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HomeMy WebLinkAbout0160 PINELEIGH PATH - Health 160 PINELEIGH PATH OSTERVILLE-:�- 'A=071 004.008 J' e I �I e a Vo. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0ppYication for 30igozal 6pgtem Construction permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System Individual Components Location Address or Lot No. /60 J T Owner's Name Addpssd Te.N it 1 Assessor's Map/Parcel 0 T P06 � So ' 2-2 Installer's Name ddress,an Tel.No. De ❑er's Name,Addres and Tel.No. r '.lir�ce 'L0-00-k1'.sttr �e�Dy/1�� sSOGi S •�®� ��.3 19`J Type of Bu' Dwellin No.of Bedrooms4__ I Lot Size 5 3 1 Z- sq.ft. Garbage Grinder( ) ther Type of Building No.of Persons Showers{ ) Cafeteria( ) Other Fixtures Design Flow I 10 10 6—P, gallons per day. Calculated daily flow Lk 40 C Ab gallons. Plan Date — o Number of sheets Revision D to Title Sl Tel�� � 5'� 'llJ ` �I/� / ) = 30 Size of Septic Tank( 7- C1-- Type of S.A.S. ',A�I d Description of Soil Z'"J''��e&41l�5 f S4!Q 1-71 ���f� _ 1ar _ .1 Z� �''�, 5 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 iss d by this Board of H al)h. Sig Date 0 i Application Approved by l_ Date Application Disapproved for the following reasons Permit No. i)`"3 Date Issued /N�,ly/ Vf e vV ,_ �,t , __.. Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS pry, F, x Y IrN PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS f Construction W- tit. ,����Ytcatton for �ig�o�at �pgtent �,� . Application fora Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System�" Individual Components Location Address or Lot No. I6 P�,t j1y'—� �6 p�rn Owner's Name,Address and Tel.No. ~ v� IC �E t�N C/rI/��li�'r✓ Assessor's Map/Parcel /)7 4 T" 71 U-��i 4 Installer's Name,Address,and Tel.No. Designer's Name,Addles r��and TeI No. '►3�„c e �tc,,cc�\1'• Stv `lbaoyL� % ssee� s ,�"A�Sb3•l99 s- �. c l-o Vec21�'le� w y a . ��a•y.38' 70 OS\tr1V16e 5s). F05AZ_I 007-1-1 02S3G '• -t-_ Type�Bu : No.of Bedrooms Lot Size .53, �Z- s ft. Garbage Grinder 't Other Type of Building No.of Persons Showers( ) Cafeteria( ) -Other Fixtures i Design Flow i l o D c/L 6:D/2 m gallons per day. Calculated daily flow ��'` 4� 6 P� gallons. Plan Date -7 '7_ - D G Number of sheets / Revision Date > Title �Q�M Y&014, 'be t_ .-5'/T�fi*A) 0642/412,4/✓ 1`i = .3D � Size of Septic Tank?_ I-ho Type of S.A.S. C*o /V—4G Description of Soil d 7" L-U 7 '"�-7 Gd,414 59E _54,V4 —3/ LU,�X,y S� -A. > _ �32." M,1_:W< S l �r Nature of Repairs or Alterations(Answer when applicable) 1 f Date last inspected: Agreement: r,. 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 tlke Environmental Code and not to place the system in operation until a Certifi- cate of Compliance,has been iss ed by this Board of H a tM Sig ,, r Date�FP%•• �, UC!f> Application Approved b Date 1l Application Disapproved for the following reasons Permit No. Q0 a3 Date Issued . --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (tertificate of QCompliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (✓)Upgraded( ) Abandoned( )by S Hu r���, c� (u^� 1 at l C� �t A r \e i C t-t 61 E� O STe.r 4 I C has been construct1di n� ,,dance with the provisions of Title 5 and the for Disposal System Construction Permit No. Ob ', dated . 04 Installer2T�QQ Designers o,1c i�1S�oC �hrle� The issuance of this permit shall not be c nstrueed as a guarantee that the system wil tion as designed. ; Date Inspector --------------------------------------- No. t Fee�00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Diopo$al *potent Couftructton Permit Permission is hereby granted to Construct( )Repair(V,5Upgrade( )Abandon( ) System located at n J 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 pe Date: 9 Approved b I °Ft"ETq►+ti Regulator`' Services Thomas F. Geiler, Director BARNSfABLE. ' MASS. g Public Health Division 0 1 39. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Fax: 508-790-6304 office: 508-862-4644 Installer & Designer Certification Form Date: A4 , .! v►6 Cr Installer ��we� 0.r_o.- lt(' Designer: Address: :address: 81 ?o+w — ." \ �c�.�l:sk2 was issued a permit to install a aao6' `fa3 On e�l• — S �, adab 3c-ucc (date) (installer) - 0 / ��Je /ei6if �i3Th �/ «v, e, r based on;a design dra�v-n bI ' septic system�at 1,60 ..a .� (address) : _.I 0.rc- �n -�e e,r dated e aa, aoa6 a - . 4 e (des finer) rv- W i I certify that the septic system referenced above was installed substai31 INaccordinto approved chang elocatg� of be the design, which may include minor appro �es such as later, W —i '. distribution box andlor septic tank. N I certa or chanaes I.e. ify that the septic system referenced above was installed elocatio00 n o any component or an v erttc greater-than 10 lateral relocation of the SAS } of the septic system) but in accordance with State & Local Re 1 ions. Plan revision or RA certified as-built by designer to follow. �H ofS moo`' R E N ER o. 1140 (Insta ler's Signature 'P�GI STS" 10 �® V (Designer's Signature) (Affix Designer's Stamp Here) 'PLEASE RETURN'TO'B. STABLE PUBLIC iHEIL BOTH TWOS FORIVRITANDAAS- OF COMPLIANCE WILL NOT BE ISSUED L1tT BUIL T CARD ARE RECEIVED BY THE B ARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: f lealth:'Septic.'DesiQner Certification Form 12/26/2019 ShowAsbuilt(1700x2800) //�� (TOWN OFBARNSTABLE' LOCATION D R.,Ck,* SEWAGEQOQS-4Qa . VILLAGE OSYer•v lII t: - ASSESSOR'S MAP&PARCEL_ . INSTALLERS NAME&PHONE NO.-6•rl4.eel(•,SlF r' Ya 8 r 5539 SEPTIC TANK CAPACITY o�t—)SOO Cn!_ Cs1-ip�- LEACHING FACII.rrY:(type)-So09,.,.,aL-cK-"- (siu)33,Sr;x t a-8(3' ' INo.OF BEDROOMS SI^ OWNER �'.a Z rX t PERMIT DATE:i SZV74,90006 COMPLIANCE DATE: D� Separytion 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 .,.I FURNISHED BY . c7-aei as-30 _ D7-a�' R3-HI, D8-a3 RS-3i �8-l5 R B D 8 C0:w,, 8G-,fig 6 https://itsgldb.town.barnstbble.ma.us:8431/Home/ShowAsbuilt?mp=071004008&sq=1 1/1 oFTME Town of Barnstable P# / 600 Department of Regulatory Services : . Public Health Division DateMASS J � 161 200 Main Street,Hyannis MA 02601 a � -c Date Scheduled 7/4 Time Fee Pd. 1/00d to Soil Suitabil'ty Assessment for Sew ge ispos t Performed By Witnessed By: o, I;OGATION Bi GENERAL INFORMATIGN: :.: Location Address L&t Ill /• r` ` Owner's Name [6 o �1.h'B1Bb�• pot-f 4 V J Ni I Address Assessor's Map/Parcel: O 7l/ego Y/0 08 Engineer's Name NEW CONSTRUCTION —iC REPAIR Telephone# -og -Y2 -7.7/q Land Use 66Fo/94 Slopes Surface Stones Distances from: Open Water Body $`"!`4 ft . Possible Wet Area_d Il'f" ft Drinking Water Well c' ft f— Drainage Way � -"0 ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes& ero tests locate we tlands strands in proximity to holes) c, POL4 # � 1-7 Z / / RZ //V/ 4 /)//' Y(/�'/�(] . my vN ! -�.'�5�'tE•�1... E'f` f`• �9��f, (may' ��� �� tt �♦ oYSr�R 'bt.42BQ2s xrvc. Parent material(geologic) Depth to Bedrock Depth to Groundwater.Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater ;DETERMINATION FOR SEASONALT IGH:WATER TABLE Method Used: Depth Observed standing in obs, hole: I in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level FERCOL"ION;TEST Observation Hole# �� Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ Cgg 0 Time(9"-6'1 End Pre-soak A✓`/G ✓=.� Rate Min./Inch L 2'`y, ti <-Z Site Suitability Assessment: Site Passed �iite Failed: Additional Testing Needed(Y/r) Original: Public_Health Division Observation Hole Data To Be Completed on Back-----_____ ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICTERCFORM.DOC ` DEEP.:OBSERVATION:HOI;E LOG: .. ;Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muusell) Mottling (Structure,Stones,Boulders. Consigogy," vel .4 _-2 Y 6 S•r4J log 3l� X DEEP OBSERVATION.HOLE:LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) . Mottling (Structure,Stones,Boulders. nsi en ° G e p A F J41 �, lJYR y2 10-22 " 10gle ` 10 22,- 132 �R C C. �r i4-e J� :DEEP-OBSERVATION HOLELOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C-wsistc % (mt.RYK ...tea. . ._. y:,.w T.^ .. _..... ...».. .... ......y.,_ r,. ,._� .. ... DEEP-OBSERVATION.HOLE LO.G::.:;°:: ; Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell). . Mottling (Structure,Stones,Boulders. ConsistencL° Gravel) 20'12C C F:,zSvl10(R 'le Flood Insurance.Rate Maw Above 500 year flood boundary No_ Yes -'� Within 500 year boundary Now Yes Within 100 year flood boundary No it- Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on 711-11 1 2 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required traituu expertise and erience described in 310 CMR 15.017. Signature Date—� Q:\SEPTIC\PERCFORM.DOC . Town of Barnstable P# Department of Regulatory Services Public Health Division DateHAM l D j��� 200 Main Street,Hyannis MA 02601 Date Scheduled c7 lle Time // Fee Pd. Soil Suitability Assessment for Sewage`Dis osal Performed By:_`�DN 1p� dyG Witnessed By: ` LOCATION& GENERAL INFORMATION Location Address Owner's Name .STE1'fl E/V° /°��j� /2 11.0 0.0 R/.0 G E CiP.CL 45 Address OS7F9V%LL,C /1l �M4, 02 4493 W645ro�1/ Assessor's Ma 1: 0 7/— DO�-ODQy �sSGC/�4 ,3' p/Parce /n/�/a Engineer's Name ✓. G LG NEW CONSTRUCTION REPAIR Telephone# -.?W-3- �p Land Use Slopes M Surface Stones IVOr OEs sc t�C O Distances from: Open Water Body> �Q D ft Possible Wet Are d� ft Drinking Water We117 Z Oft Drainage Way�d-r 045S ft Property Line J��. ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands�n proximity to holes) /Z y`• 5 S' 2 . 7-3 /1 ice, 73 Tp,2 30' J - TCr � q A�+ Parent material(geologic) 5.911�D Depth to Bedrock � C-)-4 Depth to Groundwater. Standing Water in Hole: Z A 6CJr: Weeping from Pit Face Nd wT � r Estimated Seasonal High Groundwater ��- �V' -3 L� 3 20 DETERMINATION FOR SEASONAL HIGH WATER tAB Method Used: o Depth Observed standing in obs.hole: in. Depth to soli mottics: in. Depth to weeping from side of obs.hole: _ in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor ,e� Adj.(lrondwater Level PERCOLATION TEST Djite 9 7 0 4- Time /1 1'fO Observation _ Hole# 7� Time at 9" � r Depth of Perc 36�Y r Time at V Start Pre-soak Time @ /�i 0 C, 0 O 'Time(9".6") End Pre-soak l J%�U;/S 2-Ott' G 4L SAY✓/�?� Rate MinJlnch Site Suitability Assessment:"Site Passed_iWol Site Failed: Additional;Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole#-Tip�- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. HiteGravel) Vz �'A V 7- �� �Z- CO4 sE S /�L L �.S y)e 7��4 i7''- 3j" s41UD /aYR s/. l' '132'' C Aa.S-,51nr4 /0YX /4 IVa =� DEEP OBSERVATION HOLE LOG Hole# _TP` z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. nsi to % ls81- 304 J3 o�y ;OR s/G PLO DEEP �9 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConsistencL%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, osistancy. Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes y. Within 100 year flood boundary No V Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed'throughout the area proposed for the soil absorption system? ES If not,what is the depth of naturally'occurring pervious material? Certification I certify that on / `�� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 310 CMR 15.017. Signature Date 9- 7-D Q:\SEPTICVERCPORM.DOC ,i fTOWN OF BARNSTABLE �' ` �[�� ", `Y LOCATION 1bO 1nP.`P :^1� P h SEWAGE # % -S8'O VEL AGE � V► �`P - ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO.�A loe-e-S SPA.-,, Q SEPTIC:TANK CAPACITY tt LEACHING FACILrrY: (type) T� 'r (size) NO:?OF BEDROOMS BUILDER OR OWNER :fe n PERMTTDATE: 1 D -// Of 2 COMPLIANCE DATE: _S"-.7- 9' Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge;6f..etland and Leaching Facility(If any wetlands exist `within 300 feet leaching acl;ty) Feet Furnished by t } i j i( � GJ N037 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0V TOWN OF BARNSTABLE Appliration for Bi-spaaul.Workii Tnnitrnrtiun ranfit Application is hereby made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal System ....... ........ ..... . -Address - .... Location Address f# or t No. s ------------------------------------------------------- ` /_.L _.. �xt.I.f . .---- ....................................... Owner dress .......................... L ll .. .... -`-`-= U Installer Addeess Type of Building Size ......Sq. feet Dwelling—No. of Bedrooms__________________.__.__________..__._Expansion Attic ( ) Garbage Grinder ( ,f✓ aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) PL4Other fixtures -------------------------------•--- eW* -----------------------------------------------•--------------•C---........---.. w Design Flow......................... ........gallons per peavow d y. Total daily Pow.............................��__•-....gallows, WSeptic Tank2—Liquid Length._.(____..__._ Width.:�o._4� .. Diameter________________ Depth... Disposal Trench—No. .........l.......... Width....... ........ Total Length_._.__..V ...... Total leaching area____! f'....sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total-leaching area..................sq. ft. z Other Distribution box Dosing t (� )_,���� p '~ Percolation Test Results Performed by...... Cti%�L6dX.............if,_______________ Date_._�_G.,�l �_�...___. Test Pit No. I...GZ_minutes per inch Depth`of Test Pit----- ..__. Depth to ground water.....7/ZG - f3, Test Pit No. 2__4 Z_-_._minutes per inch Depth of.Test Pit___: ____.__. De�th to ground water_7�.Z r".... --------•---------------••••••-- --- -• - O Description of Soil------. e-------•--- _...-••-•--..........................�--,��{- 2 a---------•----------- -------•---------------- x c, w ---------------------------------------..............................-------------------------=---...................................................................................................... U Nature of Repairs or Alterations—Answer when,,applicable................................................................................................ ---------------------------------••••--•---•---------------•---•--------------------_.......__--•---•-----------•-----------•-•-••-•----•----------•-•---•---.......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasbeen�,ssued by the board of health. Signed ......./!7 /..v(/.. - -------------- Dare Application Approved BYPthe - l,........ . .... .. . . ... .... ... .. . ..... ................I?ate-------------- Application Disapproved fllowing reasons: ................. -- -- --- -=------- ---------..-..-..-....-.....-...-------- -------------------------------- ..--------- --. io - NPermit No. � Issued /I lYdte 00 No .Z. `� ;�- -� - " " Fmil....... .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ov TOWN OF BARNSTABLE Apphration for Uhip ia1 Works Totts�rnrfinn ratuff Application is hereby made for a Permit to Construct ( l410r Repair ( ) an Individual Sewage Disposal System a z t; ........ ....................... !-c - ......... --- n Location Address F� &//6ty / or Lot - ••-- n {� Owner �ft, A.y dre is W - /V Z t !-X C A�' t/CPN l�NIV t4 I"S v R i G -••----••---.... Installer Address U Type of Building Size Lot_1� �1� ?_.._..Sq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder �a Other—Type e of Building No. of persons............................ Showers YP g ---------------------------- P ( )--- Cafeteria ------- r_ Other fixtures ------------------------------••••- ----------------------------------------------------------- ------------------------ W Design Flow.......................... z_<) cA ....___.gallons per per day. Total da>/ly ow----- yU...gallons,, W Septic Tank-Liquid capacity.../S�'Pgallons Length---Y_6.... Width..�_..�..... Diameter________________ Depth... ___�... x - Disposal Trench—No. .........I......... Width........ ........ Total Length....... -�...... Total leaching area.... _, ---sq. ft. Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank (/) Percolation Test Results Performed by...... / :._. / _LG ................................. Date.... ........ . Test Pit No. 1_..G_2 .minutes per inch Depth of Test Pit.....! U...• Depth to ground water-----7 .Z rX4 V_. Test Pit No. 2..G_ _...minutes per inch Depth of Test Pit....%7-6-__•_-- Depth to ground water._2-.� 42.f... a ----•----•-•-•------ ---- --••-.........••..........-•-•-•••__•---- •-••.....------•----•--• ••........................................................ O Description of Soil - -------•--�fJ'� �",..E____-•---------- - ? ' V ....••-•-••-•-----••----••••••••---•--------••......-•--•-......•••-•-•••.--•---•-•••................ W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••-••-••--•-•-•••••••-••. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------------------------•-••-- Agreement: J The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental.Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'EV �4 he board of health.' -Signed ......-�. / .. - ... ....---- /�--e---- ------- g Application Approved By . . ... ...._ }j,"� :.-..�1 Q-- \ -/1Dace Application Disapproved for the following reasons: 0- --------- ......------------------------------------------/-----.... .....------------------------------------- ............................... - f ''( ° --------_.........--------------I......................... ......- ......-- ------- r� I J Dace Permit No. -- .......s ..�--------------------------- Issued . tot..-- ; Dare' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C intifirate of Contlatianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ---------------------------------------------------------------------------------- --------...-------------- ..----....-----..... ..-...........---...-------- ----_---..--- .....------......----- Installer at .......................................... has been installed in accordance with the provisions of TITLE, Of he eate Environmental Code as described in the application for Disposal Works Construction Permit No. ...`.�....--.�.' U........ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-- ------------- -- -- --------.. - .-- Inspector .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i V TOWN OF BARNSTABLE �� No......`....(............. FEE..... Permission is hereby granted........... .... .. to Construct or Re ai a Indi rl al Sew' .e Dis osal Sy-stem, ''s�' ��tt �} , at No....i/&�� > �� - yr_ Tel- ' _ s -• --------- - ---------------• ----- as shown on the appliTl�q for Disposal Works Construction ,e Street.........� �:��Dated...._ �/�f�.............:.. /!.. �0 _ Board o/f�`H�ealth �� DATE ,--•--- --•--•;--i-------••...................................... l/ / ' FORM 36508 HOBBS&WARREN,INC..PUBLISHERS o7 } G� i- oa L� , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIIi muixTAL MTECtON ONE WINTER STREET,BOSTON MA 02108 (617) 292-6600 TRUDY COXF Secretary ARGEO PAUL CELLUCCI DAVID B. STfi':FiS Grn�erncr SUBSURFACE SEWAGE DISPOSAL SYSUM WPECTm FORM Comtaiss:ooer 160 / f Q oe /eIS l �7�" PART A CERTIFICATION . Property Address: Os�ervi Ile od C55 Name of Owner J o 4n He,NOW Il Date of lnapection: - o Address of Owner, /(o O i n e e�(7 �f�pfv�/f'e/f�/� Name of Inspector !Please Print! Na�� e^� O �j// (�d bsj I am a DEF-approved systern inspector pent to Section 15.340 of Title 61310 CMR 15.0001 Company Narna: V I O — �e C/f Maing Addrm: � o k of Eras h�,• TNepttata Number: S o8) o S O — ? 9 O 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 end complete as of the time of Inspection. The Inspection was performed based on my training and experience in the Proper function and maintenance of on-site as go disposal systems. The system: Passes _ Conditionally Passes _ Needs Fu her E ustion By the Local Approving Authority i Fails ~ htspector's Signature: Date: J C a no The System Inspector shell submit a copy of this Inspection report to the Approving Authority(Board of Health or DEP!whhin thirty(30)days of completing this Inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,eths^lnspector and the system owner shall submit�e report to the appropriate regional offlce of the Department ofrEtvironmental Proi , V11.1 re The6oryipi ahould'bs sent toff system owner and copies sent to the buyer, If applicable,and the approving authority. ®�� r NOTES AND COMMENTS r ­�# 41 re%- 1 � ?oO a revised 9/2/98 page lorll `�Prrmeii on Recycled Pape, SUBSURFACE SEWAGE DISPOSAL SYSTW MPE=ON FORM d o P l s� ���ti CENLIIITCATAIONTN eor0wed) ivle er OS�erv►ll� i!'1 q 01415� c'roperty Address: Ayrnsr: / Gt / Q ra v Dats of Irtepee0at: � / ,�� INSPECTION SUMiMARY: -�/C�tack�( A. B. G► 1N a: a. SYSTEM PASSES: I have not found any Intoltnation which Indicates that any of the!allure Condition*do"dbed in 910 CMR 1$.703 exist. Any failure o.ltwis not evaluated Are indicated below. , COMMENTS: IS. SYSTEM CONDITIONALLY PASSES: _/t/ On*or more system components es described In the'COnditlOnsl Pass'section need to be replaced or r opal red. The system,moon compl do,of the repiacement W repair,as approved by the Board of Health,WM Pool- Indicate yes, no, w not determined 1Y.N,or NDI. Desorlbe basis of determination in eN Instances. H"not determined",explain why not. _ The septic tank is metal,unless the owns?or operator hoe provided the system Inspector with a COPY of a CortMeate of Compliance(attached!Indicating that the tank was Installed within twenty(20)years Prior to the data of the IIWW NOft;Or the septic tank, whether or not metal,Is of asked.structurally unsound,shows substantial IrAtraMon or sxllhrotlon,or tack failure is Imminent. The system will pass Inspection if the existing s"Me tank Is replaced with a complying septic tank to approved by the Board of Health. Sewage backup or breakout or high static water level observed In the disMbution box is due to broken or obstructed plpslal or due to a broken, settled or uneven distribution box. The system will pass inspection If(with opp►ovsl of the Board of Health). broken pipets)at*replaced obstruction Is removed jot distribution boa is levelled or replaced The system ro**ed pumpfrfg-more then tourVmee a yr:srdus to broken Or vbstrocted plpetsh ThO trystrarn WM PM inspection if lwith approvel of this lord of HOOK: broken pipeW are replaced obstruction Is removed a revised 9%2/9E PesrIOrII I� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM f0 PART A (0 9"1G/ �/ �15� CERTIFICATION(corrtinued) Property AddrespTee vl II Owner: /J-., 11l o 1'r4 P1 Date of Inspection: -5 /S 1 o O p C. FURTHER EVALUA ON 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTE IS NOT FUNCTIONING IN A MANNER WHICH WILL PROITECT THE PUBLIC HEALTHAND SAFETY AND THE ENWRONMEN.T: Cesspool or privy is within 50 feet of 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 I. FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that tl 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. Method used to determine distance (approximation.not valid). 3) OTHER revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A // CERTIFICATION(continued) 0 l6 i 0ne)e�9 05-jerv, Property Address: Owner: doe-01 Date of Inspection: D. SYSTEM FAILS: Ao d You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No/ ✓ Backup of sewage into 4eciFryror-system component-due%to an overloaded orgylegged SASor•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. 1/ Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 day flow. Required pumping more.than 4 times in the last year NOT due to clogged or obstructed pipels). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. V1 Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. v Any portion of a cesspool or privy is-within a Zone 1 of a public well. V 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic-compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 aurfaoadrirrkiwg 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further inforgiation. revised 9/2 98 Page 4ofII M • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ///O /Jvie /e'' �y A� CHECKLIST Property Address: J Owner: //� Date of Inspection:I4CJ G 1/7 Check if the following have been done:You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant,or Board of Health. _ None of the system compoments.hawsbean puarpadutor-atJaast two weeks and•the t+ystam hasbaeoaaceiaiogwesmal flow period. Large volumes of water have not been introduced into the system recently or as art of this rates Burin that od Y 9 P 9 Y P inspection. As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System,have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction,dimensions,depth of liquid, depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ Existing information. For example, Plan at B.O.H. Determined in the field Of any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)1 _ The facility owner land.occirpaats,if difiarepi lram�waer)..weraprayiried.with in4^^��t�oo.cn.thaprvipar�alntonaooa.ot SubSurface Disposal Systems. revised 9/2/98 Page sorll SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 16o ��eICIG�V/ �� INFORMATION �/ SYSTEM INFORMATION Property Address: Owner: Hw /UrG(� Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design flow: �f10 g.p.d.lbedroom. Number'of bedrooms(design): Number of bedrooms(actual): Total DESIGN flow Number of current residents: Garbage grinder(yes or not:Feaior SLaundry(separate system) nol:Z4-10c If yes,separateinspection requi►ed _ Laundry system inspected 1 as o� 'Seasonal use(yes or no Water meter readings,if available(last two year's usage(gpd): Sump Pump oyes or no):IVtl / Last date of occupancy: 5 I �oOO COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: apd ( Based on 15.203) Basis of design flow Grease trap present: oyes 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: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION / PUMPING RECORDS an sour a of infor tion: _/ /VO — No /Yee 111 Q Syst:*pumped as part of inspection: (yes or no)_ If yeswv�olume pumped: gallons 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed4if known)-and source of4Wermetion: - - - Sewage odors detected when arriving at the site:(yes or no) revised 9/2/98 Page 6of11 c SUBSURFACE t EWAGE DISPOSAL SYSTEM INSPECTION FORM PART C (p ,Vrel L 1 � /'�Tr'1 SYSTEM INFORMATION(continued) Property Addr�5 ✓yr�1 e �Lf o, 6s� Owner: / 11 Oro(✓•1 Date of Inspection: II BUILDING SEWER: 5/7 Q (Locate on site plan) �an�( � �� l a•�h� �1 Depth below grade: Material of construction:✓ cast iron_40 PVC_other(explain) Distance from private w8 er supply well or suction line Diameter L1/ Comments:(condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ (locate on site plan) 1�✓1� � � /(!,/ �� �" �� Depth below grade: / art_ Material of construction:—concrete_metal_Fiberglass _Polyethylene_other(explain) . If tank is metal,list age_ Js.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: (p c/o 6'x 119 %SOO G,GI/`O� �" I o,h Sludge depth: L� -�/� �_ A Distance from top of sludge to bottom of outlet tee or baffle: 7 _. Scum thickness: / -/I/ A- / Y" ao�y Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottoun of ouUet tee or baffler How dimensions were determined: ale 9 �e✓�C(f- Comments: (recommendation for pumping, ondition of inlet and outlet tees or-ba:HVes, depth of liquid Ipvel in relation to qutlet invert,structureF�iritegrity, avid ye of lakage,etc.) �.r r4 Ylr7 r n �` {7Qp f✓I r er. Tgvr // gesO 2-ti GREASE TRAP: (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) ,t 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: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) revised 9/2/98 Page 7of11 ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM �1/6/ n PART C 0 t�ne ef/�� �/�,�, SYSTEM INFORMATION(continued) Property Address:�S e✓V l/l i/!� OP0S] Owner: ° Date of Inspection: H."1/0/a V1 TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(explain) Dimensions: r Capacity: gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note4 level and 4�r�utiq sis equal, evident/ f so ds car over, evidence of leakage into or out of box, �jtc.) — — /j l /Vo 3,JJ& Gt rrC l�By — �C�J /rci S•P r PUMP CHAMBER: Iy (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.) revised 9/2/98 Page 8orll SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTV��B U�` INFORMATION(continued) SSTer ; Property Address: 1 Owner: /J at �rot V 1 Date of Inspection: 51;1�0010 SOIL ABSORPTION SYSTEM(SAS) (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Type: leaching pits,number:_ leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number:_ ' Alternative system: Name of Technology: Comments: (note condition of soil, ins of ydrauljotailure,level 1 onding, damp soil, condition of vegetation, etc.) er grea S CESSPOOLS: (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: Materiels of construction: Indication of swundwater: inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure,level of pending,condition of-vegetation, etc.) PRIVY:, (locate on site plan) Materjals of construction: Dimensions: Depth of solids: Comments: (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation;etc.) revised 9/2/98 page 9orn ' O jn SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Ho,( Urot 0Date of Inspectiwr SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) GjG� ©� lllJt.(f� c - B c �4- ` I� 3 f+ `t9141-1-1 -� /I a-3q /13 revised 9/2/98 Page loorn cy • + SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM lPART C�O �ne leI (� ,�q f I4YSTEM INFORMATION(continued) Property Address:C54,/(/I//e Owner: Data of Inspection: XV13-7ACi"e NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells h Estimated Depth to Groundwater"/ Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records /Check;P local excavators,installers �/ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) ail hl5k C'Y10",,j,,,,k I k✓ a- 9 revised 9/2/98 Page 11of11 SD/L s TEST RE.S1411_ TS G G+AM .DAM A Z.SY A , �`/Z z. 5y 4/2 7 /�4pG lDUs� ,7 C S oA.t'SF 62OR EL /?..EV, Z 5�. 77 Az 5 Y.fi'r 7/sci 19 G o�9MY SAN.o B S-6 WAGE SYs T��i f'F'o, � E LOAMY 3'A/V.0 /o y/T S/c B S 2� 0 3i„ /DYR /6 16L• IS.77 3o'' 7'dP O� � R/;SE/z COVERS TD C'4 v-0R W/THIN G" F/A/.C9. COVER 3 G"MAX• C'D I/ER 7"l.> k117//d l .-�'' ' MAD/c/M pl4l/it/.1�.9 T/O�! /l9E.a/U/VI M/nl. C S�9ND SAn/1� c. EL. 23. ?'4 •D y-"¢S scH, y�.o 6''DF �" vF �/N. GR. AH1� 3G"MA�C- '�' 5r' sct/. 5�0 ,c 2 COYEl2 OF �'/' l/2 BTaNE • �AIV /9 3� �iqu�D �E�Ez Pvc A,G• CrVi�= /7. 5�3 CG►VE „ 1DYR �/G /oYR T/� 20, �9 7 I o''Mw, /5�'' iti ivv. vc "V r INV% r73y 7 '� /7.63 1/,f� Z .soa GigL> CHAM&Eie;l GAPL,6 6 BEa F ' WAS"�d n � © ,� n ' E � DEP '/1 /ZD„ onlE s?' B4X sronr a c� �► a r n ' hl/G" svMP •,4' D N/ Al T ENC UN?E�'E.o G/ZoUiv ATEie o 0 A',D v PlVOZ. h�4//sE /N1-E7- p/f'5 To 4FX/s7iA/a SO/GS 7,057" .DA7,E = 9- 7- 04 lSa e:� CAZ-. PR6CAS7- 5"5/'T/C 774A//k' :�9 - Sep/G 5' �9 SC�/�', ?"/<�N S YS TEM 0.9eIVS7-4,04E H, AEsM.�IfiQA/S 5 oll-S dg 1/A4 444Td� ./oH/V DO YGE RARC ,4770AI ,BATE -< 2 Mrn/. oReol iiVCH 3 3 - S/ SD/Ls 7r-X7 411e-44 CG ASs 49AA5 �-EW'4 GE= S YS775W 4.6;SIGN CAI- C lJG A 7-10NS .SDARZ Off' IA5AL TH IJ5S/GA/ LA/1-Y /'L DIN' ; Fr.Vis�/ GR�4hE G MAX. �Y //O 6/0.6 fee GR,6 y'' M/N. Co w c'oYER DF *,V O GAD 0. 7 3, use �3) ss"DO G/¢C. l�,�'EC�9sT GE/9Cs'�!e`/G C�'A/AMBE.es' 3/�'1_/�2 (3) 500G.CNAA40ERS 3/f I�Z� Wl�` OF 1>av,BLE tNi9 sHEz) �sTo/V� A,eOO/VZ . WA SHED a =1 0 Q Ct 1„/,gsNED 2, Epp• DEPTH i4rG'<5'D.P ' '.14/t/ A.Ce5.4 .alga V/S'/oN = STONE r..� r.� C7 � ct sroN� 7 � Q t� b Q ,BOTTDM iA�C'" /' . 93 >r 33, _s" = 542 9 s-� a ) X Z - Al-9 5 S'� 4 to L 34• ENd SECT/4/V of s.A. s. AS•S`ESSO C,5'• M44P 7/ S. a �•X/sT/n/G /S40 G�9 L. �� VA �xi sT m 2 G '• 8 P.eof', sERy�cE ; '� 1. ALL CONS-r,e r/C T"/.ON AN•D MAT2�WMI S sy�4LL CO/VFO�WNJ TD T/TG E+ F/V p PD ST p tt. p,2,pPvsCa 01 o� 23 - _ _ / �d� �` 6' pDOL h'DUS ANb T1-1 C- ,f3AR//5'TA RI-C- &349Z) OK A/E 4L Tip/ XeG bL A7/©/V S. � co �, ,`. ` ti1/,G{S//EA SM" SHALL ,8� ,�'EE �F dU�`T .4NL� /N'�a. �Q` oySA� % � � � 3. ig G L .10/NTS ,5"�AGG ,BE yV.97'��f'T!G/NT. • � � �- m Z o � 0 G� 05 0 '/: CD/�/Ti�ACTOIt' S'NAG.G /`/OTIFY l�/G-sA1GE �i� T;f� !/EEC'/F/ ITt0�41 n of i T (A OF UT/G lT/ES GOG'ATIO�IS'. b LOCu S _m ' ' o 1 % y Q 4O �` i b x .� S. CONTiE'.9crah' sN.9L G 08T.v/A/ /0VS �C LOit/ A IV b A P A6 ✓/SELL .8 Ze eC- `�► 4 i Zo A' T f' Y lb ar- s b 1 WO,A�c?A DF ,�,/E,9G.TH Nb �L�SLG/V�sl� per'/Di2 "O` �'AC�C' �/G.4/A✓l . gib ': ►t' 11 W APPR4X- , t \ Ili% `�n O G, 6M1- A1.R k5/E�1W/GA G8TA st�Y�S 7-9A ` Q0MP0/1E1VTss ,9E MA/?W,9,A W177-1",4SAIE7/C ?RNA A` e• 09 0T ,dcZ CoMp4A48LE MEAA/s 7D LOCA7�dSr b CDMf'lJ�/�/VTS• p /� � 1� Box �✓� 7 CGlV%P,4C7-01Z COMB/G.� A1V ,4C'Ctl&472!5 As-Afv147- A/.9 A4M � ©c Us M.'�� s4AVIF�v o Sl,/pW/n/� 77-/6 LG3 CA Z6D/V 5 of 7�/� ��WAGE 001W D/VEN7Z7 o ti/ 5,"TE .s'c�9 G,E " = 24op' 2�c•r� �� ' . W � _ _ AA1Z Al COPY WIT/•/ 711� 8�9�i1/S'Ti9.BG� /i�L��1�,Z� DEi°AiC'TMEJVT. �1 1 �O/G S 6�.BS�iPPT/GM LG_07- A,4a. 170 0 6� P��PA/z16,a .�411f �o. , , 23 Tp No7� ' 77V 6- E-C1.5 1AIG /S L D CAT�,U 1/11/.D�,oe, 7/-/4= ,� oPasEz> gZ' t�,E'D{�Ds f'©OL, S///I L G ,8E RPL�►CEO ,8 y �J 3S jr 2J } r ' �� �G ✓ ZZ. OG .��% OF ZN ; OF � IV07E : 77V 71-1,:f:- �,1-1sT/�il�' A�tIA AeO.,00sE1> °.,w. �� D S ���`P� OHN t�v �2 / 'D o G A p Cis stiA�L R,6s41Lr !A/ AN 'C�sv e'er 7"0 p Pf 1V .� „ a. 1140 No.33589 " .SCigZ- (� 1S�/� TIC 7�NK , 3 c, DOYI E,t(1 7�� d�©IJ.G.. A.E'.�.�J �9 N.0 A;'.�'C�,/t/�' .AI"P',�'a!/.�L. G►F �s cts=��.�� 1�,�EGISTE�`�//VGET /NVE;2T = EL. /9./S Q�,PJVST•9,B� LG gNfTAR\�`� su \j // C•8- �'C//L..1�fNG !�E-/'�9�TME/�/T_ ac p* 3 O' 6.0 lJaYLE A5soC/ATEs IroS - .6-4:3- /994Z /7!3 CG oVE=R/1'/E1.,D WAY E. FAG M 0 U 7W, MA - ©Z s'3 G SOIL TEST 70P 'OF FOUNDATION 20 FT. MINIMUM FROM CELLAR 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST OCTOBER 9, i997 ELEV. - 100.5 10 Fr. MINIMUM' CLEAN SAND SOIL TEST DONE BY UEETSER ENGINEERING P 9020 WITNESSED BY J. DUNNING CONCRETE covERs LOAM AND SEED OBSERVATION HOLE 1 t=LEv= 97.6 OBSERVATION HOLE 2 ELEv= s7.8 4" SCHEDULE 40 PVC 8" PER PIPE PERCOLATION RATE `< 2 MIN./INCH AT. 57 INCHES PERCOLATION RATE < 2 MIN./INCH AT `� INCHES 4 MIN. PITCH i/ 2" LAYER OF 1/8" TO 1/2" DEPTH HORIZ TEXTURE COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER WASHED STONE VENT • " '�' 3.9' 4" CAST IRON PIPE NOT REQUIRED 0-7 A LOAMY SAND 10YR6 1 ROOTS 0-7 A LOAMY SAND 10YR6/1_ ROOTS (OR EQUAL) MINIMUM / PITCH 1/4" PER FT.: 1 CU. FT. OF _ CONCRETE FLOW LINES - Q; ANCHOR ELEV. ---96.6 MIN. 7-21 B LOAMY SAND 10YR5/6 ROOTS 7-16 B LOAMY SAND 10YR5/2 ROOTS LEV. = 96.0 LEVEL oou �,i ea Ada �' .� a 10 ELEV. = 93.27 .. 6" SUMP 94.4 . ^i � ��. �1����>_��� ELEV. = 96.25 BAFFLE GAS ELEV. = 94.6 ELEV. DISTRIBUTION ELEV. =J y 21-120 C MEDIUM SAND 10YR8/3 16-1 20 C MEDIUM SAND t 0YR7/4 LIQUID OUTLET BOX 94.1 6 HIGH CAPSTONE T'i No CAPACITY A�NATnRS WITH 5.6T DEPTH (TO BE PLACED'ON FIRM BASE) TO BE WATER TESTED " X 49 X 10 TRENCH FORMATION 5 FEET 19 INCHES . - 50O GALLON IF MORE THAN ONE OUTLET 10 6 FEET: 24'INCHES WELL N fA NO WATER ENCOUNTERED AT 120" ELEV. = 87.6 NO WATER ENCOUNTERED AT 120" ELEV. 87.8 7 �E ET . 29 INCHES, (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION ZONE .8 FEET 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" SYSTEM (SAS) INDEX WASHED STONE \ ADJUST LEGEND: DESIGN CALCULATIONS LE ELEV. _ �Llf A EXISTING SPOT ELEVATION d0,�0 NUMBER OF BEDROOMS 4 USGS PROBABLE WATER TAB SEWAGE :DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. = _N A_ EXISTING CONTOUR ----00---__ GARBAGE DISPOSAL UNIT _ NOT TO SCALE BOTTOM OF TEST HOLE ELEV. = _87.6 FINAL`SPOT ELEVATION 00. TOTAL ESTIMATED FLOW - FINAL CONTOUR 00 ( 110 GAL./BR./DAY X 4 BR.) 880 GAL/DAY / - REQUIRED SEPTIC TANK CAPACITY 880 GAL SOIL TEST LOCATION LOT 169 UTILITY POLE -o- ACTUAL SIZE OF SEP71C TANK 2 - 1500 GAL i TOWN WATER �W ;®� SOIL CLASSIFICATION I O � _ MIN. N. 11CATCH BASIN 0.74 GAL/DAY/S.F.AY/S.F.GA5 LINE EFFLUENT LOADING RATE g 264.48 � CLEAN OUT C.O. LEACHING AREA 639.0 SQ. FT. t? (11 X49)+(6Ox2x10/12) BENCHMARK �� p0� LEACHING CAPACITY (AREA X RATE) 472.8 GAL/DAY TOP OF. BOUND P11 639.0 X 0.74 : ELEV. � 100.00 . _ � RESERVE LEACHING CAPACITY 472.8 GAL/DAY (ASSUMED) j m -- N NOTES: w 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. it Nn TITLE 5 AND THE TOWN OF BARNSTABL.E RULES AND 1500 GALLON ,� 7 ,r N 70 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. SOIL TEST i p $SEP11C TANK 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO .. . ..•.- � � 'Pa. } x q WITHIN 6" OF FINISHED GRADE. p u► 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF LOT 1'70 qq D. BOX � o, WITHSTANDING H-10 LOADING UNLESS THEY-ARE UNDER OR WITHIN - , l N 53,128 SQ. FT. 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL - i '�� BE MORTARED.IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH Dr"EDEL) OR YONiNG REGULATIONS. OWNER APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. .6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS TO CALL "DIG-SAFE" AT 1=888-344-7233 AT LEAST 72 HOURS >. PRIOR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATION'S AS WELL AS LOT 125 SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE C. 1500 GALLON O SEPTIC TAN N .. K K b i .,:.' SOIL'TEST 2 CJl x� . _ APPROVED. BOARD OF HEALTH DATE AGENT PROPOSED SEPTIC DESIGN FOR 9 , � / � ,f EA/V Ptl WERJ TIONPROJECT LOCA LOT 170• INEL H P EIG PATH r SWEETSER ENGINEERING { 1+ 10 235 GREAT WESTERN . ROAD �. -. P. 0. BOX 713 508- _ SOUTH'DENNiS, MASS. �98 3922 02660 99 Qa.Pi,' i . _ .. � -. _y SCALE ri f DATE 1 _ -. OCTOBER 9 1997 20 h z i 286.35 -'n ': v: ... - . .. .. ♦� yy , .. f.... ..,.. ,. dam- .. .. , . . . . _ `. T. A. ..� � P ..�•-- .r..-- REVISED =0� J y LIU { a4047 00 t , � n r s s REVISED .: '. 1 1 SHEET OF• LOCATION MAP : 01997 SWEETSER ENGINEER G , A, r , „