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0149 PINE LANE - Health
149 Pine Lane Osterville A = 118 075 1 / v m Tk7w. �7�F3ARN aTA,B1LE D'�ISTi�..1..Ela',S I�IAIVI�ZIt I^'�IUI�t7�N0. ,8B1E�l'tC TA N; CAP�►CI"CX L CUING FA CIL-`rY' (®Yp .,_; w a 1� kiMI`'A3l�a `} lnYrLIVIGF Su�nreitiotb Ti�i�,eztraar�rtkv�ectr tk�u Niaxii�um l��j�stccl GRautAdw�iket'���le kn tiaG�nuotrx ol:��,t<ahin�t�acilit+� ..-;�..�..�,..��' ��i I'itvaa roJ1t�t�c;ru�I7ly i?�4R1 sutci Y,cacS�ttt facility Of Imly we, ex(st.: t9ri 89tG ob 1Nitl1iY1Ut 1 fit U�1Q1Eq�ililt(tirtll{}�) _, _.. _.•-.�.(r��t cik,iA:rfi VVt4az►r9 a�idlLeac� i 114011ivy:tYl any w�ctla�►d4 exist lbfp Iurila54 ry). i Nrndsktatl b y T G _ P � -4,Z -� � n T TOWN OF BARNSTABLE LOCATION. 1 �;„� I `� t�t„ SEWAGE# � " VILLAGE ASSESSOR'S &PARCEL 0'7(-4vt-06 INSTALLER'S NAME&'PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) 2_ ,5w (04 (size) NO.OF BEDROOMS OWNER C&rro I PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: l 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 Ai"8tland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 9 W ; C> � r r Commonwealth of Massachusetts - Title 5 Official Inspection ForrTi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '( 149 Pine Ln Property Address co John Kutch ,. Owner !+ Owner's Name information is ✓ ti required for every Osterville MA 02655 4-1-16 page. City/Town State Zip Code Date of Inspection ►+ dD 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 1. I nspector.t r. . . , Shawn Mcelroy Name of Inspector Upper Cape Septic Services r 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: '' f - ® Passes ,4 ❑ Conditionally Passes _ ❑,Fails %E1 Needs Furthe ion by the. �vingthority nspe J_ .4-1-16 Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 S 1 Commonwealth of Massachusetts J Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f F`� 149 Pine Ln V i;n Property Address yt�9 John Kutch Owner Owner's Name information is `ry required for every Osterville MA 02655 4-1-16 page. •: City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/ahvays 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•3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 f Commonwealth of Massachusetts - .• Title 5 Official Inspection Form a o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Pine Ln Property Address John Kutch et Owner Owner's Name information is Osterville ��"' i; MA 02655 4-1-16 = '� required for every ,. - 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/alar.ms are repaired. ' B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or breakout 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): r .. ❑ obstruction is"removedr~ , ,." ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): i i .. r . .. . {. _."./ • ..� J •� r { -, . 1. rr :4:, •. -} b r 'tri .). - ❑ 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•bythe Board of Health: ;; . ►L` ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water - ❑ Cesspool or privy is within 50 feet'of a bordering vegetated wetland or a salt marsh t5ins-3/13 • Title 5 Official Inspection Form:Subsurface Selvage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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 ❑ ® Backup of sewage into facility or system component due to overloaded or r clogged.SAS or cesspool El ® 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments +_ 4�M 149 Pine Ln ' Property Address s John Kutch }: � Owner Owner's Name information is OStervllle - ` W required for every MA 02655 4-1-16 , page. City/Town State Zip Code Date of Inspection B. Certification (cont.) , Yes No : ._ ,i• ,k .. ; . ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool'or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or ❑ ' ® tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool•or privy.is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence _ of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis -and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- ❑ ® ,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. �Y f 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. r , . `s For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. r� . • a 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 t the system is located in a nitrogen sensitive area (Interim Wellhead Protection ❑D ❑ Area—IWPA)or a mapped Zone I1+4 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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( P ) Provided with ® ❑ information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 ill f Commonwealth of Massachusetts = Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _ T a • wM 149 Pine Ln , Property Address John Kutch Owner Owner's Name information is i> required for every Osteryille MA 02655 4-1-16 page. City/Town - State Zip Code Date of Inspection D. System Information r . .,� _• • , .° _ 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.) ' Laundry system inspected? ❑ Yes ® No • i Seasonal use? Yes ❑ No x Water meter readings, if available(last 2 years usage (gpd)): 4 Detail: , 4 a• e Sump pump? : . 4 El Yes ® No Last date of occupancy: ,, ,i� ,• Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: ' .Design flow(based on 310 CMR 15.203): } :}+ Gallons per day(gpd) . Basis of design flow(seats/persons/sq.ft., etc.):,. ` Grease trap present? Yes ❑ No Industrial waste holding tank present?.- ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system?•_. . ❑ Yes ❑ No Water meter readings, if available: - t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 4 M ,°•'° 149 Pine Ln + + Property Address John Kutch . Owner Owner's Name information is Osterville - MA 02655 4-1-16, required for every + page. City/Town State Zip Code Date of inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1811 .. feet Material of construction: 14 ❑ cast iron• ® 40 PVC �.t ❑-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: "'" r ` 112" feet ' Material of construction: ® concrete ❑ metal ❑ fiberglass El polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate),, ❑ Yes ❑ No Dimensions: _ 1500 gal 12° Sludge depth: A t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 r ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments M 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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 1" Distance from top of scum to top of outlet tee or baffle 6" � Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffled installed with 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 f Commonwealth of Massachusetts '' ; • ' H r Title 5 Official Inspection Forrih Subsurface Sewage Disposal System Form--Not for Voluntary Assessments = 149 Pine Ln M .. Property Address John Kutch s t Owner Owner's Name information is z; required for every Osterville _' ! MA— _026.55- 4-1-16 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 t5 ns•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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 chambers. 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-3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 1 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149 Pine Ln t �. Property Address John Kutch I Owner Owner's Name t information is required for every 0 tefville " a MA 02655 4-1-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number. 2-500's ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields " number, dimensions: ❑ overflow cesspool number: . . . ❑ innovative/alternative system ti r Type/name of technology: • Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): + i Leach chambers in good condition and empty at inspection with stain lines 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 3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 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•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection-.Form Subsurface Sewage Disposal System Form-Not for voluntary Assessments' SVB'� 149 Pine Ln Property Address John Kutch Owner Owner's Name - information is Osterville �' ='` MA 02655 4-1-16' required for every .• • 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 [per (f �/1� l• Pe,r c f f+ ArJ , j6i- 'r '6 �:3 = d If Le t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 a Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required for every Osterville MA 02655 4-1-16 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) _ Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 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: You must describe how you established the high ground water elevation: Original design plans show groundwater at greater than 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �. 149 Pine Ln Property Address John Kutch Owner Owner's Name information is required For every Osterville MA 02655 4-1-16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE c' LOCATION ZYd Zll e Lh SEWAGE # R;s V' r.AGE Dffew;'IlP ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY fl� LEACHING FACILITY: (type) a 5��� c�Ro '�'tr`S (size) 13�'��xo2 NO..OF BEDROOMS o;2_ BUILD R OWNER S 11�&z � PERMITDATE: /—/0--0 3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by a 5 A w � w � 6 C'� w � �,.� .� � � � � ���. � � 1 ��^ � � �, � .,, ,�.; 9J e� _ . \_ � � No. 2-Co Fee 10 C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppffcation for Mizpooal *pztem Construction i3ermit Application for a Permit to Construct( )Repair( )Upgrade(,,'<Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1,4q V'�XXr l ®`-tea r_.W, owner's Name,Address and Tel.No. Assessor's Map/Parcel 1 v�S �E'F �✓ �� /[�L�� Installer's Name,Address,and Tel.No. Designer's Namegtft Tg1:Ncr)OYJ.,E & ASSOC, ,5 'C A,, 42 ''Canterbury Lane East Falmouth, MA 02536 Type of Building: r we No.of Bedrooms 'Z— Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ZZo gallons per day. Calculated daily flow 3$'6 gallons. Plan Date 4s- 0`z Number of sheets % Revision Date %--tA-a:Z_ Title S%iry,- _(V.a.0 oy-- lm.X�N oft. ST'trF:A � �l�cs ���pl►.cif'2 Size of Septic Tank 1���� Type of S.A.S. CHcayK TL Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage Y disposal system P in accordance with the provisions Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss e by s Bo f He Signed Date Application Approved by Date I /D h Application Disapprove or the following reasons Permit No. 2-0y 3--01 `3 Date Issued f /0 -- -- _ --------A06------------------------ -- . 1 r-, ............. ..__...._. 'a=,✓S J-.^2 Iwri "$— No2� ! # Fee ��v ff• Entered in computer: � �------- `THE COMMONWEALTH OF MASSACHUSETTS �, � E: V� T - ,PU�BLICIHEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS, Yes Zipprication for Diopoal *p5tem Construction Permit Application for a Permit to Construct( )Repair'( )Upgrade(_V�Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. %40► PN �Htt)Q*A-%-A Owner's Name,Address and Tel.No. Assessor's Map/Parcel `�. Installer's Name,Address,and Tel.No. Designer's Name,Address any¢Te1JNo.DAYLE & ASSOC. � A4 Qrbury Lane C } tnukh, MA 02536 Type of Building { wel No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures } Design Flow LZfl gallons per day. Calculated daily flow 3 4 6 gallons. Plan Date ® - o Number of sheets Revision Date I- d► a Title Sve*_ %1Ca..i ot% LA.!!►\\ FotL STkv_1reA Size of Septic Tank 1<00 Type of S A.S Description of Soil '-' 1"cCwd �1 rt-, C.. o_ 1L 0�t Nature of Repairs or Alterations(Answer when applicable) Date last inspected-.- Agreement: f' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions e 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 `s Bo of He 1 _ Signed ' Date 3 Application Approved by Date I /0 I Lo 3 ` Application Disapprove 'for the following reasons Permit No. WO 3-01 9 Date Issued / /U b 3 f ———————————————————---———————— ——————---— THE COMMONWEALTH OF MASSACHUSETTS f BARNSTABLE, MASSACHUSETTS Zertificate of Cor.01'a(lnfcle THIS IS TO CERTIFY, that the On-site Sewage Disposal Systerh G nstructed( )Repaired( )Upgraded( ) Abandoned( )by t , at Y has been construct d i�}accordance go with the provisions of Title 5 and the for Disposal System Construction Permit No:200 3-0 t 9 dated / /0/D 3 Installer 17t, 44 G no Designer The issuance of:this permit shall not be construed as.a.guarantee_that the,system�will function tas.Uesigned. Date ' f - b , - _ Inspector ! J 9t� •_ $�: rr No. 2003—V«• f y r' Fee (aU— z� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEi MASSACHUSETTS NkW migozal *p$tem Con$trurtton Permit Permtssioni gran ts hereby granted to CfostruJct.� )Re air�, .Upgrade( )AbandonSystem_located at7 ' 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 complete within�thq;e years of the date of this peDate: t ! C. 0 3 Approved by 1 - / \ f = t/ r' r' TOWN OF BARNSTABLE LOCATION ��y J� e G h• SEWAGE # �2 0 043 VILLAGE asf V:lle ASSESSOR'S MAP & LOT /d INSTALLER'S NAME&PHONE NO. Ieo SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2- 3002 e4-2121�6i1~S (size) 13�xo7, ',2 NO.OF BEDROOMS o� BUII.,D R OWNER u Q� PERMIT DATE: l-/0-o a COMPLIANCE DATE:_5h_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 within 300 feet of leaching facility) Feet Furnished by 0 13 z37/33 ! � r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION e� TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 149 PINE LN OSTERVILLE Owners Name: SEIDNER /�� Q On, Owner's Address: Date of Inspection:4/11/06 Name of Inspector: (please print) Douglas A.Brown Company Name: Douglas A.Brown Septic Inspections Mailing Address:P.0 Box 145 Centerville,MA 02632 Telephone Number: 508-420-4534 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 4/11/06 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving, authority. Notes and Comments SYSTEM MEETS MINIMUM PASSING REQUIRMENTS AT THIS TIME. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different Conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Revised on 10/31/2000 Page 2 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 149 PINE LN OSTERVILLE Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 inspection Summary: Check A B, ,D or E ALWAYS complete all of Section D A. System Passes: X I have not found any information winch indicates that any of the failure criteria described in 3 10 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: one or more system components as described in the"Conditional Pase' section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. .Answer yes,no or not determined(Y,N,ND)in the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health, *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 149 PINE LN OSTERVILLE Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 C.Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2.System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ the system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 4 • Page 4 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection:4/11/06 D.System Failure Criteria applicable to all systems: You must indicate"yes or no to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool 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 1/2 day flow �1 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. 1( 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 3 10 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure, E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or no to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply. _ = the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone-11 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 yeg'n 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 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 149 PINE LN OSTERVU LE MA Owner: SEIDNER Date of Inspection: 4/11/06 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No X Pumping information was provided by the owner, occupant, or Board of Health X Were any of the system components pumped out in the previous two weeks ? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? _ Were all system components,excluding,the SAS,located on site? X _ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition f the o 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: Yes no X _ Existing information. For example, a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3 ))(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection. 4/11/06 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 2 DESIGN How based on 3 10 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: Does residence have a garbage grinder(yes or no): NA Is laundry on a separate sewage system(yes or no): NA [if yes separate inspection required] Laundry system inspected(yes or no): _ Seasonal use: (yes or no): NA Water meter readings,if available(last 2 years usage(gpd)): 6 c— v C Sump pump(yes or no): NA Last date of occupancy: COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X 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) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: 5-5-03 Were sewage odors detected when arriving at the site (yes or no)? NO Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron 40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_ (locate on site plan) Depth below grade: 12" Material of construction: X concrete_metal_fiberglass _polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): _(attach a copy of certificate) Dimensions: 1500 gal Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 5" 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: 12" How were dimensions determined: TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.)- TANK LOOKS STRUCTUALLY SOUND AT THIS TIME. GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 PINE LN OSTERVILLE Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): ►3 Leoz,e P Q l&,L,}� PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 SOIL ABSORPTION SYSTEM(SAS): _(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: X leaching chambers,number: 2 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.): SAS LOOKS LIKE IT IS OPERATING FINE AT THIS TIME 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 or no): 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.): Page 10 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection: 4/11/06 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. coo y S `t 2 3 S-2 SOT ck .v Page 11 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM ] INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 PINE LN OSTERVILLE MA Owner's Name: SEIDNER Owner's Address: Date of Inspection:4/11/06 SITE EXAM Slope: Surface water: Check cellar: Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) _ Accessed USGS database-explain: You must describe how you established the high ground water elevation: E f r No.�� ��� — �� + Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Migogar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(XN Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 1 4 9 Pine Lance Owner's Name,Address and Tel.No. Osterville Mass. 02648 Marie Taveau Assessor's Map/Parcel / 09 © �s— 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—7 7 5—3 3 3 8 J.P.Macomber & Son Inc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 Type of Building: Dwelling XXNo.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 355 GPD gallons per day. Calculated daily flow 2X 1 1 0=2 2 0 GPD gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Loamy sand to medium fine sand Nature of Repairs or Alterations(Answer when applicable) W i 11 om i t c e s s poo 1- T n s t a 1 1 1 —1 1;0 0 gallon septic tank One Distribution box and 2-500 gallon leaching chambers packed in 4 ' of 1 " stanP 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 issued by this oard of Kepalth. Signed Date 1 1 /2 2/0 0 Application Approved by0Z Date IN O Application Disapproved for the following reasons Permit No.j)001 D 3 Date Issued is f .,,,-R. 11 iNo. - l� / t � .:,.�. .�.�,.' :Fee THE COMMON 7`H OF MASSACHUSETTS Entered in computer s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS apprication,for jDigpozaf *pgtein Congtruction Permit 4 Application for a Permit to Construct( )Repair( )Upgrade(, )Abandon( ) ❑Complete System ❑Individual Components . � xX { Location Address or Lot No. Owner's Name,Address and Tel.No. 149 Pine Lanp, �s��ssyMass. 02648 Marie Temeau Installer's Name,Address,andTerl,P. Designer's Name,Address and Tel.No. 508-775-3338 508-775-3338 J.P.Macomber & Son Inc. J.P.Macomber & San Inc. Bo o t Type of Building: - - - -_ Dwelling XX No.of Bedrooms 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-2 X-I 1 0=-z'2 0 GPD gallons. Plan Date Number of sheets Revision Date Title r Size of Septic Tank Type of S.A.S. ; a Description of Soil sana to medium nine sandW j Nature of Repairs or Alterations(Answer when applicable) _ .i i omit cesspool. Instaii ga -on septic tank. One Distribution box and 2-500 4911on leaching chambers packed n 41 of 11ml stone. = Date last inspected: Agreement: , l 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 operation4until a Certifi- cate of Compliance has been issued by this Board of Health. Signed f Date 22/00 - Application Approved by _ Al Date ; -) Application Disapproved foVe following reasons i ' ,Permit No. Date Issued — -—- ——'————————————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 4` Cf fif irate of Compliance V ' THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(XX) Abandoned( )by acomner &_ on Inc. has been constructed in accordance ' with the provisions o itlnee5 ands eefor tsposal' ysstem Construction Permit No. dated" Installer Designer ,v J o ance acorn ehr on nc. & r a� . I I f The issu oFtlhis permt s all/Kote/cons rued as a guarantee that the system will function as designed! V Jl 0 y i Date //l /f' ! Inspector— I�(./ .n)jrjrr/� �� I//('f��l f1 7 t C! 4 . --------------------------------------- No. Fee V 50. 0 n n THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS x1h6 pozal *poterii Can5truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade�X )Abandon( ) System located at - 149 Pine Lane ustervilIe,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 this permit. z Date: t Approved by L.Q NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. O CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) L J.P.Macomber Jr, hereby certify that the application for disposal works construction permit signed by me dated 1 1 /22/00 concerning the property located at 149 Pine Lane osterville,Mass. meets all of the following criteria: d' The failed system is connected to a residential dwelling only, There are no commercial or business uses associated with the dwelling. 1/The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. ,f f Y There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system +* &re is no increase in flow and/or change in use proposed /There are no variances requested or needed. tl The bottom of the proposed leaching facility will Abe located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable) If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will M be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the followiog: A) Top of Ground Surface Elevation(using GIS information) O B) G.W. Elevation +the MAX, High G.W. Adjustment. f a /Z DIFFERENCE BETWEEN A and B . SIGNED : DATE: 11 /22/00 (Sketch �Foposed plan of system on back). Q:health folder,een ' t fi. � "�, u s ®' Or TOWN OF BARNSTABLE F { LOCATION Z�Z /0rti LAND SEWAGE #;O a/— O� I VILLAGE n Sfe9 V111e ASSESSOR'S MAP & LOT ( ' O -�y- INSTALLER'S NAME&PHONE NO.J y IV, 114,4 C D Aigeg f S 0 N SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /-�L f?UJC �A.�99 'S(size) NO. OF BEDROOMS BUILDER OR OWNER / PERMITDATE: -COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells.exist onsite or within 260 feet of leaching facility). Feet Edge:o('Wetland.and Leaching Facility'('If any wetlands exist:. witlun'300'feet of leaching facility) Feet Furnished bymi 44 /� - <Y TOWN OF BARNSTABLE G' LO(7ATION Z" /.fiV e 44we SEWAGE #9 00/— O� t� VILLAGE C) 5f e,<y/Zl P ASSESSOR'S MAP & LOTfl Q INSTALLER'S NAME&PHONE NOIL/% 4U AC D/1 geR f SCA/ SEPTIC TANK CAPACITY LEACHING FACILITY: (type Pd'�S(size) �a NO.OF BEDROOMS s BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by : t ,� .� � . r'� �' � �� .r � �� �- � � • - M ` � � 1 i /' '� / � � � /' ��/ /� .� � .... � � �. 1 ,, 4 °� ', t °'�'�,,, .. � . ._ �� ., �; �_ •JgoeJ7u0,6wppnq 11 '' a Inca S wo,v6lsapes�fmmm•woovblsapes�®Jaroes� ..:... ay7/o A7g916uOdsaJayl awmaq �I"l II, -'' O LL66'ObL'SOS•109L0 VW kIYwAH•bbll%ag'O'd suolsa wo Jo/pua sJo.w•sanwdaJ,slp �aavw rywwmapasay7/o lel7uaplsa.l•Islo.lawwoo aoua7da,av au7 sa7mgeue•J uoq,rulsuoa aUb�aUld y71m 6umaa,oJd vonoMsum/o UBISap BUlplinq JDYalSSajaJd y y IUW:!jju {9nJ+sua7 O 7wma,wulwo,ay7 o7 JolJd nu6paa aln � � .'•O, - -—- ---_—— /o uogw77v oy q .491 aq lays ' 57wwmop asay7wp2warvop a6wllaJp y ,��.� ga}nigogsy aa�prG� -pauua.A Jo/pua kuolswiwD'sa7oa aln w Cuo1GGEso Jo/pw sJOLa kalowdansn Auy � -JvNCu51,*,Y1H1N.C- CJNY N4V1� ma6,aaQav7/cyclaalWmd o N ua771Jm ssaJlpo 7noy71Sl pa71CWPJ0 sl asnw V onoal/IpoH vwd slyi 6wsn awoy ao JauBl623 6uryling 16uOlssalOJd 4 Aluo pue auo 7onJ7suo,o7paxuoy7na.ueld �r-5116Y4,HlaNNO-A 6 l 6 6 ! # LIE) sly7foJasay,mdlaulBlJoaylrem1746WAdo� :ao}a7uapisa�puti auio}{ tluu uto�s�7 731"OZId a'avad Japun pora70Jd am weld asau L :sa7al,osSV J21PBS 41=2.1 A0 roord 7y61JAdo'.) 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TOP FOUND. EL 41 .-L . I I I I I I I I I . I . I I . � . I I - I I I I ,?" Of 1,46' - I/V Peastone I . I � I I I I I I � � � I I I I I � . I I I . . I � I I . . I � I ! I � I _____� I 11 I I ; I � I r_�i . I I i I I I I � I � __ . . X� I I I I � - . . . . I- I . I . ! I I I ;* .&'. .. ,.�..._..�:/ �,., .*. -, I I � I I � . . "�9F� ,\\ x�\ ,\, -N-W -q�,\ - . I 11 I � I I �� . I I , � . . Nw�N . � � . . I - I - ;*_ I . .��_�_ \ S�\\\ -\ �\ M\"7\N=>KN\ -?K� I I lv� \ I N----\x V-\N N, i . I I - I I a,& a �: - \()/ I .1 00 � - ... I . I . .... -11 I f-IN . I . .- I � I O.. : I � I 1. . . . e I I 'W I .� t . � � I I � I "I -- WATER 71GHT COVV. - _\1\ 'K�\\ , � \��,\\N:�\ ,\,\\\'t '\ , I at . I I . .... I - �\W� V �f .\ " ,..-- - . , . , I � 4._��- - - '" - I . . .. a � I � I I I I . . I I . --- -A. . I I I I � i 1. -, - .��,� . . * '. . - I I I . .... I I � ... I I I I f I . . � I— = _z- . I 1. a .. r---.l k r--" , - - ,"W__1 � ' ' I I . I � I . . I . I I � I � I . ... . � I . t 1-1 I � . . . 1012-1 1� I I I � I . . . I � . I I - - ,, , I I � I� � . I I I . . � . I \ I I I I I , I I : 1-1 I . I . I - , . I I I I . N -I ,-� I I I -XI I I I N,..- � r . 2' LE14EL------I . I � - . -- ___�-*=�. I I , . <S�,- - I . I I I� . I . � 11 --_�-- -- ,- . � I hol Z<-' --- "I, �, ____ -0 01% __ I 0-% I � � I �� L :. rotal T7-e I Lcngth I I I . I . I - ,,.,�.-� .1 . � � I I I . I I I � � I . , I . - I I I I . . - - . I I .1 I I I I L . " Ir .1 I ., --m- 7�-encb 01-da'�7_'b I ___.M. , L �,� I LL I . . I I �L .5, -4" _-, 11,i� asbed Criisbed Stone , I I . �\�, I .... I I I - L, - . I � I I I I . I I I I ] I . -1 I I I L . ..1. INV. EL 2,1 -C,C I L I ,'I I L . I I I I - I I I I - I . L . .... I � . L I � I I I . - . I I I � I I 11 I . I I I I I I I ./,/ I I I . I I I .I,%. �,� � I I : , I L I . . . FLOW LINE . - :1 I I --- - -_ -I/ I I I ,� I I. 31-14" - .1-112" resbed Crus.5ed tone I � 1. I L . I I .I , I L I I - .- . L I - . . --p _r. - � I " - . I .. . -Z., :, .. r - . 1 6--.Z I I . 1 L: � I � I I wal. 61 , 11 . I .... . " j 4W I I :� . I I � . _�M _� -==�� :L_____�___A- ; ,7.1'. �- .=L" -=. 1%., I L I L I I . - I I I I I . I I I I I .... I IV' UK . I % I INV. EL. -_�,b.-L�' I I .�', I \ I� I I I U - . .��*1,- .-.- �t:��- ! � - I., ,�.O�:r I I � L. I - ' I I .... til L I . I I I , " .�. 1 � � . OSED S IL I L - I . I I . . . I " _���_ = � .L- \ I I . I I . . I I ....-...n I ^ r--..A I 1. ! I I L � I PROP ..4.S L - I I I I . . . I I .?, I .11_--- - - � - ,L I L L I L I I I I I == I , r-_-_n = L . I �, 1. 11 . . . IL I � 11 .1 I . - . I I I � I L\ L I 'h,r.- El �rl.'l I I . I L L I 11 . I . I I I 1, I - � 11 '_ I L I L .. . , L I I . 1 L , .1 I I L L I I � \ I � I . I I L I I I .1 I I I I . I I . I . . . . . 10' MIN.---� ,r UWD DEPTH I I I . - I . � I 11 � I --" r---.n . , I . I I I I I L I I I , � � I . . � �, I I I L . . - 'L I I I S - - _\ I I I . I I I I I I I . . L � I . I L . . . I I .. INV. EL. � 1�8.%'L I L . I I - I I - . . 1- 1- 4 ; -- - -\ � / =111 I C= N , == , , . L,;7j. _-_�,5--7 * I I . I � I I zl� I 1� - I . . ,, INV. E bqsk I'?- : -\��X /l I �, . cc . . L TREffCH SECTION L , I 0 , _ - . z /-- - - - L I I I I I I I I L � I I I I I I L . . I '. . I I I I // - , � , . I I - I .1 11 L I I . I I I L . , I I I . L 11 � , I I I L I I I I I I , . ', L L I I 'L L L 11 . . I -11 L . I I I . � . I I : / .1 , i � I I I . I I I I I I I . 1. . . I I I I I I I I L I I I I L I . I of L L, . / " , --I L I ,L . .... INV. EL. -38.�'C, I L I I i . I. L � I L I , : I I � I .... I _ I . I I . I I L . I . I I . I No. Trenc.hes I r . I / � L I I I I I I I I I I I � I . . I . I I I I I L . . L I I L I � - .. 11 I I I . . I . . L L I � I I I I I : L 7 1 1 1 1 1: I 11 ;I- .1 , I I . I I I I I . L . . . . . . - I L . . I . I I . . I L I L 1, I 11 . � I .1 I . 11 . I I I I I I I I I I . * * . . . L : . I I . � I I I . I L - ' ' � I �11 � I 11 I � I . I I I L L I I I -� 1, I I I I I L L L L I I I . L I I I I I L I . I L , I L � I - I IL . I � I L . . . . . . . � - -_.� �-.---;�--__=r ___ - I . . I I L No. of 500 Gallon Preca t Cb8mbers -7 - - I I I I I , - . . L . - -- 1---.I--- I - I L . I I L � I . I . . . . . I . __- I L .I I s L I I � � I I . I I �� I ____ - -..* I- �- .7- L , .-- L PRECAST REINPORCED CONCRETE L I . 11 .5' 1 .1 I I I L I ________ _ -, _ _ __ I 11-- ...___ - .1 . I . I ' "I I I L, I . I I I I I I I I I . _I.- - I I . . I I I I L I L �i � I I . I L I , 'L, ' " - , , I'll I I I I I I I I I I I I L I � � I I I - . I I I � I / I ,�. � 11 I I I I I I 1 . I I I , . I I L I I I DISTRIBUTION BOX , I I I I i � I .5 4" - L . - . I I I I I . . I 1� _ I . I I - I I _ - � I I . L. I I , IL L . - , �L I . L I . . I I . f-f : � I . I . 11 1. L I I . . I I � I I I I I I I . L I L I -/,? :Masbed Crusbed, Stone . I . I I I . I . I I I 1. I I I - I -L _ I . I I � I I I I I I L � I . I I I I I 11 � L � I . I . I . - - I I I I I �1. - 1, I 1, 1� . I � L, . I L I I L __ L ., I I I I I L I I I _. I I I I 11.1 I" I I'll �� � i I I I I I 11 . L . I . I . I I � . � I I I L I I t L W L I . I ( " , '' �- . 'L , I I I I I I I L I . I : I I I I I I L I . � . I I ` I : . I . I I . , I � I I pa . . L 11 Itt , , I ; I - I L I L T REINFORCED CONCRETE SEPTIC TANK L � � � 4 1 1 INSTALL ON A LE\/EL BASE . I I I . �� I � I L . I I , ,,;i i,,- I I I I . I I � � - - ;�, � 'L I L I - vkkt,�x 4:� . I 1. I . � I L L' . I I � � - . L - . I I I I A�. , 'T -� -M -110 I - ----- I I I � �, I I L . I . I I I L I v.&,%--V,*I,-_T_ /,'E%-. -b %.-"% I . I I , I I I I I . I I I . I I I . . I I I L , I I �� -�O.-T � � I , , L . � , I . L I L ., . I . I I I I . . I I , L , I ''I , I . I I - 'L I I L 11 - � I , I W I I I I I , . . , I L I 1, I I I M i 1 4 I'M U M WA L L '-q41CV I I I I I I I : � I I - I L I , , I f I '' I I i 11 L I I - I I I L . I I . I . I L . . I I L L I I I . I IL . I I I I L I I I : . I L I ,� , , , I I I -1 I I . I 1 26(2) 1 -I I I I I L I L I . L . I I I : I I I I I � . I % �, I�I FW 1 , `"I ,L I I I I I I � I a " " I L I . I L t . - I . L .I - �L F " , 1, I I MINIMUM CONSTRUCTION MATERIALS, PER 31MMR 15.2 , I I L L I ,� . _ I ,,� . I I . L I I I I I L I I I . , U I. .1� "I�, I � I I I I L . I . I I . L L I. I . I I I I I . I I I I I I I . . , I L I L I � . I I I I L L I MINWIUM INSIDE DIMENSION - 122" . L I � . . I I I . � I - � L L I . I I I I 11 L L I L I IL _L , 1,. _" I 11 I I I I � ,,L ,I . I . I � I L I . I I I . I . - . I I I ! I I I L L I I I . � I I I I I I I I .I I I 1 \A I I � ;�,L 3, I I I L I I � � I . 11 L I . I I t L I I . I I I I I I I I I L 11 .", i - L I 1. I I TMS SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND , L . � I I I � I I - . L . I - � I L I OUTL I . � I I . I I .. " I 1. L. I . ,." ,. I . L L I. ' I I SHALL EXTEND A MINIMUM , L I I 11 � L I. � I I L L . I ,. I I I I I I � I , I I� I '5�L 7 L I L L, , L OF 6" ABOVE THE FLOW LINE rEr INVERTS SHALL BE EQUAL TO EACH I . I I I I I - I L � . . _j I I I I L � � I I . - L I I I . I I I ,� I I L . I I L I I I I L 11 I I I I I I , I I I L I . I L I .1 I - , I - 'ro" � I I L, 11 1� . ,L. . OF THE SEPTIC TANK AND BE ON 'THE CENTERLINE OF THE . I OTHER AND AT Z' MINIMUM BELOW INLET INVERT- _. I L I I I i I � L : I I I I I ,. L I I L � I � � I L 114 1 1, q;M "#Vj);Na L' . � I I I . � I I - I . I I I 'W�,,- . I L . I I I I I I I I I . I L. I . I I I , k7 LA L SEPTIC TANK LOCATED DIRECTLY UNDER THE CLEAN-OUT . . � " I L ., I I I � L I � T . I I L � I I I I . - L . L ',,�, . 'S- ; I " I I I I I I �, I 11 I I I I I . I I I . I 11 � I , . W L., L . I I I I I L MANHOLE. L L I I � TION - I I . I : �L ''L' .. I I I I THE D!STRIBUT10N LINES M _U BOX I I L I . � I I . I . I � L , , L . 1 ZOM THE DfSTRiP 11 .. I L � L I I . 11 I L L I I I I 1. L - L-c.c 'I ;L I CE - L I I I � � . I I I I VALL ALL HAVE EM'AL INVERTS AS DETERM!NE By FLOOD114G , . . I I . I I . � I I I I "\��� I t I I I I 11 . 11 '. I I 1� �� I I :;I I I� I I I � I I I I 1, I : . I I I I I I . I . I -0 .11 I - &L .1 L � I . L 2" 14M - - I I . I I � . I : I . � I ; I I L LL V . � , - -- I , L I I I I I I L THE WLET PIPE ELEVATION SHALL BE NO LESS THAN THE: DISTRIE!U110N BOX T017HE HEIGHT OF;THE DIS 0BUTION 1 - I L' I I I L � . I , 11 -R t I I I I I I I I I I ILL LINES HAVE BEEN,,SEALED IN PLAM I . I .1 I L I I L 11 .� I I I I � I I . I I - �L L f3,,,,� .1. � L I I a 'N S I , j L I L L. I I I ABOVE THE I I . I I I I I k � I . . � I I MORE THAN 3* NVERT ELEVATION OF THE LINE INVERT AFTER A L ABLE L I I I I . I I . �",.,, � I � . T. L I I I � L � L I I 11 . ., � I I � . L ,V ':L,''� ,� L , � " �; L 11 L . . . 1, " _!" 7 " Fint I I I OUTLET PIPE L I I I INVERT ADJUSTMENTS SHALL SE MADE BY FILLING WITH DUR � I � I I I I I I I I I I - I,�' I . I r�11,� ,�' ,�., " - 1. . I I . - I I I _� I I I I I . LL L . . I I F_ . L I I I I , L,% I . . ON-DEFORMABLE MATERIAL PERMANENJLY FASTEND TO THE . I I L I I ; 11 . I . AND N I � . I I I I L I I*,4. , , - ,, 'r ' __"jj�� 'L . . I 'L I I I __ . . I I I , I k I I I I -;. ". _� , 1, I I L : �",;t , - .7\-�-",1�t� , . I . 11 � tic THE LINES UNTIL ALL NVERTS ARE OF � I L I . I I Center . � I Z,- I , ,� ..� , I I . I I L . .1 I - I - I .1 t� - . " I L ,,!, ; I I I I I� god . I I� - . ' LINE OR RECONSTRUCTI I , � �` - L I I I I . I - I I �, I I I . 1111 . I � I L I . - . I � ' I I � L ' . . . I I I I , �4 L::� M , I . I - 1. I I L . L I � I I I I I . I I 11". I - 1 4 ' .�� ' I I I I I L I . I � . ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY -, L ,� I I I I I I . St re e t I L � I -1. �, I�' 1.., V.'. " - I L 11 I I I , I , , I I I I I I I I I I . I I I I � L L I I , �--, M E . I I . I . i� ..; '.1 I L COMPACTED AN I I I I L L I I L I I -�",_�`�� 1: FS L L I - I I I � . L I � I I .1 �, , � m, �0 ? �'�1. I I I I I I L L I . I 4." ,,*I I I I I � I �, I I I L Z�___ STER E , , F e �_ ' __", � L SEPTIC TAW SHALL BE INSTALLED LEVEL AND 'TRUE TO GRADE EQUAL ELEVAWN. . I . I ' .'�'� JW'OiLl I I . I L I � I I I L " , I I I I I L L . I I 11 L . . 11 I � I I flAtv_ I �,f �V ��- .��VXI,X . I D ON To WHICH SiX INCHES OF CRUSHED STONE . I �I ; I I I 0 y 3 . 4 , I . * 1, - r ., , - . I 1, . 11 . Proposed SAS. Cbamber Trencb , I . I I . �L ILL f\(k 1.100 I HAS BEEN PLACED TO ENSURE STABILITY AND TO PREVENT � I , i - I la_�, I A, . I I . I : I . I I . I I I I ; I I I 0 1 � .. . - . I I � . L I I .1 L I . I .1 , I L I I L I I I L � � I I I - T I 1, I I - . 1. 'L , � . I SE-ffUNc. � �� :� I . I I � I I I � ! I I I - L I I I ., 11 I Eff. op CE FJ 41.17 - I I L I I I - I I I I I L . I . I - . . I I I I L I I L . I 11 I . I I I � I I I I . Datum: NGVD I . 11 I I I . i I L � L I I I I � I L � . I �, I I L . - � I . I I L I I I i I I I � I L 0::7 .: ,,, 2VI.A 1, � L I I � � SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9". I I I I I . L � I I � I I ,I r,0� (. - LT;s, , I L L I I . I . L I I I ; � I L �I I .� I I I I . I i I I I I SAS Erpansion ' 'I .1 I I I I . . -I . I I . L � LL 11 I I . I I � I I � I I I I L I I I � � I IL 11 :L . L.I., I I I I I . I I 11 . 11 I I I I ERMEABLt . I I I - I L ��,- I I I , THREE 2o*. MANHOLES VATH READILY REMOVABLE IMP I I . I I � "I I I � I . I I I I L I I . �11 . 1'1�I I I 1. I I . . � . 1. L � I I I I .. I .. I � . COVERS OF DURABLE MATERIAL SHALL. BE PROVIDED WTH ACCESS I L - L . I . I I I � � I I I I . � I I I I I P I I \ - L I I . I I L I I � CB � I I I .1 . L 1. � L . 1,11 L � I . L I . L L I I - - I I I I PORTS BEING PLACED AT THE CFNtffR AND OVER THE INLET AND . I . I � ,�1, I: L I . L. . , L I . I I I I . I � I . I I � L � I I 1. I I . - I I . L . I L � ,� I. �, I I I I � �� OUTLET TEES. I I ; . I I I F_VD I . I L � CB 11 I I � I I� I I L I I . I I I I I . I I � . . . I : I I I I L . I I I I I . I L I . L I I I t -5 1 1 = I � I . THE OUT'LJET TEE SHALL BE EQUIPPED YATH GAS BAFFLE. I I . I I I . � L N897. '40 T, , � I 1, 9g.,9.9 1 � I . I I I I . L %� I I . I . . . I . . I I I I � I I I - _; I L . I I I I I I I I I I . - L �) I . I � L . ... I I I � - I L� "___ L I � -_ L, - ..- 41.1, 1 1 L �I I - .. I - - � . I" I L . L : , . I L 11 -I . L I . ,Z) . I I I I I L , I I I . I I . ,.' I I . 1. _\ 't --t.Z--,--x 11��"_, L . I L . I . Proposed I L �L . . I L I I I . . � I I I I,- 11 . . I . I I . ) I I I L 11 ;� - I . - - L I � I I I , I ��, L I I . I I �,�.L'," : � . . : I . I I 1 1500 . I 11 I I I I I I , I I ,, � I L 1,I�L`,1.1 I . I I I L I I "I . I . q_J I I I I . I L � I L , I I it I I, '�" I I I . I I 1.r I I I j I I ,Z) L - -"I'll,,_1_1 1. I I I . I I . 11 L L - IL I , I . I � I I I , 9.;J�� ' I I Z' -7 /j, TP I I I I 11 I I I I I I I � I I I L _L - I I . . - I I .I L . I I I � I I L I I I . � I I . I I - I I 11 I I I Ck?flon I-`,_�� I � .41. 1 1 35* I L - , I ;t:1 I . L I , L L I - I L , C DESIGN DATA: . . I I . I I. L L I , L .1 �v I I I I I I .1 I I I I I L I L I I I I 1 9 ' ' I I - � 0) I . I I . .. I I I � ,� I � . I I L I L I I I I . I .. I I L . . I I I L ') . I I I I I . � :, I M L V-� I L \..__ ___TV_ , .I I I I I i I L I I 11 I � L I I . " I 1. I I I L � . STRUCTME 'r UA M tl.\*.k L.(" 17- IA- 110� . I . . I I L � L I - ;, I - �I I L� I I. I I I �, . � I I. I I. I L I .1 . I L �L . I I L I L L I I . � L I � I I I I I I . " � . I I . I L _____�___ -- - . . . , I L I . ; . I 0 . I I qZ1 IL . I L . L L I L 1. I . I I I . . I I I I I I I L' I I I I .1. . I I I I . : I L . I ",_�<, , I I ..L I L I I I L . I I I ., I I� L . . I I I . I I . TYPE NO, BEDROOMS GARBAGE DISPOSAL I I I I I .1 I . 1, I . �_ I . . I I I 11 Prcposed .Driveimy 4b qlz� , I I I . . I I I I 1. I :L 1, I I I 11 . I I I L I I I � I L I I 1 . I � � . L I I L I . 1. 11 L . I I IL L I I . L I - ,e I I . � . . ", I 11 I I I I I I �� � I I I L . . . I . L . I 11 I I., '?I I �, I 0 xll� LL I I- 1L.� I L .1 I I I ''11 � i 4Z) , (55 , I I I I I I 1. . I �. I . I . I I . I . I . I I I I I I I. , . 1. 11 I I I I I . 11�., IL 11 I L L L � 11 I � I � . I � I - � I I DESIGN FLOW - -7-'ZO cAt-Z! I . . I I I I . I I I I I . .1 I 11� I , I , I 11 L � a_ , L I I I I I . I I I I . I I I "" I � I -at-&-_"0 1 1 . I I I 1. I ; I L � i I I I L I , .0 . .1 %- .- , I L . I 1, I I I . I I I L I I 1. L . I . '. .11 I I � I ID - . a L IL L I I . I L � I . I I I . I I .1 I I � i L ,. - .� 41.2', 0 ,j � I � # ' L 44 - . I . I I I - - . I I.. L- L �, . I I L , . I I I L I I I . 1 I I 11 I L 11 I 11 . L �� I I I I . I I � � I I . � I I I I I :, � . I I I I . I . I � L � I I . 11 -_� . I � � . . 11 '� . I I I - I � I I ___*Pr1 L X ., ' tl*\3 I I", � 0 .L I I� . I 11 I I � IL I I I I I I 11 I I 1. I I . I I I . I I � .1 � I . I I . L I 1. I . L I I I I I I � I I # � - I I I I . I 11 11 I I . , I � I � L: 11 - I . t I I . I I ,. � L I I - . .. I 11 I I � 4::� I . 0 , I I :.:*L . I I I r I I . I I I . I 11 I I . . I I . I 11 L I .I . L I . I. 11 I I I L I - . I I I I I . 1 0. L, I I I � I . I I .1 I I I . __ -.-- I I I I I I . I L I � I I I I . I L. I I I -**\ LL � % - L I - - .. ' L I .L" . I I I I L I I . I I I I IL � . . IL I L I I I L L I I . . I.Geneml Conshuction Notes I . 1 I . I . � r, L" I P�Oposed ,, : - I . ,. . I I �., I I I I I I . I 11 I I I I I L I - I 1, L I . I � I . � I �I 11 I ' L I . I . I � I . I � � I I I I I � . I I . I 11 I L I I I � 6 - � I - L L� I I L - � I I L 11 L I I �, i, I I 11 L I : I .. . , . I 11 I 11 L 11 I L 1 � L q) , L - �. I " I I I I � I . I I , I I I I . I I L � 1. � : I 11 L L I . .I .1 I I I I . SEPTIC TAW Ur, L 11 . , L . I I . I �. 11 . 11 I I I . I I . I . I ,�, . 11 I 11 N '. _ ( . I I , q-9-191ve � I I - I 11 I �. L L I 1� I � IL I � . I I . . 11 I I L . 11 I I 11 i I 1 I � � I q) . I . I L I 11 'L � I I L I . . . � . . I L 11 I L, I I I . 11 - I . - r_. _�;r-tt_- "4-0,-A '1r-,r0*,-&11-T-_ ----- I I P, I I I I I - I I &� I . I .L I 1, . LL L 1 I I . , I I I 1� 11 I I I I ' , . I I " I I I I I - I . I 1. All the Workmanship and materials shall conform to 13M.P.Title 5 and the Town of L I - I I j� I ' \.�_ L - ' I I, , I I'll I I . L, 1 . L I I . I I I I . I " I � . L � I I I'll I - L I . I � I L I I I I I * � I ;.I .� I Is I. I - . - L I I I I I � I I . I L I I 1. I I .1 I . , L L.L I I 11 I I . I I I � � I "ll I I� I . L I , � I I .C) . I IL I I I ' ' . - I I 11 I I I L I I . i 4_1� . . I I I I I . I I . .1 1 *413 , - Q� L b Qj� I I , I I I . . Barnstable rules and regulations for the subsurface disposal of sevage. I � I _ # . : L"41.3j, 1 1 1 1 . A I L .I I I ; I " I I I LEEACHING FACILITY . I 1. I �, I . � I L I L I 4Z) L , `� 66 .,---: I L I 11 , I 1. I 11 I I I I I I L I �1: I I . I I I � � . I -,- I __ I L I IL I 1, L I I � L . I L I I r* , ex I I � I I I L I :'... I L X I I L I I I � I . -1 .r � 1. I I 11 I I 11 11 I IL I ., L L , , . I L . I I I I I I L - t\: 'ILI t * . I . . � I. I I I � � . I I I . I L L L I'D I I IL - L I � I I I 11 I 11 . L I I I L L "' I I # . I I I I I . I I I I I I I I � I I I I I I I �, L I I . '�L.11 + � ' L . I �, q- - . I I I � I : , , . , L I � I I I I . *4 1 1 . I . I L I 5 -,- Alt.*"';-%--L,5, Irz S!� '-I-0 "= �<\ - I (� � P, I L Z� , . . . ___- _(� Aa- L I I I 1 2. At least one access port over tank-te"shall be accessible within 6 inches of finish grade, . I L I I I I IL I I 11 L to 6, - . , a , . I I . - . L ''I I I I. ,I . . I I I . I I I .1 .1 I I 0 . I . L . � I .1 ---.--..----- I I .th 1 L I I I I I t . L -_q � I � I I .( I L . . I . le .# I � 0 -1 I I I L L. I L I I L I � I I I I IL L . L L L L I I L�I 1. � � I I I . I .1 VA any remaining access ports brought to within 12 inches Of finish grade. I I I . 1. .44 101 , 4 a I P I . L . . I I I I t I � . L I I . . I I I I I I � -G-rr�1__r3�-D:;_2!:�,zq;"= --%-LO L I -1 I I L I I 11 $ &,$'$ L 'L W , 4 I I I L - I I I � I I � �I . I . I I . I L . L I I I . . 110 � , I ... -.- I , - # I I I I � .1 I I I . � 11 I . I I I I I I. I I I .I I. I -1 . I I . I .I , I � I I L 1 10.51 1 ... I I I . I I I I . �� I 1 � ; L I I I � I � I . I I I I � � I I � . I I I .q I # , , - I � LL I I I I I I I I �, I I I ,, L I .-___� ___ ---.---- I I L I .. : L q) , , I I I I I L I I I I L � I � I I I L I I I I . � I L I L L��� � . I I � L L . I . I I � L I . I I I I . I . I � .. � I . I , P . - � I . . Zwstfng DwelUng - � I L I . I I I ,A-11 Vt. 0,-'tA-= _1-4 . 3. 1 All components of the Sanitary System Shall bC capable Of withstanding H-10 loading ; L . - 9:4 1 .Po&ear � I I L L - ____ _._ � -Tx--- - . - I L I , , .b?10 I I . � 11 . I I I I I I I I I 11 . I I 11 I 11 I 'em, & L 11 . L'. 41.4 , � vw� I I � I I I To Be ,%zed 11 . I I I I I I I - __ - �,"I----.-- I Sep tic Loca tion I I � . I �:�_'�,D_ML7�-'?_O�__!!j_%�_-<_.�J'r_'R. 1%4 'C' S' I unless they are under or within I 0 feet of chives or parkin H-20 loading shall be used I I I viz2e I . I I � . L, I . I L I I I I I I . I . L under or within 10 feet of drives or parking uffless.noted. .1 L . I I L I .L L I I I x 4.) - I I 1. I I . I .- I L � I '(Dotted) LL I BUMING COVERAGE AS PERCEWT OP L07.% . I I I I I I I I 1, � . I I I - I � I Per .As-Buflt . I I L I I . I I I � I I L I I . I I I I . I I . I : �e " I I � L L I , I I I . . L . - - I 11 L - I I I I L I L I A . . , .1 I . . L � , . L I I I 1, I - I - L . I . , JI � , . -1 (� . I � 11 � I � I L . . %.1 .96, 1 1 , I - =nyG - 6 L I I I - I . L I I . . I . I I ,� #20 O.f-01,q I I I L , .11 ", , 11 . I 1. I I I � I .4,V . I . I I I I I I . I I I I I I I I I '. 4. The L I ., I . 1 4 1. I L I � I I I I L . 11 I I 11 . . I � L I I . � .1 I L . ex&1V8t0r/Wnfta&0r Shall verify the 10CatiOn Of 211 Site utilities prior to any ,�Q I I - I .� i - I I ,rb I I L L I I .1 .� . I .1 I 11 . I I I I I I , � I I I . I I I L I � I I I - � L . . . L L I I I I I I I I I I I 11 . I I I I I . . 11 '7 L L I � L L I I I I . excavation- I I I L � , . . I L L . I � I I I - I . I L I I - 11 0 1 1 1 1 L I I I - . I I L PROPOSED - .165., 1 L I I 1 I . I L I I I 1. I I . I . I I I I I . I L I L 1 . � . '� L � . � I I I . I . I I I I I I I I I . L L . L L .. � I � x I I I � I I I I I I . I . . � .1 I � . 1, I � I '_,," L I 6 I " . I L I I I - I I I I . L - : L I L 11 I L : I L ; I 11 I I I I . I I I . I I j� I � � . IL I I I I i . I I ,_ I I I I 11 . I I L I I I I I I 1 5. Sewer pipes shal I be 4-inc 0 P . L :I I I I N . ,jo 114k". L 41-41 ,I//Ily I - L - . I I I I L I ,� soil 1,0gs - I h Schedule 4 VC laid at 0.02 Slope. L L - I L , I I 11 I .,,N I I I I I . I . I I . I I I I I I L N-14 &I - - 11� I � I I I I . I I I I I . � . L I I I 11 L � I � I I I I -1 I I I L I L I I L I . IL I I I I 11 I I I I L 11 . ( ' :� L L I � 'V L ,:L I L L L I I I I I I- I I I � I I - I .:�j I $ \ ,?3 5 L 1, " I I _� . I L I I . I I - . . . . I I � . � I � L - I L L : L I I I I I I I I * I I I - L I I I w I .L I �, L :;�, co � , � . I L I 1� I �, I I I . I L I 1. . I I L I L 1, .. I I I L I � . I . L . I.- Yest Date: September 19, 2002 . 1 6. Any masonry units used to bring covers to grade Shall be mortared in place. I � I NZI I I I " L 2.5..6* 11 I � I I I L I - L . . L I I I LOT 11 .. ' L , I I I I . I I . I I I . I I I I I : I I I I i � I . : . 1. I L I I L I I 1� L I I I � - I I I I I I I I ''I I L . L L I I r , ,,,I_ L , ,,, I , � I , 1% L . I I I L- I I I I I I I . . L . .1 11 . � � I I I I L I I I I I I I I I I L - . I . . I I I I I � I L L I I I I ,, . . I I I I L I _ . - L I I . L , I I I I I I " L I I I � �. L N I I ' I I I ' per L ' , . I I � � ft.L L I IL I I I �. L I I I I � I I I I . I � I I I � I I I � I L 'r . 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I I P_7 � r " ' L " . I 1. I 11 L I .I I I, '23 30 Ili I I I . 11 I - � I - j �, I i� �.� I 0. , , L k6 ' � L ' I L I I p 1 I I r I , I 41. I I . L .11 , I I I I I . I I I 1 � i 'K)*�* . 1, 9 t(�r'.�4114j5, _ .1 I . bv=L. A\�,o.� .#P I I 1. I L . I I . I - I I i I ' L L I I I . I � I,e; � I I I . . .11 L I I � P�v t I I - ___ 0 L .: I . I . 1 I I . I I I I . I . - I I L .1 I I"___��. I I 11 I I I L I L . � 'L I � �, r - �L 11 11 "I ' ll . � . �. L I I 11 111. . I L . . I �"; t!, . " ssa ch u§e.t ts I I I I I I I . � I I . I . I .L I . I I I I L . I I - . I I I L ,6 -, ,Y� I—-r;e, � : " , � I � I , I . L I I I r I I I I I . , - # , ; �, � I I I I " I SL I I I I I I I I 11 I I L I . . I I I L � � I ' 'I I- ,, -I L I � I I L I I I L I - L I. . I I . _� L I L I . L I �,. k., -, I L � L L I I 11 � . - I 11 � __ L '' ' . I L I I I I I L e I I I L I I I - I I . I I I I �N \1 11 I I 111, � 'I, 'L 11 I I . I I , I I " I , I I I I �, I I I I . I I I . I , . �� , , , L I I I L I I . 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IL I - , �I I I 11, I I I I . I I I I I I .. . I , _;t),��;_:,, .": `0 L I � epa I I L I I .- .- I � - I I I r I I - I I . I I I L . I I I I - I L L . . � .. ,_ I I � I . . I � 172 11 I I I I I �I 1, � I I I I I I I, I � I . 11 I .1 I ". L I L %, L - I I I I . �I I I I . I . I I L I I � I : , � I I 11 . 1, . I I I I I I I 11 I "-7- 1 . . � I I L I I . L I L I I �L I I I . I 1 I I .11 I I .. I Stepben -T Doyle And Associa tes, . .I . . I L � . . L 11 I I I I � .I L I I L I I L I .I I I I L I I. 1 1, I I I I 11 � I � I -I "I � IL I I- 11 I I L'I L � I L I .� I I L.., 1.I I I I I -L � .REFERENCE RECORD RUN - BOOK .103 PACE 53 1: . I 1 42 Canterbury Lane, R Falmoutb, NA 02536 1 L 1. L I I -I I � . I I I I . I L I I I I I .1 . I I � I I L L I I � I I L� I . L 1 . . I . I I -1 . I I � I I L I L . r L I I I . I I � . � I I I 1. I � I I I �. . � I L I I � I � I - I � 11 .. : i I I I !L ' I I - .. I I I I L I I I . I I � - I I . I L . I I I I ': I . 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