The URL can be used to link to this page

Home My WebLink About0080 ACORN DRIVE - Health 80 Acorn Drive Osterville A= 102-057 C TOWN OF BARNSTABLE LOCATION �)e SEWAGE# 2.01 I a-&V VILLAGE 4t5-rFey,/it N14 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. Raar-4-r fDti 6C ESL/b SEPTIC TANK CAPACITY /, 0,0 v LEACHING FACILITY:(type) (size) / NO.OF BEDROOMS .3 C10 OWNER E.dwose o .) .4- l�ec��Nil TLC i y PERMIT DATE: -/L/Z// COMPLIANCE DATE: y 11 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 R1,,9 f& r k4ow s v.-04 1 �j DK Q ,4 33 o x C ZQ -76 No. ®�I _ " Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISIOIN -TOWN OF BARNSTABLE, MASSACHUSETTS s 2.pplitation for -Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(✓j Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. F0 Ac r'lo J o-• Owner's Name,Address,and Tel.No. Assessor's Map/Parcel l,AO 0� c0DW0 t�l 6/, ko 2� aG/d Installer's Name,Address,and Tel.No. 4 D 3_7 3 B-b.oy y Designer's Name,Address,and Tel.No. 5 r- M rif o A-S'A-e%o-,, Qo$Le-t 1U661 EQo 01 L 0Pi Type of Building: 0 /-'- ASI~4 3 � 1 Dwelling No.of Bedrooms -3 Lot Size sq.ft. Garbage Grinder k) AID Other Type of Building ?l s 1 D. Q E 5. No.of Persons Showers(L.) Cafeteria Other Fixtures p Design Flow(min.required) ,3�D / gpd Design flow provided 3,5 5— P/2 gpd Plan Date ��Z�// Number of sheets Revision Date Title "-// / Size of Septic Tank I j D Do Type of S.A.S. G r'-9 Uh el C�{oo,�y'/-1' Description of Soil p Nature of Repairs or Alterations(Answer when applicable)� /✓�D/V�'/� L� ��/ / //� 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 of HeaAh. Signed Date Application Approved by Date '2 - � Application Disapproved by Date for the following reasons Permit No. Date Issued No. Fee V ` ,THE COMMONWEALTH OF MASSACHUSETTSEntered in comput PUBLIC HEALTH DIVISION=TBWN OF BA,RNSIABLE, MASSACHUSETTS _:" ` application for Disposal 6pstem Construction Permit e' ! Application for aTermit to Construct( ) Repair(,/�Upgrade Q ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ?o f4ro'-N /? . Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ®S �/�////)p / f1� Installer's Name,Address,and Tel,.No. q; C ? -] E Designer's Name,Address,and Tel.No. 7 t G; c 1, tr C % c Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ) X/0 Other Type of Building !✓-c, j'; No.of Persons Showers Cafeteria ) Other Fixtures Design Flow(min.required) 1,C 6 190 gpd Design flow provided . s'_`;-S` gpd Plan Date /�c��/ Number of sheets Revision Date Title Size of Septic Tank I, t:w Type of S.A.S. L f',,9 d c X, ; /,2X'1^_r Description of Soil 14 Nature of Repairs or Alterations(Answer when applicable) 74 �/� Date last inspected: - _t• 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 of Hea It. Signed ( ' Date Application Approved by W X Datea''/�f/ Application Disapproved by Date for the following reasons i Permit No. — 6 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 at n �/(.� _ o st has been constructed in accordance ) with the provisions of Title 5 and the for Disposal System Construction Permit No. p 'O dated 3 Installer Designer #bedrooms Approved design flow gpd The issuance of thi perms shall not be construed as a guarantee that the system will function s designed. r Date ;? j Inspector ---------------------------------- --------------------------------------------------------------- ------- --------- No. r C)/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair( ) U grade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permiL ''—_ Date ^a I Approved by i I0Z 9i/9 1 �ua=ao oa= Iln>; ��f u�a auto aalnlas au s�ouzoa real ann zs/ / u Regulatory.-Services _ ) •�� 1"�� •1'honras t'.C.t,tlrer;Dc[•icfor: kicaltil•.n�yisioll_. f 1Id(. D-ireetor 200 Alain Street. I1 agms;i UIGUI Date: Sewa1;cPerr[titi� .?clt oJoY, Assc�sur's.�lap�f!arcel �fe3orio �9 installer& prsigner Cerlificalion ilnrm, 1)csi oir:' L i l�r; � 6 a n,.- •.. � ��.. 2�- � 1i1J6J1 /� Y_ Address: oz 53(0 ,cam('C�►�, r?� • O�?�c� ,Oil—3/Z 0 was issued a birmit to install a r,I I-r; aAL based Ott a dcsigu'drawn by rr ;; (addr'; �` a3ta • cieF.i<'n•r T c=ii,fy that else septic w,*to trilled sttbstanually according r,,) the desmg^� wnsclt may i[aclude aminor apProvw cbanges suc b as lawraa4clocati6n of tlic r tltsirtbuttoti;box"atttlr<et.stpdic la€t�a ,;tpout (if Yzyuoaect) ,w,H ttu[iCctexl aud4lte-sails ` vere'f6unds:ltisfactorf•_* (� t certify that tlic s Yie sv5tem�fcrenc�d ib6,c w:s installcd with maj6r char.gs (ix, <.,atcr thaa !U`Iater tl relocation of the'SA.S of aiay.wagicai relocaiior.of any component of the septtr;_systern)'btit in accordaAce with Sian:&Lmal Regulations. Plan rep=imon or cc t2tfkd ss-builf b} desibier'ty full4tv:;$1ripout(if requirm-1)w+a i mccuxi:uad the coifs vv rc f�wnd:catislactoty. ��H Of q K�! LINDAJ _ o? . �G aftatlor's s:gri;ttta PINTO CIVIL -4 No.46504 (n�S1�;llE7 SaatiNlftFt: ( + � � j3it! 1');'EAsi: ltEMR-N TO GARIN TABLE t0ljr 14EA `TH 'ICATE .011 C'OA•11'LIANCE Wlt.l, !No,r im INSUED UNTIL ROTH A\1 AS- KUIL'1.`C�Af2WARP 1i.t'( -AVE.11 31'.1'fit .B:i1L•\STABLk PUBLIC It e�l:161 1)E4'I.SIQi�i. ' e''m9lctfumailc.: rcm kcti.'iW fwrirc�c... t I jo 1 Q2v l Town of Barnstable P# 3 j Department of Regulatory Services Public Health Division NA Date 2 u 139.. 200 Main Street,Hyannis MA 0260R ' Date Scheduled TimeLj Fee Pd. to - Soil Suitability Assessment for Sewa e is o Performed By: (,,a A. a (�� p sal Witnessed By: ✓,, LOCATION& GENERAL INFORMAT ON Location Address / �,!� /J�OL",� a / ,bfL n Owner's Name �(j ! AddressG/7�� Assessor's Map/Parcel: Wt 1�.�/B p2 Q Engineer's s Name NEW CONSTR��UjjCTION REPAIR I TelephoeeC# ��OS— 7� — Land Use Ks_ Slopes(%) Surface Stones Distances from: Open Water Body /dorr` g possible Wet_Area� Q ft Drinking Water Well ^f ft Drainage Way C' P ft Property Line / —fit Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) f2pd, i A tom( MPP 1 zo � l E( S 1 . MAP lzo CD Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face /✓/� , .y ' t m! Estimated Seasonal High Groundwater CJ DETE4NUNATION FOR SEASONAL HIGH WATER R TABLE Method Used: Depth Observed standing m obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: _�- in Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor g Adj.Groundwater Level , PERCOLATION TEST bath s t/ Time _ Observation ' Hole# Time at 9". --- Depth of Perc Time at 6" Start Pre-soak Time @ lime(9"-6") End Pre-soak Rate MinJlnch ? Z /rl Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:X.SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o i ten y,%Gravel) 0 --ZZ ,� 2� -Z� S. LO .312, (t ZCf- 'z7(o f� M S� �d YR 54 'r 1 e 5u /'o Y2 6 G r5 C2 e to YQ. 4/47 DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. r9n9=2Lgo ravel U --Z iddIvY,2 3 Z !O Y 6 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o i tency,%Gravel) 4 • DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders, Consi t n 1 Flood Insurance Rate Mae: Above 500 year flood boundary No Yes Within 500 year boundary No ✓' Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring per v' us material exist in all areas observed throughout the area proposed for the soil absorption system? � If not,what is the depth of naturally occurring pe 'ous material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required tra' ing,expertise and experience described in 310 CMR 15.017. Sig nature Date 1 I$ I I Q:\SEPTICIPERCFORM.DOC Barnstable vw l" Town. of Barnstable l = Regulatory Services Department `cagy" B&"SrABLE 1 1 �$ " ,m 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 CERTIFIED MAIL#.70081830000205009908 - 12/20/2010 Douglas Toccio 490 Lexington Road Concord, MA 01742 ORDER TO COMPLY WITH STATE ENVIRONMENTALCODE,TITLE 5 The septic system located at 80 Acorn Drive, Osterville MA was last inspected on. October 21, 2010,by Patrick O'Connell,a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed".under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component-due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due'to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair`/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF E BOARD OF HEALTH .�._T'h s McKean, R.S., CHO Agent of the Board of Health' M - I F . Commonwealth of Massachusetts u Title 5 Official Inspection -Form . p, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments'. 80 Acorn Drive n ( D�/ �/� {,, / fl Property Addressr _� V V�/�I V 1 oY' (�� J' / f1 IN I Toccio ;�r f (j� (JU Owner Owner's Name. j information is Osterville I�. �� I J " I MA 02655 October 21, 2010 required for State Zip Code Date of Inspection every page. Cityrrown 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. E Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508.428.1779 SI 12855 Telephone Number ,,, License Number 713. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ®. Fails - ❑ Needs!Further Evaluation.by the Local Approving Authority 0 October 21, 2010 Job# 10-255 Inspector's Signature Date The system,inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or.DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies 'sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that timer This inspection does not address how the system will perform in the future under the same or different conditions of use. F It ( t Title 5 Official Inspection Form:Subsurface Sawa Disposal Syst m•Page 1 of 17 t5ins•09/08 i I � I I I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville MA 02655 October 21, 2010 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined„" please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass,inspection if the existing,tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �I 80 Acorn Drive Property Address Toccio i Owner Owner's Name 'f information is Osterville MA 02655 October 21, 2010 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) I B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ I distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): I I i i 1 - ❑ 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 [IND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 1 i I t ( � I ,I C) Further,Evaluation is Required by the Boar d of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. . 1. System will pass unless Board of Health determines in accordance with 310 CMR t 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety a'nd the environment: i i ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface,Sewage Disposal System Form - Not for Voluntary Assessments I 80 Acorn Drive Property Address Toccio Owner Owner's Name'I information is required for Osterville E MA 02655 October 21, 2010 every page. Cityrrown j State Zip Code Date of Inspection B. Certifiication (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system.has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ I 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 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. t 3. Other: I I I i I D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No" to each of the following for all inspections: f Yes No I ® O Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded Li or clogged SAS or cesspool LiLiquid depth in cesspool is less than 6" below invert or available volume is less 29 than_day flow l5ins•09/08 I Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville MA 02655 October 21, 2010 every page. Cityrrown State Zip Code Date of inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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 surfacewater supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"'yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 &\ Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville MA 02655 October 21, 2010 every page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ '® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I 't 80 Acorn Drive Property Address Toccio Owner Owner's Name information is I Osterville I MA 02655 October 21 2010 required for , every page. City/rown State Zip Code Date of Inspection D. System Information Description: a i E I� e Number iof current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal.use? ❑ Yes ® No I _ Water me 245,000 gal.lter readings, if available(last 2 years usage (gpd)): 336 gpd. Detail: , Water usage includes irrigation system. Sump pump? ❑ Yes ® No I Last date of Currently occupancy: Occupied i . Commercial/Industrial Flow Conditions: I Type of Establishment: Design flowl(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): i Grease trap present? ❑ Yes ❑ ' No Industrial,waste holding tank present? ❑ Yes ❑ No Non-sanitary�,waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter leadings, if available: I t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 i Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface-Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn'Drive Property Address Toccio Owner Owner's Name information is Osterville MA 02655 October 21, 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ` ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. , ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts Title 1,5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 80 Acorn Drive Property Address Toccio Owner Owner's Name' information is required for Osterville MA 02655 October 21, 2010 � every page. Cityrrown ! State Zip Code Date of Inspection D. Syste',m Information (cont.) 'i Approximate age of all components, date installed (if known) and source of information: Compliance date: 8/3/81 I Were sewage odors detected when arriving at the site? ❑ Yes ® No I Buildingi ISewer(locate on site plan): 1' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): I I i Septic Tank(locate on site plan): Depth below grade: feet Material of construction: i ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) I i I I If tank is metal, list age: years Is age confir�n ed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. Sludge dept is 4" t5ins•09/08 I Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 1r I II Commonwealth of Massachusetts Title' 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville 4 MA 02655 October 21, 2010 every page. Cityrrown } State Zip Code Date of Inspection D. System Information (cont.) I Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 26 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" f. Distance`from bottom of scum to bottom of outlet tee or baffle 10 . How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid level was at bottom of outlet invert at time of inspection. Observed solids on top of outlet baffle, tank was'previously full to top. I l Grease Trap (locate on site plan): . Depth below grade: feet f Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): I t . Dimensions: Scum thickness Distance fro� top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle I Date of last pumping: Date l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville, MA 02655 October 21, 2010 every page. City/Town i State Zip Code Date of Inspection D. System Information (cont.) I Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i I i I Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concr�ete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: s Capacity: gallons DeSlgn`FIOW: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No I Date of last pumping: Date I Commentsl(condition of alarm and float switches, etc.): l t, I Attach copy)of current pumping contract(required). Is copy attached? ❑ Yes ❑ No I i t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is Osterville required for MA 02655 October 21, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Previously full to top. 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.): i Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio � Owner Owner's Name information is OSterville required for MA 02655 October 21, 2010 every page. City/Town i State Zip Code Date of Inspection D. System Information (cont.) I Type., ® leaching pits number: One 6x6 pit I ❑ II leaching chambers number: ❑ I leaching galleries number: I ❑ j . leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ' I I ❑ ` innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Liquid level was found at top of pit pit is in hydraulic failure I I I , ,I 1 Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert II Depth of solids layer fi Depth of scum layer I Dimensions of cesspool I Materials of construction Indication of groundwater inflow ❑ Yes ❑ No l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville MA 02655 October 21, 2010 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): • 5 t 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner information is owner's Name required for Osterville MA 02655 every page. City/Town October 21, 2010 State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below drawing attached.separately 15 10 29 28 A y. . tii Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 80 Acorn Drive Property Address Toccio Owner Owner's Name information is required for Osterville MA 02655 October 21, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water Check cellar ® Shallow wells Estimated depth to high ground water: N/A feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high grbund:water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts • Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 80 Acorn Drive Property Address Toccio Owner Owner's Name information is Osterville required for MA 02655 October 21, 2010 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 rs L O CATION AQI)_Sl--4gLt SEWAGE PERMIT NO. VILLAGE ®CrE.4vIl;. k7r 17 igcoaN L7-'2-. A = lzo ®29 -INSTALLER'S NAME i ADDRESS v 6 -st(+ OVA S UILDE'R OR - OWNER l0u. �'l�J/�'I'✓eQ/J/y'M ,., .Sty �.E'/d/etJ � QS/F 4 DATE PERMIT ISSUED ,_ _ DAT E ~ COMPLIANCE ISSUED ��' �� '� �. tea' �'' Psi ��' '� '� 1�9'�j' yi �a� �� ,��,� ,r �; f 1 t l No.....�......... ... Fps...... ................_ THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEP>L/TH r4.-.'vA...................OF..... ..............-V/ /!•/.'e ............................................ ApplirFation for Dispau al Works Tonstrnrtion Frrutit Application is hereby made for a Permit to Construct (VT'or Repair ( ) an Individual Sewage Disposal System : 0� �// ... .............. ...... .......................................... Location-Address or Lot No. ,�v(,v��v �bGl D G�,c� GTG►1 u- 7 C ............. _........._........... •--•----•--•-•----------------------------.... -••••-••----...................................................................................... h Owner "/ 'l [�(� Address a . ...........................•.................-^ ....... �" _-"--•`jV7........................................... Installer Address Type of Building w. ' Size Lot_...........................Sq. feet Dwelling—No. of Bedrooms............ ..............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building n� yp g N-tir.�..�t�.$.... No. of persons........ ............:.. Showers ( ) — Cafeteria ( ) Other fixtures ................................. W Design Flow......................./l/A...a..gallons ger pew per day. Total daily flow__._........._..........3 .0..........gallons. W Septic Tank—Liquid capacityl ._..._.gallons Length......"...... Width... Diameter................ Depth.......".....-. x Disposal Trench—No. .................... Width.................... Total Length........._+..........Total leaching area....................sq. ft. Seepage Pit No......./----------- Diameter...../0........ Depth be w in t..._.Sa=_........ Total leaching area..r._sq. ft. z Other Distribution box ( � Dosingtank ( '�� `'� �� a Percolation Test Results s$ Performed by. ----- Date..._..4__%_..Z._._...t............... Test Pit No. 1..�_�.. -------minutes per inch Depth of Test Pit.................... Depth to ground water........................ r=, Test Pit No. 2.),_ ` ...minutes per inch Depth of Test Pit.................... Depth to ground water........................ . •- ••-•-••• .................. Descriptionof Soil ....................................-.............................................................. W UNature of Repairs or Alterations—Answer when applicable................................................................................•.._........... ----------------------------------------------------------•------...---------------.......----------------•-....--------------------...----------------....--•-•....................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS 5 of the State Sanitary Code.—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has�eni by the rd of 1 th/. Ca'r��v Y /�OAI Application Approved By- � --- ----------------------------••----•---------................--.._. � Date Application Disappro d r t following reasons: ---------------------------------------------------------------------------------------------------- --....-•••••••••••••.........••••--•-- ••• ..................................••-•.......••-•••.......••---•••••............----••-----••••----•••-•......----•---•••-......--•-"Da......•••r-•. te PermitNo......................................................... Issued-....................................................... Date No.�...........�... Fes$........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -----71; h..................OF....�kk I--h.... /a—// Appliration for llhipos al Works Tanstrurtinat Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal system a�:C ar / /,r '/T ............./.__.._....._...................... ... ............................... ........----------------------------.....------------------------.............-----......--------- Lo ti •Address or Lot No. ...........cv�t,� _UGt v , L�fs T►rc_ .f?SS .............. Owner Address Installer Address U Type of Building 3 Size Lot_ -S. s ..-___Sq. feet Dwelling—No. of Bedrooms.......... _ ................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building ''��►T/„� No. of ersons___-•__.// C4 YP g �---------•---- -�----- P (s----------------- Showers ( ) Cafeteria ( ) Other fixtures ............................... W Design Flow....................... `..G._......___.gallons per person per day. Total daily flow........................ __G.........gallons. W Septic Tank—Liquid*capacity�G_e� ..gallons Length---- _�^ ..._.. Width__.....y....._ Diameter________________ Depth___ x Disposal Trench—No. .................... Width.._......._.._.___.. Total Length_.__...._ Total leaching area....................sq. ft. 3 Seepage Pit No......./----------- Diameter...../0!__........ Depth betow inlet.....6 .. Total leaching area.I�C�....sq. ft. Z Other Distribution box ( � Dosin tank ( /�� aPercolation Test Resylttss f Performed by. �___-_ ............. .................!..___...___'...... Date_ '�!^.___2..�i_._.._�.. Test Pit No. 1.T�!ti._..minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2--- .....minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 i _;;---- -- - -•-..... O Description of Soil-----...... �-•---•--�---- " -•-�......--•r----••---�----------�'-�•-•---� � �*z•, e. U 6 -----•--•--•----------.---•---------------------------------------- ---------- •---------- •------------------- •---------------------------------------------------------- W UNature of Repairs or Alterations—Answer when applicable............................................................................................... •-------------------------------•-••-•------••--••----•-------•-•••--•--•-•--•-•••••••.......------•-•---•----•---------------•----•-----------•-••--•-•-----------•----•----------•----•......-•--•-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI',!Z- .5 of the State Sanitary Code,— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has br<en issued by the and of 1}Ath. Signed... .....•............................................................................ ...- ..... ,�� f� ate Application Approved ,BBy......__:-'...ZZ4.t-n v{a......••..............•--•--...............--•-................... "%" "'�`"l----- --- -- Date Application Disapprove or he following reasons----------------------------------------'------------------••------------------•----------------------••------- ..................................... --------•---•-•----------------------------------•-••-•----•-•---•-••--•-•-----••-•••--••- ---------------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD• F HEA T f • -,°-z,t.. . ..................................... TrrtifirFatr of Toutp iFattrr TH' Y 0 C T FY, That the Individual Sewage Disposal System constructed dr ) or Repaired ( ) y....., 7 Installer at ---------------1� .. -p /,ail...................... .... =------ --- ....................... ------------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Codes d cr}}'bed in the application for Disposal Works Construction Permit No. ._-.,, _ .. .............. dated_.. ... .XP 61.__......._._..._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO,N S/AJ1SFACTORY. l '>`' I DATE...........................:. .....� ._��------------•--•--------- Inspector........ -��'------•-------------•-------.....-----------------......._ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA H ` No....f.... .....................OF._:......./-�? e:'.� C ��. ............... FEE............................. rk� �aa�,��ruan rrmit Permission is hereby granted...... a.. -------------------------------- -- --- ................................................. to Const/ct. � Repair.:F ) an Indio' Se��age Dis Sys C- [r(� .... ......................... - --------•---•----•••••--.-•..... --•-•----•-----•-- ----- .............. Street as shown on the application for Disposal Works Construction Permit NV.'P-3----- Dated _ __�� . �� / / )� -•-•.............•--......_..---------••---•--•-••-------.........--•-.-•--••-----•-•------•-----......_ �! l -_t'.....,.......................................... Board of Health DATE---•-••--•--------•---------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �D FT. M/N: A'07-,E /F EITHER THE SEPT/, TAit/K DR ---- - n�EfFCHIivG PIT ARE MDRE THfI/✓ ./2"BELO.IV M/AI. / !:RAAEr,.Aa 24"O/o4M.ET.ER. CONCRETE CD!/ER 5.-J4ALL BE BROUGHT TO 6/gAOE.�f+N EXTRiq CONCRETE. 4�PYC PIPE ( I h'EAvy CAST /ROW CO//ER .Sf�ALL t3E USEU (/ M/N. PITC OG /F" V ;D H /! R/VLFWA y ��•-,�fe� / CD I�ERS �8 n PFiQ FT. � • 2 • MiN: CD/VCRE•TE coVE.4 G1ewE CLEAN SANG d , ,Q.. CAST I 'LAYER IRON P/PE i v a o -FIB" -,•! � M/N.P/TCN EGG GAL. .� , a 1 • • • • • • e • A •4� WASHED STCiNE %4"PEm fT. SEPTIC TANK D/ST. o b , • . • • . : e , e a q BOX v ee � • • s • • r .°e ° i .. v o EFFECT/✓E , . � `:: ° ° • • DEPTt/ • e ' ° o WASAF .STONE 1r::e e •Q a 11 • 1 • • • • � pp O • a. a • • • • • • • •. p °•y PR,6CA5T SEF.PAGE IMViZKT ELE✓AT/GNS a • ° • . • • . • • a o P/T OR EQU/�! IN► eRT AT QU/LD/NG .. �1 7�U FT 6 j--7- D/.4M. INLET SEPT/C Ti4NK �• FT• /0 FT O/A!►9• ; C SEE T�iBUL.4TlON> OUTLET SEPT/C TANK FT. INLET D/57R/6UT/ON BOX ��' U FT GROUNo Nl�1�ER. "LE ._ OGITLETD/STRts&-r1OIV BOX 5'19 FT SECT/ON OF /NLET LEACHING F�/T �SSf FT SEWAGE O/SPOS.4 t SYSTEM LEACH//VG =/T T.'OBULAT/DN SCALE // ' = /,- O~ OIMENS/ON A 3 FT. DES/G/V CR/TER/A D/�lE/YS/ON $ FT. /VU/rfQER OF BEORaOMS 3 D/MENS/ON. 41 GAR6AGE D/SPOSAL LN/T__ SOIL LOG 5`0/L TEST TOTAL E3T/M.4TED FLO,vv_3 .3 G GA4.1,oAY SO IL TEST �/ SOIL TEST-*E � NUMBER OF LEACXllV4 P/TS_ f^ELEV �U �^-ELEY, pATE OR- SO/L TEST �^ S/OFLEACH/NG PEK P/T SQ, FT. G ? / RESULTS TNESSED dY/�1a� r 9 y e BU7"TOM_ 4E►4CH/NG PER $Q. FT. f'EItCOLAT/ON RATE / �S1 M/N�IINCH' TOTAL 4E4CH//1'G AREA '�77�-'SQ. -7 PEX COLA 7.1ON RATE Ak2 T�"`^ M/N.�INCH•..� oe VE LEACH!/VG AREA '�f�SQ. F T. d ' 4 E1 DREDGEENG/NE�, AVAW CC,/MG i /Y 712 MA/ S T., , co ��G i i NO R GOUt7 N k447-eR FAICOUNTE.2E0 N S;YAAIN1 AIA55. j (�_! GRO UIV17 PVATER AT 64-E V. - JOB /VD.. /G Z SHEET�OF V z a ' Seot.rc 1'�-.l N LEGEND EXISTING SPOT ELEVATION OxO CERTIFIED PLOT PLAN EXISTING CONTOUR — 0 - -- FINISHED SPOT ELEVATION , RO P. ERT FINISHED CONTOUR 0 8UNIK49 No,eaao I N APPROVED = BOARD OF HEALTH DATE AGENT SCALES / �� 30 r DATE I -TA- 7//5.1/. LDREDGE ENGINEERING CO. IN CLIENT O t 1 CERTIFY .THAT THE PROPOSED . EOISTERE REGISTERED JOB N0. �� 3 BUILDING SHOWN ON THIS PLAN , CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BY OF BARNS ABLE , MASS. 712 MAIN ST. CH. BY — WYANNiS, MASS. SHEET �, OF, ATE REG., LAND SURVEYOR LEGEND TOP OF FOUNDATION 24"d Route 28 05TERViLLE, iameter concrete co✓ers IVl A EL=100.E raised to within 6'of hrnsh grade (or as noted) Inspection Port and cap oath magnetic marking tape to within 3"of grade �s Enclosed is;r, EXISTING SPOT GRADE Porch fxistmgfL=99.9+ EL=99.4* EL=98.5-99.4(mar) 24x5 PROPOSED SPOT GRADE ��`� 0 EXISTING CONTOUR s \� Lndry Kitchen Eat-In c) �� /� Bth 24- PROPOSED CONTOUR z, /.�/i i �.�/�./ ,. 3 w WATER SERVICE LINE Gara e 9 Dinm -one OVERHEAD UTILITY LINES A �6? 9&6-± m Existing 97.6+ e jdr ' c GAS SERVICE LINE 9C4-± v �� EDGE OF CLEARING a` x � FENCE Go`� °x 974:+ TEST HOLE LOCATION P 97I+ =24E 96.00rV" 5T SEPTIC TANK DB DISTRIBUTION BOXExsting p 5 Proposed 9s.to FLOO PLAN SAS 501L ABSORPTION SYSTEM Gas Baffle I Longest Pun I TMENTY(20)AD5 ARC36(36/COD2) NOT TO SCALE <> /4'±-- /6' 9' --fi# LEACH CHAM29ER5/N BED Eristin g D5_6 CONFIGURAT/ON WITH FOUR(4)ROWS EL=87.8±Bottom of Test ffo% - EX/5T11V6 /000 GALLON (H-20 Rated) OF F/l/E(5)CHAMBER5 m S 1 T E LO C U S 25' SEPTIC TANK D-BOX LEACH CHAMBERS L 5 n L 5.0 L 5.0 L 5 0 L � � L Map 120 � NOT TO SCALE Parcel 13 1 F LOW P RO E I LE N Town Water I .) Assessor's Map 120 Parcel 29 NOT TO SCALE m 2.) Deed Book 2 1 74G Page 137 N �_' 3.) Plan Book 187 Page 93 D-Box °' - 4.) Th15 property 15 in a Zone II of a Public N Water Supply 5.) Flood Zone: C CON 5T RU CT I O N NOTES Inspection Port(See Note#4) o 0� 1.)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE TITLE 5 3 10 CMR I CERTIFY THAT I AM CURRENTLY APPROVED BY THE PLAN VIEW \\,` 1 5.000): STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO SCALE: I ° = 10' ��Enstmy5epteeComponents to UPGRADE, AND EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND 3 10 CMR 1 5.01 7 TO CONDUCT SOIL EVALUATIONS AND THAT be Abandoned(See Note A20) FOR THE TRANSPORT AND DISPOSAL OF SEPTAGE, AND THE LOCAL BOARD OF HEALTH THE ANALYSIS BELOW HAS BEEN PERFORMED BY ME j �`� Parcel 301 REGULATIONS. CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE DESCRIBED IN 310 CMR 15.017. 1 FURTHER Map 120 �Zr Town Water 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS CERTIFY THAT THE RESULTS OF MY SOIL EVALUATION AS Parcel 12 1 �r % / Enstmg Septic POTENTIAL FOR VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO INDICATED ON THE ATTACHED SOIL EVALUATION FORM, ARE �C // Tank to be vtl"d Q / WITHSTAND AN H-20 LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE ACCURATE AND IN ACCORDANCE WITH 3 10 CMR 15.100 Town Water (See Note#/9)�oj2 // BENCHMARK Proposed SAS VENTED TO THE ATMOSPHERE. THROUGH 1 5.107 o 'i, �� Top Corner Concrete �� 7 � � 3.)TO MINIMIZE UNEVEN SETTLING, ALL SYSTEM COMPONENTS SHALL BE INSTALLED ON A (See Plan vew) �� O EL=100.00(Assumed Datum)- - STABLE MECHANICALLY-COMPACTED BASE ON SIX INCHES OF CRUSHED STONE. TP_11 4.)COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK, THE DISTRIBUTION `t-ti . TP-2 BOX, AND THE 501L ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN G"OF FINAL GRADE. Linda './. Pinto, Certified soil Avaluator LEACHING FIELDS,TRENCHES, AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS obW, MANHOLES SHALL HAVE AT LEAST ONE(1) INSPECTION PORT CONSISTING OF PERFORATED O 20 32 4" PVC PIPE PLACED VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH �,� �� 0 N A CAP, TIED WITH MAGNETIC MARKING TAPE, ACCESSIBLE TO WITHIN 3"OF FINAL GRADE. < °�� ohs 5.) PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID Map 120 �, ` �At°t�a�x / W w G, w w !o� ON A MINIMUM CONTINUOUS GRADE OF NOT LE Parcel I I I SS THAN 2% FROM THE BUILDING TO THE 0--�, , /� 3 'F Op• \ SEPTIC TANK, AND NOT LESS THAN I%OTHERWISE. Town Water N\*� O�°J G.) DISTRIBUTION LINES FOR THt 501L ABSORPTION SYSTEM SHALL BE 4"DIAMETER / \ SCHEDULE 40 PVC OR EQUIVALENT LAID AT 0.005 FT FT. UNLESS OTHERWISE NOTED. \c ( ) / LINES SHALL BE CAPPED AT END OR AS NOTED. 7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2) FEET BEFORE SYSTEM DESIGN CALCULATIONS PITCHING TO THE SOIL ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO ASSURE EVEN DISTRIBUTION. SEWAGE DESIGN FLOW REQUIRED:3 BEDROOM DWELL/NG @ LOTS 15 17 c l/0 GPD/BEDROOM=330 GPD REDU/RED 8.)GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE � Area=25,253 S.F.± STRUCTURES IN ORDER TO PROVIDE A WATERTIGHT SEAL. SEWAGE DES/GN FLOW PKOV/DFD: T1,lEN7Y(20)AD5 UNITS INKED \ CONFIGURAT/ON IN FOUR(4)ROWS OF F/l/E(5)UNITS EACI-f \N OF 4f 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE �•� Ass SEWAGE DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM. t/t=((330/0.74)/(4.8 FTZ/PT)/5.0 LFJ = \ o�`� 4cy /9 ADS UNIT5 REDU/RED(20 PROI/IDED) i LI N DA J. r(P 10.) IN ACCORDANCE WITH 3 10 CMR 15.22 1, ALL SYSTEM COMPONENTS SHALL BE o �� c �� 0 PINTO MARKED WITH MAGNETIC MARKING TAPE. 355 GPD PROI//DFD>330 CPO RFQU/RFD OO �g f� �O �C IL n 0 �9 2 0�� 5 �� -" , I 1.)THERE ARE NO KNOWN WELLS WITHIN 100'OF THE PROPOSED SOIL ABSORPTION SEPTIC TANK CAPACITY REQUIRED: 330 GPO X 200% =660 GPD REQUIRED O, 2 SYSTEM. � O� FG p�� SEPTIC TANK CAPACITY PROI/IDFD: f)(15 RN6 f 000 GALLON SEPTIC TANK 9 FS L S T E 12.) FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL s/ONAL RECEIPT OF THE CERTIFICATE OF COMPLIANCE,THE PERIMETER SHALL BE STAKED AND A GARBAGED/SP05AL/S NOT PERM/TTFD W/Tfl THIS DES/GN FLOW 11� �a�l Survey Mork bp.• FLAGGED TO PREVENT USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. A\ v TEST HOLE LOGS \v p `O A & M Land Services 1 3.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS Map 1 20 O� \J 618 Route 28, Suite 3 CONSTRUCTED AS SHOWN ON PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY THE DESIGNER. Test Hole#1 (EL=98.3 Cf a MeSt Yarmouth, MA 02673 Parcel 28 ww11� +) � O VV Pb. (508) 737-1777 Emeil.• anmlend®comcast.net 14.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING Depth Layer Soil Class Soil Color Comments THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS Prepared for: OF THE PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE IS REQUESTED. O-22 Fill 22"-24" A Medium Loamy Sand I OYR 3/2 Edward * Dorothea P. Tocio 15.) LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE 24"-3G" B Medium Sand I OYR 5/G FOR DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR 30-53" C I Medium Sand I OYR GIG 80 Acorn Dr., Osterville, MA TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, BUT IS NOT LIMITED TO, REQUESTS 1 53"-1 2G" C2 Medium Sand I OYR 4/G TO DIGSAFE, ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. P#1 3 1 GG Proposed Sewage D15po5011 System I G.)CONTRACTOR SHALL VERIFY THAT ALL WASTELINES ARE CONNECTED BY WATER Test Hole#2 (EL=98.5-+-) 60 Acorn Dr., Ostervllle, MA TESTING WITHIN THE DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. Depth Layer Soil Class Soil Color Comments Prepared by: 17.)CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF 0"-24" Fill ANY SEPTIC SYSTEM COMPONENTS. 24"-2G" A Medium Loamy Sand I OYR 3/2 51 T E PLAN 20-38" B Medium Sand I OYR 5/G 1, 18.) INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL 38"-50" C I Medium Sand I OYR GIG CSNt at NOT BE USED FOR STAKING, OR ANY OTHER PURPOSES. 50"-1 20 C2 Medium Sand I OYR 4/G SCALE: 1 " = 20' As-Dm Engineering 19.) EXISTING 1000 GALLON SEPTIC TANK TO BE UTILIZED. PVC TEES TO BE INSTALLED ON DATE OF TESTING: 01/03/1 1 INLET AND OUTLET PIPES IF NECESSARY, AND A GAS BAFFLE INSTALLED IN THE OUTLET TEE. 501L EVALUATOR: LINDA J. PINTO, P.E., CSN ENGINEERING INSPECTION NOTE: 0 20 40 GO BOARD OF HEALTH AGENT: DAVE STANTON, BARNSTABLE HEALTH DEPARTMENT P.0_Box 2030 Phone:(508)299-3250 20.) EXISTING SEPTIC COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN PERCOLATION RATE: LESS THAN 2 MIN/INCH IN"C" LAYERS PRIOR TO FINAL INSPECTION BY THE ENGINEER, SYSTEM Teaticket,MA 02536 Fax:(508)548-5478 SAND AND ABANDONED IN PLACE. AREA TO BE COMPACTED TO MINIMIZE SETTLING. NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS. SCALE I"=20' NO GROUNDWATER ENCOUNTERED C:\CSN\AM-Aeorn\AM-Acorn-SDS Plan.dwg Date: 0 1/1 2/1 1 kale: As Shown I By: LIP Check: MA I Project No. CSNO 146