Loading...
HomeMy WebLinkAbout0049 BAYBERRY WAY - Health 49 Bayberry Way Osterville A = 114 001001 Commonwealth of Massachusetts- C rs Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, 4M . 49 BAYBERRY WAY # • ' Property Address LYNCH Owner Owner's Name information is MA ' 1-20-15 . required for OSTERVILLE - every page. City/Town .''State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms the I• /���/ compute r,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not use the return Name of Inspector key. DOUGLAS A BROWN;INC Company Name - P.O. BOX 145 Company Address ' CENTERVILLE A _ MA' 02632 City/Town State Zip Code 508-420-4534 a SI4297 Telephone Number * License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection , was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am-a DEP approved system inspector.pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority � ,. 1/20/15 Inspe is 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 x, and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same different o conditions of use. LI U.. , t5ins-3/13 Title 5 Official InwForrm urface Sewage Disposal System•Page 1 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System-Form - Not for Voluntary Assessments .. yy< 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is OSTERVILLE required for MA 1-204 every page. City/Town y State Zip Code Date of 1, B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of.Section D A) System Passes:. ® 1 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: SYSTEM MET ALL PASSING REQUIREMENTS AT TIME OF INSPECTION"'(property has very high water usage future performance under the same usage can not be predicted) z . 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 ccmpletion of the replacement or repair,'as approved by the Board of Health, will pass. ` Check the box for"yes", "no"or"not determined" (Y, N,'ND)for the following statements. If"not - determined," please explain: The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. - *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is'less•than 20 years old is available. ❑ Y • ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form' , Subsurface Sewage Disposal System Form-,Not for Voluntary Assessments 49 BAYBERRY WAY Property Address r - LYNCH Owner Owner's Name r information is required for OSTERVILLE a MA 1-20-15 _ • every page. Cityrrown State Zip Code. Date of Inspection B. Certification (cont.) ' ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): . ` ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven,distribution box. System will -pass inspection if(with approval of Board,of Health): ❑ broken pipe(s) are replaced �� ' ❑ Y' ❑ N', ❑ .Np (Explain below): ❑ obstruction is removed r ❑ 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): r - C) Further Evaluation is Required by the Board,of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health„safety or the environment. ` 1. System will pass unless Board of Health'determines in accordance with F310 CMR 15.303(1)(b)that the system is not functioning in a manner.which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 _ a Commonwealth of Massachusetts Title 5 Official Inspection dorm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, M Sye,a 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is required for OSTERVILLE MA 1-20-15' every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) , 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a"public water supply. r ❑ 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 56 feet or more from a private water supply well**. i Method used to determine distance: **This system passes if the well water analysis,performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form: 3. Other: D) System Failure Criteria Applicable to All Systems: . You must indicate"Yes"or"No"to each of the following for all inspections: Yes No. ❑ ® Backup of sewage into facility or system component due to overloaded or, Y clogged SAS or cesspool ❑ ® Discharge'or ponding of effluent to the-surface of.the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 0 ® Liquid depth in cesspool is less than 6" below invert'or available volume is less than %day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 t Commonwealth of Massachusetts.? Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for.Voluntary Assessments. 49 BAYBERRY WAY - Property Address LYNCH Owner Owner's Name information is required for OSTERVILLE' MA 1-20-15 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NQT 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 publicrwell. ❑ ®,' •,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, t 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 ❑ EJ the system is within 400 feet of Y a surface drinking water supply PP Y ❑ ❑- 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 a 'Area—IWPA)or a mapped Zone.11 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 ' l r Commonwealth of Massachusetts Title 5 Official Inspection Form ' ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is CISTERVILLE MA 1-20-15 required for every page. Citylrown 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? ❑- n Has the system received normal flows in the previous two week period? El .® Have large volumes of water been introduced to the system recently or as part of this inspection? El 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. - ❑ Z Determined in the field (if any.of the failure criteria related to Part Cis at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: per as- Number of bedrooms (design): 5 p`f Number of bedrooms (actual): •5 per owner. built DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts ' r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments M 49 BAYBERRY WAY Property Address LYNCH _ v Owner Owner's Name information is required for OSTERVILLE MA 1-20-15 every page. Citylrown State Zip Code •. Date of Inspection D. System Information , Description: ' according to as-built system consists of a 1500 gallon tank d-box and a 12x44 leach area with 330 leach chambers - Number of current residents: Does residence have a garbage grinder? " ❑ Yes ❑ No Is laundry on a separate sewage system?`(Include laundry system inspection information in this report.) ❑ 1' s,%❑, No Laundry system inspected? t ❑ Yes ❑ No Seasonal use? ® Yes.❑ No Water meter_readings, if available(last 2 years usage(gpd)):. Detail: 2014-----1139 2013------=1386gpd house has irrigation and pool Sump pump? A ❑ Yes ❑ No Last date of occupancy: - -^Date • . - Commercial/Industrial Flow Conditions: Type of Establishment: , Design-flow(based on`310 CMR 15.203): . Gallons per day(gpd) Basis of design flow(seats/persons/sq t., etc.): Grease trap present? ❑ .Yes ❑ No Industrial waste holding tank present? ' ' ❑ .Yes ❑ :No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 R r Commonwealth of Massachusetts Title 5 Official Inspection Form . -- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 5•'a< 49 BAYBERRY WAY Property Address ; LYNCH Owner Owner's Name information is required for OSTERVILLE MA 1-20-15 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: Was system pumped as part of the inspection? E1. 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 R Overflow cesspool ❑,• ! Privy ❑ -Shared system_(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval: ❑• Other(describe): " t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page S of 17 a F • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 49 BAYBERRY-WAY Property Address a LYNCH Owner Owner's Name ' information is required for OSTERVILLE MA -1-20-15A _ every page. Cityfrown State, Zip Code./ Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: april of 2002 per as-built + Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction:• ' cast iron 40 PVC a m ❑ ❑ other(explain): Distance from private water supply well or suction line: ' A•` feet r • ' Comments(on condition of joints, venting, evidence of leakage, etc.):',. t Septic Tank(locate on site plan): l; Depth below grade: 5 feet , Material of construction: ® concrete ❑ metal,` ❑ fiberglass ❑ polyethylene '❑ other(explain) If tank is metal, list age: t years 'Is age confirmed by.a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No r' Dimensions: 1500 per as-built Sludge depth: light to moderate t5ins-3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is required for OSTERVILLE 'f MA 1-20-15 � every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.)* - f ° - Septic Tank(cont.) ' Distance from top of sludge to bottom of outlet tee or baffle Scum thickness trace clumping Distance from top of scum to top of outlet tee or baffle" Distance from bottom of scum to bottom of,outlet tee or baffle How were dimensions determined? wooden pole' '. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, • liquid levels as related to outlet invert, evidence of leakage, etc.): tank is only about 6 inches deep covers could use replacing in the'near future,no signs of leakage or surcharge. irrigation lines are running over the top of the tank in the area of the covers. Grease Trap (locate on site plan): Depth below grade: „ t feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top'of outlet tee or baffle,,' Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: . d Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Assessing As-Built Cards Page 2 of 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is required for OSTERVILLE MA 1-20-15 every page. Citylrown State .Zip Code Date of Inspection D. System Information (cont.) - Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.):' Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: x Material of construction . ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other'(explain): Dimensions: Capacity: , • gallons . Design Flow: gallons per day, Alarm present: ❑ 'Yes ' ❑ No Alarm level: a 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 - L t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 http://www.townofbamstable.us/Assessing/HMdisplay.asp9mappar=130033&seq=1 12/11/2014 Assessing As-Built Cards Page 2 of 2 Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 49 BAYBERRY WAY Property Address LYNCH : Owner Owner's Name information is OSTERVILLE MA 1-20-15 required for - • , a every page. Cityrrown State Zip Code- Da_te.of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert off 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.): box showed no signs of leakage or solid carry over.at time of inspection- Pump.Chamber(locate on site plan): Pumps in working order: El Yes ❑ No* Alarms-in working order: +❑ Yes ❑ No" Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order,`system is a conditional pass. Soil Absorption System (SAS)(locate on'site plan, excavation;not required): ; If SAS not located,"explain why: 4 no observation ports were found so the level of pondin [staining could not be determined t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17' http://www.townofbamstable.us/Assessing/HMdispl4y.asp?mappar=l 3 003 3&seq=1 12/11/2014 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .M yvey`e 49 BAYBERRY WAY b Property Address " LYNCH t , Owner Owner's Name information is - OSTERVILLE- MA - required for 1-20 15 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.j ' 7, Type: ❑ leaching,pits number: ® leaching chambers number: 330 leach chambers 0 leaching galleries number: , El leaching trenches number, length: ❑ leaching fields number, dimensions:' ❑ overflow cesspool number: " ❑ innovative/alternative system Type/name of technology:` Comments(note condition of soil;signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): no signs of failure in area of leaching chambers:_there were no observation ports found so level of ponding and staining could not be determined. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 4 Depth—top of liquid toinlet invert Depth of solids layer Depth of scum layer ' Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 1 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 t f Commonwealth of Massachusetts - W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name ' information is required for OSTERVILLE MA 1-20=15 every page. Citylrown 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.): 4 r Privy(locate on site plan):' ' Materials of construction:. - Dimensions . Depth of solids `a Comments(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, , etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r ' 49 BAYBERRY WAY +- Property Address LYNCH - Owner Owner's Name information is required for OSTERVILLE " MA 1-20-15 �- every page. Cityrrown 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: a ❑ hand-sketch in the area below •-, ` ® drawing attached separately 4 r • R t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary,Assessments 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name information is required for OSTERVILLE MA 1-20-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar Z Shallow wells Estimated depth to high ground water: greater than5 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: 12015 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: r ❑ Checked with local excavators, installers-'(attach documentation) ❑ Accessed USGS database explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Assessing As-Built Cards Page 2 of 2 http://www:townofbamstable.us/Assessing/HMdisplay.asp?mappar=114001001&seq=1 2/11/2015 Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 BAYBERRY WAY Property Address LYNCH Owner Owner's Name i information is required for CISTERVILLE -MA 1-20-15 - every page. CitylTown 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. Z. Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file F t , - • .. .. � a . t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 r Assessing As-Built Cards Page 2 of 2 hq://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=114001001&seq=1 2/11/2015 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE ' LOCATION P SEWAGE# 6D VIf LAG£ rP.f' ASSESSOR'S MAP&LOT .o INSTALI ER'S NAME&PHONE NO. W&J 1 AW7 /, yW dlrU 9 I` SEPTIC TANK CAPACrt'Y LEACHING FACILrrY.(type) (si,e) NO.OF BEDROOMS /'W_ BUILDER OR OWNER PERMITDATE: _COMPLIANCE DATE: U 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 Fscility(if any wetlands exist within 300 feet of leaching facility) Feet Furnished by http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar7114001001&seq=1 2/11/2015 _ TOWN-OF BARNSTABLE LOCATION SEWAGE # ®® 30 XII_,LAGE S��:f' 1� d� f ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. W11,1-1407 12kwColrk 2 Z' ��' SEPTIC TANK CAPACITY 1 $—V Q poi LEACHING FACILITY: (type) 36 s. �o (size) NO. OF BEDROOMS h}ve_ BUILDER OR OWNER PERMITDATE:_ COMPLIANCE DATE: U -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 - t on site or within 200 feet of leaching facility) Feet ' Edge of Wetland and Leaching F2cility'(If any wetlands exist - within 300 feet of leaching facility) Feet Furnished by i \10 TOWN OF BARNSTA.BLE �Dllo - �L06 ,TION � �' �i — SEWAGE # ®© VILLAGE STa�' ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. W7L11 I A-"% 19ilwc-gk 2 Z 1"ZW D SEPTIC TANK CAPACITY 0141— A - 1 14- W 1 o o I LEACHING FACILITY: (type) 3D r, L,, -(-- (size) NO. OF BEDROOMS F Ve-. BUILDER OR OWNER PERMITDATE: L I COMPLIANCE DATE: qk V t 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 j �, � '+ _ i' s �. I� I !4 I� �� � � � - Y. T � /, �� � No Fee -`'ir► THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:� es Yes PUBLIC HEALTH DIVISION -TOWN OFBARNSTABLE., MASSACHUSETTS 01ppYication for Miowar *proem Con!6truction Permit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) XComplete System ❑Individual Components Location Address or Lot No. /19 i34j 6e r j lava l Owner's Name,Address and Tel.No. OS+rvu i I Le ia"t-c-i S . 1�` -ci-- Assessor'sMap/Parcel Z Cc.1litou bn l�vILf 1)1a 114 Pam. / /—® w co Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4 Z..S'i 131 , xt 13 S txcpr-tee. A• W i t s w. Av'Im"'a CPS N�hU� is*-.ft,, NW_ -t 1-la iVI-16M.• � Type of Building: Dwelling No.of Bedrooms S Lot Size 44,3 3 k sq.ft. Garbage Grinder 40) u Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /��A6y6i gallons per day. Calculated daily flow S gallons. Plan Date :Z/Z zlori Number of sheets a&- Revision Date 5- Z9 V Title 5 c k... - g_s c — 40t 13&tj 6c r Size of Septic Tank c> Type o S.A.S. kcosh '.1( Zt ►yt� Description of Soil 12,k 4v- rat lans 17 X Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the nvironmental Code a_nd nq_t,7to place the system in operation until a Certifi- cate of Compliance has been issued by this Boar of Health. �!- ---� Signed ' _ Date Application Approved by :,r Date Application Disapproved for the following reasons Permit No. Date Issued 2`� 8 LZ No. D�'"� �0 Fee 00, Entered in computer: '-=-T-HE COMMONWEALTH OF MASSACHUSETTS Yes OUBLIC HEALTH DIVISION'-TOWN'OF-BARNSTABLE; MASSACHUSETTS; ; pYication for Migpogaf 6pgtem Congtruction Permit ' Application for a Permit to Construct( X),Repair. p, Upgrade( bandon( ) &omplete System 0 Individual Components Location Address or Lot No. 444 Raj tier-1 (,s owner's Name,Address and Tel.No. Asses`s'or's Map/Parcel 7 t;.n l k o V . v I�x //lo 114 / /—/ Gr=cv�w�cV1 Goer, --Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4 Z$ `t 131 c xf 16 51cjjlu.% A. Wilsw% 81t YYlri�r+ Str«t G7sk►�vilie � Type of Building: r Dwelling No.of Bedrooms S "� Lot Size 4'41 330 sq.ft� Garbage Grinder 4) v Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ��O 9/"�� gallons per day. Calculated daily flow 5 gallons. Plan Date 5-1ZT Number of sheets one— Revision Date SLzgl'y Title 'x he S s —1 �c5r h - 4ct l3a 1'xr l� Io t Size of Sept=c Tank ' ��Ilu-►r Type of S.A.S. ��� G�11 !ol 2i tiijh Description of Soil ,k_l 4-r 1 y5�g r-" n l e As (-F-- `fi 8 i 3) O X Y Nature of Repairs or Alterations(Answer when applicable,) JF y, .I4 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 nvironmental Code and-n. place the system in operation until a Certifi- cate of Compliance has been issued by this oar of Health. Signed . Date Application Approved by t i Date 2 D Application Disapproved for the following reasqns Permit No. Date Issued 2 O/ --------------------------------- ----- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired( )Upgraded( ) Abandoned( lyb at y r W� 05 rv%r P has been constructed i accordance with the provisions of Title/5 and the for Disposal System Construction Permit Po. 90 1-3)' dated 60 2, Installer Designer The issuance of thiLBermit shall not be construed as a guarantee that the syqgeqi will function _ designed. Date 5 U x Inspector — .-.-----------------------------Fee No. ' Z(J THE-COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Itgogal 6pgtem Congtruction permit Permission is hereby r ed to Constfuct Repair( )Upgrade(� )Abandon( ) System located at and as described in the above Application for Disposal stem Construction Permit. The applicant recognizes his/her duty to PP P System 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 ermit. Date: r 3! z Approved by L e TOWN OF BARNSTABLE r c. LOCATION ` �' �/ "� SEWAGE # ®® J VILLAGE Sref' tee. ASSESSOR'S MAP & LOT11�-01 INSTALL'ER'S NAME& PHONE NO. W11,1-1 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) X 3a 5, Li (size) -�—.,Y y� NO. OF BEDROOMS JIMPFve— BUILDER OR OWNER PERMIT DATE: _COMPLIANCE DATE: U 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 (1f any wetlands exist within 300 feet of leaching facility) Feet Furnished by I i i I 7 ' 7 I ZHE Tp� DATE:_ V-76 0/ s FEE: sAMSPABL& MASS. 1639. ,0� REC. BY �f�"AOjA Town of Barnstable SCHED. DATE: /d/9 d/ Board of Health RECEIVED . 367 Main Street, Hyannis MA 02601 JUN 0 12001 Office: 508-8624644 Susan .Rask RS. FAX: 508-790-6304 Sumn rKTa��%r.P�:ISTABLE Ralph .Mu EPT' VARIANCE REQUEST FORM LOCATION - Property Address: G&.&t,r,ry ll1.0 0-0z v:1 6- Assessor's.Map and Parcel Number: ill 114 Pd /—/ Size of Lot: 441 Wetlands Within 300 Ft. Yes Business Name: No ,/ Subdivision Name: APPLICANT'S NAME: 1)4,1.1 `S. Phone 4�46) 38_ So23 Did the owner of the property authorize you to represent him or her? Yes _� No PROPERTY OWNER'S NAME CONTACT PERSON Name: 1[�)4„ta1 S. 1,!y%C-LA Name:mph.•. A L4jj,.c., ►0C• 1 13 e,eFrr, KN ; k a I.r..Jre•1 Address: 7 Cc-jk,4, pr. Gne-%%-.�e'r.. Address:_BIZ YYtet.j S+. OSI-try, 1A, MA Phone: Phone: 5 a s VARIANCE FROM REGULATION,(List Reg.), REASON FOR VARIANCE(May attach'if more space needed) A�U de��cn sso re�uiru�— e _ I Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request \. Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting •• date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same o-ne/]—only].outside ' dining variance renewals(same owner/leasce only],and variances to repair failed sewage disposal systems(only if no expansion to the building proposed)) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION SEWAGE# OD VILLAGE d5. L//A4LM ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. . SEPTIC TANK CAPACITY /5 W Q 0140 LEACHING FACILITY: (ty{x) X 310 S6 (size) / y NO.OF BEDROOMS�� W- BUILDER OR OWNER ! PERMIT DATE: 0 COMPLIANCE DATE: V 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 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=l 14001001&seq=1 3/11/2015 Town of uarnstame P hl Department of Health,Safety,and Environmental Services �taer Public.Health Division Date q, 367 Main Street,Hyannis MA 02601 eetuvereatE. Huss. "rfor►�� Date Scheduled �'`�.� CA2✓� Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: (� �� �(/�'4_10 y WitnestedBy: Donna- mor"c,.vji LOCATION & CENER4L INFORMATION:: Location Address 4q;s: 1' Owner's Name Ica _ Address 134 r�laer.•� t:Jn•� _ AID Assessor's Map/Parcel: {mac. 114 Pe I I— I Engineer's Name Goxh r, 1J a y H of w i—erl 5 rc vc kj3 t.c V NEW CONSTRUCTION _ REPAIR Telephone N �(7,cc ct I c.rrr / Land Use Slopes(%) Surface Stones 7 o 4e— Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft ; Property Line R Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ' hw'sez Cu y ti N �y Tf,I �a y �V, TP Z \ i 7(s,E;i \ Parent material(geologic) CD1aC«t Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater, " D.ETERMINATTOI�i F.09 SEASONAL`,HAG .WATER TABLE ....................::..........:.............................::...... ........ ..................:...... .. ..................... . Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in.. Depth to weeping from side of obs.hole: in. Groundwater Adjustment tt. -y _ Index Well# _ .._. .,. Reading Date Index Well level_-_._ Adi.factor Adj.Groundwater Level rERCOLATION TEST Rate $ Jii i to.I o Observation Hole ff Time at 9" Depth of Perc b Time at 6" Start Pre-soak Time Q 0 3o Time(9"-6") End Pre-soak Rate Min./Inch /Lss AA&—z1--"�`> Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant r DEEP OBSERVATI;ONHC.LE LOG Hole# ; Depth from Soil Horizon Soil-texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n ' tenc Gravel) CZ DEEP QBSERVATTON HOL 'LOG Hole # Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. a i to c °°Gravel) A'pa 4/1 U f 1 v t t" 5 4 t 10.\i t2 --/(.- sq �13Z'' C V11s..cQ. v�ancR 10 9 R '7l3 DIMP OBSERVATI.QN HOLE LOG Hale# Depth from S 1.oil Hdrizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.% 'ravel DEEP OBSERVATION HOLE LOG Hole;# Depth from Soil Horizon Soil Texture Soil Color Soil Olher Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. onsistenc ° Gravel i I I 1 Flood Insurance Rate Man: Above 500 year Flood boundary No_ Yes l.a' _Within_500 near boundary No ? Yes �• Within 100 year flood boundary No tom' Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? LP, If not,what is the depth of naturally Occurring pervious material? Certification I certify that on kcs (date)1 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 training,expertise and experience described in 310 CMR 15.017. Date Signature�//'y' d� ---- -—-—-—- REMODELED GAMEROOM CLOS. HVAC/ HVAC/ STORAGE STORAGE -------------------- sEMmE ------------- a t Ar . tam IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS I „,.arrs aurae lrvreawa oEr�ww.QIMATE ZONE 5IUSE EITIffRPRESCRIPTNE VALUES OR RESCHCCItC4LUlAipN TNELV Is„aM+A'tvis wvceTwixAwrvauuws a BASEMENT PLAN N�a�a�aEREa �.E • _ TABLE 40'tQ(MINIMUM PRESCRIPTNEINSUTATWN6FENE5TRltTION REONREMENTS eowppilorviwv ata uvl Gnl wsuuttw unv ae l'atuLelx LEGEND: „v eabrva,�ro rvry E-T A, EXISTING WALLS sra o CONSTRUCTION TO BE REMOVED NEW CONSTRUCTION EFEa _ a�.1L.1 Ea eME LL a-t,MUEA�EnsATrl,mt.A,loN s sua,eo r„E EaI oEo..IrvsM,�rla.laa.„„aE NOTES: I„ a„n Iucou w LE xaoa.wu.aNLUEaa 1.)CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS Y,:uasrAce &DIMENSIONS IN THE FIELD k eEnoaa evm oasucaxE 2. CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALSAT T—KATE RE s rvr ArsueE FV E ' DETAILS,8 FINISHES IN THE FIELD WITH OWNER 3.)ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS wmm.crwraom caEte STATE BUILDING CODE,8TH EDITION AM ENDEM ENT&IRC2015 4.) VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE DURING FRAMING CONSTRUCTION 5.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE _ 6.)FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY •• ••�. EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION ,!10ET�AIL FOR BASEMENT FINISHING INSTALLERICONTRACTOR. ��/J`"'`` ®C�® COTUIT BAY DESIGN,LLC NEW ADDITION/REMODELING FOR: _ SCALE: DRAWINGNO.; 43 BREWSTER ROAD MASHPEE MA. 02649 gOTSFORD RESIDENCE ii4 — D PH.(508))2%4-1166 o �`E�.Ng' A 1 FAX(508)539-9402 a oa DATE 49 BAYBERRY WAY, OSTERVILLE, MA �' �:E �o� 11/29i2017 I o-•04 �— I •I Ir Ns i II S' I J _ 1 5To (� 'b : a :6 y - p o IJ i r � F.os , I 13; I . P I N za fn I i r n ems• I © vr p 1( ' .0 > �., g Z ' A A ...._ ' ' ROYAL BARRY WILLS, ASSOCIATES, INC. 4' ► Lynch Residence x� � ��ow ��� " 1 I f �m'r�� 'r. a A R C H I T E_ C T S eny Way 6 OsteMlle,Mass. 8 NewburyStreet•Boston Richard Wills,A.LA. Ell W I� - � _ I I .c if 3G w_ O nH zm p. ^ 4 — a 1-7 ©� v o 'Avea L .Ltl 0 P "fl I r I a, icy-sue . yy @UUllp , r l ®: oil Rk R 1 -._ 7 -- - p No L rich Resid'enee° �a ROYAL $ARRY WILLS ASSOCIATES, INC. a .� Ci 9 A R C H I' T E C T S . 49 Bayberry Wa;� >a o i 2 N a Oster vile,ll�ass. _�' F u, '° 8 Newbury Street-Boston Richard WiI1s,A.I.A. i 1 j fir: � � fi .. ri .. � •. ......... , 15 7. r x� - JL8 r CP —�ro-RtrrscY. L a! • r' a e, • {- - . Uzi=-_ ., .-._ 16 �r to ll a O � J r , .l ROYAL BARRY WILLS ASSOCIATES, INC. z tn� Lynch Residence A R C H I T E C T. S z m o Ev Z 49 Bayberry Way c & p e — o € i Osterville;Mass. r8 NewburyStreet•Boston Richard Wi11s,A.I,A. it Design Schedule ule ELEVATION Leaching Area Requirements TOP OF FOUNDATION 24.5 s_w ED BASEMENT FLOOR 14.5 FINISH �S BEDROOMS AT 110 GPD/BEDROOM = 7 GPD _ FINISHED GARAGE FLOOR 23.8 ADDITIONAL 50% FOR GARBAGE DISPOSAL: NIA +��, / SEWER INVERT AT FOUNDATION 21.0 SEWER INVERT INTO SEPTIC TANK 20.8 PERC RATE = TWO MIN. / INCH (CLASS 1 ) SEWER INVERT OUT OF SEPTIC TANK ! 20.5 _% + SEWER INVERT INTO DISTRIBUTION B( X t 20.4 LTAR = 0.74 GPD/S.F. ?'0�� SEWER INVERT OUT OF DISTRIBUTION BOX 20.2 MIN. LEACHING AREA OF S.A.S. SEWER INVERT INTO LEACHING SYSTEM 20.0 BOTTOM OF LEACHING TRENCH 18.0 770 GPD/ 0.74 GPD/S.F. = 1040 S.F. MIN. +WO �, 0 / WATER TABLE None obs. @ EI 12.7 p, PROPOSED SYSTEM s � 829 GPD W/LEACHING AREA OF 1 120 S.F. 'Nol / 2$•ArA'46, E / / ��F / GENERAL NOTES ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH + TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995 AND / ANY LOCAL RULES APPLICABLE. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY DESIGN ENGINEER + _ I O �° WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, A�1 43 0?' A' -�72 80 _A=9Fa 12' NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT 4$ 76 -v / + / FINISHED GRADE FOR INSPECTION. � / / \ \ \ \ \ \ \ \ \ \\ \ \ \ \ 36"MAX:- 12"MIN. / / / / / '°p / /\/\/\/\/\/\//\//\//\//\//\//\//\//\// COMPACTED FILL o�sF / 2, /\\/\\/\\/\\/\\/\\ \/\\/\\/\\/\\/\\/\\/\\/ PEASTONE FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. s a J d 4 THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN a a z ��� 30.5" e d /4„ 70 1 1/2 APPROVAL BY DESIGN ENGINEER +�" -� 2 a d DOUBLE WASHED STONE ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC - SCH. 40 {PY 1 + SECTION EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING \ NO SCALE SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER ` c f �F 310 CMR 15.255. 4 i ��W PY oo �° / PLASTIC LEACHING GALLEY D[.TAIL PRIMARY BENCHMARK : DPW DISK 124N c' (�FZ` � PROJECT BENCHMARK ELEVATIONS BASED ON N.G.V.D. ALL PIPES TO BE SCHEDULE 40 PVC Cn 31'1 0� j + 4, / LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE os�o � +� UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. f, + a ak c'no Off, 0sF / 9, -�� . 18 TOTAL UNITS 1 STARTER,1 END, & 8 ,A TERM EDIATES. �1 +� F !y • t +� \ j .5 WASHED.STONE..'4 : f Of L C.G. 2664-120 � ,,"•,. ��N /�N�P�(�I OF,1�gSs9 +� LOT Z `,�- / j p�� STEPHEN cC\ j 2 `�/ 6 7> --� o � 44=ft SO. Is T o_30216: I '.O yes �'` PLAN 0 F �° - f �., LEACH CHAMBERS 1< IS1 -� F , . AL 6Ag• / I CERTIFY THAT TO THE,BEST OF MY KNOWLEDGE THE FOUNDATION NO SCALE �, + / SHOWN HEREON IS IN COMPLIANCE WITH THE APPLICABLE BARNSTABLE ZONING DISTRICT SIDELINE AND SETBACK REQUIREMENTS, IS c�sr J / LOCATED IN,_RELATION TO THE MONUMNENTS SHOWN, AND IS NOT PLAN ^f SCALE +� LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA. THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY-LINES. 49 Bayberry Wa / �/ y y 0' 20' 40' 60, RE G ERED PR FESSIONAL LAND SURVEYOR DATE astervilley Massachusetts BENCHMARK TOP OF C.B. ELEV.= 24.86' 9 / / PREPARED FOR DANIEL S. LYNCH TITLE - Septic System Design TYPICAL SYSTEM IJROFILE BAXTER, NYE & HOLMGREN, INC. P-9813 FINISHED GRADE = 23.8 SOIL Lass ENGINEER : Steve Wilson, P.E. DATE August 7th, 2000 ' — NOT TO SCALE i BOARD OF HEALTH AGENT: Donna Morandi BAXTBR, NYE & HOLMGREN, INC. TOP or TEST PIT 1 TEST PIT 2 TEST PIT -- RegisteredFOUNDATION Professional FINISHED GRADE OVER TANK = 23.51 5 6e,d room G.S.E. = 23.8 G.S.E. = 23.7 Engineers and Land Surveyors FINISHED GRADE OVER D. BOX = 23.Ot g>tn y- FINISHED SHED GRADE OVER LEACHING TRENCH 23.Ot Q ., „ D ,, „ "MIN. 3" (mi ;I m m t / Ap — Sandy Loam A — Sand Loom 812 Main Street, 0sterville, MA 2655 0 4" SCH. 40 PVC 2 X y u „ 10 YR 4/1 9" 10YR 4 1 Phone - (508)428-9131 Fax - (508) 428-3750 TYPICAL 4" SCH. 40 PVC FIRST 2 (TO BE LEVEL) I 8 12" (min) Cover _e. �m;r,.1 OE2 min 36" (max) Cover "B" - Sandy Loam "B" - Sandy Loam 10" CI TE€s 7.7 YR 5 6 7.5 YR 5 6 2"Layer 1/8"to 1/2" 14 15 FINISHED f _ 9 GAS BAFFLE 6" SUMP 4' SCH. 40 PVC „ / CONSTRUCT ACCESS d BASEMLNT i MANHOLE OVER INLET —� :z Peastone LEACHING CHAMBERS FLOOR = 14 5 TO TANK TO AT LAST - WITHIN 6" FINISH GRAD 6" CRUSHED �, -� _ Slope = 0.005 min C1 ' - Medium Sand 'Cl" - Medium Sand REINFORCED conlcREr STONE 10 YR 5/8 10 YR 5/6 FooT,Nr, • O O O O • O O • O • O 70 54" SCALE:i "=20' DATE: 5/22/01 , ,. 4" PVC ___ ____ O O O O O • • O O O O O O O O O O O O O O O O O "C2" - Medium Sand "C2" - Medium Sand REV. DATE: 10 YR 6/4 10 YR 7/3 REMARKS BorroM ELEV. = 18.0' 132" 132 REV. 1 5 29 01 7 Bedroom System — Bottom I w„ Bottom of Test Pit 1sp� of Test Pit0 _7'16 f�- GALLON SEPTIC TANK DISTRIBUTION BOX 5' MIN No Water Encountered No Water Encountered TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE PERC © - 60" DRAWING NUUBER SEPTIC TANK TO BE INSPECTED & CLEANED ANNUALLY — OUTLETS REQUIRED No Groundwater Observed ® El. 12.7 Plastic Leaching Galleys RATE= 2 MIN/IN H:\2001 2001 -36 Surve Worksheet 2001 -036ws 2001 -36