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HomeMy WebLinkAbout0473 SANTUIT ROAD - Health 473 Santuit Road Cotuit _ A= 019-013 I. i1� .. AL '� �� �� '" Legend Parcels , a N-WOW" Town Boundary 007027 i I 4 70 �� 4 _ Railroad Tracks VO Buildings Painted Lines 019©22 Parking Lots Goi #149 13 Paved 1. 019152 ". �;�J Unpaved 007035 pit �� 019151 .. Driveways #;32 #1j� I I( GI Paved -,71 Unpaved t,019016 _ Roads U Paved Road 11 Unpaved Road _ 0 Bridge�, i' `y�,- ;�+ 13 Paved Median 007034 m a" ;+ Y'c streams `n 7.1 #2212 Marsh �v 13 Water Bodies — I a -4 . �' . . 0t9 _____---- --- --- _r l 007039 007038 #25 019017 9010 W354 019008 %_ '50 01901.2 �' ��' 503 �_ �_� �� l' �i - t- t s 019007 007030 t : a_! ' #400 ti (I#155 (� etc =:_' — t ❑� 007014 _ 019009-- #50,6 Map printed on: 2/16/2018 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are v -- Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi O 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 83 feet ' cartographic errors or omissions. gis@town.barnstable.ma.us nn No. G _ h' :r0 Fee w V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4plitation for DispoBal *pstrm Construction -VPrmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 73 04pra,I 9J). Owner's Name,Address,and Tel.No. CGTu l Assessor's Map/Parcel 19 1121'13 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No PAV10 Type of Building: 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) 7_'-0 gpd Design flow provided ���j, gpd Plan Date /Z-/,?—l'�� Number of sheets Revision Date Title Size of Septic Tank 15ho 4vmA) Type of S.A.S. / Cry M-_C CM)7--1(_ IUCS C—V "' Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the co ruction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E ironme tal C de and not to place the system in operation until a Certificate of Compliance has been issued by this Board a th. / Signed Date (/ V t_®</ Application Approved by Date Application Disapproved by Date for the following reasons Permit No. C 6 — Date Issued If No. D C 17-17 Fee ! THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes y 01pplication for BispoBal 6pstem Construction 3permit Application for a Permit to,Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components' Location Address or Lot No.7 '� rQ.vTV! P), Owner's Name,Address and Tel.No. 60 ! 41e, a !i Assessor's Map/Parcel 19 5r 13 ` Installer's Name,Address,and Tel.No. D /1r,ryfordP�9 Designer's Name,Address,and Tel.No-DI /4V,,0 / aX� Type of Building: 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) f� gpd Design flow provided, gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /5-0 e ,6t//ln/ Type of S.A.S. e4o l e c 74G Description of Soil ,T t Nature of Repairs or Alterations(Answer when applicable)/ s- ,ss;pT_v�,r7elli1_ Date last inspected: Agreement: The undersigned agrees to ensure the con ruction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E ironme tal C de and not to place the system in operation until a Certificate of Compliance has been issued by this Board a th.Signed Date 6 4 i4// Application Approved by e- Date e, - Application Disapproved by Date for the following reasons 4 / q Permit No. C?C) Date Issued (� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS r Certificate of Compliance ., THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) ; Repaired( ) Upgraded( ) Abandoned( )b at y 73 �3'j>i 4 oeb, has been constructed in accordance / with the provisions oo Title 5 and hhee�for Disposal System Con truction Permit No.0011'r7-6 dated b-1 Installer�sj„y7�( e/r+o►a/1!oh! C- Q®j_ _( Designer I Qyi' A4cff, ) #bedrooms _ Approved design flower gpd The issuance of this permits all not If construed as a guarantee that the sy4e ll funct'o as design e Date Inspe for . - ---- No.--- -�� --'7�---- -----•- Fee ------ ------------------="* (y y THE COMMONWEALTH OF MASSACHUSETTS r PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 30isposal 6pstem Construction i3ermit Permission is hereby granted to Construct( Repair( ) Upgrade( ) Abandon - System located at A/73 jeo 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 bg completed within three years of the date of this permit. {"—^ Date r — 1 Approved by C I I I Town of Ba rnstabk �oHE r Regulatory Services Thomas F.Geiler,Director + IAIiN.SF!ABGEr s �$ Public Health Division :& Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644. fax: 508-790-6344 Installer &Designer Certification Form Date: /v Designer: Installer: r Address: . 6 ts�(C_" Address: _ was t issued a permit to install a (date) L (installer) septic system at ✓ I � based on a design drawn b (address) Y dated (o '� zoiI (designer) I:certify that the septic 9�stem referenced above was installed substantially ac y carding to he design,_which may include minor approved changes such as later relocation of the distribution box and/or septic tank, ,t I certify that the septic system referenced above was ins+ailed vsnth''ma�or.changes greater th�aa`10' lateral relocation of the SAS or any vertical reiooati ii of any component of the.septli system)but in accordance with State &L& Regulations. Plan rev.sioxk certified as-built by des gnert6 follow. z� OAVto �y. (Insta Signature) z -1 h9ASON- �9 tdo ib66 �—r (I) er s Signature) (Affix er's Stamp Her s , PLEASE RETURN TO BASTABLE PUBI.,IC HEALTR.DIVISION.. CERTIT?C TE OF CONFIPLIANCE VII�1, 'N®T s'sE SUED' BOTH"T$IS-FORM _ BUM.f g.ARE RECTI"VED B'Y°THE:B. STABLE Pt1BLIG ALTO[I YVITFR N. THANK YOU: , Q: ealtfiLSeptic/Designer Certification'Forr.; Commonwealth of Massachusetts � �� 9-Q/3 - Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .•'' 473 Santuit Road Property Address F_a Jeff& Linda Richardson Owner Owners Name information is y required for every Cotuit Ma. 02635 08/24/2015 . page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, 1113 use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere use the return Name of Inspector key. , Cape Septic Inspections Company Name 624 Old Barnstable Road �I Company Address Mashpee Ma. 02649 City/Town State Zip Code 508-280-3356 S13938 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 e!�! s�— 08/24/2015 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. �0wo., US t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewagetem•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is COtUIt required for every Ma. 02635 08/24/2015 page. Cltyrrown 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Insp ection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments .•' 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is reg uired for every COtUIt Ma. . 02635 - 08/24/2015 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed . ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Cltyrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool , ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No r� ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® An portion of a cesspool Y p p of or privyis within 50 feet of a private ate water p supply I 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- 10,000g pd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet'of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts a . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 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): 2 'Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): >220 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner information is Owner's Name required for every Cotuit Ma. 02635 08/24/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available(last 2 years usage (gpd)): Detail In 2014 15,000 gallons were used and in 2013 29,000 gallons were used Sump pump? ® Yes ® No Last date of occupancy: occupied weekends Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) !Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •�' 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owners Name information is required for every Cotuit Ma. 02635 08/24/2015 page. City(rown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 16 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.): Septic Tank(locate on site plan): Depth below grade: 6 inches feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: -years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Standard 1500 gallon septic tank Sludge depth: <21- t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'f 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635. 08/24/2015 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 39" 1" Scum thickness < 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 12° How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the tank on a maint. plan based on the future use with a local septic pumping co.The Barnstable Health Dept has a list of septic pumping co Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3113 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 w •'' 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): " Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ..'° 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Citylrown 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 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts MI Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,.•°° 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: one apx. 12 x 24 ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts ug Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every Cotuit Ma. 02635 08/24/2015 page. Cltylrown 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 f t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 °"'V"''D Assessing As-Built Cards TOWN OF BARNSTABLE LOCATION SEWAGE# =GF- �&PHONEN ASSESSOR'S MAP8t LOTLER'S NAM SEPTIC TANK CAPACITY/ 9�I.1y7C LEACHING FACUZN:(type Y 1% (size) C NO.OF BEDROOMS_ BUILDER OR OWNER PERMTf DATE M & COMPLIANCE DATE: & r Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i • i rro-,_ tQ It,4 i N r D t Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every, Cotuit Ma. 02635 08/24/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: " Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augured a hole at a lower elevation and shot it with a transit to show five plus feet of seperation 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 473 Santuit Road Property Address Jeff& Linda Richardson Owner Owner's Name information is required for every COtUIt Ma. 02635 08/24/2015 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 GrA�c. ��;Tan of SA•� S Ceti F 10 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 g I I Commonwealth of Massachusetts W Title 5 Official, Ins ' ection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection Inspection,results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: Frank Nunes III Name of Inspector saa Company Name 25 Deer Ridge Rd Company Address Mashpee MA 02649 City/Town State Zip Code 508.272.6433 Telephone 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 • z„ 6/7/10 Inspecto gna ure V 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. 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Di osal 4SYste - e 1 •f 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 CityrFown 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: Overflow cesspool is in ground water. Deep auger hole confirms the presence of ground water. System can not be within the high groundwater elevation 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. Answer yes, no or not determined (Y, N, ND) in the ❑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. ND Explain: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 473 Santuit Rd.doc-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: n/a C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if . the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 473 Santuit Rd.doc 03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °.N 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): - ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow ❑ ® Required pumping more than 4 times in the last year.NOT due to clogged or obstructed pipe(s). Number of times pumped: ® ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 473 Santuit Rd.doc•03/05 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy, is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following,,in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304..The system owner should contact the appropriate regional office of the Department. 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage.Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection C. Checklist f 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? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ Z Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts w Title 5 Officia-1 Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c,M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 Cityfrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): unk Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ -No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes. ® No Last date of occupancy: vacant 1yr per realtor Commercial/Industrial Flow Conditions: Type of Establishment: n/a Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): n/a 473 Santuit Rd.doc-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: unavailable Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1951 per age of home Were sewage odors detected when arriving at the site? ❑ Yes ® No 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments. °M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 6 feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line. undetermined feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 6„feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Block cesspool "A"functions nominally as a tank and leaching If tank is metal, list age: years � Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 2-3' deep and 4'wide Sludge depth: Dry Distance from top of sludge to bottom of outlet tee or baffle n/a Scum thickness n/a Distance from top of scum to top of outlet tee or baffle n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a How were dimensions determined? measured. 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System.Form - Not for Voluntary Assessments °M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong the life of the system' Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): n/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid,levels as related to outlet invert, evidence of leakage, etc.): n/a 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): n/a 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official, Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °.w 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/.10 ` City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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.): n/a *Attach copy of current pumping contract(required), Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert n/a Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 l Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ Teaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 1st cesspool as tank 2nd cesspool in ground water whuch constitutes afailure 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): "d Number and configuration 2cesspool Depth—top of liquid to inlet invert 66" Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 6'deep 5' wide Materials of construction block Indication of groundwater inflow ® Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 6"of static liquid in cesspool. Hole augered in vicinity of cesspool confirms ground water level/infiltration. Ground water found at 66" 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.): n/a 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection form Subsurface Sewage.Disposal System Form - Not for Voluntary Assessments c�M 473 Santuit Rd Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date,of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch 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. a 0 C) 136 V scat E 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 w Commonwealth of Massachusetts W Title 5 Official InspectionForm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 473 Santuit Rd 'M Property Address White Owner's Name Cotuit MA 02563 6/7/10 City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 66„feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record 0 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: Hole augered approximately 10' away from cesspool and ground water discovered at 66" 473 Santuit Rd.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Town of Barnstable PO o�6 oF� Department of Regulatory Services 1 I ana,+er,►ars, ; Public Health Division Date' >� �0,h� 200 Main Street,Hyannis MA 02601 f�l�!Date Scheduled Time e Fee Pad. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address/V 7,, Owner's Name �> v D . d 4A'1 rU" �` - '`` Address. Assessor's Map/Parcel: ®l �� Engineer's Name "�/ /414 `5 6A_) . NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(%) _ Sudace.Stones •�' ' Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) �V Iw 1( Depth to Bedrock `r oO Depth to Groundwater. Standing Water in Hole: 96. , Weeping from Pit Face j Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment fr. Index Well# Reading Date: Index Well level AdJ,factor Adj.Groundwater level I PERCOLATION TEST Dutp Time..�� Observation Hole# Time at 9" Depth of Perc Time at 6" 01 Start Pre-soak Time @ '. ) 'time(9"-6") End Pre-soak RateMinJlnch � y"'-�� Sk( 1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) 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:\.SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) 1 (USDA) (Munsell) Mottling (Structure,Stones;Boulders. tConsistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. , Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil \, Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Flood Insurance Rate Map: Above 500 year flood boundary No_ s Within 500 year boundary No Yes Within 100 year flood boundary No Yes ; Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious aterial exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of ha rally occurring pervious material? - Certifiication I certify that on lfl OA (date)I have passed the soil evaluator examination approved by the Department of Environ ntal Protection and that the above analysis was performed by me consistent with . the required training,expertis d ex Brien a described in 310 CMR 15.017. Signature Date l l Q:\S.EPTiC\PERCFORM.DOC i _ - YOU WISH TO OPEN A BUSINESS? _ 013 For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which y u must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. 1+ �; F� �"°"�',�:�`.�. � DATE: ill in please. E81 APPLICANT'S YOUR NAME/S: B INESS YOUR HOME ADDRESS: !.j-7 �Tfif.) m i t2cC G� fGu 1 c�263� L PHONE # Home Telephone Number - Z NAME.OF.CORPORATION: NAME OF NEW-BUSINESS:. PE OF IS THIS A HOME OCCUPATIONS YES NO ADDRESS OF:BUSINESS MAP/PARCELNUMBER a� 1��3 (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 CO ISSIO R'SZOF �EThis individu I h e inT �anermfrequirements that pertain to this type of busine UST COMPLY WITH HOME OCCUPATION Authri 'gflat e** RULES AND REGULATIONS. FAILURE TO MMEN COMPLY MAX RESULT IN FINES: 1� 0 eQal . 2. BOARD OF H TH This individual m has l l.�be n r�n�'d,Qf the permit requirements that pertain to this type of business. . Y Vll/ Authorized Signature* COMMENTS: I 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: I� t TOWN OFBARNSTABLE r LOCATION �y�6�� elf�a SEWAGE # VILLAGE s t ASSESSOR'S MAP & LOT" INSTALLER'S NAME&PHONE N SEPTIC TANK CAPACITY LEACHING FACILFFY: (typeeLJ'` _ �� 114� D (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE:6 dP COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 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) Feet Furnished by 1 �� i ,�o�. l� !l � � � � �� 1. NOTES: 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS _ 8 DIMENSIONS IN THE FIELD 2,) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS. DETAILS,&FINISHES IN THE FIELD WITH OWNER 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT F ' FIRST FLOOR TO BE 6'-10"ABOVE SUBFLOOR 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSE-17S STATE BUILDING CODE,8TH EDITION AMENDEMENT&IRC2015 - • 5.) 110 MPH EXPOSURE B WIND ZONE / • b 6.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, NDERSEN ANDERSEN ANDEa EN OR HORIZONTALLY W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING aS GLIDING G45 GLIDING Gc6 GL DING _ ,nN❑°w wI.DOVl WIND°r 7.) ALL LVL LUMBER/BEAMS TO BE L9e L/360 LOAD 8.) SEE CERTIFIED PLOT PLAN DEVELOPED BY WARWICK ASSOCIATES FOR ALL PROPOSED&EXISTING DETAILS B B ————— 9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF 3 A3 NEW 701[7 CLOS. ALL SIMPSON COMPONENTS ANDERSEN DECK ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS GLIDING—p0w ANDERSEN TO BE 3000 PSI 4 V4N Ft•.'G606 1 FRENCHVAOD b a 11.)VERIFY ALL PLUMBING 8 ELECTRICAL DETAILS W/OWNERS ON THE SITE SLIDING DOOR DURING FRAMING CONSTRUCTION 12.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE ANDERSEN 13.FOLLOW ALL REQUIREMENTS OF THE 1.10 MPH CHECKLIST SUPPLIED o G4N GLIDING ) ANDERSEN ANDERSEN DOw EXISTING EXISTING 14.)FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY TJ✓S442 Tw14<2 HVAC OOM - EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION ' INSTALL E R/CONTRACTOR. - 15.)ALL HEADERS LESS THAN 4.0" <_TO BE 3-2 X 6' UNLESS OTHERWISE NOTED i NEW I NEW I --_ —_ __ BATH NEW 2-1 Ra',11]e'l BE MAROVF.!FLUGHi r N 31rTTic, W.LC. I - __�=--,x=_�-�-- `OWI��OOEoV/ / CCEBS I GAS FIREPLACE \' r --Jm I ERRIFYALL THELDVENTING IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS .e O I I - - CLIMATE ZONE 5(USE EITHER PRESCRIPTIVE VALUES OR RESCHECK CALCULATION EXISTING LIN. �� I I I TABLE 402.1.2(MINIMUM PRESCRIPTIVE INSULATION&FENESTRATION REQUIREMENTS) KITCHEN BATH q EXPANDED FENESTRATION SKYUGH1 CEILING WOODFRAaEpY.•ALL FLOOF RASE V."BASEMENTSV9 CRAWLSPACE WAL '�\ MILY ROOM -ACTOR U.FACTOR R-ALUE R-lAt UE R VALUE R-vat DE R.VAWE .VALUF OPEN UP O OJO MASS 0.55 46V 20 c�t5.6 JO IS- 10(4FT DEEP) 15'19 2 wn u AM<ENo. 6fi I , REF 1 BUILT.IN NOTES: 1.R-VALUES ARE MINIMUMS b U-FACTORS ARE MAXIMUMS. ULOS CLb 2.15119 MEANS R=15 CONTINUOUS INSULATED SHEATHING ON THE INTERIOR OR EXTERIOR NEW - BUILT.IN a OF THE HOME OR R=19 INSULATION CAVITY AT THE INTERIOR OF THE BASEMENT WALL 3.REFER TO IECC 2015 CHAPTER 4 FOR ALL INSULATION b ENERGY REQUIREMENTS BEDROOM 4.13.5 MEANS R5 CONTINUOUS INSULATED SHEATHING ON THE WALL EXTERIOR b R13 CAVITY INSULATION A EXISTING ST G A3 LIVING ROOM E OOM - - RE-USE EXIST. RE-USE EXIST. HARVEY HARVEY VANOOW WINDOW . "° °" °"p NAILING SCHEDULE NEW FRONT STEP R COVER - 110 MPH EXPOSURE B WIND ZONE _ JOINT DESCRIPTION NO.OF COMMON NAILS NO.OF BOX NAILS NAIL SPACING 20'-P 15'{- 2E t- ROOF FRAMING' BLOCKING TO RAFTER(TOE NAILED) 2-6 2-10d EACH END RIM BOARD TO RAFTER(END NAILED) 2-16 d 3-16d EACH END WALL FRAMING: TOP PLATES AT INTERSECTIONS(FACE NAILED) a16tl 5-16d AT JOINTS STUD TO STUD(FACE NAILED) 2-16 d 2-16d 24'o.G. HEADER TO HEADER(FACE NAILED) 16d 16d 16'oC ALONG EDGES FLOOR FRAMING: - JOIST TO SILL,TOP PLATE OR GIRDER(TOE NAILED) 4-6d 4-t Od PER JOIST BLOCKING TO JOISTS(TOE NAILED) 2-6d _ 2-10d EACH END - BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-16d 4-16d EACH BLOCK FIRST FLOOR PLAN EDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-0 EACH JOIST JOIST ON LEDGER TO BEAM(TOE NAILED) 3-60 }1OC PER JOIST BAND JOIST TO JOIST(END NAILED) 3-16d 4-16d PER JOIST LEGEND- BAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2-16 d 3 16d PER FOOT ROOF SHEATHING: - - 0 EXISTING WALLS _ WOOD STRUCTURAL PANELS PLYWOOD) - CONSTRUCTION TO BE REMOVED RAFTERS OR TRUSSES SPACED UP TO 16-0c B. lod 6'EDGE/6•FIELD -- RAFTERS OR TRUSSES SPACED OVER 16'o.c. 6tl 10d 4'EDGE/4"FIELD ® NEW CONSTRUCTION GABLE END WALL RAKE OR RAKE TRUSS WO OVERHANG 6tl 10d 6"EDGE/6"FIELD GABLE END WALL RAKE OR RAKE TRUSS 6d 10d 6"EDGE/6"FIELD Q SMOKE DETECTOR - Wi STRUCTURAL OUTLOOKERS GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS Ed 10d 4"EDGV4"FIELD Q CARBON MONOXIDE DETECTOR CEILING SHEATHING'. ___ GYPSUM WALLBOARD 5tl COOIE RS - ]-EDGE!10"FIELD .WALL SHEATHING: WOOD STRUCTURAL PANELS LPL VCF0D) STUDS SPACED UP TO 24"0 c, 6tl 100 3-EDGE/12'FIELD t/2"b 25/32'FIBERBOARD PANELS Bd -- 3'EDGE.'6'FIELD i/2"GYPSUM WALLBOARD 50 COOLERS --- 7'EDGE/10'FIELD FLOOR SHEATHING: - WOOD STRUCTURAL PANELS(PLYWOOD) - 1-OR LESS THICKNESS 6tl 10d 6'EDGU12-FIELD GREATER THAN 1-THICKNESS IEd 16d 6'EDGE!6'FIELD THE DESIGNER SHALL BE NOTIFIED IF ANY ERRORS OR OMISSIONS ARE FOUND ON 43BREW BAY BROADDESIGN, LLC NEW ADDITION/REMODELING FOR. SCALE : DRAWING NO.: u THESE CRALMNGS PRIOR TO S'AFT OF 43 BREWSTER ROAD v41BERnesroNSIBLEFOPPT E°CONTEENT'OR IN THESE DFav4NGS IF CONSTRUCTION 1/4"— 1'-0" MASHPEE,MA. 02649 coMMENCESVJITHOUT NOTIFYING THE . Al c F I N I GA N RESIDENCE DESIGNER VAANY ERRORS OR OMISSIONS PH. 508 274-1166THESE ER Or ANY ARE ERRORS OR FOR T„E USE F� OF THE OWNER NOTED.ANY OTHER USE OF DATE : I FAX(50 539-9402 THESE DRAWINGS REOUIRES THE WRITTEN 473 SANTUIT RD., COTUIT, MA CRONSENI OF THFEC THE DESIGNER12/7/2017 .ARCHITECTUMI COPYRIGHT PROTECTION 1 6'.< E.6' 1 NEW ROOF CONST. �.E ROOF RAFTERS®16 o.c. NEV:U0"CIA CONCRETE SONCIUBES 2 r 10 RIDGE BOARD ON 2<'CIA.SIGFOOI FOOI INGS lU -5;B'COX PLYWOOD ROOF SHEATHING a'0"6ELOWGRAOF USE Sill.SON' C STIEN JOISTS TO BEAM ABU66 POB G BASE w,_I SOry n2 Y.TIES -ASPHALT ROOF SHINGLE.. _A3_ _ USER.FELT PAPER SPRAY FOAM@ SLOPED CEILINGS TION A N 2.5 HURRICANE CLIPS A'ALL F ENDS 2 ICU WATER SHIELD AT BOTTOM 5 b MATCH 3'0"Of ROOF ACCESS 'rt"at+ -PROP.A VENT BETWEEN RAFTERS `vTMIGSPANFL OCNING EXIST. .WIND WISH BARRIERS PANEL -ALUMINUM DRIP EDGE -- ---- — I TOP OF PLATE lxuuoou 2r Es 1TA I, _ I L 112-GYP BOARD NOTE:DROP TOP OF NEW FOUNDATION B 9 _ '�Nt6'>o STRAPPING TO MATCH NEW SUBFLOOR W/THE 3 I I I I A b - NEW WALL CONST, EXISTING S UBFLOOR.(VERIFY IN FIELD x . " 2>a STUDS IF REOUIRED). BA6EMEM I NEw 2.10's1E"oc ' I I I I NEW 6'o.c G, v.^NOSY.• I vI SPAN BLOCKING 8 G PLYWOOD i.12"PLYNOOO SHEATHING SUB -DOR GLUED NAu6D FASTEN N BEnrA To 11ousE w; - BEDROOM ].SPRAY FOAM INSULATION jR2D) a,1?GYPSUM BOARD 5 W. SHINGLE SIDING NF.w CONCRETE FOUNDATION SIMPEON HUCO ITO HANGERS SUDFLOOR FIRST R 6.TYPAR VAPOR BARRIER WALLS W.'(2)HORIZONTAL BAR N NEW P. 2 r 6 SILL NEW 2 r t0's Cc 16"P.c. AT i0P8BOTIOId OFF WALLb P,12r 10's WI SEALER Access T.tBacoYcgETEF oilNcs C PACE I EXISTING NEW --- — PANEL --- w • K--- ---J I ,2{CON.S W/EMI x CRAWLSPACE POLYU DER LATHi L . CRAWLSPACE NEW SPRAY FOAM 2-CONC.SLA6wi6MIL NEW E'CONCRETE FOUNDATION I INSUL,IR]01 POLY UNDERNEATH MALLS IN 2)HORIZONTAL BAR T�11L TlF WALL NCRETE BOTTOM°FOOTINGS P.T Z•1C LEDGER BOARD G R LOK 10 CRSOLID BLOCKINGVJ`12j LEDGERION SCREWS 686-E IN INSTALL MAxLD2,pJDIST£n NGERs SECTION @ BEDROOM INSTALL SIM S FROM TENSION TIES JOIST ST LOCATIONS iR0!A HOUSE 10 DECK A3 JOIST III EACH END I I I 4 NEW]I/TOIA . E STEEL LA LY COLUMNS I ! RAWLSPAGE NET:'p r]B'>,2 POLY UIVpERNEATHI CONCRETE FOOTINGS - 12 I12'•co~csw6wreMIL � c IxsiH� WnrvDOW I I W,MIDSPANBLOCKING TOP OF PLATE BASEMENT — NSW rsOs t 2xE'S I — s I I A EXISTING EXPANDED A3 CRAWLSPACE FAMILY I ROOM FIRST FLOOR - SURFLOOR NEW T2xE SILL NEw2r10's�„- w.SEALER NEW CRAWLSPACE I a-COND NEWS"CONCRETE MASONRY SLAB LATFORIAW/B'OEEP.72—DE FTG.TO a'0"FELOw GRADE.FASTEN L---J I FT,a r.POSTSINTO WALLS W/BIMPSDNAB POET EASE (: SECTION @ FAMILY ROOM ! A3 15'-E' L FOUNDATION PLAN NEW AZEK FAILINGS MAx. INSTALL FLASHING UNDER &DECKING FASTEN JOUTS TO BEAM j HOUSEI—Pb DECKING Lv/SIMPSON H2.S4 ilEs I INSTALL 5/B"SIMPSON TITEN HD ANCHOR BOLTS AT - I DECKING ?2 a 1D5 ED 16 o.c 4 . W/SIMPSON BPS 518--2 BEARING PLATES 1<y. PLACE BOLTS WITHIN6 15'OF EACHCORNERAND �L I PT.2r tB5 ]-P.T.Z>1p5 TO A B'MINIMUM DEPTH.BOLT LENGTH IS 117. FLOOR JOISTS NSTALL FEEL a STICK NEW t0'A,8CONCRETE TI NOTUFE RUBBER MEMBRANE - Ab Uu POST RIFF EOT FOOTING TO BETWEEN LEDGER b BELOW GRADE.USE S MPSON SHEATHING 2.6 SILL L•A'SEALER F T LEDGER BOARD ATTACHED TO BAND Z T - \ JOIST wt TWO(2)LEDGERLOK SCREWS REOUILEDPER IBCEDUP NJOIS CnSECTION DECK - DECK DETAIL JJOEISTSSMNlLBEBINSTAALL DI JOIST SPAN A3 APPROPRIATE HANGERS SIZED FOR JOISTS. ANCHORBOLT DETAIL ME°RANICAL DBN"'C'01 FOROECK LATERAL LOAD RESISTANCE i3000 LB LOAD TOTALI NS)O USE I_ZPN D1T2-Z TIN2 ONE CONNECTOR ON OR 1 t-Z TIN<LOCATIONS). ONE -110 10 BE INSTALLED WITHIN 2a"Oi EACH ENO H01 ALL B DECK.M NIIAUM LEDGER BOARD BHPLL BE P.T.218 AMC. 10 Sl RUCs L'RE PER IRS 50T.2 1HE DESIGNER SHALL BE NOIIFIED IF ANY ERROR®� COTUIT BAY DESIGN, LLC NEW ADDITION/REMODELING FOR. THESEDRAWNSSPRIORIFFWNDOH SCALE : DRAWING NO.: U 43 BREWSTER ROAD THesFDwva~eT EBUIL BUILDING CONTRACTOR CON RUCTION THE BFODING CONTRACT OR HILL ES RESPONSIBLE FOR THE CONTENT 1/4"= 1 I_OI+ HEEN DRAWINGS IF CONSTRUCTION MASHPEE,MA. 02649 DESIMNEROF JNYERRORSOROMIS I PH.(508)274-1166 F I N I GA N RESIDENCE DESIGNER°°ANY ERRORS°R OMISSIONS - A3 8 HESF.DRAWINGSARESOLELYFORTHEUSE DATE FAX(50 )539-9402 OF THE NTOFn~c5°aEaulacs ND wCITEEH 473 SANTUIT RD. COTUIT MA GONSENTOFTHFOESIGNETPROTETT 12n/2o17 PRCHITECIURAL COPYRIGHT PgOTECTION 1 7 PCl OF 19B0 i ASSESSORS MAP: -#i9 TEST HOLE LOGS. NOTES: PARCEL: # /3 SO I L EVALUATOR: W `L? FLOOD ZONE: I/6T- 1) The installation shall comply with Title V and Town of Barnstable Board of _ WITNESS : ( y Health Regulations. REFERENCE, .{�► DATE: dl l� 2) The installer shall verify the location of utilities,sewer inverts and septic h �17 PERCOLATION RA E: VA1 l �� components prior to installation and setting base elevations. , 1 , 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first TH- I i3� TH-2 two feet out of the d-box to the leaching shall be level. —— 4) This plan is not to be utilized for property line determination nor any other �jLL purpose other than the proposed system installation. l� h� 5) All septic components must meet Title V specifications. .( l 6) Parking shall not be constructed over H10 septic components. 7 The property ) p perry is bounded by property comers and property lines. LOCATION MAP �(�, 5 a 8) The property owner shall review design considerations to approve of total t design flow and number of bedrooms to be considered for design. Receipt 1( L of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall -t - � ' E D be removed along with contaminated soil and replaced with clean sand per �� Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if l applicable. The proposed SAS is being installed below the water service / SEPTIC SYSTEM DESIGN line. The line is to be sleeved as aforementioned and maintained in place. 11) If a garbage grinder exists it is to be removed and is the responsibility of the FLOW EST I MATE owner to ensure such. / - 12)The installer is to take caution in excavation around the gas line if such �� Z BEDROOMS AT 11D GAL/DAY/BEDROOM - � GAL/DAY exists. -�� 13)The installer shall verify the location,quantity and elevation of the sewer �TI-�-.�� - --- 1 lines exiting the dwelling prior to the installation. ,14 Excavate 5 feet around an ) d below to an approx. depth o5iinches or until _ ZZC:GAL/DAY x 2 DAYS - GAL sand is encountered and fill with clean sand per Title V specifications. — _ ,��►�j'�� � l� USE I d GALLON SEPT I C TANK Wu 10"WE STE gNlraRt' b 0 e, \ SYSTEM SECTION awl U-I N> � 0 � ��.00� Ml r — w b C Y C el I I W -�y.�er 1 WN. ..................*........"'*"o""""'_ 1�n -�9' I �' Smwe o�cflca�o D-BO C11, 5> \ ` GAL A wt�,w� 117o SEPTIC TANK — �. ITE AND SEWAGE PLAN LOCATION . d7� v�� � e o-ViT PREPARED FOR : ��2�>>�I yet, CaNS�2V�T1Cc� as COVAT a T5 `t''ff,, �00 SCALE: � lyb, DAV I D B .. MASON R5 DATE: 2 Zbl _ DBC ENVIRONMENTAL DESIGNS z EAST SANDWICH . MA 3 DATE HEALTH AGENT ( 508) 833- 2 1 77 W ' r SCH LOT 444 LOT 46B CB/DH PROJECT ��� FOUND y �° LOCATION SCROSS tij /� / /� EE (40' ROADSA r / l PAVED EDGE OF / VEL 1, F, �0"� PAVEMENT CATCH �r'' / WOODED N79 g '00 IN BASIN 154.01' '� � 2oN— v LOCUS MAP NOT TO SCALE r- EXIS77NG HOUSE ��P / WOODED / / 00 ,c• ai - �� 1 REBAR _ — & CAP - ! - CB FOUND` P �� 'PC ',yg FOUND- 3.7 , tk ! , FOG, �� F+JS�h1k LAWN �000 S LEGEND 0 0' EXISTING o SEPTIC SYSTEM J (LOCATION 0 LOT 40B CV8 APPROXIMATE) EX/S77NG 2 CONTOUR N F 29' 19'E /� EXIS77NG 10' CONTOUR ZU)m & L'LIZ ETH REBAR � v �" '' +,, 5 EX/STING SPOT ELEVATION VXSILOFF & CAP O� P00 BPS`j �• GUY A .�'1�0� Qp`�' pp m� FOUND ,��11 - ZO quo WIRE EXIS77NG UTILITY POLE °o LA p o __ -- --- CB-/DH GUY FOUND El _ CONCRETE BOUND WITH DRILL HOLE WIRE - pp. OHF a 409-10 WOODS O� i O LOT 40.4 ,26,615E S.F. REBAR 1 WOODED & CAP I FOUND CB/DISC J� SITE PLAN FOUND i FOR Co QP� JOSEPH & LISA FINI GAN REBAR _ �� � , . , • ,; �. � ; , & CAP pF FOUND , 579 �0 . �oG� GENERAL NOTES: #473 SANTUIT ROAD 3p•56 0 E .� PP " CO TUl T, MA LOT 39 - B/DH 1. HOUSE NUMBER. 473 All F FOUND 2. ASSESSOR'S INFORMA IION.• MAP 019, PARCEL 13, LOT 40A RTBLZ df. SATE'RT J. FLOOD ZONES. X & 0.2�' (FEMA MAP 25001 C0752J) BENCHMARK: Scale: 1 "=20' Dote: DECEMBER 15, 2017 NAIL & CAP 4. ZONING DISTRICT- RF EL 17.02 5. OVERLAY DISTRICT RESOURCE PROTECTION DISTRICT 6. LOT COVERAGE BY A. EXISTING STRUCTURES.• 1,729 S.F./ 26,615 SF. = 6.5X arw2ck & Associates Inc. B. EXISTING & PROPOSED S1RUC7URES.• 2,208 S.F./ 26,615 S.F. = 8.3X DRANK BY- L.M., R d W. DATE 07119117 63 County Road Box 80> 20 0 10 20 40 7. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND 'SURVEY NOrtfi FQl7!'tOZLtI4 Mass 0,2556 CHECKED BY4 SYEFT 1 OF 1 8. ELEVATIONS SHOWN ARE BASED ON NORTH AMERICAN VER77CAL DA7UM 1988. (508) 563 - 7777 DRA KING NAME. SS170. 50 DW SCALE- I /NCH = 20 FEET