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0044 CROSBY CIRCLE - Health
44 CROSBY CIRCLE OSTERVILLE - - A= 116 020 �j ,1. �ee r 3� o TOWN OF BARNSTABLE LOCATION q q C�t1pS�,w. -1,l`� SEWAGE# 2D?_0 VILLAGE ^ASSESSOR' MAP&PARCEL 111 -016 INSTALLER'S NAME&PHONE NO. r� SEPTIC�TANK CAPACITY J)c--e> LEACHING FACILITY:(type) YZ Z (size) NO.OF BEDROOMS OWNER PERMIT DATE: Z 3 2_0-Z-6 COMPLIANCE DATE: Separat n 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 o 41 COVA 02 GqC-� Uf `� n % �. No. dOq�_ 3 �4 K� i Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS o - Tipplitation for Bispdsal 6pstent Construction Permit Application for a Permit to Construct(1�Repair( ) Upgrade( ) Abandon( omplete System ❑Individual Components Location Address or Lot No. Nf GY C 2 Owner's Name, ddress,and Tel.No. /1'►►Q� Assessor's Map/Parcel (1 t 10,20 d S Installer's N ddress,an Tel.No. Designer'4 Name,Address,and Tel.1To. �, �u VQ,1 En�.�ree�,�Sf Ce ofFdf� C �' � 4 , og—YZ g ��3yl Type of Building: F_x('Sf,hS Dwelling No.of Bedrooms 5— Or Lot Size 16 1/ sq.ft. Garbage Grinder( ) Other Type of Building G ih to Pam,ly No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date—(I 1 7 202 0 Number of sheets Revision Date Title S',4 6.1- )0(b o5-eW / Size of Septic Tank,S-�,p lSco G<r�h Type of S.A.S. y � 6: Description of((Soil 7't4—'/ O (7/f`` `F;�� �7— S �4 �(��ii►i -fir►[l 25--f1`�� -cam Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board otllealLh. Signed - Date Application Approved by Date Application Disapproved by 1 Date for the following reasons Permit No. a t) O 3$'_' Date Issued j2. 70 ti � ter ! f� P;i J acp l V No. " Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISIOR OF BARNSTABLE; MASSACHUSETTS Yes applitatiou>,for Mts dgkt *pstem Construrtiori ermit Application for a Permit to Construct(!,)`Repair( )' Upade(. ) Abandon(�^)` Complete System ❑Individual Components r- Location Address or Lot No. y CCns ,'f"C Y �, Owner's Name,Address,and Tel.No. � Assessor's Map/Parcel fit 62 0 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ` Sv ff,'✓Q l Type of Building: y1Y Dwelling No.of Bedrooms 5 �/ Lot Size 16 i sq.ft. Garbage Grinder( ) Other Type of Building ,,t, l r�sr.�/ y` No.of Persons' Showers( ) Cafeteria( ) Other Fixtures _ ' Design Flow(min.required) / 3 5 d pI gpd Design flow provided gpd Plan Date ��rl-17 e�7° :1 Number of sheets Revision Date t Title S; Q 'E 14 1r6n � Ie( _7__4tA t o d. P�� / f d. Size of Septic Tank7E�<1 S'�`.)t✓ (>co Gar rah Type of S.A.S. Y" 50c, 6:o Description of Soil '/ 0 .r'- �, ��; ( „��S b (o4F^,yr '�,+� , h��'f`/( 13 ( j-v ,i e. "/49 E'rVAI Fri Nature of Repairs or Alterations(Answer when applicable) Date last,inspected: Agreement: Y 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 Health. - Signed ` Date Application Approved by v• G 1 "� Date 12 Application Disapproved by ! Date ,fof•thg following reasons Permit No. y 0" $6 Date Issued 12- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS t Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by at r E' has been constructed in accordance with the provisions of Title"5 and the for D .aLSystem-C-onstruction Permit No. n10 -3$6.t dated �'�` 3f O k� Installer � Designer �U (•,444-fi,ILK,r,�Tm c #bedrooms Approved design flow ' gpd The issuance of this permit shall-not be 5 hstr/ued as a guarantee that the system ill function Sie d. Date �i Yl Inspector No. - 020 ` 7j gfo _ Fee 150 y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC,,HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ' -Misposar *pstem Construction Permit` r ' Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at `�. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. h r �--� Provided:Construction must be completed within three years of the date of this permit Date ( � J u Approved by O'Connell, Timothy From: Chuck Rowland <chuck@sullivanengin.com> Sent: Tuesday, March 09,-2021 10:10 AM To: O'Connell,Timothy Subject: 44 Crosby Circle - Septic Detail Notes Tim, Thank you for taking a look at this project for me. As discussed please add this email to the file and attached to the approved plan A note about the sewer ejector pump needed to be added to the plan. As per 310 CMR 15.229 Pumping to Septic Tanks The ejector pump from the addition will be less than 25%of the design flow of the system,the pump discharge pipe is building sewer line and the non-grinder sewer ejector pump shall be less thank 60 gallons per minute and capable of passing a two inch diameter solid. I trust this meets your needs. Regards, Chuck Chuck Rowland, P.E. �lneering 8° sdivan, .Consniting,lnc 711 Main Street/P.O. Box 659 Osterville, MA 02655 508-428-3344 508-428-9617 (fax) CAUTION:This email originated from outside of the Town of Barnstable!,Do not click links, open p y y ' g email address and know:the'content'is safel attachments or.re I , unless ou reco nize the,sender's ._ .: . 1 - Town of Barnstable, . Inspectional Services Public Health DivisionHAS& - s�Rt18TAtti, •+ ,' Thomas McKean? Director a : 200 Main Street,Hyannis,MA 02601. Office: 508-862-4644 3 Fax: 508-190-6304,, Installer& Desi ner Certification Form. Date: 12- 5 Sewage Permit# Z020- Assessor's MaplParcel Designer: ;�r✓ iti ' . )��er;n Iast011er: Zi2j coca fi! ,A Address: 7t( i'-+4: S-Eree. Address: �) • On 1Z 3 Za Z G ��," "LE /1�s �Z was issued a permit to install a- (date) (installer) )l septic system at `��� Cro! , CIX�e Qs�.ar�,°�w , based on a design drawn by (address) /! +' dated t l/17`.2oZ o r, v;feJ 21(tj/2 G Z j S�ll;�Gk �� i�,e•eP;' • _ . esigner) cansc�(6,i� y I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic'system referenced above was installed with major changes (i.e. greater than 10' lateral relocation-of the SAS or any vertical relocation of any component rater septic system) but i accordance with State & Local Regulations. Plan revision or certified as-built by gner to follow. Strip out(if required)was inspected and the soils were found sat' - ctory. ~ . I certi at the system referenced above was constructed in ce with the to rms of approval letters (if applicable) �ttAOF Nqs C2 CHARLES ROWLANDtp c CIVIL —. nstaller's Signature)• Na. 52699 ,�' • F Sk1NAL ' (Designer's Signature) (Affix Design p Here) . PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- .BUILT CARD ARE RECEIVED BY THE BARNSTABLEYUBLIC HEALTH DIVISION. THANK YOU. WoAdeptMEALTIASEWER connectZEPTIMesigner Certification Form Rev&14-13.DOC • PPTOWN OF BARNSTABLE LOCATION t6 C c SEWAGE # VILLAGE / ASSESSOR'S MAP & LOT i' INSTALLER'S NAME&PHONE N0. , e -5o4giay - /O SEPTIC TANK CAPACITY d® -9' ) LEACHING FACILITY: (type) y �Q (size �� "[ �` J - NO.OF BEDROOMS nn *r BUILDER OR OWNER_c I/t l l /� PERMITDATE: rJ ^I f '29 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 3 �'� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet i Edge of Wetland and Leaching Facility(If any wetlands exist i within 300 feet of leaching facility) Feet �'G,urnished by A o/ Ci Y No. FEE- - Y ' Board of Health, A& /V ;?401Q. MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) UpgradeX Abandon( ) - kComplete System ❑Individual Components Location w •� Owner's Name Map/Parcel# Address Lot# ^-moo Telephone# Installer's Name J � � Designer's Name V/, Address C J�'1�1 ,P Address Z•45 �. Telephone# � / (� Telephone# Type of Building a le FAI)y`,� Lot Size sq.ft. Dwelling-No.of Bedrooms � Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) �; gpd Calculated design flow SOS �Fy Design flow provided 7 Plan: Date `2%-` ��j Number of sheets Revision Date �®�e- Title D escription of Soil(s) Se, &A /7 Soil Evaluator Form No. Name of Soil Evaluator ZiEiC Date of Evaluation Z�'- DESCRIPTION OF REPAIRS OR ALTERATIONS ti The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further a -es o not t p stem in operation until a Certificate of Compliance has been issued by the Board of Health. Signed , Date ��� d k I: i •./'Y•'— .-r..y. 'y,S"'.nm.RF .:1.•'�''S 7�'�'�'�.l-..G•" • w ...._.— „ •-yMgrYn.±" tqK,°�pPe P 1 '�Y+,'S'^,Z.., _ 1 .,°•.�4R��( Z/r tt� ;��, � ..�' �" _. FEE 1��2 j Board' of Health, /US�i��IQ , MA. - \ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair( ) UpgradeX Abandon( kComplete System 0 Individual Components Location j Owner's Name 6u e L/ Map/Parcel# !©'Z 0 Address S Lot# —2 Telephone# Installer's Narnesf'� Designer's Name Address S�bA J Address Es�s A4 Telephone# �-- �v/ (� - Telephone# r-3-3 211 7 ,Type of Building J//7� /� �/ 'J/ �'7 Lot Size sq.ft. .1 Dwelling-No.of Bedrooms J Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria O r Other Fixture i Design Flow (mi(n/.required) �+-S',-w gpd Calculated design flow - 6 Design flow provided gpd Plan: Dated Number of sheets ✓r Revision Date 176.,?1 a Title Description of Soils) C- Soil Evaluator Form No. Name of Soil Evaluator ID46 Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS Ale 1�e / The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees o not t stem in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date I-9ro"io-s GJ r No. ` v / FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, �t'i2/+i: 9� MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) .k Complete System ` The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ,Abandoned( ) by: ��eY.cSf-/e'�c! � ii/ � � C� 5'elf y C e :nv c - has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built pl�fhs relating to application No. `` dated Approved Design Flow (gpd) Installer 13ovS.Ce /ey / A IN Designer:. ( PAW Inspector: �1 e: �V The issuance of this permit shall not be construed as a guarantee'that the system ./ function'.designed. No.. ✓ _ FEE ttO i''.r' Board of Health, /;�XAJ $'At4�e MA. DISPOSAL. SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( Repair(Repair( ) Upgrade<): Abandon( ) an individual sewage disposal system ,-at 7 y /,-�U.� L 1// 1?�-P_ as described in the application for Disposal System Construction Permit No. g ZioW , dated 5 // Prodded: Construction shall be completed within three years of the date of this permit. All local conditiges must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date �r/7/ Board of Health r , TOWN OF BARNSTABLE LOCATION C SEWAGE # VII.LAGE_ 5 / ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.41YAW_5 1'/ C,r-gol Q SEPTIC TANK CAPACITY C'O 57-- 1 LEACHING FACILITY: (type) �� •C • — (Size) NO.OF BEDROOMS BUILDER OR OWNER�, l 4- 4 (_ G(d PERMTTDATE: ` I " COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 30, e D i I I 2/4/2020 ShowAsbuilt(1700X 2800) J u 'fUWNUF'HAKNSTABLE LOCATION V,74 - SEWAGE B � VILLAGE ASSESSORS MAP&LOT r INSTALLER'S NAME&PHONE NO.9 l O • - SEPTIC TANK CAPACITY IS-Co S q . ..LEACKNO FACILITY:, NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Oroundwata Table and Bottom of Leaching Facility . .�f Fee[ Private Water Supply Well and Leaching Facility(If my wells exist on site or within 200 fen of leaching facility) Fat Edge of Wetland and Leaching Facility(If any wetlands exist i within 700 feet of leaching facility) Furnished by 6 . it 2�1 I,I https:/fiitsq ldb.tovvn.barnstable.ma.us:8431/H ome/ShowAsbuilt?mp=116020&sq=1 1/1 f Commonwealth of Massachusetts /A W Title 5 Official Inspection Form' Subsurface Sewage'Disposal System Form -Not for Voluntary Assessments °M 44 Crosby Circle Property Address I*� Nik Shah 0 Owner Owner's Name tXi information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown State Zip Code Date of Inspection h.-:1 Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector. key to move your cursor-do not Brett Hickey use the return Name of Inspector key. B&B Excavation rsb Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113747 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 6-18-18 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 time.This inspection does not address how the system will perform in the future under t the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Crosby Circle Property Address Nik Shah - Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown 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: The system was in working order at the time of inspection. 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): d i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Citylrown 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 ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N .❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N, ❑ ND (Explain below): - ----------- C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public 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 I Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 44 Crosby Circle Property Address a , Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown 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. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered_ A copy of the analysis must be attached to this form. 3. Other: - t ' 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 clogged SAS or cesspool 0 ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool a ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool s ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (coot.) 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 surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public 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 r ❑ ❑ 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 i Commonwealth of Massachusetts , W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .' 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown 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? 111 - ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as NIA) ❑ ® 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): . Number of bedrooms(Actual) 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550/GPD z t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments °M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma _ 02655 6-18-2018 page. City/Town State Zip Code Date of Inspection D. System Information Description: , Number of current residents: 1 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ®. No Water meter readings, if available (last 2 years usage (gpd)): See beyow Detail: 2016- 186,000gallons 2017- 171,000gallons Sump pump? ❑ Yes ® No Last date of occupancy:: 2 weeks Date Commercial/Industrial Flow Conditions: s Type of Establishment: NA Design flow(based on,310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): , f Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No ,i• t Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No ` Water meter readings, if available: Y + t5ins-3/13 { Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655• 6-18-2018 page. Cityrrown 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: Owner-date of last pump is 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. El Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ` °M 44 Crosby Circle Property Address r Nik Shah ,. Owner Owner's Name information is Osteryille t. 'Ma 02655 '- 6=18-2018 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont) Approximate age of all components, date installed (if known)and source of.information: 1999 per plans Were sewage odors detected when arriving at the site? ❑ Yes ® No - Building Sewer(locate on site plan): Depth belowgrade: feet Material of construction`. ❑ cast iron ® 40 PVC„ `❑ other(explain): ., Distance from private water supply well or suction line: Town ' + feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: ,' _ - z' eet Material of construction: ® concrete ❑ metal` ` El fiberglass ❑ polyethylene ❑ other'(explain) If tank is metal listfage ,.' L years 3 Is age confirmed by'a Certificate of Compliance? ttach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500gallons q *. Sludge,depth 5 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 A to {t r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 44 Crosby Circle Property Address , Nik Shah Owner Owner's Name information is Ostervllle Ma 02655 6-18-2018 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) , Distance from top of sludge to bottom of outlet tee or baffle 31" Scum thickness 4 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 12 F 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.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is in need of pumping at this time and should be pumped every two years for maintenance. Grease Trap(locate on site plan): Depth below grade: NA 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: Date . t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '4M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityrrown 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: NA Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑. Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach`copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9 y t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 F a Commonwealth of Massachusetts W Title 5 Official Inspection Form ' . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Crosby Circle 'G„M Property Address Nik Shah Owner Owner's Name f information is required for every Osterville Ma 02655 6-18-2018 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 , 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.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up. 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.):.. NA ` 3 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: h P 1 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma .02655 6-18-2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) • Type: R ❑ leaching pits number: ' • e ® leaching chambers number: (5) 500gallons ❑ leaching galleries number: — ❑ leaching trenches -number, length: ❑ leaching fields number, dimensions:_ y ❑ overflow cesspool number: • F ❑ 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.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Leaching was dry when viewed with a stain line 1/3 of the way up from the bottom. , Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes' ❑ No t5ins•3/13 . Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. City/Town 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: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r r r t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 s Commonwealth of Massachusetts - Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 44 Crosby Circle Property Address Nik Shah ' Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. City/Town 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 Rear Al-14'6" 131-30'8" A2-29' 132-31' A3-20' 133-1 T 3 E t5ins-3/13 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form c Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water - ® Check cellar y ® Shallow wells Estimated depth to high ground water: ' , No GW 5' below the SAS feet Please indicate all methods used to determine the high ground water elevation:.. ® Obtained from system design plans on record y If checked, date of design plan reviewed: Date 9 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health.-explain: s ❑ Checked with local excavators, installers-(attach documentation) ❑ ` Accessed USGS database -explain: You must describe how you established the high ground water elevation: Plan on file with BOH. , 1 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 • f Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 44 Crosby Circle Property Address Nik Shah Owner Owner's Name information is required for every Osterville Ma 02655 6-18-2018 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 P 1 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 i l w oc p � oN � 2013 OCT —4 pill 3: 41 � x � � N 00 C'4 w CCU 00 00 DiVi .� _ CD C1d # . PWO p p . SHOWER > WIC L WM3070 — CL BENCH 1EX307 BEDROOM 2 PANTRY T14"-1"x 14'-0" up .FAMILY ROOM - F.P. U BATH 2 z 'y.i Cr c O FOYER 6C I i TABLE •a` KITCHEN BENCH W BATH 1 t 3 Q O Cub C. ; iOw x � 0 0 BEDROOM 1 13'-4"x 12'-8" Q Fl- CL r L! F TF1 OF M PROP05ED Fir.ST FLOOR PLAN '`' ssq 1688 SO. FT. TOTAL LIVING SPACE S ROBERT Byrn r. W. DENNIS,JR. i ,0 9 Na 13834 o Q/ 90 STE ``..� CALE: 3/16" — V-0" 0 L E� DILAWN BY DATE: CBH �-'� 10/02/13 i W � i OaoN � x0 h+.l 00 "� N 00 N y Y w }��i 11M3 n W W COVERED DECK e ' BENCH CL DOWN MASTER BEDROOM ---vv 4 � W 19'-7"x 12'-7" OP F.P. 4 N E U z Q' � m U 0 "LOFT � FY� �I �I O a a O w Lia/ 4 3 ml ml U z WIC 61BATH 3 !t I O WC ' U CW E 7—BEDROOM 3 t CL Q Q cue i co() O MASTER BATH Q a a FROP05ED SECOND FLOOR PLAN 1040 SO. FT. TOTAL.LIVING SPACE OFM s4 ROMRT (ihh( DENNIS, A , _ Na 13 834 Q -� sC�-�i.E: 3/16" — 1'-0" 9Q 6�STE DR-�\VV L3Y: } NA t i3 CBH I I013 DATE: 10/02/13 t � W � N 00 O 00 xj N .--� � , �I N 00 N • y �—i p 00. 10"rnICK x 4'-0"CONCRETE WALL W v 'z` ON CONTINUOU5 16"X 1 2" CONCRETE FOOTING STEP= 3'-0-1/8" FROM T,O.F. STEP = 3'-0-1/8" — FROM T.O.F. a WNOW CRAWL 5PACE W/ N OPNG. 2"CONCRETE 5LA13 10 MIL VAPOR BARRIER 5TEP = 3'-0-1/8" O"THICK x 7'-10-1/8"CONCRETE FROM T.O.F. - WALL ON CONTINUOUS I G"X 1 2" - DOWN - CONCRETE FOOTING } EX15TING POURED CONCRETE a EXISTING FOUNDATION TO - BA5EMENT-CRAWL 5PACE U STEP.= T-10-I/8" m�� STEP = T-1 0-1/8" _ NCQ .� REMAIN.UNDERMINE AS - FROM T.O.F. FROM T.O.F. REQUIRED U lD ' t PROVIDE ACCE55 OPNG.TO �O DOOR EX15TING BA5EMENT ' OPNG. m m EXISTING CAPE CID BASEMENT-FULL'HEIGMT - U z 'F O 51 1 2 k , 41 I Q v- �� 2 4"CONCRETE 5LA5 w U 10 MIL VAPOR BARRIER Q I _ c~n ]� WN DWOPNG. x CA a Lfl STEP = 7'-10-1/8' co - Y Ln FROM T.O.F. a� 10"Y IICK x 8'-10'CONCRETE WALL —icv ON CONTINUOU5 I G'X 1 2' Ln kI ss9 CONCRETE FOOTING FOUNDATION PLAN; RMRT o�c W. t DSZNkIS. JR. - : .o ,p Na 13834 o ti i e _ SCALE: 3/16" — V-0„ DRAWN BY: CBH ,i� DATE: 10/02/13 1 ( oc .44 08 w 00 ' N 20'-T / o I O'TrIICK x 4'-0'CONCRETE WALL O > �3 ON CONTINUOU5 I G"X 1 2' CONCRETE FOOTING 5TEP= 3'-0-1/8" FROM T.O.F. - STEP= 3'-0-1/8'FROM T.O.F. WNDW • CRAWL SPACE w/ N 0PNG. 2'CONCRETE 5LA5 10 MIL VAPOR BARRIER STEP = 3'-0-1/8" 1 O'THICK x 7-10-1/5'CONCRETE FROM T.O.F. WALL ON CONTINUOUS 16'X 1 2" DOWN CONCRETE FOOTING EX15TING POURED CONCRETE - BASEMENT STEP = T-10-1/8" m�� EXISTING FOUNDATION TO -CRAWL SPACE _ - U NCO I FROM T.O.F. STEP = T-10-1/8" REMAIN. UNDERMINE A5 [r FROM T.O.F. REQUIRED '"- �D U .. Z PROVIDE ACCE55 OPNG. TO Q DOOR EX15TING 5A5EMENT' G� m rr). -1 , OPN G EX15TING CAPE COD O a BA5EMENT-FULL r1EIGrIT Z Siu U O -iV., 4 W Ca N O". Z �D 4'CONCRETE SLAB �W Q 10 MIL VAPOR BARRIER m� N DW N OPNG. C/) 1 5T P = . 0-!/ _ C', L11 FR - i 10'Tn1CK x 8'-10'CONCRETE WALL 4N ON CONTI:N0005 I C'X!2' Ln CONCRE7,EFOOTING FOUNDATION PLANsi ( W_ DINES. JR. y .o p fJa 118&- p 90 �elsr�P� ��Q - SCALE: 3/1 6" — 1'-011 O�OA:. H DRAWN BY: CB {tll � L7 oI D.�TE: t 10/02/13 N ASSESSORS MAP : PARCEL : TEST HO- E LOGS : �Oj fJi �,/� � S01 L EVALUATC? : FLOOD ZONE .IIT�'R , ' I��C�h -T / �r�.J WITNESS : - / �1T-`' M I Cwt t 1 �i�-;' i 77� � - REFERENCE : DATE : �?cl1 ;I (: %/7!�_ PERCOLATION h1T�`: -� �tltrli��til . � 1 � 7�6t/�� C", �0��-;� � of` ,tip • ._ . �+ � u/ i <, 5, - -- TH- I TH-2 � %L A° oT LOCATION MAP n1,�,s, u, /,l8 C9 TU S,�►K, �� /y LPLIG��C, � _ _ I --- co r") aim 0 ` SEPT' C SYSTEM, DES I GN ,- _� '� � , \ � _.._.___. _ �� ( I•-`I`j V� '"..�.� 5 �.� Lam''�T ��,..., FLOW EST I MATE ` I \ 1 I I C'7DROOMS AT GAL/DAY/BEDROOM -,r- GAL/DAY SEPTIC TANK o g'V I " �03AL/DAY x 2 DAYS - //00 GAL USE ��GALLON SEPTIC TANK � LC. � I sp - - -- L0 ; � � w I I ��,-��� ����. �w�2 ,v�sr �L.C.CX,.��.�� �r,✓'r;: ,, - � ;I?..� �.L �r�'� , SOIL ABSORPTION SYSTEM -Fi2�,U•%'�.l...E.� 1.�.� 1`�'}-' �j '"'� } ? Ili`; Ht?tA: l_. ",; _t. . '/ # jjj BOTTOM AREA: x X C�I 4,5 S E P C' _, Y STL-M SECT I ON � i \ �'7 + t j / � � i C?�;l..tz� .. - �,�,� ����► 44 w �'1 __ _ 2' o�'• 3/8 _� cs _y� . /0O,OO' `\ !. rf L ___� iy / lGAL �`� rr,. �� D BOX ` �-_-I U, SEPTIC TANK -_ r 5,06 ' DA ;\ A4/ON _( ,,s&im" : 'a'tina %iiiY x.,._._. xwWr++.. .- � xw®YH✓'yePcas»ava.a:nYTT1a4-.,; ,.. . h� SITE AND SEWAGE -L-_� _ c s GPI�LGAi_N 4iWAJ77—V � OC TION : __— -- - - _ PREPARED FOR : �. UILU W►til WELT _ --- ,`, SCALE 20 DAV I D B . MASON '26 DATE: Z l DBC ENV I RONMEN' AL DESIGNS 1 -.._.___ —. _._.::y...:._:-`------•--. _ - __ __ ___- _ - -- EAST SANDWICH . MA DATE HEALTH AGENT EAST 833 - 2 1 77 / PERC TEST. s / l PERFORMED BY:DAVID B.MASON a , WITNESSED BY:DONNA MIORANDI,R.S.-TOWN OF BARNSTABLE Z/\ \ Pro / APRIL 29,1999 o H-20t d ., 12.8 �( D-Box SITE PASSED w4� H y ai pa TEST HOLE - 1 EL.14.0 Proposed 20 hOD\/o\ ESL Relocated ambers n \ 11.0' " 3 Water Line \ 17 ."..."...... 12.6 A LAYER 10YR3/2 q 12.6' of one VERYDARK.GRAYISHBROWN 25 LOA1b1Y SAND. 11.9 42.0' Bw LAY!✓R l0I`RS/6 S7 10.4' 41" C LAYER 1OYR 6/6 7 <0"E BROWNISH YELLOW x DD 00, 1321 FINE-MEDIUM SAND 3.0 / Existing Vent NO GROUNDWATER ENCOUNTERED Water Line to be Relocated l DETAILED PLAN VIEW 1 TEST HOLE -2 PERFORMED BY:CHUCK ROWLAND,PE SCALE 1"= 10' EL.14.0 LOCATION MAP: A LAYER IOYR3/2 VERYDARKGRAYISHBROWN 1»=2,000±' 101, LOAMY SAND 12.6 FILL ASSESSORS REF:(E�. �2) .. sHELL.nxrVE Bc s:4lvn -Zone_ 20 11.9 Map 116 Parcel 20 X(Min F/ood Hazard)_ w/ BwLAYER I0YR5/6 Proposed cb/dhProposed 5,, YELLOWISH BROWN `\ Poo/Patio Pool Equipment N o 0 41" LOAMY'SAW 10.6 OVERLAY DISTRICT" 7F + I 32sf i w F o CLAYER IOYR 6/6 \ -y200sf inside °nno xo ,�. F ei�b 3 BROWMSITYELLOW AP - Aquifer Protection District F��F/ LSCSF 1 o 0 66" FINE-MEDIUM SAND 8.S � w and Resource Protection Overlay -_ _ NO GROUNDWATER ENCOUNTERED • -� �'` J _.�: 9S 9 Q I District "J C 7 \` J �4• Proposed Addition �y ho ~ -•,� - . J \30"K;., 29sf in mapped LSCSF FLOOD ZONE. o "fie cb/dh Zones AE El e v. 12" X (0.2% o- co fnd Annual Chance) & X (Min Z o� ^ ' ~ ` w ? Flood Hazard) oN �� Proposed 4: Community Panel No. 18.18x Pool ence - \ ' 1 _ , #250001 C0544 J 8.0' `\ ` July 16, 2014 Pro Addi She ZONE. J .\ Proposed Fence RC Q�c Area (min.) 87,120 SF (RPOD) i Existing Frontage (min) 20' 9• Existing Leach Field Barn Width (min) 100' 500 Gallon Chambers / ` Proposed Septic Setbacks: to be Removed and area to Slab 13.98 o Ejector Pump with 2" Line Fron t 20' ° be filled with clean fill Invert Elev. 11.82' ^ O TH-1 rCF 14.18 r°°+ to be Confirmed Side 10 �> 4.9' k�Lot 1 ° 'o Rear 10 16,414 sf Pat Per�h7ecord Plan REFERENCES• 3 7,g0X�s,n Clean Out\ • Sept C°/%n\ vided �� Deed Bk. 31438 Pg 275 to be �'e TOnk �` Connect From 2" Pressure Line Plan Bk. 547 P 34 #44 �0Ve \ l / to 4"0 PVC Pipe with 27 an . 9 Pitch ° Patio to Septic Tank Sd \ I 2 Sty 16.k ctN I "Driveway and Invert Elev. 12.45' w/f\D well in g \0,le 9k p / ^°� Ace S on Easement" SEPTIC NOTES I I I Plan Book own Page 34 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours Sewer Pipes /�. \ Prior to Any Excavation For This Project the Contractor Shall Make 16 to be Reversed the Required Notification to Dig Safe(1-888-344-7233)and contact Sd� Inside House / f Sullivan Engineering&Consulting Inc.(508-428-3344). DESIGN DATA 2.The Contractor is Required to Secure Appropriate Permits From Town Single Family Agencies For Construction Defined by This Plan. -S Bedroom Qa 110 GPD 3. Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall 10' Min. Clean ou t �' y No Garbage Grinder Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to 0, Provided 7 Total Daily Flow=SSO GPD Assure Watertightness. In General,Water Lines Shall be Constructed in Q , 1 GN/n Coordination With COMM Water,and Shall be in Accordance g S ,,� i a� Use a 1500 Gal Septic Tank tb0 /Drive / Proposed H-20 n With 248 CAM 1.00-7.00&310 CAM 15.00. "4.A Minimum of 9 of Cover is Required for All Components. �„✓ \ -2 1500 Gallon o LEACHING AREA � Pro Septic Tank n 550 GPD/0.74(LTAR)=743.2 SF Required 5.All Structures Buried Thwe Feet or More or Subject ✓ to Vehicular Traffic to be H 20 Loading.It is the Engineer's P-Bo Sidewall=2(12.83'+42)2'=219.3 SF Bottom Area=(12.83'x 42)=538.9 SF Recommendation that H-20 Always to Used. 6.Install Watertight Risers and Covers to Within 6"of Finished Grade Q Total Provided=758.2 SF(561 GPD) 1eK Over Septic Tank Inlet and Outlet,D-Box,and One Leaching Chamber. See D o IF P 0)0 / All covers are to be maximum 18"for concrete or 24"Cast Iron. LEACHING CHAMBER DESIGN 7.Septic System to be Installed in Accordance With 310 CAM 15.00& v ��0 All Pipes to be Schedule 40. Use 248 C11BL 1.00-7.00 Latest Revision and the Town of Barnstable Proposed I 700.00, Pro �0 PLAN VIEW l 4-500 Gal.Leaching Chambers in a Board of Health Regulations. Relocated ! Vent I SCALE 1"=20' 12.83'x 42'Double Washed 8.All Piping to be Sch.40 PVC. Water Line \C� Stone Field as Shown. 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum °e 1 �' cb/dh / Sump of 6". Voted 10.The Separation Distance Between the Septic Tank Inlets and C'r�'/e %y Bench Mark Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend p Top of cb/dh Charcoal Ft1t��� 10"Below the Flow Line.Outlet Tees Shall Extend 14" / rf� Elev. 12.6' NAVD / Final Location tpeTv and Shall be Equipped With a Gas Baffle. cb/ at time of installation or in accordance with Landscape Plan F F. 1. 16.4 Note 6 (typ.) I F.G. EL. 14t F.G. EL. 14.2t F.G. EL. 14-15.5t Flow Equilizers EL. 12. 0 As Required Ins aller To Confirm Prior EL Existing To Any .work Installer To 1500 Gallon EL. 10.70 Top EL. 11.1 Confirm Prior Septic Tank 1 H-20 To Any Work to Remain D-Box EL. 10.34 LEGEND" a H-20 Confirm Soil Conditions 10.14 Leaching Prior to Installation CDT Cedar Tree To Be Installed On Chamber Finisn Grade table ompacted ose ,14 HT Holly Tree a;Max. Bedding,»T"s, 8 M'^ Com acted Fill FNter DT Deciduous Tree Fabric Inspection Port, !f Edcount8red Rerriove & Replbee And/or _ & Baffels A�1 .t,frSSurtable Soa1B Wrthin "5'bf ;n CT Coniferous Tree t Pea stone / .. as Per Title 5 The Opter Perimeter:of ThE": t, y: .. .: ... ... LEACHING oou e w P ...... I CHAMBER st ° f !ES To yGr EL. 3.0 `-Q� Utility Pole No Groundwater -E- Electric °'z t°'°- � ` ; EVELOPED PROFILE OF SYSTEM Per Test Hole 1 -� Gas wetland Fla CROSS SECTION OF CHAMBER ��`�� ` 9 \ A ���`` � Post NOT TO SCALE \�FFSsi NA NOT TO SCALE ElLight Light CBIDH OHW- Overhead Wires 25 Elevation Contour Revision: U date Pool, addition and Septic Design 1211812021 TITLE: PREPARED FOR: PREPARED BY.• Site Plan � Engineering & Proposed Improvements Matthew & Dulcey H. Connon At 19 Atwood St. consuiting, Inc. Wellesley, MA 02482 u ivaii 44 Crosby Circle (508)428-3344 • P.O. Box 659 . 711 Main Street, Osterville, MA 02655 amstable (Osterville) Mass. seci@sullivanengin.com • www.sullivanengin.com 20 o io 20 40 so Draft: ASL/CTR Comp: ASL DATE: SCALE: Review: ASL/CTR Field: CTR/WHK/ASL r November 17, 2020 1"=20' ProJ• # 1998165_44 Crosby Circle Proj. Jaxtimer/Connon