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0189 HICKORY HILL CIRCLE - Health
189 HICKORY HILL CIRUG- OSTERVILLE A= 121 - 033 o lit $ 30 00 No...._... ....... Fas............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirativit for Dhripuiittl Works Tomitrnrtiun lirrmi# Application is hereby made for a Permit to Construct ( ) or Repair (gy) an Individual Sewage Disposal System at: ...Perl. ins ..................................................... .-•--------•---------------•-•----------•--- Lo a ion- %ddres or Lot No. 189 Hickory Hi f� Girc'le osterville ......................_........................-................................................. ------------------------------------------•---------------•-••----.............---------------••-- Owner Address W J.-P.Macomber Jr. Installer Address UType of Building Size Lot............................Sq. feet Dwelling-X No. of Bedrooms...................................----------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------3----------------- Showers ( ) — Cafeteria ( ) P'' Other fixtures ................................... W Design Flow............................................gallons per person per day. Total daily flow.+....._._..._..........._................gallons. WSeptic Tank—Liquid capacity------------gallons Length................ Width---------------- Diameter.-.-.-------.--. Depth..-------------- x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter....-_------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ ,.a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------------------•---•------•-•-•••-•---•----------------•----------......_-------------------------•---------•-•--........-------------- 0 Description of Soil........................................................................................................................................................................ W Sand & Gravel V ----------------------------•---- . . ----------------------------------•-------------------------•--•-------------------•---•----...-------•-----------------------------•-•---------•------ W — U Nature of Repairs or Alterations Answer when applicable.-.-----0 0 0 qa l l on leaching pit er i t added...to. -an..ex-istin-g---tank..fox & pit�. '` .._... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate c, Compliance has e i issued by the board of health. Signed .:. . ......� 10/13/9 4 Dace Application Approved BY - .............- ------------....---------------------------- ... - Date Application Disapproved for the following reasons: .... ............ ........-. ........ - -- .......................... . - -- - .-- .- ...................... --............./........... ................................ . .... ............ ............. ..... ----------- ................. Permit No. .._ - F... __ Issued ...... ..".. �'".. e� .......... Dace ......... No:.F: .....`. 30 00 l Fes$... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Z�.Vpliratiou for Uhnp ial Wor1w Cnnnitrnrtitun rrrmit Application is hereby made for a Permit to Construct ( ) or Repair (XX, an Individual Sewage Disposal System at: Mz:...Neil...--Per-• kins......-----•--••-------------------------------•----- ......................................------------------------------------------------------------ L on. Iddress or Lot No. 189 Hickory Hi Circle osterville ......................_.......................................................................... .........................•----•---•-•.....----•--•-•----...-•----......----...................--- Owner Address W J.-P.Macomber Jr. Installer Address d Type of Building Size Lot............................Sq. feet Dwelling-X No. of Bedrooms._-•-._.-_--..3 ----------------------------Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons---------3----------------- Showers ( ) Cafeteria ( ) Q' Other fixtures ------------------------------- - - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity---------_gallons Length................ Width---------------- Diameter--.............. Depth................ x Disposal Trench—No. .................... Width-------------------. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ 04 Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water---_---_-------.-.---- (i Test Pit No. 2................minutes per inch Depth of Test Pit--.---_-._--__.--. Depth to ground water........................ a ----------------------------••-••-•----------------------•-•------------•---•-•-----....-----------•......................................................... 0 Description of Soil........................................................................................................................................................................ x Sand & Gravel V •-•------------•----...••-•--------------•---•-----••-----------••----•---------••-----•--••••-----•--•-•---•---•------•--•--------••-------------------------------•-------.........---•---••••-•-----. W UNature of Repairs or Alterations—Answer when applicable.-_1_7000 gallon leaching pit pit added to an existing tank box & pit . ................. --- ...----- -----------------•... ---.-.... ... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .{ ... .........a... ..� ..................................... ........���.3/g� Application Approved B � .� Dace Application Disapproved for the following reasons: .................................. ... ................. . . -- . -- .................... . / e PermitNo. .............� .. `.. ..... Issued ------..............................................................'�� Dare THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE (fEICtifirate of V``..���amplianve TJ-II� I�TO CFbRTIF JY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XX ) acom er r. by ------------ ----- ----------------------------.----------------------------------.-----...Ins- ------------ ------------- --------- ----------- -------.._------_------------- taller 189 Hickory Hill Circle Osterville -------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE f T,he Sta e Environmental Code as descri ed i the applicaticn for Disposal Works Construction Permit No. dated . - - - - - ;� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE (; SYSTEM WILL FUNCTION SATISFACTORY. DATE ..... ,� .. /.;�? /...... Ins peccu � - �"� � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �j TOWN OF BARNSTABLE .`�' $ 30.00 � FEE........................ Nor..... .. ........� Disposal Works Tonotrutinn f rru it J.P.Macomber Jr. Permissionis hereby granted- ------------------------------------•----.------------------ ----•----------------------------------------------------------............. to Constru ( ), o Re air X;l a ,Individual1 Sewa e Disposal System 1�9 Hic orpy H 11 ircle Oste Ville atNo.............................................................................................................. .............. Street� '" as shown on the application for Disposal Works Construction Permit �Vo/_ �G__.Dated../-.-...-?........ _ �'� ---------------------------------�------- f Q / � Board DATE----------------------------------------------- ------•-------....... r FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TU'�T d�B�ItN&'i'ABLB �• 9iCl4I'&LOT: \ A�t9TR101dB 3+I0. CAPACIRY � .( °�- IO �f . :Otwi a . �T C CB 0 '�.CJ� ,�paratial �BeEvreeg��e�" _ lgnum kdjtr 0�1.1111 " l bt�toti6,9646indLag tCng actili�y. c;4 "Y�fitg9i, n� � ► easy �mow -0 �d�c���et�d off_ E teacbl�� ih+��ty�tt�nd�ei�st .ivlth�u 3�het .i'leanl �g� e 2 :I � 13 O f . Town of Barnstable Inspectional Services Department B"`MAS& ' Public Health Division iOrFv►�6. 200 Main Street, Hyannis MA 02601. Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 7886 July 9, 2020 PERKINS, BARBARA R 189 HICKORY HILL CIRCLE OSTERVILLE, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 189 Hickory Hill Circle, Osterville, MA was inspected on 06/26/2020 by Shawn McElroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility withstanding liquid level at or,above the invert pipe (per Town Code 360-20 h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. 4PER ORDER OF T E BOARD OF HEALTH mas McKean, R.S.;CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\I89 Hickory Hill Cir Osterville.doc Town of Barnstable MASMS t6;9. Inspectional Services Department � `�� ArfD MA'S A Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA, ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover,relocation of a pipe, relocation o driveway due to H-10 components, etc) eaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts r {{{/����// r� Title 5 Official Inspection Form - " rr l Subsurface Sewage Disposal System Form-Not for Voluntary Assessments., ^ W r, t 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name / information is required for every OStefvllle MA 02655 6-26-20 . page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information /* Shawn Mcelroy Name of Inspector a Upper Cape Septic Services Company Name P.O. Box 73 Company Address East Falmouth , MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number I B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);1 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection] have determined that the system: 1. ❑ Passes t 2. ❑ .Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 6-26-20 I spector'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form i01 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): t5in=_.p.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 . 1 Commonwealth of Massachusetts r r� Title 5 Official Inspection Form w_ Y,rh Subsurface Sewage Disposal System Form -Not for Voluntary Assessments W 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 d 4 pass inspection if(with approval of Board of Health): - '• } i ❑ broken pipe(s) are replaced ❑ Y ❑N ❑ ND (Explain below)` ❑ obstruction is removed ❑ Y ON ❑ 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): 3) 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: a. 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: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form spaI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Iso 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Ostefville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form I Subsurface Sewage Disposal System_Form -Not for Voluntary Assessments S. 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) , 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No 0 ® 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 day flow ❑ ® Required pumping more than 4 times in the last year NOTdue 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 water supply 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 2000 gpd- 10,000 gpd. 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. 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes or"no"to each of the following, in addition to the questions in Section C.4. 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 0 ❑ 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form ili Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y." > 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered yes to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe 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)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Ell �w Title 5 Official Inspection Form �l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information - 1. Residential Flow Conditions: f Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? _ ❑ Yes ® No Last date of occupancy: 6-2020 Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form C�'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments k </ 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name informed for every ation is requir Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner---pumped 2 yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 f Commonwealth of Massachusetts , Title 5 Official Inspection Form !�A i0l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, >`1 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 j page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: g, , ® 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 t ❑ .Tight tank:Attach a copy of the DEP approval. ❑ f Other(describe): Approximate age of all components, date installed (if known);and source of information: 1980's with extra leach pit added in 1994 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan):, 12" Depth below grade: feet ` Material of construction: ® cast iron ' -® 40 PVC ❑ other(explain):' Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form i'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name infcrmation is regained for every Osterville MA 02655 6-26-20 pace. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 6"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 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 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form hI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir J" Property Address Barbara Perkins Owner Owner's Name information is Osterville MA 02655 6-26-20 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ' r r 8. Tight or Holding Tank (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: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box had water at working level. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 s Commonwealth of Massachusetts - r� - fw Title 5 Official Inspection Form hi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required):• If SAS not located, explain why: Type: ® a' leaching pits � number: 2-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 13 of 18 cam, Commonwealth of Massachusetts r� ,w Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is regt.ired for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): New leach pit from 1994 marked "5"was filled beyond capacity. Old leach pit was holding 30" of water inspection with stain lines above inlet invert. 12. Cesspools (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 ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 • � ` : Commonwealth of Massachusetts �w> Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form--Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ; 13. Privy (locate on site plan): - Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 4 t5insp.doc•rev.7/26/2018 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 'i") Subsurface Sewage Disposal System Form -Not for Voluntary Assessments lc! 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 017 ov 36) .� : °"•'�. � � � �� �+ '� " '� �` : III t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form, ri Subsurface Sewage Disposal System Form Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont,), 15. Site Exam: ❑ Check Slope ❑ Surface water ,. ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water:. 20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ' ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts ,� Title 5 Official Inspection Form 116) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 189 Hickory Hill Cir Property Address Barbara Perkins Owner Owner's Name information is required for every Osterville MA 02655 6-26-20 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp,doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 No. © � Fee /(_Yj_ r- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppl Lation for disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(1/j bandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./89 N% v j It 1 r'.( , is Name,Address,and Tel.No. +j ib 4-Krkrl, 1 Assessor'sMap/Parcel iZi o I J IT, Hj drl r'��l 4r SO�J yZ -t�Z�' Installer's Name,Address,and el.�o. ERIC S-MJf_1JS Designer's Name,Address and Tel.No. Aleye,,.�So,•6 w►►11S k1k° rb,61, 61 C 5,Z-,L"c A", m33 Type of Building: Dwelling No.of Bedrooms 3 Lot Size /S fa$Z sq.ft. Garbage Grinder( ) Other Type of Building �2� No.of Persons Showers( ) Cafeteria( ) r Other Fixtures Design Flow(min.required) 33 U gpd Design flow provided 3y .LS gpd Plan Date: -7/21 I Z0 Number of sheets vZ Revision Date Title Size of Septic Tank .1600 _ Type of S.A.S. WX 62) o 1 ,S�XZ- Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: .Dl.�_ 2® � 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 It Signed Date V____ Application Approved by t Date Application Disapproved by Date for the following reasons Permit No. 2-01-0 " ;L"3b Date Issued -�� '�-d 1-0 �'3 w f Fee A - No. .. THE_bM`M(D.NEALTH OF MASSACHUSETTS Entered in computer: -� W Yes PUBL-IC,HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Rppfitation for Misposal *pstern Construction Permit '. Application for a Permit to Construct( ) Repair( ) Upgrade V Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.189 K C-k d r•1� Hi it Q r, Aer's Name,Address,and Tel.No. Assessor's Map/Parcel � r 0160( flAl C%,r, sj pr ,u Installer's Name,Address,and el.No. �� - JV� Designer's Name,Address,and Tel.No. Q tr P_A: 'uox �I ►''���oh5 VM�I�S rya. t�la,d lx 9�i E ���c�w,c(-, rx►1s5. 4 Type of Building: Dwelling No.of Bedrooms Lot Size g> sq.ft. Garbage Grinder( ) Other Type of Building Qr, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 C) gpd Design flow provided l d ,? ,; gpd Plan Date ? Number of sheets Revision Date t Title 1 Size of Septic Tank,�r� Type of S.A.S. 7 5 Description of Soil ' Nature of Repairs or Alterations(Answer when applicable) Date last inspected:; , Agreem nt: w r 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 x;; J Compliance has been issued by this BoardSolUealth. Signed Date k Application Approved by jr^ Date Application Disapproved by Date for the following reasons Permit No. 2 p10 — 3�`' Date Issued 'y$ -------- ----------- ---------------------------- ---------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Crtifitat>e of Compliance " THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by rnr�'r tkT'�r"1� c� �C !SU X)CWW .tr^�1�"' � A at I has been constftted in accordance with the provisions of Atle 5 and the for Disposal System Construction Permit No. a o16 dated _ J Installer s ti e S TZ,jep5 .e,, Designer #bedrooms " +, ; _ ;Approved desi n o �} gpd The issuance of this pe it shall nnot be con trued as a guarantee that the sy��em will fun do as dewed. Date 'Ins'Inspeclo No. ZOO �7J� —Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS �is�DsaY �pstem �onstru n hermit Permission is hereby granted to Construct( ) Repair( ) Upgrade(tti Abandon( ) System located at /� #,F b a r d �u 11 Ci r t and as described in the above Application for Disposal System Construction Permit. The applicrnt recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ' Provided:Construction must be co, pleted ithin three years of the date of this permit. Date r"��•� �'"� Approved by Town of Barnstable Regulatory Services t Richard V.Scali,.Interim Director ` Public-Health Division +� Thomas'McKean, Director 200:Main Street,Hyannis,.MA 02601 Office: 508-8624644. - Fax: ,508-790-004 Installer& Designer Certification,Form: Date: Sewage Permit#Y _ Assessor's MapCParcel IZ-I v3� Designer: 4_/ n C_ Installer: tM c s'i'��ti✓ Address: y tl Address: . ' —1`y1- 53n/a-,y- L /�"T yh +425��5 i�ni Y11V?. On- SI_v��_� _wasi`ssued a permit to install a (date) (installer) ` � -t I� based on a design drawn.by septicsystem at l�... .. -. � y _ (address)-.' 1" I dated (designer)- ., . I certify that 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 we're found satisfactory. need above was installed with major chan es i.e.. I. certify.that the septic system refere g greater`than 10' lateral relocation of the'SAS or any vertical relocation of any component ! of the septic system) but in accordanm- ith 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. I certify that the°system referenced above was constructed'incompliance with the'terms of the IAA approval.letters(if applicable) r s er s Signa e)` R �' Z No.. 1140 (Designer's Signature (Affix ere) • \ i PLEASE RETURN TO.,BARNSTABLE PUBLIC HEALTH='D ON. .CERTIFICATE OF COMPLIANCE'ELL NOT BE ISSUED UNTIL BOTH THIS FORM "AND AS BUILT•CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION: THANK YOU:. Q:1Septic\Des�gner'Certification Forin.Rev 8=14-13<doc TOWN OF BARNSTABLE a.CCATION A/ & BR.Y C IR SEWAGE # VILLAGE 18 O s rek �/CASSESSOR'S MAP 6 LOTI;?I- INSTT,ALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY tEACHING FACILITY:(type 7 (size) � p NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER R OR OWNER ,� .� ez� DATE.PERMIT ISSUED: -DATE 'COMPLIANCE ISSUED: 4P-W—/7� VARIANCE GRANTED: Yes No r a TOWN OF BARNSTABLE LOCATION JAq H t + Ci J`; SEWAGE# �2-O.?-O VILLAGE (',S} u�ASSESSOR'S MAP&PARCEL ZI INSTALLER'S NAME&PHONE NO. CRAB S�£��.(<oS7� pS�I' SEPTIC TANK CAPACITY LEACHING FACILITY:(type) C�►�tw�hetrs C2 (size) f x Z_�' NO.OF BEDROOMS ;� n OWNER 4r rfNP PERMIT DATE: 2 f COMPLIANCE DATE: 3 W Separation Distance B tween 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 �4 r No .............. ...... T.......... THE COMMONWEALTH OF MASSACHUSETTS OAR® OF HE�ALTH OF.....................1.:5... ................... ........................................... ................ Appliratiou for Uhipaiial lgurkii Towitrurtivit Prrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: o . . . ................ ............................. !�........................................... Add or Lot No. . ........................................................................ OwneV'ram . Z' r . "I ) Address _V0 '4e ........... ... ... ................................................................. Installer Address -,Type of Building Size Lot......... q. feet ----------- .... U Dwelling—No. of Bedrooms........... -_----------_----_-Expansion—Attic Garbage Grinder ( ) PLI Other—Type of Building ............................ No. of persons-------4�............ Showers Caieieria ( ) Otherfixtures -----------------------------------------__-------------_--------_----- ------------_--__............................................. Design Flow............................................gallons per person per day. Total daily flow....'...23.10- ...... ...gallons. 1:4 Septic Tank—Liquid capacity/Al.Cigallons Length....A&....... Width.......A...... Diameter.................Depth................ Disposal Trench—No.._.................. Width.................... Total Length.......... ......... Total leaching area.....................sq. f t. Seepage Pit No........../...... Diameter....... ............ Depth below;inlet_...... ......... Total leaching area,LXA_Cn..sq. ft. Z Other Distribution box Dosing tank 00� Percolation Test Results Performed by.._. .. - -- ----- ....... . .... .... . 1.4 gff .... I ........... `ftv, Z.. Test Pit No. I' minutesp&inch Depth of Test Pit.................... Depth to grKhd water---------------------- 44 Test Pit No. 2.................minutes per inch Depth of Test Pit.................... Depth to ground water......__._..........___. 19 .........................................................I.................................................................................................. 0 Description of Soil------.. :,--!.0..................................................... .............................................. ------------------------*----------*---------------------------------------*------------------------- ------------------*----------------------------*----------------------------------------------- ....................................................................................................................................................................................................... U Nature 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 TL I'i U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i d by th and o I.iedlt gned. . .... ... . ..... ...................................................... ......... .... ........ .... .................. .... ............. ApplicationApproved By........ ..... .............................................................................. ....... . . ................... Date reasons- Application Disapproved fo the ollowing reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued_....................................................... Date OAF,- �7 �.. N .............�....... F�> ......... is; THE COMMONWEALTH OF MASSACHUSETTS `BOAR® OF HEALTH � .............0 F..; - ... -----• -....... tlat� fur �i,��uu�t �rk,�. C�utt,��rttr�tut� rruti# Application is hereby:made for a Permit to Construct ( ) or Repair- (~` )'an Tnd'vidiial Sewage Disposal System at: - r » ... . -- O: 2 - rt _ .... ,/� .................Address........................................... � w s IrO& �.� Address r U g Size Lot:., ' Sq. feet Dwelling—No. of Bedrooms.__.._ _ ........ :_._Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building -----------* __ No. of persons__ ............ Showers (mi) — Cafeteria ( ) 04 d Other fixtures ------------•------------...........................-..................................... W Design Flow.............................. ............gallons per person per. day. Total daily flow......... gallons. WSeptic Tank—Liquid capacity. _gallons Length_____ ________ Width._. ____ Diame er __....._.___. Depth....._.......... x Disposal Trench—No..................... idth__..________.______. Tot Length.................... Total leaching area....................sq. ft. Seepage Pit, No._____._._.�_r -.,.-'Diameter _______ Depth below inlet ___._ _..._. Total.leaching area. _ sq. ft. Z Other Distribution bojF`( ) Dosing tank ( )' Percolation Test Results Performed by.. _.. Date ���� Test Pit No. 1 minutes per inch i Hof TTest Piq i th to ground w - f GL, Test Pit No. 2_ ._minutes per inch Depth of Test Pit____________________ Feth to ground water........................ 04 ----------------------------------------------------------- ----------- _........... •------------ •--•--•-•-• --------- •-••------------- -----__-•-- 0 Description of Soil............................... V +�!!.__!a"!fin ... --- ------------------------------------------------------------------------------------••_-:-•----------------._.._....----"---------------------------•------•--------------......------........_. U Nature 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 T 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance,llat been issued by the board of health. f' igne ....... _-•-- • . •-•-•- ....L Application Approved By.. .... .`.. ----•-•---•.... ----•.................................•---•--•--• . . Date Application Disapproved f t following reasons:...------ f ----------------•---.........._._.....__...--•-----------------------._....------....._..----...-----•-------- Date Permit No............. ........................................ Issued---- ,P Date I J/ THE COMMON WEALTH OF MASSACHUSETTS . I BOARD F HE L ...... ......................OF................... Trrtifiratr of Tompliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal)ystem constructed ( r Repaired ( ) by...... 21 -' .................................. ........_...---_----••••-•---•--- at • •..._•-- - ------ -------------•. has been installed in accordance ith the provisions of Tr�'>�- y,� The State Sanitary ��1 ` r�ked in the application for Disposal Works Construction Permit No......................................... dated..----------------------------.................. THE ISSUANCE OF THIS. CERTIFICATE SHALL NOT BE CONSTRUE® A GUARANTEE THAT THE SYSTEM WILL PUN ON SATISFACTORY. DATE............ . ......._ ... .... ...-....... Inspector-------------- �........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �J .. .................................OF...................._.._....._...... ..._........._..._............._.._......_. No......................... - _ FEE .................... �t��uu�t1 Turku �utt��ri�an .rruti# Permission-i;, hereby gran - --=------- - - - ,�.j, . ��-/- /- to Constr ) pb epair t���.. i �e lage�ts al S}�stei ,! - Street Y� as shown on the application for Disposal Works Construction Permit No............ __ -_____________ ...................................•------•----=--•................. . ---------------------•-------•------------------------ DATE............................................ � ``� l of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 'lJCii'E �Cc51G�r-C�AcraQ -f'n �FchklP,i�. .• � ;4 '�/ � , 4 FEET -C��L^--Lo• L Cr t �� {.fh+,2a1.T r 1.E. ec -1-7. al 16 IN. �yJQE tt'O.CaQpJ rQ 1�I/t1 (Z. n 7 r Y CEhC.4 11.Y a 5,y4'T�ul - t , a" hj 17 v Z•4l A 1 4�'� r1 r A�tT4'^4 L } T j3 J \'S AS • � �' 2 . i .� � o•, � 1/'+s t� iPr�T }Y }4 yi����t l+ �1, �„o f`t :� 4 } t ...k V,. +F •,s ; y c " �.a off. v -0 •"x .yi k 7},x'r A�' a x.h-- F :I!1, r • ���� Iry -�r�� h, t F LOT I jCOy r'e •k r yr yr..yya'1�/�.?+' y 1 r J r N 5.•If� JJ/�` \\: �, t v" Viy, 1 V �di } ht'.�js�.,R;Y�hL$Syx,g�.r � !i.l •t" - s ... 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'` +'.`. �' rj [ ��FV1rJ '1E® PLOT PLAt i- � �fir�® ��oT� ��EV�T�o��1 ����►k A t � � , I ,d, r. i$,TfN6 "rrO"TMIJR -�4.'r y t_:a ' � Y �• / �//t / �j/(�✓�•^ `.� . 1� - _', 1 i!■omc13 '9�'POT rO:L YA'�' 1� �"1a��l�r�i �W'N •O��• V r (� 3 r q�yg�,yfi.1.�Y `� `iJ"' tfi ti r 1 ,. ? a x t y i i^ 'Ir'+ #'•" gy ° Q� RE*' N' '7A;{ n,.. ?' • ' J Tres)+-y t... { ' 1_T F Y. .1 ) li'- Y...��FJ Ii� ftl+�;�, l`YfA q`!��^��: 7 '3_ S• . C i.- xr . iS-.2 r �� & � AE CAM - r a�� • � r' �'. =±� -RTIFY -THAT THE PROS cut .it RtO ,t � O� [ arl LDINC SHOWN ON THIS. PEAR r 4"�V1L - I ��' A,A� `, T„ ,�, n ° t _ ,Jt COldl'�O.R�98 TO THE ZONING ' LAS 3 3; s ( id.✓ r". R i`� R RHSTA-BLE, 14A'!S. ,a t rot '.w J'P �g� i ''.:� •T*:Ni'd t .3- }, b,[ _ �r, t: - . /' Y,',K �''` �`r ' 17'� �_.1 ��lii. }.t} ., ^ { •^r�� r 7 T�`,. r .': I' t �. LAND SURVEYORt, , • . ...t x'.r ).. .i..,;' .,.:a;M'S's. ...•n4�,YLrx�.<:"+ Y= T '. ...x .. .,. < , r ..+...r,:�:vr.;c�'Y++p+'�a...u�•s.:�a� .s.T...;.r.,r. _:rriu .�r...y,;.,;4::t:,�::.t.r. .... ,.. ... �.�..� w ..... .,: .. .i.,.. .......�._ � ... � ...._, .. .,. ....,.<. .,.,....:_.-._.... NOTE TiNGR TA,+E.SEPT/C TAN/C OR �:�•`-. 20`FT M/N•. _ —'1. r =Ei4C.HANG PiT ARE ...MORE THA.`✓ /2 •BELOi't/ �• /D PT. M/N'. 1.4AOE, 24'O//1METER G'ONCR�TE COVER SWAtL BE 9.?0UGHT TO GRADE. `,-�,✓ YT.P.4 { j'. i w CC/VCRLTE i 4 PYC P/PE J�EAYy C� ST IRON Go l/ER Si�.4 L L 3c USEJ P/TCN . COYE/GSWA y T TAZ>B C U 4" AST /RDIY PP/PE `o p M//1/.v/TCN•: G.4L. •• . .{ . . . ... . , .ate SEPTIC TANK DIST. �, s • .1 • . . . . , WASHED 57LNE I ` ;BOX o.: t n . 1 � 8 r . •'r'� • • .�• + i. 's • •EFFECT'/VE ` • 3/��- �2• : i; •Ivy, a P • q • DEPTW ` • t ` s s.e WASh+ED STONE % _ q. . . • • . 0' • • •• • o .,p PREG4ST SEEPAGE F. ?8 �.�Q 7t� o': . • • .• . .. • • • . a ?/T OR EQC!/V. l Nf/,e t'T tL VA VON NS "— s PST C�+PA e�-ry �4.7 C#AaL �D�1Y ELr=81.8 /�VYERT AT AVVIL:DIMCk 9 I.5 FT.. G�T D%AI�J INLET .eSEPTK" TANK 90.o FT C{SEE TAdUL.4TJON� 0417LET SEPTIC TANK' INLET D/STRi9vT/DN BOX. GRDuNo DATER Ti�BLE OtIT[ETD/STR!®t/T/ON L�QX' 88.8 F7 - CT ONO/ F SEWA G rtE.oCN/NG.'.�'IT` AFT, E O/.SQfASAL SYSTEM 7A4ffVLAT/D/V L E.AC"!"a'';PI T 1 OIMENS/ON FT.. DES/6X CRJTER/�l sc.�LE . -o A. D/tlEJVS/ON $ FT. NUM�lER Of BEDROOMS 3 D/HENS/ON" .CET. M/n/ GARQAGEO/.SPOSAL.[IN�T 11/y SOIL LOG: ' ivo7>= . TOTAL EST/N1t�tTEO. FLON/ 3 3 G.�t./40 SOIL TEST A�/ $ OIL TEST�rt2 Sa/L ?"EST rVUMBFir aO L.f.4CNlNG RJTS_ .� �`Exev 980 �` ELEY, G Zb� S Z OATS OF SO/(, TEST < SIDE LCA4CHIIVO PER PIT Swt FT. RESULTS IV/TN�SSED BY R.3 90TT0/►I L,Ey1CI1/NG PER P/T 7 Fr $Q. FT- ov •LO B PERGOLA?/OlY RATBT AE/ L M%N J)VCH M 7 A .L LEACH1&Cr A4REA Z(�6 SQ. FT. v AE.ICOLAr/ON RATE 0,2 �� M/M.�/IVCI4l RESERvEGEAC'/v//V6 AREA a(�-b SQ.. FT. ? Sv/3�So/L _ z o 6107E:,muTPnCaQ;a UKAUA E cl FEET OELcW B0770M o F rye. AAQQ 4 Lj AC , Ra P#T 76. eL=1l.S� itµ Of A4gSs �� H �F;�Iq s + c� /v) �D,)U/►'? To ' ' P2�u r l�Foee �,w.--AcA t J- E AL R sYst�rn 0S'7',C2!//LL. I 3c� ROBERT; ' BRUCE '� o MORSE No.10951 DREDGE ENG/VEER/NG CO,/NC. 9dFFG�IS ��"'/� G if�,0 - 7/2.MA/" Sr. lST�� 10 FrS10ilALFav NO G�OWWO Yv,4nem —,,v ouNTER�O L'�� Cq , ENT:�, s}Nc.v 'PATE G r 4 z Q GM Ul/VO A vATER AT ELF i/ _ SHE.ETZ- -7Z_ •Ab'1'� '�;QfJTQAC-ToL -ro �,#cn��sti� _ � � Q- e"rLnl../ '�SrYi1 of L CAC:bI— '' 4 i I{16i,P{:T ! 1 E• tL-.'•II. 81 `ro {u• $ i t � •�P2e5e�x� BC'.FcR�. {IJ4,'1-j1�L1+FC� • ',�/kt:,w{1-1J%> sy s•'r£rtn .. : ' t v' � *;+ ''� t aw al t -# ��,� r `tle-O� !`* ly• ®y,:. //x+��4 .tr fx -�.q 'k hf �t{tl is s' f^ y 1., r•^ k r - rN) ! Y lb 7filtnfi+r' u V�w '"s { r2 i it A 71 �. � x .0 "r � eit { '1a� et tf ��♦' Z.je k-' :i♦n t D4 rt �•' 3 h.� J�'.'. . CC ✓ Q \ �3 f ,r � Yd Y pp99 1 . �J q �� ; r� S ; �.t rl4r 4• � �. v / �✓•' y t �/ s -/�O'Y .L.V/�e �y �� ♦i.� 'Y `� S,\. ,�t,��'�'t� fil ��T� t�$�,�`!YX)[V •f S tgf 1. 9 �. ry t 1 � 1-$ { �� . . _ � �{v *, t a Fr 1 S r�e,�,+e•.��1 a,�.� �ITC�s�:I :..`n >.' a h ,(N�} r •w,;. X„Fa '(�, 11 } !-4`x ar Y,e''k s r• �v �P� , `.�3 f ,� „a c ' t #`''����s)5�� R� >y}; -��pr��s �;�tFyya►►�r i�ii(�1�r t5 s5 t L r ,,Y , u�(f y4F�a?"•y / �'''• ^r :P 1. �� d- i.. 1r ` G tihk +' '•�yy��1Vu'" sf�+Y '�''t •r}r •rth jl.... 0 NJI,�' ��Aj�. r_ ! A4.p � µ � a r• r hSY� +�,�k s w�f�`� �� y ts�ri i r /Oot�' v�r ., s 9 ,at °+� S / r{Yt igv'YfU't*. .4 1 X+!t. .. l;U V w .ALB 'F+.�' fiwyiT ra 3y'ey:. k f b. s: -t� No'10951 !J a F % aS N 4444G ` ti Y yl ,y 1 _.O 'P .. !v 42' ,d: •�,. ,r y + i r':;5 r, wx�,y.r h 44 a'fi.r .+b H¢ as° f y f �`.'•r. Q' V a : - .�+ rr a i�� r 3N•;i � e f. ;`f;"'Y�,{af i : .S a � a ♦ \� .:,�rf ,rq,dez ;'. y '�J � M • Sa 1 5 its - tf t '� brit' h ^41°� �>r qy�:`'' , y•,HIV aSa ri' 'a t�. { 3 a } }s•"2rn r?�d Sit{9y9'S a t i1L. tk r t °' d J ��x�Y'Y�, 'S G�''aU.y � v t•,i., + -"' ^ �.t it R a$t� '�'�>Si rA b •'PLOT.ir 'PL:AN EN'C!N® �Por:::fL�E.bATfio"W �� �Q � t .rt 'ED. _ 1 ��/1 ir�F'`��'FI�® .ONTO - 'POT: •ELEVAttOY t�M�ED .Gi�NTOUR t � : 4iv, 4V .) 6h •k 1p�.,: r`* A" Yt{+�.��(.� 4t} �{5$t .�dF' '�a tl.r y i ,t Y t �I �I r SOM A 1/p s •I t t 14 L � •� ..k a'f yl 4 '� 1n4 'i �J75„ .d/�{M .. t ,i. :{.'•i. (!'. e ry rL ] =r `d ,>`'r z'a'�'•rn i S a .�. S x#�`h �17�+r.0 Y/ =. O DATE�.'•C�f// /�i t,� '� ' I A B It #R tl.! rylxy ,.yN Aipiir »` 1;JINEE `4 u.l 1' ° ' �' {r : '.OERYtt'"Y THAT THE'°PROPOSM ` ��t i DtRI® _SHOWN ON THIS PLSN A �{ '}r r � x v t tl� C►ONF�ORII�$.'. TO THE ZONING LA{�3� O�YtL D ' Tl�rit��pj{"���1.11 GTy�yYF�tg };S �,i r v ,'t h t F�• ,�. Y , (C� ,M.YA►-NPI I Sti r.lvlb$'l�: x •tNSET ,, :> :w G.... 'LAND SURVEYOR-- 377 .«;...u«:,;:n:;.eYrw,al.^.ei��:.:.+ax;s.L-Sns:t9ry[..:._'..:..o-m..�N..s::..n.n.a,.n,,,+u.l,..,.c...e>..,:...:ea:.,..n..�.e:.i6;....�..:...-,.......,......•a-',:.. ..».z::.-..,... .»_.-..s.._._ .._ ....,.......,......�_... ................. ........ _........,..u.w.....�....�.....w ...... _ .. -n N0-re /F E/TNER THEScr�T/C ^,t►�/fC OR r,• (,. P/TARET2 BELOjt/ S."ALL 8E BROUGHTTO GRAQ. h0EA:/y CA ST /RO/Y CO{/ERp _ M/N.. P/TCNtCO t/ERS As R-se /F/N .O Ri iE 1w.4 y 2 T� C E E LQ[J!O LEVEL _ 10 /RON f�/PE.• E r � o p � a o o � � � . o�, �,,F ��9� _-T•B ` j , MlN.P?L/V ' 0AI..' , _ o' • • •�. • • • . e •4 J WA SHPO STC,, YE %'PER/rT �, � SEPT/C `,TANK' • ,: s. . ••.i , . . e .�, � ._ , • B.OX o � • e •i 8 • • • . • � .•e � _ 34 - -. � D • c � • ptPTi'o • • e •. � a . WASI•eE0_STONE ; r • e i • •_ r t • • • o . p ••y PRECAST SEEPAGE- RT LL EYA7YOX 7 8 .x �IT CA PA Ca'T�l ��7 OpL,�DAY F — EL.= /NYERT A r, Sa LD/NG � PT. I INrLET SEPT/C, r,4,VK 900 FT L /O .FT O/�4M. C(SFE TAdUL.4T10N> O/J7LET SEPTIC T.�NK ' FT a r GROU)VO itATER TADLE` INLET D/STR/6!!T/ON BOX' FT. is JSEGT/ON QF :, OcITLETD/3TR!®t/T/ON BQX' 88.8 FT: /NCE?''tEACNiNG::P�T AFT.;, SEWAGE &0 SP- S'.4 C`EACH/NG: Pl T ?ABtILATION.. x n k ITCA .E %s" `/= 0" D/MEN.SlON ,q g FT DES/6JK CR/TRAZA: D/A/FevsloN FT. _ NUJHSER OF BEDROOMS 3 MENS/ON. C F T M i <� v De S M� CAA?dAGE0/SPOSAL_ UNIT i� SOIL LOG. TDTAL EST/M�•4TE0. FLOW 3 G.+z../DAY SOIL TEST ,J - SO/L TESTl*2 f"` �` AlY. OATS OF SOIL TEST .1(UMBER QF 40AC/YlNG i7/TS_ F LCC G•Y. 9 S d: SIDE L,tACH!/VG PER P_/T l sill /:T. a; / <. RESULTS AV/TNESSRO dY R 13 C- mi d 9 r�' 9oTT0/W 4164CN/NG PER P/T 7� 54.. .ir Z PtRCCLAT/Olv^R.�TE�E/ Liss M%/Vl1NCht -fillZ(,6bu Lc at iyj —,�T T07Af_ LEACH/NG AREA FT. 5t/r3�n IL AEA•COLAT/ON RATE 2 �H"'4 Mew./sNcf/ ;�ESERVEL�sc'NlN6 ARE/'► �'b •SQ FT. _ P(oi-E: courPncrnQ.�o a®�AR�lqA 4 Z — Z 4 FEET E ELc�w e6o roes o f n ./ L�Ae.FI-.,uz..PIT �c.E.Et-'1�.8� �-• �. i"I E7D L lL` ts'n p-E I'm 6QOWi0 Willle� J e , O - Jill NPE�sEuT Foee t,2zAu.t Jy>`� s4� o� AL R�r' 1 \Y SYSTEM US7L21�1 LL_� ,L? ROBERT � 6tiJCE �'+'c Q MORSE . ,,;!•�, p i 1 No.10951 O jS E N• , .v - � REDG INFER/ G CO /NG. r NG EE ati t3 A�0 GISTF .`/e �Gc`V: �6 O 7./2 MA/N ST.`, HY N/ MASS. .r� R � •cFS,S� Env\ A° c 9'!� 43 OF,AIL NC ORO[/iV0 kVATCR EtVG'OUiVTER._p .. CL/EN'T:Fil ffc.o DATE_ C4Pp s uvN�;, Q GR o 10 yvA TER A T EL Ef/ _ JOB NO.• �?y 7,�" SHEET? OF-7-•-• OSTER VI LLE ROUTE 28 PROPOSED CONTOUR ® PROPOSED SPOT GRADE kHSIC70W �� -- 98 -- EXISTING CONTOUR+ 96.52 EXISTING SPOT GRADE iW— EXISTING WATER SERVICETEST PIT46SCALE: 1"=20' / �4 e 6 T13M = EL. 44.8 / CORNER OF AC PAD „ ` LOCUS MAP EXIST. 1000G 41. �3so9 SEPTIC TANK TP-1 LOCUS INFORMATION PLAN REF: 270/077 LOT 1 0 A PA 7- 7 EL ID: 3MAP/11218 PAR. 033 PROPERTY IN ESTUARIES OT. AREA = 0.36 acres4.0 vent ' FLOOD ONE: PROPERTY NOT IN FLOOD ZONE -42 TP 2 SEPTIC SYSTEM�c�• o � h REPAIR PLAN �h4�,• 46.0 16' 2 'N �' LOCATED AT: SOO� 189 HICKORY HILL CIRCLE OSTERVILLE, MA PREPARED FOR \sF 44 BARBARA R. PERKINS I � JULY 21, 2020 1 ' `4G OF DA REN s E R ` \ �`48 � o ` V6/SfE J � MNITAR\jA P� �\ MEYER & SONS, INC. Oc P.O. BOX 981 \ \ EAST SANDWICH, MA. 02537 \ PH: (508)360-3311 FAX: (774)413-9468 meyerandsonstitle5@gmail.com SHEET 1 OF 2 J 1894 1 ELEV, TOP NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS FOUNDATION: BRING, ALL COVERS TO WITHIN 3" OF FINISH GRADE (Existing) t FINISHED GRADE'-(44.0) = 51.50�•a�F.G.EL• 45.0 F.G.EL: 44.0 F.G. EL: 43.0 VENT MAINTAIN 2% MIN SLOPE OVER LEACHING AREA w F.G.EL 43.60 1 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" ,• . STONE OR FILTER FABRIC DOUBLE WASHED STONE A 6" " 7 4" SCH 40 PVC 10"I a E3E3 3®®I3®®®®® TEE'S ARE TO BE 14 ®7. 1NV. 1� (MIUF. ®®®®®®®®®®® INV. 41 .30 2 DEPTH ®®®®®®®®®®® 4" SCH 40 PVC INV. 42.30 41 .10 4' 2 X 8.5' 4' EXISTING OUTLET BAF LE PROPOSED DB-3 DISTRIBUTION BOX EFFECTIVE LENGTH = 25' INV. 42.55 A9919 (H20) INV. ELEV.= 47.30 EXIST. 1,000 GALLON SEPTIC TANK OF GAS BAFFLE TO BE INSTALLED ON ����� ss9� BREAKOUT OUTLET TEE AS MANUFACTURED BY o DA%RN y�, ELEV.= 40.0 - _ NOTES. TUF TITE ZABEL OR EQUAL M TOP CON C. ELEV. 40.0 ------------------------- 1) CONTRACTOR SHALL VERIFY ALL EXISTING 0 PIPE INVERTS PRIOR TO CONSTRUCTION ` INV. ELEV.-_ 39.0 ®®®® ®®®®®®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TOcj�t ° ®®®®®®® GRADE ON A MECHANICALLY COMPACTED SIX SNITAR\a� BOTTOM EL.= 37.0 ®®®®®®® INCH CRUSHED STONE BASE, AS SPECIFIED IN 3.75' 5 FT. 3.75' 310 CMR 15.221(2) ' 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK WITH 1500 GALLON SEPTIC TANK IF FAILED, - SEPARATION 6.00 FT. EFFECTIVE WIDTH = 12.5 DAMAGED OR UNDERSIZED. SEPTIC SYSTEM PROFILE 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 31 .0 _ SOIL ABSORPTION SYSTEM (SECTION) REQUIRED GAS BAFFLE AS (500 GALLON H--20 LEACH CHAMBER) SOIL LOGS P#: TPT-20-141 GENERAL NOTES: DESIGN CRITERIA **IN ZONE II AND ESTUARIES PROT.** DATE: JULY 14, 2020 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOM DESIGN ' SOIL EVALUATOR: DARREN MEYER, R.S., CSE 1614 BOARD HEALTH AND THE DESIGN ENGINEER. ( / # 2. ALL WORKK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL TEXTURAL CLASS: CLASS I 0.74 GPD SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN IN WITNESS: DON DESMARAIS, BARNSTABLE HEALTH DEPT. LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: DAILY FLOW: 110 G.P.D. X 3 BR = 330 G.P.D. - 310 CMR 15.405 (1) (B): Elev. TP-1 Depth Bev. TP-2 Depth 1) A 1.00 Fr. VARIANCE FROM,310CMR15.221(7) To ALLOW LEACHING GARBAGE GRINDER: NO (not designed for garbage grinder) 42.0 0" 44.4 0" TO BE 4.00 FT (MAX) BELOW GRADE VS REWD 3 FT. (H20/VENT PROVIDED) SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXISTING 1,000 GAL SEPTIC TANK A LOAMY SAND A LOAMY SAND 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFlLLED PRIOR LEACHING AREA REQUIRED: 330)/0.74 = 445.94 S.F. IOYR 4/1 10YR 4/1 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ( 41.42 7" 43.73 8" DESIGN ENGINEER. e B 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4' LOAMY SAND LOAMY SAND FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 1GYR 6/4 10YR 6/4 ENGINEER BEFORE CONSTRUCTION CONTINUES. STONE ON ENDS & 3.75' STONE ON SIDES: 25' L X 12.5' W X 2'D 39.18 34" 41.40 36" 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.. C C 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF BOTTOM AREA: 25 X 12.5= 312.5 SF i PERC T THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF O EL 37.67 MEDIUM MEDIUM HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF SAND SAND 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 2.5Y 7/3 2.5Y 7/3 TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D B.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 31.0 132" 33.4 1 132" CONSTRUCT10N PROPOSED SEPTIC SYSTEM UPGRADE PLAN 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5.- PMC RATE <2 MIN/IN. (-C2- HORIZON) 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 189 HICKORY HILL CIRCLE, OSTERVILLE, MA NO GROUNDWATER OBSERVED 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY Prepared for: Perikins • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Design and Site Plan by: SCALE DRAWN DATE to conduct soil evaluations and that the above analysis has been performed by me consistent with the 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. MEYER&SONS,INC. N.T.S. DMM 07 21 20 requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam in October, 1999. 15. ALL PIPING TO BE 4" SCH 40 • 1/8-/FT (UNLESS SPECIFIED) PO BOX 981 / / EAST SANDWICH,AfA 02537 REV DATE CHECKED SHEET NO. 1 508-3622922 DMM' 2 of 2