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HomeMy WebLinkAbout0011 FAIRWINDS DRIVE - Health �� _ �,TAIRWINDS'���OSTERVILLE . � � � ;; o 0 �� G 41' O ;1 � COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF EN VIRONMENTAL_AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5' OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: II'Fainvirids Drive Ostei-ville;MA 02655. �i 14.64 �✓� Owner's Name: Paul Graff Owner's Address: Date of Inspection:. August 15, 2011 Name of Inspector: (Please Print) Jarrres M.Ford Company Name: Jam es M. Ford Mailing Address: A0. Box 49 Osterville,MA`.02655-0049 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT I certify thatI 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 DE P approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:` Passes Conditionally Passes eeds Further Evaluation by the Local Approving Authority' ails Inspector's Signature: Date August 20:.201 L The system inspector shall su it a copy of this inspection report to the Approving Authority(Board of Health or ` DEP)within 30 days of comp mg 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 ow�ter shall submit the report to the appropriate regional office of the . DEP. The original should be sent to the system`owner,and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ',***This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under.the same or different conditions of use. .Title 5 Inspection.Forni 6/15/20010 page 1 r Page 2 of. 1 T OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) -Property Address: 11 Fain inds Di-ive Osteiville.MA Owner: Paul.Graff Date of Inspection: August 15, 2011 Inspection Summary: : Check A,B,C,D oi-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: R.. System Conditionally Passes: One or more system components as described in the-"Conditional Pass"section need io be replaced or repaired. The systein,upon completion of the.replacement or repair;'as approved by the Board of Health,will pass: Answer yes,no or not determined(Y,N,ND) in the for,the following statements. If."not determined",please. explain.. The septic tank is metal and over 20 years old*or the.septic tank(whether inetal or not)is structurally- unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health: *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available.. ND explain: x , 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 obstruction is removed distribution box is leveled or replaced , ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). T.he system will pass inspection if(with approval of the Board:of Health); broken pipe(s)are replaced , obstruction is removed ND explain: 2 Page 3 of I l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:: I Fabivinds Drive Osterville.MA Owner: Paul Graff Date of Inspection: August IS, 2011 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 publithealth;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 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 I.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 l00 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 DEP certified laboratory, for coliform: bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached,to this form: f ; 3 Other, Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE_SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 11 Fainvinds Drive, - Osterville.MA Owner: Paul Graff Date of Inspection: August 15,2011 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No `. ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded"or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available.volume is less than%z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number.. of times pumped . ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion.of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within50 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma No (Yes/No).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 System:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,600 gpd ` .. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system:is within 400 feet of a surface drinking water supply the system-is within 200 feet of a tributary to a surface drinking water supply .the system is located in a nitrogen sensitive area(Interim Wellhead:Protection Area-IWPA)or a inapped 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. 4 Page 5 of 11. . . OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: . 11 Fainvinds Drive Osterville.MA Owner: Paul Graff Date of Inspection: August 15, 2011 Check if the following have been done: You must indicate"yes' or no as to each of the following: Yes No . ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks?>. ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection Were as built Tans.of the system obtained and examined? (If they were not available note as N/A)p ✓ 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: Yes No ✓ _ 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(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FOR M- NOT FOR VO LUNTARY TARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATION Property Address: 11 Fal;";inds Drive Osterville,MA Owner: Paul Graff Date of Inspection: August 15, 2011 FLOW CONDITIONS RESIDENTIAL - Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms). 440 Number of current residents: 2 Does residence have a garbage grinder(yes or no): i/a Is laundry on aseparate sewage system(yes or.no)-- n/a [if yes separate inspection required] Laundry system inspected(yes or no): No' Seasonal use(yes or no): No Water meter readings, if:available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): -No Last date of occupancy: Currently COMMERCIAL/INDUSTRIAL Type of establishment: Design flow.(based on 310 CMR 15.203):. gpd Basis of design flow(seats/persons/sgft,etc)::: Y Grease trap present(yes or no) Industrial waste holdin tank resent e Born 0 g p (Y ) . Non'sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,,if available: Last date of occupancy/use:, OTHER(describe): GENERAL.INFORMATION. Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): 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). Tight Tank `Attach a copy of the DEP approval Other.(describe): Approximate age of all components,date installed(if known)and source of information: - Date of installation 812411999 Per-as-built card Were sewage odors detected when arriving at the site(yes or no): No : 6 Page 7 of I 1 • OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART C SYSTEM INFORMATION (continued) Property.Address: 11 Fainwinds Drive ' Oster-ville.MA Owner: Paul Graff Date of Inspection: August 15, 2011 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc:):. 7. it SEPTIC TANK: (locate on site plan). Depth below grade: 13" Material of construction: ✓ concrete _metal fiberglass _polyethylene _other.(explain)` If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: •30." Scum thickness: 2" 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: 10" How were dimensions determined: Measurin2'stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity liquid levels as related to outlet invert,evidence'of leakage,etc.). The tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage GREASE TRAP None (locate on site plan) Depth below grade Material of construction: concrete metal fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of-scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of.leakage,etc.); 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION"(continued) Property Address: 11 FainviiidsDrir"e Osterville,MA Owner:' Paul Graff Date of Inspection: August 1-5, 2011 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity:. gallons Design Flow: g gallons/day -: . Alarm present(yes or no): - Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-Box was normal PUMP CHAMBER: None (locate on site plan) , Pumps in working order(yes or.no): Alarms in working order(yes or no) . Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11. OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 11 Fairwinds Drh,e OstLville.MA Owner: Paul Graff Date of Inspection: August 15, 2011 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: Teaching chambers,number: leaching galleries,number: leaching trenches,number,length: ✓ leaching fields,number,dimensions: 14'.x 43'yer as built 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.): There did not apyear to be any signs of failure. A camera was used for the inspection CESSPOOLS: Noire (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool:; Materials of construction: Indication of groundwater inflow(yes or no): Comments-(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,.etc.): . PRIVY: None (locate on site plan) .Materials of construction: Dimensions: . Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of pnding conditionof vegetation,eco ): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Fairivinds Drive Oster ville MA' Owner: Paul Graff Date of Inspection: Au u st 15 , 011 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties tout least two permanent reference landmarks or benclnnarks. Locate.all wells within 100 feet. Locate where public water supply enters the building. O O Q. . . a IY6 s 1 3 6 sb a8 1 II 0 r - Page 11 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS 'SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 'SYSTEM INFORMATION.(continued) Property Address: 11 Fair winds Dive Osterville,MA Owner: Paul Giaff, Date of Inspection: August IS, 2011 SITE EXAM . Slope Surface.water Check cellar Shallow wells. Estimated depth to ground water.. 40 +/ feet Please indicate (check) all methods used.to determine the high ground water elevation: Obtained from system design plans on record - If checked, date of design plan reviewed: Observed site(abutting property/observation.hole within 150 feet of SAS) ✓ Checked with local Board of Health=explain:_'_Topographic and water contottrs snaps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Usin Barnstable to o ra hic and water contours nia s the ina s were showinz approxinzately 40'+/--to kround water dt th site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date,of inspection. This report is not a warranty or guarantee that the system will function properly in the fittttre. There have been no warranties or guarontees, either expressed written or implied relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 j I No. Fee " ' THE COMMONWEALTH F MAS A H Entered in-computer: O S C USETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Migooal *p.5tem Con.5truction Permit Application for a Permit to Construct(✓"Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components i Location Address or Lot No. Owner's Name,Address and Tel.No. Pf}ut C-Q-a# �� �fl�2wI..oS D21v� 38 2E-nSrawG- �21..� Assessor'sMap/Parcel o iLA—, m A• , c> v5`S 51MS r�Ja-i, c.r• Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Sag P>A--A C-e_4 r-+-ram, t►-+.C_ 8 I Z AA A-1 I-i %W-M-CT- Type of Building: Dwelling No.of Bedrooms 4 Lot Size 45�(o sq. ft. Garbage Grinder(uo) Other Type of Building t 1A, No.of Persons Showers(,~/A) Cafeteria(►./A) Other Fixtures �­/A : Design Flow o gallons per day. Calculated daily flow 44o gallons. Plan Date $ /1 99 Number of sheets c-E Revision Date *tea+ Title SIIC- PL--n-tv h-t L_o-r Co Fsti,Qw l-IDS DlZlve , os7r-�P_voL_LE- , MAs- . i fza- PAwL- C-a-A--✓ Size of Septic Tank 1 S oo ype of S.A.S. . 14'x 4-3' Le7m c-H-N d- Pl c-L-o Description of Soil -rP4 t o -3" - a 3"- I I" - Ap a 3/2 m 5 - I o-, Qo" -I"Lo" - c - M5 - io -1-P # I O - 3" - o .I 3"-9' - A - S.L. - IotiQ 3/I 4-4-" - N - M S - I o -f a y/ - 44" I'i'L" - c - MS - I o- Q Ca/(e w H v w-r2 L!1 rrtr-O- n 4 Nature of Repairs or Alterations(Answer when applicable) t--+ A Date last inspected: I A Agreement: The undersigned agrees to ens pre- e construcuo d maintenance of the afore described on-site sewage disposal system in accordance with the provision f T' e 5 f the E iro mental Code d not to place the system in operation until a Certifi- cate of Compliance has been is ed by thi Bo d f Health. tAtA__f r1hS Signed G• to 2297 Application Approved by _ Dat � `-'�q Application Disapproved for the following reasons r Permit No. Date Issued s v p - _ 5�?- No. .ice¢', Fee / THE COMMONWEALTH OF MASSACHUSETTS t edin'1computer: s F v\1 Yes /) PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLES MASSACHUSETTS ��� Yicatior�<for` ig0o,5aY 6pgtem Z/o w5tructio n Vermit Application for a Permit to Construct(-"')"Repair( ,`)Upgrade( )Ab�tdon( )f❑Complete System ❑Individual Components Location Add ssqrLotNo. 1-b T C e `l,• r' yOwner's Name,Address and Tel.No. Pig v L Q n r F f Ff1t2w +•..Os AQv� _.-��t -i2c:-{�`-srowi=. r�fa+.iE Assessor's Map/Parcel ATE Q"'�� M A- , G'l�-°5•S r St&A rl>J P--i, c r o to 0"7 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Soy n�A - , o2r�55 Type of Building: Dwelling No.of Bedrooms 4 Lot Size 4+5,4; � sq.ft. Garbage Grinder(uo ) Other Type of Building '-IA No. of Persons '"IA Showers(,-,IA) Cafeteria(W/A) Other Fixtures /A Design Flow I gallons per day. Calculated daily flow 440 gallons. Plan Date Number of sheets Revision Date '- Title SITE- P L h"N {s, 1.r'T Co (=r1 i 2 W I IDS b 12 114: f-C- l I I c k. An 1! , { P Size of Septic Tank 1�'�� 6-" Type of S.A.S. I4 x 4 3' e <<+ 'N�. P,e L n R; j t Description of Soil 1 P44 i o -3" - _, ,. - A p - s L - 3/a.; I I". -i p" - g - na 5 -• U�e r- An s - i o �,lr c m /c. .. -r-P # I 0 3 - C, - 91" - a - 'S L - i u-1 I` q•'`- -4 4- - f6 - NI S - i -� /co - 4�}R - i 51" - c - AM s - 1 o (2 4 9 r Nature of Repairs or Alterations(Answer when applicable) Date last inspected: I-,/A ( Agreement: The undersi ned agrees to en a he constructio d maintenance of the afore described on-site sewage disposal system g g g p " in accordance with the provision of T91e 5 f th E it mental Code not to place the system in operation until a Certifi- cate of Compliance has been i ued b th' Bo d f Health. 4t7i 4xceivet-t� S � Signed �... �.��, ��.-�,�, ,-�c..�Date l -e. /. n- Application Approved by -Z. Date 67-77 f Application Disapproved for the following reasons Permit No. yy Date Issued co " ! THE COMMONWEALTH OF MASSACHUSETTS r BARNSTABLE, MASSACHUSETTS _ (Certificate of (Compliance , THIS IS TO CFYOfK,,that the'On-site S wa Disposal System Constructed(� Repaired( )Upgraded( ) Abandoned( )by a I`y ��M � at Lot F-A i C-4 sHn P_s_e= o_-� 12:- ��r M n. a�c.�y has been constructedgm cc rdance with the provisions of Title 5 and the for Disposal System Construction Permit No. CI E dated G' r Installer Designer A C The issuance_of h}s : s 11 not be construed as a guarantee that the will function as dues gnledf 1fDatet Inspector irK�D -IV I-F i .._... . _ Fee THE COMMONWEALTH OF MASSACHUSETTS µ PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS x1i5pont *pgtem Construction Vermit Permission is hereby granted to Construct(✓)Repair( )Upgrade( )Abandon( ) System located at Lc�T 4 �- F/"ate;, ns patIiW- -- C3-.r-.P.rIL.tG , n4A->5 . A c,ps A-4n-P I(nS 0irr��cL I - Co and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. II Provided: Co true � n ust be completed within three years of the date of this e t. Date: / Approved byJ / 1` TOWN OF BA]KkSTArLL LOCATION LO In uj� ,rra�S.C�ic% SSW ►vE .;; . VII.LAGE S�el�A` fie ,a►SSF R' MAP&L6T INSTALLER'S NAME&PHONE NO. d� �?�5 9C1 6/D y AI SEPTIC TANK CAPACITY .. LEACHING FACILITY: pe) (size) iq ��3f NO.OF BEDROOMS A/r 165 01.1 ®®(p BUILDER OR OWNE ,C� e-�t ``rERMTTDATE: COMPLIANCE DATE: - THE 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 f4c. 13,_6 r' gray=�� . 4s`6 6CLl5 b 53 56- S(o a W� ■ Yr TOWN OF y OCATION CO��r�_Fi¢�QL/i�'1 S.Cr2C E� 4 . ..aEAG # . �. VII.LAGE S '' � '/lei, /f e ASSR S'MAP`& LOT INSTALLER'S NAME&PHONE NO.Aee� - �. V SEPTIC TANK CAPACITY Sob 1 - LEACHING FACILITY: Pe) (size),Iq �,i3 NO.OF BEDROOMS BUILDER OR OWNS -q- C d 'ERMTTDATE: COMPLIANCE DATE: P Se aration Distance Between the: Y Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 'f 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 N U1 Ut U) cn � 616' � 6 6� w USE (1) 14' x 43' LEACHING FIELD E °„ ��• _ - (2) 4" DIAMETER DISTRIBUTION LINE o , I 2 REMOVE UNSUITABLE MATERIAL FROM BENEATH SYSTEM IF ENCOUNTERED � . .' L 0 T OVERDiG 1' INTO MEDIUM SAND LAYER10 ' , •r o , e tire. .' k BACKFILL WITH CLEAN MEDIUM SAND PER 310 CMR 15.002 _ � \,✓ ,,.• FOUNDATION EL = 99.5' PCC.RISER WITH � TEST HOLE 1 L � s DEPTH ELEVATION METAL FRAME & COVER �0 0 s 3 ji ' I E. G. 99, EXISTING GRADE _ 99' f CG , % 0' 99.3 O S, ^ r ` L 0 T 3 98.8' L O r 1 03 ao 0 0 0.8 98. : 97.3' SL 10 YR 3/2 `� • B MS 10 YR 5/6 I e e p j 97.1' 1500-GAL96.3' 3.7' 95,5'o SEPTIC 96.9 BOTTOM EL 95.3' f 96.5' PERC ® 5' East B BEDDING AS � ? TBM ® CB/DH PER TITLE 5 14 EL = 100.00' L --t34 4 r © MS 10 YR 6/6 f LOCATION MAP L=78.18' (ASSUMED) �. - `•_ R^Sz SO 10' 10.5' 9 2.5 23' In _ I R=179,46' 76 COTUIT & HYANNIS QUADRANGLES S SCALE: 1,25,000 Op•�4., f _ �tC� � • ASSESSORS ASSES _ 21.3j, _ R--30 MAP 165 PARCEL 21 - 6 ' � --____----- L=z�•�� D,�VFI,OPED PROFILE OF Pk0e0�E0 SEI�TIC SYSTEM 10.0' 89.3' No WATER EDG ZONES: - ------- E of NOT TO SCALE -- AQUIFER PROTECTION OVERLAY DISTRICT PAVEMENT ZONING DISTRICT: RC O AREA MIN 3,60 S. F IMUMSl V E FRONTAGE = 20' 6a � WIDTH = 100 �� �g 98.6 .4 FRONT SETBACK = 20' o N L 0 T 4 SIDE SETBACK = 10' \ cn REAR SETBACK = 10' < 99.5 BUILDING HEIGHT = 30' 4' FLOOD ZONE C P R 0 P 0 S E D ��99.7 1 1• E \,, FIRM COMMUNITY PANEL l 96,7 �,, D R I V E W A Y 2�,. ,98.3 No. 25001-16 D 99.4 ELEPHOO'91.Y.�' .2 m REVISED: JULY 2, 1992 / 10' ELECTRIN \ -EDGE OF PAVEMENT DATUM FOR THIS PLAN IS ASSUMED '2 100.0 TV SERVICE 98. \ RESERVE AREA 7 / N 8.4 O /96.3 a o 99.3 �- x 97.9 u0i FIELD DB � ��r'��S `. r� _ 97.2 z m LEACHING 8 R do 96.5 U '1L �h�l / o• my / S q 97.4 d 7 10' 43 ��f F cFX 95.5 I .8 \96.0 ` �6•4 l N o 8.2 0' 099.0 X 97.6 96.2 X 98. . � \�3 g 97.9 98 X 98.6 I �r; PPOPOSED SINGLE FAMILY RESIDENCE 97.7/ a L PROPOSED x \� L O T 5 p DRIVEWAY99.5' W � \ .. .• Q � FOUNDATION ELEVAITON _ , FINISH GRADE \ \ 4 _ I X 97.4 6.4 \ 2" 1/8" - 1/2" STONE x 6.5 4 PERF SCHED 40 PVC 9 .0 �' \ 6 UNSUITABLEIF CMATERIAL TOOUNTERED E INSURE THE .r ,� I 4 97. .� � f 2 OF 3/4 - 1 1/2 MATERIAL FOR 5-FEET x 97.6 SIDEWALL AREA OF SYSTEM IS IN REMOVE UNSUITABLE j \ STONE IF ENCOUNTERED 935 oq \ CLEAN MEDIUM SAND OR FILL PER 99 / 310 CMR 15.201 - 15.293 i' u \ -' \ 98.8 14' \ ' \ 61 ^5 99.4 o: 60 N O S; D S \ � U`�` 2 4' 98.30 00 W 0 0 D S / \ X 95.8 � \ 99.4 TONEWALL /" �^ \ DETAIL LEACH FACILITY x 5.8 ;jg6 x 96.4 END SECTION 114.37• 97.9 ❑ 97.4 X 96.4 � \ N. T. S. 9 7.9 I _._,_ I x 95.4 N -'-._-----_ L O T 6 x 9 7 0 \� P K NAIL FN D --`-" --------- ____ 0" W �-- '•----_. EL = 97.91° ___ 13_0.6_ g=_ 3.5 \\\ �N OF/ygss tia� a ( `� 45,436 Square Feet --- --mac 97.6 \ ''�"`" X 92.9 1.043 Acres f \ �o STEPHEN y � SITE PLAN A \ \ \ per record plan 98.3 \ '� x 95.3 \ \ AT No.30216 o c wlv 0 97.9 \ -FOOT WAY \` \ x 92 55 `,, \ \ � �F�ISTER`�� RESERVED FOR POSSIBLE 96 94 \ 'c FUTURE ROAD EXTENSION X 95.7 98 LOT 6 - FAIRWINDS DRIVE �Fss�o►vAL����� N/� LALLY �� � \ OSTERVILLE, MASS. 94 ti s ,.`a� \ FOR DESIGN DATA: 6'• PROPOSED 4-BEDROOM SINGLE FAMILY DWELLING X 96.2 P A U L G R A F F NO GARBAGE GRINDER NOTES: g8S p <Y REVISED: AUGUST 12, 1999 WATER SUPPLY FOR THIS LOT IS MUNICIPAL WATER E w DESIGN FLOW: 4 x 110 GPD = 440 GPD `� '( SCALE: 1 = 20 MAY 12. 1999 0 F 00�SE EN LOCATION OF ALL UTILITIES NOT SHOWN ON THIS PLAN. AT 2 �P / X 7.0 SEPTIC TANK: 440 GPD x 200% 880 GPD LEAST 72 HOURS PRIOR TO ANY EXCAVATION FOR THS K E Y v BAXTER & NYE, INC. USE 1500-GALLON SEPTIC TANK PROJECT THE CONTRACTOR SHALL MAKE THE REQUIRED ••�--• 812 MAIN STREET NOTIFICATION TO DIG SAFE (1-800-322-4844) AND f•�9 ` OSTERVILLE, MASS., 02655 ��N 0 LEACHING SYSTEM DESIGN: APPROPRIATE WATER DISTRICT FOR LOCATION DATA. WATER METER PIT ® / Oh ` (508)-428-9131 1 - 43' x 14' LEACHING FIELD wv THE CONTRACTOR IS REQUIRED TO SECURE APPROPRIATE WATER GATE APPLICATION AREA REQUIRED: PERMITS FROM TOWN AGENCIES FOR CONSTRUCTION DEFINED / 18 440 GPD 0.74 GPD/SF 595 SF BY THIS PLAN. CONCRETE MONUMENT .FOUND-e-- � a• M� ISTER�� APPLICATION AREA DESIGN: INSTALL RISERS AS REQUIRED TO WITHIN 12" OF FINISH GRADE. OAK TREE / L 0 T 7 S SIDEWALL AREA: BOTTOM AREA ONLY L LF� BOTTOM AREA: 43' x 14' = 602 SF GRAPHIC SCALE TOTAL AREA PROVIDED: 602 SF PINE TREE /h1z��/Sr r2 ,199�t ALL STRUCTURES BURIED FOUR FEET OR MORE OR SUBJECT 20 0 10 20 40 80 PERCOLATION RATE: LESS THAN 2 MINUTES/INCH TO VEHICULAR TRAFFIC TO BE H-20 LOADING CATCH BASIN ❑ SOIL CLASS I FAIRWINDS SIGN -a- ( IN FEET ) TEST HOLES BY BAXTER & NYE, INC. 1 inch = 20 ft. ST No. P 8543 08-03-1995 EDWARD F. BARRY, BOH 96037 (SITE13:DWG)