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HomeMy WebLinkAbout0201 OYSTER WAY - Health 201 Oyster Way Osterville A — 071 '011004 , o 0 a • " ., Commonwealth of Massachusetts ' DO 10014 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ; u 201 Oyster Way Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every Osteryille Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information c filling out forms on the computer, use only the tab Michael Sears key to move your Name of Inspector cursor-do not Robert B Our Co INC. use the return Company Name key. 363 Whites path Company Address South Yarmouth Ma. 02664 City/Town State Zip Code 508-477-8877 S114430 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes o'F'nua�,,��� 2. ❑ Conditionally Passes _�.• •°y o: MICHAEL ',m �: SEARS -�_ 3. ❑ Needs Further Evaluation by the Local Approving Authority =o. * No.SI14430 4. ❑ Fails 7-16-20 Inspector's ' nature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form lip Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c / 201 Oyster Way u Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osteryille Ma. 02655 7-16-20 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 3.10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system., upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 cam, Commonwealth of Massachusetts �v Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Oyster Way V Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. Cityfrown State Zip Code _ Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): . ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced, ❑ Y ❑ N FIND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form h i; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments l; 201 Oyster Way Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4 System Failure Criteria Applicable to All Systems: ) pp Y Y You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 L Commonwealth of Massachusetts �v ,p Title 5 Official Inspection Form <�15 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Vic !% 201 Oyster Way L Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No El 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 L Commonwealth of Massachusetts v _ ,p Title 5 Official Inspection Form 1, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments + � 201 Oyster Way u— Property Address Ray&Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts �n ,� Title 5 Official Inspection Form til Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Oyster Way Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection D. System Information 1. 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 Description: t Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No 2018-57000 gal Water meter readings, if available (last 2 years usage (gpd)): 2019-59000 gal Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NA Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form r �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 201 Oyster Way Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osterville Ma: 02655 7-16-20, page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): _ 3. Pumping Records: Source of information: 2017 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 9 p Y rY !% 201 Oyster Way u— Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a'copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2002-064 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 30" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments.(on condition of joints, venting, evidence of leakage, etc.): i l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 201 Oyster Way Property Address Ray & Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.). 6. Septic Tank(locate on site plan): 20" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 gal If tank is metal, list age: Years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal 4 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 24" 2" Scum thickness 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 12 How were dimensions determined? Sludge gudge, 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.): 1500 gal tank with in and out tees, inlet cover at 8" outlet cover at 18" below grade t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form l Disposal System Form - Not for Voluntary I Subsurface Sewage sp y Assessments !% 201 Oyster Way V� Property Address Ray &Carolyn Moran Owner Owner's Name information is Osterville Ma. 02655 7-16-20 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle � I Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.)'. 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments .............. 201 Oyster Way u Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every OStervllle Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D box is 16x16 with 2 outlet pipes cover at 2" below grade t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I cam, Commonwealth of Massachusetts Title 5 Official Inspection Form III Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Oyster Way Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 12'x45' ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments i � 201 Oyster Way u� Property Address Ray &Carolyn Moran Owner Owner's Name information is Osterville Ma.' 02655 7-16-20 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): SAS is chambers 12'x45' no sign of failure 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments ( signs note condition of soil si of hydraulic failure, level of ponding, condition of vegetation, Y etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `............« � 201 Oyster Way Property Address Ray&Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts ��-- : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments L, 201 Oyster Way Property Address Ray &Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. Cityffown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately �woin� b E O oy ,q a _ � - A9 3 _ N*7 3_ q5�6 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 201 Oyster Way Property Address Ray &Carolyn Moran Owner Owner's Name information is Osterville Ma. 02655 7-16-20 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high round water: 120" p g g 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: 12-21-98 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: 120" no ground water Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 II cam, Commonwealth of Massachusetts p Title 5 Official Inspection Form <I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ��� 201 Oyster Way u— Property Address Ray&Carolyn Moran Owner Owner's Name information is required for every Osterville Ma. 02655 7-16-20 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached I For 15: Explanation of estimated depth to high groundwater included r rw� sAs 55 Eao , 'N o to 91 r t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 � Fee-- ---=------------- No.VV)VJ ' �D� BOARD OF HEALTH ATOWN �O OF BARNSTABLE 0% application ArIvell construction-Permit 10 1 Ap�Cat' n is ereb made for a permit to Construct (i- , Alter ( ), or Repair ( )an individual Well at: — — — — TXS' Assessors Ma and Parcel a Location — Address P Cw O ner a Address --------------- - ------- ----- - Installer — Driller Address Type of Building . / Dwelling--v---- -- -- — --------- — Other - Type of Building ----------- - No. of Persons--------------------- Capacity--- -------------- -- -------- � — ---- , Type of Well—� � =s�� Purpose of Well---- 2a"`^ — Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Wel Pro cti n Regulation — The undersigned further agrees not to place the well in operation until a Pate . ce has been issued by the Board of Health. Signed ---------— — - date Application Approved By ———------ —— -date ------ Application Disapproved for the following reasons:-------- — -—----- ------- date Permit No. — Issued--- -�� ---- ---- to BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by-------------------— --------- ---- - -- - - -- - --—--- -------- Installer at- ------ — ---------- -- - -- -- -- --- ---has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------------Dated--------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- --_ ---— -— —-- Inspector-- - —-----------------------——-----— - __ o ) Fee— ---=------------ BOARD OF HEALTH i TOWN OF BARNSTABLE AppiicationArlVell Conotruct ion Permit Applicat' n is hereb made for a permit to Construct (4<Alter ( ), or Repair ( )an individual Well at: Location —Address Assessors Map and Parcel 1 e5(J 2$ 41- f Owner Address — t -------------- Installer — Driller / Address --- Type of Building i Dwelling --- -- --—-- — Other - Type of Building No. of Persons------------------------ Type of Well f — -------- Capacity-----/-- ----� Purpose of Well---- ?� �"'==---__ I j Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation —. The undersigned further agrees not to place the well in operation until a Ce ti%cate o p1i ce has been issued by the Board of Health. Signed — ---- — ---- date i Application Approved By — ----- ----—— - - F date Application Disapproved for the following reasons:--------— - ------—-- -- —--- ------- — ---- — - ----— ---- date r007Permit No. Wk(!41- — Issued-- - ----- — — - d to l _ ' BOARD OF HEALTH 'f TOWN OF BARNSTABLE Certificate Of Compriance f —THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) E ---------—-— ----- -- ------------ - — -- ----- -- j by______ Installer at—-— ------------- -- — -- --- ------ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection i - Regulation as described in the application for Well Construction Permit No. ---------------Dated---- -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------- —-- —-- Inspector-- - — - — -- -------=—-- BOARD OF HEALTH i TOWN OF BARNSTABLE Ivell Con5tructionPermit No. ;7�9 !7 Fee--� --- Permission is hereby granted _.�'_L- ___ ---- ----------- — b to Construct �ter ( ), or pair ( ) an Individ, �11 at: VA:_46 1 StreW 1 as shown on the application for a Well Construction Permit i, ) — -- ---- ---------------- - lk No. _-_�—z � �—t�` — —----- Dated.` Board of Health DATE REFERENCES: LC Plan Y 5354—t 31 Asscssors Map: 71 .rann a vsmmrd Parcel, 11-4 C�+f, of ima 6T8C8 I ZONE:RF--1 lAwd Cater 9mmd — [ftodi y Setbacks: u "ISISr F Front: 30' ....... ............... ....... ...... Side: 15' 3 tea' Rear: 15' Lot 223 � w 1 "C rdew Foundation m , as ro A s� - 5�4• . ". ( veto..............: SauAd . i 26' $'47"E e { dqa utd N� dram R. °teens jana t�R. lhs4sC► 1 certify that the foundation nog shown hereon conforz►s to the setback requirements o' the PLOT PLAN Rt aARp Zoning Bylaws of the town Lam �' of Rarnstable. Ma. IN FROM SESUIT LANDSCAPES FAX NO. 3052717 May. 05 2004 00:27AM P1 *m tee•^"J9.5' -t1� ` , 1 55,4' SBtk��••�r'vy1pP4. •CnnC, ktowrd p�ildR•'�.... (Found �w 1%0•?6 i Cane. found N IF ttholys (found) Wlltiom 0, he 6 i Janat R 15142r Cart, of TYw certify that thefoundation - v►vf+a�y shown hereon conforms to the PLOT PLAN setback requirements of the RTM _7oning .Bylaws of the town IN + LHEURFEUXrs4 of Bornstabie, Ma- B „ RNS' ' AUL (oyster Harbors) y and Surveyor Da e AA y�41 �j SCALE: j� rOf8S8 �ry��: 812,4102 /6.KY�G ��+=�K�s -NOTES: 0 20 40 60 round ao ;�-�r i. The foundation shown was located ouleh24g 2002. FOR, by conventional survey methods PREPARED informatior shown hereon wasnd �g 2 Southeast nd�r 2.) the property �egUesta, Rorkwa compiled from eSertavail AM aaneact afdon fthe ground survey - does not rep GapeSur%, lon is not for retarding ond is not PREPARED BY. .} This p 7 Parker Roar, to be used for construction layout or deed description purposes, psterville MA 0265E C372-1G1.dwg FEW. 13Y: WHK/MDN ( Ott) 420-3994 / 42�-�3995fax i FROM SESUIT LANDSCAPES FAX NO. 3852717 Maw. 05 2004 07:57AM P! rOWN UI i3A1�h1>'1'�1S3L1_. j� ASSESSOR'S MAY& VILLA(�E_�2��at' •. _ � ,7v'S1'AL,I,ER'S NAME&PHONE NO- �'��(.s��` !f}vr9 �� �✓ r- Yd'-Ctil—� SEPTIC Tr•.Nlc cAPAexrr ,(i.p�b (1�i9n/ ,� _(size} LEACl�1G FACaITY: (type)_ NO.OF BEDROOMS BUIi.DEp,OR OWN'FR /ha 64 PER1%4JTDATE; COMPLIANCE DATE: Separation Distance Between.O)e' Feet 1vlaximwn Adjusted GfO-indwatu Table and BOHOri+of Leaching l=actlity -- privatc Wale.*supply Well and Leaching Facility (If any wells exist Feat on sate or wit-hin 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist _ Feet within 3w feet of Icaching facility) Fw ished by - 41 2. a 4 ,my ti r.o TOWN OF BARNSTABLE C LOCATION ZO/ Q y idelO Iae - 1 SEWAGE # A002 -Gb y VILLAGE �} �S7V -//A ASSESSOR'S MAP & LOT 071-rl' y INSTALLER'S NAME&PHONE NO. LAW&J�� �Ti9 fM .S -', t J�=SYe� D 9I/ SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �� �� � ��tis (size) NO.OF BEDROOMS BUILDER OR OWNER IN PERMITDATE: U2 COMPLIANCE DATE: �� 2 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by y rh Sep. 1. I pp t. Z, 29 � ..sir 5 r'E.r�=.�r ��,..s3' 'ti::' :';. f §'�•'c.'tq+'t x'..'£' ..y} :�". ':*�vrtT'W;3'� �b+�nd��' :�iS ���-�'. .am .:•:':`'�- ''s`.0 �f ��Y aaro" A F _ S, 1 - /•VIN _2 6 1 , 4;1�f w CrA u a r S_ SCT� d�J Gh Army=✓S r'. 3 76 r s$� 5��` .F OF tg - 2 � I ��✓j c.F' �rI� t r No. �� ` • Fee F THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yd' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS Application for �Digoml *pztem Construction Vermtt Application for a Permit to Construct Q()Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2.0 1 O V 51�R WA,1 Owner's Name,Address and Tel.No. 05tz5RVILLE/ /71,955 P-MMOND K MORi=W Assessor's Map/Parcel 19 O 2 b`soz/tNt= S 1 V 1 L LASE 1!'CL L= 14 7/ //—Ii/ rj QUL=-srp , Fz- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.50 _ y 3 a Lie{ GAR Y -rA v+4kES SUGL I I/!a/✓ �AlG!NG�21 NG I NG. 7 PAR-K R 1ZP f� V/LLF ASS Type of Building: Dwelling No.of Bedrooms Ll t Size L sq- t. Garbage Grinder(IVCa Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date 65-6. I cl , Zoa 2. Number of sheets I Revision Date Title P20Pcy5i=D SITE PLAN 4- SEPT/c 5Y5Y"6M Size of Septic Tank 1500 Type of S.A.S. 12X 4S LG-4c14. ifAA If3E2 Description of Soil ���0 it J 0 P/NG 11/65 D4,-- 5 /3F 0AIZE2 ; 0!= 6 A 1vI 10YR S�H ; �' 3S" L3 MAD. SA/V7� to Yi2 T�; 35 " I2o" C /VIED S,0/yp /o Y 2 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore descri - ' sewage disposal system 01 in accordance with the provisions of Title 5 of the Environmental C of to plac a system in operatio until a Certifi- cate of Compliance has been iss oard of Signe Date Application Approved by ® Date Application Disapproved for the following reaso s Permit No. 4 Date Issued A t` /b" �..: •,At v �' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yei . �. PUBLIC HEALTH DIVISION ;.TOWN OF BARNSTABLE., MASSACHUSETTS ,I' 2pprication—for-Migpogar 6pgtem-ton,5truction Permit Application for a Permit to Construct(;X5 Repair( )Upgrade( )Abandon( ) Complete System O Individual Components Location Address or Lot No. 2.0 1 O 1/5_t 4t 2 WADI Owner's Name,Address and Tel.No. osf�Q 1ILLt, /r1/91:55 ia,A�lMOA-1n K MaRf4w 51 Assessor's Map/Parcel c" 19 D 2 5- So a ,W 7/Z P //-N e�__�- -^ GNU t3S Tf7 , F4- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 50 3 3 4 R( G/1RY T11VAPti5 �5ul.LiI//-4N ING, 7 FARKt=R R-P �" i Type of Building: ' Dwelling No.of Bedrooms .41 J�Size /'sL sfl--f Garbage Grinder((V(a+ t Other Type of Building No.of Persons Showers( ) Cafeteria( ) _ Other Fixtures , Design Flow 5D gallons per day. Calculated daily flow 56 8 gallons. r Plan Date FEB. 1 9 d 2-00 Z Number of sheets l Revision Date Title PROf>05ED S 1 T& FLAN 4- SE(�T/G�> 5y5*E%✓1 �\ Size of Septic Tank /5©U GpLGowS. Type of S.A.SI 12�X 4 S'��/�GIU C'tipi4�13E2 Description of Soil a O��i O�.PI NG IVI L-'DLE s 14e.AF 17E2�; O'- 5-' A M E D. SR/yo -to yR 4 y ; 811- 38" 2 P162 S/2/VE3 'loYlZ &S E_F_- O 11o" C A16-D sA/vb 1 o y 2 Nature of Repairs or Alterations(Answer when applicable) t Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore describ site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code- of to place a sys�operatio .urifil a Certifi- cate of Compliance has been issue b _ oard of - Signe c7 Date Application Approved by _ �.I.c__.- O `' Date Application Disapproved for the following reaso On Permit No. rn - Date Issued ———— ————— ——————---- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( x)Repaired( )Upgraded(i ) Abandoned( )by P- at 2a 1 o Ys7E(L WO O--1EP_V/1 L L A 5 s has be ` construct d in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No & dated Installer Designer.SDI L I t/F?N E/1/Y/ EE 21!V G I NL The issuance o this permit shall not be construed as a guarantee that the s s m wi function as designed. Date 1 Inspector J --------- I ---- --- No. .o - _. Fee— -% THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogal *pMem Congtruction Permit Permission is hereby granted to Construct(x)Repair( )Upgrade( )Abandon( ) System located at 2-0 1 O Y-S TE R WAY 0_57ER-Vt L_,L&, 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. t Provided: Constifucti n must be completed within three years of the date of this permit., Date: Approved by W . A p TOWN OF BARNSTABLE LOCATION ZO/ QVideO •t r4 k SEWAGE # . 200)-Gb y VILLAGE ASSESSOR'S MAP & LOT 071-)1' y INSTALLER'S NAME&PHONE NO.J�i�Nf�s� �Au�t�cS c- =S ��p9// SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �� e� � '�/�"S (size) I Z X 4S NO. OF BEDROOMS BUILDER OR OWNER6 PERMIT DATE:-�i COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by El r G r °�1 10%%11 Ul 1 ,11SWUle t• + },1 Department of Health,Safety,and Environmental Services 1Z S Public Health Division gate d �.S1 367 Main Street,Hyannis MA 02601 ' co .aansr I ! pAvK . . Fee Pd. l� reso a Date Scheduled"�E Z1> Time 1 .: � _ � :;. R •,. . - Dis oral.... soil Suitability Assessment for Sewage p Svt.VwA►� �N�.f,rN-- 1 4 Witnessed By: Performed By: . LOCATION& GENEKAL'I1,41rVR me L.A.G Location Address 't p 1 0%t'5 TC Q.. �'�'� f.10 ArrTOrL Y L4�+ LoT 223 O YyTES�k*c*oK.S Address r ^%ov'6-r 06ro 41.6 s d Engineer's Norm 24 miz.S Assessor'sMap/Parcel: •1, -- � •11— ��{ �� Telephone N 'gZ�.3'34 dj NEW CONSTRUCTION . REPAIR Land Use Q ra!4%D�s't1'�a t.i Slopes(%) � Surhoe Stones � ----r R Possible Wet Area ""'' itDrinking Watu Well Distances Isom: Open Water Body R Drainage Way It Property Line 1 O , II other SKETCH:(Street name,dimensions of lot,exact locations of test holes dt Pere tests.locate wetlands In proximity to hold) oN e►s•�o'as•E i - rk� 70.&V --1.ou�s e?k % P99.02 ss o� oAw Gay o % ! rs p� )� wetir.4 Ca QM J70.26 �eu ?89.P9 i r I it 4 11 1V bk-r%t1Nb. e6 r vA) Depth to Bedrock 60 Parent material(geologic) M,p �p Face Depth to Groundwater. Standing Water in Hole: Weeping(torn Pit * N 6 v P i Estimated Seasonal High Groundwater L lti5`� DETENIMINATION FOR 5EASONA GAt AUR Method Used: In. Depth to loll monies: In. Depth Observed standing a obs.hole: ._�..Q�.�—.—.—in Groundwater Adjustment n Depth to weeping from side of obs.hole: i Ad factor_=Adj.tfundwatef Level Index Well q__'::!,_ -Reading Dale:—= Index Well level j• ZSt'oA.c.r.,0V16 11,, 1 asrrPEhCOLATIOPV•' EST�> Observation 1Tme st 9" — Depth of Pere 5��l cc.,��,,�� Time( V�l4Z t,,� 9", Start Pre-soak Time Q _.�_ .. End Pre-soak Rate MlnAnch Site Suitability Assessment: Site Passed E7 Site Failed: Additional Testing Needed(Y/N) - Original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant DEEP OBSI�VA'IXOIYXO ,E o1e Depth from Soil Horizon Sod Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. �J1 . D O 1tN P MA $(� S A/b 1 C`E1Ls �� M cCT RrDOTS )2o sr9-a )C'>4 �tN16L.t:. Gft.A�w ti,ly uU A,* , DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soli Texture Soil Color Sod Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulderes. --y 0 . 9 Q "'►� IDYe5 w►mo Coe" P toy2 5/4- iy C�Rr►v . ..12Z C. s�s� )DY2(o 0 St�iQal,ti �o¢��au i10 p CrV OurJ • C�,It�vCw t CEP 4 S RVA� ` ON R.L Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. OBSERVATION HOLE LOG . Hole Depth from Soil Horizon Soil Texture Soil Color Soil Mottling (Structurree,Stones,Boulderes. Surface(in.) (USDA) (Munsell) Flood Insurance Rate hl Above 500 year flood boundary No Yes Within 500 year boundary No-. Yes Within 100 year flood boundary No,L Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi us material exist in all areas observed throughout the area proposed for the soil absorption system? 1cS If not,what is the depth of naturally occurring pervious material? —� Certification it evaluator examination approved by the I certify that on Qt721 C. S (date)I have passed the so P Depa rtment of Environme ntal Protection and that the above analysis was performed by me consistent with the required trai °ng,expertise and expe °e cc described in 310 CMR 15.017. Signature O Date ' l VWJ 'O • - - ! � � .e _ � �� as 1 � a 71 x0 . z �„�•B'eff ff• - j 77\ -- — i Far .11�• - -- — --ED -- �. 0K — • � -.-gas Orel._ • COMM.NO. i, DATE DRAWN BY TT F M.rwp. 11rfi: Gn11Ab cy /,%%// SHEEP NO. • Iry . ►-i It r -------- - -------- ---- --� I =w =m Ix v ca ElE i n - i I _::klru+eal 1 fYiLJOD 4KV- ------------ I N flil — — 1 L lip I� I • I I II II . • I I I+ II s I i I I I i _ _� - � • � I I - ir I I I I I II I I II II .�i I II II L 4 I cr —err UX I � I!- I---• -m - I�v Q I I- --- - - -- --- - -- -- ---- -� I % I " COMM.NO. 285b DATE DRAWN BY T to SHEET NO. I. �J 1 4 1 y F r--I a� I _... �a Eli '0 1-u o, VL COMM.NO. 'LaSB DATE DRAWN BY SHEET NO. s t -. I3Rst s LOCUS PLAN i - EG.23.5 t _11 1 a Fabne C•aW4d Fill FG.23.0 a n o „o , p Scale I =2000 • N IDE A& yst6r ;, Assessors Map71 Poo S; 21.5 20.5 osz, r '�� o 'N Parcel 11 -4 ;, — ; • a-` teaching 150C Gallon Top El.21.5 LOCUS Zoning RF-I N 21.3 Septic Tank 21.1 ` • Chamber 3/4•—I I/2"Doubb • Setbacks: Front 30 Washed =l: Bot.El.18.5 • Side 15' 2o.s 20.E _xr 6.2' Rear 15 Ir-o• Bedding as Tee or Boffle Bot.TesttHole EL 12.3 Ground Water OverlayAP CROSS SECTION OF CHAMBER Per Title 5 NOT TO SCALE N o Groumd Water -.._. DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM o I ._ _oa _ N/F a a Not to Scale .� John D. Osmond t Cert. of Title 67606 a 1 o Tree Line',, o � � Chain lank Fence o 3 '2 3 — N 88'1 558 E 178.29' w �, Land Court Bound Shrubs V shrub ..22 I � .(found) � ,I � � �/ Q 1 Cedar Tees �t ka Cb 00 ,,/// Z. Utility Pole r— e Conc. Bound .,� (found) .o _ (MIN) _. .-. ._.___ _..-.. p _gox 4 NOTES . SPACE O 11. VVinter Supply For This Lot is Municipal Water. '2.1-cDcation of Utilities Shown on This Plan Are Approx. Ar Least 72 Hours Prior to Any Excavation For This ZEsgt't)� O Pttaject The Contractor Shall Make The Regwired rANK C3 _23 Nwtification to DIG SAFE-1-888-344-7233. - `'' ' 3.Tine Contractor is Required to Secure Appropriate Permits From Town Agencies For Construction Defined by This Plan. 4Inetall Risers as Required to Within 12"of Finished Gsnade. 1 ' S.A11I Structures Buried Four Feet(4) or More or Surlibject to Vehicular tobe H-20 Loading. +� t S.Segptic System to be Installed in Accordance With CL 311D CMR 15.00 Latest Revision And The Town of o ryry - Stsrnstable Board of Health Regulations. P\-rs FoR I Ali]Piping Lobe Sch.40 PVC. o DESIGN DATA r o , , Single Family-5 Bedroom No Garbage Grinder 0 Daily Flow: I10 x 5 =550 gpd f / .{ 3Lu�srorsc , Septic Tank:550 gpd x 200%=I IOOgpd s h .- pool piecK Use a LEACHING AREA Galion Tank. U#ility21 V, 4fl 550 gpd/0.74=.744 s.f.Required Ole ) 1 11 Z t'; >� i Sidewa11:2(12+45 )2=228s.f. 4 B Bottom Area: 12 x45' =540 s.f. 21 �� 00, + 0 �X 30. , l 768 sf.Total Provided._ :' ¢ °t• Ip LEACHING CHAMBER DESIGN --_- ; c Ail Pipes to be Schedule 40 PVC.Use s Stone 1 - 2 3 ., -500 Galion teaching Chambers in a Delve Z 2 12 x 45 Washed Stone Field as Shown. � 1 to _ } 110 W 1 I t I 1 v =1 a � � � -' poo t.Equ tP• 1 IT FOVO' \Pp LVPRAW DdWN 1 TO S% IDzONLi 1 1 ; 14O O,y° e t �_ Lot Area 1.0 ac 1 Conc. Bound (found) !utility , 1 Pole � 1 \ � 170.26' \ N 83•44'47" E Tree Line PLAN VIEW 1 Conc. Bound\ Scale* I"= 20' 1 (found) ' 1 � NSF 0. Matthews 1, \ Itilliam e Matthews Coat o R.`Title 151420 3 y,l. TIII ST 14Ot-r= 2 rdLQ.V. - PINt' NL'EDLYSPINIS t_tAt=MATTdtZ , O Lt/►F 1�1 TT R/ A "r—tslu" SAND O h. MIIEP\uM SANp Bn 10 v R 's/y/ q,l 10 YtZ 6/3 38' EYR 3/6ANO IO g Mr-DIYM SAND rr YN S'114 0 d A R COARSE S. N C at, Io C COARser SAND Nth C2o•" 122 to OF If 4/44 NO GROUND WATISQ NO G1120'sAub WATER ROM CL-AS t-A't- TtgST CLASS \MATERIAL 'CLASS t MA`rATETitAL DEPTHS 4z\I •y�� Liz55 THAN Z mlm./mck-4 #W9 �v MATE: 12/21 f 9P� CIVIL IMYe SULLIV4N EAIG1Ne.e:R1NV ttVG•. 1 WITNe:5S1 3'.DLINtr1KtG� 1',O.tj.�Ci.0.41 � ,��,:;°,,i' Na, P— a3z'2. Title: PREPARED FOR: PREPARED BY.• PROPOSED SITE PLAN a SEPTIC SYSTEM Raymond K. Moran Sullivan Engineering, Inc. �apaSury CD 201 'OYSTER WAY Carolyn A. Moran PO Box 659 7 Parker Road OSTERVI LLE , MASS. 18025 Southeast Village CiirC/e Ostervlle, MA 02655 Osterville MA 02655 Tequ e s t a Fl. 33469 (508)428-3344 (508)428-3115 fax (508)420-3994 (508)420-3995_fox v PSu11PEOaol.com capesurvQlrapecod.net O Field: WHK/MDH Draft: MDH/Ms D 20 o to 20 40 so Date: February 19, 2002 Scale: As:S.hown Comp.: MDH Review: RLH Proj # C372_1 Drawing # C372_1 G1.dwg Of N o gR i s 7`••Tltna ; O • •.; LOCUS PLAN = rut« — F.G.23.5 F.G.23.0 t -7 Cons j- 0° - i$ n r a A r.e,r Cupped" p �t Scale:I =2000 ve•-tn' . •o i a � ysttr :: °4 Assessors Map71 _ P44Stmr 21.5 20.5 rl�bts o Parcel 11 -4 1500Gallon Top El.21.5 Wchua si,•-1 vz•tt«w. 21.3 Septic Tank 21.1 ` — • .1� LOCUS Zoning RF-I chi o o^_ •o Washed v'li Bot.El.18.5 Setbacks: Front 30' Side 15t I ! ,-to 1 I :•tx:: r .,:: 20.9 20.7 6.2' tx-u• Bedding as Tee or Baffle D` •' ' Rear 15' Per Title 5 No Ground Bot.Test oWaterle El.12.3 u \ CROSS SECTION OF CHAMBER Ground Water Overlay AP NOT TO SCALE NIF DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM •1s�'c. John D. osmond Not toscale Cert. of Title 67606 a I Tree Line �' Chain Link o —3 o ( \ 2 c 178.29' N 88'15S8 E � \ Land Court Bound Shrubs \ Shrub `•� ` \ 1 22 ' \ (found) \ \ ( to \ \ Cedar Tees to t o• v \ \ y$' CM1N00 \N \� � I � � 100 90 Rr,,86RVd. 0 utility ? = V Pole �►, 0 Conc. Bound 1 (found) Q \ Y 10 � pf31 TAARY N N \ �pA1N N \ CRAWL- -sox NOTES SPACE o0 D 1. Water Supply For This Lot is Municipal Water. 2.Location of Utilities Shown on This Plan Are Approx. O I At Least 72 Hours Prior to Any Excavation For This t \ rgp�lc I t0 Project The Contractor Shall Make The Required \ 4' -23 Notlficationto DIG SAFE-1-888-344-7233. w TANK CS3.The Contractor is Required to Secure Appropriate (A Permits From Town Agencies For Construction t ` I N Defined byThis Plan. 4.InstallRisers as Required to Within 12"of Finished Grade. ti • 1 I 5.All Structures Buried Four Feet(41)or More or Subject to Vehicular Lobe H-20 Loading. 6.Septic System to be Installed in Accordance With 310 CMR 15.00 Latest Revision And The Town of Barnstable Board of Health Regulations. /ryry I �\ ` t-1trAGH P"'" F R 7 All Piping tobe Sch.40 PVC. gr �, t - I CRAvt/` \ (ZOOP tiuN 0 4 tPAC� � CTYP) DESIGN DATA Single Family-5 Bedroom 1 No Garbage Grinder o p Daily Flow: 110 x 5 =550 gpd 11 I 0 y 0 I ` 1 Septic Tank:550 gpd x 200%=1100gpd l 9 p�U E S-r0 N = 6 0 N poet p1LevC Use a 1500 Gallon Septic Tank. LEACHING AREA -b ' N I P� t 550 gpd/0.74=.744.s.f.Required Q utilityi I 0 r Sidewall:2(12 +45 )2=228 s.f. Pole )� )1 Bottom Area: 12'x45'=540 s.f. 1 1 I tll t a s'x�o' 768 s.f.Total Prrvided. 21 I Oa I > �' 0 Pool. � �, LEACHING CHAMBER DESIGN 0 ,, � 1 86 � 1 ' O � 5 All Pipes to be Schedule 40 PVC.Use 5 ® 1 ... 2 Stone z -w 3 Z 12x0 Chambers 45 Was ed Stone s ne Field Shown. ..� 1 I Y ; tv y Drive I I o I I vs 46, 1 I v I I pool- _GLU 1?• N g 1 I 1 LGAGH PIT F'OR \ 1 I I hoot, pRAW OowN 1 I NoTst 1P0'01- TO BR OzONL \ 1 I I 'INZaGTuto \ 1 I lyor " -� sfon 1 I I 1 �_ Lot Area >� 11 1 1 , • 11 1 Conc. Bound 1 ► 1 1 (found) l u 11 170.26 tnity ' Pole " E t 91 11 l N 83'44 47 Tree Line PLAN VIEW 1 1 Scale: I"= 20' 1 1 Conc. Bound\ , 1 (found) It NeF 1 1 0 Matthews MUM 11 IFL t Janet R. Matthews uiEVF" N Cert. of Title 1q�312 !� °ass art TnSTNoasi \ ELay. 2Z .d of TUST HOt_E 2 1¢L4'r.Z.Z•.V' V PINQ Nai.Ot-RS/ Q PINCL mr-&PLTis/ O LVLAX MArT�da O LU^P! MA,rr11R A "'""u" tsAND A M1zp1uM SANG 8n to Y IR S*ld4 q.r 10 V R 5'/3 Ir a O macstum O YR J/ N SAND S MaoluM SAND ,t 10R �'/.4 µOF 38 C COA%%rL SAND SAND 3L CpARStS D t2o IOYR (�/r•1 ;I e C IOYR L/y �� NO r atouNo WATER 122. 4J0 C.R04N0 WATER �' M••LNAN PBRGOL.ATtO N TKST CLASS 1 Mn.TEti1AL NO•29M � CLASS 1 MArER1AL cm D73PTHt N2`I LUSS •THA 2MIN•f'INCI{ PATE; 12�21 /9� - � pYt t3LLL1VAN ENGIN6DR1Ntl 1NC• WITNEss i T•r>UtA%IV_IG� TO,t3,�r3.t7.4t Not P- C13 24•► t C Title: PREPARED FOR: PREPARED BY W PROPOSED SITE PLAN a Sullivan Engineering, Inc. ccalP8Su rSEPTIC SYSTEM Raymond K. Moran g g, CI)Q Carolyn A. Moran PO Box 659 7 Parker Road .-1•• 201 OYSTER WAY 18025 Southeast Village Ciircle Osterville, MA 02655 Osterville MA 02655 OSTERVILLE , MASS. Te u es t a Fl. 33469 (508)428-3344 (508)428-31 i5 fax (508)420-3994 (508)420-3995 fox q PSu11PEddol.com capesurvOcapecod net O v 20 0 10 20 40 so Field: WHK/MDH Draft: MDH/►tis o Date: Scale: Comp.: MDH Review: RLH February 19, 2002 As Shown � pro I # C372_1 Drawing # C372_1G1.dwg