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HomeMy WebLinkAbout0622 MAIN STREET (OST.) - Health 622. Main Street (Ost.) Osterville x a A = 141 060 r 9 1 1 f Commonwealth of Massachusetts ���^ 0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ~. A. 622 Main St �.. Property Address fn Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 X. page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in"any way. Please see completeness checklist at the end of the form. A. General Information <57--e /o7&99 1. . Inspector: Shawn Mcelroy ` Name of Inspector Upper Cape Septic Service Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 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 maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ -Fails ❑ Needs Further Evalua ' y the,Local Approving,Authority 11-1-17 Ifispector'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 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. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 i Commonwealth-o"f Massachusetts :a=1 Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 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: System is in good working order with no sign of failure. 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts , Title 5 Official Inspection Form �, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) . ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms'are repaired: 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): "A e + I lta ❑ 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. 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.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 r T Commonwealth of Massachusetts a=1 f Title 5 Official Inspection Form li;�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � F 622 Main St Property Address Mike Curley Owner Owner's Name information is Osterville MA 02655 11-1-17 required for 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 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. 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 El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 f s Commonwealth of Massachusetts lay Title 5 Official Inspection Forts ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is Osteryille MA 02655 11-1-1.7 required for 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: El ® 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- 1 0,000g pd. ® 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 T , Commonwealth of Massachusetts Ral Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name informatifor every on is required Osteryille MA 02655 11-1-17 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: T r ® ❑ 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): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f _ Commonwealth of Massachusetts r. lay Title 5 Official, Inspection Form Ins . r•+ p -4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments + 622 Main St , Property Address - Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-1.7 page. City/Town State Zip Code Date of Inspection D. System Information , Description: Number of current residents: 0 Does residence have a garbage grinder?, ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) s ' Laundry system inspected? ❑ Yes ® No Seasonal use? , ❑ Yes ® No + Water meter readings, if available (last 2 years usage (gpd)): + Detail: Sump pump?. ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: - s 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? Y c. El 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts a=i Title 5 Official Inspection Form ' ' �I Subsurface Sewage Disposal System Form,-Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 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: N/A 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 f Commonwealth of Massachusetts , 1a=1 Title 5 Official Inspection Foftn� +�r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address , Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 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: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 11 , 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.): Good condition. Septic Tank(locate on site plan): Depth below grade: ; 12"feet Material of construction: _ ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years ` Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts ^r Title 5 Official inspection Form ;W-i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments hV CFI 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 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 20" Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle - 15" How were dimensions determined? - . r Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. 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.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts �al ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 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 attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Forrin . "A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is Osterville MA 02655 11-1-17 required for 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 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.): Good condition with water at working level and no sign of back-up from field. 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts :a=l Title 5 Official Inspection Form ."'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a� 622 Main St l J' Property Address Mike Curley Owner Owner's Name information is Osterville MA 02655 11-1-17 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3-500's ❑ 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.): Leach chambers in good condition and empty at inspection with stain line at 6"off bottom of chamber. 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts ^+ f Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osteryille MA 02655 11-1-17 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts ' � Title 5 Official Inspection Form • �I Subsurface Sewage Disposal System Form -Not for Voluntary i 9 p a Assessments Y rY 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA. 02655 11-1-1'7 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 JJ 13 . 33t Bi?� qy -3 51s,,, ' . . mat. 57 - - t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection For ' �� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a; 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope I ❑ Surface water R' ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: n • — Y You'must describe flow you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 f Commonwealth of Massachusetts I; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 622 Main St Property Address Mike Curley Owner Owner's Name information is required for every Osterville MA 02655 11-1-17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E 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 E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 1 Z No. ��. ✓ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes _�L PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppliLation for Mispo8al 6pstrm tonstrUrtion permit Application for a Permit to Construct( ) Repair(/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.4 ,.�.Z %", .S f p �-eV�`� wner's Name,Address,and Tel.No.�®.1 Assessor's Map/Parcel /l f l— 8(o D ✓ ,d Z Innstalk's Name,Address,and Tel.No i6-6f 4V 1'r'7 Designer's Name,Address,and Tel.No. D;6 .. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: i'le"I ,P? 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 an of to place the system in operation until a Certificate of Compliance has been issued by this Boar�He . /Signednn Date �%6 Application Approved by " m, t :�((PiL�.Z t�j Date -7 W Application Disapproved by Date for the following reasons Permit No. �.�G(y s Date Issued �O C) No. Z 11/ l 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ►.� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Misposai �&pstrm Construction Permit Application for a Permit to Construct( ) Repair((/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. -If Pf�-d V/`# wner's Name;Address,and Tel.No.XB,4,C/.f' Mfrs.v Assessor's Map/Parcel I y f — (o D ✓ 10�'2 Z /No, '" S't e0�fi�tf✓i// C Installer's Name Address,and Tel.No. 56g!- � SS�7 Designer's Name Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil �r Nature of Repairs or Alterations(Answer when applicable) 0., �4- Date last inspected: Z-{H y,h J✓ 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 of to place the system in operation until a Certificate of Compliance has been issued by this Board of He Signed Date ;;7— Application Approved by Qi(��7_`�_ f C.,S Date (D Application Disapproved by Date for the following reasons Permit No. I 0(19 Date Issued ­7 4 " (O ----------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ") Upgraded( ) Abandoned( )by )ilk t, >n v !;c"., C� 0,12s, at/, 2 Z d has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 7— Installer Designer #bedrooms Approved design flow gpd The issuance of this permit shall of bel construed as a guarantee that the system wiT Mu cti assdeess gt d. Date Inspector ' No. t — 7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS -Misposal *pstent onstrUctlou PPrutit Permission is hereby granted to Construct( ) Repair( &" Upgrade( ) Abandon( ) System located at ,0 2 L ' �h,l� 5 �" 1S S 4'-C� ✓ %/�� 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. Dater �' / rQ Approved by LS r AsBuilt Page 1 of 2 TOWN OF BARNSTABLE LOCATION l �Z /4 A IIV Sr SEWAGE# A DO.3 3 VILLAGE O .ST e k V i"I/-° ASSESSOR'S MAP&LOT �—U INSTALLER'S NAME&PHONE NO. f P A4 A C o Ni I31?R 7 S 0," SEPTIC TANK CAPACITY /,is 6 O U G Z7 LEACHING FACILITY: (type) 3— 124 IAJ P%/S (size)3 3 6.S r 1A.9'•Z NO.OF BEDROOMS y BUILDER OR OW72- PERMITDATE: 0 ? COMPLIANCE DATE: Z Q.S Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply WeU and Leaching Facility (If any weUs 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 —J h C3 :� yy � 330 0 v, O O ti http://issgl2/intranet/propdata/prebuilt.aspx?mappar=141060&seq=1 7/8/2016 f Boa 16106 P0186 0115758 12--18-2002 a iD 1 Z 47p TURN CLE K BARivS r�A E fA6,SS. Lt 207 11-W 20 AN li• 38 TA Nld Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal 2002-126-Harmon Section 3-1.1(3)(D)-Family Apartment Special Permit Summary: Granted with Conditions Petitioner: Ann N.Harmon Property Address: 622 Main Street,Osterville,MA Assessor's Map/Parcel: Map 141,Parcel 060 ++,t Zoning: Residential C&Groundwater Protection Overlay District 2 N Relief Requested: GC Q� In Appeal 2002-126 the applicant,Anna N.Harmon is seeking a family apartment special permit. The apartment unit is to be located in an existing detached accessory structure located on the property. The �b family apamnent unit is an efficiency unit of approximately 360 sq.ft.and is to be occupied by the applicant's daughter,Anne L.Jordan. The subject lot is 0.25-acres. The principal structure is a one-story,three-bedroom 1,464 sq.ft.single- family dwelling. That accessory structure is shown on a plan submitted with the application and is v identified as a 20.4 by 18.7-foot garage. The second floor was added to the garage in 2000. Building Permit No.47068 was issued to the applicant to"construct second floor to existing 20'x 18'garage to be used as potting shed&finished storage." d In addition,the accessory structure is located within the 10 foot required side yard setback for the `v Zoning District. The structure is non-conforming in that respect and can not satisfy the requirement for the location of apartment unit in conformance with Section 3-1.1(3)(D). The applicant has also requested a variance in appeal 2002-127 to provision`e'of that Section to allow the unit in the existing accessory structure. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the'Zoning Board of Appeals on October 8,2002. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened November 06,2002 at which time the Board granted a Special Permit for a family apartment subject to conditions. Board Members hearing this appeal were Gail Nightingale,Thomas A.DeRiemer,Jeremy Gilmore, Ron S.Jansson and Chairman Daniel M.Creedon. The applicant,Ms Anna N. Harmon represented herself before the Board. She explained that the apartment unit was to be located in the accessory structure that has been on the property dating back to the 1930's. She noted that it was expanded in 2000 to be used as a potting shed and workroom for her I r� pp y 7 iy y 1Co Vk 161�D►fa Pai8! Tii5IJV and her husband,however family difficulties have called her to assist her daughter at this time. She noted that she has read and would abide by all of the requirements for a family apartment and that the property would be the primary residences for both she and her daughter. She stated that most of the apartment was completed,however the kitchen was not equipped with a stove at this time. With the grant of this permit she would install the stove. Ms Harmon noted that she was aware that only three bedrooms are permitted on the property. She is willing to abide by that maximum limit. The Board asked the applicant if she understood all the requirements of Section 3-1.1(3)(D) of the Zoning Ordinance and that the kitchen would have to be removed if a family member no longer occupied the apartment.Ms Harmon indicated she understood all the requirements.of the family apartment section. Public comment was requested and Ms Harmon submitted a letter from Harvey(Harry)G.Williams an abutter favoring the grant of the family apartment. The Board noted there was one letter in objection to the grant of the permit from Pauline G.Larson. Findings of Fact: At the hearing of November 06,2002,the Board unanimously found the following findings of fact: 1. Appeal 2002-126 is that of Ann N.Harmon. She is seeking a Family Apartment Special Permit in accordance with Section 3-1.1(3)(D) of the Zoning Ordinance. The family apartment is to be located in an existing accessory building located on the property. The property is shown on Assessor's Map 141,Parcel 060,commonly addressed as 622 Main Street,Osterville,MA,in a Residential C Zoning District and within a Groundwater Protection Overlay District. 2. The family apartment unit is to be located in an existing accessory structure located on the property. The accessory structure dates to the 1930's and does not conform to the required side yard setbacks for the district. It is a pre-existing non-conforming building. 3. The family apartment is within an existing structure located on the property and it is under the 50% size limitation.Scaled plans of the proposed family apartment have been submitted to the file. 4. The family apartment is to be occupied by the applicant's daughter,Anne L.Jordan. 5. The applicant has testified before the Board that he understands all of the requirements and restrictions for a family apartment and that she will abide by all of those restrictions including removal of the apartment unit when it is vacated. 6. The application falls within a category specifically accepted in the ordinance for a grant of a Special Permit,and after evaluation of all the evidence presented,the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to the public good or to the neighborhood affected. Decision: Based on the findings of fact,a motion was duly made and seconded to grant the family apartment special permit subject to the following terms and conditions: 4 2 �7 Bk 16106 P9188 1157s8 1. The family apartment shall comply and be maintained in accordance with,all restrictions of Section 3-1.1(3)(D)of the Zoning Ordinance and shall be the primary year-round residence of the family members residing therein. 2. The family apartment shall be developed and maintained as per plans presented to the Board and contained within the files. 3. The unit shall not exceed 360 sq.ft.in area and shall not exceed one bedroom. 4. There shall be no more than three legal bedrooms located on the property. The applicant shall remove one of the existing bedrooms located on the property by the removal of all closet areas and doors to the bedroom. 5. The locus shall comply with all State Building Code,Town of Barnstable Board of Health and State Fire Prevention Regulations. 6. The creation of the units shall comply with Title V without variance from the Board of Health. The vote was as follows: AYE: Gail Nightingale,Thomas A.DeRiemer,Jeremy Gilmore,Ron S.Janson and Acting Chair, Daniel M.Creedon NAY: None Ordered: Family Apartment Special Permit 2002-126 is granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision,if any,shall be made pursuant to MGL Chapter 40A,Section 17,within twenty(20) days after the date of the filing of this decision. A copy of which must be filed in the office of the Town Clerk. Daniel M. Creedon,Chairman Date Signed I,Linda Hutchentider,Clerk of the Town of Barnstable,Barnstable County,Massachusetts',�e,je, y certify that twenty(20)days have elapsed since the Zoning Board of Appeals filed tle*sloa ud U no appeal of the decision has been filed in the office of the Town Clerk. W Signed and sealed this la ^ day f under the pains pp 'of Z penury. Linda Hutchenrider,Town Clerk BARNSTABLE COUNTY REGISTRY OF DEEDS h A TRUE COPY,ATTEST 3 JOHN F.MEADS REGISfiER i 2G?IV } - �� aAl A s \\� .rim �1 � � �� Y>• 1 .i �r i y E V - t 1 A4 S 'Y' Y'�L i,✓� �aM� � y�3�� J TOWN OF:BSTABLI" lI 1- 17 �,ptrp;'I'l0N -- A rc e,� v ;1_a___ � -sESS �s i►�a a a�ox INST7 ,. pQME NO S8FACTAN cAPAc�rx oR 0WN1� 1 EMIT1DA'1 -- $epsuaWon Iisea�Ga$etv�ee t��e Maxi numAd}ustGt�Gtaniecfwacet't bW9a tlaa.86ttom ofUAphingI kility ltv4�; 1al��c apply s cx4st a�seta a� uvlthln 7A(f feataf laacEurtg frtcit�tY) Eclgi�cyf ief�ans!au�d Leachtntt�s�cttry.{IE iny..wotland s ease E�ae 1Vft)11;13Q0 fC f 1C(to I is�t�G1�6[y} `,C qu .3 - [�3 a 33 x - O _ TOWN OF BARNSTABLE LOCATION �Z tit A I AI S SEWAGE # A O D 3 - -3/ �AjLLAGE O S-fE'K V - ASSESSOR'S MAP & LOT f—060 J INSTALLER'S NAME&PHONE No. ' / - y sal C O/tl 13 i� SEPTIC TANK CAPACITY A 4 6 D o L d LEACHING FACILITY: (type) t,tJ 4>115 (size) 3 3 9--*,7- NO.OF BEDROOMS y BUILDER:OR OWNS PERMITDATE: COMPLIANCE DATE: 2� 3 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 within300 feet of leaching facility) Feet Furnished by �t � O � yy UL Z9 44 Z2 No. ,, 3 —3 y ) Fee $5 0. 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: � Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for 33igpog r *pgtem Con!5truction Permit Application for a Permit to Construct( . )Repair( Upgrade( )Abandon( )XRXomplete System ❑Individual Components Location Address or Lot No. 622 1�a-i n S-t Z e e-t Owner's Name,Address and Tel.No.R O f p_2�t 77. H a it m O n ssess.z<e,z apVcel Nazz. 02655 Same or s arc Installer's Name,Address,and Tel.No. 5 0 8—7 7 5-3 3 3 8 Designer's Name,Address and Tel.No.5 0 8-2.7 3-0 3 7 7 a. P. Nacomee z & Son Inc. aC Cng.inee/z-ing Inc. 5 Round 11.iii BL B Box 66 Cen.tezv.ii e, Na.6.6. 02632 East 1daAeham, Na3,3. 02538 Type of Building: DwellingXX No.of Bedrooms 4 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 7 1 Q 0 rj m 14 Qa ad i oC i n,2 m$d bum 4 a rash Nature of Repairs or Alterations(Answer when applicable)Om T n A t rr O P i n 4 4 5 0 0 a n 0 0e)a teaching chamPLe2 Racked .in 4' o-/ 1!' z.tone. 33. 5 'XIL 2' Om.it.t.ing /a.ited ieach.ing ni.t. 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 Certifi- cate of Compliance has been iss ed by this o o ealth. wS ` Si ed Date 7124103 . Application Approved b Date 175 u �. Application Disapproved for the following reasons Permit No. C-).©0"� ' 3� l Date Issued No. J —'3 7 "s . '_' '`•. Fee $5 0. 00 1 ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _ . Yes - � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2ppftcation for Mt!6 f *patent Construction Permit Application or a Permit to Construct( . )Repair( Upgrade( )Abandon( )X(E%Complete System ❑Individual Components Location Address or Lot No. 622 Main S t 2 e e t Owner's Name,Address and Tel.No.Rog e a t 7. Ka z m o n t Ass10K�)441"P& 1, Nab4. 02655 Same Installer's Name,Address,and Tel.No. 5 0 8—7 7 5_3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8_2 7 3 3 0 3 7 7 I. /). Nacom&e.¢ & Son Inc. ;C Cng.i_neea.ing Inc. 5 Round Hi i BL D /Box 66 CenteAv•i-Ue, Na36. 02632 Cazt ldaaeham, (7a•S•s. 02538 Type of Building: DwellingXX No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date t Title Size of Septic Tank Type of S.A.S. Description of Soil ;r Pe O M a M Ig 6nYrl f A ,P n Q m,2 d)�i m A re n d, r Nature of Repairs or Alterations(Answer when applicable)Om-I UP4.1.i_n;e 4—5 00 aa.P_.Pon Peach.ino cham.ke2 12acked .in 4' o,e 11'_,` hs _one. 90. 5'X13'X2' Om.it.t.ing -�a.i.eed teaching 1211. ` 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 Certifi- cate of Compliance has been iss ed by this -oard o ealth. r Sig eti d /.� .1 �//� Date 7�24/03 Application Approved b� ` Date5A, 3 Application Disapproved for the following reasons ILI v 0C,0 Permit No." ��c c,-3-- 3 14 Date Issued —7 -D`J G 3 THE,COMMONWEALTH OF MASSACHUSETTS T BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )RepairedXXX)Upgraded( ) Abandoned( )by I. /P• Naeomgea 9 Son Inc. at Pln.,i.n o has been constructed n ac 'rdance with the provisions of Title 5 and the for Disposal System Construction Permit No. WO 3` 31-8 dated -7 Installer 7. 2, Marnm0,ea R San Tnr. Designer ,JC Ent7_inee/t_ingj The issuance of t''s pef t shall not be construed as a guarantee that the system wil �' `�' � si f/OLO/d.� Date 2 �7 63 Inspector 1 ,. No. Doc --� ( ------ -----------------Fee $ 50. OG THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS igo�aY 4-onotruction Permit Permission is hereby granted to Construct( )Repair( Upgrade f X/yAbandon( ) System located at 622 Na-in S.t2eet 0.6.tenv.il ee. Naa.a. 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:Cons ction must be completed within three years of the date-at flu e it. Date: �a 5 ��3 Approved by TOWN OF BARNSTABLE LOCATION 'Z A 1 SEWAGE# OO ,i- 3 e// VILLAGE © S e 9 V ZZI-e ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY 6 0 C> J 0 LEACHING FACILITY: (type) (size) 3 3ds` NO.OF BEDROOMS y BUILDER OR OWNS 1W PERMIT DATE: Q COMPLIANCE DATE: 2 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by I i I C h �—Ilk, Jo \ 4r o � No. 003 Fee$50. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered'in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3pplication for Mtgogal 6petem Construction Permit Application for a Permit to Construct( )Repair)tX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.1 41 —6 0 Owner's Name,Address and Tel.No.Robert F. Harmon 622 Main Street�Osterville,Mass. 622 Main Street Assessor's Map/Parcel t e r v i 11 e,Mass. 0 2 6 5 5 Installer's Name,Address,and Tel.No. 5 0 8—7/- 3$ Desig isName,Address and Tel.No.5 0 8—2 7 3—0 3 7 7 J.P.Macomber & Son inc. JC,.� gineering,Inc. 5 Roundhill BLV Box 66 Centerville,Mass2 East Wareham,Mass. 02538 Type of Building: DwellingXXXNo.of Bedroom 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Buildi No.of Person Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calcula ed daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic TankEx stin 1 000 ,Ty e of S.A.S.Existing 1 —LP-1 000 Description of Soil Nature of Repairs or Alter tions(Answer when applicable) Omitting leaching i t. I n s t a l l i n 3-500 allon leac in ,:chambers in serie . 33. 5 'X12' 9"X2' 457 gallons .per day'.' Date last inspected- Agreement: The undersigned agrees to ensure the construction and maintenan e of the afore described on-site sewage disposal system in accordance with the provisi Title 5 of the En ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by ' Bo d e t . Signed Date 5 12 10 3 Application Approved by — Date Application Disapproved r the following reasons NNI Permit No. 20 0 — "'�;ca­ Date Issued - ————— --- — ---- ------------- TNW TH OF MASSACHUSETTS BLE, ASSACHUSETTS !IS icate of ompliance THIS IS TO CER that ewage Disposa System Constructed( )Repaired]tXX)Upgraded( ) Abandoned( )byM. at has been constructed in accordance with the provisions of Title 5 and the fostem Constructio Permit No. P003—19i dated .Y Installer D gnerJ.C. Engineering, Inc. The issuance of this permit shall not bs a g antee that the system will function as designed. Date Inspector rdtrr No. C�00 . 4,. ` fl f Fee$50.[�0 i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-TOWN OFBARNSTABLE, MASSACHUSETTS ZIppricatton for 30igossal 6p tem Conotru'ction Permit y` Application for a Permit to.Construct( )RepairjX)Upgrade( p)Abandon( ) ❑Complete System ❑Individual Components t' Location Address or Lot No.1 41—6 0 Owner's Name,Address and Tel.No.Robert F. Harmon 622 Main, Street�Osterville,Mass. 622 Main Street Assessor'sMap/Parcel terville,Mass.02655 e ' Installer's Name,Address,and Tel.No. 5 0 8-7 7 5- 38 7D 'gn is Name,Address and Tel.No. 5 0$-2 7 3-0 3 7 7 ,,. - " .Macomber & Sonzinc:, , gineerin*,Inc. 5 Roundhill 3LV, t, Bo6'.Centervi11e,Mass 02632 Fast Wareham,Mass.02538 '. Type of Building: DwellingXXXNo.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Buildin No.jof Persons Showers( ) Cafeteria( ) l Other Fixtures i Design Flow gallons per day. Calcula ed daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank sting 1000 Tyoe of S.A.S.FxiSting 1-LP-1000 Description of Soil ``"`. ., Nature of Repairs or Alter tions(Answer when applicable) Omitting leaeliing pit.Insta 'ling 3-500 gallon leaking chambers in series. .,5X,12' 9' 457 gallons per dal: r Date last inspected- T Agreement: The undersigned agrees to ensure the construction and maintenan a of the afore described on-site sewage disposal system in accordance with the provisio Title 5 of&thneEnronmental Code nd not to place the system in operation until a Certifi- gate of Compliance has been issue by la's Be t . Signed Date 5/2/0 3 .''•. Application Approved by v �� �. M1 '+ t Date Application Disapproved or the following reasons a r Permit No. )003-10 Date Issued U THE COMMONWE LTH OF MASSACHUSETTS BARNSTABLE, I ASSACHUSETTS CertificateFo" ompliance THIS IS TO CET } I .�,that the On-site Sewage Disposal ystem Constructed( ��)Repau'ed�K�Upgraded Abandoned( )by, it ��, �[�omber & Son Tnc "�`` at 622 Ma A 19treet Os erville,Mass. 'd has beenxednstructed in accordance witlte 'rovisions of Title',and the for 's�posal System Constructio Permit No. 9Oi-2"/ ated nstaller 4 P M mber Sont'�,uC D gnerJ.Cg` Fngineering,In ./P` e_sstzance of this permtt�slall;not be construed as a guarantee that the system will funct on ash esigned!`� ""`" Date Inspector Y ,.� C _ ——————---————————--- —-------------- t�. 'C No. �tQ�3-���i Fee 50.00, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mwigpogal *pgtem Conztruction Permit Permission is hereby granted to Construct.( )Repair(XX1 Upgr de( )Abandon( ) Systemlocatedat 6Z2 Main S-trdet Osterville,Mass. 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:Construction must be completed within three years of the date of tl�s_ errrit]/�,j Date:- �- 1) 1 Approved by r- 1114Q S, w LD trrty., T Lo CD LTI 01) C` -J tD m TITS COMMONWEALTH OF MASSACHUSET A S Ln -a co DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. D O as satisfied the Depanment's qualifications as required an is hereby s authorized to use the title Q0 CERTIFLED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 2IA of the General Laws. Issued by The Department of Enviromnental Protection_ ]unr 8, 1945 M Acting Director o10"On(f Water PoI7ufian Control C" I r. b S77 hbWer, 1 SIQ Sink` Bat' --�-�° P t, H N is T s < S � s ' "}'' 'x> s 7 y,'s9t t u2F3 i ' r. .r ; N,� m rx' r s ,"� t1. r 1 i 03/22/1994 19: 07 508-790-1570 T.P.MACOMBER & SON PAGE 03 PRDDUCT 100 ( Ta Reorder 1A*V64 o,.WWW.r'W3.= STATEMENT JOSEPH P. MACOMBER & SON, INC. 508-428-620.3 Tanks - Cesspools - Leachflelds FAX-508-428-2649 Pumped & Installed 5/2S/O2 Town Sewer Connections DATE P.O. Box 66 Centerville, MA 02632.0066 775.3338 775-6412 Anne Harmon .......................... . ............_ .. ....,....... .... .................... 622 Main Street .........,.........Os t er.111e, Mass .02655 Cash upon comPletion . 1 � interest TEr+us every 30 days . PLEASE DETACH AND RETURN WITH YOJR REMITTANCE DA7>< '. INVOICE NUMBER!OE3cAiP n0N — CNJI��ARQ�B i cgEDIYs' BALANCE BALANCE FORWARD address how the system w ' I1 tt ;A .......... R.'Z_r.. ..o.x.m.....1..n.. ...t..h.e.......f..u:.t..u.x..e �, under the same �r ____�. �: .......:..:... ...........d. .f....f e.r. n.t_...c..�n..d..i.a..,. ..ns.......Q..f............................._ use . __ . —_ $ 150. a 0 _............... 0 : 150. r_ . ....... ... ............ ......................... _....... ............... ................ ....... _... ............................ .. ...... .... ................. ........................ JOSEPH P. MACOMBER & SON, INC. .huh RAY LASY AMOUNT r IN 7H:6'0QLJMN 03/22/1994 19:07 508-790-1578 J.P.MACOMBEP CON PAGE 02 PRODUCT® �ToReoldK t-89P?Zb-11=orwww.nos,wn � I STATEMENT 508-428-6203 JOSEPH P. MACOMBER & SON, INC. Fax-426-2649 Tanks - Compools - Leachfieids Pumped & Installed 5/2 5/0 2 Town own Sewer Connections DATE P.O. Box 66 Centerville, MA 02632.0066 775.3338 775-64 Y 2 Anne Harmon ....................................................,..,.... .............._...........,...,.....................................:................................... .... 622 Main Street Osterville,Mass . 02655 Cash upon completiot . li% interest TEAMS: every 30 days . VLE.A3E DETACH ANO AZTVRN WITH YOUR REMI"AAC;E - $ DATE I INVOICE NUMBER/DESCRIPTION _ CHARGES ._ - .. .�CR6®IT$ � BALANCE ^' OALANCE FORWARD 5/25!02 Septic, system evaluatio W.._...._...._..... ... This is a title f ve septic system ( 78 God ) i The septic system is in proper -working order - �..-----...... at the preseht time. The system consists of .. ..... 1-10 $allon septic tank. 1. -.�..W_ L . 1-1000 gallon precast ....... leachin zt h. rite w a..te.r...... ts. X1.0 below the invertip.e...................:. A11, Sch . 40.....4�.I.......P.VC.;;'pzpe & fittings throe&h 'out .. .. ,.. ... the system. .._..._....._.. This evaluation only .......... ................ describ es . ... onditx6bns at the tim.e...._o._f viewing: l... ...... . . ...... ......... and under the condition .................._._.................,.........__. ...._. ........ ...... of use at this tirnP_, JOSEPH P. MA�COMBER aT SON, INC. IN T��-� = Hty�oVNT (41t. StL iN F1�S cv�Urnw M � r C,p / ,0 kal co c i 1. Sower stalWTI l , Barth ass I ; l i S• L t 1 ... y! b µ {y f ' Closets/Stora ge �� 3 � � � ; . ., _ x ._.-. , i Town of Barnstable Health Inspector CF'THE T Office Hours ti Y Re ulatorServices - o g 8:00 9:30 Thomas F.Geiler,Director 1:00—2:00 BARNSPABLE, Only 9�A MASS. ,.� Public Health Division rEn��A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 2 2 fy-V 1 N 5 0- +- Map _Parcel 0&�} Name: r n Phone: ry 0,45 L-f Zg (o zz 2a. How many bedrooms exist at your property now? 2b. How many bedrooms total are proposed at this property(including the amnesty unit)? Cce 2c. Please include a copy of the floor plans for the entire property. veS 3. Is the dwelling connected to public sewer? YES or O j If the dwelling is connected to public sewer, skip questions 4- elow. 4. Location of dwelling is INSIDE or OUTSID a Zone of Contribution to public supply wells? S. Is the dwelling connected to an ONSITE WELL or to UBLIC WATER. 6. Is a disposal works construction permit on file? YES or NO 6a.If yes, how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property. Signed: Date: Inspector(Print): Q;/health/wpfi l es/amnestyapp t Town of Barnstable Health Inspector Office Hours o Regulatory Services 8:00—9:30 Thomas F.Geiler,Director 1:00—2:00 « Only Y 1639' Public Health Division . ♦0 orEpr�,Ip Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: (Q 2-2- �l tc�, St; , @S t�2.J 11k e Map(Parcel �4e 0 Name: "--A n vie.. N. Phone: 5 �5 — ` 243 — Le Z L93 2a. How many bedrooms exist at your property now? 2b. How many bedrooms total are proposed at this property I ing the amnesty unit)? 5+x4LD 2c. Please include a copy of the floor plans for the entire property. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer, skip uestions 4-9 below. 4. Location of dwelling is INSIDE o OUTSIDE a Zone of Contribution to public supply wells? :WATER�? 5. Is the dwelling connected to an ONSITE WELL or to :NO LIC 6. Is a disposal works construction permit on file? YES or 6a.If yes,how many bedrooms were approved according to this permit? j Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division?rfEES or NO 9. s the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY p,�W The Public Health Divi 'on has no oble tion to _bedrooms at this pro e rty. I�J S s � ,/,, Signed: Date: Inspector(Print): ("Leg`y �1 �2 . Q;Aealth/wpfiles/amnestyapp 1 R (40 TOP OF FOUNDATION = 106.75' 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS= 96.50'-97.05' GENERAL NOTES REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OVER D-BOX= 98.5' 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. FINISH GRADE @FND. EL.= 105.0 FINISH GRADE OVER TANK EL.= 100.0 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 20"MIN.ACCESS COVER TOP OF SAS= 94.08' PLACE RISERS ON ALL CHAMBERS 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL (TYPICAL FOR 3) 36"MAX. , 9"MIN. TO 6" OF FINISHED GRADE BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. EXISTING 4 f 93.25 36 MAX. BREAKOUT EL = 93.75' PIPE 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN I ELEVATION = 93.75' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS 6" 3„ 2" DROP MIN. 3 g„ PROVIDE WATERTIGHT A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 3' DROP MAX. JOINTS (TYP.) 00000 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. o 4" PVC IN FROM O oo O o 0 5. SLOPE ALL SOLID PIPE AT 1.0 % MINIMUM. " 97.60 SEPTIC TANK 4" PVC OUT TO o 0 0 0 0 97.85 T 14 r LEACHING FACILITY 000 00 0 o0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. f o 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN OUTLET TEE 96.75' MIN. 96.58' 2' 0 0 0 0� 0 0 = o� SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO CONTRACTOR TO VERIFY SIZE 48 0 0 o BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. GAS BAFFLE o `� o 0 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.00' MSL OBTAINED 29.1" OF TANK AND CONDITION OF o 6" CRUSHED STONE © o 0 EXISTING TEES OVER MECHANICALLY �0 4 Q - FROM A NAIL IN A TREE AS SHOWN ON PLAN. COMPACTED BASE 8.5' - I 4.0' 4.0' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 4_9 THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE 5 OUTLET DISTRIBUTION BOX 33.5 (TYP.) AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV= C 86.10' 12.9' DISCREPANCIES TO THE DESIGN ENGINEER. EXISTING 1000 GALLON CONCRETE SEPTIC TANK BASE. FIRST TWO FEET OF OUTLET 91 .25 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE - LENGTH 8'6" WIDTH 4'10" DEPTH 57' PIPES TO BE LAID LEVEL. 500 GAL CHAMBERS 5,MIN. STRUCTURES SHALL BE MADE WATERTIGHT. CROSS SECTION VIEW CHAMBER END VIEW 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR TYPICAL CHAMBER PROEM- ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH SEPTIC TANK PROFILE DISTRIBUTION BOX DETAILNOT TO SCALE NOT TO SCALE CHAMBER DETAILS DETERMINATION FROM APPROPRIATE AUTHORITY. NOT TO SCALE ~--rv ---- - �- �-- ---~ - 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE TEST PIT DATA THEY SHALL WITHSTAND H-20 LOADING. 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND MAP 141 f 3I€ AGENT: FINES. EXISTING LEACHING PIT zk �ya Q 1 � � '� � s�� �� "\,"�^ ,fi ,'"°,� ��,�� EVALUATOR: Samuel Philos Jensen 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND j T3 BE PUMPED AND FILLED PARCEL 58 b UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF WITH CLEAN SAND ; 'fL April 30;2003 LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN O , DATE: p COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN U TEST PIT#: 1 � ACCORDANCE WITH 310 CMR 15.255(3). EXISTING 1000-GAL �,, ELEV TOP= 100.75' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN SEPTIC TANK -,' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. I ELEV WATER= 1' BGS I. ; E ., 16. PROPOSED PROJECT IS LOCATED WITHIN: } f fir. s 7 ,rr PERC RATE _ <2 MIN/IN ASSESSORS MAP 141 PARCEL 60 � .< ,- !�f GARAGE �g v _' N72o17 "., � ✓ mr.;., r ^. '.. §� .,,,,� � � ; DEPTH OF PERC= 54 -72 17. OWNER OF RECORD: ANNE N. HARMON ! OS„� V z .,_ :.- ADDRESS: 622 MAIN STREET _ �.., T.O.F. = 103.00 tp9 �, O1�; *. TEXTURAL CLASS: 1 C T/ . ,.. SI } J /p � `f < /C r /, t OSTERVILLE, MA 02655 ..,.�' ✓'� -,. '" t � �( m 'S�, 5 � kK� ��'� ��p "+"�„`'i �'�w�`.`� i •'i�mr £, i _�1'��, fi+,�t°t�„�,: 1 d..... v' ,aflau ° try fi? r a i, _ ` n P 0 100.75 18. FEMA FLOOD ZONE C >:�'°. 3 ,4 NR �: +#' "" i� { n v. �.,+.� ^ x"}r�'>F'n ,,'".: �, k .s'� �w, co l I ti, R 4 k AS SHOWN ON COMMUNITY PANEL# 250001 0016 D � P} Fill PLAN REFERENCE: t'�`a� '\nf i z li _ # , .:.rt ,, `4,, �'`...$p I ,�, ; ,s i`4 ,,i,'� 19. _,. fi $ 4 ;" , °,, 1. PLAN ENTITLED" PLAN OF LAND IN BARNSTABLE OSTERVILLE MASS. FOR RICHARD L. & ` }• : I M"v""e '° a»'„" ' ; 14\\N- .'"'^+w" e�: 'Efi +r .._.�� ,. `�"" •ek i r fib'$:;4u ra,i 7 i.. MAP 141 � w, y4�h 17" 99.33' JOYCE A. JANDLE " DATED FEBRUARY 17, 1983 AND SCALED AT 40 FEET TO AN INCH. 1 !r/ 0 LP } "�� �'�. �,,e,�`°� .��, � � ; �R � .. a� �,� ,� � � ������x+�,���: BOOK 371 PAGE 49. " �, .i �* Mg, ��. a "w a „ PARCEL 60 , k ; t 2. PLAN ENTITLED PLAN OF LAND-OSTERVILLE-BARNSTABLE, MASS. DATED JUNE 1946 .. ` Div mro,.r .. j B Loamy Sand ��' � b,' 10YR 5/8 AND SCALED AT 20 FEET TO AN INCH. BOOK 75 PAGE 29. t �^ DECK AREA= 10,890 ± S.F. : ,,. ,,,.�..: :. .. , 3. PLAN ENTITLED TOWN OF BARNSTABLE PLAN OF A PORTION OF OLD MILL ROAD, ^,,��,jj' "' r r s ''= " * ,,yf{ ' ° may, ` ''Sy`, • '" 54" 96.25' OSTERVILLE " DATED FEBRUARY 27, 1950 AND SCALED AT 40 FEET TO AN INCH. JJ 0 d+°• e 1'K^£ i,¢•.i *tif :'.`'' vAir � � r ti + , °" Perc 4. PLAN ENTITLED"COMMONWEALTH OF MASSACHUSETTS PLAN OF ROAD IN THE TOWN � OF BARNSTABLE BARNSTABLE COUNTY DISCONTINUED AS STATE HIGHWAY BY THE 72" �` F-M Sand 94.75' :.•:'• I t ' :,. 1= .. � T OF PUBLIC WORKS DATE ANUARY 1 931 D AT 40 FEET C-1 DEPARTMEN D J 3, 1 AND SCALE EE /�.^w�j mh` {.. TO AN INCH. �...f _ .r- „ ty may. ;�,<41 .. ram:.: a"^. , v. r3 x •'.•.• • • ••. • Till-, .. .. bm'. 3'+,t w^•'',....w^^reyr,ww� :*9 �3 a 3A` ...-- f 3 �'� .:: dtk ;. �s".t^e ..,.E :": l.. ,15. �'� : ':k.•�".,3 St•....z 1.4 I ., •. -. ., r r „ 3'` ^.,,. .,„„.T,„, "'.. is a.;a, t<.: ' afk , '" .m a .. EED BOOK 7535 PAGES 77 ! `g ,. .,. .,• .-,•• � ,. -..,� , ,..,•' R � �„n + , n��'` ate°, t - +. ' .. �� ... ' 20. -..m„} � yy.. j J UO I , rr"'° P � � �"�. y�•• � l pp:� �j ` C ':<FI���"�f����'��� 21. ALL DISTURBED AR EAS SMALL BE RESTORED TO ORIGINAL CONDITION. 1 - C Medium 2 5Y 6/4 d 22 PRO E INFORMATION IS ONLY APPROXIMATE T PLAN IS TO B ED ONLY i 2 San ., ,,, N { PROPERTY LINE HI.� E �1S P w i FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY SHED } f - .? ' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. f r :r LOCUS PLAN F�° ,I, #622 SCALE: 1' = 1000' Q, ^ , , s 132" 89.75' F { 100.75 EXISTING 3-BEDROOM DWELLING �'� � TES DATA LEGEND T T T.O.F. = 106.75' y�y PROPOSED 3-500 GALLON ' AGENT: €� EXISTING CONTOUR ,° `wS ..r NUMBER OF BEDROOMS (ASSESSORS) 3 LEACHING CHAMBERS •��;''° _-�� 620 ; EVALUATOR: Samuel Philos Jensen } S3 ARBUK I NUMBER OF BEDROOMS (DESIGN) 4 50 PROPOSED SPOT GRADES � 32" � - DATE: April 30,2003 PROPOSED � � 0" F f z' DISTRIBUTION BOX 4 �^ , MAP 141 DESIGN FLOW 110 GAUDAY/BEDROOM TEST PIT#: 2 E PROPOSED CONTOUR o � , 1, TOTAL DESIGN FLOW 440 GAUDAY •i:tX ELEV TOP= 97.10 e �c - - lr�r. ,- EXISTING OVERHEAD UTILITIES cn PARCEL 61 t w o I DESIGN FLOW X 200 % = 880 GAUDAY ELEV WATER= > 1 V BGS B.M. PROPOSED 90 LONG ' _ USE EXISTING 1000-GALLON SEPTIC TANK -•.•...' -------•`,� ...... EXISTING WATERLINE Nail in Tree Elev. = 10Q.0' SWEEP WITH CLEANOUT PERC RATE _ Assumed TOG DE ` �'S INSTALL 3 - 500 GALLON CHAMBERS DEPTH OF PERC= -- �s---- 4s- - As--- EXISTING GAS LINE EXISTING RETAINING .X WALL ''a TEXTURAL CLASS: 1 TEST PIT LOCATION SIDEWALL CAPACITY 0 97.10' (�} y { PROPOSED 1500 GALLON SEPTIC TANK MAP 141 `� X' (LENGTH +WIDTH) (2) (2' HIGH) (.74 GPD/S.F.) = GAUDAY Fill _ �� �_- 4"SOLID SCHEDULE 40 PVC PIPE PARCEL 59 (33.5' + 12.9') (2) (2') (.74 GPD/S.F.) = 137.3 GAUDAY � ��,,.< � I� DISTRIBUTION BOX "`" 22" 95.27' BOTTOM CAPACITY 500 GAL. LEACHING CHAMBER Loam Sand (LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY B Y 10YR 5/$ \jam (33.5'x 12.9') (.74 GPD/S.F.) = 319.8 GAUDAY i 42" 93.60' TOTALS: REV. DATE BY APP'D. DESCRIPTION PROPOSED SEPTIC SYSTEM UPGRADE TOTAL NUMBER OF CHAMBERS: 3 PREPARED FOR: M-C Sand TOTAL LEACHING AREA: 617.7 SQ.FT. C-1 2.5Y 5/6 � v1J MR. & MRS. ROBERT F. HARMON TOTAL LEACHING CAPACITY: 457.1 GALJDAY 10-20% Gravel •... ,.., k LOCATED AT 622 MAIN STREET If SB (FND) OSTERVILLE, MA 02655 DRIVEWAY I 132" 86.10' ' I RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 10 FT. DATE: MAY 1, 2003 NB1°46 50 t�+ 0 5 10 20 40 FEET 65.50' STe. .._ I ��° C JOHN L. cyw PREPARED BY: t FAIN _Et1GE OF PAVENI HURCHILL �+ PUBLIC) JR, JC ENGINEERING, INC. ckvrL (4Q'W1oE No. tB07 5 ROUNDHILL BLVD. EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"= 10' Drawn By: DFS Designed By: DFS Checked By: JLC JOB No.411 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS= 96.50'-97.05' L NOTES TOP OF FOUNDATION = 106.75' REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM 1, UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OVER D-BCX= 98.5' 4" SCHEDULE40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE FINISH GRADE @ FND. EL.= 105.0' 100.01 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. FINISH GRADE OVER TANK EL.= 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 20"MIN.ACCESS COVER TOP OF SAS= 94.08' PLACE RISERS ON ALL CHAMBERS 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL (TYPICAL FOR 3) 36"MAX. 9"MIN. TO 6 OF FINISHED GRADE BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. EXISTING 4 - 93.251 36"MAX, BREAKOUT EL = 93.75' 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN PIPS, _ � ELEVATION = 93.75' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS J�J 6„ 3„ 2" DROP MIN. PROVIDE WATERTIGHT A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 3" DROP MAX. 3" 9„ JOINTS (TYP.) 0000 oQ000 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. o 4" PVC IN FROM O 0 �,� 0 0 0 o a 5. SLOPE ALL SOLID PIPE AT 1.0 % MINIMUM. 14" �97.60 SEPTIC TANK 4" PVC OUT TO o ooa ao 000 97.85 LEACHING FACILITY o00 o 0 6, THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. �, 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN OUTLET TEE 96.75' MIN. 96.58' © 0 � 0 0 0 � 0 0 0 � 0 � � � � � Il. 2 0 0 o SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO 00 00 � BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. CONTRACTOR TO VERIFY SIZE 48 o0 0 o0 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.00'MSL OBTAINED 29.1' OF TANK AND CONDITION OF GAS BAFFLE 6" CRUSHED STONE o0 � 4ar OVER MECHANICALLY - FROM A NAIL IN A TREE AS SHOWN ON PLAN. EXISTING TEES COMPACTED BASE 4A _ 4 0 4.0. 4.0' 9• CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 8.5' 4•9 THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE 5 OUTLET DISTRIBUTION BOX 33.5 (TYP.) AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY TO BE INSTALLED ON A LEVEL STABLE , GROUND WATER ELEV= c 86.10' 12.9' DISCREPANCIES TO THE DESIGN ENGINEER. BASE. FIRST TWO FEET OF OUTLET 91 .25 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE EXISTING 1000 GALLON CONCRETE SEPTIC TANK A PIPES TO BE LAID LEVEL. 3 - 500 GAL CHAMBERS 5'MIN. STRUCTURES SHALL BE MADE WATERTIGHT. LENGTH 8'6" WIDTH 411011 DEPTH _� CROSS SECTION VIEW CHAMBER END VIEW 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR SEPTICPROFILEDISTRIBUTION DETAIL TYPICAL CHAM ER PROFLE DETAILS CHAMBER ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. NOT TO SCALE NOT TO SCALE NOT TO SCALE 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS u N LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE TEST T T THEY SHALL WITHSTAND H-20 LOADING. �rA gin y y@ 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT DUST AND �4 P f � 4�":n ,µH ,,�t{t 1� it"^F w� l A+'a^ �°3r �p IYIY NMI � MAP 141 L� IL � , FINES. AGENT: CONTRACTOR SHALL REMOVE ALL LOAM SUBSOIL AND EXISTING LEACHING PIT '.. , fi .,: � �"� ., �;� ,�, � � ; , ' � �> � � *:: 14. . WHERE REQUIRED, C�BE PUMPED AND FILLED PARCEL 58 < EVALUATOR: Samuel Phllos Jensen T UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF WITH CLEAN SAND � �, z ,�, ,�� � t �� ��`� � �� � , .�: �:�;� r«�� � DATE: April 30 2003 LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN � � ���� COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN TEST PIT#: 1 •.;.� ACCORDANCE WITH 310 CMR 15.255(3). V Jm u" EXISTING 1000-GAL ;` a ELEV TOP= 100.75 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN Q N ,.ED SEPTIC TANK _ SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. 16. PROPOSED PROJECT IS LOCATED WITHIN: V WATER- > 11' BGS PERC RATE _ <2 MIN/IN ASSESSORS MAP 141 PARCEL 60 GARAGE ' ,__ j m f , r DEPTH OF PERC= 54"-72" 17. OWNER OF RECORD: ANNE N. HARMON d 7' rr /?�" y„�! 0 6d _ z ( f ADDRESS: 622 MAIN STREET T.O.F. = 103.00' 70 9 S W �. , O p, w 11. �„ TEXTURAL CLASS: 1 x r .... w R _. _� t l I .1 T/ 7s 1 ,�'. -� i< :,` " � �� �w OSTERVILLE, / " MA 02655 (tea Pry 7 J t f. Rr m l , aT A 'k& e„ i 64 I ;, � ) `* tEt 3. 0 100.75' 18. FEMA FLOOD ZONE C k1 o� O d e" 'i qR +' ' '' .ls�s:o-.: h al fW „„ n � "� �,9r^ r ° �'yM `� � .�., rry ry !' an{a? AS SHOW O _. FIII „ N N COMMUNITY PANEL# 250001 0016 D `� " �,,,- 19. PLAN REFERENCE: �;,. ,� �.;,�� 1. PLAN ENTITLED PLAN OF LAND IN BARNSTABLE (OSTERVILLE) MASS. FOR RICHARD L. & F MAP 141 i �,�,�" �, ;b �. � �' � � � u i JOYCE A. JANDLE " DATED FEBRUARY 17, 1983 AND SCALED AT 40 FEET TO AN INCH. �. � � , w BOOK 371 PAGE 49. s a „ PARCEL 60 Loam Sand 2. PLAN ENTITLED " PLAN OF LAND-OSTERVILLE-BARNSTABLE, MASS. DATED JUNE 1946 'w. r` f .,.r`• 0 I '- , aa. E 3h�'y� :.,i sx{ .: I i nil `1� , ` a;' ;t�' s ; ..,,», „v F DECK = ±S.F. �� ., .,, B 10YR 5/8 AND SCALED AT 20 FEET T(�AN INCH. BOOK 75 PAGE 29. •« AREA 10,890 �p 2 3. D"TOWN OF BARNSTABLE PLAN OF A PORTION OF OLD MILL ROAD, ? „ E y PLAN ENTITLED ,f .• .• rW. [ 4. ' , 54" w 96.25' OSTERVILLE" DATED FEBRUARY 27, 1950 AND SCALED AT-40 FEET TO AN INCH. mr,. '• I�LQ.�` 0� � ;�,�" ir^,x zy�:, ` 'w '� ^yy'. �r �� , • >v „+�M g,; ' �' ,�=i 4 ;.: �;� ;_ �� " „ „� ? 4. PLAN ENTITLED" COMMONWEALTH ONWEALTH OF MASSACHUSETTS PLAN OF ROAD IN THE TOWN C a 97.10 ;r ( o�S '"" �- °. � ,: " / `� Perc t: M • �j - �� � � � ,�.,: .��� ,;>�,� �,;,;. _��., � ;, ��, �;� � ,� ,� .",;�� � .�, 72" 94.75' OF•BARNSTABLE , BARNSTABLE COUNTY DISCONTINUED AS STATE HIGHWAY BY THE :y..�`-` - «' >= I= i ' r . . : _' F-M Sand DEPARTMENT OF PUBLIC WORKS " DATED JANUARY 13 1:31 AND SCALED AT 40 FEET •, _._, _._. �,. � w 5Y 5/6 O AN INCH.Wa '0 � "'' 90" 93.25' 20 DEED REFERENCE: .,. ,.`! ,, - i 14 €� n � 1. BOOK 7535 PAGES 77 21 A E RESTORED TO ORIGINAL CONDITION. ALL DISTURBED AREAS SHALL B � ! ,�� �•. �''•C' �, � � �� a �� ,, ' �4 . �, t� `"; �,.; �, a C-2 Medium Sand l 2.5Y 6/4 22. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 29.1' �i N FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY SHED ~ .. FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. ,:. �°C _ r LOCUS PLAN E r l r w #622 SCALE: 1" 1000' 132" 89.75' e - ,� � i.. I "ate,� s 100.75 EXISTING 3-BEDROOM DWELLING I DESIGN T TEST l F' T.O.F. = 106.75' t g� j AGENT: 0 EXISTING CONTOUR PROPOSED 3-500 GALLON �`� 'f ' NUMBER OF BEDROOMS (ASSESSORS) 3 LEACHING CHAMBERS �` ` -� ` Ss?� _ EVALUATOR: Samuel Philos Jensen s3 ARBUK NUMBER OF BEDROOMS (DESIGN) 4 50 PROPOSED SPOT GRADES 32 - DATE: April 30,'2003 PROPOSED ' Q9� F f c Z ' DESIGN FLOW 110 GAUDAY/BEDROOM DISTRIBUTION BOX ` MAP 141 TEST PIT#: 2 r v0� PROPOSED CONTOUR o TOTAL DESIGN FLOW 440 GAUDAY � °' ELEV TOP= 97.10' EXISTING OVERHEAD UTILITIES i w a PARCEL 61 DESIGN FLOW X 200 % = 880 GAUDAY --r«r -..•.__ r, ......,w.. - 1 V BGS r _..•.- EXISTING WATERLINE B.M. PROPOSED 90° LONG � _ � � � USE EXISTING 1000-GALLON SEPTIC TANK ELEV WATER- > k Nail in Tree ;. � Elev. = 100.0' SWEEP WITH CLEANOUT PERC RATE TO GRADE ti-, --GAS -- - GAS (;AS --- EXISTING GAS LINE Assumed p, 1 INSTALL 3 - 500 GALLON CHAMBERS DEPTH OF PERC= EXISTING RETAINING WALL i TEXTURAL CLASS: 1 TEST PIT LOCATION �} { SIDEWALL CAPACITY 0 97.10' ( { { PROPOSED 1500 GALLON SEPTIC TANK MAP 141 `' X. (LENGTH + WIDTH) (2) (2' HIGH) (.74 GPD/S.F.) = GAUDAY Fill; _ 4" SOLID SCHEDULE 40 PVC PIPE PARCEL 59 (33.5' + 12.9') (2) (2') (.74 GPD/S.F.) = 137.3 GAUDAY DISTRIBUTION BOX 22" 95.27' M.. I BOTTOM CAPACITY 500 GAL. LEACHING CHAMBER • N ,. ,"i" (LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY B Loamy Sand t $ - 10Y R 5/8 y - 33.5'x 12.9 .74 GPD/S.F. 319.8 GAUDAY `� 42" 93.60, �`h � �:�' TOTALS: REV. DATE By APP'D. DESCRIPTION PROPOSED SEPTIC SYSTEM UPGRADE +i f ti,�- TOTAL NUMBER OF CHAMBERS: 3 PREPARED FOR: M-C Sand h >' TOTAL LEACHING AREA: 617.7 SQ.FT. C-1 2.5Y 5/6 MR. & MRS. ROBERT F. HARMON >,..�° TOTAL LEACHING CAPACITY: 457.1 GALJDAY ° - - - - ^„°�"�°� t 10-20/o Gravel LOCATED AT 622 MAIN STREET OSTERVILLE, MA 02655 PAVED SB (FND) RIVE"O ,"Y' I => - 132" 86.10' SCALE: 1 INCH = 10 FT. DATE: MAY 1, 2003 1°46'50"' I RESERVED FOR BOARD OF HEALTH USE N8 - g 0 5 10 20 40 FEET E LEE �4' ---- JOHN L. PREPARED BY: / MAIN STR -'"" `". _ � } CAI PAVI MENT v CHURCHILL E � CIVIL JC ENGINEERING, INC. No. 41807 5 ROUNDHILL BLVD. EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"= 10' Drawn By: DFS Designed By: DFS Checked By: JLC JOB No.411