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0078 FOX HOLLOW LANE - Health
78 FOX HOLLOW LANE, OSTERVILLE A= r r r l 0 I� RR//TOWN OF BARNSTABLE L&ATION 28 )'&rAlow /,v SEWAGE# 10f7-111,el VILLAGE 05A1y; 2/Y ASSESSOR'S MAP&PARCEL/Vr-O 26--03 INSTALLER'S NAME&PHONE NQ 13r, L.✓c SEPTIC TANK CAPACITY XIS LEACHING FACILITY: (type) I cmo�lrlGn/ (size) f a A US-X2 NO. OF BEDROOMS11 ,3 OWNER PERMIT DATE: I (- Z:2 -/'7 COMPLIANCE DATE: //d y/7 Separation Distance Between the: 1t)( e Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility erG 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��� 1, COt-1 r� Aavr -,�ty 3 ` H3 ' -Bcxdr— 32 i ! � — 3 0'31 OUT — 3G' ICE'1 ��ISP� No. GPI 7 qo/q �^'l C �Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftptiration for -Misposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(Upgrade Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 76)---,K d"J vi'o La^V e Owner's Name,Address,and Tel.No. G?+C-0,V1 ti 5ker- c" Assessor's Map/Parce j Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ��J�I;C•ta�;i—nJC_ .��. t', �;u r'�Ot ' Type of Building: Dwelling No.of Bedrooms =� Y Lot Size 3 3t 3 sq.ft. Garbage Grinder( ) Other Type of Building (r57�.,;} (6� No.of Persons i Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 13! �'� gpd Plan Date 1!- 2-T—I.7 Number of sheets Revision Date Title ii Size of Septic Tank L'"X►�Ft.y-� Type of S.A.S. 7•— t Ic,v � �u CytuMrO i°'►'S Description of Soil Nature of Repairs or Alterations(Answer when applicable) d-6:6)nn 1 rb r c.� _ , ��-(n f;,y{ �y;C� rL Date itst inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. SIM163, Date /f -2 7 J Application Approved by i , Date----------- 2t� Application Disapproved b Date for the following reasons PermitNojG l7'` "f�( Date Issued 1/ - ------------------------------------------------------------------------------------------ - - ---- ---- .n�ry_yr ._!' .a'"... .-,,"+ ...,- -..'�-•.ra.-n,r..-r.« +. .R '_-q,,y� ,,.,,.a•-^r...w.--•ti....-,w,T..w.-^r«r�,"�Rs'+*.:w„ ..- .. �.-s%+�."+.:..-.-�^e":..... �QJ,n,_ .. ' , r r No. Fee (w THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpfication for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No..7,6 roll 14011,9w 4.6,vc Owner's Naamme,Address,and Tel.No. riyrh, rriv" Assessor's Map/Parcel I S-_®p(, _Goa g Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: r •-sr Dwelling No.of Bedrooms pp Lot Size 33, )')5 sq.ft. Garbage Grinder( ) Other Type of Building (t'S r)y. 1 fG l No.of Persons Showers( ) Cafeteria( )` Other Fixtures Design Flow(min.required) '3 3C) gpd Design flow provided ��c�r 7 gpd Plan Date //" x `� '/7 Number of sheets 2 Revision Date Title Size of Septic Tank ey,1'5'-1N: Type of S.A.S. 9--S00 GG<e G�J h �C7 e- V �t brrS d Description of Soil i Nature of Repairs or Alterations(Answer when applicable) 17-^k5'rG l 4 0 Ni"cJ `n- 7 U ae\)C) � Date kst inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in t 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 fi2-- Date �� 'd"1 7'! F Application Approved by Date it 1 Application.Disapproved by' Date for the following reasons f> PermitNo.l ,9r 1A Date Issued Al t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS 4 Certificate of Compliance THIS IS TKO'CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( ) Abandoned( )by �; Jr.I� at 7F Ft*' �11cti:�. Lu:i1� Mw���ir' has been constructed in accordance swith the provisions of Title 5 and the for Disposal System Construction Permit No l�� ?-" dated � 0 Installer Nc Designer t:-N y N c r✓ t IV bedrooms Approved design flow (� _ gpd The issuance of this permit tshall not be !!construed as a guarantee that the system wilkffi—nc tion des'11_1� d. Date ! 1 77 � Inspector -----------'--------------------- - --------------------- -------- --------_- No. �/� �t I Fee �t`,�/0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS ' misposal *pstrm Construction Permit Permission is hereby granted to Construct( ) Repair( ) U grade( ) Abandon( ) System located at `i X %0 fG jMOW 1,"e' �)S't"#�J 1. t-_ 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. r Provided:Construction must be completed within three years of the date of this permit r "w Date ( � 7 Approved by L r, Town of Barnstable �n+rro Regulatory Services Richard V.Scali,Interim Director + RARNSTAW.F. b s �0� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-S624644 Fax; 508-790-6304 Installer&Designer Certification Form Date: 11 "2�,1� Sewage Permit# Assessor's Map\Parcel 14 t -p06—003 Designer: �nylr,ee�;n�//Wor-Lis., inc. Installer: j3rp,,g' I"C- Address: iZ U9, C bss+-,e 1.1 i�-'4 Address: { ,p. �cx 14_g- TJoresta6Ae 1'uA ®ZG 4 M1+ d?1Q3<— On A ? P•g Ca vim _was issued a permit to install a (d e) (installer) septic system at 7ir Fa 7, lid1ju,,,'3 ased on a design drawn by �e ie f t. lM C-Gn*te t[✓ (address) Go "ncj WCrLu Li , dated 11 � 22� t� (designer) ' �— I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Ship out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component. of the septic system)but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. T certify that the system referenced above was eonstructe nce with the terms of the RA approval letters(if applicable) t%OF PETER T. M*NTEE `— --�' CIVIL Instaallle Signature) NO.35109 RFGtSTEA (Designer's Signature) (Affix Designer amp 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 BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. r QASeptic'0csigner Certification Form Rev 3-14-13.doe F V , TIM Town of Barnstable P# �� Y� Department of Regulatory services ' Public _H:eallth Div' t5' Z ' MASSL ��� Division note •_� I I4 ? i :yq. �� 200 Main Sn-ect,Hyannis MA 02601 c.. . Ar f0t Date Scheduled_ . s Time Fee Pd. - 3:- r�; Soil Suitability Assessinent for !) age Disposal Performed Qy:���TC.��j�.Q (� S tC - 1 imessed By:_ 1 OCATION & GENERAL I_NI'ORMATION Location Address 79x L Owner's Name,a ri �✓1� Address d t'-'a--16' Assessor's Map/Parcel: U �STC��r« �& i �—do&—B613 Engineer's Name a ny n--e1^ ell b� (�C NEW CONSTRUCTION[ON REPAIR _7� Telephone# -5zr?- y Tj--5_3!J!_3 Land Use i Slopcs(%)__L Surface Stones__r\j"_`\x " Distances from: Open Water 13ody-7[jdG ft. Possible Wet Area Drinking Water Well ( ft -- Dminage Way d�1—lik ft Property Line 0 C= _ft Othcr• ft SKETCH:(Street na ,dimensions of lot,exact locations of test holes& erc tests,locate wetlands in proximity to holes) 41 Parent material(geologic) Depth to Bedrock. Depth to Groundwater: Standing Water in Hole: - -___ Weeping from Pit:FNe /V�l Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE 3 Method Used: Depth Observed standing;in obs.hole: in, Depth to soil ttlotdog; Depth to weeping from si,3e of obs;hole: ` - _ in, Groundwater Adjustment v ft.4 Index Well# Reading Date: , Index Well level e y Aaj,factor;,,,_-___ Adj.Clrouttdwater 1 t7vel PERCOLATION TEST ante Thne �.•___ Observation r Hole# l :1 _ 1 Time gal:4 Vj Depth of Perc 2 Time at 6" Start Pre-soak Time @ — Time(f'-6") — End Pre-soak _ Rate Min./Inch. 2� Site Suitability Assessment: Site Passed Site Failed:— = Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back------------ ***If percolation test is to be conducted within 1.00' of wetland, you must first notify the Barnstable Conservation:Division at least one (1) week prior to beginning. Q:\SEP1X,VERCPORM.DOC DEEP OBSERVATION HOLE LOG T;[ole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, on istenc �L Q avcl) 0 n DEEP OBLSERVATION HOLE LOG F(Ole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottli:rg (Structure,Stones,Boulders. _ Consistency,%Gravel)- DEEP OBSIERVATION HOLE LOG Hale# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consiste qy,TO Gmvc)-- DEEP OBSERVATION HOLE LOG T Hole#—_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% Orav D T_ Flood Insurance Rate Man., Above 500 year flood boundary No— Yes Within 500 year boundary No��~Yes__ Within 100 year flood boundary No Yes Depth of Natur L11y 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? .� If not, what is the depth of naturally occurring pervious material? Certification t t ed the soil evaluator examination approved by the I certify that on _ (date) I have pass Department of Environmental Protection and that the. above analysis was pe:-formed by me consistent with . the required train' ,expertise and experience described in 310 CMR 15.0111. Signature Date. — --- , Q:VSE"lC\l'ERCFORM.DOC > 6 _ Co'.%BIONZ EALTH OF MASSACHLSETTS £ _ EhEcu= OFFICE OF E.N-mO\mE\TAL AFF.AJRS DEPARTMENT OF ENVIRONMENTAL PROTECno ONE WL\'TER STREI:. BOSTON MA 0210i• (617j 292-55(st+ .J' TRH DY COL Secre:a_-t ARGEO PALL CELLUCCi DAVID B STP.-Hc • Goverao: Comzniss:oner SUBSURFACE SEWAGE DISPOSAL SYSTEM MPECTION FORM_ PART'A CERTFICATION Property Address: 78 Fox Hollow Lane Name of Ownw_a n BaX f P r 0 s t e r v i l l e Address of Owner: Date of Inspection: Name of inspector:tmeme mno Wm. E. Robinson S r. f am a DEPm appEved to Sectio 15_W of Title 51310 CMR 15.000)R bC�,y�: W nson Septic Service MaIngAddress: PO Box O 9. Centerville .--MA Telephone Number: 7 7 K—R 7 7 0 CERTIFICATION STATEMENT 1 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 inspection. The inspection was performed based on my training and-experience in the proper function and- maintenance of on-site sewage disposal systems. The system: ,1 Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ /Fails oe Inspector's Signature: �y �+ .Date•.. , r The System inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to ttte system owner and copies sent to the buyer,if applicable, and the approving authority. NOTES AND COMMENTS 1® . S E P 8 2004 TavwOFWNsr KkTII DEPT. a ^Y Jt _evise:5 5/2/9G. Pagrtotll o^Recavrd Psnr: ,, SYSTEM INSPECTION FORM SUBSURFACE SEWAGE DISPOSALS , . PART A CERTIFICATION(continued) Nop"Address: 78 Fox Hollow Lane , Osterville .)wner: Ben Baxter Date of Inspection: INSPECTION SUMMARY: Check 10 B, C, or D: A. SYSTEM PASSES: have not found any information which indicates that•any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. YSTEM 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. Indicate es,no, or not determined(Y. N,or NO). Describe basis of determination in all instances. If "not determined'.explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance lattached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection: or the septic tank, whether or not metal,is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection If the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipets) or due to a broken, settled or uneven distribution box. The system will pass inspection if Iwith approval of the Board of Health). broken pipets)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipets). The system will pass inspection if Iwith approval of the Board of Health): broken pipets)are replaced obstruction is removed revlseQ 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Icontinued)' Property Address: 78 Fox Hollow Lane , Osterville Owner: Ben Baxter Date of Inspection: 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 the public health, safety and the environment. SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) THER 4 rev, se: P2Rc3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:78 Fox Hollow Lane , Osterville t Owrw: Ben Baxter Date of Impaction: pacti V D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: 1 have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct.the failure. Yes No Backup of sewage into facility or system component due to an overloaded orclogged 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. RGE SYSTEM FAILS: You mu t indicate either "Yes' or "No' to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public ealth and safety and the environment because one or more of the following conditions exist: Yes o the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area•IWPA)or a mapped Zone II of a public water supply well) The ow er or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office o the Department for further information. revised 5/ 2/91b Pagc4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART B CHECKLIST Propmy Address: 78. Fox Hollow Lane , osterville owner: Ben Baxter Date of Inspection: Check if the following have been done: You must indicate either "Yes- or "No" as to each of the following:' Yes No t/ _ Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been.receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this / inspection. , _✓ _ As built plans have been obtained and examined. Note if they are not available with N/A. V _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. ` The site was inspected for signs of breakout; t• All system components, excluding the Soil Absorption System, have been located on the site. J _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: ✓ ✓ _ Existing information. For example, Plan at B.O.H., ` _ Determined in the field(if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) / 115.302(3)(b)1 V- _ The facility owner (and occupants,if differeru.from owner) were provided with information on the propermaintenaac."f Subsurface Disposal Systems. Page 5 or I l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 'rop"Address-78 Fox ;follow Lane , Osterville Owner: Ben Baxter Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:36 v g.p.d./bedroom. Number of bedrooms(design): Number of bedrooms lactual):,j Total DESIGN flow L o Number of current residents: Z-A Garbage grinder(yes or no): U Laundry(separate system) (yes or no)/A Q If yes, separate ins pecti on.required. Laundry system inspected lyes or no) Seasonal use (yes or no):/ v Water meter readings, if available (last two year's usage Igpd): 1999 104, 000 Ral. Sump Pump (yes or no): A D 1998 81 , 000 g l. Last date of occupancy:-0' 6 CO ERCIALANDUSTRIAL: Type' establishment: Design low: gpd 1 Based on 15.203) Basis o design flow Grease rap present: (yes or no)_ Industri I Waste Holding Tank present: (yes or no)_ Non-so tary waste discharged to the Title 5 system: (yes or nol_ Water eter readings. if available: Last do a of occupancy: OTH : (Describe) Last d e of occupancy: GENERAL INFORMATION PUMPING RECORDS and so of information: System pumpLCd as part of inspection: (yes or no),A,-,O If yes,volume pumped: gallons Reason for pumping: TYP OF YSTEM Septic tank%distribution boxisoil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records;if any) VA Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other Q c�7 y� APPROXIMATE AGE of all components, date installed lif known)and source Of information: l lJ f• /y G Sewage odors detected when arriving at the site: (yes or no)�d revise-6 Page 6ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'rop"Address: 78 Fox Hollow Lane , Osterville Owner. Ben Baxter ` Date of Inspection: TI OR HOLDING TANK: (Tank must be pumped prior to, or at time of; inspection) (1, eon site plan) Depth below grade:_ Materi I of construction:_concrete_metal_Fiberglass_Polyethylene_otherlexplein) Dimensi ns: Capacit gallons Design w: gallons!day Alarm pr sent Alarm le el: Alarm in working order: Yes_ No Date of revious pumping: Comm ts: (condi on of inlet tee, condition of alarm and float switches, etc.) ' DISTRIBUTION BOX:►I (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence solids carryover, evidence of leakage into or out of box, etc.) PUMP C AMBER:_ (locate o site plan) Pumps in orking order: (Yes or No) Alarms in working order(Yes or No) Commen (note co dition of pump chamber, condition of pumps and appurtenances,etc.) revi seG 9/2/98 page 8or11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ropertyAddress: 78 Fox Hollow Lane , Osterville owner: Ben Baxter Date of Inspection: BUILDING SEWER: (Locate on site plan) Depth be grade:_ Material of construction:_cast iron_40 PVC_ other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK: flocate on site plan) Depth below grade: Material of construction: oncrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age_ Wage confirmed by Certificate of Compliance_(Yes/No) Dimensions: Sludge depth: 3-41 Distance from top of sludrge to bottom of outlet tee or baffler Scum thickness: 1 Distance from top of scum to top of outlet tee or baffle: 1 1 Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: 6 �Vr�..� ir 6• JL �omments: (recommendation for pumping, condition of inlet and outlet tees or baffle), depth of liquid level in relation to outlet invert, structural integrity, evidence of lea age, etc.) ¢* ,b L !� w 1 6A J7 JC/1,1- /d C - GREA sit TRAP: (locate o e plan) Depth belo grade:_ Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimensions Scum thick ess: Distance fr m top of scum to top of outlet tee or baffle: Distance f► m bottom of scum to bottom of outlet tee or baffle: Date of las pumping: Comment (recomme dation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence f leakage, etc.) ret'_SeC 5/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continted) 'rop"Address:78 Fox Hollow. Lane , Osterville Owner: Ben Baxter M .. Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods) ' If not located, explain: Type: leaching pits, number:_ leaching chambers,number: leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alteonative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition pf vegetation, et e W IC rt— CEIIPOOLS: (local on site plan) l y Number nd configuration: ;• Depth-to of liquid to inlet invert: Depth of s lids layer: . r )epth of s m layer: Dimensions f cesspool: a Materials of onstruction: Indication of roundwater: inflo (cesspool must be pumped as part of inspection) f`y Comments: (note condition f soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY .-, (locate on site pl n) Materials of co struction: 4 Depth of solids. Dimensions: Comments: inote conditi of soil, signs of hydraulic failure, levelyof ponding, condition of vegetation, etc.) - - PARC 9 ofA 1 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Icorronued) Nop"Address: 78 Fox Hollow Lane , osterville , )wnef: Ben Baxter Jate of Inspection: 9- 'T-C-0 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) _ U , yL O D" i �a - re-visec G;'2/9E PaKc 10 0l 11 • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) roperty Address:78 Fox Hollow Lane , Osterville Owner- Ben Baxter Date of Inspection: NRCS Report name Soil Type_ Typical depth to groundwater a .> uSGS Date website visited - Observation Wells checked Moderate Deep Groundwater depth: Shallow SITE EXAM Slope t r < Surface water Check Cellar Shallow wells ) t Estimated Depth to Groundwater/L4 Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site (Abutting property, observation hole. basement sump etc.) ` " Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators. installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) ,e f rev=Sea 9/L/9E. Page uonl 'f _ TOWN OF B`ARNSTABLE4; 4 (jog LOCATION '6" /#4/v SEWAGE # O 7� VILLAGE �S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) —(size)—c/o NO. OF BEDROOMS3 _PRIVATE WELL OR PUBLIC WATERll�O�C BUILDER OR OWNER t DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: L( - VARIANCE.GRANTED: Yes No . �� _ __ ------- �" " �� 2, Zoo Y i i i �. 1. i � h r THE COMMO EALTH OF MASSACHUSETTS _ BOARD OF HEALTH ...V. U_J..t..................0F......tAA .ws..�.�.. ................................ Appliration for Disposal Works Tonstrnrtiun Frrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual. Sewage Disposal Stem at: ............ - _..... ..: - •-------•- -^I --•---------------------- -._...._..........._.. .........----- ocation-Address t No. 5.. ................................... �� Rl ... Ls 4? r...... ..63�6 Owner A Address 1.4� 'V Installer l�-no Address d Type of Building ICJ Size Lot_35,33a.....Sq.. *t Dwelling—No. of Bedrooms............................................Expansion Attic s Garbage Grinder '4 Other—T e of Building No. of persons............................ Showers — Cafeteria 04 Other fixtures .................................. W Design Flow.._...._._..5 57.........................gallons per person per day. Total dail_v flow......�0__._.____. ......._._..gallons. WSeptic Tank—Liquid capacitytCO•-gallons Length.?;:lea._... Width.A ... Diameter..- Depth.5: _. x Disposal Trench—No.................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---_-___--_I........ Diameter.....1T.......... Depth below inlet...'.............. Total leaching area_? .b...sq. ft. Z Other Distribution box ( ) Dosing-lank ( ) ff '-' Percolation Test Results Performed .............. Date......�1 .................... a Test Pit No. I-_LS...._minutes per inch Depth of Test Pit......1Z........ Depth to ground water.A�T&.9 9xd MO_0P Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------- ----•---•--•---------•- .................... .---..._:•-------.....--.............. 0 Description of Soil.----- �_ o� ... � <<-.2- x V .._......-•-•••-•-----••................••--•••-------_..... W ••••-•--•••--•.................•---------•----•••-...-•••--•..._...--•-•----•--._...------------...------------------------------...----------------•--------------••-------------------._...-•-------•- UNature of Repairs or Alterations—Answer when applicable............................................................................................... -------••-------------------•------------------------------.•._.....--••------------------•-------------------------------------------------•-•------------------........-------------------._......•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned fu zer rees not to place the system in operation until a Certificate of Compliance has n issued by t e boar of "!lam ig ed. . ..-•...... •- --•-- -- - --• ---•---r--••------- -..... -__- ---- e Application Approved By.. Q. . -• •---•----•-------- a g - Date Application Disapproved for the following reasons:.............................................................................................................. -•--------•----------•--------------••--•--•----......-•----•----------------•=•---------------•-••--_-- - Q9:7Permit No �?..-_�...... ...... Issued---------------•--•------•-•---•-------....Date............. Date T t` No... FRic ............ THE COMMO EALTH OF MASSACHUSETTS BOARD OF HEALTH ,va_. .... oF...... i tilS.) r................................. Apphration for Disposal Works Tonst ttriion jhrmft Application is hereby made for a Permit to Construct Vt.") or Repair ( ) an Individual Sewage Disposal Sys,�em at .......................... - ...__...........(G......-------------- ------........--------------------------...........................------... c)� ...-•---•� station-Addre s orlmot No. f_ ------------- - ----_..... .....-----------------------.......- �� a p��-Y W-ner W t= L V i 1 �t - ;'� �a.? ! ..0�atPs4.5.. ...................... ............... ...... ...................... j..... ......_.......... ...................................... ..._._ Installer Address d Type of Building Size Lot_3 2, _J .....Sq. feet Dwelling—No. of Bedrooms......`. .................................Expansion Attic W o Garbage Grinder W,�C) Other—Type T e of Building ............... No. of persons............................ Showers — Cafeteria G� YP g --------••--- P Otherfixtures -----•------•-----------------------------------------.-----------------------------------•-------•---. ....-------------•--.....----......-------- W Design Flow..........`..5.........................gallons per person per day. Total daily flow......._(D........................gallons. WSeptic Tank—Liquid capacit}. ..gallons Length_&�.-.G._.. Width4_-Q.... Diameter__--.-"'_...... Depth.5::!B._. x Disposal Trench—No.......:............. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------I........ Diameter....62-......... Depth below inlet.. .............. Total leaching area:?:�).-b....sq: ft. z Other Distribution box ( ) Dosin tank ( ) '-' Percolation Test Results Performed by._ x_. .. _ :_.�C:............... Date....:'~ .......... as Test Pit No. L-��'-__-_minutes per inch Depth of Test Pit....._'.._......_. Depth to ground water.�J_G`-It-/.,tr.Qc3 CEL Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ai .............................. ................ ----••-•--------- ................................................................ D Description of Soil----- ...... ..... .................W V ...........................-------------------------•---....•-•----•-------------••------•......---.....-•----•------•-••--•-----------------••-•-----•...........------•-------------------•-•--------- W -----•--•---•------------------------------------••-----•-----------•---•--•-••--•-•-------••--------------------•------------........ ---------------------------- ....... ------------ UNature of Repairs or Alterations—Answer when applicable............................................................................................... -•--------------------------•---....-----------------------•------------------------............................---------------------------------------•-------------------•---.............-•-•---_.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI.i; 5 of the State Sanitary Code— The undersigned f,I er grees not to place the system in operation until a Certificate of Compliance has `den issued by e boaro of�ealth , ? r i)ned_ ...... ... to Application Approved By----.. ........... �t-'�=��` ate Application Disapproved for the following reasons--------------------------------•----------------------••---•----------------....-----------..................._ .............................•-------•-----•-•--•--•----•--•-•-•-•--•------•----•-------------•--•-------'--------------.............-----------------------------------------------------------•......-- /� r 1 Y] Date PermitNo.�..�......._ _.------....rj-------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Au)..`... .............OF......... ............. Trriifirair of Toutpliana THIS IS TO ERTIFY, That the I divi ual Sva a Disposal m constructed ) or Repaired ( ) ��by------- .i.a�� 1� .... ..�....��'+n: ..i'(_..... ...... ................... y► �/'�'� y ' r��a ) / I scarier A �" ' /) at--•---L 1•--•--- -�•----� .Ll..._. ✓"� f a, v �c j--.-. .�(-L- 1��.V-d-.'-rim, .... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Coe a described in the application for Disposal Works Construction Permit No.IT"__.` �......... dated.../.�___�7,�... ....................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARAN14E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 01 DATE....................... 7).......................... Inspector.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l..l,r•. _r ...........OF.�,. .. .! .�� .......................... FEE..l. Y �•/C� � r No.Q / Y .......... Disposal Works TonstrMtWu ramit Permission is hereby granted.... ..--------- to Construct ) or Repair ( ) an Individual Sewage Disposal System D at No.. - - -----_..+ � --• T�3 'je� C'= = r� -L: as shown on the application for Disposal Works Constructi 7 Datedj.P_ f --------_-----.-- .h 11 -"' Board of Health FORM 1255 HOBBS & WARREN. INC:'PUBLISHERS d a 41 1 �pGTHE Tp�� DEQE File No. SE 3-1569 ..,�� ('Io be provided by DE(,}:', r q'f Commonwealth � DAHI9TIRLE- � Cii.)(I'o;vn: B=s;o':)le of -Massachusetts rA,td i639• ��. Applicant Roberts Realt;, 0 m AY Order of Conditions MASSACHUSETTS WETLANDS PROTECTION ACT ` G.L. c. 131, § 40 _TOWN OF BARNSTABLE WETLANDS PROTECTION BY-LAW, Ch. 3, Article XXVII FROM: BARNSTABLE CONSERVATION COi\MMISSION To Roberts Realty Robert Burpee & Robert ciinn;ngh- (Name of Applicant) (Name of property owner) P.O. Box 954 P.O. Box 954 Address Duxbury, MA 02332 Address Duxbury, I�Lk 02332 This Order is issued and delivered as follows: D by hand delivery to applicant or representative on (date) �{ by certified mail, return receipt requested on March 23 1987 (date) This project is located at Lot #3 Fox Hollow Lane Ostervil le Barnstable Assessor's Map # 145 Lot 6-3 The property is recorded at the Registry of Deeds -n Barnstable Book 3454 Page 264 Notice of Intent dated Jan. 20, 1987 Date of Hearing miarrh 3_, 1987 This Order is issued on March 23, 1987 _ Findings The Barnstable Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has held a public hearing or, the project. Based on the information available to the Bamscable Conservation Con.- mission at this time, the Barnstable Conservation Commission has determined that the area on which the propu� •d work is to be done is significant to the following interests in accordance Nl ith the Presumptions of Significz-"nce set forth in the regulations for each Area Subject to Protection Under the Act (check. as appropnate): ARTICLE 27 ONLY Public water supply i i Storm damage prevention X Erosion Control Private water supply k Prevention of pollution Wildlife k' Ground water supply Land containing shellfish7 Recreational Fisheries Flood control a - .aesthetic Therefore, the Barnstable Conservation Committee hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the regulations, to protect those interests checked above. The Barnstable Conservation Committee orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. GENERAL CONDITIONS 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. . 4."-The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: (a) the work is a maintenance dredging project as provided for in the Act; or (b) the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or debris, including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires, ashes,refrigerators, motor vehicles or parts of any of the foregoing. i. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the Barnstable Con-,ervat;on C0m7._S:s_C on the form at the end of this Order prior to commencement of the work. 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bear- ing the words, "Massachusetts Department of Environmental Quality Engineering. �F 3-15r,A 1 LLV uaiaU ca 10. Where the Department of Environmental Quality Engineering is requested to make a determination and to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hear- ings before the Department. 11. Immediately following completion, the project shall be certified to be.as per these conditions and plans, in writing, to the Barnstable Conservation Commission by the project engineer who shall be registered in the state of Mass. 12. Upon certification by the project engineer the applicant shall forthwith request, in writing, that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 13. Prior to any work being done at the site, all legal advertising bills incurred by the petitioner in relation to the Wetlands Hearing held on this project shall be paid. 14. This Order is issued under Article XXVII of the Town of Barnstable By-Laws as well as under Mass. G.L. Ch. 131, sec. 40. The Barnstable Conservation Commission or Conservation Officer shall be notified no more than two weeks nor less than two days prior to the commencement of work, and have the authority to issue an Enforcement Order if the terms or intent of this Order are not complied with. 15. It is the applicant's responsibility to provide all contractors with a copy of this Order and to ensure that all v.,orkers are informed of the conditions of this Order before they begin work at the site. 16. The work shall conform to the following plans and special conditions: PLANS: Title Dated Signed and Stamped by: On file with: Commissicr, Plot Plan Peter Sullivan, P.E. Barnstable Conservation Rev. Oct. 1986 Dec. 12, 1986 Mare—I.98 Special Conditions (Use additional paper if necessary) 1. All areas disturbed during construction shall be revegetated immediately following completion of work at the site. No areas shall be left unvegetated or unmulched for more than 60 days. 2. This approval is contingent upon approval by the Board of -Health of the subsurface sewage disposal system. 3. Dry wells shall be installed to handle roof runoff. 4. The driveway shall be constructed of pervious material. 5. The work limit shall be established as shown on the approved plan. Staked hay bales shall -be set at the work limit prior to the start of work at the site and maintained throughout construction. 6. All wooden portions of the deck shall be CCA-treated or the equivalent. No creosote-treated material may be used. 7. A 10' X 101 .deck may .be constructed to the side of the house. 8. There shall be no disturbance beyond the work. limit line, including the cutting of trees and clearing of brush without prior approval of the Conservation Commission. 9. Where possible, trees of significant size shall be preserved (6" dia. or 10. Approval shall be contingent upon receipt of a revised plan indicating the footprint of the approved deck. ........................................................ (.Leave Space Blank) Issued By Barnstable Conservation Commission Signatur s1 _ 4 ?isOrd7ermust be signed by a majority of the nservation Commission. On-this 23rd day of March 19 87 before me personally appeared Thomas Cambareri to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as h Ob c is/ r e act and deed. //a,9-N—) November 28, 1991 taryMy commission expires The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land is located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order, providing the request is made by certified mail or hand delivery to the Department within ten days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. .........-...............-.................._............................................................................................................................................................ Detach on Dotted Line and Submit to the Issuer of this Order Prior to Commencement of Work. To Barnstable Conservation Commission (Issuing Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT FILE NUMBER HAS BEEN RECORDED AT THE REGISTRY OF ON (DATE) If recorded land, the instrument number which identifies this transaction is If registered land, the document number which identifies this transaction is Signed Applicant i, r — 97——EXISTING CONTOUR O CoP` �� N o Ln _x 100.98 EXISTING SPOT GRADE Q �5 Vermeer Ct 97 PROPOSED CONTOUR p cD fn P�de W EXISTING WATER SERVICE O O C G EXISTING GAS SERVICE CL coof ROUTE 28 —UGW—UNDERGROUND WIRES —'—'— WETLAND LINE & BUFFER O PCofc\ ON 0-. G�rc\e WET-'20 WETLAND FLAG D ,\II, WETLAND SYMBOL p < O s LO TEST PIT BENCHMARK 4c�o o yollow \.ore LEGEND ° a (N LOCUS N LOCUS MAP NOT TO SCALE --- N 86'24'00i�-lW q 1 165.00' I 1 X 26.8 f � I Cb ! f 1 \, UOT 3 34,338 ±SF f PARQEL ID': 145 ' 006 ' 003 / 3 ,11►, I r' rb N 0 / f Q� 0 � 1 t � 'coo �\ WET-05 `p I 16.84 N ISOLATED FRESHWATER WETLAND\\ WET-04 \ 17.33 ll WET 1 / Z N (0 i 16.30 C' ►7 I 24.40 N \ t\ 24.07 x 13. \ \ GARAGEd o 24. DRI VEWAY' \ EXISTING, WE I \ 15.27 , \ HOUSE(178) 24 ` 1 ► T \ G�'�` T.O.F.=25.1 t TP ---- )x 16.17 / 19.16 24.33 2 A 2V 26 / DECK G2 TP ' y a0o V€N T / / $ o c a. ;©:°.: EXISTING LEACH PI T W 01 16.24 .7j / \ : -� CONTRACTOR SHALL PUMP, 4, S . 72 , \ ��::` .:, FILL W/SAND & ABANDON • st .s R, r C11 � .o -•� + �y 4.12 / 23.25 AN -- / , 3. 0 \ ELE ❑ PA VED 23.46 N* OF Mgss9� EXISTING SEPTIC TANK \`(/ 1 DRI VEWA Y TOP OF oANK, EL.=22.33 C' \ 1 PETER T. CrCrl APRON 23.21 McENTEE INV.(OUT)=21.00E \�� � CIVIL % 24"1 No. 35109 W BENCHMARK RfGIST MAGNETIC NAIL SET NAIL 23.13 w EL.=23.03 G 1 v \22.63 { vo Z � yy WETLAND CONSULTANT �O MARSH MATTERS ENVIRONMENTAL P.O. BOX 554 y FORESTDALE, MA 02644 978-434-1228 FLOOD ZONE DESIGNATION O OWNER OF RECORD MAP NO. 25001CO494J SHERIDAN, JANE E EFFECTIVE DATE: JULY 16, 2014 78 FOX HOLLOW LANE ZONE X, NON HAZARD OSTERVILLE, MA 02655 Engineering by: SCALE DRAWN. 278 N� PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET ND. 78 FOX HOLLOW LANE OSTERVILLE MA (508) 477-5313 11/22/17 P.T.M. 1 of 2 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02 332 ;A V NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:21.00 SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROPOSED S.A.S. INSTALL WATERTIGHT RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" COVER SET E I T GRADE OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F.=25.1 t CHARCOAL Cl F.G. EL.=24.OtF.G..EL.=24.3t VENT F.G.fG EL.=24.4t � F.G. EL.=24.4t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. 1 - 8, L = 5 ® S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4'SCH40 PVC 6" Li 10"I . 6 866�aBe 14" 6aaaaaa EXISTING 48' LIQUID MINIMUM LEVEL ADD. 4' 4.8' 4' GAS ALE INV.=20.77 PROPOSED INV.=20.60 INV.=21.00t D-BO EFFECTIVE WIDTH = 12.8' (FIELD VERIFY) H-20 RATEDINV.=20.50 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-20 RATED TOP CONC. ELEV.=21.6t BREAKOUT ELEV.=21.00 - NOTES: INV. ELEV.=20.50 aaaa Baaaa aaaaB 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ease aaaaa INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=18.50 4' 2 X 5'=17.0' 4' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURRING 8.EFFECTIVE LENGTH = 25.0' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP- EL.=13.3 - , 4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON THE 3/4" TO 1-1/2" DOUBLE OUTLET TEE. WASHED STONE 3" LAYER OF 1/8" TO 1/2" SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) SOIL LOG ` DATE: OCTOBER 31, 2017 (REF#15,518) DECK EXISTING SOIL EVALUATOR: PETER McENTEE PE(SE#1542) HOUSE(# GARAGE WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT T.6.F=25.1t ELEV. TP-1 DEPTH ELEv. TP-2 DEPTH 24.3 A 0 24.3 A 0 , FILL FILL _ 23.8 6" 23.8 6" B B � LOAMY SAND LOAMY SAND v- a 10YR 5/8 10YR 5/8 cPo N 22.5 22" 22.4 23" i� M Cl PERC C1 24'%42" PROP. % S.A;S.t� MED. SAND COP MED. SAND 2.5Y 6/6 2.5Y 6/6 SEPTIC LAYOUT 13.3 132" 13.3 132" PERC RATE: <2 MIN./INCH "C" HORIZON • GENERAL NOTES: NO GROUNDWATER ENCOUNTERED 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR DESIGN CRITERIA TO DESIGN INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE R. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING NUMBER OF BEDROOMS: 3 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 1 SOIL TEXTURAL CLASS: CLASS I ENGINEER BEFORE CONSTRUCTION CONTINUES. DESIGN PERCOLATION RATE: <2 MIN/IN 5. ALL ELEVATIONS BASED ON ASSUMED DATUM (BARNSTABLE G.I.S.t). (0.74 GPD/SF LOADING RATE) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF DAILY FLOW: 330 GPD THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. DESIGN FLOW: 330 GPD GARBAGE GRINDER: N0 7. WATER SUPPLIED BY TOWN WATER SERVICE. , LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 8• THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 74 GPDSF 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS / AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE EXISTING SEPTIC TANK: 1000 GALLON CAPACITY DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY USE 2-500 GALLON LEACHING CHAMBERS IN SERIES THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE TOTAL AREA:..............................................................471.2 S.F. INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL. DESIGN FLOW PROVIDED: 0.74 GPD SF 471.2 SF 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND / ( ) = 348.7 GPD IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. Engineering by: SCALE DRAWN JOB. NO' PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 278-17 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 78 FOX HOLLOW LANE OSTERVILLE MA (508) 477-5313 11/22/17 P.T.M. 2 of 2 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 i 17 . 33�33 • �, ' --------_, kO , AP- M DESIGNS-TA rvV s r KJCVL.E F.4&MI LY _3 p _A:)F-CCM - _1 1,LY_ l-C l =33 k 3 _� 330 C pD \,/vim ��5� OF Sf t G "T A NAG ax 15•0 0 4�57 c:p �o �I\ s I PETER uss I Wb 6,N- Tip.IvIL ; U SULLlVAN � . 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