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0025 VINEYARD ROAD - Health
25 Vineivard Road _ Cotuit �J A = 016 023 TOWN OF BARNSTABLE LOCATION =),5 V!t-Lg 1e-�&� .tom SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL y j —G.). INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �Ati� .�- • t�CC���at� LEACHING FACILITY: (type) efK 1 C t 444f, (size) NO.OF BEDROOMS OWNER C?t�:b[.4 j PERMIT DATE: S- 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 LL oZL,c�AC— eF �c9 19 r JAN-07-2021 08:01 From: To:15087906304 Pa9e:1/1 _. . _..__.........____ .__._.__.___.._._........_...._._..............__.........—_..__--.___......__ Town of Barnstable Inspectional Services �sraeia, Public Health Division 03 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: ' �, Sewage Permit# au 9' Assessor's MaplParcel fipo Designer: Go,4LAts C,V, GinIE�Ri,t�G' Installer: C Address: 496' 19. / hI4 JT Address: J ' On lao was Issued a permit to install a (date) (installer) �� septic system at D IKD,67T17- based on a design drawn by s'T V-r (address) VIL E dated 3—,-L3-a2o (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. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. certify referenced above was constructed tla:Lrazplranth the terms of approv .-letters (if applicable) c�: Sell h", a (Install#'s Signature) 3 1/ �� • V:/Uv D signer s`Signature) (Affix Designer's Stamp Here PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE QF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THY FOAM AND AS- BUILT CARD ARE REgLIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANKYQU- Woaldeptsl[TEAL•1 MEWERwnnedUSEPT100aisna CeniFication Form Rcv SI4-I3.DOC N No. o� ... Fee 090"cx/8 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .,. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Misposar 6pstem Construction 3permit Application for a Permit to Construct Repair Upgrade Abandon pp ( ) p ( ) pgr ( ) ❑Complete System ❑Individual Components , Location Address or Lot No. D/4"� J Owner's Name,Address,and Tel.No. Assessor's Map/Parcel iYJ'�' i � ' P-,1M y Ins ler's Name,A &Vss,and Tel.No. 9t g 1! 7 f Designer's Name,Address,and Tel.No. P�-'�T i7T, k4 r / Type of Building: ,, �j Dwelling No.of Bedrooms L Lot Size 6l'h"I"I sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations( saver when applicable) va 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 a nd not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 1�1/JL4 Application Approved by Datel ,�'�� Application Disapproved b Date for the following reasons Permit No. U Date Issued 3llz,12-0z0 .; , ,:;.._.,�,;mom_,. ;•ri. �. � ... -* ._. �,, No. cs � A i Fee `' t/p�s` (. '✓ y Entered in'6omputer: ✓ THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION,- TOWN OF BARNSTABLE, MASSACHUSETTS ►�� application fo ]Disposal *pstrm ConstrUctiorC Permit ,_J Application for a Permit to Construct( ) Repair( ) Upgrade Y) Abandon( ) ❑Complete System ❑Individ"ual Components Location Address or Lot No. 0/40!d 0J Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Wrr l K64. Installer's Name,Address,and Tel.No. S�T-- -77 f - Designer's Name,Address,and Tel.No. jWrN W9IV7 Type of Building: rw:. a aA •a w 'q Dwelling No:of Bedrooms 46 Lot Size Af sq.ft. Garbage Grinder( `) Other Type of Building No.of Persons Showers( ) Cafeteria;(, )',w Other Fixtures Design Flow(min.required) gpd Design flow provided :'N. gpd Plan Date Number of sheets Revision Date Title t j Size of Septic Tank Type of S.A.S. Description of Soil • f 1.. Y Nature of Repairs or Alterations(Answer when applicable) - it p A a r Date last inspected: > Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal systerr_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 of Health. / Signed /'"`,�� �--`." ..,�,...... . Date Application Approved by_��. %_-,f-� � "' �"^^�--"�`^`• ' Date Application Disapproved bye"' lJ Date for the following reasons F. y Permit No. (�%� •^ �}` Date Issued .7//7/z-0-7 n THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Q � Certificate Of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded`(,) Abandoned( )by _ at has been constructed n'accordance / with the provisions of Title 5 and the for Disposal System Co struction Permit No.42(;?o- y dated Installer 3,a t rz-i' #bedrooms �'t' Approved design flow A Bq_ and The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date`. (� I, o Inspector i� 1,4•✓ '5i \J - - ----- - - -------------- - --- ---------------- ---- - - - -- ------------ - --No. c� 1), Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Nsposal 6pstettt Construction Permit Permission is hereby �granted lttoo�C/o�nsstruct( ) ",,�R,�e.,pair( ) Upgrade( Abandon( ) System located at �/,+� V 46 4 9v & i�o! . m A and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date � Approved by j i ell �...' EEEE6�1'GES I � . BARNSTABLE COUNTY REGISTRY OF LEE- LAND COURT CERT.1FICATE#22DD56 ) WID COURT PLAN I1542-%Y BARNSTABI.E ASSESSOR'S VAP!6,LOT 23 ' 20N.'4G: FLOOD EONS:X AND A£(EL.12) fEAA HRN 825001C0')52J RESiOENCE P(RF) EFFECTNE DATE JULY 16,2014 RESOURCE PROTECTION 04ERLAY Di5HC1'(PPOD) IRON!SET—X,.LAN.REOJ�REJ,85.5.40:.PROi9 0 SIDE SEIOAOX:15•uiN.REWREO,IE.0•UIN.NiOYiDEO R.SETBACK 15'4:X'.REWEiEO.203.5'-N. � PROPOSED LOT CP/ERAGE:12.4% 'SITE BENCHMARK: TOP Q CCNC MAP 16,LOT 31 'BOUND,EL: 16.05(NAVD 88) 54 LOWELL ROAD ;PROP05E0 SEPTIC TFN�C'� �� I'�� `P EXIS RNG LEACHING-BED F STL4G ONELUNG BE RAZED _ .2A \ I zt 6.6 0.22 ANNUAL CHANCE FLOOD ZONE , s ('!0u tEAR FLOOD EONE BOUNDARY ) 4RA`A } EXiSiI(NG t To Be DOGONEI bNm) •+,_ ����� .1T.6' J?oho\ ` J o° �,,, /_ t0 rtt // ,: /" • ', ill - .� - ''��yW� \ \ ¢r '�� 'ti..-_ -�i/,'!' / J °off - 5,:"D� _ r m Z c Locus r P 1 � __ r z 31G GE I� t MAP 16.LOT y ( l -.._ \� ��`/•\ �` ~,/,� '�� // 25 VINEYARD ROAD ` 69.401 S.F. R /r 7 O ld 1 v\^' o' '"'.., ''o. -�, .:r'-...".i �?j' Co , P' 1 ' r S � Ba00E0 �`- 201 acm`�a" e- :i��ti 1,\ ,/y `•,.Z, h ,- �C�� /, +`•11 PROPOSED B'STRAW WATTLE °' � / i NM 16.LOT 1 (STAKED EAERY 6') % l45 VINEYARD ROAD % 1 / w B Sc0le i" = 20' LEGEND PROPOSED BUILDING LOCATION PUN .40.3 almuc sRm nc/A1rox3 25 NINEY,ND ROAD 3-0-2r• R COTUR,L'.A P.O.BOX 95025.NEWTON,NA 02495 o¢am COWNS CIVIL ENGINEERING GROUP, INC.Paces o+.Awc xa "" BIi1INER86-PA[NOUSB-HEST BRIDGEAATEA.MA ,QP¢e1:B0i61A1N4-II. 808v2Y-LB.P.�vt69 BOBTit WIN eIV88t• BNDOeKlT60.W 0W]4 r 61 Co- Da,3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 25 Vineyard Road Law Property Address Burke f Owner Owner's Name information is required for every Cotuit ✓ Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms P on the computer, use only the tab Chad hathaway key to move your Name of Inspector cursor-do not HPS use the return key. Company Name P.O.Box 151 �4 Company Address Forestdale Ma 02644. Cityrrown State Zip Code �� 774 274 2581 12866 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 16.000);1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was,performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 5-1-19 Inspector's Signature Date The system inspector shall sub It a co f this inspection report to the Approving Authority(Board of Health or DEP)within 30 day ompleting 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 d Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. City/Town. State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: Septic in good working condition. No failure criteria was encountered during inspection 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 v Commonwealth of Massachusetts rs - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. City,Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ® Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every COtUIt Ma 02635 5-1-19 page. Cityl town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/2 6120 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code, Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 L -- f Commonwealth of Massachusetts ,ip Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health El ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened,.and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 t Commonwealth of Massachusetts Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. City?own State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 Description: Designed for 5-bedroom count is 3 Number of current residents: seasonal part time Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes Z No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2018-281,000 gallons 2017-239,000 irrigation is hooked up to town water and yard has larger then average lawn Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Catuit Ma 02635 5-1-19 page. City:?own State Zip Code Date of Inspection D. System Information (cont.) 2. Commercialflndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes,.discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: unknown Was system pumped as part of the inspection? ❑, Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts P Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection D. rSystem Information (cont.) 4. Type of System: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DIE approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2.25' feet Material of construction: ®cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 15+see asbuilt feet Comments (on condition of joints, venting, evidence of leakage, etc.): no evidence of leaks or poor venting t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . �� 25 Vineyard Road Property Address Burke Owner Owner's Name information is Cotuit Ma 02635 5-1-19 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade- 1.75 feet Material of construction: ® concrete ❑metal ❑fiberglass ❑ polyethylene ❑ other(explain) 1500 gal. H10 If tank is metal,list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No- Dimensions: 10'6"x5'6" Sludge depth: 411 Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 0 Distance from bottom of scum to bottom-of outlet tee or baffle 0 How were dimensions determined? 0 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tees in place. no signs of leaks or visable decay k _ 9 I t5insp.doc•rev.7/26I2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: I❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 13 Commonwealth of Massachusetts r� F Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 8. 'Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Dbox in good condition no cracks or major decay water level to bottom of outlets t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 13 Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System form -Not for Voluntary Assessments Y� 25 Vineyard Road Property Address Burke Owner Owner's Name. information is required for every Cotuit Ma 02635 5-1-19 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n : * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 9 x Type: ❑ leaching pits number: ® leaching chambers number: 4)500 gal. Chambers ❑ leaching galleries number: i ❑ leaching trenches' number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system T e/n yp ame of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts 1 p Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form Not for Voluntary Assessments 25 Vineyard Road Property.Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Chamber dug up and dry and clean inside no staining to indicate past failure. Chambers are H2O and located in driveway with no riser J 12. Cesspools (cesspool must be pumped as part of Inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owners Name information is required for every Cotuit Ma 02635 5-1-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form jo Subsurface Sewage Disposal System Form-Not for Voluntary Assessments <P' 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately �y �9 -HI D-T �k t5insp.doc•rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pa ge age 16 of 18 - Commonwealth of Massachusetts Ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. CitylFown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope Surface water ® Check cellar Z Shallow wells Estimated depth to high ground water: >12'feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2002 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: perc test no water at 12'or 144" bottom of leaching at 5' below grade Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts • - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments U 9 25 Vineyard Road Property Address Burke Owner Owner's Name information is required for every Cotuit Ma 02635 5-1-19 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked C. Inspection Summary: 1, 2,.3, or 5 completed as appropriate 4 (Failure Criteria)and 6(Checklist)completed D. System Information- For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection,Form:Subsurface Sewage Disposal System•Page 18 of 18 f4v A Crocker, Sharon From: Juliet Gil <juliet@atlanticbaycontracting.com> Sent: Thtarsday, November 21, 2019 12:40 PM To: Health Cc: Alien Young; Elizabeth Lopez Subject: Abatement 25 Vineyard Rd, Cotuit, MA 02635 Attachments: ANF100320074.pdf Good afternoon, Atlantic Bay Contracting Co., Inc. will perform an abatement project at 25 Vineyard Rd. Cotuit, MA 02635 on December 9-13, 2019. We have DEP's Asbestos Notification Form attached for your records. The scope will be to remove, label and dispose of: 1. Up to 1,500 SF of roof Asbestos Containing Material and 40 Sf of window glazing by method of exterior EPA Guidelines 2. 460 SF of Joint Compound by method of full containment. Please let us know if you have any questions or need additional information. Best regards, Juliet Gil, Business Development Manager Atlantic Bay Contracting 100 Hano St. Suite 23A. Allston, MA 02134 (617) 782-4986 www.atlantiebaycontractina.com https://Youtu.be/i,VrBEGsn-q This email may be confidential. If you are not the intended recipient, please notify us immediately and delete this copy from your system. Our staff may be part-time employees, please "Reply All" to make sure we respond to your needs on time or call the office directly. CAUTION: email originated from.outside of the Town of Barnstable) Do not click links,open attachments or reply,.unless you recognize the sender's email address and know the content is safe!'. 1 I Massachusetts Department of Environmental Protection >>� eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: ABCALLEN Transaction ID: 1154489 Document: AQ 04-Asbestos Removal Notification Form ANF-001 Size of File: 231.88K Status of Transaction: In Process Date and Time Created: 11120/2019:2:33:25 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection ULBWP AQ 04 (ANF-001) PreForm Asbestos Notification Form m r This is a revision to an existing form. Project ID for existing form to be revised: C This job is being conducted under a Blanket Permit. MassDEP assigned Blanket Authorization ID: r This job is being conducted under a Non Traditional Abatement.Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: r This job does not require the use of an asbestos contractor licensed by the MA Department of Labor Standards because(please check one box below): r This job involves breaking,shearing or slicing of non-friable asbestos-containing material only(e.g.cement shingles/panels,cement pipe,asphalt roofmg or siding,vinyl floor tiles,etc.)in a manner that does not generate asbestos dust or render the material friable,as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.13(2)(a)5.All work must be done in compliance with the applicable regulations at 310 CMR 7.15;or r This job involves work on asbestos containing material that is classified by the Department of Labor Standards (DLS)as a`Small-Scale Asbestos Project,' an`Asbestos-Associated Project',or an`Asbestos Response Action' by qualified`in-house' personnel as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.00,and will be performed in accordance with all the requirements of 453 CMR 6.13 (1)(a),'453 CMR 6.13 (2)(a)1.and 3., and 453 CMR 6.14(1)(a),as applicable. All work must be done in compliance with the applicable regulations at 310 CMR 7.15 r None of the above conditions apply,generate a new form. Revised: 11/13/2013 Page 1 of 1 Massachusetts Department of Environmental Protection - - 100320074 BWP AQ 04 (ANF-001) t, Asbestos Project#Asbestos Notification Form r Project Revision r Project Cancellation A. Asbestos Abatement Description- 1.Facility Location: 25 VINEYARD RD,COTUIT,MA 02635 25 vINEYARD RD Instructions 1.All a.Name of Facility b.Street Address sections of this form gARNSTABLE must be completed in MA 02635 . 6179695705 order to comply with c.City/Town d.State e.Zip Code f.Telephone MassDEP notification MARK D.COPPOLA OWNER requirements of 310 CMR 7.15 and g.Facility Contact Person Name h.Facility Contact Person Title Department of Labor Worksite Location: WINDOWS,ROOF AND THROUGHOUT STAIRWAYS Standards(DLS) notification i.Building Name,Wing,Floor,Room,etc. requirements of 453 2. Is the facility occupied? r a.Yes 171b.No CMR 6.12 3. Is this a fee exempt notification (city, town, district, municipal housing authority, state facility, or owner-occupied residential property of four units or less)? r a.Yes r b.No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5.Non-Traditional Asbestos Abatement Work Practice Approval, if applicable: Approval ID# 6.Asbestos Contractor: ATLANTIC BAY CONTRACTING COMPANY INC 100 HANO STREET a.Name b.Address ALLSTON MA 02134 6177824986 c.City/Town d.State e.Zip Code f.Telephone AC000309 h.Contract Type: r 1.Written ri 2.Verbal g.DLS License# 7. MARLON E.ESTRADA AS061570 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# 8 FRANK N.BALAGTAS AM000091 a.Name of Project Monitor b.DLS Certification# 9 FU ENVIRONMENTAL INC AA000144. a.Name of Asbestos Analytical Lab b..DLS Certification# 10. 12/9/2019 12/13/2019 a.Project Start Date(MM/DD/YYYY) b.End Date(MM/DD/YYYY) 8AM-4 PM N/A c.Work Hours-Monday Through Friday d.Work Hours-Saturday&Sunday 11.What type of project is this? ri a.Demolition r b.Renovation r c.Repair ri d. Other-Please Specify: Revised: 11/13/2013 Page 1 of 4 Massachusetts Department of Environmental Protection 100320074 BWP AQ 04 (ANF-001) - -- --- Asbestos Project# Asbestos Notification Form r, Project Revision 7 Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): [ a.Glove Bag r b.Encapsulation [; c.Enclosure[! d.Disposal Only r e.Cleanup FF f.Full Containment r g.Other-Please Specify: EPA OUTDOOR GUIDELINES 13.Job is being conducted: rl a.Indoors rl b.Outdoors 14 a.Total amount of each type of asbestos Containing materials(ACM)to be removed,enclosed,or encapsulated: 2000 1.Linear Feet(Lin.Ft.) 2.Square Feet(Sq.Ft.) b.Boiler,Breaching,Duct, c.Transite Pipe Tank Surface Coatings 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. d.Pipe.Insulation e.Transite Shingles 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. f. Spray-On Fireproofing g.Transite Panels 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. h.Cloths,Woven Fabrics i.Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft. j.Insulating Cement JOINTCOMPOUNDIMNDOWS&R 2000 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft. 2.Sq.Ft. 15.Describe the decontamination system(s)to be used: CREATE CONTINUOUS NEGATIVE AIR PRESSURE WITHIN CONTAINMENT SYSTEM AND EPA EXTERIOR GUIDELINES 16.Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): ADEQUATELY WET IN CONTAINMENT DOUBLE BAG MARKED ASBESTOS BAGS AND EPA EXTERIOR GUIDELINES 17.For Emergency Asbestos Operations,the MassDEP and DLS officials who evaluated the emergency: a.Name of MassDEP Official b.Title of MassDEP Official c.Date of Authorization(MM/DD/YYYY) d.Waiver# e.Name of DLS Official f.Title of DLS Official g.Date of Authorization(MM/DD/YYYY) h.Waiver# 18.Do prevailing wage rates as per M.G.L.c. 149, § 26,27 or 27A—F apply to this r a.Yes r- b.No project? Revised: 11/13/2013 Page 2 of 4 i Massachusetts Department of Environmental Protection 100320074 w 7, BWP AQ 04 (ANF-001) Asbestos Project# 1 Asbestos Notification Form r Project Revision r Project Cancellation B. Facility Description 1.Current or prior use of facility: RESIDENTIAL 2.Is the facility owner-occupied residential with 4 units or less? r a.Yes Poll b.No 3 MARK D.COPPOLA P.0 BOX 95025 a.Facility Owner Name b.Address NEWTON MA 02495 6179695705 c.CityfTown d.State e.Zip Code f.Telephone 4 MARK D.COPPOLA P.O BOX 95025 a.Name of Facility Owner's On-Site Manager b.Address NEWTON MA 02495 6179695705 c.Cityffown d.State e.Zip Code f.Telephone 5 ATLANTIC BAY CONTRACTING 100 HANO ST.SUITE 23A a.Name of General Contractor b.Address ALLSTON MA 02134 6177824986 c.City/Town d.State e.Zip Code f.Telephone TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA g.Contractor's Worker's Compensation Insurer 7PJUB5B61141717 12/16/2019 h.Policy# i.Expiration Date(MM/DD/YYYY) 6.What is the size of this facility? 1450 1 a.Square Feet b.#of Floors Note:Temporary storage of Asbestos C. Asbestos Transportation & Disposal containing waste 1.Transporter of asbestos-containing waste material from site of generation: material is only allowed at the place r a.Directly to Landfill or r b.To Temporary Storage Location/Transfer Station of business of a DLS licensed Asbestos contractor or a transfer ATLANTIC BAY CONTRACTING 100 HANO ST.SUITE 23A station that is c.Name of Transporter d.Address permitted by MassDEP and ALLSTON MA 02134 6177824986 operated in e.Cityffown f.State g.Zip Code h.Telephone compliance with Solid Waste Regulations 310 CMR 19.000 2. If a temporary storage to cation/transfer station is used, list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: SERVICE TRANSPORT GROUP 301 OXFORD VALLEY RD.SUITE 803B a.Name of Transporter b.Address YARDLEY PA 19067 2673999411 c.Cityffown d.State e.Zip Code f.Telephone Revised: 11/13/2013 Page 3 of 4 Massachusetts Department of Environmental Protection 100320074 BWP AQ 04 (ANF-001) _ -__-- f Asbestos Project# Asbestos Notification Form r. Project Revision r i Project Cancellation C.Asbestos Transportation&Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: ATLANTIC BAY CONTRACTING 100 HAND ST.SUITE 23A a.Temporary Storage Location Name b.Address ALLSTON MA 02134 6177824986 c.City/Town d.State e.Zip Code f.Telephone 4.Name and location of final disposal site.(asbestos landfill): MINERVA ENTERPRISES FRANK STUFANO a.Final Disposal Site Name b.Final Disposal Site Owner Name 9000 MINERVA ROAD C.Address WAYNESBURG OH 44688 3308663435 d.City/Town e.State f.Zip Code g.Telephone Note:Contractor mus`. sign this form for DLS notification purposes A Certification ALLEN S YOUNG ALLEN S YOUNG "I certify that I have personally I.Name 2.Authorized Signature examined the foregoing and am CEO 11/20/2019 familiar with the information contained in this document and 3.Position/Title 4.Date(MM/DD/YYYY) all attachments and that, based 6177824986 ATLANTIC BAY CONTRACTING on my inquiry of those 5.Telephone 6.Representing individuals immediately 100 HANO ST.SUITE 23A ALLSTON responsible for obtaining the 7.Address 8.City/Town information, I believe that the MA 02134 information is true, accurate, and complete. I am aware that there 9•State 10.Zip Code are significant penalties for submitting false information, including possible fines and imprisonment.The undersigned , hereby states that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised: 11/13/2013 Page 4 of 4 TOWN OF BARNSTABLE GC, / SEWAGE #LOC TIONA -1' 1 � gooa VILI.i�GE O�U/ l ASSESSOR'S MAP & LOT '023 :..$"BVS'IALLER'S NAME&PHONENO. -T- ,Op '4m C O,'" SEPTIC TANK CAPACITY' /J-0 LEACHING FACILITY:.(type). 0/PY GU QLL S (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: 07 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 Q '0 I b , / TOWN OF BBARNSTABLE c `OCATION `� V (rV,C In rr4 `IlD)CO SEWAGE # VILLAGE' l 1��ic ,J ASSESSOR'S MAP & LOTWO23 ZI INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY (PI )CS/ C�PSS k�O I LEACHING FACILITY: (type) (size) NO.OF BEDROOMS N0IJOUSItlI a311VA BUILDER OR OWNER IL PERMITDATE: 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)Z Ir /p Feet Furnished by �I IQ'i �IZ � Z r __�-=.V .. ,� (� 4 C�� � 5� �G . TOWN OF BARNSTABLE G k LOCATION 2 S V1A1,f_YAX Q SEWAGE # 900249 9 VILLAGE c ©T U l ASSESSOR'S MAP & LOT '023 p INSTALLER'S NAME&PHONE NO. / XnA C 0,41 Z5 C'X t g oN SEPTIC TANK CAPACITY 1r�® LEACHING FACII,ITY: (type) W 4eLL S (size) NO.OF BEDROOMS BUILDER OR OWNER f I PERMTTDATE: 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 I f ` �\ a 1 1.3 -?4 J • L No �l FJ 5 0. 0 0 ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r ' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZppYication for Oigpogar *p5tem Cow6truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.25 Vineyard Road Owner's Name,Address and Tel.No. ;_ �'_Othy Hill Cotuit,Mass.01,-),: 25 Vineyard Road Cotuit,Mass. Assessor's Map/Parcel 0/62---0612) 02635 Installer's Name,Address,and Tel.No. 5 0 8-7 7 5- 3 38 Designer's Name,Address and Tel.Ncf 0 8-2 7 3—0 3 7 7 J.P.Macomber % Son Inc. J.C. Engineering Box 66 CEnterville,Mass.02632 5 Roundhill BLVD E. Wareham,Mass. 02538 Type of Building: DwellingXXXNo.of Bedrooms S Lot Size 71 , 880 sq.ft. Garbage Grinder ki ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 5 6 3 gallons per day. Calculated daily flow 5 X 1 1 0=5 5 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 c; +box Type of S.A.S.4-500 gallon chambers. Description of Soil 0"-2"=fill, 2"-32"=Medium sand, 32"-1 44"=Medium sand Nature of Repairs or Alterations(Answer when applicable)Om i t t i ng cesspool.Installing 1 -1500 gallon septic tank, 1Distribution box and 4-500 gallon 1Pachinq chambers_ Packed in 4 ' of 1:�lj" stone_ 42 'X12 ' 10"X2 ' 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 t e Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by th' pf Health Signed Date 9 1 7 0 2 Application Approved by 4 Date Application Disapproved or the following reasons �� Permit No. Date Issued C�,&' �09A' $50.00 THE COMMONWEALTH OF MA SACHUSET4* Entered in computer: (, r Yes PUBLIC HEALTHbIVISION -TOWN-OF-BARNS-TABLES MASSACHUSETTS' { _ 01ppYication for Migogar *p5tem Conotruction Permit' Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( )`El Complete System ❑Individual Components Location Address or Lot No-2 5 Vineyard Road. Owner's Name,Address and Tel.No. Dorothy Hill Cotuit,Mass,.0263 Assessor's Mdffarcel 25 Vineyard Road, Cotuit Mass. , 02635 Installer's Name,Address,and Tel.No. 5 0 8—7 7 5— 3 38 Designer's Name,Address and Tel.Nd9 0 8—2 7 3—0 3 7 7 J.P.Macomber & Son Inc. J.C. Engineering Box 66 CEnterville,Msas.02632 5 Roundhill BLVD E. Wareham,Mass. 4 Type of Building: 02538 DwellingXXXNo.of Bedrooms S Lot Size 71 R� 8 Q sq.ft. Garbage Grinderl¢) ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 5 6 3 gallons per day. Calculated daily flow 5 X 1 1 0=5 5 0 gallons. Plan Date Number of sheets . Revision Date Title- Size of Septic Tank 1 500 +box Type of S.A.S.4-500 gallon chambers. Description of Soil 0"-2"=fill,2%32"=Medium san4" 32"-144"=Medium sand Nature of Repairs orA fi rations(Answer when applicable)©mitt-Ahg Cesspool.installing 1 -1 500 aalloh rt tank. 1 bi stribution bow a�ic7. 4-5004 gallon ' leaching chamt�e�__ Packed in 7 4 ' of 1-�" stogie.42'X12.' 10"X2' f Date last inspected:- ` Agreement: -' The undersigned agreesensure the construction and maintenance of the afore described on-site sewage disposal system - in accordance with the pro vi on`s of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been su by th 5 B f Health w Signed 4 _Date 9 17//0 2 Application Approved by _ � , i. Dateq Application Disapproved the billowing reasons �. �' Yin Permit No. / v �T Date Issued / ---------- ----------- ---------- - THE COMMONWEALTH OF MASSACHUSETTS f BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired)�XX)Upgraded(, ) Abandoned( )byJ.P.Macomber & Son Inc. 25 Vineyard Road Cotuit Mass. at Y , haebb 'Onstructed in accordance 01 with the provisions of Title 5 andthe for Disposal System Construction Permit No .Ved InstallerJ.P.Macomber & Son Inc. DesignerJC E gineerinc. The issuance of ' permit shall not be construed as a guarantee that the sy`s ern\will"f}��ctiton s d' st�ned. Date .712 r Inspector �/ ,X 'IV CI ' No. L/1/ ,r (.f -----------------------Fee $50.00 , .. (( THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Dioo!6ar *raem Construction Permit Permission is hereby-granted to Construct( )Repair( )Upgrade`-,X )Abandon( ) System located at-=25"Vineyard -.-Road Cotuit,Mass. and as described in the above Application for Disposal SystemiConstruction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special,conditions. Provided:Construction /st b com�l ted within three years of the date of thi pe it. ?4/ Date: Approved by ^ Fee— BOARD OF HEALTH I► TOWN OF BARNSTABLE Application,,is hereby made for a permit to Construct ( ), Alter (w', or Repair (E-�an individual Well at: - _a__ml ----------------------- -------------------------- - --------- ----------------------------------------------------------------- Location — Address Assessors Map and Parcel ,M/s Ht,7 --- - - ��^' -4------------- &k,7`- - - - - -1 --------- - -- - - - - �' '-- Owner ` !/'f 7 �7� Address —�''i G!f ---f p,_'��o�c �© �'.e�'S- ----------�'-`-�--Q�6 ------------------------ - ---------------- Installer — Driller Add s Type of Building Dwelling--------/A ---------------------------------------- Other - Type of Building--- - -= -- No. of Persons-------------------------------------------------------- Type of Well '- — - --w�----------------- Capacity-- ------------- - -- P y-- - Purpose of Well....� �-``-�$T�-------—------------ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of.Compliance has been issued by the Board of Health. Signed �` S - --------- ------shq l--------- ------------------- date 2 Application Approved By- --GOI �% _ - -- - - � >� �i��j�j� ---date Application Disapproved for the following reasons:-------------------------QQ----------------- -—----------------—_---------------______ ---------------------------------------------------------- -------------------------- ------------ —- --------- ---------------------------------------------------------- �,, date Permit No. v = ----------------— Issued- --- 1----- - date l "',, J No.-._^ `=------- �i Fee____---_----- -- BOARD OF HEALTH ' TO OF BARNSTABLE A61itat ion Ar Well Con0ructionpermit Application is hereby made for a permit to Construct ( ), Alter ( or Repair (C.*dn individual Well at: JS Ui� 0�1 f ,! • 7- 7 —Location — Address Assessors Map and Parcel �— Owner ` �,�.RI,/ -- — Address�� _/�/, l /^ O. �C]/tax G o 1 ..o 1,4" ( C.r D6.S' i stal nler — Driller —~ Addrefs t Type of Building Dwelling— - Other - Type of Buildin :----- ----- No. of Persons---- Type of Well- J c ` Capacity Purpose of Well- -^^__T�c __ --------------------------- Agreement,- I The�ersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Heath Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until � Certificate of Compliance has been issued by the Board of Health. tLs� � I � Signe .� 5�----- v6 ,1____-- date Application Approved By - _— �� �=�.� i date l Application Disapproved for the f flowing reasons: _--_—____--_�-_ _-__________—_ � /�� � date (J Permit No.—_� l�__ - Issued - — -- -/I-r-----------: -" date II BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY; That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by--------- ---\===-- - --------- - ------------------------------------------ Installer at-- - -- - - - ------ - -- —a---------_._ _ _ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection -Regulation as described in the application for Well Construction Permit No. ems— !; -_ =Dated—!L ?-------- \ 1 THE ISSbD�f OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS,�, GUARANTEE THAT THE WELL SYSTEM WILL TION SATISFACTORY. Y'°k-j 9-v 1 \ DATE- .- - Inspector .4�L2,� BOARD OF HEALTH TOWN OF BARNSTABLE eYf Con!6truct ion Permit No. - ----------------- Fee ---'"�---��--�- Permission is hereby grantedto Construct ( ), Alter ( ), or Repair ( ) an Individual Well at: No. - - -- - - ----------------------------- - ---------- — — — ----- Street as shown ,,on-the ©application for a Well Construction Permit j No.- 7 < f n1----2----------------- Dated----- �� � ----- / Board of Health (/ DATE -- No.- -- ----- Fee--------------------- BOARD OF HEALTH T6 OF BARNSTABLE �` APP 'litat ion-for Vell Con5truct ion 3permit Application is hereby made for a permit to Construct ( ), Alter ( *rY, or Repair (z,)An individual Well at: -= - - ------------------ --------------------------------------- Location — Address Assessors Map and Parcel --- ---- - �--p---., Owner f1 / +, 01! Address 1 _-c ! QX '�o l�-��-s [ _tea /uv - - -- - ---. _ . o - ri. - - - -- ' >nstalle --,Driller t' ! F.S i , „ q Addle s Type of Building I Dwelling------ ----------- - ------------r Other - Typildin ------------------------------------ r No. of Persons------ -� ------------------------ - Type of Well-------'-`-'-� -------- -------- c�=--------- --,, x� Capacity---------------------------- ------------------- Purpose of Well----6Oo sT'`- 1------------------------------------ Agreemenf� I The-dpAersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of He ,th Private Well Protection Regulation — The undersigned further agrees not to s w place the well in operation until Certificate of Compliance has been issued by the Board of He lth. (\j Signe , tom— - -— - �S ----------------------_ __-� �6�9/---------- date Application Approved By- date Application Disapproved for the f flowing reasons:----------------------------------------------------------------------------------- -------------------- -- - y --------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------- /�/ date Q Permit No. gym ` =- ------/ ----------------------- Issued date .� BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance 1 � THIS IS TO CERTIFY`T at the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------- i Installer at----------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection 'Regulation as described in the application for Well Construction Permit No. � -:9 `"4XI—Dated--- THE ISSU E OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE WELL SYSTEM WILL TION SATISFACTORY. DATE------- --r--- ---- ------ - k - Inspector -- « --J'� BOARD OF HEALTH TOWN OF BARNSTABLE s Veil,Construct ion permit Fee ------------------ Permission is hereby granted------------------------------------------------------------------------------- -------------------------------------------------------------- to Construct ( ), Alter ( ), or Repair ( ) an Individual Well at: No. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Street as shown on the application for a Well Construction Permit No. --------------------- -------------- Dated---------- ----------�--- ---------------------------- - - 7- - _- ------------fj- Board of Health !/ DATE---------- —---------------------=r f i Q �) IJ U r) c' y f EFFECTIVE DATE: JULY 16, 2014 , PROVIDED -� 'ROVIDED PROVIDED SITE BENCHMARK: TOP OF CONC. e l.:.90240 BOUND, EL. = 16.05 (NAVD 88) , PROPOSED SEPTIC TANK EXISTING LEACHING, BED ° " x 14.8 EXISTING DWELLING TO BE RAZED rn ao -� WOODED � x16.6 I j O ! O i O f O 18 � r pJ d-00 t _ j It ` 11 f ` G WOODED O x16.8 , EXISIIh G SE f TI TANK - A� TO BE DEC\ 0 M M I I'NED � '� '� //� '� - SEAGC i 11.00, 0 / Y 203.5 LOCUS MAP 16, LOT 23 ' 25 VINEYARD ROAD l 69,401 S.F. x19.6 � � `� �H ,�� � �` � \ r f .. �'4--��---7. I Tom'- r , , � � --A� PROVIDE PRECAST CONCRETE EXTENSION , • 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS= 48,2' - 49.2' S GENERAL NOTES RISER TO WITHIN 6"OF FINISHED GRADE OVER REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM OUTLET FINISH GRADE OVER D-BOX= 49.3' 4"SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE FINISH GRADE OVER TANK EL. ' 1 UNLESS,OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 50.50 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. CRAWL SPACE 20"MIN.ACCESS COVER TOP OF SAS= 46.20' PLACE RISERS ON ALL CHAMBERS AND SLAB (TYPICAL FOR 3) 36"MAX. , 9"MIN. TO 6"OF FINISHED GRADE 2 ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD EXISTING 4 /// 45.20 36"MAX. BREAKOUT EL = 45.70' OF HEALTH AND THE DESIGN ENGINEER. C.I. PIPE 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 6" 3" 2" DROP MIN. 3„ g„ PROVIDE WATERTIGHT BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 3"DROP MAX. JOINTS (TYP.) o 4"PVC IN FROM = O oo O 00 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN 14 46.15 SEPTIC TANK 4 PVC OUT TO o 000 00 0o ELEVATION 45.70 FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS 46.40 LEACHING FACILITY oo o o A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 0o THE LINER IS NOT LESS THAN.THE BREAKOUT ELEVATION. (CONTRACTOR 12„ o0 ' 2 o0 0 o0 5• SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SHALL VERIFY) OUTLET TEE 45.60 MIN. 45.43 00 00 00 48" .. 6" CRUSHED STONE o 0 . 0 0 0 a oo 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. VARIES 22 ZABEL FILTER OVER MECHANICALLY o MODEL#A1801 HIP COMPACTED BASE 4' _ I 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED , (GAS BAFFLE ON 8.5 4' 4' PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND BOTTOM) 5 OUTLET DISTRIBUTION BOX 42.0' �P) READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED TO BE INSTALLED ON A LEVEL STABLE , GROUND WATER ELEV.= < 37.77' 12.9' WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. PROPOSED 1500 GALLON CONCRETE SEPTIC TANK BASE. FIRST TWO FEET OF OUTLET 43.20 � �� � �� PIPES TO BE LAID LEVEL. 4 - 500 GAL. CHAMBERS 5'MIN. , LENGTH 10 6 WIDTH �8 DEPTH 571 8. ELEVATIONS BASED ON ASSUMED DATUM OF 50.0 MSL OBTAINED CROSS SECTION VIEW TYPICAL CHAMBER PROFILE CHAMBER DETAILS H-20 CHAMBER END VIEW FROM NAIL IN TREE AS SHOWN ON PLAN. SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL (H-20) NOT TO SCALE ( 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION NOT TO SCALE NOT TO SCALE THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY TEST PIT DATA DISCREPANCIES TO THE DESIGN ENGINEER. f ° 3 v 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE _ STRUCTURES SHALL BE MADE WATERTIGHT. INSPECTOR: MAP 16 PARCEL 031 SOIL EVALUATOR: John L Churchill Jr. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR I' NSF HENDERSON �" " DATE: August 15.2002 ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. TEST PIT#: 1 LEV TOP= 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS f E 49.77 LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH 1 „ i f ELEV WATER- >12' BGS CASE THEY SHALL WITHSTAND H-20 LOADING. N ' y " _ PERC RATE 2MIn/In (Assumed) 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. E � r DEPTH OF PERC- N.A. 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND PROPOSED 4-500 � • " t TEXTURAL CLASS: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT ON ALL SIDES OF LEACHING FACILITY REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN EXISTING CESSPOOL GALLON CHAMBERS COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN 0" 49.77' ACCORDANCE WITH 310 CMR 15.255(3). TO BE PUMPED AND PROPOSED s FILLED WITH CLEAN oafs Fill 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES DISTRIBUTION BOX " FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. SAND B.M. x . 5 Driveway Gravel Nail in Tree 2' 49.60' 16. PROPOSED PROJECT IS LOCATED WITHIN: Elev. = 50.00' r , O/A ASSESSORS MAP 16 PARCEL 23 N87°02'S0"W Assumed REF ,gg q �• .�.. , w f }�d ini �W, ' 'fl ^' � C� ` �""' NN.nu j 17.92' N87°02'50"W , ,. Mjj id ' 8" 49.11' 17. OWNER OF RECORD: DOROTHY H. HILL 350.24' x « " Med. Sand ADDRESS: 200 EAST 66TH STREET #D703 �' B 2.SY 6/8 NEW YORK, NY 10021 ---Loose L(.r `� TP 1 • rm d • .11 PLAN REFERENCE: Q 32 7 18. _ _ r'r " " 4 REF LAND REGISTRATION BOOK 153 PAGE 113 • �'� '`r � f` 49.77 t :. � '•• ... � x ��� � � Med. Sand WITH CERTIFICATE OF TITLE NO 20533. r' 2.5Y 6/4 19 ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. MAP 16 PARCEL 23 -'" ~ ° ' C �. ! �• No Groundwater 71 ,880 SQ. FT. ± -••.•-••- --• ---- ��~ �~ h :f'� ^,� Encountered 20• PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY cP _ ` ti~ LOCUS P LAN 144" 37.77' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY (� o FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. o ° I o s #25 r `~ Aid SCALE: 1" = 1000' on w � EXISTING DESIGN DATA BEDROOM - LEGEND DWELLING �i�i y` ,;1 x 50 EXISTING SPOT GRADES PROPOSED 1500 �, � 0 �L, �, ••--•• ••••••• 0 ------- •~---~• EXISTING CONTOUR k I ;;1 NUMBER OF BEDROOMS 5 50 PROPOSED SPOT GRADES GALLON SEPTIC TANK ;,�0'i NUMBER OF PERSONS 5 DESIGN FLOW 110 GAUDAY/BEDROOM 50 PROPOSED CONTOUR TOTAL DESIGN FLOW 550 GAUDAY - - --- E/T/C ------- EXISTING ELECTRICAL UTILITIES `+ � . DESIGN FLOW X 200 % = 1100 GAUDAY ��' � � R GAS EXISTING GAS LINE 1 S87°02'50�'E USE NEW 1500-GALLON SEPTIC TANK 16.51' S87°02'50"E ® M` ' ------------------ `��' -------------------•-- EXISTING WATER LINE P 261.3T �. '� ,a �� • TEST PIT LOCATION EXISTING WELL �' s 4 ,�� ,�.�, Q INSTALL 4- 500 GAL. CHAMBERS TO BE ABANDONED s 163 G O Q Q Q PROPOSED SEPTIC TANK SIDEWALL CAPACITY LENGTH + WIDTH 2' HIGH .74 GPD/S.F. = GAUDAY 4"SOLID SCHEDULE 40 PVC PIPE p0 � ly 1 ; G (42.0 +12.9) (2) (2) (0.74 GPD/S.F.) - 162.5 GAUDAY i v� p DISTRIBUTION BOX 500 GAL. LEACHING CHAMBER MAP 16 PARCEL 001 ; ��J� BOTTOM CAPACITY NSF ERIKSON tt P (LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY [(42'x12.9) (.74 GPD/S.F.) = 400.9 GAUDAY TOTALS; REV. DATE BY APP'D. DESCRIPTION TOTA L NUMBER OF CHAMBERS 4 PROPOSED SEPTIC SYSTEM UPGRADE TOTAL LEACHING AREA 761.4 SQ.FT. PREPARED FOR: TOTAL LEACHING CAPACITY 563.4 GAL./DAY DOROTHY H. HILL LOCATED AT 25 VINEYARD ROAD COTU IT, MA SCALE: 1 INCH = 30 FT. DATE: SEPTEMBER 11, 2002 0 15 30 60 120 FEET OF4L1e_ JOHN L. PREPARED BY: 8 CHURCHILL CML JC ENGINEERING, INC. . 5 ROUNDHILL BLVD. EAST WAREHAM, MA 02538 SITE PLAN _ 508.273.0377 SCALE: 1"=30' Drawn By: JLC Designed By: JLC Checked By: JLC JOB No.264 e