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0266 SCHOOL STREET - Health
266 `- ) SCHOOL COTUIT = 020-062 A _ �J --- - ---- - -- -- A i I I' No. �/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLation for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(e Upgrade( ) Abandon( ) ❑Complete System .e1ndividual Components Location Address or Lot No.,,2(,4 X5/—. <20A4 ip Owner's Name,Address,and Tel.No. 99/8 Assessor's Map/Parcel c2c,/ya m i° co�,` Installer's Name,Address,and Tel.No. 6�6-°7'2/ g 3`�'9 Designer's Name,Address,and Tel.No. j ow—ss 44 A OaG7S Type of Building: Dwelling No.of Bedrooms Lot Size c3 41)SU sq.ft. Garbage Grinder( ) r Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(main..required) C�—.,;I U gpd Design flow provided 319 gpd Plan Date/ P, aWel Number of sheets / Revision Date Title. Size of Septic Tank�"11Q41AAQ /(� �„eIZ Type of S.A.S. Description of SoilQ_Grn� Q/p;:2� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of fore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code of t ace the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Co Application Approved by Date Application Disapproved by Date for the following reasons fi Permit No. Date Issued (/ CD No. c�C/�(//` (y"(Q r Fee - 7 Entered in com uter: A THE COMMONWEALTH OF MASSACHUSETTS p Y� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppllcatloO for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair R� Upgrade O Abandon( ) []Complete System Individual Components Location Address or Lot No.���o sf . 00A c,<.:(�-'- Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel as/�� a�gdj,1 s4. Installer's Name,Address,and Tel.No. j• 7' y/- 2 3S9 Designer's Name,Address,and Tel.No. 84;1-5/7y f pr��(� Ccr:Sfrc�c ovr,ZrC uS 1r um 1943 i)�a -�rkji �i a,,c Type of Building: Dwelling No.of Bedrooms d Lot Size 3,5 7 5r j sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) 4 Other Fixtures Design Flow(min.required) c> U gpd Design flow provided gpd , Plan Date*d• awe, Number of sheets / Revision Date Title j[� r Size of Septic Tank �r�(,��� /(;r'�+ �r.0 Type of S.A.S./0?-f3��jX a5L iwvwo? Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of theafore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and noot t• ace the system in/operation untila•C6A&fi teof Compliance has been issued by this Board of Health. Signed Date Application Approved by Date !t_A Application Disapproved by Date for the following reasons r Permit No. /rn — Date Issued, ,J ' (C ------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage 1J Disposal system Constructed( ) Repaired,(,K) Upgraded( ) Abandoned( )by�� �� � 0&2S�r1 r 4�n, at t,76.6 ._aCl)[h��: �U`�t rg� has been constructed in accordance with the provisions of Title 55 and the for Disposal System Construction Permit No0 l,_ 't �Ldated Installer&rk- ,b5it �J11,G t,.1 114C58'1 r 1 nL. Designer I�,�o .� rr�pv�i r�-__ #bedrooms Approved design,,Ao��w A Z�o gpd The issuance of this permit s all not be construed as a guarantee that the system will Pu Aonla's designed1 / ! fSDate � Zk l L Inspector 1 ------------------//----------------/----------------------------------------------------------------------------------------------------- No. r}G/LG "_ tP Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,.MASSACHUSETTS 3 Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(P� Upgrade( ) Abandon( ) System located at ���� and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co 'pletedd'w'thi/n three years of the date of this permit. Date f( �fpr ! { (/� Approved by 16 -�� Town of Barnstable P# g) P�arament�of health,Saf ty�'•�a `% Y*R754az�,2 �$ Public gifealth ]Da�QI<s>toin gate. ��al%� i 367 Main Sieet,Hyaanis MW 011 3 ewawsrnnra. � _ � MAE& � n j, sass . Time--f=— —'`'' Fee Pd. h. mate Scheduled l0�• U U . lea cw S®ad Sudtablla Assessment ►Suva e �s osa { Performed By: �cf C CCe / Witnessed By:_ v V� � W l- - - W Q. Location Address , nG/ / /1f Owner's Name Address Assessor'sMap/Parcel: ao/6d Engineer'sName �Ot.i1 e NEW CONSTRUCTION REPAIR Telephone# C��J 36O1 — "6fyl Land Use 4& Slopes(°/a) "2S�d Surface-Stones Distances from: Open Water Body 3Gb It Possible Wet Area GtJ tt Drinking Water Well _ft Drainage Way 1GO+ ft Property Line 1 5 ft Other ft ` SKETCH:(Street name,dimensions of lot,exact locations of test holes& erc tests,locate wetlands in proximity to holes) LP.c�ts��t� .1 i • , ° s •,+ I Parent material(geologic) �4 iG r ip Depth.to Bedrock Depth to Groundwater: Standing Water in Hole: IV 4rc., Weeping.from Pit Face Estimated Seasonal High Groundwater_ _.._. .._ •:;;::8::;s:: :�;.'•:.'•:a:::;.:.,:...,....:.:.......::•<.:":•<:<:'`3:::::..,,,,:.;..:.._'.....;,:.;.:,.,.....•<�`•'��";•'�:`;i'•;::;ii;•�:•;'::`�-:`:;• ' '�'�:: :: �� ' is ii%::.•`iS?�la�`i �i�i'•tz�?iii %`:`.`• iz Depth Observed standing in obs.hole: in. Depth.to,soil-mottles: in. Depth Yo weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well#___._._ •Reading Date:_.___ Index Well level•__' Ad0factor " ^ ' Adj.Groundwater Level te.... :::::::.::::.:::.::::.....:.:.::::::::::::::::::::....:: ::.:.:..::::::::::::::.:::::::::.:................ ................................................................................................................................................................. .................y .......::...:.........:..:::........ Observation Hole# Time.at 9,,, Time at`6"; .Depth-of Perc__ Start Pre-soak Time Q >, ;b7 Time(9-6 End Pre-soak Rate Min./Inch 9. Site"SuitabitityAssessment. 'Site^Passed• -=SiteFailed:a*.- Additiai�alrTgCtng!Needed.(YIN,) Original: Public Health Division 0bservati®n 1(1-IoIe''to�o Pe,&mP"Ieted'onTack Copy: Applicant Depth from Soil Horizon SoiI�T`exfure ! 7!>±SoiNColor'+ 'E: Soil Olher 'Supth from (USDA). (Munsell). Mottling (Structure,Stones,Boulderes. e o Gravell Lblt;c AL I • .� ,�,� e a rx' S i'+" s^ i.1,t+,U'�"��',J4�is .�:'�.'4: Ci Z two � :LE..�+.D::.::::::::::.;;:.;;;:.;:>:.;::::::.;::::>•::::::..... iD'eplh from Soil Horizon' Soil Texture Soil Color Soil Other .Sa"dace(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n %Gravel) ®�� L� •' I: -3� L 0 9 L_ y.-1!Z S toY" ` 'Deepth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones,Boulderes. onsistengy,%Gravel) So m zon epth from il hori Soil D Texture Soil Color Soil Other Suiface (USDA (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o r e iPldodAnsur'a�nce�ll8aDe_A'tW Y Above 500 year flood?boundary.RNo••_ Yes td W3t61n-Z00,year,boundary No_ Yes aft `"' witHin?1OO year'flood"6oundaiy No;�':`Yes _ • >nth of Naturally®ccurring 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? lie If:not,what is the depth of•t ifturally occurring pervious material? C'erti9ication 1*certi that on > (d-ate)I Have passed the soil evaluator examination approved by the D'epartment ofEiiviron entahProtection_and,that•the-above analysis was:performed by,m e.consistentw:ith Ahe required training,.expertise and,experiencedescribed in 310 CMR 15.017. Signature 1�ate C Town ®f Barnstable r ya Regulatory Services Thomas P.Geiler,Director MASS&* aaxtvsn+$�a, `erg Public Health Division ApEn ° Thomas McKean,Director 200 Main Street,Hyannis,NIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: /4 Sewage Permit# c�0/6 Assessor's Map\Parcel Zo �a Designer: u 0 LA) v` �2. Installer: ��t�A Address: �c� tL1•. Address: Yay-mo ratic On rlv C.L,Z�,,�� ,Ywas issued a permit to install a (date) (installer) septic septic system at ab( (/ 40( ��� based on a design drawn by (address) dated #/,-1/ (' signer) " I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes.such as lateral relocation of the distribution box and/or septic tank. a 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-b ' by designer.to follow. of Massgcy t. �. ��� DANIELA. (Installer's Signature) o 0JALA m U CIVIL cn N0.46502 FG/S T S?- 8/OVAL e .(Designer's Signature) (Affix esigner's Stamp Here) PLEASE RETURN TO BARINSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMEPLUNCIE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc po )OCII � w Town of Barnstablearllstb� Regulatory Services Department m'caC j BARNSTABM &" Public Health Division m �fD MA't a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO • r CERTIFIED MAIL# 7012 1010 0000 2847 8131 November 1, 2016 HARDY, PAUL C &LOIS M 10 RICKER CT MALDEN, MA 02148 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 266 School Street, Cotuit, MA was inspected on 09/29/2016 by James D. Sears, 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: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period wiltresult in future enforcement action: PER ORDER OF THE BOARD OF HEALTH Tho - cKe , R.S:4, CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\266 School Street Cotuit.doc r .4` i Of T�tqy Town of Barnstable s w 6 9. Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA*02601 Office: 508-862-4644 Richard Scali,Director FAX: 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 o 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 outlef 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 acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑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) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Cl Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc ®-t 11 2016, 12:04 Jim The Inspector Man 5085349919, page .I ® Odd - 6Z¢Q- Commonwealth.of Massachusetts I Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form Not for Voluntary Assessments t 266 School Street ti � Property Address Fes+ O? Paul Hardy - . owner Owner's Name/ information is Cti[ d MA 02635 9-29-16 required for every ou f page. CitylTown State Zip Code Date of Inspection Co t . Inspection results must be submitted on this form. Inspection forms may not be altered in any f way. Please see completeness checklist at the end of the form. ' ' a I Important:When A. General Information /(9�-O i filling out forms'`p,�atOFngal��,� on the computer, ESN Mq i� use only the tab 1 Inspector: _�'� key to move your ' cursor-do not DAMES % James D.Sears use the return Name of Inspector _aj SEARS r r key. Capewide Enterprises, LLC ` Company Name 153 Commercial Street %.,,,S d N SPE knm�rrmM�'1 r Company Address ; Mashpee MA 02649 k City/7own State Zip Code 508-477-8877 S1623 ' Telephone Number License Number B. Certification I . 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 f was performed based on my training and experience in the proper function sand 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: i ❑ Passes ❑ Conditionally Passes ® .Fails ❑ Needs Further Evaluation by the Local Approving Authority I � 10-5-16 ; nspector's Signature Date i The system inspector shall submit a copy,of this inspection report to the Approving Authority (Board f 1 of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority, t """This report only describes conditions at the time of inspection and under the conditions of use i I � at that time.This inspection does not address how the system will perform in the future under 1. the same or different conditions of use. ( ( Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page 1 of 17 t5ins.doc•rev.5116 L� I ct 11 20,16, 12:04 Jim The Inspector Man 5085349919, page e Commonwealth of Massachusetts r Title 5 official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments [ t 266 School Street Property Address t Paul Hardy Owner Owners Name t information is MA 02635 9-29-16 t required for every Cotuit ' i page. city7Town. State Zip Code bate of Inspection R. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D• ! i i I ' 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: Failed -Leaching The system is a 1500 Gal. Tank D Box and 60'trench. I i f } i " � 1 I. B) System Conditionally Passes: i ❑ 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. I i 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 indicating4hat the tank is less than 20 years old is available. i i i ❑ Y ❑ N ❑ ND (Explain below): i. t s Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 15ins.doc•rev.6116 ct 11 2016 12:04 Jim The, Inspector Man 5085349919 Pdye o �— A I commonwealth of Massachusetts ' i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 266 School Street Property Address Paul Hardy Owner Owner's Name t information' Cotuit MA 02635 9-29 16 required for every i page. City/Town State Zip Code Date of Inspecion { B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Healthapproval if ! i pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑. Observation of sewage backup or break out or high static water level in the distritution box du, j to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box, System w1"i, pass inspection if(with approval of Board of Health): z I ❑ 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): i - i ❑ 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): ❑ i obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): I f i ! ,I 1 , 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 hea 1.lth, t i safety and the environment: r ❑ 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 - Title 5 Official Inspection Form:Subsurface Sewage Disposal Systen•Page 3 of 17 t5ins.doc-rev.6/16 t i r t act 11 2Q16, 12:04 Jim The Inspector Man 5085349919 page 4 I I s Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 266 School Street _ Property Address a Paul Hardy Owner Owner's Name information is required for every Cotuit MA _ 02635 9-29-16 t page. City/Town state Zip Code Date of Inspection i 1 ' 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: t ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 1 100 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 t supply. 1 ❑ The system has a septic tank and,SAS and the SAS is within 50 feet of a private water ! supply well. l ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or r more from a private water supply welly. Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal I 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, 4 t 3. Other: 1 , { I t 1 D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No i i ® 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 j due to an overloaded or clogged SAS or cesspool i ® ElStatic liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in&EIMM is less than 6" below invert or available volume is less El than '/2 day flow 15ins.doc•rev.6116 Title 6 Official Inspeciion Form:Subsurface Sewage Disposal System•Page 4 of 17 I t s r i i t St 11 2016, 12;04 Jim The .Inspector Man 5085349919 page o i Commonwealth of Massachusetts Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form Not for Voluntary Assessments f .. 266 School Street i Property Address ! Paul Hardy _ l Owner Owner's Name I information is required for every Cotuit MA 02635 9-29-16 y 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 e, 0 ® obstructed pipe(s). Number of times pumped: i ° ❑ ®. Any portion of the SAS, cesspool or privy is below high ground water elevation. ! t ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or t tributary to a surface water supply. ® Any portion of a cesspool or privy is within a Zone 1 of a public well. t4 ❑ ® Any portion of a cesspool or privy is,within 50 feet of a private water supply well t lt ❑ ®. 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 f of ammonia nitrogen and nitrate nitrogen is equal to'or less than 5 ppm, I provided that no other failure criteria are triggered..A copy of the analysis and chain of custody must be attached to this form.] f The system is a cesspool serving a facility with a design flow of 2000gpd- t ❑ ® 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 t system owner should contact the Board of Health to determine what will be i necessary to correct the failure. I t S E) Large Systems; To be considered a large system the system must serge a facility with a { ? design flow of 10,000 gpd to 15,000 gpd, t i For large systems, you must indicate either."yes'or"no" to each of the following, in addition to the t questions in Section D. i 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 drinkingwater supplyj 0 ❑ Y . the system is located in a nitrogen sensitive area (Interim Wellhead Protection El ❑ Areay IWPA) or a mapped Zone 11 of a public water supply well ; I If you have answered"yes" to any question in Section E the system is considered a significant threat, I or answered"yes' in Section D above the large system has failed. The owner or operator of any large t 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. i 11 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 5 of 17 ISins.doc•ray.6116 itti11 E 2 {' t 7, Ft 11 2016 12:05 Jim The Inspector . Man 5085349919 page fo f f `'� Commonwealth of Massachusetts Title 5 Official� Inspection Form p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments j _ f i 266 School Street r s Property Address Paul Hardy Owner Owner's Name information is Cotuit MA 02635 9-29-16 required for every -- page. CityrTown 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: i t 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? t ❑ ® Has the system received normal flows in the previous two week period? t 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? i 1 ® ❑ Was the site inspected for signs of break out? } i ® ❑ Were all system components, excluding the SAS, located on site? 1 ® ❑ 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 f 0 ® information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has ` s been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. r Q ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.3'02(5)] t , D. System Information j Residential Flow Conditions: { i I Number of bedrooms (design): 2 Number of bedrooms (actual): 2 i DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 220 ' (t( 1 i I Title Official Inspection Form:Subsurface Sewage Disposal System-Page 6 o1 17 15ins.doc•rev 6116 f i Qct 11 2016 12:05 Jim The Inspector Man 508534991.9 page i \ Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 266 School Street i i Property Address . 1 Paul Hardy Owner Owner's Name t information is required for every Cotuit MA 02635 9-29-16 ' Page. CityrTown State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal. Tank D Box and 60' trench. , , I } Number of current residents: 0 i # t a Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? El Yes ® No , i 4 Seasonal use? ® Yes ❑ No } Water meter readings, if available (last 2 years usage(gpd)): 2014-12,000GaIs2015-10,000Ga's f Detail t i i Sump pump? ❑ Yes ® No NA Last date of occupancy: Date i Y Commercial/Industrial Flow Conditions: I Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) i i Basis of design flow(seats/persons/sq.ft., etc.): I l Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No i Non-sanitary waste discharged to the Title 5 system? El Yes ❑. No T f Water meter readings, if available: j 15ins.doc•rev 6l16 Title 5 official inspection Form:subsurface sewage Disposal System•Page 7 of 17 � � _ r E 1 ct 11 2016. 12:05 Jim The Inspector Man 5085349919 page 8 • I i 4 Commonwealth of Massachusetts , I Title 5 Official Inspection Form � F Subsurface Sewage Disposal System Form Not for Voluntary Assessments t 1 r 266 School Street I Property Address Paul Hardy Owner Owner's Name s information is Cotuit MA 02635. 9-29-16 r required for every page. City/Town. State Zip Code Date of Inspection D. System Information (cons.) } Last date of occupancy/use: Date i I Other(describe below): j v t r I General Information P , Pumping Records: j NA r Source of information: is 4 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons , How was quantity pumped determined? Reason for pumping: 1 Type of System: i i ® Septic tank, distribution box, soil absorption system i i ❑ Single cesspool - 6 i j ❑ Overflow cesspool j ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) i , Z f ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest i inspection of the I/A system by system operator under contract i ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): r I { 15ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 or 17 t { ct 1.1 Z016 12:06 Jim The Inspector Man 5085349919 page Y I f Commonwealth of Massachusetts i Title 5 Official Inspection Form { Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I e �'P 266 School Street Property Address Paul Hardy _ Owner Owner's Name { information is Cotuit MA 02635 9-29-16 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source.of information: 1995 Permit#95 - 1596 r I Were sewage odors detected when arriving at the site? - ❑ Yes ® No i Building Sewer (locate on site plan): I 2011 i Depth below grade: feet i Material of construction, i i 1 ❑cast iron ®40 PVC ❑ other (explain): i Distance from private water supply well or suction line: feet ' Comments (on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40. i I - I , } t Septic Tank(locate on site plan): Depth below grade: feet ' i I Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) ; E , I' I If tank is metal, list age: years t Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No E I i 1500 Gal. Precast H-10 , Dimensions: 411 Sludge depth: l5ins.doc•rev.6/16 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 9 of 17 i 1 } Oct 11 2015 12:06 Jim The Inspector Man 5085349919 page 10 ? Commonwealth of Massachusetts Title 5 Official Inspection Form I 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 266 School Street Property Address ! Paul Hardy Owner Owner's Name ` information is t i required for every Cotuit _ MA 02635 9-29-16 page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) j Septic Tank (cont.) I Z6„ s Distance from top of sludge to bottom of outlet tee or baffle I Y F Scum thickness ' i k Distance from top of scum to top of outlet tee or baffle 8 + Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Asbuilt-Tape } Sludge Judge i 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 level up into inlet and outlet lines. Tank and coves's at.1' below grade. I i + t i S + Grease Trap (locate on site plan): + Depth below grade' feet 1 Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)`. f Dimensions: { Seim thickness j r Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle I Date of last pumping: Date F t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 or 17 + i i i y i t I I i 1 Oct 11 201� 12:06 Jim The Inspector Man 5085349919 page 11 t eel-� Commonwealth of Massachusetts i Title 5 Official Inspection Form a o . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 266 School Street # Property Address Paul Hardy Owner Owners Name information is Ctit MA 02635 9-29-16 oU required for every -- I page. CityrFown State Zip Code Date of Inspection Do System Information (cost.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): t i r l 1 i t � I I i i i Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: 1 Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): j l i I } j Dimensions: t l Capacity: gallons 1 Design Flow: I gallons per day + Alarm present: . ❑ Yes ❑ No l E i Alarm level: Alarm in working order: El Yes [I No Date of last,pumping: Date l t ' Comments (condition of alarm and float switches, etc.): I ( i. c i I t 1 "Attach copy of current pumping contract(required). Is copy attached? '❑ Yes ❑ No I . I t5ins.doc rev.6116 Title 5 Official Inspection Form'Subsurface Sewage Disposal System•Page 11 of 17 i n i i 1 } i t e ;Oct 11 ?016 12:07 Jim The Inspector Man 508534991.9 page 1 1 1 }` 1 Commonwealth of.Massachusetts Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form -Not for Voluntary Assessments ° 266 School Street hl d • s Property Address 1 Paul Hardy i Owner Owner's Name information is Cotuit MA 02635 9-29-16 .required for every ' `s 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 Over Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any j evidence of leakage into or out of box, etc.): D.Box is 16"x16"-18" below grade wlone line out. Box is full over out let line. f t { i 1 1 , Pump Chamber (locate on site plan): t ' Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ Now i Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.)" e I 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): i I 1 If SAS not located, explain why: 1 i s t i I t5ins.doc•rev.6/16 Title 5 tJtfidal Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 { t I � E t i I , ;Oct 11 Z016 12:07 Jim The Inspector Man 508534991.9 page 13 I I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i 266 School Street t Property Address Paul Hardy i Owner owner's Name information is Cotuit MA 02635 9-29-16 required for every page. Clty/Town State Zip Code Date of Inspection i D. System Information (cont.) f Type: ❑ ` leaching pits number.. t i 's ❑• .leaching chambers number. ' ❑ leaching galleries number: i ® leaching trenches number, length: 1 60, ❑ leaching fields number, dimensions: i ❑ overflow cesspool number: { i ❑ innovative/alternative system Type/name of technology: , I i Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): '. Leaching is a trench 60'x4'x2' ck D Box and camera out. Box full over out let. Trench full not leaching. Need to replace leaching. I i i s , i i Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): i Number and configuration Depth —top of liquid to inlet invert ' 1 f { I Depth of solids layer .Depth of scum layer s Dimensions of cesspool 1 Materials of construction i Indication of groundwater inflow ❑ Yes ❑ No i t5ins.doc-rev.6/16 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 13 o1 17 i i , t f Oct 11 2016 12:07 Jim The. Inspector Man 5085349919 page 14 I } Commonwealth of Massachusetts w Title, 5 Official Inspection Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments I 266 School Street ' M Property Address Paul Hardy i j Owner Owner's Name information is Owner's required for every Cotu MA 02635 9-29-16 page. City/Town State Zip Code Date of Inspection f D. System Information (cons.) ; 1 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I i , i Privy.(locate on site plan): Materials of construction: i 1 I Dimensions { Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): • i ! E S i I ! 1 1 jj i i t I fi } t i P i i I { i t ± 1 t I 15ins.doc•rev.6/16 Tills 5 Official Inspect on Form:Subsurface Sewage Disposal System-Page 14 of 17 T , I F , 1 ''Oct 11 ?016 12:07 Jim The Inspector Man 50853499/9 page 15 f i e\ Commonwealth of Massachusefits w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i I 266 School Street Property Address ' Paul Hardy Owner Owner's Name information is Cotult MA 02635 9-29-16 required for every page. Cityfrown State Zip Code Date of Inspection I 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: and-sketch in the area below p drawing attached separately I i S i E �v^i1 i 1 i I i A f. 1 I r I �JI i G G rid t ( 4 1 r i 1 - { 13 y.l -3 r1 , i �._ q 9 r i 15ins.doc•rev.&16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 r f y S i Oct 11 2016 12:08 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 266 School Street Property Address Paul Hardy Owner Owner's Name information is Cotuit MA 02635 9-29-16 required for every i page Cityrrown State Zip Code Date of Inspection p , D. System Information (cont.) i Site Exam: 1 ❑ Check Slope _ ❑ Surface water ❑ Check cellar I i ❑ Shallow wells NO 12'+ Estimated depth t high ground water: feet i i Please indicate all methods used to determine the high ground water elevation: i 1 ❑ Obtained from system design plans on record I j If checked, date of design plan reviewed: i Date Observed site (abutting propertylobservation hole within 150 feet of SAS) P. ❑ Checked with local Board of Health -explain: I f j i i I ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database - explain: l i You must describe how you established the high ground water elevation: ! Abutting property across street 12'+ no G.K. Bottom of trench around 4' i i r s i 9 I Before filing this Inspection Report, please see Report Completeness Checklist on next page. i 15ins.doc•rev.6116 Title 5 Official Insoechon Form;Subsurface Sewage Disposal System•Page 16 of 17 1 I , t ct 11 .2016 12:08 Jim The Inspector Man 5085349919 e page 17 j e (S 1 I Commonwealth of Massachusetts s W Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . ti 266 School Street ; Property Address f. fff Paul Hardy Owner Owner's Name t information is required for every Cotuit MA 02635 9-29-16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist .f ® Inspection Summary: A, B, C, D, or E checked I ® Inspection Summary D (System Failure Criteria Applicable to All'Systems),completed t ® System Information— Estimated depth to high groundwater i ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file ITT if NMI I : i i F 1 f{3 ' 1 1 1 i 1 i i 1 f i i t ' f f • I, 1 i f 1. t l i f i5ins,doc•rey.6/16 Tina 6 Official Inepeclion Form:Subsurface Sewage Disposal Systen•Page 17 of 17 I TOWN OF BARNSTABLE LOCATION C SEWAGE# VILLAGE (20-17L_re— ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. .G. SEPTIC TANK CAPACITY LEACHING FACILITY. (type) (size) Js�77 NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: 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 C tl A - 3 r �I c te-lzj r TOWN OF BARNSTABLE LOCATION � c ,c4- �� SEWAGE # T'S; VILLAGE ASSESSOR'S MAP & LOT14WU INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY Lvk j LEACHING FACILITY:(type)--ry'-ee�G L-\, (size) NO. OF BEDROOMS c - PRIVATE WELL OIL UBLIC WAT R V BUILDER OR OWNER DATE PERMIT ISSUED: " DATE COMPLIANCE ISSUED: " � VARIANCE GRANTED: Yes No G � _(� . r f� �' �" T �. �`. � -, M� ,t � ,r �J 4-. (' /` ;� . < <� I, f, � . �► �� 1 � � '1 ��t ,� ; �, . � � � � � � -�lC' 160 .-.. .. .., � .. } q 43a N4� P No. FEE THE COMMONWEALTH OF MASSACHUSETTS MASSACHUSETTS 4pliration for jJermit Application is hereby made for a Permit to Construct ( ) or Repair( Jan On-site Sewage Disposal System at: Location Address or Lot No. n g A �l/ T Owner's Name,Address and Tel.No. 'Nl I (�(,�j Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C`45�, �wJ��� Z ")o 6� Type of Building: Dwelling No. of Bedrooms Garbage Grinder( � Other Type of Building No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �"Q gallons per day. Calculated daily flow gallons. Plan Date V4-- Number of sheets Revision Date Title Description of Soil ��Q Nature of Repairs or Alterations(Answer wheQ applicable) Date last inspected: Agreement: ' The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environ ntal Code and not to place the system in operation until a Certificate of Compliance has been issued b this Bo rd of Hea Signed Date Application Approved by jDate Application Disapproved for the following reasons ' Permit No. Date Issued No. FEE 0, 110 I�� �/ THE COMMONWEALTH OF MASSACHUSETTS MASSACHUSETTS t c�Jjplirativn for pispusal �S !Skrmi`(gIInstrurttIIn Permit ,. Application is hereby made for a Permit to Construct( ) or Repair( '�an On-site'Sewage Disposal System at: Location Address or Lot No. lff Owner's'nName,Address and(Tel.No. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No. of Bedrooms Garbage Grinder( � X. Other Type of Building G No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7> Ac gallons per day. Calculated daily flow e�c y gallons. Plan Date Number of sheets Revision Date Title Description of Soil &,!!,Q Ste; Nature of Repairs or Alterations(Answer when applicable) tN fi \ l�7(JD-SC VON Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environm ntal Code and not to place the system in operation until a Certificate of Compliance has been issued byfhls Bo rd of Hea / Signed Date �j/� Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued y THE COMMONWEALTH OF MASSACHUSETTS 6 MASSACHUSETTS (9ertitirate of Gumylianre THIS IS TOO CERTIFY, that the On-site Sewage Disposal System installed( or repaired/replaced(y) on c3Lq — 7 ) by v4 , fob at bc� Ste"' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that he system will function as designed. This Certificate expires on DATE / � � �"t/ Inspecto�'r' THE COMMONWEALTH OF MASSACHUSETTS D No. 14 AiO_Gs C,� -. MASSACHUSETTS FEE �is osttl s#em (fonstrnrttun jJermit Permission is hereby granted to to construct( ) or repair(L-4-I'n On-site Sewage Uc m located at 2(a(i� L S� L and as described in the above Application for Disposal System Construction Permit. The applicant recognize his/her duty to comply with Title 5 and the following local provisions or special co aions. All construction �usst'Jb completed within two years of the date below. ® 0 DATE W Approved by , FORM 1255 Rev.3/9 A.M.SULKI CO.-BOSTON,MA CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, CO- ,� y ,,�S , hereby certify that the application for disposal works ' i construction permit signed by me dated to— a , concerning the .�. property located at 5T— meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED: - DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. ,3 \v O >pp 5� O l0 w� s r v v ` LEGEND NOTES o, 99 — EXISTING CONTOUR 1. DATUM IS NAVD 88 0 X 99 J EXIST. SPOT ELEV. SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE 2. MUNICIPAL WATER IS EXISTING a a MARKED WITH MAGNETIC TAPE OR a —[99]— PROPOSED CONTOUR PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Cb [98.41 PROPOSED SPOT EL. ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXT 2' CAST IRON COVERS TO GRADE OR CONCRETE 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS Locu School ILE TO BE AASHO H-2 \ TOP FOUND. EL. 47.3 FILTER FABRIC OVER STONE COVERS TO WITHIN 6" GRADE, COORDINATE W/ OWNER St. TH1 46.5 5. PIPE JOINTS TO BE MADE WATERTIGHT. TEST HOLE MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM COtulet NOTE: 2" MIN. WALL 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH hoc 2% SLOPE OF GROUND THICKNESS REQUIRED BLOCKS OR 310 CMR 15.000 (TITLE 5.) Bay :14"OSCH40 PVC PRECAST RISERS + 45.7' MORTAR ALL H-20 UTILITY POLE 6" MIN. SUMP PIPES LEVEL 1ST 2' J�ENDS COMPONENTS 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO She//12" MIN. INT. DIM. (TYP.) INV'S EL. 42.5 4' BE USED FOR LOT LINE STAKING OR ANY OTHER err 3 ,ot SIDES 43.5 PURPOSE. 0 esse Zr FIRE HYDRANT 10" 14" oo°TEE "EXISTING TEE r m0mm 0 m��� �m0m �0m0 ' OODO NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING �k 0 0 0 0 0SEPTIC TANK 44.29 ° ° ° '° ° ° Do��o�o��o���o�o �o o��o�o�o Do Do��o Do�o ,°°°°°°°° 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. "ire Ri eo°o°o°o°o°o° WATERTEST D'BOX Oo p O o O O O o o OOOOOOO 000 'o°GAS BAFFLE : 1°o°o°o°o°o°• ° E�E�E�D��O�E�E�� aoa0000M000 ,°°°°°°°°40 FOR LEVELNESS a ° o000000000 o0000000000 ° ° ° °° 0�0�(]D000O� ° ° ° ° 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED c� 42.77' 42.60' 40.5' WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. 0 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFEALL AROUND PRECAST STRUCTURES (2) UNITS REQUIRED LOC TION(1OF8ALL344-7233 UNDERGRO ND & OV RIHEADHUTILITIES LOCUS MAP 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' PRIOR TO COMMENCEMENT OF WORK. COMPACTION. (15.221 [2]) SCALE 1"=2000'f Sri 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED ASSESSORS MAP 20 PARCEL 62 *THE INSTALLER SHALL VERIFY THE LEACHING FACILITY. LOCATIONS OF ALL UTILITIES AND ALL SITE IS NOT LOCATED WITHIN A ZONE II 3 35.0' BOTTOM TH-1 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND BUILDING SEWER OUTLETS AND ( % SLOPE) ( 1 % SLOPE) NO GROUNDWATER FOUND I REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. ELEVATIONS PRIOR TO INSTALLING ANY H-20 LEACHING PORTION OF SEPTIC SYSTEM FOUNDATION— EXIST. SEPTIC TANK 54' D' BOX 12' FACILITY **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY FOR RE—USE. REPLACE WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF NOT SUITABLE TEST HOLE LOGS ENGINEER: CRAIG J. FERRARI, SE #13871 WITNESS: DAVID W. STANTON RS DATE: 1 1/21/201 6 PERC. RATE _ < 2 MIN/INCH CLASS I SOILS P# 15203 v I ELEV. ELEV. 0„ 4 46' O,p 4 46' A A / LS LS 0 170.00 6» 1OYR 4/2 8» 1OYR 4/2 �6 LOT / / B B LS LS 35,750 S.F.f ° 0.82 AC.f /26 36„ 1OYR 5/6 43, 1OYR 5/6 34 43.2 vll �J)j j X � �Q) C C EXISTING w PERC DWELLING N N ^ MS OHE OH x �-OHE ��' OHE OHE I I \ TO = 47.3 '�/ MS 0 OF E — 0 E ° — w w ° ° J \ \ C�D O 1OYR 7/4 1OYR 7/4 G I �' �'� 70 j^ 10 0 oo ; 132" 35' 132" 35' ° O SHED ' � N NO GROUNDWATER ENCOUNTERED I--3 I 7 2. � BOCCE COURT CrI A- 23 � 200.00' 1 5.00' BENCHMARK: FE PLAN CBDH ELEVATION =46.6 NAVD88 �/ OF #266 Z0,*3" CHOOL STREET SYSTEM DESIGN: GARBAGE DISPOSER IS NOT ALLOWED — UOTUIT, MA EXISTING 2 BEDROOM DWELLING PREPARED FOR DESIGN FLOW: 2 BEDROOMS © 110 GPD = 220 GPD 0'%ONSTRUCTION/ USE A 220 GPD DESIGN FLOW B%CjNRTU` L0TT1 C SEPTIC TANK: 220 GPD (2) = 440 PAUL HARDY USE EXISTING 1000 GAL. SEPTIC TANK** LEACHING: DATE: NOV. 22, 2016 SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD REV: DEC. 6, 2016 (BOH COMMENTS) BOTTOM 25 x 12.83 (.74) = 237 GPD TOTAL: 472 S.F. 349 GPD Scale: 1"= 20' USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) 0 10 20 30 40 50 FEET WITH 4' STONE ALL AROUND .\0 o �,,5 �0` AR off 508-362-4541 fax 508-362-9880 rDAN downcape.com C +;'ALA'' r I down cape L98 Meeting inc. NO 465i�_ MA APPROVED DATE BOARD OF HEALTH ��, �° `�f � ��' �� civil engineers _ v�s°o �� land surveyors l � 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 DCE # 16-381 16-381