HomeMy WebLinkAbout0043 HOLLINGSWORTH ROAD - Health A3 Hollingsworth Rd
N A = - 059
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No. Fee Z
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:��
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppliLAtion for NspoSAY*6pBtrm Co=stem
vertu
Application for a Permit to Construct X Repair( ) Upgrade( ) Abandon( ) ❑Individual Components
Location Address pf Lot Ng. :3 ® `i Owner's Name,Address,and Tel.No. ('CL'A (\1pes 1� ev'o-e,
4
c o ram, � 1
Assessor's Map/Parcel UA cel ) s
Idler's Name,Address,and Tel.No. Dysigner's Name dress,and Tel.No.
j'J�PLke"� cc"%��
Type of Building:
Dwelling No.of Bedrooms Lot Size 15 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons 1 Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.re wired) ® gpd Design flow provided gpd
Plan Date Number of sheets Revision Date )OW
Title
Size of Septic Tank l S�()'O Coal,D o. �pe of S.A.S.
Description of Soil 1
Nature of Repairs or Alterations(Answer when applicable) 4ioa GIM ID —��
lu0 CW raol an te&c h C17 a ma6lrc
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Si Date
Application Approved by Date (0 G
Application Disapproved by Date
for the following reasons
Permit No. Date Issued D J�
Fee SC)No.
Entered in computer:
THE COMMONWEALTH OF*MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION - T WN OF BAR,�NST.ABLE, MASSACHUSETTS
I A ` �
iYication for aYstern 1onstruction Permit
Application for a Permit to Construct X Re lir ade Abandon } m lm lete S stem Individual Components,
PP P ( )� .Pam' ( ) (r,)..ti:!-Ede" P � Y ❑ P
Location Address r Lot Now.(�3 O) n(� r Owner's Name,Address,and Tel.No.
C�ICJ� t �GCR.r1 n T.
Assessor's Map/Parcel _ {�'' tK 4
Installer's Name,Address,and Tel.No. Definer's Name A dress,and Tel.No.
Type Building: `
Dwelling No.of Bedrooms Lot Size sq.E. Garbage Grinder( )
{'� SR
'j Other Type of Building 2,Q S No.of Persons ` Showers( ) Cafeteria( )
Other Fixtures `
Design Flow(min.required) (� gpd Design flow provided �A gpd
Plan Date �„�dj Number of sheets Revision Date
Title r
Size of Septic Tank f �(� (,,, n rrw n� ype of S.A.S.
Description of Soil t
Nature of Repairs or Alterations(Answer when applicable) —3
-VZ4
- Date last inspected:
Agreement:
a
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.
Si Date
Application Approved by Date ZZ
Application Disapproved by Date
for the following reasons
R
Permit No. d/ Date Issued JC1
`'.- ----------------------------------------- ------------------------ - - ---------------------- ----------
U u �IU c/J P THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance m
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed) Repaired( ) Upgraded( )
Abando�ed( )by
at Wen has been constructed in accordance
with the provisions of Tid 5 and the for Disposal System Construction Permit No �j�' S dated
Installer - l� p ; Designer
#bedrooms Approved des/' floes 1 � gpd
The issuance of this ermi shall not be construed as a guarantee that the system d 11 functio Is designed.
Date 0 Inspector
No. �) r7 "3 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction Permit
Permission is hereby granted to Construct Repair( ) Upgrade( ) Abandon( )
System located at �
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date lCL/_ _ h Approved by Y
29-Jun-2020 09:18 Fax 5082587068 p.2
Town of Barnstable
Inspectional Services
s E Public Health Division
DARNBTABLE,
MASS. Thomas McKean, Director
A�FQ MAI A 200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 12-1 Zo Sewage Permit# 9019- 31'5' Assessor's Map\Parcel
` ��� s
Designer: J-0 m C _4Z e Installer: i SI��.
Address: e. d�IC.Address: C~�C -
On ps' was issued a permit to install a
(date) (installer)
septic system at f43 t SuAt>24 ?,V I based on a design drawn by
(address)
"�'!• g/ ',4550c, dated
(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. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
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.
I certify that the system referenced above waVwnst=r ted in compliance with the terms of
OF
the I1A approval letters(if applicable) s` � z DF M
.20
zdxJ
(Installer's Signature) z.5: y CIA
(Designer's Signature) - afO.X esignei;:`FStrrp> e
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'YO .
WoAdoptAHEAMASEWER connecMEPTICNDesignerCertificetion fomt Rev W441DOC
TOWN OF BARNSTABLE
""IG-ATION �3 //yry � � SEWAGE#. aOOY-OZ'
ILLAGE 0..3 A-5--u ri// ASSESSOR'S MAP&PARCEL %y®� QS'�
NSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY ff� I,YVO
LEACHING FACILITY:(type) f ap S'00 e•C- (size)
NO. OF BEDROOMS S
OWNER T�rA/
PERMIT DATE: /—/Y-08 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility feet
Private Water Supply Well and Leaching Facility(if any wells exist
on site or within 200 feet of leaching facility) feet.
Edge of Wetland and Leaching Facility(if any wetlands exist
within 300 feet of leaching facility). feet
FURNISHED BY
l
0
t� j3
yy o
, // TOWN OF BAR/fNSTABLE
ILOCATION `3 91—liqis"r4A SEWAGE # 7- M-CIdOn
VILLAGE �� ✓ ASSESSOR'S MAP & LOT
IN R'S NAME&PHONE NO. 're' (g4lonrwil Cog_rn-?
SEPTIC TANK CAPACITY �sSP�f
LEACHING FACILITY: (type) 'VLOU) (If (size) /6C4'
NO. OF BEDROOMS Q
13UILDER OR dox
PERMITDATE: CONNt CE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
_ •i��ln�5 cuorfi h ,
I
��3
No. Fee --
.•.
' THL COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTAB.LE, MASSACHUSE-I47S Yes
ZIppYication for ;Migponl i§pgtem Con0truction Permit
Application for a Permit to Construct(V) Repair( ) Upgrade( ) Abandon( ) IF Complete System ❑Individual Components
L ocatigLp �e✓sssoorr Lot No. i 1v7 ��`���y����rr-� Owner's Name ddreesss,anT e�No.
Assessor's Map/Parcel 705/ lllle ��®
Installer's Name,Addre,,and Tel.Ny Designer's Name,Address and Tel.No.
77
/7/= 75Z)z
Type of Building: �7
Dwelling No.of Bedrooms Lot Size 2 TLT/ sq. 8. Garbage Grinder ( )
Other Type of Building R&5,o j911Ce No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.require ) 5—C gpd Design flow provided / gpd
Plan Date Number of sheets Revision Date / v
Title .Se /t' Cyr Or Y4
Size of Septic Tank Type of S.A. . '5V?Z9 ae 0 0 �
N
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board o /ea
Signed lee Date
Application Approved by Date
Application Disapproved b Date
for the following reasons
Permit No. D-Out0.-7 Date Issued —� ��
rf, I) YY g
i�i A
No. W 'O� ktj(uI M i Fee ( �,-y'
i
+t n
yTHE"C'4MMONWEALTH f�.F I�IA�SA�HU:S�T-T.S Entered m computer:
a e�z' lA :: + * w Yes
`- �PUBL�C HEALTH DFV,1§ION - TOWN OF"BARNSTA`B�LE, MASSACHUSETTS
lication for dig p ogaY tent Coy ruction erruit 3
Application for a Permit to Construct(!�Repair Upgrade( Abandon( .) LJ•.Complete System ❑Individual Components
Location Ad ss or Lot No. /)3T ®�/� Owner's Name, ddress,and e Tel.
Assessor s Map/Parcel 1, '
Installer's Name,Addre5,and Tel.N Designer's Name,Address and Tel.No.
Type of Building:
i
Dwelling No.of Bee&ool Lot Size T97 7sq.ft. Garbage Grinder. ( )
` Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
K�
Design,Flow(min.require ) gpd Design flow provided o66�2 d
gP
Plan Date ///e/ z�5, Number of sheets Revision Date
Title .,S'e'V fi �e,5119wf /'
r 1
iSize of Septic Tank""--/ / Type of S.A.S. �� !�'
Deicription of Soil
i
trNature of Repairs or Alterations(Answer when applicable)
I
Date last inspected:
Agreement: i
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 Healt . ( t
Signed � E _ Date
Application Approved by ) r Vim; ri2j Date
Application Disapproved b t Date
P
for the following reasons
Permit No. D 0 U Date Issued y F t
-------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-sites Sewage Di sal System Constructed ( �` Repaired ( ) Upgraded ( )
Abandoned( )/by _4' r x�✓,X
atz y _,M % 5 has been constructed in accordance
with theprovisions of Title'5 and the for Disposal System Construction Permit No. cD wf- "G a 7 dated
Instal gr Designer
#bedrooms Approved design—flew S 1 ?J gpd
The issuance of this per hit s
}hall not be construed as a guarantee that the system will.fM
J)Udesigned.
Date � 1 l 1 Pq Inspector ,J / ,.
�' /, n
No. Qua—tip f Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
lwigogal 6p5tem Con5tructiou Permit
Permission is hereby granted to Construct ( �� Repair ( ) Upgrade ( ) Abandon ( )
System located at y j ® /i1�5 r r� l _t;
I;
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Const action must be completed within three years of the date of s e iU
Date ' � ( Approved b�.
r
KEVIN W. QUINN ,,,. A-IV�
ET UX.
g0 jr
�R No Qgto
40
N/F \ f 2 V03.
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J UX. \\ 6d
C9/DH FND
. ..- _aFr,_...ea— a —+%- :: ..�. - ..:'�.: ..�.S�6a`%•,v'-'"'3�3,—f'^..'"— �..
4
NO, RON PIPE FND
ti m
t
M
,887 SQ. FT.0.69 ACRES
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N/F
RICHARD W. SHEEHY - C�DSe �}"I� i 4 n�
w Il-k� Wt' t A
h .
NIP
PAUL M. MULLEN
c� OHN �� 67
E11t3 N
No.29874
h �l6r$TLF�6�ca
'�+AZ L171J
��e -o'
pod uv� TOWN OF BARNSTABLE O� p
LOCATION /�� �( RMA SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL 146G
INSTALLER'S NAME&PHONE NO. ✓ .f 4 24Z 16 i'
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type l� �cx
NO.OF BEDROOMS l
OWNER CC
� µK'
PERMIT DATE: hl. A, COMPLIANCE DATE: o �'
Separation Distance Betty en e: 3 t 3 Z G
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
4
Town of .3arnstaaie
p IINE rp
' Py �tie Department of Regulatory Services
Public Health Division Date
• BARNSTABLE. -
v� is q. �e� 200 Main Street,Hyannis MA 02601
ar fp • � ,
Time Fee Pd.
Date Scheduled C=
Soil Suitability Assessfnent for Sewage Disposa
Perfomred By: �t " II f � V I"` ^S � Witnessed By: -
o`
c
LOCATION & GENERAL INFORMATION
o � (tRaw _ cv
Location Address �(3 , I���y5 1av+�? � 6 Owner s Name T t� y r7
RC fleA✓jLL �s�
`- as��vt t-L� Address (off 0ATtra- 0 5� o V
Assessor's Map/Parcel: (y
o Engineer's Name � �0�}� l tj
NEW CONSTRUCTION REPAIR
Telephone a`$ `? °Z
Land Use
Slopes(%) b '� % Surface Stones
a
ft Possible Wet Area _
ft Drinking Water Well D/iC.ft.
Distances from: Open Water Body Zp0 /
Drainage Way
-K L--R Property Line C D , ll Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) ,
VP
i
bp
PiRCEl on
2 SM . t
•� t+ .d t�
1 .,ypQf
,.r 1 • ,4
I � i
1
Depth to Bedrock_
Parent material(geologic)
Weeping from Pit Face
Depth to Groundwater: Standing Water in Hole: V
� �2 6s
0 '(1
Estimated Seasonal High Groundwater
DETERNIINATION
Fr.?R SEASONAL HIGH WATE
R TABLE i
Method.Used; in. Death to soil mottles:
Depth ULa ed-+,ndt rlobs:ilgie: Y,___,..�_.._ _ v —i, GroundwaterAdjustment B
_t yt,,, oui,,+I:m sluc•of obs.hole: — �,d ,actor Adj.Groundwater Level_
Index Well# �Rc ufng=u tz::. -• Index Well level _ J
Date Time
- _ PERCOLATION TEST — - -- -
3 ,r;22 11;5 3
Otservattc.1— - . - Time at 9" f /
Holed d.R
1f E
Time at 6
Depth of Perc it
1o� Time(9"G") �;ti
Start Pre-soak Time n
End Pre-soak
Rate Min./inch
C2wl`,�
Site Failed: Additional Testing Needed(Y/N) /
Site Suitability Assessment: Sito Passed_,X,_. v
Original: Public health Division ObservaVon Hole Data To Be Completed on Back------
- and
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Consery ttion Division at least one(1)week prior to beginning.
• �:i-t�Af,TH/wP/t'CRCPGCciw .
DEEP OBSERVATION HOLE LOG . Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Mansell) Mottlipg. (Structure,Stones,Boulders.
Consistency,°o ravel
.3`(uF �T_� - h/oi.�. IM Sive `211�✓3c�
2�SYk/aI3
Stiryle. �,�2�}iN.
DEEP OBSERVATION HOLE LOG Hole# `L
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
" G rC"l��S 1D Z•.5 *�� tact
lit
DEEP OBSERVATION HOLE LOG . Hole# _
I Depth from Soil Horizon Soil Texture Soil Color Soil Other
'. Surl'ace,(in.)- - - (USDA) -(Munsell), Mottling _(Structure,Stones,Boulders.
Consistency.%Gravel)
Yf
o jY� [ Cz�
lam
q if � �.11�:�•'J/`WJ w/ � .� ��� �/
DEEP OBSERVATION HOLE LOG
Depth from Soil-Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
Consistency,% ravel
v1 �( � 20 ;ire 'lh/
i 1b
� � C
.• I`�`� : . � �.�..�. �tD �� cam.
— Flood Insurance Rate Mari:
Above 500 year flood boundary No_ Yes
Within 506 year boundary No Yes
`Within 100 year flood boundary No Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring per is ipateriaI exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pet' ions material?
Certification.
I certify that on 0 (date)I have passed the soil evaluator examination approved by the
Department of Enviro nental Protection and that the above analysis was performed by me consistent with
the required trai eiI xpertise and xperience described in 310 CMR 15.017.
! Signature C _ 1 _ Date
Q:H EA.LTH/W P/PERCFO.RM
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c.
t �
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is '=
required for Osterville Ma 7-9-19
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: I t A. Inspector Information
When filling out p
forms on the
computer,use Douglas A Brown
only the tab key Name of Inspector
to move your D.A.Brown Inc
cursor-do not Company Name
use the return
key. P.O. Box 145
Company Address
Centerville Ma 02632
Cityrrown State Zip Code
508-420-4534 S14297
Telephone Number License Number
B. Certification
I certify that: I 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 the property 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 I have determined
that the system:
1. ® Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approving Authority
4. ❑ Fails
7-9-19
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system 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
@ Title 5 Official Inspection Form
la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown 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:
At this time this system met all passing requirements. This report cannot predict the future
performance under the same or increased usage.
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):
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
i
. Commonwealth of Massachusetts
(o Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Citylrown 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
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18
Commonwealth of Massachusetts
(P Title 5 Official Inspection Form
to Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Ostervllle Ma 7-9-19
every page. Cityrrown 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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/Z day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply
well.
❑ Z. 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 faciility 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 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section CA.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a 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
(o Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every 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?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owners Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown State Zip Code Date of inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms(design): 5 Number of bedrooms (actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
Description:
Number of current residents:
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
Seasonal use? ❑ Yes ❑ No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
2017--301gpd 2018---297 gpd This system is not designed for usage with a garbage disposal
Sump pump? ❑ Yes ❑ No
Last date of occupancy: Date
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
(- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owners Name
information is
required for Osterville Ma 7-9-19
every page. Citylrown 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:
Was system pumped as part of the inspection? ❑ Yes ❑ No
If yes, volume pumped: gallons
How was quantity pumped determined?.
Reason for pumping:
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
J. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address ,
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known)and source of information:
2009 per as-built card
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
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.):
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
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 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:
1500 h-20
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle
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
How were dimensions determined?
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
If tank has not been pumped in the previous 3 yrs I recommend pumping
t5insp.doc•rev.7l26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
18 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osteryllle Ma 7-9-19
every page. Citylrown 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.):
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
ro Title 5 Official Inspection Form
1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every 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.):
box was functioning properly
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 12 of 18
c , Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. CityrFown 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:
❑ leaching pits number:
® leaching chambers number: 5
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18
Commonwealth of Massachusetts
(P Title 5 official Inspection Form
b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown 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.):
No clear signs of failure or heavy staining
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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
I
'Commonwealth of Massachusetts
(o Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
s% 43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown 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.):
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
c , Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every page. Cityrrown 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
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
u 43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osteryllle Ma 7-9-19
every 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: none encountered at perc
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
7-2019
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:
design plan
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
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
43 Hollingsworth
Property Address
McCartin
Owner Owner's Name
information is
required for Osterville Ma 7-9-19
every 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 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
Assessing As-Built Cards Page 1 of 2
TOWN OF BARNSTABLE
LOCATION fl3 //sn�r���,2 SEWAGE# _2boy-OZ7
VILLAGE ASSESSOR'S MAP&PARCELS'O—05"3
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY ffZO />Z1O
LEACHING FACILITY:(type) I/a(> S=S�L G (size)
.NO.OF BEDROOMS _ 5—
OWNER Al
'PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility feet
Private Water Supply Well and Leaching Facility(if any wells exist
on site or within 200 feet of leaching facility) feet
Edge of Wetland and Leaching Facility(if any wetlands exist
within 300 feet of leaching facility). feet
FURNISHED BY
1
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https://townofbamstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mappa... 7/9/2019
Town of Barnstable RECEIPT
RAMSTABLL
MAM 200 Main Street, Hyannis MA 02661 508-862-4038
Application for Building Permit
Application No: TB-16-2915 Date Recieved: 10/5/2016
Job Location: 43 HOLLINGSWORTH ROAD,OSTERVILLE
Permit For: Building-Detached Garage-Residential
Contractor's Name: MATTHEW K TEAGUE State Lic. No: CS-083445
Address: Yarmouth Port, MA 02675 Applicant Phone:
(Home)Owner's Name: MCCARTIN,JENNIFER A& MARK S Phone:
TRS
(Home)Owner's Address: 43 HOLLINGSWORTH ROAD, OSTERVILLE,MA 02655
Work Description: construct a detached 1 bedroom 1 bath heated pool house with fireplace
t
Total Value Of Work To Be Performed: $200,000.00,
Structure Size: 0.00 0.00 0.00
Width • Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for'every contractor, subcontractor, or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: REEF REALTY LTD. 10/5/2016
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost: $200,000.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $1,120.00
Total Permit Fee Paid: $0.00 '
THIS IS NOT A PERMIT
' COMMONWEALTH OF MASSACHUSETTS
F' EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
HAY, FBhRN,-^TA-
d DEPARTMENT OF ENVIRONMENTAL PROTECTION
106 JAN 10 P11 1: 42
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 43 Hollingsworth Road
Osterville MA 02655
Owner's Name: Joy Merrow
Owner's Address: Same S,Z: 3�3
Date of Inspection: December 15,2005 Job#05-372
Name of Inspector: PATRICK M.O'CONNELL
Company Name: SEPTIC INSPECTION SERVICES CO.
Mailing Address: 189 CAMMETT ROAD
MARSTONS MILLS MA 02648
Telephone Number: 508-428-1779
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I a IIII
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The syste+ �� '(�.0F�Aq• ii���'''
_X_ Passes �y
Conditionally Passes = ;• P TICK R,
Needs Further Evaluation by the Local Approving Authority
Fa'
�Inspector's Si ature: - Date: 12/15/05
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments: Cesspool with overflow pit with no standing water and has never been more than half
full.Main cesspool pumped as part of inspection and is structurally sound.
****This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
_XX_ 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:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to be replaced or
repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please
explain.
The septic tank is metal and over 20 years old*or the septic tank(whether 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.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
Title ;incnartinn I~nr 4/1 ciInnn 2
Page 3 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
_ Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other:
T41a G Tncnwntinn T;nr Oil ci,)nnn 3
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
_X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
—X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
—X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow
—X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
X_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
_X— Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
X Any portion of a cesspool or privy is within a Zone 1 of a public well.
_X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
_X— Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
_No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
the system is within 400 feet of a surface drinking water supply
_ the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system has failed.The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304.The system owner should contact the appropriate regional office of the Department.
Tifla C 1nanar6nn V^r All G/701)n 4
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
_X_ Pumping information was provided by the owner,occupant,or Board of Health
_X_ Were any of the system components pumped out in the previous two weeks?
_X_ Has the system received normal flows in the previous two week period?
_ _X_ Have large volumes of water been introduced to the system recently or as part of this inspection?
N/A Were as built plans of the system obtained and examined?(If they were not available note as N/A)
_X_ _ Was the facility or dwelling inspected for signs of sewage back up?
_X_ _ Was the site inspected for signs of break out?
_X_ _ Were all system components,excluding the SAS, located on site?
_X_ _ 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?
_X _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
_ _X_ Existing information. For example,a plan at the Board of Health.
_X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable)[310 CMR 15.302(3)(b)]
Titla G Inr++ontinn Rnren r,r1 sronnn 5
Page 6 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15 2005
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 2 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):220
Number of current residents:0
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use:(yes or no): Yes
Water meter readings, if available(last 2 years usage(gpd)): Two years total: 120,000 gal.= 164 gpd.
Sump pump(yes or no): No
Last date of occupancy: unknown
COMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):_
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records: None
Source of information:
Was system pumped as part of the inspection(yes or no): Yes
If yes,volume pumped:_200+/-_gallons--How was quantity pumped determined?
Reason for pumping: Cesspool inspection.
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
_X Overflow cesspool
_Privy
_Shared system(yes or no)(if yes,attach previous inspection records, if any)
_Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no): No
TWA C Tncnartinn l:nrm 411 rllnnn 6
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
BUILDING SEWER: XX (locate on site plan)
Depth below grade: 6"
Materials of construction:_cast iron _X_40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: No (locate on site plan)
Depth below grade: -
Material of construction: concrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions:
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle:
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:
How were dimensions determined: STICK WITH HINGE FLAP.
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
GREASE TRAP: No (locate on site plan)
)
Depth below grade:
Material of construction:_concrete_metal_fiberglass . polyethylene_other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:_
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
Title G Tnenartinn Rnrm till donne 7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
TIGHT or HOLDING TANK: No (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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: No (if present must be opened) (locate on site plan)
Depth of liquid level above outlet invert:
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
PUMP CHAMBER: No (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Tiflo 4 lncno,-firm Vnr 411 c1onnn 8
Page 9 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
leaching chambers,number:
leaching galleries,number:
leaching trenches,number, length:
leaching fields,number,dimensions:
X overflow cesspool,number: One 6x6 block pit
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
etc.): Pit empty at time of inspection,has never been more than half full.
CESSPOOLS: XX (cesspool must be pumped as part of inspection) (locate on site plan)
Number and configuration: One with overflow
Depth—top of liquid to inlet invert: 4'
Depth of solids layer: 8"
Depth of scum layer: 0"
Dimensions of cesspool: 4' dia x 5' effective depth
Materials of construction: Block
Indication of groundwater inflow(yes or no): No
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
Blocks are intact,no evidence of backup.Recommend annual pumping.
PRIVY: No (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.):
Ti41a C Incm-ef;^n Rnrm AEI cnAAA 9
I
Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch 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.
Hollingsworth Road
Driveway
48
41
32
# 43 35
Water service
Blanid Road
Titles G Tnonontinn V^r All V»nnn 10
Page I I of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 43 Hollingsworth Road,Osterville
Owner: Joy Merrow
Date of Inspection: December 15,2005
SITE EXAM
Slope None
Surface water None
Check cellar Dry
Shallow wells None
Estimated depth to ground water: More than 25 feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators, installers-(attach documentation)
X_Accessed USGS database-explain: USGS topo map and town GIS
You must describe how you established the high ground water elevation:
Town groundwater contour map shows water below el.5 and topo map shows property above el.30.
1
T;fl.C fno an finn Fnr All VIMI) 11
Town of Barnstable ° q
�t r Regulatory Servic s ILe Ca
�Og
Thomas F. Geiler,Direct 9 �'
MASS � Public Health Divisio
MASS
9�ArFo �a 9. `�� Thomas McKean,Director axee�r1.5\09- �O
200 Main Street, Hyannis,MA 026 -`Ne`�
Office: 508-862-4644 Fax: 508-790-6304
Date: ' o Sewage Permit# Z009 02 Assessor's Map/Parcel
Installer&Designer Certification Form
Designer: 1 r n eest Installer: '63nf 1 e�-�. �ov�g`'�R4�►` "
o to �ox /
Address: 09T ST j*%V-0 Ftvk, Address: ' 5 h & ' �� I
On Qog'jb`OT-V1 Cp!y:qtuTcjk�was issued a permit to install a
(date) (installer)
septic system at� 1,. 4 arc -Ty� 1 based on a design drawn by__1 "
(address)
a �^•ee dated y�
--
•
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Stripout (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 ons. Plan revision or
certified a - uilt by designer to follow. Stripout(if re q Q iS✓ cted and the soils
were nd atisfactory.
STEPHEN yG
D. �rh
MATSON
CIVIL
1411 (Installer's Signature) No.46345
o�FSS ONAi. �,11G,��i
(Designer's Signature) (Affix Designer's Stamp 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.
q:\office forms\designercertification form.doc
I
Town of Barnstable a%-4
Regulatory Servic s �Le �09
~° Thomas F.Geiler,Direct 9
PEAPMNSe�s�e
ublic Health Divisio
Thomas McKean,Director gaXge� SvNey`o0
200 Main Street, Hyannis,MA 026 `�9
Office: 508-862-4644 Fax: 508-790-6304
Date: Z Sewage Permit# Z60$—02 Assessor's Map/Parcel 51
Installer&Designer Certification Form
Designer: Q - 6 t n 'j ec %j Installer: 13ot�p l Q CanSAjl�u�1�
Address: Address: � 0 ale 7
OL610 f {y1 S S ft, N1 07 ($
On l �� n g 60"A LOT -1 Coty!5+tuc�was issued a permit to install a
(date) (installer)
septic system at �,. W 0Nt-T"N based on a design drawn by
(address)
h f C rn W;ee- dated
(d signer)
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. Stripout (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 anv vertical relocation of any component
of the septic system) but in accordance with State & Local ons. Plan revision or
certified a - uilt Y designer b to follow. Stri out(if re
� p q S/. ected and the soils.
were nd atisfactory. ��``1'- see
�o STEPHEN yG
D.
0 MATSON y
CIVIL
(Installer's Signature) 0 No.46345 Q
0ccc Fa S T E��,A���r
S "ONAL ENG
(Designer'sSignature) (Affix Designer's Stamp 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.
q:\office forms\designercertification fonn.doc
l
" Town of BarnstableECEiPT
200 Main Street, Hyannis MA 02601 508-862-4038
639�-
Application for Building Permit
Application No: TB-16-2915 Date Recieved: 10/5/2016
Job Location: 43 HOLLINGSWORTH ROAD,OSTERVILLE
Permit For: Building-Detached Garage-Residential '
Contractor's Name: MATTHEW K TEAGUE State Lic. No; CS-083445
Address: , Yarmouth Port, MA 02675• ` Applicant Phone:
(Home)Owner's Name: MCCARTIN,JENNIFER A& MARK S _ Phone:
TRS
(Home)Owner's Address: 43 HOLLINGSWORTH ROAD, OSTERVILLE,MA 02655
Work Description: construct a detached 1 bedroom 1 bath heated pool house with fireplace
_ r
Total Value Of Work To Be Performed: $200,000.00 {
Structure Size: 0.00 0.00 0.00
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand'that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: REEF REALTY LTD. 10/5/2016
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost: $200,000.00 I Date Paid Amount Paid .Check#or CC# Pay Type
Total Permit Fee: $1,120.00
Total Permit Fee Paid: $0.00
y THISf IS.NOT A PERMIT
Barnstable Property Maps Page I of 1
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Parcel Details f
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Location 1 ~~~ #141
Parcel: 140059 IP �r.
40025 / f
Address: 43 HOLLINGSWORTH ROAD #74
Village: OS
Acreage: 0.68
Full Property Info y
A-----------------------------------------------
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140026 ._
Property Photo ; , #86 140049
#33
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1401027 14004E
#9ii #43
Owner& Mailing Address
Owner: MCCARTIN,JENNIFER A&
MARK 5 TRS
JENNIFER A MCCARTIN
TRUST _ t
Mail Address: 43 HOLLINGSWORTH ROAD'' ( ',- 14 0028
x+ 1
OSTERVILLE ( 1 #106 + +
MA `
�, 140047
02655 r^ �� #5
Assessed Value (FY16) t
Building Value: $479,900 + 140029
Extra Features: $107,500 + #114 } ��
Outbuildings: $28,900 ` t
1�0046
Land Value: $315,900
Total Value: $932,200
Residential Exemption
Exemption Amount: $90,000
Building Details
Model: Residential (,
Style: Colonial . c
Year Built: 2008
Replacement Cost: $510,543
Stories: 2 Stories
i
Bedrooms: 5 Bedrooms v
Bathrooms: 3 Full-2 Half '
Home Layers Pacel Details j[Baerna] IUOit[
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https://gis.townofbamstable.us/Html5 Viewer/Index.html?viewer=propertymaps&run=FindParcel&propertyID=140059 10/7/2016
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TOWN OF BARNSTABLE
LOCATION S/3 11s yr SEWAGE# -200,Y-027
VILLAGE 0L 1�.d, ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY #Z0 /»o
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NO.OF BEDROOMS S
OWNER .✓
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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
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-ALL INTERIOR DOORS TO BE SOLID WOOD DOORS FOR PAINTED
LQ
FINISH, 2'-8"X G'-8" !1►
O WOOD PORCH -ALL COUNTERTOPS AT KITCHEN CABINETS,BUILT-IN CASEWORK,AND
VANITIES,TO BE GRANITE
W
I -ALL WALLS TO HAVE
M COAT
AND
F TWO PIECE BASE FOR PAIN ED FINISSH,TE G W1 1/2"POUND ID WOOD i
-GREAT ROOM TO INCLUDE 3'-0"TALL RAISED PANEL WAINSCOT.PAINT J
p _ - " FINISH �"� 1
FLOOR FRAMING, I G"0.(��
m INN M - YPICAL FLOORING TO BE WOOD,BRAZILIAN CHERRY
� M
m 5 U Y I I I-G -ALL BATHROOM FLOORS TO BE STONE TILE, 1 2"X 1 2" /Yy.I
W
14' 1 " -MASTERBATH TO HAVE 4'-0"WAINSCOT OF TILE TO MATCH FLOORING/ i.l O
I G'-0" GLASS TILE ACCENT iLY
-KITCHEN 13ACKSPLASH TO HAVE STONE TILE AND GLA55 TILE ACCENT �(
UI T N -ALL PLUMBING FIXTURES TO BE KOHLER111
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DATE:— 12/2/08
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24 S,h I Street
PO B; 186
b '- West D s•MA 02670
F t 508 394.3090
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WINDOW SCHEDULE �{
' ITAGI MODEL TYPE I R O R H CommentsCount e'-0' 15'-0" 20'-0" O
A 33-5/8"x 48-7/8" 400-Series Tilt-Wash Double Hung 2'-10 1/8" 4'-1 3/8" - 2 O t
B Window-Awning-Andersen-400 Series 2'4 x 2'4 400-Series Awning 2'-4 1/2" 2'-4 1/2" 2 ^
D custom 400-Series Awning 2'-6 1/2" 2'-0 1/2'
1 TO SHED SLAB Grand total:8
AREA CALCULATIONS:
FIRST FLOOR=684 G.S.F.
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001 003,004 002 005
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05TERVILLE,
GENERAL NOTE5: SOIL TEST LOGS: 5Y5TEM DESIGN CALCULATIONS: MA
A.)NEITHER DRIVEWAYS NOR PARKING AREAS ARE ALLOWED OVER SEPTIC SYSTEM TEST HOLE 1: EL=29.0± SEWAGE DESIGN FLOW-
UNLESS H-20 COMPONENTS ARE USED, DEPTH FROM 501L 501L 501L SOIL OTHER I BEDROOM POOL HOUSE @ 11O GPD = t 10 GPO
SURFACE HORIZON TEXTURE COLOR MOTTLING LEACHING CAPACITY REQUIRED-
B.)THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE 5Y5TEM AS DESIGNED UN- (INCHES) (USDA) (MUNSELL) 3 BEDROOMS(MAX.) @ I 10 UPD = 330 GPD REQUIRED
LE55 CONSTRUCTED AS SHOWN, ANY CHANGES 5HALL BE APPROVED IN WRITING. 0-19" A LOAMY FINE SAND I OYR 215 NONE SEPTIC TANK CAPACITY REQUIRED- MAIN ST.
C.)CONTRACTOR SHALL BE RE5PON5113LE FOR VERIFYING THE LOCATION OF ALL 19"-37" B LOAMY FINE SAND I OYR 5 G NONE DAILY FLOW= 110 GPD Q 200% = 220 GAL. REQUIRED
UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. 37"-GG" C I FINE SAND I OYR 7 G NONE
CC��`('p �'` GG"81" 2 FINE LOAMY SAND I OYR 4 G NONE TO BE REMOVED SEPTIC TANK CAPACITY PROVIDED-
CO N 5 i RU CTI O N N OTf-5: 81" 132" C3 MEP/FINE SAND i OYR 6 2 NONE 15 GALLON DMA MEN SEPTIC TANK(MIN. ALLOWED} �q/V/y0 q��
LEACHING CAPACITY PROVIDED-
TEST HOLE 2: EL=29.4± ONE(1)25.0'X 12.83'X 2.0'LEACHING CHAMBER CAN LEACH: LOCUS O
DEPTH FROM 501L 501L 501L SOIL OTHER Vt=[(25.0 X 12,83) + (25.0 X 2.0)2 + (12.53 X 2.0)21 X 0,74 GPD/5F=349.3 GPD z
1.)ALL CONSTRUCTION SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, SURFACE HORIZON TEXTURE COLOR MOTTLING 349 GPD>330 GPD REQUIRED
TITLE 5,AND THE REQUIREMENTS OF THE LOCAL BOARD OF HEALTH. (INCHES) (USDA) (MUNSELL)
2.)SEPTIC TANK(5), GREASE TRAP(5), DOSING CHAMBER(5)AND D15TRI15UTION NOTE: A GARBAGE DISPOSAL IS NOT PERMITTED WITH TH15 DESIGN.
O-I G" A LOAMY FINE SAND tOYR 2 NONE 2 �
BOX(E5)SHALL BE SET ON A LEVEL 5TA13LE BASE WHICH HAS BEEN MECHANICALLY I G"-34" 13 LOAMY FINE SAND i 0 5 G NONE INSTALL-
ONE(!)- 1500 GALLON,TWO COMPARTMENT SEPTIC TANK
COMPACTED, OR ON A G INCH CRUSHED STONE BASE. 34"-84' CI FINE SAND I OYR 7 G NONE ONE(1)-3 OUTLET DISTRIBUTION BOX(H-20 Rated) �p
3.)SEPTIC TANK(5)SHALL MEET A5TM STANDARD C I !27-93 AND SMALL HAVE 84"-98" 2 FINE LOAMY SAND 1 OYR 4 G NONE PERC, 104" TWO(2)-500 GALLON LEACH CHAMBERS WITH 4'OF STONE ALL AROUND Cj
AT LEAST THREE 20"DIAMETER MANHOLES. THE MINIMUM DEPTH FROM THE BOT- 98"-14' C3 FIN E Y FINE SAND I 0 G 2 NONE RATE: <2 MIN IN �I
TOM OF THE SEPTIC TANK TO THE FLOW LINE SHALL BE 48 NOT TO SCALE
TEST HOLE 3: EL-30.0±
m
ca
4.)SCHEDULE 40 PVC INLET AND OUTLET TEES SHALL EXTEND A MINIMUM OF G" DEPTH FROM SOIL 50IL 501L 501L OTHER
ABOVE THE FLOW LINE OF THE SEPTIC TANK AND SHALL BE INSTALLED ON THE SURFACE HORIZON TEXTURE COLOR MOTTLING
(INCHES) (USDA) (MUNSELL) PLAN BOOK 93 PAGE 47
CENTERLINE OF THE TANK DIRECTLY UNDER THE CLEANOUT MANHOLE. ,� DEED BOOK 30207 PAGE 338
5.)RAISE COVERS OF THE SEPTIC TANK AND DISTRIBUTION BOX WITH PRECAST 0-12 15 LOAMY FINE SAND I OYR 2 NONE
f 2"-30" B LOAMY FINE SAND I OYR 5 G NONE $ ASSESSORS' MAP 140 PARCEL 059
CONCRETE WATER TIGHT R15ER5 OVER INLET AND OUTLET TEES TO WITHIN G"OF 30"-158" C i MEDIUM SAND 1 OYR 7 G NONE 311 ED
FINISH GRADE, OR AS APPROVED BY THE LOCAL BOARD OF HEALTH AGENT.
31,8 LEGEND
G.)PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT, PIPE SHALL 30•3 IL
BE LAID ON A MINIMUM CONTINUOUS GRADE OF NOT LE55 THAN I%,
TEST HOLE 4: EL-29.8±
7.)DISTRIBUTION LINES FOR SOIL ABSORPTION SYSTEM (AS REQUIRED)SHALL BE --- - ^32 EXISTING CONTOUR
4"DIAMETER SCHEDULE 40 PVC LAID AT 0.005 FT/FT. LINE SHALL BE CAPPED DEPTH FROM 501L SOIL 501L 501L OTHER -32 PROPOSED CONTOUR
SURFACE HORIZON TEXTURE COLOR MOTTLING 29.5
AT END OR AS NOTED. (INCHES) (USDA) (MUNSELL) X 12.34 EXISTING SPOT GRADE
8.)OUTLET PIPES FROM D15MBUTION BOX SHALL REMAIN LEVEL FOR AT LEAST 0-12" A LOAMY FINE SANDI O NONE [�� 2.6 24x5 PROPOSED SPOT GRADE
2'BEFORE PITCHING TO 501L AB50RPTION SYSTEM. WATER TEST D15TR15UTION 12"-33" B LOAMY FINE SAND I OYR 5 G NONE OP
r�
BOX TO ASSURE EVEN DISTRIBUTION, 33"-157" CI MEDIUM SAND 10 7 G NONE PE C. 64 g.. -W-- WATER SERVICE LINE
28.6
RATE- <2 MIN IN `, P� �) -o- OVERHEAD UTILITY SERVICE
9.)DISTRIBUTION BOX SHALL HAVE A MINIMUM SUMP OF G"MEA5URED BELOW R3 32,2 -U UNDERGROUND UTILITY SERVICE
THE OUTLET INVERT. ` P �� 2 g
10.)BASE AGGREGATE FOR THE LEACHING FACILITY 5HALL CON515T OF 3/4"TO �V �J P` QaJeme 5t� -,p GAS SERVICE LINE
1-1/2"DOUBLE WASHED STONE FREE OF IRON, FINES AND DUST AND SMALL BE 08/02/2019 DSO e �e 0' 28.9 0 TEST HOLE/ BORING LOCATION
INSTALLED BELOW THE CROWN OF THE DISTRIBUTION LINE TO THE BOTTOM OF THE PERCOLATION RATE: LE55 THAN 2 MIN/INCH IN C3 LAYERS,TEST HOLES 1-2 �d LOT 5T SEPTIC TANK
SOIL ABSORPTION SYSTEM, BASE AGGREGATE SHALL BE COVERED WITH A 2" MTNE55ED BY: MATT FARRELL, EIT, J.M. O'REILLY*ASSOCIATES, INC.
LAYER OF 1/8"TO 1/2"DOUBLE WASHED STONE FREE OF IRON, FINES AND DUST. DAVE STANTON, AGENT, BARNSTABLE HEALTH DEPARTMENT 2 29.0 ^ 29'S Area= 29,885 5F± vB DISTRIBUTION BOX
NO WATER ENCOUNTERED i `�
l 1.)VENT 501L ABSORPTION SYSTEM WHEN DISTRIBUTION LINES EXCEED 50 FEET; _ 27.8 i SAS SOIL ABSORPTION SYSTEM
USE A LOADING RATE OF 0:74 GPD/SF FOR SIZING OF SOIL ABSORPTION SYSTEM.
WHEN LOCATED EITHER IN WHOLE OR IN PART UNDER DRIVEWAYS, PARKING AREAS, ,^. `� Reserve RESERVED FOR FUTURE
TURNING AREAS OR OTHER IMPERVIOUS MATERIAL; OR WHEN PRESSURE DOSED. BENCHMARK#2: 27,\ 1Z `� � 29, �� •�� \�� Gray `QJ UTILITY POLE
12.)501L ABSORFTION'5Y5TEM SHALL BE COVERED WITH A MINIMUM OF 9"OF CERTIFICATION T of Pool Co m Jr 127,2 28.7 .\ x .�i `� e1 or
I CERTIFY ON 1 1/25/1995 (DATE)I HAVE PASSED THE 501L EVALUATOR EXAMINATION APPROVED BY THE op p 9 J / s ^ 298 �ewa ® CATCH BASIN
CLEAN MEDIUM SAND(EXCLUDING TOPSOIL). DEPARTMENT OF ENVIRONMENTAL PROTECTION AND THAT THE ABOVE ANALY515 WAS PERFORMED BY ME CON5E5TANT WITH EL-30.5± (NAND 1988) 27 6 - ��` <,r �� i •�- `� y FIRE HYDRANT
13.)FINISH GRADE SHALL BE A MAXIMUM OF 3G"OVER THE TOP OF ALL SYSTEM THE REQUIRED TRAINING, EXPERTISE AND EXPERIENCE DESCRIBED IN 3 10 CMR 15.017, 0 91 ,^�\ v ���� <� r� `�\ \\ 30.3 30.6 WELL
COMPONENTS, INCLUDING THE 5EPTIC TANK, DISTRIBUTION BOX, D051NG CHAMBER 7 �r� �--' Q
AND SOIL ABSORPTION SYSTEM, SEPTIC TANKS SHALL HAVE A MINIMUM COVER Signature Date yy \ \ r✓S 29.6 ��\ ��\ �, \\ `�\\ Q ® DRAINAGE MANHOLE
OF 90. /ZQ� �k 29,9 i� ,`�/ Exi5tm 5.D.5 er`. �,<�r� �� O ■ CONCRETE BOUND, FOUND
14.)FROM THE DATE OF INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL ! ( ��, `� D.O.H. ����i �� / TOP OF BANK
RECEIPT OF A CERTIFICATE OF COMPLIANCE,THE PERIMETER OF THE 501L A1350RP- O , ✓�� 29.7 LIMIT OF WORK
TION SYSTEM SHALL BE STAKED AND FLAGGED TO PREVENT THE USE OF SUCH S / 919 r -x-z
AREA FOR ALL ACTIVITIES THAT MIGHT DAMAGE THE SYSTEM. 27,5 /` / �ah covey 29,8 FENCE
15.)5UB5URFACE COMPONENTS OF A SYSTEM SHALL NOT BE 15ACKFILI ED OR 27.7 J ��, /� 6� eaA lie EDGE OF CLEARING
OTHERWISE CONCEALED FROM VIEW UNTIL A FINAL INSPECTION HAS BEEN CONDUCTED ��/ `�c` o^c O Q
BY THE APPROVING AUTHORITY AND PERM15510N HAS BEEN GRANTED BY THE APPROVING / 29, h
AUTHORITY TO BACKFILL THE SYSTEM. THE DESIGNER SHALL INSPECT THE CONSTRUCTION / 28,3
AFTER THE INITIAL EXCAVATION, PRIOR TO BACKFILLING, AND DURING BACKFILLING. ` Q 290 " � 3o,a Tp�sb7 274 U
IN ADDITION,THE FINAL INSPECTION OF THE SYSTEM 5HALL BE CONDUCTED BY THE --28.0 - F 9• v J
APPROVING AUTHORITY,THE SYSTEM INSTALLER AND DESIGNER PRIOR TO THE ISSUANCE \ .Patio 30, \3�yeJJ�9 OF A CERTIFICATE OF COMPLIANCE PURSUANT TO 310 CMR 15.021(3). ANY COMPONENT /r x _
OF THE SYSTEM WHICH HA5 BEEN COVERED WITHOUT SUCH PERMISSION SHALL 8E 3 30,2
UNCOVERED UPON REQUEST DF THE APPROVING AUTHORITY OR THE DEPARTMENT. x
� 8,4 t 29,5 �
O 1 3 30.3 30,6 30,1�
I G.) OWNER/CONTRACTOR SHALL REVIEW POOL HOUSE LOCATION, GRADING AND -'f O 13,2 2 2819 O ZONING TABLE
POOL HOUSE ELEVATION PRIOR TO THE START OF CONSTRUCTION. 9'6 \ " " 30.3
c' AP AQUIFER PROTECTION OVERLAY
17.)INSTALLER TO CONFIRM LOCATION OF ALL UNDERGROUND AND OVERHEAD 2 ..� ��' �� O �'33x Pool Apron
UTILITIES PRIOR TO START OF CONSTRUCTION. 28,8 \
I
1
18. SOI MOVAL- A A B C I C2 LAYERS PER TEST HOLES I-2 SHALL BE REMOVED < a 30.3 ,o RC-RESIDENTIAL
L RE ALL / - �\ 30,5 30, R
I1
FOR A D15TANCE OF 5 FROM THE 501L ABSORPTION SYSTEM DOWN TO THE CLEAN " �4, y DB I
30A
SAND LAYER, EL=21.2±. AREA TO BE 13ACKFILLED WITH CLEAN SAND AND COMPACTED TO O �d C o
MINIMIZE SETTLING. SAND FILL MUST MEET 5PECIfICATION OF 310 CMR 15,255(3)
30ered REQUIREMENTS-
4 9.9 Existing e f
CONSTRUCTION IN FILL. A SIEVE ANALYSIS MAY BE REQUIRED BY THE LOCAL u) ° �� x I Pool 30.5 `
APPROVING AUTHORITY. ` �\ 3 �, LOT SIZE 43,560 SF
�c w2 ,�? 30,5 FRONT SETBACK 20 FEET
,6'= ; 30.3 30,0 8.5
atch Basin SIDE SETBACK 10 FEET
\ 25
`\� 9,3 o x� 30, - REAR SETBACK 10 FEET
/ BUILDING HEIGHT 30 FEET
a �\ \ 30.3
/� �T ,L 30,5 m 28,6 FRONTAGE 20 FEET
�l 1 .,. -
,,. \ ;'
c@ \ 30,5 30
,, \ o T.pS Gana c i BENCHMARK#
1r WIDTH 125 FEET
P 2 9TJ0PF� 30•S9 \ E.9 Centerline Frame And Grate PROPOSED BUILDING COVERAGE
28,7 = 8 5+ (N
/ -
. 30 m . LOT AREA 29,885 5F±
EL 2 AVD 1958)
0
J,
291 c'� �r y` TpO F6 \2 page 4.226 5F±
BUILDING COVERAGE:
POOL HOUSE 1,058 5F±
TOTAL 5,284 SF+
29,1 Fo c G 3a,1 COVERAGE=(5,284/29,885)X I DO%= 17.7%
Aproximate Existing Mature 2x • E E so.o 0
Oak Tre ` E / �f\ e9,4 1 GRADE PLANE CALCULATION
., F � aa_
TO BE SAVED
p ,8
+� Tr 3 \ F '^ 2g NORTH: 29.G + 29.8/2= 29.7
83, 9.7 29,7 41 SOUTH: 29.0+29.G/2= 29.3
EAST: 29.G+29.8/2= 29.7
/4 ��e `n WEST: 29.0+29.G/2= 29.3
283, SAS PLAN VIEW o.00- 3 'eAr Qti 29x4
\ SCALE: I = I O g0 f/ 0 �a 6'� 294 GRADE PLANE EL=29.5
O 30.6 m Existing Gas Meter 1� - MAX PEAK EL= 30+29.5 FL=59.5
Generator, Private Gas HEIGHT FROM TOF 19.9 FEET
^, Line TO BE MARKED AND PROPOSED POOL HOUSE HEIGHT
TWO(2) PROPOSED 4" PVC m
RELOCATED, IF NEEDED TOP + 19.9' = EL=51.I
CLEAN OUT - TO GRADE 3p 30.1 HEIGHT EL=51.1 < EL=59.5,HEIGHT OK
PLAN CMJ29,8
PRPOSED UDERGROUND
29A ELECTRJC SERVICE
SCALE l"=20'
THIS AREA IS SERVED BY
TOWN WATER
FLOW PROFILE:
NOT TO SCALE 5 COVERS TOTAL: 3 SEPTIC TANK, ONE D BOX , RAISED TO WITHIN G"F.G.
24"DIAMETER CONCRETE COVERS ONE SAS COVER RAISED TO WITHIN 3"F.G.
RAISED TO WITHIN G"OF FIN15H REVISED PLAN, 1 1/21/19: NEW POOL HOUSE FOTPRINT, ADJUSTED PROPOSED UTILITY
TOP OF FOUNDATION GRADE(OR AS NOTED) LOCATIONS, INCLUDING SEWAGE DISPOSAL SYSTEM.
EL- 31.5± (SEE NOTE#5) OF M �.�
24.3± Pro osed EL= 29.4± Pro osed EL=29.G± Pro osed EL=29.G± ��� As�� tt' \A OF tgy s REVISED PLAN, 10/1/19, MOVED 5A5 TO RESERVE AREA, ADDED SOIL REMOVAL,
.. / \�\ /� =' �� �� AND ADJUSTED THE FLOW PROFILE•
+1 ,•. o ? o j /\�r�\� :••''•. ,...• ,..•. . , ����\� / \sC` �c n''p' veQF�IJG
VENTE�' ' JOH�161>I.
m r O O + 29"Proposed O'REILLY M. r.
,L 28.I_ „ „ r> CIVIL O'TiE.ILLY -� McCartin Re51 dense
O (9 Min -3G Max)
oc 2 .0± NO.36200 t
s N. -4 _,9 NO.4673:3 do Jim Hagerty, Reef, Cape Cods Home Builder, PO Box 18G, West Dennis, MA 02G70
2"LAYER OF 1/8"- 1/2"STONE
28.50 2.0'± 27.00 IO"
14 14 2G.75 �2G.25!. _ /` 3/4 - 1-1/2 STONE �k 5ITE 5EWAGE D15PO5AL DE51GN
3a 2G.G I 2G.44 / N cv - ��_�-`� .;
T T 43 HOLLINGSWORTH ROAD, OSTERVILLE, MA
G'0"BAFFLE AS BAFFLE 2"DROP
24.25 J M O TEILLY & ASSOCIATES INC.
i 000 GAL. 500 GAL.
s •. USE TWO(2), H2O SHORTY PRECAST
�.. .... ...:... ..,:.., 500 GALLON LEACH CHAMBERS G.5' 0 20 40 60 Surveying Services
Professional. Engineering & Land
Longest Run WITH 4'OF STONE AROUND
5T 1500 GALLON TWO COMPARTMENT7� 15' (END VIEW)
SEPTIC TANK DB 3 LEACHING CHAMBER --EL=17.1 BOTTOM TEST HOLE 2 SCALE I "=20' 1573 Main Street - Route 6A
D-50X (508 896-6601 Office Brewster,Box 1773
25.0'x 12.83'x 2.0' ) MA 02831 (508)896-8802 Fax
H-20 DATE: SCALE: BY: CHECK: JOB NUMBER:
H-20
G:WAJOB5:\REEP\87G5 McCARTIN\DWG\87G5 PROPOSED 51TE PLAN.DWG 8/29/201 9 As Noted MTF/9 JMO JMO-87G5
TYPICAL SYSTEM PROFILE GENERAL NOTES
NOT TO SCALE 2.5' .:`A i. ,� .�:.; 2.5' 1.) LOCUS AREA iS COMPRISED OF .
NOTES:
/ i.x r �s11 BARNSIABLE ASSESSORS MAP 140 PARCEL 059
APPROMMATE TOP OF 1. ALL MATERIALS SHALL. MEET H-20 LOADING REQUIREMENTS. _ DEED BOOK 12,215 PAGE 256
FIRST FLOOR = 29.5 11.0' 8. ' 4.83' 5 CHAMBERS '
LOT 1 IN BLACK B AT PLAIN BOOK 93 PAGE 47
PROPOSED GRADE = 28.5 SET ONE (1)) MANHOLE FRAME dt CODER SET MANft FT6ME 3 COMER ~'3.1'' :•' , -
TO 1;L d' OF HOLE GRADE TO wmrN 6 OF FINISH GRADE ' '" r n' '� OWNER/APPLK,ANL• THE JOY MERROW REVOCABLE TRUST 1999
RISERS COVERS SHALL BE WATERTIGHT ' 107 PORTLAND STREET
LANCASTER, NEW HAMPSHIRE 03584
FINISHED GRADE OVER M BOX = 2&0* 47.5' 2.) PROJECT BENCHMARK : srA m ELEV• 35' NGVD 1 FOOT ABOVE GRADE
FINISHED GRADE OVER rANIc = 28.Ot MAxIMIIM GRADE OfAtR tFAC11ING srsTETr = 29.0 b 2&O T"
9� (min) Cover pL.AN OF 80L ABSORF''T10N SYSTEM WITF� AT UP/LP114 1/2
4' SCH 40 PVC 3. MIN. FIRST 2' 1O) BE r*A!D' �� ElEV-26A UBLE 36 mox CoverE- t1' S=4.9T.r •;; . ..: All ONE INSPECTION PORT TO NORTH OF LOCUS PER BAItNSTABLE BASEMAP 14O
LEVEL. LONGEST YYTT1iIN 6' OF FIMISFI GRADE
, F
3•) ZONING INFORMATION
MN• ''y O 0%SCH 40 PVC PIPE LENGTH-30 IF CHAIIIIBER2& CONCRETE LEACHING CHAA�RS CONNECTION NO SCALE ZONING DISTRICT : RC (ReakWftl)
INN OUT • 26.37 NV 25.83 10' MN. OUr� 2S .• ,rtN'r. .».%s�! ::rr r''
�.
PVC
2. 4 SCH. 40 PVC -4Y; ?,,..,.�". , f„ 8'_4- MINIMUM ZONING REQUIREMENTS
NV N�25.53 :� Nj MV M� 25A6 O O C O O BOTTOM ,
MIN. LOT AREA = 43 560 S.F.
o :; CHAMBER 6' (H-20) 20' DIA I- �_
. j�. GAS BAFFLE i SUMP . OIIT=25.36 -STONE MIN. LOT FRONTAGE = 20'
14' . • UNSUITABLE SOILS, IF ENCOUNTERED BELOW 5' MIN JAW _ 150 EL = 23.08 FRONT YARD SETBACK- 20'
REINFORCED so man C SIONE r -r+' f.:. THE PEAST�ONE ELEV (TOP OF SAS). SHALL BE W�Wp $ia� 0�� 0 ® ® 1
'r' ,'. ' 6- CRASHED REMOVED TO THE *C HORIZON' AS REQUIRED ; ® ® ® ® ® ® ® • SIDE REAR = 10' / 10'
,:: ;.: -;;,,.< �, .'•.' STONE BASE - SEE NOTE #5 HEREON. 3'
No Groundwater observed To Elev. 16.5 ® ® ® ® ® ® ® •c♦v
4.) A TiTLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE IF DETERMINED
DO I FM I ION BOX OW LOADW SOL ABSORPTION SYSTEM (SAS) LEACFlNG CHALM iTYMAU H2O LOAM ® ® ® ® ® ® ® To BE NECESSARY A TITLE SEARCH SHALL BE PERFORMED BY OTHERS.
WN GALLON ONE-COWPARTWENT SEPTIC TANG GO LOADNOi Nrs
ROTONDO DB-9 OR EQUAL _ T� 5.) THE PROPERLY.LIE NFnRMATION SHON�N IS BASED ON CIIRRENr AVAu/IBLE REOORD
ROTONDO ST1500 OR EQUAL TO BE INSTALLED ON A LEVEL. STABLE BASE
TO BE INSTALLED ON A LEVEL STABLE BASE 2 OUTLETS REQUITED MFORMATiON COMM OF PLANS AND DEEDS.
SEPTIC TANK SHOULD BE INSPECTED R CLEANED ANNUALLY THE OMMf' FEATURES SHOWN HEREON WERE O8TANED FROM AN ON THE GROUND FIELD
SURVEY PERFORMED BY BAXTER NYE EHNGwMMG & SURVEYING ON DMI ER 20, 2007
SET FRAME # COVER
SEPTIC SYSTEM CONSTRUCTION NOTES: RISERS CMM FINISH GRADE°V► +r s') c°M~n'"r"' PANEL Nu"�ER'
0 S 74 ° 1. ALL SYSTEM COMPONENTS SHALL 8E INSTALLED IN AI��ORLIIiWCE WITH TIRE V OF (FOR INSPECTION PORT) DOUBLE w STONE THE FLOOD IISURUNCE RATE MAP DEFINES THiS AREA AS ZONE C.
22 4 0 THE STATE SANITARY CODE DATED 4/21/06. AS AMENDED THROUGH THE DATE OF THiS
Z 2 O 0 PLAN, & ANY LOCAL RULES & REGULATIONS APPLICABLE f PECTONE 7•)
m RTE. 28 Q' .
3 ZANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY THE ENGINEER Fm UK i t- •SITE IS NOT WITHIN AN A.C.EC. (AREA of CRITICAL ENVIRONMENTAL CONCERN)
ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN PRIOR APPROVAL -�-��
lett�7 y. a `•.3• �' SITE IS NOT WITHIN AN AREA OF ESTIMATED HABITAT OF RARE WILDLIFE PER
-) EFFECTIVE • `f,.�Hiv ::i��`' kirj �� _� 4�1 �� \L'., <r •
x 34.2 5 BY THE ENGINEER. 24 �`• ;;, t.•
.....
DEPTH �' .� �:'i:-, -, ;,�•,,.'•�'�:...��••' NHESP MAP OCTOBER 1, 2006 'ESI1MATm HABITATS OF RARE FE"
3.1' 4.8' 3.1' FOR USE WITH THE MA WETLANDS PROTECTION ACT REGULATIONS 310 CMR 10).-
3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, NOTIFY THE BOARD 11• •SITE DOES NOT CONTAIN A CERTIFIED VERNAL POOL PER NHESP MAP OCTOBER 1. 2006
i WG OF HEALTH AGENT AND DESIGN ENGINEER FOR INSPECTION• -CERTIFIED VERNAL POOLS.'
33.9�" x34.02 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4' SCHED 40 PVC. UNLESS CONCOTE LEACHNO CHAMBER SYSTEM DETAL . SITE IS NOT WITHIN A PRIORITY HABITAT PER NHESP MAP OCTOBER 1, 2006
OTHERWISE NOTED HEREIN. (N 20 LOOM) 'PRIORITY HABITATS OF RARE SPECIES' FOR SPECIES UNDER
MAIN ST NO SCALE THE MASSACHUSETTS ENDANGERED SPECIES ACT, REGULATIONS (321 CMR10)
LOCUS BENCHMARK: 5. EXCAVATE UNSUITABLE MATERIAL AS NOTED, TO THE 'C HORIZON' f FOR A HORIZ .SITE IS NOT WITHIN A STATE APPROVED ZONE I GROUND WATER RECHARGE
NAIL IN UTILITY POLE DISTANCE OF 5' SURROUNDING THE LEACHING HELD, AND REPLACE WITH CLEAN SAND PROTECTION AREA
o EL- 35.00 (GIS) PER 310 CMR 15.255 TO THE 70P ELEVATION OF THE SAS.
9.) UTILITY INFORMATION SHOWN HEREIN:
�o
6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN 3 OF
• EXiS'TiNG CESSPOOL AND OVERFLOW TAKEN FROM TOWN OF BARNSTABLE
UP/LP 414 1/2 7. THE SEPTIC SYSTEM DESIGN INCLUDE GARBAGE GRINDER DISPOSALS. AS BUILT CARD DATED 12/15/05.
LOCUS MAP PROPOSED • WATER LINE AND APPURTENANT INFORMATION IS BASED ON INFORMATION TAKEN
T\ U j P 414.-1 � �• !' 32.5 a�1\ 8. �� THE CONTRACTOR SHALL CONTACT DIG SAFE (AT 1-888-DIG-SAFE) AND
N.T.S. OVERHEAD
ECTHRICAL °y \ UTILITY COMPANIES TO LOCATE ALL EXISTING UTILITIES, AT LEAST 72 HOURS BEFORE FROM COMM. WATER DEPARTMENT CARD JO-1224-T DATED 9/30/75.
`'' w r THE START OF THE CONTRACTOR SHALL DETERMINE THE EXACT
W �. '� FLAG)POLE FAA • BASED ON ##IDRMATi W PROVIDED BY KEYSPAN, THERE IS No GAS SERVICE
°ti 30,44.E 32,12 � EXISTING HOUSE LOCATION. BOTH HORIZONTALLY AND VERTiG1LLY, OF ALL EXISTING UTILITIES BEFORE
WATER k P TO BE REMOVED THE START OF ANY WORK THE LOCATION OF EXISTING UTILITIES ARE TO 43 HOWNGSWORTH ROAD.
�O SHUT FF �, � 33.09 SHOWN IN AN APPROXIMATE WAY ONLY. MAY NOT BE LIMITED TO THOSE SHOWN • PER INFORMATION RECEIVED FROM INSTAR ELECTRIC, AND VISUAI. WPECTiON AT
6" WATER n�A!N � � .� �,, HEREON AND HAVE NOT BEEN INIDEPOVDENfLY VERIFIED BY ME OWNER OR ITS
SITE. SERVICE TO 43 HOWMGSWORTH ROAD IS FED OVERHEAD FROM UTILITY 1
W � T�� ` 31.26 `� e , DATIVE THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR MY AND
fk \ _ 31.65\ S,x 32.66 ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE CONTRACTOR'S FAILURE TO �- POLE #414-1.
5' OSERDIG. SEE EXACTLY• IF ELEVATION INFORMATION DIFFERS FROM PLAN
2� CONSTRUCTION NOTE ' � � 3 8�.�'
LOCATE THE llTiL111E5 '' .
#5 HERE-ON X 47 / ice :9,2 3 � INFORMATION. THE CONTRACTOR SHALL NOTIFY THE ENGINEER,IMMEDIATELY FOR `
t� "r �- 31, -,- POSSIBLE REDESIGN. AT UTIJTY CROSSINGS .VERIFY IN FIELD THE LOCATION / INVERTS
UP/LP 413-2 OF
x \ 3 57 \3 �.� PROPOSED INVERTS PER PER ENGINE TELEPHONE & S DIRECTION. THCOMM AND E CONTRACTOR SHATE F LL
WON
7 35� �la� S 33.17 PRESERVE ALL UNDERGROUND unL1ilE;S AS REQUIRED.
9. THE PROPOSED UMITY CONNECTIONS SHOWN HEREON ARE SCHEMATIC. FINAL
._1.52 ` COMPANY.
PROPOSED WATER 47. ' 11' S. S. . Y:.:, F x �� LAYOUT SHALL BE AS DETERMINED BY THE APPROPRIATE VILLAIN'
SERVICE -PREINC
CAT ,t
__ 9
c3•I , W � � . ` �`� ,76 LEACH AREA REQ S
1,.
Q
�
..� NITROGEN LOADING LIMITATION: NA
? p I ti• �� fi '� . :i. 32 .23 5 BEDROOMS
'� � . . T RESIDENTIAL.-
\ �0 '� 6��� ��-� tip' D-BOX .' �' ::::. 9�� 3D.24 O
' x 110 GPD/
�� 5 1. 4' PVc 5 TOTAL DESIGN FLOW = 550 GPD
7�24 0. min ��� GARBAGE GRINDER (NOT INCLUDED) = N/A
I
x U/P 414-2 x7053 O I �.. Y 2 +�
�8.81 28.25 I ;. 4 a�`:;.... ltix \. �9.74PEW
�� .,, ! � �, I I �o , � - 9.s8 LiAR �0.74 GPD/S.F.IN. f INCH (CLASS 1) SITE LOCATION:
tjH `rAiC) E r�� 1500
MIN. LFACHiNG AREA OF SAS. REQUIRED: 43 HOLLINGSWORTH ROAD
_ yrc8.76 `11 LF 4' RF�0�„ SEPTIC `, / 29,44
0 ( S=4.9x \. ; 550 GM/ 0.74 GPD/S.F. - 744 S.F. MIN. OSTERVILLE, NA
_15 A'QpQ 27.41 PREPARED FOR
o cEss oo AND ENNIFER M ARTIN
x 28,32 -2.7 98 ��` sF 2& � DRIVEWAY � PROPOSED s•YSTEM: MARK A J CC
3 G-:2 F• 29.25 5 ,.► 500 GALLON PRECAST CONCRETE CHAMBER UNITS
x 2 ✓ ` M,A,P 140 2&6 � � Lis 2&83 � WITH 3.1' OF STONE ON SiM 2.5' OF STONE AT ENDS 476 WAIN STREET
PARCEL 059 28 :n x 1, }'f ,' Q SIDEWALL AREA (47.5' + 11)2 x 2' DEPTH = 234 SF COTUIT MA 02635
``0.5' sties ' 2&6 ��� I / BOTTOM AREA: (47.5' x I V) = 522.5 SF
29,887 S Q. FT. 2I3 3 26.6 TOTAL EFFECTIVE LEACHING AREA - 756.5 SF
30,51 �, 0.7 ACRES 2&5 ?9,72
� 2&5� SYSTEM DESIGN CAPACITY = 756.5 SF x 0.74 GPD/5F = 560 GPD
TiTLE
26.5 CESSPOOL (PER SEPTIC TANK SIZING: 550 GM x 20OX = 1100 GAL Septic Design Plan
x , .09AS-BUILT) TO BE USE 15M GALLON TANK MIN.
28.5
x 29.37 '� 2&4 x 28.6 -� ` 29. FILLED WITH CLEAN
x 28,61 0 �� SAND AND SOL LOGS DATE m 01-U-08
'-bQS71NG SHED ( �8. v�OR BARNSTABLE BAXTER NYE ENGINEERING & SURVEYING
x2851
To BE REMOVED x 2&6 L, NECESSARY SOIL EVALUATOR. BOARD OF HEALTH AGENT
29.02 SIEVE MAROON, P.E DONNA MIORANDI, R.S. Registered Professional Engineers and Land Surveyors
~�� `�_------�---~ - '\ TEST PIT 1 TEST PIT 2 TEST PIT 3 TEST PIT 4 78 North Street-3rd Floor,Hyannis,
H Massachusetts 02601
CV ON G.S.E. = 28.0 0' G.S.E = 27.9 0' G.S.E. = 28.50 0' G.S.E. = 29.0 Phone-(508) 771-7502 Fax - (508) 771-7622
Q 29.25 A ; IOYR 2/1 ; SANDY LOAM A ; IOYR 2/1 ; SANDY LOAM FILL ; IOYR 2/1 SANDY FILL ; I 2/1 SANDY
�HOFMgss'
�- 16' (ELEV 26.67) 16' (ELEV 26.57) 8' (El.EV 27.83) LOAAM 8' (0" 28.33) LO�IM 20 0 20 40 a°� W c�
mmmw
00 \ B ; 7.5YR 4/6 ; LOAMY SAND B ; 7.5YR 4/6 ; LOAMY SAND FILL ; 2.5YR 6/3 ; FINE SAND FILL ; 2.5YR 6/3 ; FINE SAND SCALE IN FEET v c
183
o
N • 4
SCALE: 1 - 20 �r � ��
9.78 ---�� 2 .67 34' 25.17 34' ELEV 25.07 38' ELEV 25.33 38' ELEV 25.83 F �s L
� �x �' �S�ONAL
' ~`•�� 29,20 C ; 2.5YR 6/3 ; FINE SAND C ; 2.5YR 6/3 ; FINE SAND A ; I 2/1 ; SANDY LOAM A ; I 2/1 ; SANDY LOAM 1 1 Og
46' (ELEV 24.67) 46' (ELEV 25.17)
x s �4 2 120 (ELEV 18.0) 120 (ELEV 17.9) DATE: 01 14 08
i 2 �o / /
o o B ; 7.5YR 4/6 ; LOAMY SAND B ; 7.5YR 4/6 ; LOAMY SAND
o 58' (ELEV` 23.61) , 58' (ELEV 24.17)
29.0
x 31.29
0.92 C ; 2.5YR 6/3 ; FINE SAND C ; 2.5YR 6/3 ; FINE SAND 0
J
I C
144' (ELEV 16.5) 144' (ELEV 17.0) N0. BY tIu4TE REMARKS
U ( 8 OF O;§ DRAWN BY: SDM BY: SDM CKED BY MWE DRAB NUMBER
t NO WATER Al 120 ELEV 18.0 NO WATER AT 120 EI.EV 17.9 NO WATER AT 144 ELEV 16.5 NO WATER AT 144 ELEV 17.0
PERC O 56' (ELEV 23.33) � O n' (� 22•08) 0:�2007�2007-069 CML PLO
0 3D,03 RATE= < MIN/IN RATE- <2 SOIL MINIIN
�C SS? SpILiN CLASS? SOIL IN 112007-069-PS.dwg
N ! Cuss I SOIL CLASS 2007-053
i
0
0
N
TYPICAL SYSTEM , PROFILE 5.2 ' 2.5'
�pT To GENERAL NOTES :
APPRO) IE TOP OF 1. ALL MATERIALS SHALL MEET H-20 LOADING REQUIREMENTS.
NOTES: :, -:, • =• ,�' s1GrIE 5:1" 1.) LOCUS AREA IS COMPRISED OF
M
FIRST FLOOR = 31.0
a, . 4.8S 5 CHAMBERS BARNSTABLE ASSESSORS MAP 140 PARCEL 059
PROPOSED GRADE = 29.0 SEf ONE t) IIANFIOLE FRAME COVER SET FRAME& COVER :.:'a DEED BOOK 12.215 PAGE 256
m wrrH�Nt N!� OF FINISH WADE. m wiTt 6' of FINISH Gr�DE �'31' *'= °._' '; ' - _ LOT 1 iN BLOCK 8 AT PLAN BOOK 93 PAGE 47
RISERS R OOVEIIS SHALL BE WAiER71CHT `
OWM/APPLICANT THE JOY MERIM REVOCABLE TRUST - 1999
Fu�xsHED GRADE OVER TiAN( = 2aot MkWN N,W OVER LEACHING SYSTEiM - 20 0 Le 21LO r- 47.5 107 PORTLAND STREET
FNTSHED GRADE OVER D BOX = 28.Ot LA CASTER, NEW 94UPSMRE 03584
9 jjmin Cover
r SCH 40 PVC ITOF 'Jf -14' OOUBLE " ( x� Cover PLAN OF SOL ABSORPTION SYSTEM W171� 2.) PROJECT BENCHMARK : SCALED ELEV. 35' NGVD 1 FOOT ABOVE GRADE
L= 13' S=2X ,. r MIN. FIRST 2 Tb BE WASHED PEASIONE BE04U ALL ONE INSPECTION PORT TO L'SOO GALLON PRECAST MACE M CHAIIERB AT UP/LP 1114 1/2
' 5 LF»4' SCH'40 PVCF - LONGEST CHAMBER TOP WITHIN 6" OF FINISH GRADE NO SCALE NORTH OF LOCUS PER BARNSTABLE BASEMAP 140
6' MITI. OS=1.OS PIPE LENGTH-30 LF ELEV- 2d.0 CONCRETE LFACHNG CfAM M CONNECTION
0S=t.ox _ . 3.
NV OUT 26.09 NY N= 2S.d3 10' MN. . ` :::y•:, ;., "-'
PVC 4" SCH. 40 PVC ) ZONING INFORMATION
4= 25•5B 2,. ^r'"`';'. =�=Mrr•.��"A ZONING DISTRICT RC Residential
LA
• tj Nv IN= 25.08 BOTTOM OF ( )
NV W25M :.
BAFFLE ' SUMP OUr 25.311 a :•` t= C t� GO O O CHAMBER 6" (H-20) MINIMUM ZONING REQUIREMENTS
!< _
14" t ` _ <2•' EL • 23.08 -4 20" DIA G -• I_
MIN. LOT AREA = 43.560 S.F.
CONCRETE r•. STONE BASESP. err :' THE PF.ASTONE EL& (TOP D SHALL BE 5' � D BELOWOUBLE 1 g� p=p O OQ G7 � ® MIN. LOT FRONTAGE 20'
.{jam• .; :�:•r.:l z•'• .. •. � UNSUIMARE � � _ ' �
`..••• .. '_... .. A' . ,. STONE BASE REQUIRED 3" O C= O C= O C= I�...
6" CRUSHED REMOVED TO THE OC HORIZON' AS REQU FRONT YARD SETBACK- 20
- SEE NOTE HEREON. No Groundwater Observed To Elev. 16.5 C7 La L4= C= C= ® ® '•r SiDE & REAR SETBACKS = 10' / 10'
DO I FORM BOX OW LOADIM SOL ABSORPTION SYS1'E�1 MW LEACIK CHAP RYPICAU H2O LOADI o ® ® T��T� o T� N
ROTOHDO D" OR EQUUAL. NIS 4.) A TiME SEARCH HAS NOT BEEN PMRMED FOR THIS SITE. IF DETERMNED
R0 O DO ST1500 OR EQUAL M BE INSTALLED ON A LEVEL STABLE BASE _6 T-f- re BE NECESSARY A TITLE SE�i CH SHALL BE PERFORMED BY OTHERS.
70 BE ASSAILED ON A LEVEL STABLE BASE
SEP11C TANK SHOULD BE NSPEC ED E CLEANED ANNUALLY 2 OUTLETS ROQURED 5.) THE PROPERTY LINE IFORMA ION SHOWN IS OW ON CURRENT'AIAIIABIE RECORD
IFMATION CONSLSTNG OF PLANS AND DEEDS
THE EXISTING FEATURES SiM HEREON MERE OBTAINED FROM AN`ON THE GRDW FED
SET FRAME !'00ALFR SURVEY PERFORMED BY BAXTER NYE DIMMING & SURVEYING ON DECEMBER 20, 2007
• RAERS COV SWSHALL TERTI6HI! 3i�r
SEPTIC SYSTEM CONSTRUCTION NOTES. r
1. ALL SYSTEM COMPONENTS SHILL. BE INSTALLED IN ACCORDANCE WiTH TITLE V OF ( I W►M SIONE 6.) COMMUNITY PANEL Nl1MBER:
t
22 4 Q„ THE STATE SANITARY CODE DATED 4/21/06. AS AMENDED THROUGH THE DATE OF THIS THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C.
2Q F PLAN, &ANY LOCH. RULES & REGULATIONS APPLrABLE r PFASIONE'
RTE. 28 ' 00 J.
` 1 ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WOW BY THE ENGINEER. _ 7.) ENVIRONMENIAL
ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT WRIT YEN PRIOR APPROVAL FtArr LINE 11. �?;��,�• r, `�,� ��� � ' 1:Y;� �{�+�:+,.•�,
��•• x 34.25 BY THE ENGINEER 24 .�a"��.,;;••� y;'s �.rr :�;' *? ,a,a;�c<•' •SITE IS NOT WITHIN AN A.C.EC. (AREA OF CRITICAL ENVIRONMENIAL CONCERN).
�:
4.b' 3.t' •SITE IS NOT WiiHIN AN AREA OF ESTiM 70 HABITAT OF RARE WILDLIFE PER
3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILUNG,-NOTIFY THE BOARD 1 t' NHESP MAP OC70M 1 2OD6 'ESTIMATED WWBITATS OF RARE WI ,
y WG
OF HEALTH AGENT AND DESIGN ENGINEER FOR iNSPECTION FOR USE WITH THE' MA �i fff4 DS PROTECTION ACT REGULATIONS 310 CUR 10).
t1+ x34.02 r CONCRETE LEACHMIO'CHAMM SYS"TEbi DUAL •SITE DOES NOT CONTAIN A CERTIFIED VERNAL POOL PER NHESP MAP OCTOBER 1, 2006
�► 33.9�~ 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4 SCHED 40 PVC. UNLESS TERTiFIED VERNAL POOLS.
MAINS OTNERWASE NOTED HERON. NO SCALEH 20 ) r SITE IS NOT WITHIN A PRpRITI' HABITAT PER NFESP MAP OCTOBER 1. 2OD6
BENCHMARK: 'PRIORITY HABITATS OF WIRE SPECIE" FOR SPECIES UNDER
LOCUS 5. EXCAVATE UNSUITABLE MATERIAL AS NOTED. TO THE � HORIZON" , FOR A HORIZ
NAIL IN UTILITY POLE THE MASSACHUSETTS ENDANGERED SPECIES ACT, REGULATIONS (321 CURIO)
pR EL: 35.00 (aS) DISTANCE OF 5 SURROUNDING THE LEACHING FED. AND REPLACE WITH CLEAN SAND
PER 310 CMR 15.255 TO THE TOP ELEVATION OF THE SAS •SITE IS NOT WITHIN A STATE APPROVED ZONE N GROUND WATER RECHARGE
p PROTECTION AREA
p 6. INSULATE ALL PIPES AGAINST FREEZING AS REWRED WHEN LESS THAN 3' OF
REMOVE EXISTING WATER COVER
9.) UTILITY INFORMATION SHOWN HEREIN:
PER WATER WAgTMENT >r
REQUIREMENTS ,'� �;� UP/EP 414 1/2 7. THE SEP 1C SYSTEM DESIGN ES INCLUDE GARBAGE GRINDER DISPOSALS
LOCUS MAP ��� f, 32,541` 8. THE LONTWICTC)R SHALL. CONTACT OiG SAFE At 1-888-DiG- AND �.T DCESSPOOLATED 2/15 OVERFM TAKEN FROM TOWN OF BARNSTABLE
N.T.S. OVERHEAD U/P 414-1
°s /" �� �\ UTiLITY COMPANIES TO LOCATE ALL DMING UTILITIES, AT LEAST' 72 SUM
30 , THE START OF THE CONTRACTOR SHAD. DETi RMIK THE DUCT WATER LINE AND APPURTENANT INFORMiITTON fS BASED ON INFORMATION TAKEN
n %�� FZrP,Gi POLE , o� OUSE LOCATION, BOTH HORIZONTALLY MD VERTICALLY, OF ALL DOSSING UTILITIES BEFORE FROM COMM. WATER DEPARTMENT CARD 10-1224-T DATED 9130175.
WA ER oy 30,44 32.12 �` .TKO'BE REMOOVEED THE START OF ANY WORK. THE LOCATION OF DOSSING UTILITIES ARE
•BASED ON INFORMATION PROVIDED BY KEYSPAN, THERE IS NO GAS SERVICE
'�C) sty r oEF- �, �. 33,09 SHOWN IN AN APPROXEMIE WAY ONLY, MAY NOT BE LIIntED 1O THiOSE SHOWN TO !13 ROAD.
6' WATER MAN � 4 HEREON AND HAVE NOT BEEF! INDEPENDETNRY VERIFIED, BY THE OWNER OR ITS
31.2 REPRESETNTATNE THE CONIRAC'T17R AGREES To BE FULLY RESPONSIBLE FOR ANY AND" •
j PER"INfORA�WTION'RECENED FROM Ns'TAR ELECiRIc. AND vISLAL`IAIPECTION AT
2 � 5' OVERDIG. SEE / - .\J. 31,85\� 32.66 ALL DAMAGES WHICH MIGHT BE O BY THE CONTRACTOR'S FAILURE TO STii:. SERVICE TO 43 HOLUNG.SWORTH ROAD IS FED OVERHEAD FROM UTI.IiY
T,� CONSTRUCTION NOTE r , Z` LOCATE THE UTILITIES DUCKY. NF ELEVATION INFORMATION DIFFERS FROM PLANK POLE 414-1.
' 31.9$ ..�' a _. _ �_. ____� ___._. ._� _
HERE-ON
INFOTtMII THE,CONTRACTOR SHILL NOTI:Y;THE ENGINEER IMMEDIATELY FOR
31.91� POSSIBLE REDESIGN. AT UTILITY CROSSINGS. VERIFY IN FIELD'THE LOCA71ON / INVERTS
UP/LP 413-2 OF ELECTRIC, GAS, 711E WW d: DATA/COMM AND RELOCATE TF CONFUCTING WITH
o�� 28•0, r`� x�� �� r 33.77 PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE-CONTRACTOR SHALL
Q 7. 5 i� v0 S ~� PRESERVE ALL UTILITIES AS REODUIRED.
9. THE PROPOSED UTILITY CONNECTIONS SHOWN HEREON ARE SCHEMATIC. FINAL. ,
7.' ,�X 11 S.A.S. 1.52
LAYOUT SWILL BE AS DETERMINED BY THE APPROPRIATE UTiUIY COMPANY.
/ WI 5 PRECIS . { ? x
PROPOSED WATER �+ S�CH G t
SERVICE / r / GFIAMi1ER$
�.�� 3,.: L.EAC AREA REQUg3ENRENTs
-8 .76
dap 9 - 41. NITROGEN LOADING L IMITATION: NA
?V0 1RESIDENTIAL: 5 BEDROOMS
-'ra a{L D-Box 0.24
x 110 GPD/BF�ROOM
5 LF 4' TOTAL DESIGN FLOW - 550 GP'D
r•' S=1.0lG
dy24 (min. 3.. ! GARBAGE GRINDER (NOT INCLUDED) _ N/A
U/; 28.25 2 1 x 29.74
c.8,81 ` X ;. 4
37 0 a 9.s8 ' PERC RATE _ <5 MIN.••/ INCH (CLASS 1) SITE LOCATION:
a H r D �• �. 1 O LIAR 0.74 GPD/S.F
�- x 29 J �.� 1500 43 HOLLINGSWORTH ROAD
28.io
29-- 43.t>: 4dC v tier SEPTIC .� I, i 29.44 MIN. LEACHING AREA OF SAS. REQUIRED:
a 2x , \ .74 .F. = 744 S.F. MIN. OSTEIMLLE, MA 02655
� .. 'Q x2741 I i - �
29, 2 550 GPO/ 0 GPD/S
i
p r' LESS 0) I
' PREPARED FOR
x 28, '
29.�2
�� �� u .: o r MARK AND JENNiFER MCCARTIN
29.25 5 N 500 GALLON PRECAST CONCRETE CHAMBER UNITS
28.96x �� ��� Sr Q WITH 3.1 OF STONE ON STD!~ 2.5 OF STONE AT ENDS 4T6 MAIN STREET
P .,�E� 059 ,6Q{ a F a
, : j Q S►DEWALL ARfJI: (47.5� + 11�2 x 2' Dl7rfH = 234 SF COMM MA 02M
88 / SO. FT. �.
�' � -. �'.. �•:~� �--�t,•• 1 � BOTTOM AREA: 147.5 x 11 ) _ 5225 SF
\ 0.7 ! R E S TOTAL EFFECTIVE LEACHING AREA = 756.5 SF
3 a 5 % SYSTEM DESIGN CAPACITY = 756.5 SF x 0.74 GPD/SF = 560 GPD
STING E70STiNG SHED COOL (PER S67W TANK SiZING: 550 GPD x 200% = 1100 GAL TITLE •
TO BE REMOVED x 28,92 .� .09 PUMIPIM7TO BE USE 1500 GALLON TANK MIN. �pffC Design Plan
x 29,37 �, "�� -� ` 29. FILIED MATH CLEAN
.. 1 0 , �, SAND AND 80L LOGS DATE 01-14-08
L t; ,w
�. ,� w `S,dABAPIDOMED OR
REMOVED BARNSTABLE BAXTER NYE ENGINEERING & SURVEYING
f- 29.02 .,� SOIL EVALUATOR: BOARD OF HEALTH AGENT:
STEVE MATSON, P.E. DONNA MIORANDI, R.S. Registered Professional Engineers and Land Surveyors
78 North Street-3rd Floor,Hyannis,
TEST PIT 1 TEST PIT 2 TEST PIT 3 TEST PIT 4 y
02601
,Massachusetts
___ 0r _ O» _ O.
--------------- x 4 L921 :.-.. � _ - 7.9 - Phone ) 771-7502 Fax -( 0 )77 2
ON G.S.E 28.0 G.S.E 2 G.S.E.G.S.E 28.50 G.S.E. �- 29.0 - (508 S $ 1-762
29:25 ORI Ay A ; 1OYR 2/1 ; SANDY LOAM A ; 10YR 2/1 ; SANDY LOAM FlLL ; 10YR 2/1 SANDY FlLL ; 10YR 2/1 SANDY N of MgSs�c
r r N LOAM r LOAM �O� MATTHEW
29.3 x r _16 (ELEV 26.67) 16 (ELEV 26.57) 8 (ELEV 27.83) 8 (ELEV 28.33) 20 0 20 40 EW.
C
M
B ; 7.5YR 4/6 ; LOAMY SAND B ; 7.5YR 4/6 ; LOAMY SAND FlLL ; ISM 6/3 FlNE SAND FILL ; 2.5YR 6/3 ; FINE SAND SCALE IN FEET .$ -4 630
q.7 -`-`'��-� v�'° -- 2�6 34" ELEV 25.17 34' 25.07 38' t1EY 25.33 38' ELEV 25.83) SCALE: 1" _ 20' on►AL
a�
s�� - �' EN
29.20 C ; 2.5YR 6/3 ; FINE SAND C ; 2.5YR 6/3 ; FlNE SM A ; 10YR 2/1 ; SANDY LOAM A ; 10YR 2/1 ; SANDY LOAM
x S 7a �\
120- (ELEV 18.0) 120- (LIEN 17.9) 46 _(ELEV 24.67) 46 (ELEV 25.17)
�0» \
B ; 7.5YR 4/6 ; LOAMY SAND B ; 7.5YR 4/6 ; LOAMY SANO DATE: O 1�14�08
- 58- (ELEV 23.67) 58- (ELEV 24.17)
1 x 3L29 29.9
0192 C ; 2.5YR 6/3 ; FINE SAND C ; 15YR 6/3 ; FlNE SAND MINE e/» F001PRNT REVISED 0
C
144" (aEb i 6.5) 144r (ELEV 17.0) NO. BY DATE REMARKS =
1 8 U�Q:
NO WATER ATr120 ELEV 18.0 NO WATER AT 120 ELEV 17.9 NO WATER AT 144 ELEV 16.5 NO WATER AT 144 ELEY 17.0 ' Nl1A1BER
l PERC O 56 (ELEV 23.33) PERC O 77" (ELEV 22.08)
RATE• <2 MINIIN RATE= <2 MINIIN RATE- <2 MIN/IN RATE= <2 MN/IN 0:\2007\2007-069\CML\PLOT\2007-069-PS.dwg
c r 30.03 CLASS i SOIL CLASS 1 SOIL CLASS I SOIL CLASS 1 SOIL
r
` 2007T069