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Home My WebLink About0143 PINELEIGH PATH - Health 143 Pineleigh Path Osterville P e4 — A = 071 001005 - - I. i u �I v TOWN OF BARNSTABLE LOCATION N3 � I/ 1e/ev6H6 SEWAGE#o�Ga(- y31 VILLAGE®.STGtiil- -OrsTo "ASSESS_OR-'S MAP&PARCEL®°1(100 t-aoS INSTALLER'S NAME&PHONE NO. �,l��ZCLLl ,-Tc--1 - .5--08 SEPTIC TANK CAPACITY o7 000 6-1( 02 Cb - f�'a2O CG xc s i� LEACHING FACILITY:(type)S-&-60GR. COY H (size) .S-O,d 1C /02•B3 eY-ao NO.OF BEDROOMS OWNER t.✓'1�� f %tfMe� /U PERMIT DATE: /a-d' oZf COMPLIANCE DATE:06C_ a0 Z,( 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 ro s - p p ull A Rom^ 'io6�`-v66�FEH s{`�c c M .�- ��F,�TOWN p1 OF BARNSTABLE LOCATION �L(3 It A e\ec� ? SEWAGE# 96611- Lf 3°? VILLAGE 0S-rvt( c ASSESSOR'S MAP&PARCEL D 11-'00!-©dS INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /5oo G61 r1,�;C) _ LEACHING FACILITY. (type) /6'�!!.Cffrq&&C (size) I6 6 g y- a NO.OF BEDRO�(O�MS �I70d- bhwf OWNER W(, GfAk �C('ylF.e dCCc PERMIT DATE: (02' "02 COMPLIANCE DATE: ec 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 � V n i� Caw LF � M1 Z4 �1L No. Fee —�— ® THE COMMONWEALTH OF MASSA H Entered in compute' er:�� C USETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 9ppliLation for Bisposal 6pstem ConstCUttlon Vmit Application for a Permit to Construct(.Repair( ') Upgrade( ) Abandon( ) [.]Complete Systems ❑Individual Components Location Address or Lot No. l ei511` � Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 0-7 -00 Installer's ame, dress,and Te o. S oB-3�6" Designer's Name,Address,and Tel Na G�� L I ETC f 5V 1�d-io& fP S`+ Type of Building: � tk 1 w21c� Dwelling No.of Bedrooms F- Lot Size L173,011 sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) . Other Fixtures Design Flow(min.required) (o(oU .gpd Design flow provided 6(06 t" Zy Z— gpd Plan Date h_54— zS. Z e�Z' Number of sheets 2 Revision Date kq j]lZa Z Title Size of Septic Tank ��o� J 0 �av � e of S.A.S. 6-SOO�04\ t►1r,,M�� \�—SOc9 6kL C1ncw�LZr Description of Soil �} ZI Z.-7 u "�-�-1`3Z � � M�►i� ,S G Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in..".* accordance with the provisions of Title 5 of the Environmental Code and not tAplace the system in operation until a Certificate of Compliance has been issued by this Board oUlealth. Sin Date Application Approved by Date Application Disapproved by ( Date for the following reasons Permit No. O Date Issued 1 'r� No: a ! r tics!!:: Fee .. ^' r• A THE COMMONWEALTH.OF MASSACHUSETTS k Entered in computer�.�r ' PUBLIC HEALTH DIVISION TOWN OF�BARNSTABLE, MASSACHUSETTS .. a 21ppYIcatlDn for VspOsaY 6pstel Construction Permit � Application for a Permit to Construct(,' Repair `Upgrae(z) Abandon( ) Complete System` ❑Individual Components Location Address or Lot No: 14Vt` Iti54N Owner's Name,Address,and Tel.No. 00 Assessor'sMap/Parcel 0 1 0a# Z o&S "Installer's-Name,Address,and/Tel, o. ��B' Designer's Name,Address,and Tel.No. / P r d' /cr,1,5i< 057;:.rt'/� �= ll r�twr.,��. /►7d.va►� (a Sy Type of Building: rer•S1� Cgll�n� „��F;I�,R�L�� a u2to J Dwelling No.of Bedrooms F' fj Lot Size-—Li 3, sq.ft. Garbage Grinder(A,9 r Other Type of Building ," No.of Persons "r t_,;Showers( ) Cafeteria( ) Other Fixtures N .� Design Flow(mein..required) 6(' gpd' Design flow provided gpd Plan Date t�*1`" yr� Z�+ I Number of sheets _ _ Revision Date.f 1\ �I a Z 1 �. ,f: Title r'3sde T��h 1'reOoLr� .�+Q"oJ-P✓4Evi.+.,3 . Size of Septic Tank k;O Dt 4- '1 0'6 "Type of S. Description of Soil'" Lw\fn 5hiA->,. 1141 g14D Nature of Repairs or Alterations(Answer when applicable) i d Date last inspected: t 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 to7place the system in operation until a Certificate of Compliance has been issued by this Board o 'ealth. ~^ti Signed ~� n Date Application Approved by 7 Date Application Disapproved by Date t for the following reasons Permit No. fT �'�r Date Issued �w. THE COMMONWEALTH OF MASSACHUSETTS -- c7r BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(/� Repaired( ) Upgraded( ) Abandoned( )by S a 1jt r. Co,1.537- at 1�i`� I?AA C 04 �h, has been constructed in accordance r with the provisions of Title 5 and the for Disposal System Construction Permit No. n l Ll3 dated Installer ' t)/6,CC hacr-►` ---s r Designer #bedrooms (t G Approved design flow �p (f r gpd The issuance of this permit shalt not bel construedas a guarantee that the s stem will<fu cttion s designed;. Date `�_J' l f Inspect _ No �G�I �- G°I_? -.-meµ__ .-.-:-.�.-.-,-.-.,-:_.-.- -- - --.-_� :-:.�-�-.•r--• --• ---------•----- ---Fee-----,�-�----�---- - THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS -Misposar :i�pstem Construction Permit Permission is hereby granted to Construct( ..)- Repair( ) Upgrade( ) Abandon( ) System located.at •k 4 C. ti f and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her-duty to,comply with Title 5 and the following local provisions or special conditions. .. y Provided:Construction must be completed within three years of the date of this peMU*t_. ,--- , � -.�- C� Date Approved by ti ,''<, = Town of Barnstable ' Regulatory Services Richard V..Scali,Interim Director Public Health Division - Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer&Designer Certification Form 12/16/2021 171/001-005 Date. ,:. .. Sewage Permit# a4�2('y3 „Assessor s MaplParcei _, . Sullivan Engineering&Consulting, Inc. Designer: Installer: 711 Main Street/PO Box 659 ,� �� Address: Address: S Osterville, MA02655 ((C On TCC-4, aaac S�n,�e (`(a (<<s-i�r was issued a permit to install a ' `(date} (mstailer} 143 Pineleigh Path,Osterville MA septic system at based on a design drawn by (address) Sullivan Engineering&Consulting, Inc. dated 8/25/2021 Revised 11/17/2021 (designer) X I'certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank, Strip out (if required) was inspected and the soils were found satisfactory. I certify.that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the.soils were found satisfactory. I certify that the system referenced above was construct a� nce with the terms of the IAA approval letters (if applicable)A"IAI ,roc (Iris lei, :Signature) g' gr !E?NAI ' (Designer's Signatur;; . (Affix Designer's Stamp Here) ..,PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH.,DIVISION. CERTIFICATE„ ;.OF COMPLIANCE WILL NOT BE ISSUED "UNTIL BOTH THIS FORM AND AS. BUILT"CARD ARE RECEIVED BY--THE BARNSTABLE'PUBLIC HEALTH DIVISION. THANK YOU. _... Q:\Septic\Designer Certification Form Rev 8-14-13.doc TOWN OF BARN TABLE �•co LOCATION lq3 eele h SEWAGE # VE LLAG ASSESSOR'S MAP & LOT "� j INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY W®® v LEACHING FACILITY: ( pe) (size) I NO. OF BEDROOMS I BUII..DER OR OWNER PERMITDATE: � ®� COMPLIANCE DATE: 4,.11to1L2:2 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 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 -,r �4 Z --37 R ' 361 63- -71 0 3 /Z - l tic. tt 3-3®is" t f rt Fee ( We THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: f Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS L 2pplication for Oiopogal *pgtem Conotructton Permit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) 17 Complete System ❑Individual Components Location Address or Lot No. 1.43 Onc Ic,1b. R fi i Owner's Name,Address and Tel.No. �� HCsrbesa*5 �h¢tzw E L7cZvtlt. ita�� Assessor'sMap/Parcel 61i Yoernaok, W, Wclksi Me4 CZ461 Installer's Name,Address,�and y Tie /o►,� fit. Designer's Name,Address and Tel.No. 4Z5e-9 t 31 Type of Building: Dwelling No.of Bedrooms Sr?c Lot Size 43;5(-1 sq.ft. Garbage Grinder Vt/c) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //O 2024 &/-07 V40"t"". Calculated daily flow 640 gallons. Plan Date of ,9 Number of sheets aozp Revision Date 9/5/ 5� Title SeJz 61cui -k Sej2k psi§!^ Size of Septic Tank 'ZCrcxn ne itr."A Type of S.A.S. 1 e,r C6.4yes W x Pad XZ° Description of Soil pt� �cc s-e j=jc -A� gie-I I !aq;!, Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this B d o e Signed Date 3 Application Approved by e Date Z 7- Application Disapproved for the following reasons Permit No. 9 Date Issued No --� "�`!e :m" aK4n Y_ Fee �VV THE COMMONWEALTWOF MASSACHUSETTS A Entered incomputer: M Yes PUBLIC HEALTH DIVISION` TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Migotal *p! tem Conztruction Permit Application for a Permit to Construct( ( )Rep'r( )Upgrade( )Abandon( ) '®'Complete System ❑Individual Components Location Address or Lot No. 143, #j►1e Iet1h Po kn Owner's Name,Address and Tel.No. b �'2N �"t4r b✓'S l7KCI"ttJ f �1 ZY{.E.. TZ Assessor's Map/Parcel y bfr Yarmook, Po/t wedlesi4 M-4 GZ461 Installer's Name,Address,.and Te1.TNo Designer's Name,Address and Tel.No. r , ' ! 7 �'� �� S12 m4t., 5f OSlzroi'ItQ , m►* buss � f Type ofaBBuilding: Dwelling No.of Bedrooms S j2s Lot Size 43,5G 1 sq.ft. Garbage Grinder(A/o) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //O 9'pklhA, —v40M4qff4aY. Calculated daily flow 640 gallons. Plan Date 6hh F1'4 Number of sheets a�-w Revision Date VA&I; Title 51lr 67l inn lr Se j2k Size of Septic Tank Zcroo ae 1 tcsL4 Type of S.A.S. l g"k C4&,6,rs W x 61 K Zt �«G Description of Soil bh co se 4" � sd i I 1C. Lr Nature of Repairs or Alterations(Answer when applicable) � 1 i Date last inspected: Agreement: The undersigned agrees to ensure the construction acid 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 b thi B d A, ,eg Signed Date 3 Application Approved by A" f Date a 7' Application Disapproved for the following reasons :r I Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site ewa a Disposal System Constructed( Repaired( )Upgraded( ) Abandonef ( )by 01 �a�s at / i C,, `'11.e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer` Designer The issuance of thi e t shal ngojLbe construed as a guarantee that the s m 1u c o as igne� Date d Inspector �� ---9_r--------------------------------.�r-- No. Fee THE COMMONWEALTH OF MASSACHUSETTS r _ .. PUBLIC HEALTH a1VISION-.BARNSTABLE, MASSACHUSETTS-..,,-,---. � . Migool 6 tenY Construction Permit Permission is hereby granted to Construct( to Repair( )Upgrade( )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons'ruc, ion must be completed within three years of the date of this e t. Date: -� Approved by —'� - r _ f IME rp� DATE: �O r FEE: * IARNSPABLE, # 9 MASS. g 039. �0 REC. BY ' Town of Barnstable SCHED. DATE: Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. REQUEST FORM LOCATION Property Address: I�3 1�inc I�t�k R}h 04Qk,- Ha,r bars Assessor's Map and Parcel Number: 7/ Pc//—s Size of Lot: 43 Wetlands Within 300 Ft. Yes Subdivision Name: No &,-- Business Name: APPLICANT CONTACT PERSON Name: Name: lk),Isem r' c 2 AAA Address: jq�rirb�fL //cs! _ Address: B/2 I,los St Ds W/lam Phone: Phone: 42fr— FAX: FAX: 423--�3.7 S o VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variances only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G. Rask,R.S.,Chairman NOT APPROVED Sumner Kaufinan,M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy,M.D. Q:/WP/VARIREQ 1 I J p susr 2 1 I 1 4CBEEHE "'" I LAW— I/ -- . _ - —_ _—_—__ —_— _ _ _.. ------ _ 'C-j -------- BALL I11 3S I _c I n N FAWLYBDOIA Nli 1I —0 BREAKFAST MWEN uurmxrl .SLG.y. 1 I I J.m 1 i , 0 T' ..,, l 4.. __..__�L ..__ 1` 1 1' KIDS BIKE/ BU KPAIrtHY —� \\ /�i , _ H YBS pI�n , B�Mg I It b1YlIL9. a I -�sa a.� P.R:1 , pw=lm L� r,. ca 1 ;:. HALL I �� f O In UMLUAV.O -------- --- �W I O I � a�l � \ Rot { — PROPOSED — — — — — — ' FIRST FLOOR FOVEH scuez PLAN c' 1 �1 I •.— w -- — I OB.PS.mI RO r nr i v,. � en ov I Ho. oaro -I `c I 1 �. PROPOSED FIRST FLOOR PLAN - s.u<.ro ,\j%�=� I `l I 1 oDAvt\c Ko.: ' Al . I zo p o o �> „ T �o o e m i ®p T � erni "sFaK da Rol; III �:--�•-•-- i I I Jillli ll aos� � swsEr o aos� .. ._.:. r° m y d lom ° I_ h j l ° I i I I cs CLOS PROPOSED ADDITION&RENOVATIONS TO � �`'�} D O�� Y ` w O n O0 BURCK RESIDENCE pp�a g z O O architecture Interiors von z m where visicns take shape "' 143 PINELEUGHT PATH _'' 6 OSTERVILLE,MA 02655 t G I II h I :I :N Jy 5 8 III � CIA�ET I� J 9 m G I k s 1 k M •i 4 .,�,.� I i, i LNEl1 � sy (R'I a O PROPOSED ADDITION&RENOVATIONS TOCab jI' X $ - O z BURCK RESIDENCE \iT ! = I Ix.r z Architecture Inteflors Where visions take shape : Js '"N ; 143 PINELEUGHT PATH u� �° OSTERMLLE,MA 02655 .N V 3 i i -' -------------------- ...... - k I STORAGE a 2 IN; a. 9 i E� !iI �� illll i m I ❑In I till 7- CLOSET -- ---- �cLos � _ CLO a I a Mos I I j dsGs g PROPOSED ADDITION&RENOVATIONS TO a v r m O m fySt a O E—n BURCK RESIDENCE architecture interiors OZ Z where visions take shape _ 143 PINELEUGHT PATH �l A1wuOM.iEEn.¢'nE� �)= N s z OSTERVILLE,MA 02655 Dec 18 2018 00:44 HP Fax page 6 Commonwealth of Massachusetts Title 5 Official Inspection Formrd Subsurface Sewage Disposal System Form Not for Voluntary Assessments y s 143 Pinelei h Path ' s Property Address Henry Sunderland Owner Owners Name / information is required for every osterville MA 02655 12-11-18 - page. Gty/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. ``a�ttttutnuurnq��1 Important:When A. Inspector Information s� 3�8 filling out forms i p rya " s9�,y on the computer, O� G use only the tab James D.Sears = JA M ES m key to move your Name of Inspector : 51HARS cursor-do not Capewide Enterprises use the return % �- 0 O key. Company Name ��j`- TI '`.. 6� 153 Commercial Street 4�qF S INSPE�� Q Company Address Mashpee _ MA 02649 City/Towr1 State Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the Inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 12-12-18 pector's Signature Date t 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. i5lnsp.doc-rev.7l26120i8 Title 5 OHidal Inspection Forth:subsurface sewage oisposal system-page 1 of 18 Dec 18 20,18 00:44 HP Fax page 7 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Ve 143 Pineleigh Path Property Address Henry Sunderland Owner Owners.Name Information is Osterville required for every MA 02655 12-11-18 page. City/Town 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 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.. Comments: The system is a 2000, Gal. Tank D Box and 12 Chamber's per plan 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 sub stantial 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.71`26/2018 Title 5 Offdal Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Dec 18 2Q18 00:45 HP Fax page 8 Commonwealth of Massachusetts Title 5 Official Inspection Form .P Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 143 Pineleigh Rath Property Address Henry Sunderland Owner Owner's Name information is required for every Osterville MA 02655 12-11-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) . 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): I 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: 15msp.doc-rev.71282018 Title S 08idal Inspection Form:SLbswfeoe Sewage Disposal System•Page 3 of 18 Dec 1.8 2Q18 00:45 HP Fax page 9 `y Commonwealth of Massachusetts vg Title 5 Official Inspection Form it.) Su bsu rfac e Sewage Disposal System Form Not for Voluntary Assessments !02 143 Pinelei h Path Property Address Henry Sunderland Owner Owners Name Information is required for every Osterville MA 02655 12-11-18 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 feel but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7126/2016 Title 5 Official Inspection Form:Subsurface sewage Disposal system•Page 4 or 16 Dec 18 2018 00:45 HP Fax page 10 Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 143 Pineleigh Path Property Address HenrySunderland Owner Owners Name information is required for every Osteryille MA 02655 12-11-18 page. City/Town State Zip Code Date of Inspection Cr Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in anspot is less than 6" below invert or available volume is less than 1/z day flow 4L81;e*A16 ❑ ® 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. An portion y p o of a cesspool or privy is within a Zone 1 of a public water I ❑ ® Po p Y P 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- 101000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM R 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 15insp.doc-rev.7/26/2010 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Dec 18 2018 00:45 HP Fax page 11 Commonwealth of Massachusetts o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments v 143 Pineleigh Path r Property Address HenrySunderland Owner Owners Name information is required for every Osterville MA 02655 12-11-1 S page. CitylTown State Zip Code Daze 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 NIA) ® ❑ 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.7/26/2010 Title 5 Official Inspection Form:subsurface Sewase Disposal system•Page a of 19 Dec 18 2018 00:46 HP Fax page 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 143 Pineleigh Path Property Address Henry Sunderland Owner Owners Name informatbn Is required for every OSterville MA 02655 12-11-18 page. City/Town State tip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 6 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 660 Description: 2000 Gal. Tank D Box and 12 chambers. Number of current residents: 2 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 information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, If available (last 2 years usage (gpd)): 2016-44,00OGals 2017-45,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date t5lnsp.doc•rev.7/26/2018 Title 5 ONciel Inspection Form.Subsurface Sewage oisposei system•Page 7 of 18 Dec 18 2018 00:47 HP Fax page 13 Commonwealth of Massachusetts z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 143 Pineleigh Path 19C-V$ - Property Address Henry Sunderland Owner Owners Name information is required for every Osterville MA 02655 12 11-18 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: NA 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 Dec 18 2018 00:47 HP Fax page 14 Commonwealth of Massachusetts �- Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 143 Pineleigh Path Property Address Henry Sunderland Owner Owners Name information ired is every Osterville wired torev MA 02655 12-11-18 page, City/Town State Zip Code Dave 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: 1999 Permit#99- 549 112-2018 New H-20 D Box. Were sewage odors detected when arriving at the site? ❑ Yes ® No i 5. Building Sewer(locate on site plan): Depth below grade: 20" 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.): Pipeing is 4" PVC SCH -40. 25insp.doc-rev.7/26MI8 Title 5 Ofriciel Inspection Form:Subsurface Sewage Disposal System-Paige 9of 18 Dec 18 2018 00:47 HP Fax page 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System form -Not for Voluntary Assessments 143 Pinelei h Path Property Address Henry Sunderland Owner Owners Name information is required for every Osterville MA 02655 12-11-18 page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 10" feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene' ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 2000 Gal. Precast H-10 Sludge depth: 2 f, Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness ill Distance from top of scum to top of outlet tee or baffle 81, Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Plan-Tape _ Sludge Judge 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 at working level. Tank at 10"below grade wlinlet cover at 6"and outlet cover at 4". H-20 Tank. No sl n of leakage or over loading,' t51nsp.doe-rev.712512018 Title 5 Official Inspection Form:SubsuAace Sewage Disposal System•Page 10 of 18 Dec 18 2018 00:47 HP Fax page 16 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments C, 143 Pineleigh Path Property Address Henry Sunderland Owner Owners Name information is required for every Ostenrille MA 02655 12-11-18 page. CityrTown State Tip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5lnsp.doc-rev.7/261201B Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page i i of 18 Dec 18 2018 00:48 HP Fax page 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 143 Pineleigh Path Property Address Henry Sunderland Owner Owner's Name information is required for every Osterville MA 02655 12-11-18 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 H-20, New 12-2018 wlone line out.W/ raised cover in stone drive way. I I6insp.doc tev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Dec 18 2018 00:48 HP Fax page 18 Commonwealth of Massachusetts Title 5 Official Inspection Form iit Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .'` 143 Pinelei h Path Property Address Henry Sunderland owner Owners Name infof nation is required for every OSterYille MA 02655 12-11-18 page. Qty/Town 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 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5lnsp'doc•rev.7/2612018 Title 5 official Inspection Form:Subsurface Sewage Disposal Syslem-Page 13 of 111 Dec 18 2018 00:48 HP Fax page 19 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments F 143 Pinelei h Path Property Address Henry Sunderland Owner Owners.Name informationis required wir for for every Osterville MA 02655 12-11-1$ page. City/Town 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.): Leaching is 12 chamber's per plan. Camera out w/no sign of over loading or solid carry over. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5insp.doc-rev.7/2812018 Tithe 5 Orfidal Inspeetion Form:SLbsurface Sewage Disposal System Page 14 of 18 Dec 18 2018 00:48 HP Fax page 20 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v� 143 Pinelei h Path Property Address Henry Sunderland Owner Owners name information is OSteNiNe required for every MA 02655 12-11-18 page, Cilyrrown State Zip Code Date of Inspection D. System In, (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-iev.7/2612016 7111e 5 Orfidal Inspection Form Subsurface Sewage Disposal system•Page is or 18 Dec •18 2018 00:48 HP Fax page 21 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 143 Pineleigh Path Property Address HenrySunderland Owner Owner's Name Information is Osterville equired for every MA 02655 12-11-18 page. CityTrown 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 ISlnw.doc-rev,712612018 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System-Page 16 of 18 Dec 18 2018 00:48 HP Fax page 22 1 O No!OF BEDROOMS- 12 1 u BM DER OR OWM--" !Aae PERMITDAM 31ZO UA6 COMPLIANCE DATE: Separation Distance Setwecn the: Maximum Adjumd Groundwater Tabloto the Bottom of Leaching Fatality Feet Pfivpte Water Supply Well and Imching Facility (if any wells exist an silt or within 200 feet of leaching fgCiLty) Feet Edge of Wetland and Ltac*g Facillly(if my wedlands exist within 300 feet of leaching facility) _ Fect Furcushed by 47 z -37 � a�..ys 83-7/ 4 O 1 v A-� 31 N Al. 3s LZ'd LL6V-LLb-809 sesudje)uaep!madeo d£L:£0'gLbLnoN Dec -18 2018 00:48 HP Fax page 23 Commonwealth of Massachusetts Title 5 Offici al Inspection Form Subsurface Sewage Disposal � g System Form Not for Voluntary Assessments 143 Pineleigh Path Property Address Henr Sunderland Owner Owner's Name information is required for every Osterville MA 02655 12-11-18 page. Clty/Town State Zip Code Date of Inspection D. System Information (cont.) 15, Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow welts N� Estimated depth t high ground water: 11 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: 6-5-89 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: T.H. on Design plan 6-5-89 1 Von G.W.. Bottom of leaching is 4' below grade. Bottom of leachingat T above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15h8p-doc•rev.7/26/2016 Title 5 Of dal Inspection Force:Suhsurfooe Sewage Disposal System-Page 17 of 18 f Dec 18 2018 00:48 HP Fax page 24 P Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 143 Pineleigh Path Property Address HenrySunderland Owner Owner's Name information is required for every Osterville MA 02655 12-11-18 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 6: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included �oV—,M j-c c NO -w t5insp.doc,rev.7/26/2018 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 No.�20!(v Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9ppfitation for Bisposal .6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. f 3 PtIJC-L-"(4!-1 P,4T11 Owner's Name H EN K*Y ,Address,andLel. 17o. e"ER Assessor's Map/Parcel 0 f 0 00 5 ° t>D C3ag aoO.)� dIYST'ER k{AV,90-4 O Installer's Name,Address,and Tel.No.. 502 v 47 7—8 17 Designer's Name,Address,and Tel.No. C/��wt0� a✓aaT�'�L�S�3�Q N �{ C i l Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ZN5D!i:L1' Wl7H RfS� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea th. Sign Date l —1 Application Approved by Date Application Disapproved by Date for the following reasons Permit No.__ �/ Date Issued B I �� e+'".. T- } ,r. 34.e«-.ro;"'i,'Xr.-�«.r.:swt-ram ..r-�'S-- `..-p w+,�",.s. ,...X t.. .rTa•�,,�;S!is.i .• - ..'•.., - '44 f ."�T.:rTMR.''!+4tifiMr�*',f* ivr►:v^+t+'4}Awh.,,. ••.,1-�...-t'.:.. -ol ^1 t• No. Fee Entered in computer:uteri THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for Misposaf 6pste»t Construction 3permit Application for a Permit to Construct(.) Repair( ) Upgrade(. ) Abandon( ) ❑Complete System ❑Individual Components : Location Address or Lot No. (q3 p(MC-LiG/GY PATW Owner's Name Address,and Tel-No. Assessor's Ma /Pazcel 0 � H leN K-1 §vtq Vir L �'L p 0 1�Do �00 p0c3OX ;took„ oYSTr:TL K�4� S O5='. Installer's Name,Address,and Tel.No. ,$t+g-�f'Z1-$ `i 7 Designer's Name,Address,and Tel.No. N lA . . l�3 sr titsc�D ' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow,(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. ti Description of Soil Nature of Repairs or Alterations(Answer when applicable) 2N5D+-c1 N EA..) --:;L O 0 —AQ9- W I'Ty ( lam Date last inspected: M Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of } Compliance has been issued by this Board of Health. 4 L Signed-.---,, / _ Date -(.0 Application Approved by `•� - ;.,,�,,,,, Date /A,L« Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by, (24(1 EWr D at lt 3 P IAj6L c-t et4 P47 f 4 5 7'°" has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No�Q/g' 3t,";dated Installer g;wcb& �7j'Z�]Q�,lQt,4" d Designer #bedrooms * Approved design flow gpd The issuance of this permit shall not:be construed as a guarantee that the system wi•1112rai=esi6;d.Date � 1 �� . Inspector /�.._.. -:- - - • - - ------ --- ---------- --------------- ------ No. ( Q` Fee v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *Pstem Construction Permit Permission is hereby granted to Construct( ) Repair(� ) Upgrade( ) Abandon( ) System located at `T:�j t+ /1U t~4.c-(( E'( p�-!'� ' , and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date / I j U /I Approved by 1 TOWN OF BARN TABLE LOCATION !f 19� �l17` SEWAGE # 99 S`y9 VILLAGE D51r-tV�ll� ASSESSOR'S MAP & LOT "Gb INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 94/ LEACHING FACILITY: ( pe) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: 3/z,qA0a; 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 — - -....... ...... .------------- _._ .. . ..... _ 0 � COMMONWEALTH OF MASSACHUSETTS _ CU�G EXECUTIVE OFFICE OFENVIRONMENTALAFFAIDEPARTMENT OVENVIRONMENTAL PROTEC ' TITLE 5' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION- MAP Property Address: � � n a !� ®®t_ I'HI�C�..L Owner's Na r^ LOT ...... ..._.... Owner's Address: b.'(7511-10 Date of Inspection: 3 r Name of Inspe tor. (please rint ) 104r ' Company Nam Q ^ Mailing Address: ! p Uc OV Telephone Number: 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 complefe`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 pursuan71P ection 15.340 of Title 5(310 CMR 15.000). The system: asses Conditionally Passes Needs.Further Evatuation by the Local Approving Authority • ils Inspector's Signature: mate: '�03 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 k. tt bA4 o WL w.. ****This report only deicribJ conditions at ttie_tim'e*of nspecfion'and un�J 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 I r Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A, e CERTIFICATION (continued) Property Address: Owner- j / Date of Inspection: Inspection Summary: Check A,B,C,D or E!ALWAYS complete all of Section D A.^ SS stem Passes: V I have not found an informat ion tion which indicates that any of the failure criteria described in 310 CMR 1.5303,or in 310 CMR 15.304.exist.,Any_failure:criteria not e.valuated-are-indicated.below:—> w Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approvedby the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. • .l 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: a.Observation ofsewage.backup,_or-break out-or.high-static-water ieve�l-in-the•distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System willpass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or.replaced ND explain: The system required.pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health):. broken pipe(s)are replaced obstruction is removed ND explain: 2 'Page 3 of 1•l OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM -PART A CERTIFICATION(continued) Property Address: . /4 Owner. Date of Inspection: 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 s net`f,�actening`ir a nanre; hi� .vs"i profect p� biic iieaith;sa-fety:and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a borderinc,vegetated wetland or a salt marsh 2. System will fail unless the Board,of Health (and Public Water Supplier,if any)determines that the system is_functioning in'a.manner that protects the public health,safety'and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private.water supply well. _ The system has a septic tank and.SAS and the SAS is less than 100,feet but 50 feet or more from a private water supply well"..Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the.presence-of aminonia,r i7ugen and•nitrate ziLiegen' s'equal to'^cr'less tha.::5:pf'm;providedzft at no,ot:�er- failure criteria are triggered.A•copy-of the analysis must be attached to this form. " 3. Other: 3 Page 4 of I I OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) .Property Address: lei. 19v,� Owner. Date of Inspection: ZrA A D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: . Yes No/ _l Backup of sewage into facility.or system component due to over':oaded_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 _ V Liquid depth in cesspool is_less than 6"below invert or available volume is less than '/z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number ff of times pumped _ tlf Any portion of the SAS, cesspool or privy is below high ground water elevation. _77 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 cesspool or privy is less than 100 feet butgreater 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 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correctthe 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-system s in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1.1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 9 ` ow Date of nspection: Check if the following have been done.You must indicate."yes"or."no"as to each of the following: Yes No _ tf�_,Pumping:information was_provided,by.the:own(r,occupant;or Board-of Health .. . Were.any of the system components pumped out in the previous two weeks? ` V/ 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? II/// Was the site inspected for signs of breakout? _ 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? t/ 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 o Existing information.For example, a plan.at the Board of Health.. V — 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 l Page of 11 OFFICIAL INSPECTION•FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C _ SYSTEM INFORMATION Property Address: /&A Owlt�Q �2p Date of Inspection: /K s > FLOW CONDITIONS RESIDENTIAL &--' Number of bedrooms(design):. Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for exam le: 11.0 s)• bPdx#of bedroom p �G® ,Number of current residents` Does residence.have.a garbage grinder(yes or n6):Zj Is laundry on a separate sewage system (yes"or no : f es separate in*s econ required] ~ Laundry system inspected yes or no):/ Seasonal use: (yes or no. Water meterreadings, if afilable' (last 2 years usage(gpd)): OZ,- 63 �®t'1 01 -Z_3 jA0ej Sump pump(yes or no)AQ- Last date of occupancy: COMMERCIAL/INDUSTRIA L/j(0— Type of establishment: Desigri flow(based on 310 CMR.15.203): gpd Basis of design.flow(§eats/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'ofthPnpecti n(yes r no): If yes,volume pumped: gallons--How was qua ti�mped determined? Reason'for purnping: — TYPE F SYSTEM eptic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _:Privy _Shared system.(yes or no)(if yes, attach previous inspection records, if an 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 _Othe"(describe): A rozimate age of all components,da a insta led if known)and source of information.- Were sewage odors-detected when arriving at the site(yes or no)/1 6 Page 7ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: r Owner. ; Date of Inspections 3 BUILDING SEWER(locate on site pla� Depth below grade; Materials of construction:_cast iron _40 PVC_other(explain):- Distance from private water supply well or suction line: Comments(on condit;bIi of joi�7ts,.veriting,evidence of leafage,etc.): } SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction:concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list_age:— Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: T Sludge depth: i [ Distance from top of sludge to bottom of outlet tee.or baffle: �© Scum thickness. !/ !� Distance from top of scum to top of outlet tee or baffle: j Distance from bottom of scum to bottom 9f outlet tee o baf e: l Z- How were dimensions determined: Comments(on pumping recommen' ations, 'filet and outlet tee or baffle condition,structural integrity, liquid levels s related to outlet invert, e i ence of leakage Lea,—I& iPe2rw--1ZW-1i1 7/,�Qh/ Ot GREASE TRAPD locate on si e pla ) 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.): 7 Page 8 of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY,ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C SYSTEM INFORMATION(continued) Property Address: -0 I Azj- oh , Ownei Date of Inspection: 3 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.): r DISTRIBUTION'BOX:zif present must.be opened)(locate on site plan) Depth of liquid level above outlet invert:il pp 0�r Comments(note if box is level and distribution to outlets'�qual, any evidence of solids carryover, any evidence of akage into or out of box, .): ' P. 19�6-j A,0�-yi - g'-) 0 A111. 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 chainber,condition of pumps and appurtenances,etc.): .. 8 i Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION'FORM. 'PART C SYSTEM INFORMATION(continued) Property Address: Owner - Date of Inspection: /, 3 SOIL ABSORPTION SYSTEM (SAS):._(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ ching chambers,number: 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.) I CESSPOOLS: (cesspool must be pumped as part of inspection)(locate bn 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.): 9 I Page 10 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address Owne Date of Inspection: i v 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. 9 10 Page 11 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM,INSPECTION FORM PART C '. SYSTEM:INFORMATION(continued) Property Address: o Owner. Date of Inspection SITE EXAM. Slope Surface water Check cellar. Shallow wells r Estimated depth to ground water 00 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: :'ou must describe how you established the high ground water.elevation: a A l�lif O�lll ��I 11 I Permit Number: Date: Completed by: L Olt HIGH GROUND-WATER LEVEL COMPUTATION Site Location:/ j /lie, Lot No. Owner. T,/ �• Address: Contractor: Address: Z Notes.: STEP 1 Measure depth to water table to nearest 1/10 ft. .............................. . Date _. .. . month/day/Year STEP 2 Using Water-Level Range Zone. and,1ndex Wel'I•Map locate site and determine: OAppropriate index well.................................��/ ..... Water-level range zone ........................................... i STEP 3 Using monthly report'"Current Water Resources Conditions" determine current depth.to / water level-for index Well .......::.. 07/0 ' ��V ! ' ................ month/year S T=P 4 Using Table of.Water-level Adjustments { for index well (STEP 2A), current depth to Water level for index.well (STEP 3)., 'and water-level zone (STEP 2B) determine water-level adjustment-.......,...: �•� STEP 5 . Estimate depth to high water by subtracting the water- .level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ...................•.......-. l Figure 13.--Reproducible computation form. i l Y 'a L . i f �E 3 3. ii s i S I A r I I I I jQ, j f I I•: � f II'I :p q - v � 1 11,• I I ,� �,P I I _ ^, I A -1V t o _ Fes,' ®._ ' � � 'C $�13 �—CG15NfWE5�� E-- PJp� ��'i I - • YI O _ II I LPiI •s g gl .L �•— ma's_ — � w I. 1'. }- i :s... . ab a o' 1 5-6' , _.-6_6'_ I-h� �ia �_lo• _5-aE- 21G` ._._.1'_°•..._— .l � _}. —� ao - 000 , — —4 J - S- [o xe IN O - --- — OGG : q ' ' >P ill I I � �� -•�9 S' j: I I !V9 s I p 7' I.� z�• ' - #� e,:d :'N• Imo-. __-_- - —_ �d; Iq ic. • qL .77 i to50`"I• 8 I I C:� I. j o�.l'; u I B e ' & I •y i � I. ri Ic y. n S y EE I -eF I E- -� - la /ice I i 1 SS c . .;r.... .� �'�•�'11 .' I I I LG iNC �,_— 3'-5✓ �.D. =l y Yt'o E r 1 _ CF 11 B 10 I!Dora, B:wrh —__ :'• I I rlr ® Iq gs Fp.� 1 �I I I 1 alro I a n tC I � � 5o�•v ��i � �� 1 I I ® f 1:L�Poe�da SC n _ 1 "3 1 a f 3 G. w l • I Q � I i I iz N N yy' �5J IE a b I it o I c. e 1 L Ic 1"I. of n of iiAD p I b,l , --r a;n• � j I I N P F ILI T I I ^ G I. 1 jI I ' I�� .- Cil� 41�10•� }... P� ! I I/Fli li i � I I - I I I. 9� . _ID .wawx+aaswcaac a3n. .. � > .•, .. � � ` - t t I 'Y y� •' i_ r y c i r �6. - a w - . I li LLLJJJ i ------------- g - �.I .�.:_..-.,. ro- - _-�- ', .,:,•� , F'., ,., �, V, u a� .i f I�J .. �1 .. a lJ SNEI-FY LOD I L ° i P �r I j ad;'t:'N el '+ a,:F •.t .'�"Ir b; °N� I'�' i I 6 a Y I I ' ry� ...'1 � T�Y �p TV'•. .S L I � ��'.,}f"s' F,(� a �' I ti . ., p �I Izz SN[li' :/►[� [ � �#' i e'�� . O fSI_o v µ ` 17 f-I I - I <} gi 'Ir U n I v I `' I' — Pkl2lcrl- vl rt\ O _ 6 Bl fot6 I;� x wza I . 1 2 tit �'�t 43� .+�: �' � �`V•m.� � a..� .. _—�- �, I� a 4 a r I — -- --- — —————————— — - --- —1 — d. r a .. _ _.� _ 1. -- _ ....�,®..�. -:1�. - -.V,J.-m ...«... .- s..v. ... ...:...... _„-.�,.......--�.—�.+a�.s�«.,� w..m _ -.o....`m..�_-.. a... ..-T. �-.�—r... .•.,.®+.,.f --�-+,. �.... ,. .-.a. .•.K.+— , G lzLS� '4 cr r ' v, r Y ---— 21� � 2a.11 .• - yw .. I as�l 1 r N:�. J vl h,t�f��f. {•!V ; 16 V411Y.-I r'. mT� w nic.,��.: U 4 '`3C�v • 1 r �r 711 =IA ��a.ul3ao•1�-t7 �� I•• ot4 '4t'.0 wxu. 1- ft r I` �I , .. ...:..:- .QIM....S.lo�•IS .,�.1'1�..C;�p.:;�C��;.. ... �.1"O...hc.�.t�� . , ?.OAS I CERTIFY THAT THE PROPOSED FOUNDATION 1. REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL RF-1 & AP M Ir�� CI�AitBBR DESIGN WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS.FOLLOWS: NOT COMPLIES WITH THE TOWN OF BARNStABl..E SIDELINE � CU MINIMUMS AND SETBACK REQUIREMENTS AND IS NOT LOCATED I N MR OR �gjmiA(�3N'j' MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED 29.5 --------- ---�� ON No. 50 SIEVE,. OF FRACTION PASSING No. 4, 10% OR LESS TO PASS No. AREA = 43,560 S.F. WITHIN THE FLOD LAIN. ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED 100 SIEVE AND 5% OR LESS TO.PASS No. 200 SIEVE, SOIL TO BE APPROVED FRONTAGE = 20' DATE: `�"► �- _ R.L.S- 2g•3 x ; WITH CAPPED ENDS BY ENGINEER FOR COMPLIANCE PRIOR 70 PLACING ON SITE. WIDTH = 125' C.B. #145 12\ USE i - 4" DISTRIBUTION LINE IN 8 RECHARGER UNITS 2. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS FND. 7.9.4 , FRONT SETBACK = 30 29 6 � �"`� IN A 12 X 81 WASHED STONE TRENCH AS SHOWN PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE SIDE SETBACKS = 15' \ 1r'�1. LEACHING AREA REQUIRED THE REQUIRED NOTIFICATION TO DIG SAFE (1 888-344-7233) AND APPROPRIATE WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. REAR SETBACK = 15' 29 5 \ 660 G.P.D./.74 + 507 = 1338 S.F. 3. TWO COMPARTMENT SEPTIC TANK REQUIRES 2 WEEKS OF LEAD TIME BUILDING HEIGHT 30' x 2(81( 2 1X>81) 2 972 S.F.FBOTDTOMALL AREA AREA TO ORDER. FROM SUPPLIER. \ O� �� 1344 S.F. TOTAL PROVIDED 4. THE SEPTIC TANK'S FIRST COMPARTMENT SHALL BE SIZED FOR 1.320 GALS.\ MIN. L THE SECOND COMPARTMENT SHALL BE SIZED FOR 660 GALS.\ MIN. _ �� PERCOLATION RATE 11N.IN 2 MIN. OR LESS. ALL IN ACCORDANCE WITH 310CMR 15.224 MULTIPLE COMPARTMENT TANKS. aE28.3 TWO TANKS IN SERIES MAY BE. SUBSTITUTED SUCH THAT THE FIRST. TANK °33:2� -'x 29.6 v� IS 1500 GALLONS & THE SECOND TANK IS 1000 GALLONS AS PER 15:225. N 4 l 5, 5 x 31. 28.5 DN DATA SINGLE FAMILY- 6 BEDROOMS \� 1�' • WITH GARBAGE GRINDER DAILY FLOW = 110 X 6 = 660 G.P.D. x 2F.t •�� `,r- � �,.i"'i! SEPTIC TANK 660 X 200% = 1320 30 ._ f ,f` ,. BENCHMARK USE 2000GAL.TWO COMPARTMENT SEPTIC TANK C.B. �, 20, MIN• ��0 �, #1655 TOP OF SPINOLE COMPARTMENT ONE 660 X 2 1320 G.P.D. MIN. 2 .3 05�0 N �� jz ` EL. - 30.63 COMPARTMENT TWO 660 X i = 660 G.P.D. MIN. PRpr P-�10N N .� 2 •� �.� � � �OVA pUN�P"(10 x , � �'_a •s 10?pp Of11 30.00 28.2 u► # 27.0 2$.0 27.2 • x 29.1 .-- " �'Q f' x 27.4 _-__-_---__._12' �•-"� Z� / I nN&ft CRAM COMPACTED FILL Q W A \ 36"MAX.- 12 IN '` O�C11C IaN 'CER 2- .. PEASTONE x 29.1 28.7 DOUBLE^"`� DNA \ a•+ , a`. ,.•:- r 3/4" TO 1 1/2 x a C� w 1 f S 41 \ �,. .... pROp. i �,�. WASHED STONE �.''T�DN LOT 200 No scare 43,561 S.F. : -' . f� x 27.5 Y 26.7 26.2: t 1,00 AC, x 28.3 1 x 28.5 ,i' l \ �:��• 26.tT.._ 3 x 28.3 -- o x ,�' C.B. 12 TOTAL UNITS 1 STARTER,1 END, & 10 INTERMEDIATES. © N / 27.7 .'1 , FND. I• 26. , 3305 TYP. 3301 330E 2.4 �t ! -' 2.4 7.5' 6.25 6.25' 4 -' y1- �"j 1.5" WASHED STONE 1 ,26.0 312,81' 25.2 81.00' S g1°27 x 26.2 f OF MAM 27,7 / NO SCALE x 27.7 L l 1.9 x 27.2 ' x 26..3 PLAN C.B. . SCALE: 1"= 20' SITE PLAN & SEPTIC IDESIGN ELEVATIONS ARE BASED ON NI.G.V:D LOT 200, PINELE(GH PATH 1t� OYSTER HARBORS. COVERS LOCATED TO WITHIN BAXTER & NYE INC. Cs.wiisan� 6" OF F.G. #P-7335; 6/5/89 JUNE 10, 1999 ELEV. = 29.3' REV.;'AU.G 5, 1999 TOP OF FND. = 30.0 F.G.. 29'# .. . � F.G.= 28 t 28't LOAM & SUBSOIL INV. L.C.C. 15354-127 INV. _ LEVEL 27.1 ¢ 200o CAL. " aAM_TER -2' 26.9 2 COMPARTMENT rNv T DIST 2, SCHED� £ P� LEACHING CHAMBERS P`t of ASSESSORS MAP 71, PARCEL 1-5 SEPTIC TAN K 26.6 INV. =26.4 t -4 PERC TEST BOX INv. =26.2 INV. - 26.A yG ' 10.Oo' .s: ::;:��:5:: -�----�,_6" STONE BASE MEDIUM EDIUM SAND ,-P N OF MIN. MT4 �� 14tgssq� i ANDREW & DIANE TAPPE F rsc4�t ST PHEN BARTER & NYE INC. BOTTOM ELEV. = 24.0 �.t• ` 05� -6 -6 t FINELY STRATIFIED -� LAND SURVEYORS, CIVIL ENGINEERS .• No CIO OSTERVILLE,MASS. ,ti "` MEDIUM SAND STER�� PRO 01VAL EN% NO SCALE -11' NO WATER THIS PLAN IS NOT BASED ON AN INSTRUMENT SURVEY AND ELEV. = 18.3' #99051 THE OFFSETS SHOULD NOT BE USED TO DETERMINE LOT LINES, DIRECTIONS: � X Y From Hyannis - Take Route 28 into Osterville; At the lights by White Hen Pantry take a left onto Osterville > West Barnstable Road and follow to the end, Take a left onto Main Street; Take a right onto Parker Road; At the stop sign take a right onto West Bay Road; '' Bear left onto Bridge Street, and follow to the Gate House; Continue Straight and stay Left onto Oyster Way ; and stay right onto Grand Island Drive and turn left 2 onto Pineleigh Path #143 Site is on the right, . C6„°" LOCATION.MAP: Scale: 1" = 2000't Approx. Existing 6 Bedroom \ ` ASSESSORS REF Septic System as Shown on Town B.O.H. As Built Tie Card. �\�e Map 071, Parcel 001-005 Trs TO BE REMOVED -� / 0 F Morrissey .• �oPe o N I rt f• Trust . 01 ch & Robe Re°Ity k M 0 OVERLAY DISTRICT: Michael 23 Pynele'gh path -tbec = o -� aiding,. .`m .o AP Aquifer Protection District 15� g„ .. o o Saltwater Estuary Protection District '2 55 n 0 �o Resource Protection Overlay District 2O W 3 Sg�• 3� A/C°s INV.INV. t Irrig. 0 28.0 _ on trol NGE 0 a a� FLOOD ZONE. G P00 t Zone X R / IN OCommunity Panel No. A 0� #25001 C 0756 J `�J r !M July 16, 2014 wM` Sill 30.8' j N�o o Hydrant CB/DH di PROPOSED . o �� fl- fnd r ... w,•_ 16' x 2' Sill 30.8' N v ADDITION , D / �N Lot' •200• . . . 16 SPs N #143 o t N ' 43,600±SF pRO. 2 Sty. WIF ,1 `, RF-1 O o \, Dwelling < Area (min.) 87,120 (RPOD) g Guy Pole CZ .._ q � Pole r.,_ Frontage (min) 20 0', CD �' Width (min) 125' O Setbacks: R O 15.6 � � Fron t 30' cn I O D/ 9.. 30.8' / O pRB X Guy Side 15'' o ` O PR rH-a Sill S P�1C �' Rear 15 x SLEE U p o TANK TANK / f, _-28- y o AS REO �i - Sill 29.5' olk N/F o m , .. Sill 29.5' Brick W —W --�v Oyster Harbors a oo m' v ��°0 Club, Inc. o cn m n D� Sill 29.5' Z�oN Stone rive � 000 Slab 28.6 Zia N rH-3 �• and Patio �0 .... /. ' � o I PRONOUTS o and pool OSEp zoo ,. ro z cLEA l} �o Existing In9 PRP T►O o�m-310 B/DH ZNROPOS t.µi ( _ 1 tb fnd P�PA guiding V _ ��0� Propane o G I.A _ 29 ... W� ER ~� o Poo f �Pror 25. R T o�D µ m `rM j ?FE TE LEGEND: / oU�D •'�j .-"� CDT Cedar Tree 3 KITCN .a � `a rj HT Holly Tree .::> EpG POOL FENCE DT Deciduous Tree Hedge pOS Benchmark - Top of Conc. CT Coniferous Tree Bound E1.=25.34 (NAVD '88) Utility Pole —E— Electric c6s ' �€b1 —G— Gas L� Wetland Flag �;101Sfi ® NSF 0 CB/DH �`�SS/0 AL John Carroll l Light Post fnd CB/DH OHW— Overhead Wires 25 Elevation Contour REV.: NEW SEPTICS 11 17 2021 TITLE PREPARED BY. PREPARED FOR: NOTES: Site Plan 1) The property line information shown . hereon was compiled from available record N Proposed Improvements Engineering & information. m 2) The datum used is NAVD 1988, a fixed r1 At ivanconsuiting, Inc William A. & Aimee W. Burck mean sea level datum obtained by RTK GPS • •/� performed by Sullivan Engineering & 143 Pinel ei h Pat (508)428.3344 • P.O. Box 659 . 711 Main Street, Osterville, MA 02655 Consulting Inc. on May 21, 2021. seci ullivanen m.com • www.suilivanengin.com 3) .Topographic information Was collected � (Oyster Harbors) Mass. � g g using conventional survey method on May 21, B'I rnstabl e, � Draft: CTR/ASL Field: CTR/WHK 20 0 10 20 40 80 2021. �. 4) Utilities to be Confirmed Prior to DATE: SCALE: Review: CTR/JOD Comp.: CTR/ASL Construction. August 25, 2021 1" = 20' Project: Burck Project # 4100022 PERC TEST: 21-274 SEPTIC NOTES PERFORMED BY:JOHNODEA,PE- SULLIVANENGINEERIlVG 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours &CONSULTING,INC. Prior to Any Excavation For This Project the Contractor Shall Make SOIL EVALUATOR NO.2911 the Required Notification to Dig Safe(1-888-344-7233)and contact WTINESSED BY:DONNALD DESMARAIS,R.S.-TOWN OF BARNSTABLE Sullivan Engineering&Consulting Inc.(508428-3344). OCTOBER 5,2021 Finish Grade 2. The Contractor is Required to Secure Appropriate Permits From Town SITE PASSED Agencies For Constriction Defined by This Plan. " 3. Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall 9, Manx. Be Constricted of Class 150 Pressure Pipe and shall be Water Tested to TEST HOLE - 1 EL.27.5 TEST HOLE 2 EL.27.5 Comp°°ted Fill Filter Assure Watertightness. In General, Water Lines Shall be Constructed in .. Fabric Coordination With COMM Water,and Shall be in Accordance .. FBLL.. FH.L An » _ With 248 CAR 1.00-7.00&310 CMR 15.00. 26' 25.3 21"...:..... . .............. 25.8 1 Pea Stone 2 4.A Minimum of9"ofCoveris Required for All Components. . BLAYER.IOYR 4/6.... ..... B LAYER.IOYR 4/6 3 3/4„ - 1 1/2" .. .. .. S.AllStructuresBuriedThreeFeetorMoreorSubject DARK.YELL.OWISH.BROWN..... ....DIm.YELLOKgA..BROWN LEACHING Double Washed to Vehicular Traffic tobeH.20 Loading.Itis the Engineer's 341 ...: L.OAMYSAND... 24.7 31' LOAMYSAND.. 24.9 CHAMBER Stone Recommendation that H-20 Always be Used C LAYER 10YR 614 C LAYER 10YR 614 6.Install Watertight Risers and Covers to Grade in Paved Areas,to LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN I I . Within 2"of Grade in Gravel Drivewyas,and to Within 6"of MED SAND AMD SAND r- 4' - - 0 1 Finished Grade m Landscaped Areas Over Septic Tank Inlet 3 PERC TEST 24.3 12' " and Outlet,D Box,and One Leaching Chamber. 25 GALLONS GONE IN 3 AMV.30 SEC r All covers are to be maximum 18"for concrete or24"Cast Iron. 132' 16.5 120' PERCRATE<2 M1N/IIV(LTAR=0.74) 17.5 �/CROSS SECTION ON �F CI-)AMBER 7.Septic System to be Installed in Accordance With 310 CAR 15.00& NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED 248 CMR 1.00-7.00 Latest Revision and the Town ofBarnstable Board ofHealth Regulations. NOT TO SCALE 8.All Piping to be Sch.40 PVC. 9.D-Box Shall Have a Minimum Inside Dimension of 12.and a Minimum TEST HOLE- 3 EL.27.5 TEST HOLE -4 EL.29.2 Sump of 6'. 10. The Separation Distance Between the Septic Tank Inlets and .... O/..LAYER IOYR........ Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend ............. .DARK .. ..BROWN ..'........: '.:...FiLL........ a Minimum of 1O"Below the Flow Line.Outlet Tees Shall Extend 14 8" S;N. k.LOAM.. ... . 26.8 36" 26.2 Below the Flow Line,and Shall be Equipped With a Gas Baffle `...B L;4YER 101'R 4/6.. ... B.LAYER l0YR.4L6... .. DARK.YELLOWISH.BROWIV .... .. DARK.YELL.OWISH.BROWN..... ........... ... .. ...... .... .......... 26' ....... .......LOAMY SAND..... ....... 25.3 41'...... ........L.OAMYSAND............. 25.8 C LAYER 1OYR 614 C LAYER 1OYR 614 LIGHT YELLOWISHBROWN LIGHT YELLOWISHBROWN AMD SAND MED SAND PERC TEST 24. 25 GALLONS GONE IN 3 MW.30 SEC. 120' PERC RATE<2 MIN/1N(LTAR=0.74) 17.5 1201 119.2 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED i-Inar Location to oe uetermrnea at v Time of Installation so as to be as Inconspicuous as Possible F.F. El. 30.80 See Note 6 (typ.) F.G. EL. 28.50* - *Final Foundation Grading To Be F.G. EL. 275 DESIGN DATA Coordinated With Landscape Plan Single Family ri Flow Equilizers -6Bc&wm@110GPD EL. 28.00 As Required No Garbage Grinder EL. 26.60 F11 Total Daily flow=660GPD Installer To EL. 26. 0 1500 Gallon Use a 1500 Gal Septic Tank Con firm Prior Septic Tank EL. 25.75 Top EL. 26.00 To Any Work H-20 Required 2 60 H-20 LEACMVG AREA (See Note 5) D-Box EL. 25.43 2500 H-20 . 660 GPD/0.74(LTAR)=892 SF Required Leaching Sidewa11=2(12.83'+50.5')2'=253 SF f Chamber To Be Installed On Bottom Area=(12.83'x 50.59=647 SF stable Compactedase EL 23.00 Total Provided=900 SF(666 GPD) Bedding,"T"s, . ...... . ::::. .: :. Inspection Port, tfaErteciti3aecgd:Reidawe: 8t;Relaee;:.: ................... ..... .. ..... . .. ... .._.... .... LEACHING CHAMBER DESIGN & Baffels ./:I::.Cf»strit.at{e: So15:: I7t!iaiiz:: a'c A10 All Pi to be Schedule 40. Use as Per Title 5 :;::Th Outer Perim e t er.a f:,The;: arri.: p� :.:...;.. . 5-500 GaL Leaching Chambers in a EL. 16.5 12.83'x 50.5'Double Washed No Groundwater Stone Field as Shown. Per Test Hole 1 DE I fEL OPED PROFILE OF DWELLING S vQ TENt EL. 2 Groundwater NOT TO SCALE Per T.O.B. Standard F.F. El. 29.10 F.G. EL. 29.1 F.G. EL. 28.9 See Note 6 (typ.) F.G. EL. 28.9 Flow Equilizers 26.63 _ As Required 25.80 Top EL. 26.00 EL 27.00 , �\��2 5_.4 H-20 DESICiNDAT.f� Installer To D-Box EL. 25.23 Con firm Prior 1500 Gal, Pool Cabana&Sink To Any Work Infiltrator IM1530 25. 0 Leaching -I Bath/0 Bedroom Plastic Tank Chamber No Garbage Grinder Bedding,»T„s Use a 1500 Gal Septic Tank got. 23.00 Inspection Port, - & Boffels ::.. ..:..:..I.. •:.::•::•:•:.....:::.:.. ............... .. as Per Title 5 tf: i4C:attn(el'ed::1r pte LEACHING AREA ..: ::Au v;is�rraar ie: so r. :: rya i� ..5':: f...:: LO fa�3::Od t r:'P@rim:e:d r: :f`: :e .S�;s m.: co To Be Installed On Sidewall=2(i2'--10"+16'-6")2'=117 SF c� BottomArea=(12-10"x16-6")-211 SF a e ompac a ase EL. 16.5 Total Provided=328 SF(242 GPD) No Groundwater Per Test Hole 1 LEACHING CHAMI3ER DESIGN EL. 2 DEVELOPED PROFILE OF CA All Pipes. ea Schedule 40. BANA SYSTEM Groundwater Use Per T.O.B. Standard 1-500 Gal.Leaching Chambers ers in a_' 12'-10"x 104"Doublewashed stone NOT TO SCALE Field as Shown. LIFTING STRAP(TYP.) LIFTING LUG(TYP.) RISER CONNECTION(TYP.) B ACCESS PORT RIM _ CONTINUOUS LID CONTINUOUS A ' A' ELASTOMERIC TANK TOP ELASTOMERIC 10__ ° ° GASKET HALF GASKET° ° O O r O ° TANK 81 7 INTERIOR SEAM CLIP c� o b a o b a o b �xri Rir INLET (86) O O O ° wtonr TAW HALF ALIGNMENT INTERIOR DOWEL,(46) TANK BOTTOM HALF 0 0 0 © PIPE PENETRATION SECTION DETAIL ®MID-HEIGHT SEAM SECTION DETAIL B• 75.6[4,4601 EX701OR uarGnH TOP VIEW TANK EXTERIOR LIQUID LENGTH 1753--4,460 EPTH 1,118 TOTAL CAPACITY 1,787 GAL 6,765 WIDTH 61.7 1,567 INVLHF 3.0 (76] L WORKING VOLUME 1,537 GAL 5,818 HEIGHT 54.5 1,384 FREEBOARD 10.1 257 L 0 24.0[610]ACCESS PORT 04[102] WITH LOCKING LID(3) PVC OR ASS OUTLET TEE INLET TEE _ 0411021 (TYP.) OR ABS OUTLET TEE INLET 16.9% AIR SPACE OUTLET 1_ FIBER- 2[51]X 2[51] ® SEAM CLIP SUPPORT i O FIBERGLASS <_ SUPPORT (TYP.) S2' (TYP.) LIFTING STRAP a (TYP.) SECTION A-A` END VIEW SECTION B-B' ti ISOMETRIC NOTES: ° ° VIEW 1. ALL DRAWING DIMENSIONS IN INCHES[MILLIMETERS]OR AS NOTED. ° INFILTRATOR' 2. EXTERIOR OF ACCESS OPENING LID INCLUDES THE FOLLOWING WARNING IN ENGLISH, c o watertechna"Ies FRENCH&SPANISH:"DANGER DO NOT ENTER:POISON GASES."L NUMBER,LIQUID INFILTRATOR WATER TECHNOLOGIES �JN OF pq4 3 CAPACITY,DATE OF MANUFACTURE,TANK MARKINGS WILL INCLUDE: NMAXIMUM EBURIAL EDEPTH,EINLET,AND OUTLET. ' ° 4 Business Park Rd.Old Saybrook,CT 06475 s� 4. MAXIMUM BURIAL DEPTH IS 48 in 11,219 mm]. o (soo}22t-aa36 �o� JOH 5. MINIMUM BURIAL DEPTH IS 6 in[152 mm]. ° ° IM-1530 l rlL ' 6. TANK IS FOR NON-TRAFFIC APPLICATIONS: SIDE INLET/ 1-Compartment Septic./Pump Tank Configuration tss 7. AIRSPACE IS 16.9%. OUTLET A e 8. OUTLET TEE IS COMPATIBLE WITH AN EFFLUENT FILTER. , 90 c STC2 c0 � 9. LENGTH TO WIDTH RATIO IS 2.8:1 (175.6-INCH LENGTH/61.7-INCH WIDTH=2.8). ° D►awnby* JLB Date: 10/09/2013 FFss 0 0A� `�� Scale:NOT To scALE 0mcked by heet:. DJL S 1 of 1 , ii L REV.: I NEW SEPTICS 11 17 2021 TI TLE: PREPARED BY.• PREPARED FOR: NOTES: Site Plan Proposed osed Improvements • Engineering & 1) The property line information shown hereon was _ compiled from. available record information.. � Ativaii consu- ItingInc. William A. & Aimee W. Burc 2) The datum used is NAVO 1988, a fixed mean sea i // * level datum obtained by RTK GPS performed by Sullivan 1 `Tr� P'ne/ei / ( Path Engineering & Consulting Inc. on May 21, 2021. g (508)428-33"•P.O. Box 659.711 Main Street,Osterville, MA 02655 n` seei@sullivanengin.com•www.suilivafwngin.com 3) Topographic information was collected using Barnstable (Oyster Harbors) Mass. conventional survey method on May 21, 2021. O Draft: CTR/ASL Field CTR WHK 20 p 10 20 40 80 DATE: SCALE: Review: CTR/JOD Comp./Review CTR/JOD August 25, 2021 1 = 20' Project: Burck Project#• 4100022 NOTES - ZONES I CERTIFY THAT THE PROPOSED FOUNDATION 1. REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL RF-1 & AP COMPLIES WITH THE TOWN OF BARNSTABLE SIDELINE CMM LLACMG CHAIGM DMIGN WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT MINIMUMS AND SETBACK REQUIREMENTS AND IS NOT LOCATED N MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED WITHIN THE 'FLOC LAIN. 29.5 BR a9a�OR ORB UIV� ON No. 50 SIEVE, OF FRACTION PASSING No. 4, 10% OR LESS TO PASS No. AREA = 43,560 S.F. '� UM 100 SIEVE AND 5% OR LESS TO PASS No. 200 R SIEVE, SOIL TO BE APPROVED FRONTAGE = 20' DATE: $ �q �`- �`-'^ _ R,L.S. 29.3 x ALL PIPES TO BE'SCHEDULE 40 PVC PERFORATED BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. WIDTH = 125' C.B. #145 12\ WITH CAPPED ENDS FRONT SETBACK = 30' FND. i USE 1 - 4" DISTRIBUTION LINE IN 8 RECHARGER UNITS 2. LOCATION OF UTILITIES NOT .SHOWN ON THIS PLAN, AT LEAST 72 HOURS 29.4 � U PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE SIDE SETBACKS = 15' 29.6 \ % IN A 12 X 81'' WASHEQ STONE TRIENCH, 'AS SHOWN' THE REQUIRED NOTIFICATION TO DIG SAFE (1-888-344-7233) AND `t v__A APPROPRIATE WATER DISTRICT TO DETERMINE UTILITY LOCATIONS, REAR SETBACK 15 LEACHING AREA REQUIRED BUILDING HEIGHT 30' x 29'5 'r \ �-�1 660 G.P.D.f.74 + 50% = 1338 S.F. 3. TWO COMPARTMENT SEPTIC TANK REQUIRES 2 WEEKS OF LEAD TIME 2(81 + 12) X 2 = 372 S.F. SIDEWALL AREA TO ORDER FROM SUPPLIER. 4 �, \ ..o (12 X 81) s„ 972 S.F. BOTTOM AREA ' LOT 2 1 4. THE SEPTIC TANKS FIRST COMPARTMENT BE SIZED FOR 1320 GALS.\ MIN. - ,�'' \ G 1344 S.F, TOTAL PROVIDED THE SECOND COMPARTMENT SHALL BE SIZED FOR 660 GALS.\ MIN. ., T� ALL IN ACCORDANCE WITH 310CMR 15.224 MULTIPLE COMPARTMENT TANKS. PERCOLATION RATE 11N.IN 2 MIN. OR LESS. TWO 00 KS GALLONS 0 SERIES& THE Y BE SECONDSUBSTITUTED 1000SUCH GALLONS THE AS PFIRST ER 15 225. 4.33 2oNE � 29.6 28,3 IS 1500 L N N �j x 31.; A, .. � I 2$.5 DIMN DATA SINGLE FAMILY- 6 BEDROOMS co WITH GARBAGE GRINDER s' 3 � "3Q,4 ' x 288 \rn� DAILY FLOW 110 X 6 660 G.P.D. ;:. W SEPTIC TANK 660 X 2009p _ 1320 i ' BENCHMARK USE 2000'GAL. TWO COMPARTMENT` SEPTIC TANK .�� C.B. 2 .3 #1655 TOP OF SPINDLE COMPARTMENT ONE 660 X 2 = 1320 G.P.D. MIN. o�pSEd N �� o \ EL. _ 30.63 COMPARTMENT TWO 660 X 1 = 660 G.P.D. MIN. p00NpA�p P��N 6, 0 `. pF 0� F p,00 28 2 ' -a rn #11 27.0 z$.o lo 3 .®- x 29.1 ...� 27.2 ANf, x 27.4 - \ nNISHED GRADE 36"MAX.- 12"M N. COMPACTED FILL W P(ER 2 PEASTONE x 29.1 ,., x 28 7 e L R� III PEER / 30'S" y O 3/4" TO 1 1/2 ` -.• (�1) pDOUBLE ` po0- WP�'°EST WASHED STONE LOT ,?oo UMN NO SCALE 4 3,5 61 S.F. 1,00 AC, x 27.5 x 26.7 26.2 x 28.5 GP�PO� z6.o 3 x 28.3 ; o CM x 27.7 , C.B.f 12 TOTAL UNITS 1 STARTER, \ 1 END, & 10 INTERMEDIATES. 26� 2.4 330S TYR. 3301 330E 2.4 o - 7.5' 6.25' 6.25' Z r--° _Q 1-1.5" WASHED STONE v^' O E.y 312181, " 2&2 wo S81'27 51„'W x 26.2 81.00' --1 P" OV ICI CRAMB R8 27.7 x x NO SCALE i LOT 19 x 27.2 ��' rr 26.E 27.7 PLAN C.B. , SCALE: 1 = 20 ELEVATIONS ARE BASED ON A.G.V.p SITE PLAN & SEPTIC DESIGN , TEST LE LOT 200 PINELEIGH PATH OYSTER HARBORS COVERS LOCATED TO WITHIN BAXTER & NYE INC. w;I5Qvl) 0s 6" OF F.G. #P-7335; 6/5/89 JUNE 10, 1999 ELEV. 29.3' REV. AUG, 5, 1999 F.G. 29'� TOP OF FND. 30.0 F.G.-T 28'� / _B y F.c.� 28't /, LOAM & SUBSOIL I 27.1' 2000 GAL. �. LEVEL , INV. L.C.C. 15354-127 INV. 9 2 COMPARTMENT INV. DIAMETER T 2' scH�Du DISE LEA RING CHAMBERS or -? ASSESSORS MAP 71 , PARCEL 1-5 SEPTIC TANK 6.6 INv- -26.4 BOX Z6 a a�`P��M y -4' PERC TEST eox INV.�...:...:::.: iNV- a 26;0 APPLICANT: MEDIUM SAND10.00 . _6 STONE BASE P� -- as ANDREW & DIANE TAP PE I MIN. F FR�U P /o` ST PHEN BOTTOM ELEV. 24.r'. .rs, tCt$tk 5a 6 6 BAXTER & NYE INC LANs LAND SURVEYORS, CIVIL ENGINEERS FINELY STRATIFIEDNo.so2is "'/ OSTERVILLE,MASS. i z' MEDIUM SAND G/STE�� 4`�/ PROFILE \810NA N0 SCALE -11' NO WATER Y THIS PLAN IS NOT BASED ON AN INSTRUMENT SURVEY AND ELEV. = 18.3' #99051 THE OFFSETS SHO ULD NOT BE USED TO DETERMINE LOT LINES.