HomeMy WebLinkAbout0041 SHELL LANE - Health 41 Shell Lane
Cotuit
- - - -- -. _ - --- - - ---- - - j A = 019 127
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TOWN OF BARNSTABLE
LnCATION s/ S :�/ � SEWAGE# 90lO
VILLAGE ��;,t,,,o �- ASSESSOR'S\ MAP&PARCEL f _ 117.
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY I �
LEACHING FACILITY.(type) !V xsize) 3..:l X13�
NO.OFBEDROOMS 3 C)e5l&Al
OWNER �j t✓�,
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 a155 Q ' a
�-G3 � � 1
y 'let 5
I �
TO N OF BARNSTABLE
LOCATION �l ;� d 01; SEWAGE#
VII°LAGE CrQ-4T ASSESSOR'S MAP&P CEL 019 /a
SEPTIC TANK CAPACITY
LEACHING FACILITY. (type) (size)
/f
NO.OF BEDROOMS �'
OWNER 4eaae�
PERMIT DATE: 0 1 ZY,' COMPLIANCE DATE:
Separation Distance Between the: A
Maximum Adjusted Groundwater aBle 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
� � l
L A
e
No. /. Feewe
THE COMMONWEALTH OF MASSACHUSETTS Entered in co pater:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitatton for MisposaY *pstetu Construction Vermit
Application for a Permit to Construct( ) Repair(0-1upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. -1 j 1 e 11 LCWCf (S7t�V t Owner's NamerAddress,and Tel.No.
Lott) lc,--,
Assessor's Map/Parcel A? i 2
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�5��5 3to�NSNC 50�—N00`7J L.v i,�� Y�� j4,&jlc5 S -y77- 53`3
Type of Building:
Dwelling No.of Bedrooms Lot Size ` 'S A ter_sq.ft. Garbage Grinder( ),
Other Type of Building 6o&2�!C No.of Persons Showers( ) Cafeteria( )
Other Fixtures
i
Design Flow(min.required) _33(7 gpd Design flow provided 3'S�, '� gpd '
Plan Date -3 2 Co 6 O Number of sheets 2- Revision Date
Title
Size of Septic Tank t 5Z0 Qe 0 Type of S.A.S. 'SOp Gc,Ur,,3 C jk6,,10 r5
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 the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board ea h.
g ed Date O
Application Approved by 0 Date
Application Disapproved by Date
for the following reasons
Permit No. 71SW Date Issued
Fee
N. D-7vl
fi
THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter;
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS . Yes
Yication for 1\ : 2J�l � stJDBaY *pstertt CDTYstrUctIDII permit
Application for a Permit to Construct( ) Repair(4upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 11/ 5�P)� LGe Cc V i 1- Owner's Name;Address,and Tel.No.
Wi11ic�.S
Assessor'sMap/Parcel A? 1� )? -
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
t,�g�� trneaN NC- SOB-a-1DO` 71$� L.v �N-er,-r•� ��i�c5 SOrU'y77- S3/ 3
Type of Building:
F Dwelling No.of Bedrooms Lot Size .'S Arj(�e sq.ft. Garbage Grinder( ) L �l
r Other T e of Buildin
YP $ Inoy��c No.of Persons Showers( ) Cafeteria( )
Other Fixtures
f
Design Flow(min.required) 3S gpd Design flow provided -3 j 7, gpd
Plan Date 312 c b Q Number of sheets 2 Revision Date
l Title '•
Size of Septic Tank 1 5CY0 ADl'o Type of S.A.S. SOp ctoc,r. \ofr
Description of Soil
j
Nature of Repairs or Alterations(Answer when applicable)-_ �NDS'v C,0 r)•e„D
Date last inspected:
Agreement:
4
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board.ofkfea h.
ig ed 5�2Date —1 0 O
Application Approved by D Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued .
� ,.
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(. �Upgraded( )
Abandoned( )by 1�.. OQ")c, A
at t-1 1 has been cons j WO
ucted in ac r ance
with the provisions of Title 5 and the for Disposal System Construction Permit No dated
Installer —Z-'b J c1 c, �l cawrl A T7IJC_ Designer l"•-iyc tN i'Y'
#bedrooms ( Approved desig�o.1 �'7`` � gpd
The issuance of this permit shall not be construed as a guarantee that the system wi7)(A-
nction as design .
Date L 1��� (� Inspector
NO. Fee
" THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Misposal *pstem Construction permit
Permission is hereby granted to Construct Repair) Repair L Upgrade( ) Abandon( )
System located at `�/ / 5�e/� GG�✓L' �d f d!J
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.
r
Provided:Construction mus be c letedtthin three years of the date of this permit.
Date Approved by
_ v
TV
APP .ICA1Ti
ApI A-I 5 tti C�ve C'm �r
gpa
REVIEW EWRY:
f. .
Le al boundaries denoted 310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted'on'plan [310
CMR 15.220 4 `u
Locus Provided 310 CMR'15.2204(t)]
Plan proper scale? (1"=40' for plot plans, 1"- 20' or fewer for
components) 310 C MR 15.220 4
Easements shown 13.10 CMR 15..220 4 b
System located totally on lot served [310 CMR 15.405(1)(a) for ✓
upgrades]- i not, a variance is required 310 CMR 15.412 4
Location of impervious surfaces (driveways, parking areas etc.)
310 CMR 15.220 4 d
Location all buildings existing and proposed 31.0 CMR ✓,
15.2200)(01
Location and dimensions.of system components and reserve areas. ✓,
310 CMR 15.220 4 e
System Calculations 310 CMR 15.220 4
daily flow
s c tank aia red and rovided
soil abso tiQn s stem r. aired and provided)
whether s stem d--- ed for arba a der
North arrow 310 CMR 15.220 4
'Existing and ro osed contours 310 CMR'15.220 4 ✓
Location and. lo$ of deep observation holes (existing grade el. on
each test) [310 GMR 15.220(4)(h)]
Names of soil evaluator and BOH representative [310 CMR
15.220 4 and i
Location and dale-of percolation tests (performed at proper
elevation?) [310 CMR 15,220(4)(i)]
Percolation test results match load'Ing
rate? 31.0 CMR 15.242
Certification statement by Soil Evaluator 310 CMR 15.220(4A)]
Observed and Adjusted groundwater (method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.22 4 n.' . ,
Address of 9
a
N/A fK ice'
Location of every water supply, public.and private, [31 O CMR
15.22,0 d, *k ,
within 400 feet of the proposed system loeation in the case
of suri'ace water su l es:.a4d vel: ckod, c WOW.$u _1 ✓
within 250 feet of the proposed sterim location in the case
wrthin-_150.fed of the proposed system location in the case
of ..'vate water wells
Lora#oat of'. surface waters and wetlands located up to 100 ft.
x k e m "10t 1 .21 I aid aty,c�tCh:basins
be� 3 ! d
" 50»ft 310 CI1 ;15 22n 4 1:
meter lames abd of or subsurface utilties..loc$terl [3 fl tG149R '
15 220 4 } wa er-line cross see 310 C" 15;211 1` 1
Protyle�ofsytem shawizag invert elevations o€all system ,
c. e <,ad tla hattocs.af'the SAS 310
S o f deli, "er 31 a CM1Z 15.220 1 and 310 CIViR 15.220 2
Stamp of Registered Land'Surveyor(required if construction
ac v t Es-wi i $ ; of lot hil 310 CMR 5,19
220 3
Test Holes adequate (two in each of the 0iim `y and reserve '
ess trendies a errn i' ins 31.Q 15. 02 2 or as
unl. p ( } ,.
a royed,fot an u ade under LUA at 310 CMR-`I5 4'O5 1 'k
TOt hole-ad�q ate=to demonstrate£our feet of suitable material?
:310;CMR
Test Hales eq}tate-^to confirm adequate,groundwater separation?
R 0 C1V1 l5.103 3
9enehka�+iti�n.5..0•75'af.s: stem 31.0 Cl1i>�. 15,22Q
1Vaterials spec�ficafons.:noted`?:Ivarious sections.of 310 C1V�R
✓Y
stetra.corn °on rits nat>36 deep (unless.Local L......
y p q ✓ ,
A r®va1 arL>UA re`' nested 3`1`0 CNIR i 5. 405 1
Ad i e; s Shed 2 of 0
t .
N/A QK
"SizeK? 310 CMR 15.223 177,
Inlet tee located ten inches below flow line 310 CMR 15.227(6)]
Outlet tee 14" or 14" + 5" per foot for increase ft depth [310
CMR 15.227(6)].
Outlet tee with gas baffle or ! roved filter 310 CMR 15.227(4)1
Note regarding irpullation on stable oxnpacted-base [310 CMR
15.228(l)] .
Separation between inlet and outlet tees (go less than liquid d*h)
310 CMR 15.227 2
Inlet/Outlet elevations at least 12" above high groundwater
(except as descri* 3I,0 CMit 15.227(5)) or permitted for. '
upgrades under LUA P10 CMR 15.405 1 k.
Minimum cover (Tanks buried more.than 9" must have risers
on aU openings and on the d-box) [310 CMR 15.•2228(1) and 310 a
CMR 15.232 3
Three access cnyers (inlet and outlet must be 20" or greater) -
middle access at least 8 7/07 310 CMR 15.228 U2
Access to within'6 " of grade -one port for systems<10449pd,
two ffor st j >1:000. d. 310 CMR 15 228 2
All at-grade covers secured to unauthonzed access? [31 O CSM
15.228(2)]
> l0 ft`from foundation 310 CMR 15 211 1
Buo anc calculation Re uired/Dvne P10 Chit•15.221: 8 t�
H-20 Where:.a -ro' riate? 310 CMR 15.226 3
Setbacks from resources J310 CMR 15.211
Required when other than single-family dwelling or flow>1000
d 310 CMR 15.223 1
First compartment 200% daily flow; Second compartment 100% - 1p
dafly flow 310 CMR.15..22 2) and .3 .
"U' pipe xhrough or over baffle, outlet of each compartment with -
as bale or ap
proved filter 310 CMR 15.224 4
Address:: S 3 of 9
i
N/A OK NO
Located`at least ten feet.from any water line? [310 CMR
l�
1S.222(2)].
Disposal piping�t least 18" below water line{when water and
sewer cross see 310 CMR 15.211(l)[1]. .
Cleanbuts 'aired/ rovided ? 310 CMR 15 222 8 ;
Thrust blocks s. in force mains? 310 CUR 15.221 6 c
Slope of kW&litie not less than 0.01 (1/8"/$) 0.02 preferable
V/
310 CMR 15.2 . .6
Proper pitcl 'on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251 9 and 310 CNM 15.252(2)(c)]
Siphon roblem/. eaclfeid below pump chaniber
Endca s°orvettf tna' lti ed?
Size and origin of discharge.holes.specified?.(not smaller than .
3/8" not larger than.5/8") [310 CMR 15.251(8) and 310 CMR
15.252 2
Materials specified (310 CMR 15.251(5) specifies various pipe /
es allowed
Stable compacted base [310 CMR 15.221(2) and 110 CMR
15.232 2 a
Splash`plate or baffle tee required on inlet/provided?(when
p sewer to d=box or-steep itch of gravity sewer) [310
ressure P P
CMR 15.323(3)(a)]
Riser i ;dee er than 9I 3 jO CMR l5 232 3
Inside ibtimuii esion 12" 3.10 CMR 15.232 2
Minimum 310 CMR 15.232 3 e
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
3.10 CMR 15.232 3 d
c store a above warking—�dekgtr
Clpaei ( Y g
Pro er setbgeks 310 CMR 15.211 same.as tic talcs
Watertigb 1041n minium access manhole at least 20" MUST BE
'f0 GRADE 3;1.0 CMR 15.231(5)]
3ervi6e accessible(not too deep with piping,
disconnQcts accessible
Alarm, 64 . .alarm on circuit separate from s specified?
Exceeds two ud must leave two pumps operating in lead-lag
Triode 3;1:0 CNI1?�1.5.21 6 and 8
Stable Co Base 310 CN%.l5.2212
x r _ Sh�t'd of 9
Addfess
y
Buq g us noO d:?Provided? 310 £R 15.221 8 -
.: .. ... .. ..� ,. 4 Tr
� p 1
V
owe
5 YW..
VON
• .. _
R too 37SM
f
rl
Y '
.��;��tZt •.�: ri �.
x
7
r
, i
NOW
-... .. -
ANNA
/
y
of
• c
N/A OK NO
Calculations corr.�ct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.24 1
Required s aration togroundwater? 310 CMR 15.212
Aggregge specified as double washed 310 CMR 15.247(2)]
System Venting required/provided?-(system under driveway-or
>36"d 310 CMR 15.241
Inspection ports dfied and within 3"final grade? [310 CMR
15.240 13
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15:211(1)[4] and +�
Guidance Document]
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. 310 CMR 15.253 6
Each structure vNith one inspection manhole(if>2000 gpd must be
to ade 310 CMR 15.253 2
Aggregate 1' minimum- 4' maximum: 310 CMR 15.253 l
2' sidewall credit maximum 310 CMR 15.253 1 a
In bed confi ration, inlet every 40 sq. ft. 310 CMR 15.253 6
Width 2'minimum 3' maximum 310 CMR 15.251 1 b
100 feet- maximum length 310 CMR 15.251 1 a
Minimum separation 2x effective depth or width whichever greater
3x if reserve between trenches 310 CMR 251 1 d
Situated along cpntours 310 CMR 15.251 2
Breakout OK? 10 CMR 15.21 li 1 jj4j and Guidance Document
nnrumurri 2 dis�nbution lines "310 CMR 15,252(2)(a
se ra between Imes 6' 310 CM 1t15. 52 2 d
Maximum separation between lines and outside of bed 4' [310
C1�dR 152SZ
Aggregate depth below discharge pipes 6" minimum, 12"
triaxu�ltm. 310 CM#t 15,252 2
S ` sraion betwe beds 10' mourn• 310 CNIR 15.252 2
Bottom area u ' m calculations only 310 CM. 15.2$ 2 i
Shed 9
a.i
Pressure Dosed System ? Provided pump and piping calculations
as required 310 CMR 15.220(4)(r)]
Pressure dosing required on all systems >2000gpd or alternative
systems under remedial approval-[310 CMR 15.254(2) and I/A
Remedial Use vats
If used in gravelless system -make sure jet is directed as not to
scour soil interface. Guidance Document
Inspections once per year(systems<2000 gpd)or quarterly
>2000 dgood to note on plan 310 CMR 15,254(2)(d)]
Consftction.in fill -Did the plan specify that the fill shall meet
the s ecific400n pf310 CMR 15.255 3 ?
Impenvious bairn r and/or r wall ? Guidance Document
Impervious ' neon must be supervised by design
310 CMR 15.255 2
Retaining wall must be designed by Registered Professional
En ' eer 310 SM 15.255(2)(a)]
Side slope not exceed 3:1 ? 310 CMR 15.25 5 2
Breakout re4uiremertts met![310 CMR- 15.252(.2)and
Guidance Document
At least 5 ft. from impervious barrier to edge of SAS (101
recommended 60 CMR 15.255 661
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge
to scour soil interface
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions? 477
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a tote on the plan regarding the requirement for
Perpatual m*tgianceagreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has..amficint submitted a co of a maimenance eemerxtT
-j4
Are the variances listed on the plan ? [310 CMR 15.220
4 L/
RLS S.;; ;jnecessary On plan if a component is within five
feet of.=Pefty be f 310 CMR 15.4144)]
�r. • x� .7.of•9
310
f �
Jv.
. . .....
i 1
f
k' L
Wi r+}p dx.3�y.
4 hvBB�,iw�
,
�c,`��h�3.. �s��sr��- '.,uc "ryY�{•ia'�'��`r ram' et �
4
e
i
`. Address
N/A QK NO.
Is the system in a Designated Nitrogen Sensitive Area (Zone H for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.21¢ - also refer tb Policy regarding upgrades of such
w istin systems]
Is the system proposed on the same lot as served by private well ?
310 CMR 15:21 2
Are.the nitrogen:loads proposed in compliance? [3 10 CN#R
15,21 , 1
Pump ng to septic tank ?. 310 CMR 15.229
Shared System 1-0 CMR 15.290
.. . f
1
j
Address Sheet 9.of 9
Town of.Barnstable
Regulatory Services
Thomas F. Geiler,Director
• Public Health Division
>
t63q• ��
Thomas McKean,Director -
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: ( (� Sewage Permit#"0 -O Assessor's Map/Parcel [q J -7
Installer&Designer Certification Form
Designer. mnW-en'w Y1 c Installer;
Address: n- W Cr&4 s� cal Address: Q c 49 f
0ZA 3
On 0- Y` s rouwi /a was issued a permit to install a
date) (installer)
septic system at S)kd/ brx 6 -Vc based on a design drawn by
(addres /
M C_&%1-�e�e Z' E dated #74( o
(designer)
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... Stripout (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State &Local Regulations. Plan revision or
certified as-built by designer to follow. Stripout(if required) was inspected and the soils
were found satisfactory.
� kA OF M,,so
Gam'
PETER T. G�,
staller?s Signature) o WENTEE
CIX;Z/
VIL v
-0 9 No.35109 0 �
&#e's1gneLr'sSignature) (Affix De e)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISI N. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND:A
um ARE RECEIVEDBY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANKYOV.
q:\office fo:mAdesipercertification form.doc
-Town of�ar>q�s�a•ble r# 2�� 7
i
Department of Regulatory Services
F Public Health Doision Hate `_ I
16 «�� 200 Main Street Hyannis}MA 02601
{
. Date Scheduled
Soil`SuU bri ty Assessment for Sewage disposal
PerFormed By: ff'�1"ie ' !�J Witnessed BY.
` ivr�
LOCATIO1& GENERAL INFORMATION
Location Address Owner's Name D Av\✓ ) �
' �l $►'►.ell hcNn.� .:
- Address �` Stie.lt �-o'it'`Q- -��'
i
_ 4UZ(p3
Assessor's=Ma 1. Engineer's Name Mee O 1 9:--1"2 .. €�
NEW CONSTRUCTION >e REPAIR Telephone#.. $ 73 7
Land Use 5 \ Slopes(96) Surface"Stones "
Distances:from. "Open Water Body ZfkJ �` ft Drinkin pe Y7 ft 'Possible Wet Area g Wateir Well � ft
Drainage Way ft Property Line Other >-Q
SKETCHi,(Street name,dimensions of lot,exacYlocadons of test holes&perc"tests,locate wetlands' proximiry,�toles).
ti
LA
Parent.material(geologic)v`� Oi S�. Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: Weeping Prom Pit Face
Estimated SeasonaLHigh Groundwater
DETERAHNATION FOR,SEASONAL'gIIGH CATER TABL;E''
Method Used:,
Depth Obseived standing in obs.hole: Itt. Depth to soil mottles,
Depth to weeping from side of obs.hole: in.. Groundwater AdJustment ft
Index.Well:#" Reading Date: Index Weli level AdJ,ihctor,.s,. At({ dtoufldwaterLeva)
PERCOLATION TESL'- Date '
Observation
Hole# " TI the at 4" .�. ._._. ....r__.
Depth'of Pert�: r/�'/ / X b Z G Tlme at 6" x
.Start Pre-soak'11me C� G. ;y,� TSme(V"V)
End Pre-soak
Rate Min
Site Suitability Assessment: Site Passed_✓ Site'Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observ6tion Hole Data To Be Completed on Back----------
***If percolation test is to be.conducted within 100' #f wetland,you must first notify,the.
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTICIPERCRORM.DOC
i
DEEP.OBSERVATIONHOLE LOG Hole
Depth from Soil Horizon Soil Texture. Soll•Color` Soil'
(USDA) (Munsell) Mottling (SWeture;Stones,Boulders:
Surface'.(i v,.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surfac4in.) (USDA) (Munsell) Mottling (Structure,Stones Boulders.
CV, Mg
DEEP`OBSERVATION'HOLE LOG Hole#
%N from... Soil'Hdrizon Soil Texture. Soil Color. Soil Other
SurFace:(in,) (USDA) (Munsell) Mottling (Structure;Stones,Boulders.
Consistency.WOraVell
�Z-3� �j t✓S L6
5/0
-t3 G S ZL •
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color . go" Other
Surface'.(ia;) (USDA) (Munsell) Mottling (Structure,5toies Boulders,
fj --j 2 � - L 5 I B �� Z •
fZ- CS
Flood,Ii urance:Rate 1VIaM..
Above SDO year°flood boundaryy No Yes ---
J
V✓ithlo SOU.year"boundary No Yes
within f(j6' r flood boundary No— Yes_._.
De; th of Naturally Occtirrfn�Pervious Maierfal
Dobs'at least four,.feet.of naturally occurring pervious material�xisrin all areas observed throu�haut,the
area proposed for.the sotlabsorphon system?
If.not,:what.is the depth'of naturally occurring perv' us material?' �.._.
Oertiff� cation
I cerpfy that on ( � (date)I have passed the Soil.evaluator examination approved by the
Department of Enviro mental Protection and that the above analysis was performed by me consistent with .
,...
the requtr-ed traintn ,expertise and ex perience•descnbed to 10'CMR 15.017�:
Date &1�—y
..Signature: •
N.S. CFORM.DOC
II
Town of Barnstable
�tHE Tp�
�, do Regulatory Services
Thomas F. Geiler,Director
BaRi STABM •
Public Health Division
' � .i639.. ♦0
NrEp�A-
Thomas.McKean,Director.
200.Main Street,Hyannis,MA 02601
Office:..508-862-4644. Fax: 508-790-6304
October 4, 2006
Ms.Diane Roper
10 Elm Street
Milton, MA 02186
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5.
The septic system owned by you located at 41.Shell Lane,Cotuit,MA was last inspected
May 9th, 2006 by Robert a. Paolini, a certified septic inspector for the State.of
Massachusetts.. -
The inspection of your septic system showed that your system"Failed"under the
guidelines.of 1995.TITLE 5.(310 CMR 15.00)due to.the.following:
Cesspools.are collapsing (very undstable)need.to be replaced.
You were given 2 years from the date of the system failure to.bring the system into
compliance...As.of this.date.(10/2/06 we have not been informed of any repairs done to
the system in order to bring it into.compliance.
If there are any questions.about this reminder,please feel free to.contact the.Barnstable
Health Department..
BARNSTABLE HEALTH DEP TMENT
T omas A..McKean, R.S., H.O.
Agent of the.Board of Health
IQ Town of Barnstable Barnstable
. . �; Regulatory Services Department AWWWWaCj
BARNgrABM
"1A8S Public Health Division m
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Final Order
02/17/09
Diane Roper
10 Elm St.
Milton, MA
02186
re: 41 Shell Lane
Cotuit, MA
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located at 41 Shell Lane. Cotuit, MA was last
inspected 5/9/2006 by Joseph P. Macomber and Sons, Inc, a certified septic inspector for
the State of Massachusetts.
The inspection of your septic system showed that your system"Failed" under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"Cesspools are collapsing (very unstable) need to be replaced."
You were given two years from the date of inspection to bring the system info
compliance. As of this date (2/0"9) we have not been informed of any repairs done to
the system.
You have 60 days from 02/17/09 to bring the system into compliance.
Your may request a hearing before the board of health,a written petition requesting
a hearing on the matter, with in seven days after the day this order was served..
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action. Any person who shall fail to comply shall be fined not less than
$10.00 no more than $500.00. Each day's failure to comply with an order shall constitute
a separate violation.
BARNSTABLE HEALTH DEPARTMENT'
Thomas A. McKean, R.S., C.H.O.
Agent of the.Board of Health
rU For delivery information visit our website at
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PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047
i Ok
Town of Barnstable
do Regulatory Services
* BARNSTABLE, Thomas F. Geiler, Director
69: •�� Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Final Order
02/09/09
Diane Roper
41 Shell Lane
Cotuit, MA
02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located at 41 Shell Lane. Cotuit,MA was last
inspected 5/9/2006 by Joseph P.Macomber and Sons, Inc, a certified septic inspector for
the State of Massachusetts.
The inspection of your septic system showed that your system"Failed" under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"Cesspools are collapsing (very unstable) need to be relpaced."
You were given two years from the date of inspection to bring the system into
compliance. As of this date (2/09/09)we have not been informed of any repairs done to
the system.
You have 60 days from 02/09/09 to bring the system into compliance.
Your may request a hearing before the board of health, a written petition requesting
a hearing on the matter, with in seven days after the day this order was served..
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action. Any person who shall fail to comply shall be fined not less than
$10.00 no more than $500.00. Each day's failure to comply with an order shall constitute
a separate violation.
BARNSTABLE HEALTH DEPARTMENT
i
Thomas A. McKean, R.S., C.H.O.
Agent"of the Board of Health
: Town of Barnstable
CF THE Tp�
do Regulatory Services
SFAB Thomas F. Geiler, Director
MASS
9�A1639. •�� Public Health Division
• rFD MA'S A
Thomas McKean,Director
200 Main Street,Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
July 31, 2006
Ms Diane Roper
41 Shell Lane
Cotuit, MA 02635
SECOND NOTICE
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located 41 Shell Lane, Cotuit,MA,was last inspected
on May 9tht'2006 by,Robert A. Paolini, a certified septic inspector for the State of
Massachusetts.
The inspection of your septic system showed that your system had"Failed"under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:,
Cesspools are collapsing (very unstable) need to be replaced.
You were given 2 years from the date of the of the system failure to bring the system into
compliance. As of this date ( 7/31/06 )we have not been informed of any repairs done to
this system in order to bring it into compliance
If there are any questions about this reminder,please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEALTH PARTMENT
c ean, S., C.H.O.
Agent of the Board of Health
Town of Barnstable
do Regulatory Services
saxxsrnsLE Thomas-F. Geiler,Director
"9. •• Public Health Division
TED MA'S A
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
May 15, 2006
Ms Diane Roper
41 Shell Lane
Cotuit, MA 02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located 41 Shell Lane, Cotuit,MA,was last inspected
on May 91h, 2006 by, Robert A. Paolini, a certified septic inspector for the State of
Massachusetts.
The inspection of your septic system showed that your system has "Failed"under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
Cesspools are collapsing (very unstable) need to be replaced.
You have 2 years from the date of the system failure to bring the system into compliance.
If there are any questions about this reminder,please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEALTH D ARTMENT
Thomas A. McKean, R.S., C.H.O.
Agent of the Board of Health
I
DATE 5/9/06
PROPERTY ADDRESS 41 shell Lane
Cotuit
MA 02635
On the above date, the septic system at the address above was
Inspected.
This system consists of the following:
�. 2-6X8 Block cezzpoo2z 1-6X8 ce zpooi
Based on Inspection, I certify the following conditions:
2., 7h.is .ins not a 7i.t 2e Five zeptjic .sy-5tem., It .i-s ¢ .sewage zyztem
3., Sept.ic �5y-stem .i.a .in P-a.iiuze Both eess/2ooez aize caving .in and
ve2y un.etag.2e.
SIGNATUR
Name: Robert A. Paolini
Company: Joseph P. Macomber & Son Inc . j =
Address: P. O. Box 66
Centerville. Mass 026325.
r
Phone: 508-775-3338 or 508-775-6412 M
JOSEPH P. MACOMBER & SON, INC.
Tanks-Cesspools-Leachfields
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 026.32-0066
775.3338 775.6412 '
•
COMMONWEALTH OF MASSACHUSETTS
EXECUTNE OFFICE OF ENVIRONMENTAL AFFAIRS
> DEPARTMENT OF ]ENVIRONMENTAL PROTECTION
a
TITLE 5
OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART-A
CERTIFICATION
Property Address: .. 41 Shell Lane
Cotuit MA 02635
Owner's Name: Diane Roper
Owner's Address: Sam _
Date of Inspection: 5.1 A f n ti
Name of Inspector:(please print) Robert. A P o.ini
.:
Company Name:.9. ?.Pacoa�.ea .. So.n Inc.
Mailing Address:_PAY .66
:en eav14 e, 7 a-s.s. 02632
Telephone Number: 5 0 8-7. 7 5:3 3 3 8
CERTIFICATION STATEMENT
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 15:000j The system:
Passes
Conditionally Passes
Deeds Further Evaluation by the Local Approving Authority
F '
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.
Notes and Comments
""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 diffaregt
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11
OFFICIAL INSPECTIONYORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM !'
PART A
CERTIFICATION (continued)
Property Address: 41 Shell Lane
Cotuit MA ..02635
Owner: Diane Rover
Date of Inspection: 5/9/0 6
Inspection Summary: Check A,B,C,D or B/ALWAYSVeomplete�all of Section:D
A. System Passes: NO
S 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.-
NO 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 approyed�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.
NO 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:
NO 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 pipes)are replaced
obstruction is removed
distribution box is leveled'orreplaced
ND explain:
NO 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:
2 .
Page 3 of 11
OFFICIAL-INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 41 Shell .Lane
o ui
Owner:. Diane Reiner
Date of Inspection: 5 f 9/ ti
C. Further Evaluation is Required by,the Board of Health-
NO Conditions.exist which.require further evaluation by the Board.of Health in order to determine if the system
is failing to protect 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:
n Cesspool or privy is within 50 feet of a surface water
1L1)Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
e.
Z. 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:
noThe system has aseptic tank and.soil absorption system(SAS)and-the SAS is within 100 feet.ofa
surface water supply or tributary to a.surface water supply.
ao' The:system has a septic tank and SAS and the•SAS is'within a Zone 1 of a public watersupply.
The system has a septic tank and.SAS and the SAS is within 50 feet of a private water supply well.
no The system has aseptic tank and SAS and the SAS is less than 100 feet but 50 feet or more fronl a
private water supply well". Method used,to determine distance i ;,61,cr e.
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from!that facility 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:
3
f
Page 4 of 11
OFFICIAL INSPECTION FORM:NOT FOR:VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART.A
CERTIFICATION(continued)
Property Address: 41 Shell Lane
rnt»i t MA n2635-
Owner: Di anP Rn=Pr
Date of Inspection: 19 ()6
D. System Failure Criteria applicable to all systems:.
You must indicate"yes"or"no"to each of the following.for all inspections:
Yes No
x 'Backup of sewage-into facility or system component due to overloaded.or clogged SAS or cesspool
X Discharge:or ponding of effluent to the surface of the.ground or surface.waters due to an•overloaded or
clogged SAS or cesspool
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
x Liquid depth in cesspool is less than 6"below invert or available volume is less than'%.day flow
y Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
X 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 wgter supply.or tributary to a surface
water supply:
X Any portion of a cesspool or privy is within a Zone 1.of a:public well..'
X Any portion of a cesspool or privy is within.50 feet of a privat6Lpater 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 coliform bacteria and volatile organic compounds
indicates..that the well is free from pollution from that facility 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 fora.]
NO (Yes/No)The system fails.I have determined that one or:morefof the:above.failum,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 1.0,000 gpd.to 15,000.
gpd•
You must indicate either"yes"or"no"to.each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
X the system is within 400 feet of a surface drinking water supply
_ x the system is within 200 feet of a tributary to a surface drinking water supply
-X— the system is located in a nitrogen sensitive area(Lnterim 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 r
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.
4
Page 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL:SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 41 Shell Lane
Cotuit MA 02635
Owner: Diane Roper
Date of Inspection: s 19/o 6
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
X Were.any of the system components pumped out in the previous two weeks?
_ X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
N.,A4 Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X Was the facility or dwelling inspected for signs of sewage back"lip
V _ Was the site inspected for signs of break out
IV _ 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:
Yes no
X Existing information.For example,a plan at the Board of.Health..
x _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.3020)(b)]
..
5
Page 6 of 11
OFFI:CIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT'S
SUBSURFACE SEWAGE DISPOSAL-SYSTEXINSPECTION FORM �
PART C
SYSTEM INFORMATION
Property Address: 41 Shell Lane
Cotuit MA 02635
Owner: Diane Roper
Date of Inspection: 5/9/0 6
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): Z Number of bedrooms(actual): 2
DESIGN flow based on 310 CMII';15.203(for example: 110 gpd x#of bedrooms): 2 P 0
Number of current residents: 0
Does residence have a garbage grinder(yes or no):aQ
Is laundry on a separate sewage system(yes or no): [if yes separate inspection required]
Laundry system inspected(yes or no):LLe z
Seasonal use?(yes or no): .0 • . Z004-1, 0.00 .ga22ons G%D=2.,74
Water.meter readings,if available(last 2 years usage(gpd)):2 n o 5- 2. 0 0.0-ga i i o n s y%D=.5 4 8
Sump pump(yes or no):
Last date of occupancy:
COMMERCIAL/ USTRIAL
Type of estabti�sia
ment: NI R
Design flow on 310 CMR 15.203): avd o
Basis of d�sign'flow(seats/persons/sgft,etc.):.,
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):_
Non-sanitary waste discharged to the Title 5 system-(yes or no):_
Water—meter readings,if available:
Last date of occupancy/use: .
OTHER(describe):.
GENERAL INFORMATION
Pumping Records
Source of information: N/4
Was system pumped as part of the inspection(yes or no):_
If yes,volume pumped:_gallons--How was quantity pumped determined?
Reason for pumping: .
TYPE OF SYSTEM
_Septic tank,distribution box,.soil absorption system
A Single cesspool
A 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)
_Tight tank. _Attach a copy of the DEP approval
—Other(describe):
Approximate age of all components,date installed(if known)and source of information:
oa.ig.inai zurt2m 1949
Were sewage odors detected when arriving at the site(yes or no):_am
6
Page 7ofII
_ OFFICIAL INSPECTION FORM—NOT FOR-VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 Shell Lane
Cotuit MA' 02635
Owner: Diane Roper
Date of Inspection: 5/9/0 h
BUILDING SEWER(locate on site plan)
Depth below grade: 22"
Materials of construction:_cast iron _40 PVC_other(explain): c.2au. t.i.ee
Distance from private water supply well or suction line: 2 D f
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK:no (locate on site plan)
Depth below grade:
Material of construction: concrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age:- Is age confirmed by a Certificate of Complianee(gees or no):_(attach a copy of
certificate)
—` Dimensions:
Sludge depth:
Distance from.top of sludge to bottom of outlet tee.or baffle:
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:
How were dimensions determined:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid.levels
as related to outlet invert,,evidence of leakage,etc.):
Sel2t.ic .tank :iz not Paezent
GREASE TRAP:NO(locate on site plan)
Depth below grade:
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:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
Gaea se .tea .i. not /ze seat
r
7
Page 8 of 11
OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 Shell Lane
Cotu t MA 02635
Owner: Diane Roper
Date of Inspection: S(9/0 6
TIGHT or HOLDING TANK: no (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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes.or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
Tight o.z hoiding. tank '.iz not pzezent
DISTRIBUTION.BOX:NO (if present must be opened)(locate on sitd`plan) .
Depth of liquid level above outlet invert:
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.):
dizt,ziguiinn Pox 1A nnf nna6bai
PUMP CHAMBER: NO (locate on site plan).
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Pump can2eea i. not Raesent
8
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued).
Property Address: 41 Shell Lane
Cotuit MA 02635
Owner: Diane Roper
Date of Inspection: 5/9/0 6
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Located see 12age' 10.1
Type
leaching pits,number:_
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
l_overflow cesspool,number:_—I
innovative/altemative system Type/name of technology:
Comments(note condition.of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
Loamu to medium nand., No a.ignz o� Rond.ing zo-iizaze
day-iVpgelafann aA aoamaLi. ce64R001 iz caving in.,
CESSPOOLS:_y_"(cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: .077a
Depth—top of liquid to inlet invert:
Depth of solids layer: (�
Depth of scum layer: (�
Dimensions of cesspool: )C�.
Materials of construction: Co _(
Indication of groundwater inflow(yes sir no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
Soiiz ate d/CU , vegetat-ion -iz n0 mn0 ,9 .snno0,6 O/ID roDdna in i
PRIVY: NO (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.):
a.ivy .iz not pnesent
9
r
Page 10 of 1 I
OFkCIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUASURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
l PART C
�.. SYSTEM INFORMATION(continued)
Property Address: 41 Shell Lane
Cotuit MA' 026T
Owner: Diane Roper .
Date of Inspection: 519106
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.:
tp
9 ?`
i
• � j
10
Pa$e 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 Shell Lane
Cotuit MA 0263S
Owner: Di aAe Rop Pr
Date of Inspection: S�f n
SITE EXAM .
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plants on record-If checked,date of design plan reviewed:
u e z Observed site(abutting property/observation hole within 150 feet of SAS) fi
c, Checked with local Boazd:uf Health-explain:a s a i p t e_azd
n o . Checked:with local excavators,installers-(attach documentation)
i�e_s Accessed USGS database=explainAt;CP:t own: 9aAn zi aI.2 me.,u s
~, You must describe how you established the high groundwater elevation: *'
Uzed. : Cape Cod Comm.izion tdatea 7agie Cohtouaz And %uliic Glatea Suppiy
Oete head paotect.io•n. ..a/teas .map.- Sept 1995
Vatea aesouacez oielice cape cod eomm.izion.-
Tbp of Ground
Leaching
Pit 'Feet
Groundwa 1 Feet Be y• low Bottom Pit High Groundwater Adjustment 1.8 ft per Frimpter Method
Therefore,the.vertical.separation dlstanee between the bottom
of the leaching pit and the adjusted groundwater table is � f_�
feet: - (d t0
TOWN OF BARNST BLE 130ARD QF II8A1,T1I
agUI)SURFACR 8%WA0H DISPOSAL SYSTEM I BPECTION FORM .. PART D CERTIFICAT-110N
~•T"'*•`'"^^'"`'9E""'"1°""�" TYPE 01 PAINT M ARLY—
PRO•PERTY IN•SPFCTED
STREET ADDRESS 41 Shell Lane Cotuit 02635.
ASSESSORS MAP, DLO.SK AND -PARCEL —
OWNER's NAME Diane. Ro r
PART` D CHRrXFX0AT30N
NAME -OF INSPECTOR
COMPANY NAME
oza h :n.� P1aaoMle :San Inc
Box 66 ' Cen�.eavj a ee Oazh•.026 32 ,
COMPANY ADD.R.ESS... . scr� I' lotim orCity. A906 L P
COMPANY TELEPHONE ( 508. ! fi73 - 3338 FAX , .508', '90 f 578 .
CERTIFICATION. STATEMENT
i certify that I hhave personal.-ly ..ins•pected .tie sewage •di1jpoAal. system at
this address. and that• tliie' information reported .is true,. gocfta•te-p and
omplete as of the tithe .of•sinspeotion., The impeotion was performed and any
nt
recommendations regard-ing enceain th@np�coperefuncti�•onparid •tnainten.$anoeeof on-
site my training and exppri
site sewage disposal. systems. ,
Check one; '
Systecl PASD • .
The inspection which I have •oonduoted has ,,nvt- •fo4nd any information .
which indicates that the system fails to '.adequately. protect .public
health or the enviropment as defined Lo- .310 CMR. It 30.3•i -Any failure
criteria *.6 ••evalunhed are. as staffed in the FAILUttE CRI`i'RRIA -section o.f
this, form.
System FAILED*
The inspection which I have 06ndritted -has'-1ound that the system fails to
Protect the public Iiealttl And the enV+ ronmen•t in aogeVd•enee with Title
61 310 CMR 15 . 305, and as • specifically noted on -PAT' C FAILURE
CRITERIA of this inspection -f oyzj '
Inspector. Signature' Dato
)7� copy of this eeetl f i.cativn must 'be grovi'ded :to :the •OWNM, BUYER'
where spPli.oab1*) and th!i 131PARD OF HEA Ttl• ..
* If the inspection FAIL'Eb,, thb .owno�' .oroperator •el.ha11 . upg•s?e►de'•the system•
within dne year of the date the inspection, unlesa. al-lowed ar regia#.,rod
^EhArw{ae as Provided in qAO CMR
of
�co
OFFICIALFor delivery information visit our website at www.usps.come
`; Postage $ ..39 \
CCertified Fee
Return Receipt Fee �, _ /✓� `� Po 1
M (Endorsement Required) p
O Restricted Delivery Fee \� v�i a�
•D (EndorsementReguired) ��j
r ,` t Og
r9 Total Postage&Fees
Ln
O Sent To
r_ Street Apt.No.;
or PO Box No. ,(�
--------__l,/�y�_�'_Se--_.--------- —
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City,State,Z/P+4PS Form
:00 June 2002
(v
Certified Mail Provides:
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e NO INSU.fiANCE.COVERAGE IS PROVIDED with Certified Mail. For
valuables;please consider Insured or Registered Mail.
■ or an additional fee,a Return Receipt may be requested to provide proof of
'delivery.To obtain Return Receipt service,please complete and attach a Return
'Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
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Internet access to delivery information is not available on mail
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Postal ServiceTM
cc • , • •
M
f11. Only;
F6r;j delivery information visit our website at%wmw.usps.coma
Postage $ S Mq o
0 ,rt Certified Fee
0 Return Receipt Fee I� On�P H mark
t
(Endorsement Required) 5/ v 4-2006
0 Restricted Delivery Fee
.0 (Endorsement Required)
r�1
Total Postage&Fees �o USPS
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or PO Box Afo
City,State, ✓O
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Certified Mail Provides: (asranay)zooZ eun
■ A mailing receipt Noose-04 Sd 1
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valuables,please consider Insured or Registered Mail.
■ For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt servioe,'please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
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required.
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endorsement"Restricted Delivery". .
■ If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed to APOs and FPOs.
Post I Service,.
CERTIFIED MAILT. R ECEIPT —7
M1 (Domestic hiail Only;'No Insurance Coverage Provided)
rR
m OFFIC
IAL SE
-
ra
C Postage $ .� 71
026do!
Certified Fee
o •dry ,
E3 Retum Receipt Fee �/,�/' F f Postma�d�0 1.
(EndorsementRequirod) a f v _ VG Hefe
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_a (Endorsement Required)
Total Postage&Fees '(�
Ln Sent To
f Street t No.;
'LP7 ---... - --------------------•-•-
or PO Box No.
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City,State,ZlP+4 ---------------�"^
i
Certified Mail Provides:
■ A mailing receipt (asJanay)Zooz eunf'ooes wJ0J Sd
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■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail&
e Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
■ For an additional fee,a Return Receipt mar be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted-Delivery".
■ If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed.to APOs and FPOs.
i.
UNITED STATES POSTAL SERVICE _................................... .-
First.Class ,;,,,.. .
Po�ge" :Fis'is: aid ".
USPS....:: .:...::...:.:.::
I • Sender: Please print your name, address;,`and-ZIP+4-.1n,this -
I
I
PUBLIC HELATH DIVISION
TOWN OF BARNSTABLE
200 MAINSTREET
HYANNIS, MASSACHUSSETS 02601
ff i�i ?fi i {fff t ��
Itt?i??iFf!? 33??i ?iff3ff1fff fill 1ff1Fi?H1:111:?3 ff
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signetu
item 4 if Restricted Delivery is desired. V
d A t
IN Print your name and address on the reverse X ddressee
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
N Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
If YES,enter delivery addreOs`` lC Ns TpN o
�O
/D 6&L� I Service Type r1,G ti
0 / / ❑Certified Mail ❑ F�tp Asa �$�
❑ Registered ❑ Return Rgge:i ,t,o Merchandise
9 ��.p
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number_ 7005 1160 0000 0191; 1208
(transfer from servlce label).
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540;
_ . I
MAIL.
Town of Barnstable
o 11 -YC
• Public Health Division F
ST
• 0a 200 Main Street
Hyannis, MA 02601 ` 7 wnaev eowEs
t 0004606238 $ 04 640
7005 1160 0000 0191 1734 MAILED FROM ZIP CODE 0 2 6 01
Ms Diane Roper
n� 41 Shell Lane
' I Cotuit, MA 02635
RETURN >NXXXE 029 1 02 08/10 06
>�� T S�
E'7'U)�N TO SENDERI AT- E
mpYgo NOT KNOWN
UNAOL.E TO FORWARD
mc: 02601400200 *0969— 0116.-04—e40
_ r no lll, I,1,II.►!1 ll,I II)IM11MIJI,III„s IMI1.)Id
li
\ •ER: COMPLETE THIS SECTION • • ON DELIVERY
I ■ Complete items 1,2,and 3.Also complete A. Signature I ';-
item 4 if Restricted Delivery is desired. ❑Agent
j ■ Print your name and address on the reverse X ❑Addressee I
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
E Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
I 1. Article Addressed to: If YES,enter delivery address below: ❑ No
I I
I �
I
I Ms Diane Roper
4R-6hell Lane 3. Service Type i
i I Cotult, MA 02635 ❑Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise I `
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number - 7005 1160 0000 0191 1734
(Transfer from service label)
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
Town of Barnstable
FTHE laY
o Regulatory Services
snxrrsrns Thomas F. Geiler,Director
�$ . •�� Public Health Division
iOrED�+°i
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
July 31, 2006
Ms Diane Roper
41 Shell Lane
Cotuit, MA 02635
SECOND NOTICE
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located 41 Shell Lane, Cotuit,MA,was last inspected
on May 9thth 2006 by, Robert A. Paolini, a certified septic inspector for the State of
Massachusetts.
The inspection of your septic system showed that your system had"Failed"under the
guidelines of 1995_TITLE 5 (310 CMR 15.00) due to the following:
Cesspools are collapsing (very unstable) need to be replaced.
You were given 2 years from the date of the of the system failure to bring the system into
compliance. As of this date( 7/31/06)we have not been informed of any repairs done to
this system in order to bring it into compliance .
If there are any questions about this reminder, please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEALTH PARTMENT
C5c ean, S.. H.O.C.
Agent of the Board of Health ,
'T t" ff.. yaw 4-�1 f: (f ��. �' _ .,Fi.. — • .. ,. .,. .Grr ,s , :,.
PLACE STICKER A-F�TOP O'F ENVELOPE TO THE RIG
RIFTLkRNADQBESS,.FQLDATDOT7E0 LINE
IF
Town of Barnstable I y�pSPCsr,�
Public Health Division o �"
200 Main Street 3
PITNEY BOWES
Hyannis, MA 02601 $ A c4
\ 0004606238 MAY 6�20 6
.\ 7005 1160 0000 0191 1178 MAILED FROM ZIPCODE 02601
l Ms Diane Roper
' i 41 Shell Lane
Cotuit, MA
Nxx2E 029 1 0.2 OS,/19,E+06
RETURN TO SENDER
ATTEMPTED - NOT KNOWN
LJNA6I_E TO FORWARD
• DO: 02601400200 *0969-06720-17--39
V i- ...r... •.
0aeoiC�+4c+o2 111,,,►,I,I,U„11„,,,,11,1„111,,,I1,,,,,I,111,,,11,,,,L1,1
I
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A: Signature
item 4 if Restricted Delivery is desired.,�r e z. ❑Agent
■ Print your name and address on.the•reverse X L ❑Addressee
I .,. 1.a
l
SO that we Can return the Card to you. B.Receroed by(Punted Name) C. Date of Delivery �
■ Attach this card to the back of the,rnailpiece 44 ;
or on the front If-space permits"'""
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If,YES;•enteiddelivery address below: ❑ No
3. Service Type
����"�"• �j�/� Q��— / ❑Certified Mail ❑ Express Mail
L�) ❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
/ 4. Restricted Delivery?(Extra Fee) QYes
2. Article Number
(Transfer from service label) 7 0 0 5 116 0 0000 0191 117 8
: PS Form 3811,February 2004 Domestic Return Receipt 259 -02-M-1540 I
\
Town of Barnstable
CF THE T�
o Regulatory Services
saxxs,AB Thomas F. Geiler, Director
9�A 1639.MASS. Public Health Division
lFD MAC a
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
May 15, 2006
Ms Diane Roper
41 Shell Lane
Cotuit, MA 02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located 41 Shell Lane, Cotuit, MA,was last inspected
on May 91h, 2006 by, Robert A. Paolini, a certified septic inspector for the State of
Massachusetts.
The inspection of your septic system showed that your system has "Failed"under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
Cesspools are collapsing (very (jnstable) need to be replaced.
You have 2 years from the date of the system failure to bring the system into compliance.
If there are any questions about this reminder,please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEALTH D ARTMENT
Thomas A. McKean R.S. C.H.O.
Agent of the Board of Health
;,
., 9
CERTIFIED MAIC.
P pp ENE Town of Barnstable '. - _ .Mpg paSrQ
Public Health Division
BARNSTABI.E. ` 2 }
Y NASS. 0P GOO Main Street
$AJED MP�P a Hyannis,MA 02601 =MEMMOVPITNEY BOWES
' 000460.6238 FEB05-320
7008 1830 0002 0500 8277 MAI LED FROM 21P CODE 02601
e
L--ee-.n -e,
C, m A
V
RPTURN TO SENDER
NOT DEL,Ib'):iR ADL E AS ADDRE:sSCO
rS'�91 :r,rzi -.S '+`i'!` .V,;.}U'_ . Sc
,� 02801m-4C) .2 �?1,,,,,1,1,11„)1,,,,,,)),1,,1)),;,11,,,,,1,111,„11`,�„1,111
i SECTION ---�--
y.
. . _
MPLETE THIS SECTION COMPLETE THIS @ ,
I ■ Complete items 1,2,and 3.Also complete A. Signature I
f I item 4 if Restricted Delivery is desired. X ❑Agent
■ Print your name and address on the reverse ❑Addressee
f y so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
{ I ■ Attach this card to the back of the mailpiece,
> i or on the front if space permits.
D. is delivery address different from item 1? ❑Yes
� I '
1. Article Addressed to: If YES,enter delivery address below: ❑No
MA -;�01 rvice Type
l� Certified Mail ❑Express Mail "
OZ, &3� ❑Registered ❑Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes I
12. Article Number 7008 1830 0002 0500 8277
(rransmr from service.labeq I
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M.1540 I !`
Town of Barnstable
u�, o Regulatory Services
snx�vsrns Thomas F. Geiler, Director
y Mnss $
�bplf1639. Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Final Order
02/09/09
Diane Roper
41 Shell Lane
Cotuit, MA
02635
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
i
- The septic system owned by you located at 41 Shell Lane. Cotuit, MA was last
inspected 5/9/2006 by Joseph P. Macomber and Sons, Inc, a certified septic inspector for '
the State of Massachusetts.
The inspection of your septic system showed that your system"Failed" under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"Cesspools are collapsing (very unstable) need to be relpaced."
You were given two years from the date of inspection to bring the system into
compliance. As of this date (2/09/09) we have not been informed of any repairs done to
the system.
Y 6 d, _, 2 n91/09 t 1, g th of intn
1OU11aV�" tn:, d3s-�i�39TI"��/L'�iw �C�v:1T:a .,..eSy.,.�11�-___�_ C0117JltapCP..
Your may request a hearing before the board of health, a written petition requesting
a hearing on the matter, with in seven days after the day this order was served..
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action. Any person who shall fail to comply shall be fined not less than
$10.00 no more than$500.00. Each day's failure to comply with an order shall constitute
a separate violation.
B ABLian.,R
E TH DEPARTMENT
(�2s A. .S., C.H.O.
Agent of the Board of Health
�l School St APN 19-130-001
N 94
�. cow 93.00 S93 25K }
a 66.00' STK TK
� Sao Z / 94.03
a /
�y APN 19-127
0.33 Ac.t
2a + 92.28
Ocean
f APN 34-002 ;
Shell Lane /
y /
LOCUS 19 93,07 /
0
LOCUS MAP RESER "
NOT TO SCALE _3 j � N 94.55
9 09 1 AREA 93,01 1-
-- 98 -- EXISTING CONTOUR I 1 �°'
x 100.98 EXISTING SPOT GRADE \� 1 23
I. , 22,
102 PROPOSED CONTOUR .PROP _ v 0
S.A.S.-::i 7P�2 C
-W EXISTING WATER SERVICE a 15 3.52 /v
-O:H.•W.-OVERHEAD WIRES
TEST PIT
BENCHMARK PROPOSED SEPTIC TANK
- LEGEND qW A -
• � IJ; 0 x 094.79 0 00 /
o O /
°`�� Q 95.87 24'
BENCHMARK SET - � APN 19-093
OUTSIDE CORNER OF N�� 974 i'�
CONCRETE SHOWER PAD +f + 97,72 N
EL.=97.91 (ASSUMED DATUM) _ _y�l
t` �� .. 97.35
.08 \� 04
97.83
PROPOSED SEWER CONNECTION + 96. 8
TIE IN AT, OR ABOVE, INV.=93.0
(INSTALL CLEANOUT)
cP� + 9 .10 + 7 ��
7.91 _ 1
�� EXISTING CESSPOOLS
/- 7 669 67 (FROM RECORD AS-BUILT)
9 96 I + 9 ,7 98 0 CONTRACTOR SHALL LOCATE,
IPUMP AND FILL WITH SAND
8.9 '+ .07
DECK 9 .16
IP FND
' PROPOSED SEWER CONNECTION
100,03 x TIE IN AT, OR ABOVE, INV.=93.0
9+6o HOUSE(#41)
TO.F.=102.34f - -----aoo
100.48
PLAN REFERENCES: 10 .51+
LAND COURT PLAN 15287 A +
PLAN BK 38 - PG 117 DIRT 10 .04
PLAN ',BK 140 - PG 37 /
PLAN BK 169 - PG 63 DRIVE // BRICK #_ 3 =10 0
PLAN BK 563 - PG 50 05 10.0.02 WALK + DRIVE
I
FOUNDATION CERTIFICATION / 100.34 TOp
1159 MAIN STREET, 9/23/05 /
PLOT PLAN OF 45 SHELL LANE
BENNETf ENGINEERING, 3/11/09 %+ 5 3 I 100. 9
CB/dh 9 9 97 100.09 . 110 F61`�D
t 99.60 100.00
99,72 99,80 edge of pavement ? 1 99.65
GENERAL NOTES: 99.62 99.55
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL HELL LANE
BOARD OF HEALTH AND. THE DESIGN ENGINEER,
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS V OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 11
LOCAL RULES AND REGULATIONS.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR •••
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE �F Mgss
DESIGN ENGINEER.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ya`� tiG
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o PETER T. s
ENGINEER BEFORE CONSTRUCTION CONTINUES. MCENTEE �-
5. ALL ELEVATIONS BASED ON ASSUMED. v CIVIL '
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF No. 35109 OWNER OF RECORD
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF p Diane Roper
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
53 Cedar Pond Drive
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. E�
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. I //,) Walpole, MA 02081
9. ALL 'AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS Ic(/
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE p/�p PLAN
DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED SEPTIC SYSTEM UPGRADE f" N
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 41 SHELL LANE, >COTUIT MA
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Prepared for: D.A. Brown, Inc., P.O. BOX 145, Centerville, MA 02632
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). Engineering by: SCALE DRAWN JOB. NO.
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE Works, "=20' P.T.M. 127-10
INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. Engineering YY orks, Inc.
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. (508) 477-5313 3/26/10 P.T.M. 1 Of 2
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:91.0
FOR A DISTANCE OF 15' AROUND THE
PERIMETER OF THE S.A.S.
SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S.
PROVIDE TWO ACCESS MANHOLES TO WITHIN 3"
INSTALL RISERS & COVERS OVER INLET INSTALL WATERTIGHT RISER & OF FINISH GRADE FOR INSPECTION PURPOSES
T.O.F. AND SET TO 6" OF FINISH GRADE. - COVER SET TO 6" OF GRADE
R OVER OUTLET COVER
PROVIDE ACCESS TO GRADE
F.G. EL: 94.3 MAX.
EXISTING F.G. EL.=95.0t F.G.,EL: 94.3f ( )
f f /MNTAIN 2% GRADE (MIN.) OVER S.A.S.
L = 67(MAX.)' L = 14' L = 5'(MAX.)
® S=1% (MIN.) ® S=1% (MIN.) @ S=1% (MIN.)
4"SCH40 PVC ' ' '' 4"SCH40 PVC. 4"SCH40 PVC
6"
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INV.=92.25 O 48" LIOUID aaaaaaa
LEVEL ADD 4' S.2' 4'
INV.=91.67 INV.=91.50
GAS BAFFLE PROPOSED
INV.=92.00 D-BOX
EFFECTIVE WIDTH = 13.2'
INV.=90.50
PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS
SURROUNDED WITH STONE AS SHOWN
TIE IN TO EXISTING SEWER H-10 RATED
AT, OR ABOVE, INV.=93.0
TOP CONC. ELEV.=91.3t-
BREAKOUT ELEV.=91.0 r
INV. ELEV.=90.50 a eaa
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NOTES: BOTTOM ELEV.=88.50
4' 2 X 8.5'=17.0' 4'
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE
I R TO INSTALLATION.
5' MIN.. ABOVE BOTTOM OF EFFECTIVE LENGTH = 25.0'
INVERTS, PRIOR
! 2 SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO T.P. EXCAVATION OR. G.W.
�f ) � LEACHING SYSTEM SECTION
GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED NO GROUNDWATER, EL.=82.0 -
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2).
3) INSTALL INLET-& OUTLET TEES .AS REQUIRED.
4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" TO 1-1/2" DOUBLE
OUTLET TEE AND REPLACE IF NECESSARY. WASHED STONE
SEPTIC SYSTEM PROFILE
3" LAYER OF 1/8" TO 1/2"
N.T.S. DOUBLE WASHED STONE
(OR APPROVED FILTER FABRIC)
Td
23_�-1
'-� SOIL LOG
Ki i PROP. S.A.S.
�- DATE: MARCH 24, 2010 (REF. P#12867)
_ SOIL EVALUATOR: PETER McENTEE PE, (SE#1542)
WITNESS: DAVID STANTON R.S.
HEALTH AGENT
ELEV. TP_ 1 DEPTH ELEV. TP-2 DEPTH
- - 93.0- A .93.5...,A -
LOAMY SAND LOAMY SAND
92.0 10YR 4/2 12„+ 92 5 10YR 4/2
12
B B
LOAMY SAND LOAMY SAND
10YR 5/8 10YR 5/8
am 90.5 30" 91.0 30"
C1 C1
PERC
cD 36"/48"
00 MED. SAND MED. SAND
2.5Y .6/4 2.5Y 6/4
82.0 132" 82.5 1 1132"
NO GROUNDWATER, PERC RATE: <2 MIN./IN.
1 ELEV. TP-3 DEPTH ELEV. TP-4 DEPTH
BACK 93.1 A 0.1 93.7 A 0"
S.A.S. LAYOUT LOAMY /2. LOAMY /2D
DECK / 92.1 12" 92.7 12"
B B
DESIGN CRITERIA. LOAMY SAND LOAMY SAND
10YR 5/8 10YR 5/8
30" 91.2
NUMBER OF BEDROOMS: 2 EXIST. + 1 FUTURE = 3 TOTAL : 90.6 C1 C1 30"
SOIL TEXTURAL CLASS: CLASS I PERC
36"/48"
DESIGN PERCOLATION RATE: <2 MIN/IN
DAILY FLOW: 330 G.P.D. MED. SAND MED. SAND
DESIGN FLOW: 330 G.P.D. 2.5Y 6/4 2.5Y 6/4
GARBAGE GRINDER:
PROPOSED SEPTI TANK: 1500 GALLON CAPACITY
82.1 132" 82.7 132"
LEACHING AREA REQUIRED:
NO GROUNDWATER, PERC RATE: <2 MIN./IN.
.74
USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 41 SHELL LANE, COTUIT, MA
SIDEWALL AREA: 2(13.2' + 25.0') X 2 = 152.8 S.F.
BOTTOM AREA: 13.2' x 25.0' = 330.0 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
TOTAL AREA:............................................................. Engineering by: SCALE DRAWN JOB. NO..482.8 S.F. NTS P.T.M. 127-10
Engineering Works, Inc.
DESIGN FLOW PROVIDED: 0.74(482.8) = 357.3 G.P.D. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
(508) 477-5313 3/26/10 P.T.M. 2 Of 2