Residence and Abutting 0 Properties Within 150 Feet. THE-PROPERTY LINES ARE APPROXIMATE AND First Floor EXISTING COED ASSOC. SURVEYORS COMPILED FROM THE SURVEY PLAN GEORGE LOW & SSOC. SU VEYO S w • I ' DESCRIPTION BY OWNER ENTITLED: "CERTIFIED L LA 8 RTIFIE PLOT PLAN OF 1 1 SANDALWOOD DRIVE COTU IT MA" • � 3 BEDROOM I e I HOUSE DATED JUNE 22, 1977 full] foundationAND IS NOT INTENDED TO BE A SURVEY PLOT PLAN IT SHOULD BE USED FOR NO PURPOSE OTHER THAN #181 I ❑C U S MAP THE. SEPTIC SYSTEM INSTALLATION: EXISTING SAS TO BE PUMPED OUT AND FILLED IN PLACE NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE . ay FROM THE EXISTING SAS TO BE DISPOSED GRAVEL OF AS PER BOARD OF HEALTH SPECIFICATIONS. e9 c DRIVEWAY dam �\ 'PROJECT, BENCH MARK 0 TOP OF FOUNDATION Q I 181 EI-EV. = 100.00 (ASSUMED) I s�anda�oodor � HLU — n \ - A OF PROPOSED SEPTIC SYSTEM UPGRADE PREPARED FOR LONG i i , I BRUCE & GWENDOLYN MANROSS 20,000 SNose Feet AT \ ; I 181 SANDALWOOD DRIVE \ ( ASSESSORS MAP 10 LOT 34 COTUIT MA 125.00' ��aF nr' i�c�` � PREPARED BY: %� r C�1R1y1�'N E. ,S1I14 Y Q \ s �. 1. °" ENVIRONMENTAL SERVICES _ .0 P.O. Box 1576 �.ANI3.AL W® 0ID -DRIVE 0 20 40 50 MASHPEE, MA 02649 (40 FOOT RIGHT OF WAY) SAN-1T TEL/FAX 508-294-7498 SCALE: 1 "=20' DRAWN BY: CES DATE: JULY 16, 2017 SCALE: 1 "=20' PROJECT#181 SANDAL ILENAME:181 SANDAL.DWC SHEET 1 OF 2 VENT PIPE ({®Least 24 inches tall) 10' min. from *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. Schedule 40 PVC w/Charcoal Odor Filter SECTION A —A EXISTING Foundation house to septic tank SAS c thn s rof"GWe PROFILE VIEW OF LEACHING SYSTEM • Septic tank covers must be D—BOX cover must must have riser and be ` t within 6 in. of finished grade within 6 in. of finished grade Grade over Septic Tank — 99.00 Grade over D—Bok— 99.00 de over SAS — 99.00 7 /4•to r r/s •ladwd er„eAea aeon. •W r/e•— r/u• Wad"Podolia" t INSPECTION cover must be S 70,02 Tee to be placed in dbox 3 HOLE H-10 r within 8 tn. of Flntehed g_deDIST. BOX TOP OF SAS— 95.60 .OT � EXIST" PIPE . 1,000 GA 0000FROM FOUNDATION n 80' N i r WOPTiC TANK N 20' C3 C3 c C3 0 C3 0'H-10 o C3 0 ►'nqa yt CAorne.r .►'.ro".,ntsoN 0C3 C3 C3 ui ui o 000NCRETE FULL FOUNOATI ' II II 11 � � m OI+—j/ SYSTEM PROFILE ,r � ri 9' PF OVIDED S Units 6 ' = 30' Not to Scale R•8' Z.8'e 3.b 30. 3.b 6ln.of 3/4"-1 1/2' S 6' '10a Width ' ' NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE compacted atone Effective � Effective Length . O° SOIL ABSORPTION SYSTEM (SAS) Bottom of Test Hole 1 Elev.- 88.00 LC-6 H-20 LEACHING UNITS / WIGGINS PRECAST Not to Scale 2-16• DIAM. ACCESS MANHOLES P E R C 0 LAT I O N TEST ALL OUTLET PIPES FROM THE �{ (/� DISTRIBUTION Box SHALL BE 12' - 6' � L ✓ 7"" SET LEVEL FOR AT LEAST 2 FT. CONCRETE COVER T ;;a `L"r•�r: s' .:_3::_:�.'• 3— 6.OUTLET •.i 'u'e..m• ..R.+� 2 Date of Percolation Test: 2017 �� ,r r "�'` b Test Performed By. CARMEN E. SHAY, R.S., C.S.E. C:� T Results Witnessed By.DONALD DESMARAIS BARNSTABLE BOH) — s's" OUTLET ') { 12• t"iFr EXCAVATOR: CARMEN SHAY Perc #1 6• B ;. Percolation Rate: Less Than 2 MPI ® 30" <' .�• �•.� ,-� . . ' 2 T " 1ss- i Depth to Perc:30 to 48 4" — SCH. 40 To 1.75• ::� F:• THE ACCESS COVERS FOR THE SEPTIC TANK, Test Hole Test Hole Perc Rate= 2 MPI ASSUMED PLAN SECTION CROSS—SECTION { ti DISTRIBUTION BOX AND LEACHING COMPONENT Nt 2 Groundwater Not Observed •�+. + c '�— r ^• r. SET DEEPER THAN 6 INCHES BELOW FINISHED No. 1 "„, "� :., "•;: :`:, ''' :`: '�': GRAOE sHALL BE Raseo To NATHIN s• aF No Observed ESH WT ® 132" STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. DEPTH, SOILS ELEV. DEPTH SOILS ELEV. ADJUSTED H2O Elev. = None ® 132" 3 HOLE H-10 DISTRIBUTION BOX PLAN VIEW INSTALL TUF-TITE GAS BAFFLES OR EQUALS 0 99.00 0 99.00 -Sandy Sandy 3-24• REMOVABLE COVERS Loam Loam 10 YR 3/2 10 YR 3/2 4. r; 0"_ 6" 98.50 0"- 6" pb 98.50 PLOT PLAN ',.. .3_min. clearance 8" min.T 2" min. Inlet to outlet t3• INLET•r% Sandy Sandy _— _� 6•min. OUTLET loam Loom 10•mfn. LiquTdTevel— r is .� T _ " 10rR5/6 " ,DYR6/6 OF PROPOSED SEPTIC SYSTEM UPGRADE 5' —T• '�. --- :-, s —7 6" 30 96.50 6"— 30 96.50 4'-0' min. Med. Med. PREPARED FOR .9� — eg an a :I Liquid depth SandSand zgY7/4 ' 2.5Y7/4 BRUCE & GWENDOLYN MANROSS 30"-132" ,a 30"-132" C, 88.00 Cry 88.00 AT L e'—°• 'V -'D• 181 SANDALWOOD DRIVE CROSS SECTION END—SECTION TYPICAL 1000 GALLON SEPTIC TANK assEssoRs MAP 10 LOT 34 COTUIT MA Design Calculations Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gol.lboy per Title V) PREPARED BY: Garbage Grinder. No A1.SNP Leaching Capacity Proposed: 330 Gal./Doy Minimum (440 Proposed at Clients Request) Septic Tank - 2 x330 Gol./Day = 660 USE EXIST. 1.000 GAL. Septic Tank.. o�'� G � I � `c'; SHAY ENVIRONMENTAL SERVICES SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch Bottom Area: 0.74 go[/day/sq. ft. x 407 sq. ft. = 301.18 gallons/day Sidewall ENDS Area: 11' x 2' 22 SF A I' Sidewall Area: 0.74 gal./day/sq. ft. x 192 sq. ft. = 142.08 gallon/day 22 x 2 ENDS = 44 SF 'i) }V1 4 P.O. BOX 1576 Providing: =443.26 gallons/day Sidewall(Side) Area: 37 x 2' = 74 SF �:i SY%�. ""'4 MASHPEE, MA 02649 7,4 x 2 SIDEWALLS =148 SF " �A�.,Q Use: (5) LC-6 H-20 CONCRETE CHAMBERS, HAVING A 1' EFFECTIVE DEPTH, i �S'Gt.4I F� TEL/FAX : 508-294-7498 s�� �+ (3' W x 6' L) TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND TOTAL SIDEWALL AREA ' =192 SF SCALE: 1 "=20' DRAWN BY: CES DATE: DULY 16, 2017 3.5' OF WASHED STONE ON THE ENDS AND 1 FOOT OF STONE UNDER ENTIRE SAS Bottom Area: 37' x 11'; = 407 SF PROJECT#181 SANDAL ILENAME:181 SANDAL.DWC SHEET 2 OF 2