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Home My WebLink About0219 POND STREET - Health 219 Pond Street - Osterville. P J fJ 1 r I 0 I q�. 4 f T . No. r� I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes � j 9pphratiou for Misposal 6pstem Construction Permit e Application for a Permit to Construct(Repair(�pgrade( Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No..°/qA Owner's We,Ad ess,and Tel.No. t Assessor's Map/Parcel� -.v I J Installer's NameAddress and Tel.Noj-O37-yY,57_ Designer's Name Address and Tel.No.3D�' PVA Type of Building: VIV 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) l� gpd Design flow provided /33 1 gpd Plan Date Number of sheets Revision Date Q Z Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs orAlterations(Answer when applicable) /LfA• ^ Date last inspected: Z/ 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. t/ Signed Date 1/ 2-1 Application Approved by11' -(Date p 1 Application Disapproved by Date for the following reasons Permit No. `Z f f21 Date Issued `L Y1;,-'»;••-��,».. ,r:; ' ' .-'.;:r�-^.n� •,�e�..,,.•,�-�.a,a ,yy � �;t�ti7,�_.:��; -uxry,� aar ,;•-r," "'F"`�';u'1;,..'i s„wuC. i }s' r S ::.� Y .: �` 7''t%` dr "�1y,. ,,�,F,., as�i'F-.f' r^,`".* 5,.•-.. t-• .17 �, � L�' '/+J i. K�v.� �°`.•>N4't'. �x�",Jl.... ��' sx� �t:,�,,J t ._ `_ �'.�s�.+�✓ ?!' ".y�"," IVA allo /F/� Fee `�— �✓`� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 'PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes i� r NPOration for Misposal 'pstenn.Conkruction 3pernit � A lication for a Permit to Construct / "ke air "U rade Abandon� ;}pp (� p (� pg ( ) (. ) ❑Complete System. El individual Components � ' k` Location Address or Lot No.214'I-,o,IGr .�7~��1��/'//� Owner's Narmeea Address;and Tel.No. § Assessor's Map/Par V! / rr{tQ In allec's Name,Address and Tel.No.,j a'5_elya-'q_15 3\ Designers Name Addr ss,and Tel.No.JA3'-.t-,97-3 pQ zri i � � 1 :: ,.s r�t��r`7 °'' • Type of Building: - tti v a t - Dwelling No.of Bedrooms �' Lot Size:`._ ,' <' sq.ft. Gazbage,Grinder .Other Type"of Building No.of Persons tShowers(° ) Cafeteria( ) Other Fixtures / Design Flow(min.required) / �/D gpd Design flow provided / gpd Plan Date Number of sheets Revision Date Z, ( ,l �...�— Title Size of Septic Tank Type of S.A.S. - ;Description of Soil " Nature of Repairs or Alterations(Answer when applicable) //I/ 1ir9 420d ��fJ = /r/~ ,, 7,We ,�.f�y�e I Aa tX'iy, yr. �q/A "Date last inspected:' 4 Agreement wrx z 1 The undersigned agrees to ensure the constructi6fil'aiid maintenance of the afore described on-site sewage disposal system m ' accordance�tnth fhe 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. a r " Signed i'?�['� Date Z t Application Approved by Dater'".'T J / Application Disapproved by Date t t for the following reasons <{ Permit No. Date Issued a THE COMMONWEALTH OF MASSACHUSETTS - BARNSTABLE,MASSACHUSETTS max. (Certificate of Compliance Y, THIS IS TO//CERTIFY,that the On-site Sewage Disposal system Constructed(" ) Repaired O.- Upgraded(�) `- Abandoned( ' )by tl/�J r'64 1 z2' �j; /1st has been constructed iri accordance [l 1, /with the provisions of Title 5 and the for Disposal System Construction Permit No. 2411,7 d l,)[lated� �7//`!/z Installer,�/�5r� ��G/7lq�J"/'YJ� Designer '51� `V ZAI?. #bedrooms / Approved design flow /D gpd The issuance of this permit shall not be construed as a guarantee that the system will functio as designed j A Date �� r' ' " t 500 Inspector r No L ..- - _4 Fee . ) ... THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS t Misposal 6pstem Construction 3permit Permission is hereby granted to Construct( ) Repair(4),— Upgrade( — Abandon( ) System located at / , 2o r�- and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Titled d the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. ' !" Date , Approved by TOWN OF BAMSTABLE y \!LOCATION X119 /,,Vv/ SEWAGE #6--OA6'-�t VII.Z:AGE � ASSESSOR'S MAP & LOT .01 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) G��C/"`"1 � � (size) NO. OF BEDROOMS BUILDER OR OWNER ?WA%49oV PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leacking Facility (If any wetlands.exist within 300 feet le n a 'lity) Feet Furnished b � ap .. 1,`�!/' �I �,\ � � �� , ��, `�'�� ;. � �- r , r Town of Barnstable Inspectional Services i SAMerA" g Public Health Division &63 Thomas McKean,Director ° 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . Installer& Designer Certification Form Date: 4f2 l /Z I "Sewage Permit# 16.2/— 1,2Z Assessor's Map\Parcel tit P�g Designer: Installer: =_0 G; Address: Address: 1A � 6A4 Qt�L 1u1��63 ��(hQb�Ss"'N�i ✓On was issued a permit to install a (date) (installer) septic system at based on a design drawn by �7 (address)dated �_7A 4-le/01 A' (designer) _. 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/;;SEE p out (if required) was inspected and the soils, were found satisfacto :-�& C aS� Sp-\/Pxt X. �� e- 2 4 a I certifythat the � � / I � T a 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 c�1- ff f, of the septic system) but in accordance with State&Local Regulations. Plan revision orQ�`� 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 constructed ins p_iance with the to rms of the I\A approval letters(if applicable) DAMD D. .t P/ ERTY JR. u, ( staller's Si nature) No. 1211 �aY � 18TAM esi s Si ature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED U IL BOT THIS FORM AS. BOLT C ARE RECEIVED BY THE BARN STABLE PUBLIC HEALTH DIVISION. THANK YOU. WoaWeptsWEALIMSEWER conned\SEMODesigner Certification Form Rev 8-14-13.130C Town of Barnstable Board of Health BAMSTABM 200 Main Street,Hyannis MA 02601 �D MAC A`0� Office: 508-862-4644 John Norman,Chaimnan FAX: 508-790-6304 F.P.(Thomas)Lee,P.E. Donald A.Guadagnoli,M.D Daniel Luczkow,M.D.Al March 8, 2022 Mr. Edward Stone P.O. Box 1729 Sandwich, MA 02563 RE: 219 and 219A Pond Street,`Osterville A=119-029 Dear Mr. Stone, You are granted variances on behalf of your client, Sarasota Realty Trust, to install a smaller sized septic tank at 219 and 219A Pond Street Osterville, Massachusetts. The following variance was granted: 310 CMR 15.223: To install a one-thousand (1,000) gallon capacity septic tank, in lieu of the minimum 1,500 gallon capacity septic tank requirement. The new septic tank will be connected to an existing one (1) bedroom dwelling. This variance is granted because in the opinion of the board of Health, a one thousand (1,000) gallon septic tank should be sufficient for one bedroom. Also, the applicant testified that there are two large trees located in very close proximity to the work area. The installation of the smaller tank will prevent the removal of these large trees. Sincerely yours, jog Norman Chairman Q:WP\Stone 219&219APondStreet0sterviIle Variance May 2021.docx I 1 DATE: _ O,^ x $95.00 FEE*: /4 9�RN3TABGE,A Town of Barnstable RE .BY; f �. �G MASS. � s6gq. a Board of Health SCHED.DATE: ( aoxl 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 John T.Norman FAX: 508-790-6304 Donald A.Guadagnoli,M.D. F.P.(Thomas)Lee Daniel Luckowz,M.D.,Alternate VARIANCE REQUEST FORM LOCATION � Property Address: p2�i� '" �/�'!1� 37- C A ')& Assessor's Map and Parcel Number: ��p� % Size of Lot: /,a 2-SO Wetlands Within 300 Ft. NO. Business Name: AJ 4!tf OF Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: /{SO' �/ZUST— Name: gEjLc)� �A �1�1� Address: Address: Phone: ULA i iJ (IneI.Reg.Code a) REASON FOR VARIANCE(May attacli separ to sheet if more space needed) cer 1( G -ram ► 1Sfu, i n hes .setae I a-i d t-_ ®F /4 1 Sa® CA&NATURE OF WORK: House Addttton House Renovation LJ Repair of Failed Septic System ►�h� Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as S collated packets. 7/' A. Five(5)copies of the completed variance request form i/ B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: healthpa town.barnstable.ma.us *(Pool Plan—5 hard copies) D. Five(5)copies of labeled dimensional floor plans submitted(e.g. house plans or restaurant kitchen plans)and one(1)electronic version. 5,("v_d1r9% ✓ A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or RS. Signed letter stating that the property or business owner authorized you to represent him/her for this request _ Applicant must notify abutters 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—Five(5)copies of full menu submitted(for grease trap variance requests only). -�' Fee Submitted*$95.00 for the following variances: 1) New construction, 2) Septic repairs with increase in flows, and 3) New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans, and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED John T.Norman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL F.P.(Thomas)Lee Q:\Application Forms\VARIREQ Rev 2020 1-1-2020.docx I 1,� -4 a" LA C's IM La 4 of lz Ilk eN !g -W '19 • ke, de 4\ r IN •� �� ° 4 10� 6.0 ts me ohs 4 cftl< . '� Ok OL Lq "Coe o \`� b ,tea,; ,,...,.-.�..._., .,,.,,,.. . . , .-......�.....�,._m.. E.A.S. Survey, Inc. 141 Route 6A, Salt Pond Building, P.O. Box 1729, Sandwich, MA 02563 Telephone: (508) 888-3619 L�v115�- ' w�o� r�ooM He>Q Iv r ,4 i Commonwealth of Massachusetts l l q• d�-g Title 5 Official Inspection Form Subsurface Sewage,Disposal System Form-Not for Voluntary Assessments Property Address . Owner Owner's Name kdbffnation is �ST2/e 1�l L L E. ll/j required for every '� d� SS ✓. /zG , Me, City/Town State Zip Code Date of Inspection � Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the farm. S�# 3q b"a0r an":When A. Inspector information Sim out forms use cmftcom the tab 17 t5v-r� key to move your Name of Inspector "— cumor-do not use the return .Company Name —tz key- Company Company Address NYw �t� MA City/Town State Zip Code ��- 5 2�—_�d s� Z p 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 1 have determined that the system: 1. Passes 2. ❑ Conditionally Passes 3. 0 Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails tnspectDes ' atmre Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. if the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP..The original form should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 45kap doc-rev.7/26WS Trtie 5 ofigal Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 { Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-riot for Voluntary Assessments otip 5 Property Address Owner Owner's Name Manrequired ion is � -�✓/L L ` 55� L�/ adz required for every Me- 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: 2) Sy em Conditionally Passes: ❑ One more system components as described in the"Conditional Pass"section need to be rept repaired The system,upon completion of the replacement or repair,as approved by the Board Ith,will pass. Check the box for"y ", "no"or"not determined"(Y, N,ND)for the following statements. if"not determined,"please exp The septic tank is metal and o r 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial inf tion or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is re with a complying septic tank as approvedd by the Board of Health. *A metal septic tank will pass inspection if it i structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than years old is available. ❑ Y ❑ N ❑ ND(Explain below): 6c•rev.7l26/2018 We 5 Official inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 I 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments zt9 -poNo �r Property Address Owner Owner's Name information is /ZV C 4- L C required for every � l l Paw. Cityfrown State Zip Code Date of inspection C. inspection Summary (cunt.) N/�) Sy tem Conditionally Passes(cone.): ❑. P p Chamber pumps/alarms not operational. System will pass with Board of Health approval if pu s/alarms are repaired. ❑ Observation sewage backup or break out or high static water level in the distribution box due to broken or ob cted pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection approval of Board of Health) ❑ broken pipe(s j re replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is rem o ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is level or replaced ❑ Y ❑ N [ ND (Explain below): The system required pumping more than 4 times a y r due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Boa of Health): ❑ broken pipe(s)are replaced ❑ Y N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ND (Explain below): 3) FZ�valuation Is Required by the Board of Healt ❑ Conditions exts require further evaluation by the Board of Health in order to determine if the system is failing to p public health,safety or the environment. a. System will pass unless Boa ealth determines in accordance with 310 CUR 15.303(1)(b)that the system is not fun in a manner which will protect public health, safety and the environment: Skq;kd--rev.MAM18 Title 5 Mid Inspection Form.Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface sewage Disposal System Form-Not for voluntary Assessments Property Address / OU owner Owner's Name hftmationis t"uired for every rvL � PW- City/Town State Zip Code Date of Inspection C Inspection Summary (cunt.) 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 i fail unless the Board of Health(and Public Water Supplier,If any) determines th the system is functioning In a manner that protects the public health, safety and env ant: ❑ The system has eptic tank and soil absorption.system(SAS)and the SAS is within 100 feet of a surface w supply or tributary to a surface water supply. ❑ The system has a sep tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic to and SAS and the SAS is within 50 feet of a private water supply wen. ❑ The system has a septic tank and and the SAS is less than 100 feet but 50 feet or more from a private water supply wag". Method used to determine distance: '*This system passes if the well water analysis,perfo ed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of a monia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria a triggered.A copy of-the analysis must be attached to this form. c. Other. 4) System Failure Criteria Applicable to Ail 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 dogged SAS or cesspool ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or dogged SAS or cesspool lB .doc-rev.72W018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments _Property Address Owner Owner's Name oration is as�-7�'-V 1 L t_ t5 s- required for every Ma. City/Town State Zip Code Date of Inspection C. Inspection Summary (coat.) 4) System Fallure 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 l Liquid depth in cesspool is less than 6"below invert or available volume is less ❑ �� than Y2 day flow Required pumping more than 4 times in the last year NOT due to clogged or ❑ tlk" obstructed pipe(s).Number of times pumped: ❑ T Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ N�� Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ N Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ] IUk Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Nl A 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 colifmm bacteria indicates absent and the presence of ammonia nitrogen and_nitrate nitrogen is equal to or less than 5 ppm, provided that no other fare 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- 0 gpd. ❑ The system fgds.1 have determined that one or more of the above failure criteria exist as-described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. / 5). Large Systems: To be considered a large system the system must serve a facility with a ` of 10,000 gpd to 15,000 gpd. For large s s,you must indicate either"yes"or"no"to each of the following,in addition to the questions in Secti Yes. No ❑ ❑ the system is within 4 of a surface drinking water supply [] ❑ the system is within 200 feet of a trib a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area . Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply Movkdoc r rev.712 8 12 0 1 8 Title 5 Of6dal Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official inspection Forte Subsurface Sewage Disposal System form-Not for Voluntary Assessments ZI 9 -�L n1 D Property Address Owner Owner's Name bftmat�uiredb on{for every Me. City/Town State Zip Code Data of Inspection C. inspection Summary (cons.) 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 C.4 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.C.4 shall upgrade the system in accordance with 310 CHAR 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 aft 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? ❑ P. Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A) ❑ Was the facility,or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of break.out? 13 tvtc� �h Were all system components, Qhe 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 toe site has been determined based on: �)6: dAd A 1 o lJy ��,,//FOZ)g�t� ❑ Existing information. For example,s plan at the Board of Health. ��t_r 5.3�-v2.r�acuwtgg� ❑ 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)1 Gkop doc•rev.7/26✓2018 rife 5 official Inspection.Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's(Name idortnation is 61�J L L_LE Fequired for every P"e, Citylrown State Zip Code Date of Inspection D. System Information 1. Residential flow Conditions: .Number of bedrooms(design): � Number of bedrooms (actual): z DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of.bedrooms): ZZC� Description: !> .. c� Number of current residents: Does residence have a garbage grinder? ❑ Yes No Does residence have a water treatment unit? ❑ Yes No If yes, discharges to: Is laundry on a separate sewage system?(include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ❑ Yes IV I+ Nola Seasonal use? ❑ YesX No Water meter readings, if avaitabte(last 2 years usage(gpd)): Detail. Za IJJ5- 7D Sump pump? ❑ Yes ( No Last date of occupancy: Date dkapAw•rev.7/26/2018 Title 5 Offiaat Inspection Pone:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Titre 5 Official Inspection Farm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �-- Property Address�'274 Owner Owner's Name A72FA information is f445 required for every l Page. Cityfrown State Zip Code Date of In pection D. System Information (cont.) if/_2. C erciallindustriai Flow Conditions: Type of Es lishment: Design flow(base n 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(se Lpetsons/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 sys m? ❑ Yes ❑ No Water meter readings,if available: Last date of occupancy/use: ate other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ,,r ElYes No If yes,volume m c9' T� a the �an� pumped: gallons How was quantity pumped determined? �('a Reason for pumping: doc•rev.712612018 Title 6 OfficW Inspection Form Subsurface Sewage Disposal System•Page a of 18 Commonwealth of.Massachusetts HOW Title 5 Official Inspection Farm Subsurface Sewage Disposal System-Form-Not for Voluntary,Assessments Property Address Owner Owner's Name tt is require for 6Zi6 SS 4 /0 I Z(quired for every . PO, CdyTrown State. Zip.Code. Date of Inspection D. System information (cont.) 4. Type of System: Septic tank, distribution box,sort 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: Were sewage odors detected when arriving at the site? ❑ Yes No 5. Budding Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron 40 PVC ❑other(explain): Distance from private water supply well or suction line: feet !qr- Comments(on con d' ' n of join ventin vidence of leakag , etc.): ftwp4oc•rev.7/Y812o18 Title 5 Of6dal Inspection Form:Subsurface Se p Disposal system•Page 9 of to Commonwealth of Massachusetts Title 5 Official Inspection Farm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name Ntorm for s NK#dmdr fo every Citylfown State Zip Code Date of In4ecrion D. System Information (cunt.) 6. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: concrete 0 metal n fiberglass El polyethylene 0 other(explain) If tank is metal,list age: 7 years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) Q Yes E] No/VA Dimensions: �51X ��—�`��C t, ({41 D) V a-Q Sludge depth: 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 Distance from bottom of scum to bottom of outlet tee or baffle 3,r Mow were dimensions termined? Al D•t- ,Comments(on pumping.recom'm ations inlet and o e or baffle condition)(structu aj fr►#egrity) liquid levels as related to outlet inve evi nce of leakage,e c.): .doe•rev.7/26/2018 Title 5 Official Inspection Porte:Subsurface Sewage Disposal System•Page 10 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Zi4J Property Address Owner Owner's Name grad fo is ►squired for every P"e, CityrTown State Zip Code Date of Inspection D. System Information (cont.) r`A 7. G se Trap (locate on site plan): Depth bNgrade feet Materiaconetal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum\evidence ee or baffle Distance from bottom of sc o t tee or baffle Date of last pumping: Date Comments(on pumping re ,inlet and tlet tee or baffle condition,structural integrity, liquid levels as related to oof nce of leak e,etc.): A114 8. Ti t or Holding Tank(tank must be pumped at time of inspection)(locate on:site plan): Depth be rade: Material of constructio ❑concrete El metal ❑fiberglass 0 polyethylene ❑other(explain): Dimensions: Capacity. gallons Design Flow: gallons per day Oftp.doc-rev.n262018 rna 5 OKdW lnspeO Form.Suhsurfa�Sewage Dispose)srerem-pop»of t8 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System form-Not for Voluntary Assessments Propprty Address �o Owner Owner's Name 10ftmation is required for every �`7✓ V!C C,E Me- Cityrro" State Tip Code Date of Inspection D. System information (cont.) d)�8. Tig or Holding Tank(cont.) / Alarm prese ❑ Yes [] No Alarm level Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm a float switches,etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No S. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert n 2 � y10�2 Comments(Tote if box is lev of anted disttib '�•on to outlets(Q equal any evidence of solids caryove , any ence of leakage into or out of box,etc.) MM100c•rev.T/2512018 Tice 5 O(frdal Inspection Form Subsurface Sewage Disposal System•Page 12 d 18 Commonwealth of Massachusetts Title 5 Official -inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ° ZP7 Property Address Oar Owner's NameIrdarm on is required aefor every PW_ City/Tom State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Ch ber(locate on site plan): Pumps in working rder ❑ Yes [] No- Alarms in working orde . [ Yes ❑ No* Comments (note condition of mp chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. 11. Soll Absorption System(SAS)(locate on site plan, excavation not required): .ArSAS .located,explain why: Type: leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ teaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: ftwpAm•rev.7126018 Me 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Pepe 13 of 18 Commonwealth of Massachusetts Title 5 Glfficial Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Z t� �0►'SD �T Property Address Z-a Owner Owner's Name Nation is t"`�t �t t_CrE — 6-7&5� 4-10?zv mquired for every - - pop, City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption stem (SAS (coat Comments(nole cUtion of soil, ' ns of hydraulic failure�elof ponding, a p soil, ndition of waaetation,etc. : ", — �Y Zwh (q-ZO 44 241!=k L1?� Ll o%.J CIVe l%v boa'.-� �M Iol,) wt AV-� w. (e-k- v V t.Ct L 44l1e -eVt in Ce 51, ear wrc�Jesr L_G��.L ��ti�� `L->:ZU ��t.,0.5T1�t�.Cc��Z��EF/- v7 (n�l✓�`�7 /D-d r 91A_12. Cess is (cesspool must be pumped as part of inspection)(locate on site plan): Number an nfiguration Depth—top of liqu 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 fa' e, level.of ponding,condition of vegetation, etc.): WmWdoc•rev.?rz6M18 Title 5 Officw Inspection Fow..Subsurface Sexmp Disposer System•pW 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address Owner Owner's Name kdwmetion is eequired for every Imo, Cityfrown State. Zip Code Date of inspection D. System tnformat oh (cont.) 13. P I locate on site plan): Materials of con uction: Dimensions Depth of solids Comments(note condition of soil,signs o raulic failure,level of ponding, condition of vegetation, Gh doc•rev.7/26/2018 Title 5 Of al Irrspedion Form Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Farm. Subsurface Sewage Disposal System form-Not for Voluntary Assessments Property Address Owner Owner's Name formation is required for every Me. City/Town State Zip Code bate 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 eaters the building.Check one of the boxes below: hand-sketch in the area below drawing attached separately <�2��. � 9 A= 2l� Z3o�sF F;-(1) (v � a _ � F3 Zrl' Z 40 5L ru t e -- \ C? IN Me- J hoc-rev.712WO18 Me Official Inspection Form Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form--Not for Voluntary Assessments - 2(� �o►J+� �r Property Address O�) Owner Owner's Name information is '�i` �E (� C,ZCoS`j d /Z irequired for every P"e, CItyfrown State Zip Code Date of insp ction D. System Information (cont) 15. Site Exam: Check Slope Surface water 04 Check cellar __P P-Y Shallow wells Td'^J�� Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on recor i 4 Z Z d v l CD If checked, date of design plan reviewed: -1Ae2 bate ' Observed site(abutting property/observation hole within 150 feet of SAS) El 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_0A'C_l-1 t I's ft-. Q tT- p. &I ` Y. Z' ol 6 r �W 17-$ /Yv�� All 5---za zo Before filing this inspection Report,please see Report Completeness Checklist on next page. Gkq4=-rev.7/2612018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 L Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 219 �o �S9- cam Property Address �6L)SA Owner Owner's Name teWredfo is tl7"t L� W�pt ��j' l2I rer�ir�for every . P"e, City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: Inspector Information:Complete all fields in this section. Certification: Signed 8 Dated and 1, 2, 3, or 4 checked XB inspection Summary: 1,2, 3,or 5 completed as appropriate 4(Failure Criteria)and 6(Checkiist)completed Lq D.System Information: For 8: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 t %Sn pAoc•rev.7126=8 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 48 of to Desmarais, Donald From: Anderson,.Robin Sent: Thursday,April 23, 2020 4:38 PM To: Desmarais, Donald .Subject: Re: 219 pond st. osterville. Yes thank you. Hope you are well and stay safe! Sent from my Verizon, Samsung.Galaxy smartphone ------ Original message ---------- From: "Desmarais, Donald" <Donald.Desmaraisgtown.barnstable.ma.us>` Date: 4/23/20 4:30 PM(GMT-05:00) To: "Anderson, Robin" <Robin.Anderson@town.barnstable.ma.us> Subject: 219 pond st. osterville. Hi Robin, Ring a bell? Two houses, 2 bedrooms in one and 1 in the other. Can they keep three bedrooms for the property if they tear down and rebuild one 3 bedroom? Donald Desmarais, IRS Health Inspector Town of Barnstable Public Health Office: 508-862-4740 Fax: 508-790-6304 donald.desmarais(cDtown.barnstable.ma.us 1 t TOWN OF BARNSTABLE a LOCATION t� '/9 ®��` S 7 SEWAGE # _ VILLAGE n S 1 ASSESSOR'S MAP & LOT - INSTALLER'S NAME & PHONE NO. j, to III(A C 0,11 i?6R, 4 5 XA/ SEPTIC TANK CAPACITY 1, 660 LEACHING FACILITVICPRIVATE �'� (size) 10 D d NO. OF BEDROOMS WELL OR PUBLIC WATER BUILDER OR OWNER �f cxttavC. DATE PERMIT ISSUED: / ti/D 42 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �. P r � i TOWN OF BARNSTABLE LOCATION &lq PQV�b 5T K- SEWAGE # } S ASSESSOR'S MAP & LOT I 1 Ct`-00'Lq INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FFA,CILITY:(type) (size) 3 10 O 1" NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER SAME C , AA-0P-Pt DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes 't 6 �� a � 11� 1�� m ASSESSORS MAP NO: No....r, .�. � PARCEL NO: L� 9 Fx$.....�...3o 00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE y C. ! U Appfiration for Dw n1 Works Toltil '" _ t Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage, Disposal System at: .219...P-anrl...S tr e-et.... S t V.K v 11 e: ............. Phllllp Moran Location-Address or Lot No. ........................ .................. .............................................••... ............................. - ........ ..... Owner Address fix.,................................................... Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms........... ...............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers � YP g ---------------------------- P ( ) — Cafeteria-.......... Otherfixtures -----------------------------•--•--•------------•-----...................------------------------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter--.-_-_--__--_- Depth................ x Disposal Trench—No. .................... 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.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit---:................ Depth to ground water........................ 9 •------------------------------------------------------------------------------------------------------•--------•-...........-----...--.-----•--------------- 0 Description of Soil............................................................................... --•-----------------••-----------•-•-•...................................... x Sand & Gravel V -•------------------------------ ....--••-------••--•-----•---•----•......--•-•------•-•-•---•-----•---•-•---•---••---•---------•----••--------------•••---•-----•-----------......------•---•---- W --•-------•------------------------------------------------•---------•-••. ---------------------------- ----------------------------------------------...-•-----------------•----....----------------- U Nature of Repairs or Alterations—Answer when applicable----------------------- - . . . - A•allon leach------1-t------------------------------------------------- 1-i JG G �.ls�n dank= d-box 1----•..... .................................. =.. 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 Complian i e has be n ' sued y the bo of health. Signed 6/10/92 ----- . .. ....---- = -------------- .................................. Date ., Application Approved By .:�....... ..... ........... .....-----...�----.................. .................................. -----------�/�.-�� Date Application Disapproved for the following reasons: ................................................... ----................................................ --- --- ------------ --------. ..Date..... ..................... .. ......��.............--.. .... ---- --------------- Permit No. �.......... ...'i...... .:r�.........------ Issued ............... Gl.. ..Lam` Z Date f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal `Works Tonuirnrt o irmit Application is hereby made for a Permit to Construct ( ) or Repair (c ) an Zividual Sewage Disposal System at: 219 Pond Street Ostierville. ............ . ................•---------------.....-•------------•-•--•...........------ ..............................-................................................................... Phillip Moran Location-Address or Lot No. ......................--.......................................................................... --•-•----••-•-------•-----••-•••----.........-••-•-•...........................---........----••-- W J.P.Ma e omb e r Jr. Owner Address Installer Address UType of Building 2 r Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (_)-' Garbage Grinder ( ) a`4 Other—, Type of Building No. of persons............................ Showers � YP g -------------------•---•---- P ( ) — Cafeteria.(-•---). d Other fixtures .........................................------------••----•-----••-•-...---•--•------------•---•--••-•----------- - `W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... 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 ( ) aPercolation Test Results Performed bY------------- ............................................................ Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fX4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ , P4 -----------------------------------•----...-----•----------......-•----.....----•---•--•----•--•----.........................................................O Description of So' -•••---• --------------•-------_-----------------•-------------------------------------------------------------------------------------------- x and--�c Grave Z U -----•---••---•----•-••-----•••-----••--------------•••---••--:.........---•---•-•-...........-----•-••-----•--•-------------•---•----•-•••---•-••-••--•----•----•••------.......-•-•-----••----•••--•-- W UNature of Repairs or Alterations—Answer whe �licable...._ Gallon tank. d-box - 2000 gallon Ieacfl-pi --- ----------------•-------------•----------------------..........••-•-- 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 Complian�e has ben is'sued .y the board of health. 1 /92 Signed /7�. .. l..- ..--. .. Dace Application Approved By -- --------- -...--... ' .................. i ---------------------------------------- A c �✓ram�- /2 Dace pplication Disapproved for the following reasons: ....................... .--------------- /,, ---------- -------- ----------------- ------- Permit No. ...................�.� '°tom.-T°° , Issued .......-------. to .� Dace i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE % Qxr#ifiratro of Contplinure JTHIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ) . J.P.Macomber Jr'. by........... .. ................ - --------------------------------------------------------------------------------------------------------------------------------- 219 Pond S�hreet -0s tery - -e................:nsm,Ier at -------------------------- - - ------------------ ......----------------------------------------------------------------------- ........----------------- ....... ---.........---........................----------------- has been installed in accordance with the provisions of TITLE 5 0£ he $.t t E vironmental Cod -gas described'in- the application for Disposal Works Construction Permit No. ............... .7 9...................:....._ dated ------�.:.�.-�_L'.f..-`-- ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. � --...II..."......a------------------------------- Inspector ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No. ! ..`.`...' FEE...30.00 Disposal Works Tunu#riuliun rrmii J.P.Macomber Jr. Permissionis hereby granted..............................................I--•••---••--------••--••.......-••••---•--•••-•--••----......-••---•-:................-•-•-•... to Con2tju t 1(or)dorSRjp ( Q �, ivjjdjLkal Sewage Disposal System atNo............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction Permit No._ � 4A ed.._.._.__ DATE..---- ". �oa�rdiof�-Health - --------------------------- FORM 36508 HOBBS&WARREN,INC.,PUBLISHERS O W TOWN OF BARNSTABLE LOCATION `� /j '�Ji/ 5.'� SEWAGE # VILLAGES $ ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE NO. �' 4 A C 0,411 ig R:� > XAI SEPTIC TANK CAPACITY 60 LEACHING FACILITY:(t ) ' r (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER 'i `` BUILDER OR OWNER i DATE PERMIT ISSUED: j - DATE COMPLIANCE ISSUED: r`� �— f VARIANCE GRANTED: Yes No 0 v Y dd TOWN OF BARNSTABLE LOCATION OLI Ci POW 5 F R�— SEWAGE # VILLAGE (1,1 EP-V1I-L� ASSESSOR'S'- MAP G LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 4 LEACHING FACIL.ITY:(type.) C E- (size) 3 E 0 b NO. OF. BEDROOMS PRIVATE WELL OR PUBLIC. WATER BUILDER OR OWNER C AA D `'NM DATE PERMIT ISSUED: P I DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes FUR SKEW r -------------------- v • � � S / 3 C 6�� I L TOWN OF BARNSTABLE LOCATION / /0n 41/I0 s�/�y�/�� SEWAGE# 'a�✓ �2 7 VILLAGE ASSESSORZ Y' `'J// 'S MAP&PARCEL Zly-O INSTALLER'S NAME&PHONE NO. ag SEPTIC TANK CAPACITY Mad LEACHING FACILITY: (type) r/%��i/C!�/�s (size) �� x 2 Z�I� NO.OF BEDROOMS / OWNER /= PERMIT DATE: 41 /�/ ,'Z 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 FURNISHEDBY —C s•^t N r--. s o � l_•1� ,V1 W DATE:_5/30/02--_- PROPERTY ADDRESS:219-Pond_Street -_-_ Osterville ,Mass. �� 02655 On the above date, I Inspected the septic system at the abo rOFIVE® This system consists of the following:.. 1 . 1-1000 gallon septic tank. JUN 0 4 2002 2 . 1-Distribution box. 3. 1-1000 gallon precast leaching pit . ( 6'X10' ) TOWN OFBARNSTABLE HEALTH DEPT. Based on my inspection, I certify the following conditions: 4 This-is a _title- five_ septic systm ( 78 Code � e ,-,5 The septic.- ystem is in proper working order ` � mom. ,x MAP .. ,w �^ qat the , present 'time � r 6 Waste water is 30" below the invert pipe.of the PARCEL : ® Z' leaching pit . 7. System installed 6/92 LOT SIGNATURE::; _ � 1�/ Name:-1 ------- .Company: J_os_eph_P_ Macomber_& Son , Inc , Address: Box 66 Centerville , Ma . 02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY FJOSEPH MACOMBER & SON INC. P, ,anks•Cesspools•Leachflelds Pumped & Installed Town Sewer Connectlons 66 Centerville, MA 02632.0066 775.3338 775.6412 1 e COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 219 Pond Street Osterville,Mass. Owner's Name:Phil Moran Owner's Address: Same Date of Inspection: 30 02 Name of Inspector: (please print) Joseph P.Macomber Jr. Company Name: J.P.Macomber & Son Inc. Mailing Address: Box 66 Centerville.Mass .02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that I.have personally inspected the sewage disposal system at this address and that the information reported below is true.accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: �� Passes Condirionally Passes _ Needs Further Evaluation by the Local Approving Authority _ Fail aim OEV or Inspector's Signature: ' Date: - dg, P 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 ..... This report only describes condtttons at the time of inspection and under the conditions of use at that time:Thts:inspection does not address how;the system will pei form'tn the;futtire under the same or. diffe,ren conditions of use. ,-x - T .- Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I I OFFICIAL INSPECTION FORM= NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 219 Pond Street stervi e , ass . Owner: Phil Moran Date of lospectioo:5 30 02 Inspection Summary: Cbeck A,B,C,D or E/ALWAYS complete.all of Section D A. stem Passes: : .L� have not found any information hick indicates that any of the failure criteria described in 310 CMR 15.303 or in exts . try failure criteria not evaluated are indicated below. Comments: The . se: tics stemis .improper working order ' . B. System Conditionally Passes: Wd 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. Answer),es, no or not determined(Y,N,ND)in the for the following statements. lf"not determined" please explain. VO 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 septio lank 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. N'D explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box:System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced _ obstruction is removed — distribution box is leveled or replaced ND explain: IV 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 I f OFFICIAL INSPECTION FORM - NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 219 Pond Street Osterville ,Mass. Owner: Phil Moran Date of lospectiou: 5/30/0 2 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: �1,2I Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: Ab The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. �� The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. " The system has a septic tank and SAS and the SAS is less than 100 eet b 50 feet or more front a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFI CATION.(continued) Property Address: 219 Pond Street Osterville.Mass. Owoer.Phil Moran Date of lospection: 5f 10/(l? D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no" to each of the following for all inspections: Yes No �✓ cicup 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 �ogged SAS or cesspool tatic liquid level tot a dismbution box above outlet inven due to an overloaded or clogged SAS or Of c esa�ee esspool _ �iquid depth tn'i l is less than 6 .below inven or available volume is less than ''A day now 1/ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number /of times pumped Q. 9ny 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. y onion of a cesspool or privy is within a Zone I of a public well. portion of a cesspool or privy is within 50 feet of a private water supply well. An,v 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 qualiry analysis. jTbis 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 oitrogen�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 forma Vol (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 Boarc e' Health to determine what will be necessary to correct the failure. ' E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either'yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) des no�� 4/the system is within 400 feet of a surface drinking water supply r' th 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— IWP.A)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" to Section D above the large system has(ailed.The owner or operator of any large system considered a s:e�tf,cani threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 5 304 The system owner should contact the appropriate regional office of the Department. 4 it Page 5 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 219 Pond Street Osterville ,Mass. Owner: Phil Moran Date of Inspection: 5/3 0/0 2 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health —/Were any of the system components pumped out in the previous two weeks ✓ _ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? / l ✓ Were all system components;` ludingthe 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: Yes o 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(3)(b)) 5 Page 6 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 219 Pond Street Osterville .Mass . Owner: Phil Moran Date of Inspection:5/3 O/0 2 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):.1— Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x N of bedrooms): &_e.& Number of current residents: 4 Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system e or no):40 cif yes separate inspection required) Laundry system inspected(yes Seasonal use: (yes or no): Water meter readings, if available(last 2 years usage(gpd)):2000-78, 000 gallons=213. 70 GPD Sump pump(yes or no): ZVU1-94, UUU gal lons=257. 54—GPD Last date of occupancy:l�� "�` COMMERCIAUINDUSTRIAL Type of establishment: yi17 Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): la 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: None Available Was system pumped as pan of the inspection(yes or no): If yes, volume pumped: O gallons--How was quantity pumped determined?,,0;&ej r&p� Reason for pumping: T 7SOF SYSTEM Septic tank,distribution box,soil absorption system ,k Single cesspool &Overflow cesspool 4,Q Privy Shared system(yes or no)(if yes,attach previous inspection records, if any) 4V Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be ottained from system owner) 0 Tight tank ;t4O Attach a copy of the DEP approval 4L Other(describe): Approximate age of all c m onents,d to 'nstalled(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 02�* 6 i; Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:219 Pond Street Osterville .Mass. Owner: Phil Moran Date of Inspection: 5/3 0/0 2 BUILDING SEWER(locate on site plan) Depth below grade: / ' Materials of construction: cast iron AX40 PVC A other(explain): Distance fro rivate water supply well or suction line:.O' 4 Comments(on condition of joints, venting,evidence of leakage,etc.): _rni ntc ap=Par ti ght No evidence of I eakage The system i s vented through the house vents. SEPTIC TANK: (locate on site plan) 1"g-v.Zo; Depth below grade: Material of construction: concreteXkmetaW fiberglass bpolyethylene X�Iother(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no), rg attach a copy of certificate) Dimensions: ��6aAJolOiif)jD� �'�s Sludge depth: 0 Distance from top of sludge to bottom of outlet tee or baffle:_ Scum thickness:_ 9/ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet to or baffle: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet tnven,evidence of leakage,etc.) Pump the septic tank every- 2 3- .years:=The etank needs to be pumAed.Inlet & outlet tees are in place The tank"' "s "s:eruct'urally sound and shows no evidence of leakage. GREASE TRAP locate on site plan) Depth below grade:412) Material of construction-AN concreteX#metal 4ehlfiberglass4kpolyethyleneAAofother (explain): AO Dimensions: Alk Scum thickness: Distance from top of scum to top of outlet tee or baffle:AI Distance from bottom of scum to bottom of outlet tee or baffle: — Date of last pumping: Ali# Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Grease trap is not present . 7 Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 219 Pond Street stervi e, ass. Owner: Phil Moran Date of Inspection: 5/3 0/0 2 TIGHT or HOLDING TANKt&N (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:d9 concrete Ah? metal fiberglass polyethylene�other(explain): Dimensions: .Uif Capacity: N14 gallons Design Flow: IV4 gallons/day Alarm present(yes or no): Alarm level: A), Alafm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): Tight or holding tanks are not present . DISTRIBUTION BOX: Z/of present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): Distribution box No evidence of solids carry over. o evi a ce o leakage into or out o t e. . ox PUMP CHAMBER&ke (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): 4?eo Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Pump chamber ; s not present - 8 L 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: 219 Pond Street 0sterv111e ,Mass . Owner: Phil Moran Date of Inspection; 5/30/02 SOIL ABSORPTION SYSTEM (SAS : (locate on site pl�n,RcavajiQn not required) 1-1000 gallon precast leaching pit. 6 X10 1) If SAS not located explain why: Located ; See page 1,0 T y leaching pits, number: leaching chambers,number: leaching galleries, number:Q AM leaching trenches,number, length: leaching fields, number,dimensions: _overflow cesspool, number: 6 4& 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.). Logmy sand to medium fine sand No signs of hydraulic raiiure or pon ing.Soi s are dry. Vegetatlon. is nbrinat . CESSPOOLX,l &(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: O Depth—top of liquid to inlet invert: AV _ Depth of solids layer: Depth of scum laver: Dimensions of cesspool: /Q 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.): Cesspools are not present. PRIVY(locate on site plan) Materials of construction: Dimensions: rS�. Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): _Privy is not Present. 9 Page 10 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSA-L, SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (cominvcd) Propirry .,ddress:219 Pond Street Qs t e r v iTre, ass. Oworr:Phil Moran Dm of lnipcclioo: 5/30/02 SKETCH OF SEWACE DISPOSAL SYSTEM Provide s sketch of the "wile dilpolel sysscm includ(ng Iles 10 Of Icasl rwo perrnancni rcrcrcncc landmarks of oencnmukt. Lome ill w`clll within 100 rcct. Locale whcrc pvblic wiler supply enlcrs the bvilding. to Page I I of 1 I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 219 Pond Street Osterville.Mass. Owner: Phil Moran Date of Inspection: 5/30/02 SITE EXAM Slope Surface water` Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: btained from system design plans on record-If checked,date of design plan reviewed:_zJA served site(abutting grope bservation hole within 150 feet of SAS) A16 Checked with local Board of Health-explain: 4.44 ecked with local excavators, installers-(attach documentation) _AccessedI-SGSdatabase-explain:HTTP; 11 Town.Barnstable.MA.US You must describe how you established the high ground water elevation: Used ; Gahrety & Miller Model . 12/16/94 Water elevations above spa level Used ; USGS Observation wa11 data _.TnnP 1992 Used ; USGS Terhniral hn11Prin 92—fnQ2 Plata #2 Annual ranges of water level c Tan3aa�y vroun 1 9%9 of Leaching Pit :eel Groundwater!, Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore,the vertical separation distance between the bottom Of the leaching pit and the adjusted groundwater table is �'� feet. 11 ' • -1•T.1r+.—nrr+�.+r• rnr+rr.•niT'Trs'l*ras+r.rrr.:-nI•+Trtrr*n-RTT.+!m•'s`La par.Iirrn1 v 1 TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION •••T•'-•.:!—T.IIT.�.�T.T.}'.'nl-R.1S1T11r11TfPf1�}RT.T!'1.••tl)nt`f iRRpI�TRITINR If111-RIRTT}R}RgrAr..�•T•T•1•�. -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 219 Pond Street Osterville .Mass- ASSESSORS MAP, BLOCK AND PARCEL i 119-029 OWNER' s NAME Phil Moran' PART D - CERTIFICATION NAME OF INSPECTOR _Joseph P-MacomhPr .Tr_ . COMPANY NAME J•P•Macomber & Son Intl COMPANY ADDRESS Box 66 Centerville Mass 02632 Street Town or Crty State LIP COMPANY TELEPHONE ( 508 ) 775 - `3338 FAX ( 508 790 - 1578 R CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate, and omplete as of the time of .inspectionl The inspection was performed and any recommendations regarding upgrade , maintenance , and' repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* \ The inspection which I have c 'L cted has found that the system fails to Protect the jiublic health and the environment in accordance with Title 5 , 3.10 CMR 15 - 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date ns copy of this certification must be provided to the OWNER, the BUYER ( where applicable) and the BOARD OF HEALTH, * If the inspection FAILED, the owner or " perator shall u pgrade ' the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 16 . 305 , partd.doc • v JOSEPH P. MACOMBER & SON, INC. P.O.BOX 66 CENTERVILLE.MA 02632-0066 775.3338 775-6112 FAX COVER SHEET DATE:y5/30/02 T0; George Whittly -508-961-2444 FAX PHONE r For: Phil Moran ------------------------- f;ROM:j.P.Macomber & Son Inc. FAX PHONEY 508-790-1578 Skip. Macomber TOTAL r OF PAGES INCLUDING COVER: 15__ IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL 508.775.3338 RE: o Phil Moran 219 Pond Street Osterville,Mass. SPECIAL INSTRUCTIONS OR MESSAGE:C'opy title five inspection. TOWN OF BARNSTABLE • LOCATION � vs SEWAGE •r `. VILLAGE n ge� ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACELITY: (type) 'Gt (size). 9 NO.OF BEDROOMS BUILDER OR OWNER � PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Fet Private Water Supply Well Leaching Facility (If any wells exist on site or within 206 feet of leaching facility) Feg Edge of Wetland and Leacking Facility(If any wetlands exist within 300 feet lefiin lity) Fe( Furnished b i � '�'� a° k. s LOCUS DATA 28 x a I PROPOSED 1,000 GALLON \ p BENCHMARK BUMPS RIVER TOP OF O CURRENT OWNER THE SARASOTA SEPTIC TANK \ \ Roo N ROAD REALTY TRUST \ \ \ osFO SLAB. ELEVN 43.30 \ \ \ \ \ gTFR cu PLAN REFERENCE ABUT. PL. 639-11 \ \ \ ED sFR�/c co 6, Locus DEED REFERENCE 32981-6 O !z F 2 \ \ #219 A> <- RF�� 4 EXISTING O ZONING DISTRICT RC ^ 1 I 1 1 BEDROOM s 593� y RO o�/ DWELL. ,3),*' \ u- LOCUS MAP �. ^�' \ I NOT TO SCALE: — — \ ( DECK. G' FLOOD ZONE X 7 16 14 ,ti/ � k� n ASSESSORS MAP 119 a % \ \ \ ( Oyp 20-0142 PARCEL 029 h°/ \ �\ (o 5, 10.0 i\ IV \ n OVERLAY DISTRICT ZONE II/WP/SEP \ \ \� \D.T. #2 o LOT AREA 21.230f S.F. �' 1 I / \ N Cb W SY E 11 / 0//P) G o �o / I � I D. .H. 1 SITE 8c SEWAGE I � EXISTING S I I \ II � / y I i P w YWELL � w - DR TO / I I SYST I REPAIR PLAN / i I I II w N I I II°qST ABANBE DONED 219 & 219A �, 3812'^ 43_ � i \ Oyp� F / I a POND STREET / I i i I I / / \� GU N // 11 I I II f ENCLOSED OyP /j I N / PORCH J \/ ELE HYD /\ OS.TERVI LLE, MASS , i / D.S. TIE METER AUNINTO E � E DATE. DECEMBER 14, 2020 SYSTEM I #219 UNDERGROUND LE.\ ERVICE / REV: APRIL 8, 2021 1 II EXISTING EXISTING 2DBELLING PARCEL 29 OWNER/APPLICANT: 1 I J I \ GARAGE 21,230± S.F. MARIE M. SOUZA PROPOSED S.A.S. I S THE SARASOTA R. T. `� (2) 15- LONG x2 x2 Ap \ � \ \ � G' �✓ P.O. B 0 X 394 LEACHING TRENCHES \ \ _ \\ \ \ A3\ j��' / Q / BARNSTABLE, MA 02630 � 6 , �� \\ \\ � � / // A� -1 1' SHEET 1 OF 2 SHOE,�.y�� PUMP, CRUSH AND os,09, \ \ ABANDON EXISTING CESS 76) PREPARED BY: �� EDWARD POOL IN ACCORDANCE o q WITH TITLE 5. \ EXISTING STONE N \ GRAVEL E A S SURVEY, INC. No.28980 PARKING O,Q71" \\ Q P. O. BOX 1729 SANDWICH , MA 02563 Lm 0 20 ; 30 40 CELL (508) 527-3600 Z GRAPHIC SCALE: EAS.SURVEY@YAHOO.COM �" 1 INCH = 20 FEET SYSTEM DESIGN PROPOSED 4 BAND STAINLESS STEEL RAISE COVERS TO WITHIN 6" OF FINISH GRADE CONNECTOR FIRST 2' LEVEL OBSERVATION PORT EXISTING DESIGN FLOW TCF = 40.84 FINISH GRADE / SCREW CAP BEDROOMS AT 110 GPB/D 1]0 GPD GRADE 40.3 ELEV. 40.2 FINISH GRADE 37.5 ELEV. 38.1 FINISH GRADE � ELEV. 36.5 REQUIRED SEPTIC TANK EX 4" C.I. TOP - ��///`� �� _ 110 x 2 = 220 / C.O. TOP ELEV 35.3 15, SEPTIC TANK PROVIDED = _1_iQ00A GAL. s• PROPOSED 4" PVC 18®5=0.16 BOUT EL=35.0 4" PVC SCH 40 V as= 0.01 °000000000000 S=0.005 000oo00000 00 SCH 40 INV.= 2 MIN-3 MAX PEA STONE AND/ SIZE OF LEACHING FACILITY REQUIRED CRAWL ,- INV.= 39.3 38.20 10"TEE 14"TEE INV.= 000000000000000000000 O OR FILTER FABRIC INSTALL 38.00 6" �00000000000000000000 O N 3/4" - 1 1/2" DESIGN PERC RATE __ <2 -MIN./INCH 5-7" GAS BAFFLE 3 OUTLET DOUBLE WASHED LONG TERM APPL. RATE 0.74_GPD/S.F. 4'-61/" TWO 15' LONG TRENCHES 2 4'-1" LIQUID LEVEL H-20 DB3 > STONE DATUM: INV.=35.09 INV.=34.88 a 34.80 SIZE OF LEACHING SYSTEM PROVIDED: INV. 34.92 S.A.S. 2(15'x2'x2') w L 32.80 110 _ 0.74 SF/GPD = 149 S.F. MIN. REQ. VERTICAL DATUM: L BOT. o 0 MSL± / BARNSTABLE S 33.67 "TEE" REQ' 6 ui BENCH MARK USED: PROPOSED H-10 1,000 ELEV. 97.8 USING (2) 2' WIDE x 2' DEEP' x 15' LONG HYDRANT TAG BOLT GALLON SEPTIC TANK OF 2x (2'+2'+2'x15') = 180 S.F ELEVATION 46.39 y � q 20-0142 �- .x G SF = 133 GPD .� DAVID �; � 180 S F 0.74 / CONSTRUCTION NOTES: F. �, ..'..'•.'•.'•. �• �[ 133 GPD PROV > 110 GPD REQ. = 23 GPD RES. SITE 8c SEWAGE FL H .� 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND o• 1 " \ ��' dr �.o NO (GARBAGE DISPOSAL / GRINDER ALLOWED) ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 24 24 REPAIR PLAN WORK ON THE SITE. sT �� 3t � �� 3 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE SgNIrAR�� , 219 & 219A1 IS TO OBTAIN SUCH NG D2.80 NTH DEEDED ORETERMINATION NATION FROM REGULATIONS. wAPPROPRIATENERCANT AUTHORITY. 2 4 - 1 2 TP-20-235 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING T POND STPEET MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND 4 $ 2' CROSS-SECTION D.T.H. #1 D.T.H. #2 S.A.S. AREA IS PROHIBITED DATE: 11-5-2020 DATE: 11-5-2020 IN GROUND ELEV. 38.8 GROUND ELEV. 41.7 GENERAL NOTES: I CERTIFY THAT I AM CURRENTLY APPROVED BY THE. NO GROUNDWATER NO GROUNDWATER 0 S TE R VI LLE, MASS 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL FILL 18" SYSTEM II 2. ATR SUBSURFACE DISPOSAL OF SEWERAGE.LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE EVALUATION ARE ACCURATE AND IN ACCORDANCE WITH 310 A A ' ACCESSIBLE WITHIN OF FINISH GRADE WITH ANY REMAINING CMR 1 . R 15.107. LOAMY SAND LOAMY SAND 1OYR 5/2 10YR 4/3 DATE: DECEMBER 14, 2020 ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. _ ��-�/'2� _ 24" 6" 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE EDWARD A. STONE, CERTIFIED SOIL EVALUATOR g g REV: APRIL 8, 2021 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS LOAMY SAND LOAMY SAND OTHERWISE SPECIFIED. 7.5YR 5/6 7.5YR 5/6 OWNER/APPLICANT: 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION I 1 "40 18" OF ALL UTILITIES PRIOR TO ANY EXCAVATION. DTH #1 10 INDICATES DEEP EL. = 35.5 EL. = 40.2 M A R I E M. SO U Z A 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE TEST HOLE OR 6" OFTHE S A R A S 0 TA R.T. 6. FINISH GIRADE SHALADE HAVEHALMINIMUM OF 0.02BE MORTARED1 FEET PER, FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. INDICATES 42" P.O. B 0 X 394 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF P-1 42" PERC TEST SCHEDULE 40 PVC AND EXTEND ABARNSTABLE, MA 02630 THE FLOW LINE AND SHALLALL BE ON THE CENITERLINEOAND, ABOVE NO MOTTLING MEDIUM SAND MEDIUM SAND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. NO WEEPING 2.5Y 7/6 2.5Y 7/6 SHEET 2 OF 2 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT 132" INDICATES ADJ. GROUNDWATER ELEVATION OF THE OUTLET PIPE. NO G.WATER " NO G.WATER PREPARED BY: 9. THE SEP11C TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES NO OBS. GROUNDWATER EL. = 27.8 132 EL. = 30.7 132" 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS E A S SURVEY, INC. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC NO OBSERVED GROUNDWATER B.O.H. TIM O'CONNELL 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND SOIL EVALUATOR P. O. B 0 X 1729 SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE DEPTH TO BOTTOM OF HOLE 11.0 ED. STONE FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL VARIANCES REQUESTED BACKHOE OPERATOR. SANDWICH , MA 02563 BE LEVEL JOEY DeBARROS 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATIONTO EAS TO ALLOW A 1,000 GALLON SEPTIC TANK TO SOIL TYPE: CELL (508) 527-3600 AND APPROVAL. INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW SERVICE THE 1 BEDROOM IN LIEU OF A 1,500 GALLON PERC RATE: <2 MIN. PER INCH EAS.SURVEY®YAHOO.COM 13. MAGNETIC TAPE ON ALL COMPONENTS. LOADING RATE: 0.74 GAL/SF/MIN