HomeMy WebLinkAbout0074 KING ARTHUR DRIVE - Health �-�' �.• 74 �ii'ng ,A.rthur`Drive
Ustgville" ,y
45
04,
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TOWN OF BARNSTABLE
LOCATION. 7 c( SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL /c(S- U-(/
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY 1c)pV t-+, y
LEACHING FACILITY:(type) C--x (size) to .k
NO.OF BEDROOMS 3
OWNER } S C)a La
PERMIT DATE: lk-
COMPLIANCE DATE: 10-3-O�-
I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility. ✓iru / 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 Capew'\d� LLC
F �y ��.3 3Y 3�. 3
\ I
#7�
LO•CAT10N SEWAGE PERMIT NO.
VILLAGE
Os1 aV �� Ic
INSTALLER'S NAME & ADDRESS
T;��b egi C vr� Co..
1449 w icA
8 UIIDER OR OWNER
C 4 Ae 1-'),e I
(J A ni IV I
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
Llz�
T L4
n�T
allo. . Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Y&
Rpplication for Miopo5al 6p6tem Construction i3ermit
Application for a Permit to Construct( ) Repair( ) Upgrade Q/j Abandon( ) ❑ Complete System U✓Individual Components
Location Address or Lot No. IJ� Owner's Name,Address,and Tel.No.
u�
Assessor'sMap/parcel �(¢� b/� � �JLLG 14 K O(q J�Q. LLE
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C"JU�S
P a BD+c (�3 Jcl ,M u(02—� _ a�
Type of Building:
Dwelling No.of Bedrooms Lot Size 1,5 M6 -� sq.ft. Garbage Grinder
Other Type of Building No.of Persons l Showersv,) Cafeteria P )
Other Fixtures Wffiflimfi. AtAa-f
Design Flow(min.req .red) 330 gpd Design flow provided 301. 80 gpd
Plan Date 14 (o Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. S
Description of Soil _SEE
Nature of Repairs or Alterations(Answer
when applicable) C QCj �K 11e.U)
\` I r 'GU L,
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 oLaealth.
Signe ate 1 1K' 00
L
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued
---- ___-- ——————————— — --_— ---------- -- --- -
No.. � r = "a Fee
r' p in comuter:
THE COMMONWEALTH OF MASSACHUSETTS EnteredY
.PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for �i� o�aY * 5terrt Cott5truction Permit
Application for a Permit to Construct( ) Repair(.-') Upgrade V45" Abandon( ) ❑ Complete System 12Individual Components
Location Address or Lot No. 14 6 O�"0&R Owner's Name,Address,and Tel.No.
�Assessor's Map/Parce1 145 04 1 Q I W1 i4l K,v� Jkfzz1•F c D � ��� LLE
__- 1`
Installer's Name,Address,and Tel.No. `'tiW ,DE Designer's Name,Address and Tel.No. CA4NW C
�k '7 to3
Type of Building: _ +
rDwelling No.of Bee4rooms Lot Size �J;� V� sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers ) Cafeteria f )
Other Fixtures (,O 6 N AQW Kk
Design Flow(min.req 'red) gpd Design flow provided • U� gpd
�f•
Plan Date �4 Number of sheets f' Revision Date
Title dG srwop
Size of Septic Tank Type of S.A.S. kA_ 6 1 _5
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) asp, e E I` o . i" K he-A)
Date last inspected:
Agreement: ` 1
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. I
Signed j l 1 y/ ate
Application Approved by // /) �f/ SDate
Application Disapproved by: �.V Date r
for the following reasons
.,
Permit No. Date Issued
— ———————————————————————— ————————=——
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (V/) i
Abandoned( )by ( 5
at F KtO6 UMA E • 05TE920(LL E has been constructed,in accordance i t
with the prroovisiio'nss,o\f Title 5 and
�,the
-,for
pDisposal System Construction Permit No. o �C3� dated
Installer l..r,U'Irb)(OE (43 :— UNGS Designer UW4Z_tv S '
#bedrooms �( • d
"� � Approved design_flow gp
t
The issuance of this permit shall not be construed as a guarantee that the system will functio�signed)
Date CO Inspector
---No. ----- . ----- ---------------- Fee
H1E COMMONWEALTH OF MASSACHUSETTS
�"APUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
1=i o!6AY.* gtem Con5tructioit Permit
Permission is hereby granted to Construct ( ) Re air ( ))r Upgrade (�' Abandon ( )
System located at �4.. rC TF�-t��. (ATE y l Llk
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions. _
Provided: Construction must be c 'mplle`ted within three years of the date of this pn.
Date ( Approved by � /��
y
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
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:When filling out A. General Information
forms the S� # `^ o
computer,
`hJ
r,use 1. Inspector: L/J,
only the tab key
to move your Robert Paolini
cursor-do not Name of Inspector
use the return
key. Capewide Enterprises,LLC.
Company Name
r� P.O.Box 763
Company Address
Centerville Ma. 02632
r City/Town State Zip Code
(508)428-4028 S 14454
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenanc Pf on--site
sewage disposal systems. I am a DEP approved system inspector pursuant tc Syection 15.34V&
Title 5 (310 CMR 15.000). The system: may`: ccs� n
® Passes ❑ Conditionally Passes ❑ Fail.�' -
❑ Needs Further Evaluation by the Local Approving AuthorityITI
�`-
t
c.
12/05/2008
Inspec or's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
Lod
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 2
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
The septic system is in proper working order at the present time.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 2
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 3
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No" to each of the following for all inspections:
Yes No
III ❑ ® Backup of sewage into facility or system component due to overloaded or
I clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than %day flow
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 4
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osteryille Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory, for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area— IWPA)or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5
L
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate "yes" or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ 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)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 6
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
The septic system consists of a 1000 gallon septic tank,Distribution box and 5 infiltrators.
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 2007:1,000
9 ( Y 9 (gpd)): 2008: 0
Detail:
2007: 3 gpd. 2008: 0 gpd
Sump pump? ❑ Yes ® No
Last date of occupancy: 2006
Date
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
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 7
Commonwealth of Massachusetts
W Title 5 Official Inspection Fora
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
c,M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped:
gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 8
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed(if known)and source of information:
New leaching installed 9/18/2006
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 18"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.):
Joints appear tight.No evidence of Ieakage.System vented through the house vents.
Septic Tank (locate on site plan):
Depth below grade: 18
11
feet
Material of construction:
® concrete ❑ metal ❑fiberglass' ❑ polyethylene ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gallon
Sludge depth: 0
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 9
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
^M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
32"
Scum thickness 0
Distance from top of scum to top of outlet tee or baffle
8"
Distance from bottom of scum to bottom of outlet tee or baffle
14"
How were dimensions determined? Measured
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pump septic tank every two years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank
appears to structurally sound.
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
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 10
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 King Arthur Dr.M '
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attache
d? El Yes ❑ No
t5ins•09/08 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 11 of 11
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert No
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 is Ievel.Box has one outlet Iateral.No evidence of solids carryover.No evidence of leakage into or
out of box.
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.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 12
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M ,•''v 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 5-Infiltrators
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Sandy dry soil.No signs of hydraulic failure.Infiltrators were dry at time of inspection.NOTE:System
has only seen 1000 gallons of water since installed in 2006.
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
l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 13
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
74 King Arthur Dr.
1y
Property Address
James Anthony
Owner Owner's Name
information is
required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 14,
i ,
Map Page 1 of 2
Town of Barnstable Geographic Information System
Parcel Viewer Custom Map Abutters Map Size 0 E ❑ Zoom Out D J f J J J;J J-DIo
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r nn,,rinh4 7nnr,_7nnA Tn...n of Pornciohlo KAA All rinh4c roc—,
http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=145041&map... 12/5/2008
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
❑ Shallow wells
Estimated depth to high ground water: Bottom of Infiltrators 30'
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 9/14/2006
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
As-Built Card
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 plate#2 annual ranges of
groundwater elevations.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 16
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 74 King Arthur Dr.
Property Address
James Anthony
Owner Owner's Name
information is required for Osterville Ma. 02655 12/05/2008
every page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
❑ Inspection Summary: A, B, C, D, or E checked
❑ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
❑ System Information—Estimated depth to high groundwater
❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
f _
12/30/2016 00:58 FAX 002/002
Town of Balrnstable
Regulatory Services
�xer�
Thomas F. Geiler, Director
Public Health Division
" Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862.4644 Fax: 508-790-6304
Installer &Designer Certification Form
Date: 10/03/06
Designer: ShayEnvironmental Services Inc. Installer: Ca evvide '
Enterprises s
Address: P.O. Box 627 East Falmouth Address: P.O. Box 763
MA 02536 Marstons Mills. MA 02632
On 9/20/06 Capewide Enterprises was issued a permit to install a
(date) (installer)
septic system at #74 King Arthur Drive, Osterville. MA`based on a design drawn.by
(address)
_Shay Environmental Services. Inc. dated 9/19/06
(designer)
XXXX I certify that the septic system.refereneed 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.
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.
ji�OF
CARMEN 30
staller's Sign e) U° E. r
SHAY y
No. 1181
OIST
(Designer's Signature) (Affix p Here)
PLEASE RETURN TO BARNSTA,BLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF, COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE.RECEIVED BY THE BARNSTA.BLE PUBLIC HEALTH DIVISION.
THANK YOU,
Q:HealtUScptic/Dcsigncr Certification Farm
4
Town of Barnstable P# _
Department of.Regulatory Services i
Public Health Division Hate
arAK
•s61 $ 200 Main Street,Hyannis MA 02601 ^
y -. r• -
1
E
O IYI�
Fee Pd. ��.
Date Scheduled Time
r' - tom^
3 L
`oil Suitability Assessment for
u�a�e D' sal
Performed By: Witnessed By:.
LOCATION & GENERAL INFORMATION
location Address .� Owner's Name "}(_p(��
Address
• i�� , �Q:t I Engineer's Name C
Assessor's Map/Pareel: _ -
s � j Telephone
NEW CONSTRU ON REPAIR — '
Land Use vi1 Slopes(%) Surface Stones
Distances from: Open Water Body ft Possible Wet Area
ft Drinking Water Well
., 'Q�'�I ft Other �` ft
Drainage Way fr. Property L'ne
SKETCH:(street name,dimensions of lot,exact locations of test holes&perc tests locate wetlands in proximity ro holes)
,6 Depth to Bedrock
Parent material(gedlog►c)
Weeping from Plt Face o
Depth to Groundwater. Standing Water in Hole: f
Estimated Seasonal i1jigh Groundwater
D&ERMINATION FOR SEASONAL HIGH WAT]C4R TABLE
t A .A In.
Method Used: �.�b—jo��ed
�`'�e.�hc� a �_iti, Depth to soil mettles;
Depth standing in obs.hole: la groundwater Adjustment
Depth tolweeping from side of obs.hole: Adj,factor r.r- AdJ,OWundwater
Index Well# Reading Date: index We I level -
TEST D
PERCOLATION ate
Observation Time fit 9" ----
Role# ► `
q " Time at 6" --
Depth of Perc .
I Titre (9"-6') �---- _
Start Pre-soak Time.(?
End Pre-soak x O:Q
Rate MinAnch
Site Suitability Asse�smet►t Site Passed
Site Failed Additional Testing Needed(YIN) '
• Original: Public He'�Ith Division Observation Hole Data To Be Completed on Back —;-
***If ercola'ion testis to be conducted within 100' of wetland,you must first notify the
P prior to beginning. -- -
Barnstable C6Iise 'ation Division at least one(1)week p .�
'DEEP OBSERVATION HOLE LOG Hole#J
Depth from Soil Horizon Soil Texture Soil Color Soil i Other E'
Surface(in.) (USDA) (Munsell) Mottling (Struc�re,Stones,Boulders.
on ten Gravel)
• `3� �� Ls � � s �cc�lc:
DEEP OBSERVATION HOLE LOG. Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) i (Munsell) Mottling (Structure,Stones,
;• O-3c� • �.� �-��. �ib•O5 i �3' A tes"S��ca.r-'tS
ea
r Boulders.lde .
nsisten el �DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) {USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistencv.
DEEP OBSERVATION MOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Coior Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consislgency,%Gravel)
cJ
Flood Insuranje Rate Map:
Above 500 year flood boundary No__ Yes _ -_---
Within 100 year boundary No-1/-' Yes
Within 100 year flood boundary No Yes
Depth of Nafidifl-V Occurring Pervious Material
Does at least fo4r feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed fbr the soil absorption system?
.�7-
If not,what is the depth of naturally occurring pervimerial?
Certification
I certify that on• (date)I have passed the soil evaluator examination approved by the
Department ofnv'nentatection and that the above analysis was performed by nle consistent withthe required tm ' gd x rience described in 310 CMR 15.017.
Signature Date I Off.
Q:1SEMC%PERCFORM.DOC
93• F $ � �
THE COMMONWEALTH OF MASSACHUSETTS
'i BOARD OF HEALTH
f..... - OF.... ..
(� Appliration for Diipnii.Fal Works Tomitrurtiun 1hrmit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: r
. •.oc ion- r or Lot ;Io.
.. .................... ................. .................. ...........................................
Own Address
A
Installer Address
Type of Building Size Lot--------.' °...Sq. feet
Dwelling—No: of Bedrooms._.__„-------------•_.................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building .............................No. of persons............................ Showers ( ) — Cafeteria ( )
WOther fixtures --- .................................................----------------------------••--------------...-------------------------
W Design Flow......._...��C!......:...............gallons per person per day. Total daily flow..................._`�.�,_.`?_.......-_.gallons.
WSeptic Tank—Liquid capacitylons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No..................... W th................ tal Length........... T 1 leaching area...................sq. ft.
Seepage Pit No..... 0r0 ............. . w _----(�-,---- --- 1 leaching area_-_-:�._Bg..sq. ft.
Other Distribution box ( ) Dosing tank ( ) a► `� �'//l- "/- 2 3. 7�•
a�Percolation Test Results Performed by....... ,Qti...—___..q_0. ............. Date...../-aJT:..7J:. .......
st Pit No. 1...
�A.....minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
fZ4 Te �No2 ----.minutes per inch Depth of Test Pit.................... Depth to ground water........................
ar !................... �. ..--
ADescription of Soil......... D -- •-- ; t -------•--•---•----
x
V ---------•-------- ------------------------------------------------------------
-...................................................................................................................
W
UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
• ••-••-•--•••••••-•--•-...-••-••------•.........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI'i U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Siga ......... • ....... .... ......................
D to
Application Approved By.........(/. �.�_ ''w^ L
Date
Application Disapproved for the following reasons---- --------------- -----------•------------------------------------------------......- • --•------•-•------
-•.......-•-••--•-•-•-•••-...•------••-•-•-•-•-••-----------••--•--•-•---••--•--•••-•.......................•••••-•--••----•---------------------------------------------------------------
• Date
Permit No......................................................... Issued--
Date
No..............f:.......... Fuu�.......................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....... �' '?w ....... OF...;05_A.°i•, w� ► ... ............
Appliratinn for Dispaoul Works Tonstrnrtion ranfit
Application is hereby made for a Permit to Construct 4') oRepair ( ) an Individual Sewage Disposal
Syst at t,
ocationf- d 9 or Lot o.
Ownr°� ` Address
Installer p^ ""•�° Address
Type of Building -^'/ Size Lot____ :. Sq. feet
Dwelling—No. of Bedrooms..... .................................Expansion Attic ( ) Garbage Grinder ( )
'4 Other—Type T e of Building ........_ No. of persons............................ Showers
G.1 YP g ---•--------------- P ( ) — Cafeteria ( )
Q' Other fixtures .. ~
W Design Flow.........sr�O......................gallons per person per day. Total daily flow.................... r'.. ...........gallons.
_.W Septic Tank—Liquid capacity/& lons Length................ Width-----........... Diameter................. Depth................
x Disposal Trench ,' No W th ,,,,-Total Length............
.. T 1 leaching area....................sq. ft.
Seepage Pit No, �` - '" `Do
���......... " low � al leaching area._.4 .sq. ft.
Z Other Distribution box ( ) Dosing tank
Percolation Test Results Performed by...... •--------' ......... Date.../ --�2_ '. ........
A
aTest Pit No. 1___ ---+�_-____minutes per inch Depth of Test Pit.................... Depth to ground water........................
f3 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water.........................
04 •r ....................................... e j jj
D Description of Soil " "' .P[df... .................
x
V _:......----•-----••--••-
W
U Nature of Repairs or Alterations—Answer when applicable.___....�':"'.................
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T ITIL4 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of-Compliance`has been issued by the board df health
�. ._.:..� -.r-• ���_ ......
-- ........
-•-•-- ------------Date---•--• -•-.- j
Application Approved By........ ...... .....
Date
Application Disapproved for the following reasons------------------------------------------•-------------•--------------------•-------------......--------•--•--
...........................•----•...----------•----•--------------•---•-•----•-•-------•--•--•------...•••-------------•--•-•-----•••----•--•--•----------•............................................................
Date
PermitNo.............................. ..................-•---- Issued.------------------------------t. ...................
Date
i
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OIF HEALTH
�.
.... . r ....OF..... . .....................
Tntifiratr laf Tantpliatta
THIS IS T.§) CERTIFY, That, -h nd v Sewage Dis osal Sys constructe or Repaired ( )
by........... . ....---• �1 .......: ....... ...................-- . ...............................
1 ✓ Installer00
"
at..- p r r- ----- --------- -----------yl: ------•--------- .... " '��......----•------------------------
has been installed in accorda with the,provisions of T 1 5 of The State Sanitary Code as described in the
application for Disposal Wo s Construction Permit No. �s.'.._--f.,�..................... dated_..._s�'--- -_ -.-.._._.•......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Ins pector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALT
..O F.. ..: :.:..:.... ,n/r�-...� £ .......................
No........ ..�P�� FE; .............
tops nrkii Tn, omit
Permission is e y granted.....f ..••--- --- •---1W.... - ...... ----- -- -- - ......... ....................
to Construct or Repair ( n Individual Sewa a isposal System,
at No..... •-- --•• s �—------------
as -
- - - - -- ---------
f
f'-
sh wn on the application for D3sp" sal corks Construction Per 't/"'
/.. ........ ... Dated.__ _. "_ ''_............
------•-------••--------•----
DATE. °?2 �� Board of Health '
- --- --•. .. .......
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
r ,
33cd 6-RZ2.
�F�f-lG T'A+—i►� = 3�0� Ir7U % L>�1�7 6.P.D. y�' ; '`
USG- 1 00C:3 E- A L-. I
s
` 1
SPoS ,L PtT - �sa loco (GAL-. ao
:,UGWAL►._ AV-rA. = lS0 S.1=.
i�� S►= ,c 2.S = 3 7S G.P.D. Z F
8oT-r0/A AeFA- rA ST-. c+c-
yam. So sPv
TOTAL �ESIG►J = d25
ToT4 L UA.t L-.-( FI..vW T 330 &F D.
PErlGDLQT10LJ . QATrr ` Iw SmIQ o1zA.".
i O ,
.� t
Jl-
S •7 � z 2
o ALAI
O
'tr C .� ( /'�' t 'N,r,�s- ..,r '!'•' 'I'�-. 1. •4 1.,_.•. -�: `"; �.� ' r t., t�s I n`i 1 ! -
. • ,T i.ti.. i Q r
Rfr(;}-fARUJo
A.
Arc BAXTER
�v No.2404£i TE`��i
bw G'/STE��p� ,_°
Tor 1=wo s goo e
4.
� .- •/ / \ ///\ / • //./\�� �. ... _ 4'r"Pa
/i
LOAM
Iw.
! 9.5, Tit11fK
do
GAS. + 9G 3 96'3P
3 , - LsAGN i t �.. r f i. 1 ; , r � x I_ ,,,
Meo PIT
SAND
WAIWED I t
} ' T 101-4 r
t -
PS,coo tJ -
GA �V t t„r�. E'
t o .
0..
1:
F
4aC.AL �Inl, G 1�AT1✓ ►�L3f�8 -
NO WATt= ez IZ//S/77 �
t. .1 GGtzTtt= TWA-r .T14E FaUNDATIotA 5t-law�J
WZ-A Lbt-1 Gc�titPL�{S• W 1't'{-Z 'C'4-1�: SiD�..l_{►-ate ` j , ! t F a ; I`;p Y I Q 4 i'' '
Aua
B NS 'TAN L-E
`i.A1J0 15Veva%?oV-,
='rlA 15 C7 t_Ah-1 1 S t.1OT LA�,CG7 ; U�-1 AeJ 1 05TE�LV1l..l.�
tt./ �:Jd✓IE�WZ" 'ljCl t��/C_y� ~ftaC-. UFc�:'S�C'�j. S11GSilLD QP '1::1 CA.
ru -1�r�'cekt►: 1r.::_i_.LO� i �W •�_ - __F� t C�PIE WIDE VrYEL ,
_.____.._— _.. r.r, 1 A t7r - - :ik+ �t�.^:?r i..T•fs-,�•�.�r�r�
Sv3�11Echttwus<exl=" '4� •4 '"'�'�� Map► Int
e}f � 'Cerfislr•ter•i ..-
� *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A --A -
Existing Foundation I se to tic tank (C/ . PROFILE YIEII OF ADDITION TO LEACHING SYSTEM
TOP OF FOUNDATION = ELEV. 100.00 (Assumed) vR1tan` eAHrin to GRADE w/56.e1 Cow-' '° " .`� ro4 ,
` a in. of thm Waft Orede aver Septk Talk-am Grade ever D-Bow-98.00 ever SAS-9e.00 3- of t/8" - 1/r Washed P ft We !e`u i=Orr�'"•`_`.'�
3 HOLE H-'Iq�
GIST FIO)� 3/4• to 1 1/2 Washed Crushed Stony 1 N:
S • 0.02 C PVC(CAPPM)NS OMM PORT 10 BE
'. 3' Lloekveen Corer Taq _Ekm , INSTALLED AND TO BE M119N 9.OF GRADE f ' , + r•' irf ? '�
n 12 EXIST. 5-001 or Peoter �•
oosT.P)P£ o n 1.000 GAL . S. MOI'psr Ibot • aP En ea..
FRrl1 EXIST. FOU7011T101 a, o SEPTIC TANK a aP� � �� � /� �• '
r a t r10
.
1 sore. ar n
in
CONCRETE FULL FOUN011 o A H-10 1 a, OAS (10 inches) 5 Units @ 6.25' = 30'
o 3' +moos►.u..es�.cCM�ooa NNllpisw ��t:IMC"
SYSTEM PROFILE a In of 3/4•-1 1/2• o o 31.25'
`°"'poctidstans - °� 37.25' GENERAL NOTES
Not to SoDb A ` o > i 3.5' 3.5' 1 Effective Lw gth
SOIL ABSORPTION SYSTEM (SAS) 1. Contractor is responsible for Digsafe notification, Verification of Utilities
6 hof 3/4'-1 1/2" c 10' -9 and protection of all underground utilities and pipes.
eal vaeted to ao Efre< s ' INFILTATR13R HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN 2. The septic"tank on j distrl ution box shall be set
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE m level on 6 of 3/4 -1 172 stone.
o (OR EQUIVALENT) Not to Scale 3. Backfill should be clean sand or gravel with no
i?T Bottom of Test Hole 2 Elev.- 86.0o NOTE: OVERALL HEIGHT OF INFILTRATOR IS IS- /EFFECTIVE HEIGHT IS 10' stones over 3" in size.
Ika.+ewoter observed -HONE oeSERVFD 4. This system is subject to inspection during installation
P E R C 0 LATI 0 N TESTP A by Carmen E. Shay - Environmental Services, Inc.
1 5. The contractor shall install this system in accordance
I I with Title V of the Massachusetts state code, the approved plan
Date of Percolation Test SEPTEMBERI3, 2006
and Local Regulations.
Test Performed By. CARMEN E. SHAY, R.S., C.S.E.
6
Results Witnessed By. DON DESMARAIS (BARNSTABLE BOH) . If, during installation the c encounters any
soil conditions or site conditionsitions that are different
EXCAVATOR: Shay Env. Svcs. ALL ounET 111110 FRw IM from those shown on the soil log or in our design
Percolation Rate: Less Than 2 MPI 0 36 asTRieunoN Box SHALL BE
SET IEVEL.FOR AT tEIIST 2 FT. Na��
'r co Corot installation must halt 5: immediate notification be
Test Hole Test Hole ' ` '' Kitchen Bath Bath Bedroom made to Carmen E. Shay - Environmental Services, Inc.
No. 1 No. 2 GARAGE Dining 7. No vehicle or heavy machinery shall drive over the
. s5• 1r NLET septic system unless noted as H-20 septic components.
DEPTH SOILS ELEV. DEPTH SOILS ELEV. le - OU ET
-
a•
0 98.00 0 9BLoO - 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
_ s 9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes.
Loom L� 15'• 4' - SCH. 40 T• ,7S- Living Room edroomFedr00rr10. All solid piping. tees do fittings shall be 4" diameter
10"t 3/2 101"t 3/2 PLAN SECTION CROSS-SECTION
7.25 0•-9' Ae 7.25 Schedule 40 NSF PVC pipes with water tight joints.
0•-g' As
11. Municipal Water is Connected to ALL OF The Residence and Abutting
�y Loom Properties Within 150 Feet.
3 HOLE H-10 DISTRIBUTION BOX 3 BR HOUSE FLOOR SCHEMATIC
to VR 5/16 10 VR 5A NOT TO SCALE
THE PROPERTY LINES ARE APPROXIMATE AND
r- 36, B, 95.00 9'- 36' Be 95.00
Meal COMPILED FROM THE SURVEY PLAN BY BOXIER do NYE, INC. E
NTITLED
Meal
Sand sand N/F TOWN OF BARNSTABLE C;o (h Cb CERTIFIED PLOT PLAN OF LOT 10 KING ARTHUR DRIVE, OSTERVILLE, MA
25 T 7/4 15 r 7/4 , DATED JULY APRIL 13, 1976
121 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
36'- 132 G 67.00 36'- 13 C, 87.00 100.00 ► IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
sit THE SEPTIC SYSTEM INSTALLATION.
LOOM
2.5 Y 7/15 ; I
32'- 144 C, 85.00 SHED t I EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE
t► NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
TEST HOLE2 t I FROM THE EXISTING LEACH PIT TO BE DISPOSED
9&-- ------ ELEV.= 98.00 t I OF AS PER BOARD OF HEALTH SPECIFICATIONS.
BO I `; THERE ARE NO !""ETLANDS ARE PRESENT WITHIN 200' OF. THE PROPERTY
Depth to Perms 40 to 58' I ► M
.- • • • • f i ► ASSESSORS MAP 145, PARCEL 041
PercGroundwater
Ratee 2 MPI .�'`• LEGEND
Groundwater Not Observed s- '=c�i.; .. ��� '
No Observed ESHWT � r.----- --, �'
TEST HOLE1
ADJUSTED H2O Elev. = None
ELEV.- 98.00 / Failed i I
LOT #f f --------'� Leach Pit f i `�` LOT 19 F104X11 DENOTES PROPOSED
2-18'DIML ACCESS MM00Es `v\` SPOT GRADE
x 104.46 DENOTES EXISTING
--- �-.,r-1_;�_.•., / 4�,/ � � SPOT GRADE
10PROJECT BENCH MARK ► I
TOP OF FOUNDATION j l000 gal. �� ; i PL PROPERTY LINE
ELEV. = 100.00 (Assumed) I Septic Tank ► /
96 PROPOSED CONTOUR
_- -" 1W ACCESSa+ FOR ►`.�` `�`1 ►� w -- ----97 EXISTING CONTOUR
MSMWM.__� -��a-r.r�!^:•r t+,--� SET DEEPER THAN E NCHES BELOW FMHM �� ----- - DECK t L
s -• '` ••, GRADE SHALL BE RAISED To WMW r of ----- _ ► L
STEEL REINFORCED PRECAST CONCRETE �"ED GRAM ��� t � ® DEEP TEST O T c LOCATION
PLAN VIEW NsrALL AW-mE GAS BAMM OR PERCOLATIONES
EWALS .l I
3-2r REMOVABLE COVE M RMS'TING i ► i . .
{ c BUsTrn► , s BEDROOM I 6 FOOT STOCKADE FENCE
_ _ •^ter. ..:-._ ''�._y � 4• - .t: Q GARAGE
min.
clearance '1T
N� B•min-T- 2'min plat to oeBet s• - OUTLET #74 / `\
7 w _ - I P LOT P LAN
Ea eve erM * ►*"depth [ �i�J / I /
f 's �-------------- / t
OF PROPOSED SEPTIC SYSTEM UPGRADE
II I v
.� ..�. -. • ...L :..�... .;- .�. -_...- / i I o ' : PREPARED FOR
,,
AMR. JACABUS ANTHONY
z •s-a- ` Q I 'i LOT #10 � �� / � j�
CROSS SECTION END-SECTION
I
a> 1 r5.000 Square rwt +/- ��' AT
TYPICAL 1000 GALLON SEPTIC TANK i i ___" #74 KING ARTH U R DRIVE
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NOT TO SCALE 98- "------ = %/ OSTERVI LLE, MA
100.00PL
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Design Calculations
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BottomPREPARED BY:
Number of Bedrooms 3 Bedroom EXISTING , / t ��----
Garage Grinder: Na ARMEN E. SHAY
Leaching Capacity Required: 330 Gd./Day (MIN. PER TITLE V) ------�--�� \�-----------!}��---I----------Septic Tank - 2 x 330 Gal./Day = 660 USE EXIST. 1.000 GAL Septic Tank. C+�SOIL ABSORPTION AREA: Using percolation rote of <2 min/InchRON111ENTAL SERVICES, INC Area: 0.74 gd/sq. ft. x 370 sq. ft. - 273. gallons KIN(T A R TH UR DRIVE .� P.O. BOX 627
Sidewall Area: 0.74 gal./sq. fL x 78 sq. ft. = 58 gallons F Is EAST FALMOUTH, MA 02536
Providing: = 331.80 gallons 0 20 40 50
ANI TAR�P 40 FOOT RIGHT OF WAY SN
( ) TEL/FAX 508-539-7966
Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH,
To BE USED WITH 3.5' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE CALE: 1"=20' DRAWN BY: CES DATE: SEPT. 14, 2006
ON THE ENDS. NO STONE UNDER. SCALE: 1"=20' PROJECT#SD965 FILENAME: SD965PP.DWG SHEET 1 OF 1