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0087 SEAPUIT ROAD - Health
n 87 Seapuit Road Osterville A= 117119017 Commonwealth of Massachusetts UM Title 5 Official Inspectioh Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , ^ 87 Seapuit Rd u Property Address p� Li Na Owner Owner's Name information is l ,« required for every O MA 02655 9-7-20.SterVllle V . � ._ page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may riot be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information Shawn Mcelroy Name of Inspector' y - _: j a„v• ,, Upper Cape Septic Services Company Name P.O. Box 73 Company Address East Falmouth MA ,02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);l have personally inspected the sewage disposa(system-at theproperty 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 l have determined that the system: 1. ® Passes` - ;1,�..,, ,, et ,2. ❑ Conditionally Passes -3. ❑ Needs Further.Evaluation by the Local Approving�Authority, r - r 4. ❑ Fails 9-7-20 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the'approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 usetts Commonwealth of Massach r n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M. 87 Seapuit Rd u— Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary . Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1)� .System Passes:' ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. f 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y El ❑ ND (Explain below): r t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •� 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville '. i MA 02655 9-7-20 page. City[Town - State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally,Passes,(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. w `• ' !' ' 1y•... ,:} } "e �. a .'' r e . ." v '<. '. X. . _.i•,,. - ❑ 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)`afe replaced r,_ }' t. ❑ Y ' ❑N ❑ ND (Explain below): ❑l obstruction is removed ' '' ' ❑ 'Y ❑N ❑ ND-(Explain below): r ❑' distribution box is leveled or replaced ❑Y •'❑ N ❑ ND (Explain below): 1 .i tk• •{. / ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: , ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public'health', safety or•the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -u, 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ' ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety'and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within r5O feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: ` 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection .-Form Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville- MA 02655 9-7-20 page. City/Town . State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to AII.Systems: (cont.) f Yes . r ❑ ' ®' Static liquid level in the distribution box above outlet invert due to an overloaded ' or clogged SAS or cesspool ' ' ' Liquid depth in cesspool is less than 6" below invert or available volume is less ' ® "than '/z day flow i - w � ' , ❑ ® Required pumping more than 4 times in.the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or,privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to'a surface water•supply. r - ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. _, ' 1 ❑- 4 ® ' ` Any'portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® '' Any'portion`of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system_is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd' ; ❑ ® The system fails. I have ermined that one or more of the above failure `criteria exist as described in 3MCMR 15.303, therefore the system fails. The „ system owner should contact the Board of Health to determine what will be ,.,necessary to.correct the failure., 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes".or."no"to each of the following, in addition to the questions in Section CA; • ;. , Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of.18 Commonwealth of Massachusetts 1 Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 em 87 Sea uit Rd u, p Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15..304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for aN inspections: Yes No , ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at.the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection form , Subsurface Sewage Disposal System_Form -Not for Voluntary Assessments u � 87 Seapuit Rd t , Property Address -- Li Na Owner Owner's Name information is required for every Ostefville MA 02655 9-7-20 a page. City/Town , , State Zip Code Date of Inspection D. System Information 1 da :J'•1'1 4 n - 1. Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#,of bedrooms) 550 Description: Number of current residents: 2 Does residence have a garbage grinder?, ❑ Yes ® No Does residence have a water treatment unit? - ❑ Yes ® No If yes, discharges to: , Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) .`' Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail' Sump pump? .:+ �' t ❑ Yes ® No Last date of occupancy: ,,. tj, , , ;, < 7-2020 Date t5insp.doc•rev.7/26/2018 _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts t Title 5 Official Inspection Form JQ, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Seapuit Rd ' Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont) 2. Commercial/Industrial Flow Conditions: Type of Establishment: ' Design flow(based on 310 CMR 15.203): Gailons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form = 4f Subsurface Sewage Disposal System Form -Not•for„Voluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.} 4. Type of System: ® Septic tank, distribution box, soil absorption System - ❑ Single cesspool rr , ❑. , Overflow cesspool f , ❑ 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): • 7 P Approximate age of all components, date installed (if known) and source of information: 2012 Were sewage odors detected when arriving at the site? ,. i . . , <❑ Yes ® No 5. Building Sewer(locate on site plan): 4, ; 4 r�n ;, , „•; , 24" Depth below grade: ' feet Material of construction: fa. t 4 "2r'•' 1D cast iron Z 40 PVC " " other(explain)-' t Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 c Commonwealth of Massachusetts a J Title 5 Official Inspection 'Form + Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Seapuit Rd u� Property Address Li Na Owner Owner's Name information is required for every Osteryille MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' 6. Septic Tank (locate on site plan): 18" Depth below grade:. feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" 211 Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" . How were dimensions determined? Tape . Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign,of leakage. There is a zabel filter in the outlet baffle with the handle broken off,that should be maintained every 1-2yrs. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection - Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 87 Seapuit Rd A Property Address Li Na Owner Owner's Name _ information is required for every Osterville z ,..,, MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (conf) 7. Grease Trap (locate on site plan): Depth below grade: ` : feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene" - ❑ other(explain): Dimensions: Scum thickness _ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping:,, Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,,etc.)':r a, i .a. 4 5 s 't i •t < T 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: _ Material of construction: . ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts p Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sea uit Rd u=- P Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order:' ` ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on.site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. 15insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts a Title 5 Official Inspection Form' Subsurface Sewage Disposal System Form -Not fortVoluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osteryille - MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes- ❑ No" Alarms in working order: 3' '❑ ''Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan,,excavation,not required): If SAS not located, explain why: Type: 3. ►+ ,`,d . .❑ leaching pitsr :r number: . r - • J . ® leaching chambers number: 5-Flodiffusers ❑ leaching galleries number: ❑ , leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System'Form -Not for Voluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville MA. 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Flodiffuser field in good working order with no sign of back-up into d-box or surrounding stone. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration t Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.=Not for'Voluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville - MA 02655 9-7-20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): �" t Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ondin condition of vegetation, 9 Y P 9. 9 , etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: p Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 'r A tr t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora I Subsurface Sewage Disposal System Form--Not for Voluntary Assessments F, 87 Seapuit Rd u� Property Address 3 Li Na t. Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.)- 15. Site Exam: .., . ;t•,. i .,, ❑ Check Slope ❑ Surface water - . .. . ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: .. !.- , 124 feet Please indicate all methods used to determine the high groundwater elevation:' ® Obtained from system design plans on record If,checked, date of design plan•reviewed: .Date ® Observed site (abutting property/observation hole,within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form :Not for Voluntary Assessments 87 Seapuit Rd Property Address Li Na Owner Owner's Name information is required for every Osterville MA 02655 9-7-20 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed r ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn onp9 ' . 16 or attached p Y For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOE 4RAOXSTABL I �3Ct3'TfGl�t; �• .:� ��, SEY+�ACE� ..6 1APSxA.�.Eg"S NtAltrfE 3'4. $aNE YO LEA►CF�G F�C 'Y' ftyp��_,�_�._� •€; .�EJItjD$R Off,�D�R • S P lion D PAcc B een Ette' t Mwm,Ac�t�ste�C,�w��water"�t►Ie�o=t��Bot�omof�SachwgFacil�ty ;' .--.;�---�; hi p8 y af �, � mot: sQ0':£ee ofit'eae6g � ee c y 1?3 S 4 3c/' Ty- �a6`- C-y- (/l•y� �,I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessmen CO PS 87 Seapuit Road r� Property Address t Na Li _ A Owner — — -- -- Owner's Name./ Y information is Osterville Y MA 02655 October 26, 2018 required for every _ _ page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. filling out forms A. Inspector Information / - fat( filling out forms on the computer, use only the tab Patrick T. Sullivan _ key to move your Name of Inspector cursor-do not Read Rooter ooter Excvating use the return -- - key. Company Name PO Box 89 r� Company Address --- -- -- Forestdale _ MA 02644_ City[Town State Zip Code 508-509-0802 _ S112843 _ Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails October 29, 2018 Inspector's Signature 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 a conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts 4- , ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .!� 87 Seapuit Road Property Address Na Li _ Owner Owner's Name --------------..---------------- information is required for every Osterville MA 02655 October 26, 2018 ---- — page. CityrTown 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: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments` 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. t Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. i' The septic tank is metal and over 20'years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): j - — t5insp.doc•rev,726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Seapuit Road Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 — page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or breakt or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is level d or replaced ❑ Y ❑ N ❑ ND (Explain below): / ❑ The system required pumping more than 4 times'a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ! ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required�by the Board of Health: ❑ Conditions exist which requ-fre further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.71.2612018 Title 5 Official 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 .�! 87 Seapuit Road Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 _ page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS�and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and S S and the SAS is less than 100 feet but 50 feet or more from a private water supply well* . Method used to determine distance: ** This system passes if the well wat fi analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent a7rtd the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7t2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts ,V Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 87 Sea uit Road Property Address Na Li Owner ---------------- ------------ Owner's Name information is required for every Osterville MA 02655 October 26, 2018 _--_ page. CityrTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this forma ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section CA. Yes No f ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWP )or a mapped Zone II of a public water supply well t5insp.doc•rev.7126/2018 1"itle 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Seapuit Road Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 -- — page. CityfTown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, .dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.712612018 Title 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 87 Seapuit Road Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 —_ page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 5 -- Number of bedrooms (actual). 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 603 GPD Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): 2016= 389 GOD 2017= 420 GPD Detail Sump pump? ❑ Yes ® No Last date of occupancy: . Summer 2018 Date t5insp.doc•rev.7/2 61201 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts ; r Title 5 Official Inspection Form — Y Subsurface Sewage. Disposal System Form - Not for Voluntary Assessments Ilk (Y 87 Seapuit Road Property Address Na Li _ Owner Owner's Name ----_— ----- _--- ---_ - ----- information is required for every Osterville MA 02655 October 26, 2018 _ _— page. City/-Town _ State Zip Code _ Date of Inspection D. System Information (coot.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: -- Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): -- Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: --- - - - Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: No previous records found Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Site tube on truck Reason for pumping: Maintenance t5insp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts +n ,1 Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form - Not for Voluntary Assessments l 87 Seapuit Road Property Address Na Li Owner Owner's Name information i e Osterville _ __ MA 02655 October 26 2018 required for every _ _ , page. City[Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the 1/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: Tank installed 2004. H-20 Leach system installed 04/25/2012. Certificates of Compliance on file at Health Dept. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2.2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): - Distance from private water supply well or suction line: n/a _ feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts 1 ;y Title 5 Official Inspection Form _ t� i�,l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sea uit Road Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 -- - page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): tDepth below grade: fee Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 10.5' x 5.5' x 5' 1500 gallons Dimensions: — 5" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 29" -- 10" Scum thickness - Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 20 _ How were dimensions determined? Dip tube and tape measure -- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet tee in place (Viewed with mirror). Outlet has A100 effluent filter. Liquid level at outlet invert. Risers brings outlet cover within 2" of grade. Inlet under large bush. Recommend maintenance pumping every two years. Recommend cleaning filter every year. Tank and filter were pumped and cleaned by Ready Rooter, Inc. after ins ep ction. _ 15insp.doc•rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth & Massachusetts �n iv Title 5 Official Inspection Form �s I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .......... , '� 87 Seapuit Road _ Property Address Na Li Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 — page. City/Town State Zip Code Date of Inspection D. System Information (coot.) 7. Grease Trap (locate on site plan): i Depth below grade: feet Material of construction: ❑ concrete ❑ metal fiberglass ❑ polyethylene ❑ other(explain): Dimensions: --- — Scum thickness — Distance from top of scum to top f outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumpin91recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: --- Material of construction: /� Elconcrete Elmetal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: --- - -- - Capacity: gallons Design Flow: - gallons per day t5insp.doc•rev.7,26I2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 .- Commonwealth of Massachusetts :;_, � Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Seapuit Road _ Property Address Na Li Owner Owner's Name information is Osterville MA 02655 October 26, 2018 required for every _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float 7"y 7es., tc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution BOX (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 011 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.): One inlet, two outets. Equal flow with speed levelers in place. No solids carryover. No high water staining over outlet inverts. D-box is 2' below grade. Riser 10" below grade. Unable to extend existing riser due to angle__ — I i t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 r Commonwealth of Massachusetts s Title 5 Official Inspection Form — � Subsurface Sewage Disposal System Form - Not for Voluntary Assessments /- .� 87 Seapuit Road Property Address Na Li Owner Owner's Name information is Osterville _ MA 02655 October 26, 2018 required for every _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - 10. Pump Chamber(locate on site plan): Pumps in working order: ` ❑ Yes ❑ No* Alarms in w / *Orkin order: 9 i ❑ Yes ❑ No Comments (note condition of pump cha l er, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not.required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 4- Flow diffusers ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: — ❑ overflow cesspool number: - ❑ innovative/alternative system Type/name of technology: 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 r ! N Commonwealth of Massachusetts Title 5 Official Inspection Form ill Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Seapuit Road --------------- Property Address Na Li _ Owner Owner's Name information is required for every Osterville MA 02655 October 26, 2018 _ _ page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil,signs of.hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): System is 48' x 12' x 2'. 4 Flow diffusers with 4' of stone around and 1' below. SAS located and inspected with camera. Under driveway. No standing liquid at time of inspection. No sign of high water staining or past hydraulic failure. 12. Cesspools (cesspool must be pumped as part of i spection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert --- Depth of solids layer / Depth of scum layer % ------ Dimensions of cesspool -- Materials of construction Indication of groundwater i flow ❑ Yes ❑ No Comments (note conditi n of soil, signs of hydraulic failure; level of ponding, condition of vegetation, etc.): i 15insp.doc•rev..7126l2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts -; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .......... � 87 Seapuit Road Property Address Na Li Owner Owner's Name information is Osterville MA 02655 October 26 2018 required for every _ _ page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan).- Materials of construction: - i Dimensions Depth of solids /J-- - ---- - Comments (note condition of soil, signs fif hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �xx I�l Subsurface Sewage Disposal System Form - Not;for Voluntary Assessments 87 Seapuit Road ------ -- -- - ------ Property Address Na Li Owner Owner's Name information is required for every �Osterville MA— 02655 October 26, 2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below-. hand-sketch in the area below ❑ drawing attached separately u c, J ?� Lo b, i L J J1 01 I 1 -L -- t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 -a 4 � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sea uit Road Property Address Na Li Owner Owner's Name information is Osterville MA 02655 October 26, 2018 required for every — _ _ _ page- Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >55feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 01/03/2012 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database -explain: maps.massqis.state.ma.us/oliver.php ___ You must describe how you established the high groundwater elevation: Test hole in 2012 to 132" (elv= 25.9)found no ground water. Base of SAS at elv= 32.3 per en ineered tans. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2.6/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts y: _ �p Title 5 Official Inspection Form �I' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Seapuit Road Property Address Na Li Owner Owner's Name information is Osterville MA 02655 October 26, 2018 required for every _ page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3; or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 3 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Town of Barnstable Regulatory Services Thomas F. Geiler,Director x �„ LE. * Public Health Division { i6;q. � '°ran nn�+a Thomas McKean,Director M 200 Main.Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: `1 Z'5 Zg1Z Sewage Permit# 20/7-7U1 7 Assessor's Map/Parcel JAAt`l-oof Installer&Designer Certification Form Designer: QJr=jQ1 i, A U1,6c,, V(F Installer: U,wJ 0o6a,6'- .nns Address: Address: : 27'7 54-oku5 H 0 f Rd Giu� �Y On 'f I I Z �I,L3 0 07' i t 5o,u was issued a permit to install a (date) (installer) septic system at 97 5euanvr 9J , 05 k-r of i'l(c: based on a design drawn by (addres ) �'Inl l� G�rlsE,.►: dated (designer) V/ I certify that the.septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above.was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but ' accordance with State & Local Regulations Plan revision or d as-built to follow. Stripout (if required)was inspected and.the soils were ands 's factory: OF Mgss STEPHEN yG m (I s a ler s ature ALLYN o wwsoN No.30210 �fi"ISTERti� signer's Signature) (Affix De f ere) PLE SE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice formsWesignercertification form.doc TOWN OF BARNSTABLE LOCATION CL4 SEWAGE# i)'e C VILLAGE OS'er Lh )lP ASSESSOR'S MAP&PARCEL �`�g )jq'00 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I S00 0110.45 LEACHING FACILITY:(type) Wl9r 0�4(size) 14 NO.OF BEDROOMS OWNER PERMIT DATE: t 7 + 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 leachin facility) Feet FURNISHED BY • �- Q h-t 96 y r 61. 35' L� r, No. lJ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN bF BARNSTABLE, MASSACHUSETTS Ye Aiptitation for Disposal 6 stem Construction i3erndt =�01 Application for a Permit to Construct( ) Repair( ) Upgrade V$ Abandon( ) ❑Complete System ❑Individual Components Location Address r Lot No. G 7 + Owner's Name,Address,and Tel.N o� � Gal —Z, '} <r ; `�ct � Assessor's Map/Parcel 1 f3P `� , i 19--001 Installer's Name,Address,and Tel.No. 7? s�a�y f(( �f8 Designer's Name,Address,and Tel.No. ck)"I5 t510 S G 1��1<�vv, � ��2.0 �e_r 7 E Fl) 1 pl ee/-z i-SvS-V Type of Building: 5016 9YS 6a 8 Dwelling No.of Bedrooms b Lot Size C5/1.38S sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Jib gpd Design flow provided 6 cZ gpd Plan Date Number of sheets Revision Date Title A n� Size of Septic Tank /J`&D � Type of S.A.S. } ®Ey GCAosr,,q�$ Description of Soil Nature of Repairs or Alterations(Answer when applicable) d a VS 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 of to place the system in operation until a Certificate of Compliance has been issued by this Board of He igned Date Application Approved by Date �'— Application Disapproved by Date for the following reasons Permit No. ��1 ^� Date Issued - - - - - - ---------------- - --- - - - - - - No. Fee ( I THE COMMONWEALTH OF-MASSACHUSETTS Entered in computer: PUBLIC HEALTH.DIVISION -..T0WN'0E-HARNSTABLE, MASSACHUSETTS Ye 2ppr Yitation (or is oral 6 stem� onstruttion Permit Application for a Permit to Construct( ) Repair O Upgrade V* Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. rtpttt kP_d Owner's Name, dd�ress,and Tel.NL0.. C� 681 �'Z� Cjac �i `� Assessor's Map/Parcel M JW 11c6 + `19—Gp1 Installer's Name,Address,and Tel.No. / Designer's Name,Address',and Tel:No.' Type of Building: 91/5 t5 Dwelling No.of Bedrooms Lot Size C�(,j �j sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) jp gpd Design flow provided 6 cZ gpd Plan Date 9"4 - 1'a- Number of sheets � Revision Date Title Size of Septic Tank /j'� tit Type of S.A.S. POW- Description of Soil f Nature of Repairs or Alterations(Answer when applicable) C w pia n.a� e L-- CJU i 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 an of to place the system in operation until a Certificate of Compliance has been issued by this Board of He th. igned Date —12! s Application Approved by Date L . -7,11 Disapproved by Date i ' for the following_reasons Permit No. -a—/ �� Date Issued ) �- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Canstructed( ) Repaired( Upgraded( ) Abandoned( )by at G 4�. has been constructed in accordance e with the provisions of Title 5 and the for Disposal System Construction Permit No.,_-';i2 1 }'? dated Installer e �� Designer � � y r-r� 1Q1QPVS!yC.rS #bedrooms �j Approved desi'' flow ' ? - gpd The issuance of this permit)shall of be construed as a guarantee that the syst m will funct'i as gn d. Date % ' 5410 . ",'Inspector ------- ---- --- --- ---_ _ _: . r ---- -- m- ---- --.--_ --- y-� -- - -_ : __:_ No. of "�-'� ( !'y .Fee o0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar *pstertt construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located atC__Iem ,a� and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. N 6 Provided:Construction must be completed within three years of the date'of this pe it. Date i ) '' Approved by Town of Barnstable P# 0 o� w�lte rod o Department of Regulatory Services / R 's Public Health Division Date 6 y MASS. 200 Main Street,Hyannis MA 02601 �rF0 MPy_► Date Scheduled / t� Time Fee Pd.., Soil Suitability Assessment for Se e Disposal Performed By: 5 Ir3 i'L °"7'soK •?E' Witnessed By: 91 LOCATION & GENERAL INFORMATION Location Address S7 'Sceg3LA 1�&� m Owner's Nae (A) zln m. C4 11a✓t 5 1^uv IlC 1(?YI L.'k, t-(oi�/Se 0 Address "Q, .Pc iw, t3c h 1=l 3341 Assessor's Map/Pnrcel: :.-._�,l,�,l 1 i —,�C�f Engineer's Name 13�iKlr.apt NEW CONSTRUCTION X REPAIR Telephone# Land Use d5kkav\11;'t Slopes N Surface Stones rb3glZ Distances from:• Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street,name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) " tv uaz o rn Parent material(geologic) V 1,4 r lRS 0'j —WQIS� ." Depth to Bedrock Depth to.Groundwater: Standing Water in Hole: Weeping from Pit Face Esthnated Seasonal High Groundwater DETERMINATION FOR SEASONA'HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in• Depth to weeping front side of obs.hole: in. Groundwater Adjustment ft, Index Well N Reading Date: index Well level Adj.factor Adj.Groundwnter Level— PERCOLATION_TEST Date Time Obse atton , t HoIgN i'�. � '7 Time at 9,,., Depth of Perc �G/ Tire et 6". Start Pre-soak.Tinle a /0' . TO%1 Time(9"-6") End Pre-soak .. . lD; �' l0 23 tJrtoLiL! Sd�h Rate Min./Lich Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) original: Public Health Division l Observation Hole Data To Be Completed on Back---------- ***If percolation testis to be conducted within 100' of wetland,you must first notify the beginning. Barnstable Conservation Division at.least one(1)week prior.to Q;IiEALTH/WP/PERCFORMCj(o3; y DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.). (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ve s t",'•�.� �1° 6c:Ad.yl.u2w� �v`(i2��Zic6lt It WfAu� 'F11V 10 �t2 7j — IoosG . &�i.h�. c c.Kr� 6 /vO !tee, �7S cvvrc0 DEEP OBSERVATION HOLE LOG" Hole# Z Depth from Soil Horizon Soil Texture. Soil Color, Soil Other . Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.°o Grave U-E 14 Ap Sartofy L,oawt l0 `�K S�Z �' �Jc 8t� 2va zau�y S�.�o1 /o yl? �/y - �trtGbl6 7Z" :l/ sp y �cxw► �� Y .SIZ _' Ir't�.6 L'— 7Zr`- l s" Sol c /0 YKD4 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon . Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,° 'Gravel) 0-.12 r pI,oswq rt-a,tole.. IZ- 30 t�mu � Scr• Q to Y� jy!!2v` fir.(l 5oAAy ` 12 S�z Irla:b/� �� . 132 G 10 �to 2/6 l c s.•e- �� 4r4k� v Sc✓r/�� . DEEP'OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Coilsi ei c °° ve 1tr $ate to `doe . �rtabl¢, 2.•2g- . ,/� i e (n1cc��yM. �inC Q 9 214). A1,0 liJaLc✓ U6 c.r✓-c a( 'Flood Insurance Rate Map: Above 500 year flood boundary, No— Yes - Within.500 year boundary No ✓ Yes Within 100 year flood boundary No� Yes Depth of Naturhlly Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption.system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envirom ental Protection and that the above.analysis was performed by me consistent with the required traini g,a pert' a nd ex erience described in 310 CMR 15.017�2, C l �l Date 4-fL _ ' Signature _ (426 11 - Q:H EALTH/W P/PERCFORM LEgCh/pc VENT P ` -REES P`k�� i-- I TREES �p PAVED DRIVEWAY W/STONE OVER D-BOX LIGHT ! pQ• / j (_ tt ;/ LfgClifry t I o`er/ 'Q 1500 GAL. 1 � SEPTIC TANK (PAINT A�ARKED) t O I i PROPOSED,pPoVEWAY - K �{ - - � >• � CH ENO '122.3' _ `t i\``. �� 5�0 v 1 .6 3� 8.g j SCgpEQ ls. 1 2N PL• 'M / TREES F.F.E.=41.0•Ip w /).g• C - C �t piCKET yCE 1 1 ®'d" SS GATE i ./ - _ r t 18.9' 5 j, 1 ll 1 i 1 DTORy A80.1 TP N2 i' �.. _ .. a H'F .. %. ,�i, 11 i ® / .f. W1 Ci"Nh O 'J * 1 F.F.E.-40.9' 1 i Y0.01 fl r 1 i 1 ]] t 4 IO t N - r _ , f t�. ------ ' r I PRO.ECT B0lCHY�1Itl( i i SPUD 1 f t EL-36.Oe t 1 ! ! ! ! TREES �. TV$OX'(P699 �f-ABANDONED) RC ` 1 �Be, . ' 1 STOCKADE FENCE �341 .W. i S -ROM :Stenbeck & Taylor, Inc. FAX- NO. :17818378238 Feb. 13 2006 10:15AN P1 At Town of Barnstable oF.wE Regulatory Services Thomas F. Geiler,DirectO r HAEMSTAE{ MA�- public )El Q• ' ealth Division ibj9 Thomas McKean,Director 200 Main Street, Hyannis, V1A 02601 Fax. 508-790-6304 C)f3iCe 508-862-4644 Installer &Des+ ner.Certification F.Orm Date: Designer: e• kt I>astaller: �t`ve� �a-�a-�t�� S teC' 4flep Address, Address:O -- - --- --- 1 r�,�� �ca� �� was issued a permit to install a (date) (installer) Q septic; system at g`� L��� � ' �° �i�.t based on a design drawn by 1 (address) dawu des er) 1 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 d.istributacin box and/or septic tank- 1 ,certify that the septic system referenced above was installed with major changes (I-E. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local REgulations. Plan revision or certified as-built by designer to follow- H F DAVID G. y DRAW N (installer's Signature) CIVIL No,32808 9F s ERA�'c� • IG� Affix 17esi er's tam Here (Design 's ignature) ( i� F ) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFI ATE OIL COMPLIANCE 'WILT, NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: ElcaltlVSeptic/Designer Certification Fomi r 2006 FEB 13 F?l 12: 3 3 I ,I 1, TOWN OF BARNSTABLE LO;4ATION Sea SEWAGE#p'�-534 "'VILLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY s � � � �;, T°OwW 6F BARNSTABLE LOCAT16N VE6 � t' ��� SEWAGE # N71LLAGE S`el—G c , ASSESSOR'S MAP CLOT INSTALLER'S NAME&PHONE NO. �i CX SEPTIC TANK CAPACITY 2,206 LEACHING FACILITY: (type) C'`y F/2� ,9 (size) NO. OF BEDROOMS II BUILDER OR OWNER }-/Qm e S i �A J-3o I®e2nS PERMPTDATE: 14P/01—! 7 COMPLUNCF DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of.Leaching Facility Feet Private Water Supply Well and Leaching Facility (1f any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by o. � a ir \b LC 1=-- - - No. _� v FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct"Repair( ) Upgrade( ) Abandon( ) - eComplete System ❑Individual Components Locatio Owner's Map/Parcel# Address 76Z" Lot# f Telephone# Installer's Name Designer's Name Address Address �� Telephone# Telephone# Type of Building �.� �r < Lot Size sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons ,Ap- Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) /.S-Sc� gpd Calculated design flow Design flow provided gpd Plan: Date Number of sheets l Revision Date Title AQ Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS j4asitl.SY�Cfc Y .:�. .y.cf ,�s>S y, C.✓sis:�.v c f-✓t� �'ir2L_' m..i�:tli/r //,s-91.� _ //'-/Jt'& ,%-w'�.r <_-''-�'-S9ii�'�'1�aG�/�//.✓ '�%�i.�:,c��-� The undersigned agrees to install the above escribed Individual Sewage Disposal System in accordance with 5 and further'agr to not to place a system' p afion until a Certificate of Compliance has been issued by d g_f,& Signed ZO '0 Date o b CHAP 1,011014 v o CML Inspections NO'37136 �� �;;•;,,.._.�.,,T'y^.->.'M.°-'iy'.rY"�',: �4, +I .rr`,. �w'v,:+ -;�+�v� ;y.:.��•.�,y-'�:A`+.�,.�p..�H.+�,yyl....� ./� ": "f...'�,'�'"".�""".T�°.``'lt3afi ,.�j..2-yi,�. •r..�-. FEE —*"- COlam®' ,�LTW®F MASSAC14USETTS r - l _ _ oard of Health, f_7✓� s7.s�c°3.c < MA.B APPLICATION FOP, DISPOSAL SYSTEM-CONSTRUCTION PERMIT Application for a Permit to ConstructPQ'Repair( ) Upgrade( )-Abandon( - ❑O Complete System ❑Individual Components r Locationt�, J �U/T /�c.� 1"<�"� Owner's Name�.�v�l✓��o b.�s��,�� v�< Tc-sy- `Map/Parcel#' Address Lot# f Telephone# Installer's Name Designer's Name Address Address vF,�tni Telephone# - Telephone# Type of Building --` Lot Size Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons /r2 "Showers ( ),Cafeteria O « Other Fixtures Design Flow(min.required) S �',-: gpd Calculated design flow .- S cr Design flow provided c gpd Plan: Date 3/ 9 Number of sheets Revision Date Title /�'a.bc'O..St /� ,at.�_�rfE .,�./ t �,.-.•rRa� ft.sz.v . Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS n/.5�.lfJC> /$ ..•�!w.�,"t° .�ios r'c.-.� c s✓_5.�3 ricer. t+�':' /9 /_5'�� �� ✓�r>>/s /iT.. A The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with th TLE 5 and further agrees to not to place/the system operation until a Certificate of Compliance has been issued by Signed Date 2 2 .CJ TERENCE J.9�yG <a 5/6 f k CHASE m Inspections 1 v CIVIL ti �F. No. / FEECOMMONWEALTH OF MASSACHUSETTS Board'of Health, MA. F'Y CEPITIFIC. COMPLIANCE Description of Work: ❑Individual Component(s) ©-Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( )„Repaired ( ),Upgraded( )`','Abandoned (#) by:-, at ` 7,n17-N I Ili f R_O..k' 0_ 0 has been installed in accorda cb with the provision o�fl310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. A W 4 5-3 j dated �/"yl/rile)"! . Approved Design Flow < (gpd) - 'Installer '�AD�tat,;l:�a� Designer: (7 Inspector: Date: 2A c S" The issuance of this permit shall not be construed as a guarantee that the system will function as designed. ` No. C0041 53f0 FEE O COMMONWEALTH OF MASSAC14USETTS Board of Health, DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission iiss.,hereby granted to; Construct ),, Repair( Upgrade( ) Abandon( ) an individual sewage disposal system at (� 1 soa�k� IF- ( �1'q N°,J t �{� as described in the application for �l J Disposal System Construction Permit No. s/ 5 3 dated C h p-/ q Provided: Construction shall be completed within three years of the date-of-this.permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date /V//rT/2t Board of Health c:lsandtNoshlsoilogs\Soil_Logs.)ds 3/23/04 Stenbeck& Taylor, INC. Page 1 of 1 Engineers& Land Surveyors 844 Webster Street, Unit 3 Marshfield,MA 02050 (781) 834-8591 DEEP HOLE#: 201 DATE: 3122104 TIME. AM WEATHER: Sunny 40's L'OCATION.= Lot 1.7. Seapuit'-ft Osterville,MA OR MR: Zoo jid LrfrPa(L�1Zoal i n cy} LAND USE: Woods SLOPE(%). 0 1% SURFACE STONES. No VEGETATION. Pine, Oak LANDFORM DISTANCES FROM.• OPEN WATER BODY.• 100+ PROPERTY LINE: 50+1--- POSSIBLE WET AREA: 100+ OTHER: DRINKING WATER WELL: 100+ DRAINAGEWAY. 100+/- DEEP OBSER VA TION HOLE L 0 G Depth Soil Horizon Soil Texture(USDA) Soil Color(Mansell) Soil Mottling Other(Structure, Consistency, Gravel, Stones,Boulders) 0-5 ft Organic 10yr212 5-10 E Med Sand 10yr6/1 Friable 10-37 B Loamy Sand I0yr518 Friable 37-130 C.1 Coarse-Med Sand 2.5y616 No Mottles Friable,�ornv� PARENT MATERIAL: Sandy Till DEPTH TO BEDROCK: 130+ DEPTH TO GROUNDWATER: STANDING IN HOLE: None WEEPING FROM PIT FACE: None DETERMINATION FOR SEASONAL HIGH WATER TABLE' METHOD USED:SEE COMMENTS:SEE TEST PIT x DEPTH OBSERVED STANDING IN OBSERVATION HOLE -- FT NONE OBSERVED TO 130" DEPTH WEEPING FROM SIDE OF OBSERVATION HOLE FT DEPTH TO SOIL MOTTLES FT GROUNDWATER ADJUSTMENT FT. INDEX HELL NUMBER READING DATE ADJUSTMENT FACTOR PERCOLATION TEST DATE: 3122104 TIME: 10:/6 OBSERVATION HOLE#: 20, DEPTH OFPERC: 48-66 START PRE-SOAK- 10:10 AM END PRE-SOAK- 10:20 AM TIME AT 12': -- TIMEAT 9" -- TIME AT 6"TIME ff"--6'): -- RATE MINIEV: 24 Gal use7d/PR-2 mpi SITE SUITABILITYASSESSMENT SITE PASSED: x SITE FAILED. ADDITIONAL TESTING: PERFORMED BY. Terence Chase PE, SIT,SE-Stenbeck and Taylor,Inc. COMMENTS: Witnessed by David Stanton-Barnstable Board.of Health c:\sandtyosh\soilogs\Soil_Logs.xls FORM II-SOIL EVALUATOR FORM Page 1 of 1 Location Address or Lot No. 201 Lot 1- Seapuit Rd, Osterville, AM Determination for Seasonal High Water Tdble Method Used: Groundwater table not detemi»ed! Depth observed standing in observation hole >130" inches No observed to 130" � �. Depth weeping from side of observation hole inches ® Depth to soil mottles inches Ground water/adjustment feet Index Well Number Reading Date Index well level f Adjustment actor Adjustment groundwater level J 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? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in Fall-1995 (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: /yeG r c t�esE Date: DEP APPROVED FORM-12/07/95 r c:\sandtyosh\soilogs\Soil Logs.)ds 3/23/04 Stenbeck Taylor, INC. Page 1 of 1 Engineers& Land Surveyors 844 Webster Street, Unit 3 Marshfield,MA 02050 (781) 834-8591 DEEP HOLE#: 202 DATE: 3122104 TIME: AM WEATHER Sunny 40's -LOCATION. Lot 1:7 Seapuil-Rd,Osterville,MA _ OWNER v;: 1>: nrutne I�.ygley I(11T} LAND USE: Woods SLOPE(a/o) 0 1% SURFACE STONES: No J VEGETATION.• Pine, Oak LANDFORM DISTANCES FROM. OPEN WATER BODY.• 100+ PROPERTYLINE: 50+/--- POSSIBLE WETAREA: 100+ OTHER: DRINKING WATER WELL: 100+ DRAINAGEWAY: 100+/- DEEP OBSER VA TION HOLE L OG Depth Soil Horizon Soil Texture(USDA) Soil Color(Munsell) Soil Mottling Other(Structure, Consistency, Gravel,Stones,Boulders) 0-5 Organic 10yr2/2 5-10 E Med Sand 10yr6/1 Friable 10 37 B Loamy Sand 10yr5/8 Friable 31.130 C.1 Coarse-Med Sand 2.5y6/6 No Mottles Friable, PARENT MATERL4L: Sandy Till DEPTH TO BEDROCK.• 130+ DEPTH TO GROUNDWATER: STANDING IN HOLE: None WEEPING FROM PIT FACE: None DETERMINATION FOR SEASONAL HIGH WATER TABLE' METHOD USED:SEE COMMENTS`SEE TEST PIT.- x DEPTH OBSERVED STANDING IN OBSERVATIONHOLE =- FT.. NONE OBSERVED TO 130" DEPTH WEEPING FROM SIDE OF OBSERVATIONHOLE FT. DEPTH TO SOIL MOTTLES FT GROUNDWATER ADJUSTMENT-� FT. INDEX WELL NUMBER READING DATE ADJUSTMENT FACTOR PERCOLATION TEST DATE: 3122104 TIME: 10:44 OBSERVATIONHOLE#: 202 DEPTH OF PERC: 48-66 START PRE-SOAK- 10:44 AM END PRE-SOAK- 10:52 AM TIME ATI2": -- TIMEAT 9"TIME AT 6"TIME(9"-6'): -- RATE MIN./IN.: 24 Gal used/PR-2 mpi SITE SUITABILITYASSESSMENT. SITE PASSED: x . SITE FAILED: ADDITIONAL TESTING: PERFORMED BY. Terence Chase PE,SIT,SE-Stenbeck and Taylor,Inc. COMMENTS: Witnessed by David Stanton-Barnstable Board of Health :\sandtljosh\soilogs\Soil Logs.xls FORM II_SOIL EVALUATOR FORM o Page 1 of 1 Location Address or Lot No. 202 Lot]4 Seapuit Rd, Osterville,MA Determination foorSeasonal Hirh Water Table Method Used.• Groundwater table not deteminedl Depth observed standing in observation hole >130" inches No observed to 130" 0 Depth weeping from side of observation hole inches 0 Depth to soil mottles inches Groundwater adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjustment groundwater level 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? Yes If not, what is the depth of naturally occurring pervious material? Certification 1 certify that in Fall-1995 (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: /cec,�c� L.�•v.�r Date: Jp DEP APPROVED FORM-12/07/95 I'P1IC.GJ.GV-J'U•-i f •JCJI"II'I DI'BCIIJ I I'1DLL DL+Pn[L Jr nLn1_i n ,ice. w Town of Jlarustable rrE JtaCpWrbamtotAe((nlntoty8ervleea / ]Public Ilealth Division path 200 MA n SnRt*mnts MA 0201 • � uo Z • Date SdiotfiJ)ed Fen Pd.[ Q 3 — Titn@ . , ent or Se a�7isp0sal soil suitability Assessor , � � ' E,,.�� C:f�s'h W;tnestadp'Y• � v�� 3�.av��.v LOCATXON&GENAML M®M"TION /� /} OWner�eName /r7/t, 1QAv/v L9vatioti AddrM ,SEq/� d/'r/1d 7G 2 ll/af:J sr, Addresb mSJFsv �ie<; �s1 fJ o2oSa AnUftr'a MeptPaPcel: 1J3W Ct7NG1RtJCfIQN .✓lin�.,� E �� Smpes(9i;„�—�-r $u�ee$tOtias%��a land Lie o Posetble Wee Area/ � A'ater Well / o Diauintesl+orn; 4Fen water body ' Orainc�Ws+f Jo n y Property L11ro `sue �/R Ogles —� 'Ti t(9Lsot nema dimeneiiAu of M4 food W-09 i>g of test hobs&pot tum,watt Wetla:lds in pmcimitr tghow) 7617 Io r lc�y/,q . Y J` A41 zoq -- i Parent awwrial(9ed98in3 Aapth b t3odtOnk s DepditGGMtp+dweW.StandfABW�ainFlnle / o /lam Weq�i•tERlvmPaFlas 6aenteted 8eaeooal High Gm.Vnd*I A<GI. v CMG aas� DET�AxION FOR SEASONAL SIGN W4TER TABLE Mesiod Used:Dq— ;n h hi soil mo$1ea:_ �• �t]bee elsndht8 in o6a Hotel- —"' pept �•« g Mph toWre"fmIgmeofobl,hol. 4U GedW00>u ind�Well$ jleaQins �� bided Wel.level MA MIN A0j.OroandwnterLmel� PERCOLATION TEST Dale 3 —f2 Time — Ob�rvaOon ' j 2e7 3 ZO�i TinlC at 9" Hot 0 - bapUiaitinie Stalt Proses t fime® TlnlC(SIN1 findrm4aek ' g;taBtilmbititvA59esemeiN. $itePadStd ffikoFtil�a e. AddNlolrol7esdnpAadod(Y7FU n� — ong;eoi, pubuo Heatdt D;vtatan Observafl=Hole Data To Be Com&I"an Batik ---� #*if porcoindoll testis to be conducted within 100'of Watlaad,you mast first notify the �• Baraatable Conaervatial►riirt�aioa at least atoe(X)week Prior�bedai q!aTEALTK/WP1P8�PDAM � DEEP OBSERVATIOV AUTA Lu%* •auw** J k►ttpfn Sat!Morino Sod TW*" Soil Ooler soil Clher gucthes(tnJ (Ulm blotting (13in ONmsow,WORM 41-4 . � fj�aTTt�'S il.a 1n�r a,.rL OEEEVP GHSWVATXONIRgOLELOG eeSoleN Sejt Color b Deprhfnru SbilHedaon 8oi �oe Q+ 19 Mommg (8erncS4astanes,9ontda�x, 8arfece Gn) ei 3 7- DFM OBgERVATLONHOVELOG Rote#2a Soil Nahum SoiNeO Sett Cob) Soil' a Depth� (NJrioeelq Mottilna (Strvolnre,8e0nes,Booldera. - Sul-ace(in.) LeaYr•.. w/: Mks l3EElr OB RVA ON ROLE LOG Bole# 8olifthrCe sail Cole? soil i)eprh ha,n SailHarinoti (UCA) atmnetO Motdfag (stalomm,Stares,Dow&[$. 3orrbae(1n.) �I�aeraneeB�)a_ MAn,; . pheveS00yam'need boondM NO— YMJ4:f Wale S00Yen bComary No-�t'— Y1i Widrlet00y,orilaadYanndoyNo You— Does at Ieast fm fact ofsatwoy oacu»o pervious ms tmial mx st it all arm obaazved throughout the mu proposed for the soil absOfPtion aystem7 yi-- If not:what 4 the depth afnaoualtY o0fffif M Pefviol"mawlat4 c� 9- 01")1 have passed the sal evaluator eao�miaatiait app�v�hY� ICeettrfy�skt on ._—.� erEarmafl by tee consistent vn"S1f Acparim=of Bmiroumental Pmteotiosr and flratthe above nna�j'ais was p the required rsitaid&expertise and o-gcrimee described in 310 ChM 15.011. aWre �/,ia9 T Datc Q�flR1�1•'1}vWP/PF�SL"PC1tM, 1 �2"c�p�I e. 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Mom- -�,�� : _totA ,.:r2-�;^-+- ram, . i; ` ( r TOWN OF BATUN STAB LE Z it ►�.t 19 Rl U 'O - Hnwt of waark Cn — ALIGN ICY O[CC W1IH O05T1WO[1k30C �• 4� $*S % ALIGN ANGLE ON PORCI PWAALIEL TO POOL - ��. 07NIOIU016 . PARTIAL HEIGHT WALL- NEW I - OOOt - I d MN aCf1b4 mmi Podh > NEW DECK NEW PORCHEXISTM OBOL ALUMM OF POACH WALL OOSTIHG NEIN WALL WALL .......W/EI E BAY WR"W WM AL _ I r __ 71 f 1 E-1 Q0 j RT IOR31 =i oo LAUNDRY / E mmw EXTERIOR WALL m SIFJW D W I 1ca CAM �- — — — — — — — — o L_ L ru 0 0 O W W Q. O O 0 0 0 0 N G C4 100 00 � •� N t7 W N m Not for Construction A1,0 l ll I E ON FGURE S7) NEW - 'GU E M A R,V i N - --------- _ N. •• ACCESS/EGRESS TILT/TURN CLAD PAnMND OWWINDOW ROUGH cal oom\ HIGH." e sOPENING 32-1/2'' X \ 48-I/2° oP'csll to:rl CONCRETE Ii L.`I .L'Li BILCO SCAPEWELL ,:' \ \\ \ \ \ \. \ �I - 396 oft i \ \ \. MODEL tt4862-42 DanceStudlo I' — --� WITH BILCO SCAPEWELL DOME I Weight Room MODEL tt48 2 LV;, 2 71-L 4 C g \I \\ \ ` \ \ \\ `\ \ Electrical Mechanical Room WALLOP 1,11IRtIRM \ \ i \ NEW GIRT(7)1-3/1' MARVINi�X 1-1/2-LVL -'21 -�/4' 1.557.55syt wood Nun,3-d C.I..B b.PI.* of ACCESS/EGRESSs/Yd!/ i' / J �- zeo I i I �wJ�`�/� HANGER TILT/TURN. CLAD. I ,!, ` //�/ / (TYP.) T OPENIWINDOW ROUGH •— T-M NG 32-1/2" X I INACso� /I '" REMOVE EXISTI `�'� /197 LALLY COLU - - i/,. 137%R orage 1W0111 l _. Agpedm emtmm$tran 5hor�oCmbo j. zn ogltr�j ` +9Ran MhBukn Gbrcb 3 w�6 - Bath Room i i �. Slttmg Room B I L C O SCAPEWELL - : E Cardio Room /.Meehan cal.Room 7i/ MODEL tt480-42 I °� �'nmtewcsm : i 7 WITH BtLCO - ' � 7 SCAPEWELL DOME MODEL 44842C /wvNmdsmeaR BASEMENT • , � ----�., — - - �\, .. 19._L. H•c1pZ .. 7�._I 1s'-9�' \ µ OTC : &L-L- IMISit Gr- >LrNO2 y}V-%Q4Ys -7_`n U��SS'O'�t4Ceaa��Ste. l e+►�D�c?�►t'rc.i� BASEMENT FLAN SCALE: I�ii® ,� ,, s t LOT 14 ° j k� 81 SEAPUIT ROAD OSTERVILLE, MASSACHISETTS w � � �`"Cec1: �( e Design ll(ll �walliftnt H � ds�e ����� z MODIFICATIONS TO BASEMENT �� x BASEMENT PLAN n AA p } 8 4 0 � 8 16 -a� dM' - F, � ,4a � a� c. Fri. 27 Jul 2012 - 8:31am - y �- ^APO Box13235a more Beach MA02562 >fi mom. DRAWN BY: CED- DES. SCALE: AS SHOWN E: 87 Seopuit CEDAR%ALLE DESIGN Drawin s ✓ /8'— —0' \ \ \ e\ Phone (508)367-0701 - �4 , apuit Road CDS A1.dwg ' `-Er all cedes filled sign@aol"com '� DESIGNED BY: DATE: 3/12 87 Se CHECKED BY: LATEST REV,: 1/23/12 �wfb' t ' z ce Y m SEAPU►T RD z 0 0 PBM 48.4`� TOP OF STAKE f '� NAILED TO TREE 22. �28 EL. = 41.00 LOCUS MAP �p S�9'40'Sg.E �a L.CB.Fnd. 44.67> ,ZONING NOTES L (Roe.) L:C.8 Not ZONE. RF - 1 �eC> Fb� MINIMUM YARD SETBACKS: S> Z FRONT. 30' SIDE: 15' REAR 15' 2 9 SCHEDULE OF ELEVATIONS • >, O a Proposed AS-BUILT TOP OF FOUNDATION 40.00 40.99 -� ^ FLOWS. I VERT AT FOUNDATION �6 j `4� t �. SEPTIC TANK - INLET 37.19 63 0 OUTLET 36.9 37.48 o �s lbD-B X - INLET 36.43 36.84 w �_e'X ' � VWr 6 OUTLET 36.69 ca t7o N l , " PIPE INV. - 3-6.22 36.61 o >so 36.00 35.92 807TOM OF TRENCH 4 00 9 g Easement ° ��S � ' �'1175' 37.0 37.28 e �oC ob �� WATERLEVEL .QjA WATER TO EL .28.6 1 p: , ,2�2:5' r7 TIES TO SYSTEM � AC r 80.2' 34. gBF C 15.0 zati�,n AD 25.7' 14.7 0 ''• Portion Of Parce1118-119 AE 58.0' E 40.5' o Lota�. 62.0- 5 ' AG 16.0 BG 38.0 87,495 *-Ft. � 2.00 Acres N O NOTES o ^ � ` I CERTIFY: 1. THE LOCUS IS LOCATED IN FLOOD ZONE %`.,.. 9 04.9' ON AF.R M.REA FMAP MINIMAL 0 250001NG DSHOWN DATED REVISED JULY 2, 1992 2. THE SUBSURFACE DISPOSAL SYSTEM WAS H INSTALLED IN COMPLIANCE WITH 7ITLE-5 (Roe.) Fnd. , C>44vID G QF THE STATE ENVIRONMENTAL CODE, THE R ee RULES AND REGULATIONS OF THE BOARD DRAIN N83•29118 E CIVIL � OF HEALTH AND THE APPROVED PLAN. �" No.32sos � 284.05 NOTE: ' poi � � GARAGE AND DRIVEWAY WERE RELOCATED Al AFTER SEPTIC SYSTEM PLAN WAS APPROVED. VENT WAS ADDED To SYSTEM BECAUSE - z PROPOSED PAVED DRIVEWAY CROSSES 5/,6 5� OVER TRENCHES PROFESSIONAL thIdINEER LATE SCALE 1 " = 40' 0 20 40 8 0 120 160 Drawn For: HOMESTEAD PROPERTIES Revisions buy ' a` 0 5- Drawn By.JM ttP t1 OF /y Checked B STENBECK & TA YL OR, INC. SEWAGE DISPOSAL SYSTEMss9r vGD Registered Professional Engineers and land Surveyors VVIL JAM 4� DAVID G. �c Scale: l"=4o' g g y AS-BUILT PLAN cGOJOSVE R DRAIN Since 1951 844 Webster Street 9 Steeple Street � '�Ae,GOVEf��9 a CIVIL ., too.39692 " Igo.32808 y Date:MAY25 Zoos Suite 3 P.O. Box 630 LOT 5 ` EAPUIT ROAD '°'oF �� ��' 9 �4 `� Job No.: 6630 s ' T Marshfield Ma. 02050 Mash pee Commons Ma. 02649 �u onsiA � .�,� 781-834-8591 �08-539-9300 OSTER LILLE, MA f - Plan No.: 6630 SEAPLTIT Fax: 781-837-8238 Fax : 508-539-9301 www.stenbeekandtaylor.com Email:sandt@gis.net B�►XTER NYE r o / r',O a i.�♦.`,\ �fir• ,,{.1"j `"',l 4`� fh��jq -,,� : `` ENGINEERING & >04 L • .7- l f i .'•' J ti� K . j SURVEY { ----w-�t =C r r fie.., i1 La 1t•.• '= • �'• , •o�.. , /'rj,'+�3" .. LNG � !�T y Registered Professional Engineers ?t• '� ''+�e`,•ter �iG'.�. :,.{n� :\ �v-L r y;_ ••Lsi 1 �R•,. „�, +� }-.ri�+1,a p •� c, �? • ,s. _.X«J:�' •' ;w ...1,.ar � rhi vim. r ``' '�' and Land Surveyors �� �:t .;:� r:•,,', .� �w . Z ` --ti � �'�(•' 78 North - 7-.. • Street �. ',� '�;�C�";��oJ �� `� ••�, ��� .��� ; �r•,`�`"': ,. 3rd Floor Hyannis Massachusetts 02601 z;'per '?.;\ %`•�,.� ,e�) 1 r r �!- f 1.�'Y' ''.. y � � ► 9 Phone - (508) 771-7502 __ '^•'} it fi 4tV.i fr. � L .�..: ,` ` .'.r•4 ..�i �'F - - •'1 ( ��•'', .. t a e •r•.r �_ °.:2I 'J \ .,� . Fax (508) 771 7622 www.baxter-n com Cq BOX_------ w `_� --,- \ ,: w.+v • �, �i' - '`ti ti ;.:.,. .. � '';� • '�t,;+• 'L•7� , -_ / - C al.wwi t ,.r► ,. 1+`:. �' L ' x 1N 9 \ a,.,,�,, t>:�/ Er , 7 a r` • ( -• STAMP STAMP 27� �0 \, \c •' r j.� \c ,�, •,: l► t�l ' !?r?r ` y TEPHEN �yG ELEC. BOX P O *�i" \ +a \` e:" `. .�r- r e � a�•s` (P kftk UP/LP 112/9 � c » �,w \ Locus M Scale 1" - 2009 No.302, Map - 9F'ccc.,-�,� � � P•cF�^ �/BIER ' \ GCB J - 1.0 ��' \ s \ \c PROJECT BENCHMARK j _ I ; x 34.5// \ \ \ \c = MAG NAIL q \ EL 38.09 (NGVD29) x / x 1 � CONSULTANT r' 33.2 \ \ ' \\c GENERAL •TREES ,_- � , ,,- ,, ,' ,' \ \ R \� ERAL NOTES . i 1 / "I \ r' 31.2 r' ------_�' ' - 36.7 `�� s , O x \ \`c 1.) THE INTENT OF THIS PLAN IS SHOW PROPOSED WORK AT LOCUS 9. i l AO 'FREES �I \ NQ �QV 2 c 0 2. 1 ' C,33. CS 6o\c ) LOCUS AREA IS COMPRISED OF CONSULTANT x 35.6 x 36.2 x 3 �, -- - - \ \ �E) \ # 1964 \c ASSESSOR'S MAP 118 PARCEL 119-001 '' 2. •11• \x 7.8 / \ \ LAND COURT PLAN 15MW (PENDING) w--- -\- ' ' ''MAP 118 PAR�EL.� 119-001 , ' ' w\\'� MAIL BOXES X U \c \ REGISTRY OF DEEDS)PENDING - DECREE PLAN NOT - COPY OF PLlITIONERS PLAN OBTAINED FROM x REPIrACE E70S1MG r ,/ .' cb CMG }7;385 S.F. 37.8/ ( NEW LEACHING CHAM9ERS �' 1 '/ IGHT c \ x 3�.4 ` 2.0 AC. f (SEE DETALS) �` 3 G \ c CERTIFIC/ITE OF 1TiLE: 179750 ' ! .'' x 37.3 , X 35Y�' ,' ----- ' .'' x 38.6 �' x 38.5 UP/LP 112/7c e ry \ HOMESTEAD PROPERTIES, INC. PREPARED FOR : s 1/ ` .4 - v� APPLICANT C.H. NEWTOIN BUILDERS, INC. �T► / i' / 48.8\ ELEC. BOX ` ` �N 38.7 919 MAIN STREET OSTERVILL.E; MA o2s55 C.H. NEWTON BUILDERS, INC. 2 x`37 , \\ / / 39.1 3. PROJECT BEIYCHMAItK: As SHOWN ON THIS PLAN 819 MAIN STREET ,- 37.75 �GB) D�e6x NEW VENT / )x 35._ .52__x-33,6 38.4 _ F---____ -- OSTERVILLE, MA 02655 2 �!' 9 i X 38•0 VENT PI TREES 'P39.0 4•) ZONING INFORMATION o � �' x 7.4 37.31-00 x � 3 ��-� \ �' ---- PAVEDZONING DISTRICT : RF-1 and RC (ReskknW) ' / DRIVEWAY W/ STON VIER, D-BOX � 0 9.1 �� x 33.5 ' r LANDSCAPE �r , \Jw /r, rr EXP06ED AOGREGAiE CONdaETE ' / � 0 1\ x .' ^`; ypFF/�Q x 39.2 03 d• EASEMENT CURRENT MINIMUM ZONING REQUIREMENTS (RF-1): ! 34.2 / r \ 37.5 ,� 3 2 CE �c�� IG I G' `' Qom' `L' MIN. LOT AREA - 87,120 IF. i O qC � Y 5 , 1 ' v , , 37.9 M c / o ce SKETCH NA7H 2. i 1 y �`" / i `\ -X S\ rR `y '��` 39. �� la ( R7IFlCATE ,179750 MIN. LOT FRONTAGE = 20' \ x 1 ��P / \\ 8 F 9� \ 3 ! 3�.7 W3• MIN. LOT WIDTH = 125' 4i 3&4 8 y� x / Q FRONT YARD 30 SIDE & REAR YARD - 15 15 \ i ' 35.1 \\ X,;3 3 EPT1C TA. \ ) I \ i 33.7 t x 34.2 I / ��' \ t x 7 1 \ 11 7 3&7x s.s / o OVERLAY �: RPOD, MVP AND ZOC SALTWATER ESTLAARIES Z 38.4 5n' Cq�,OSG 133.3 33.7 ' o 37.72 PGA L-c1 38.9 0 3 .0 \\ x 36 9.7 5.) A TALE SEARCH HAS NOT 8Ea1 FOR THIS SITE E DElFJ7MIED ; 2.6 x3 4.5 w w 3 s.1 may\ i GPR 0 po 70 BE NECESSARY, A TIRE SFJI ! ,,_8E PERFORMED BY OTHERS { • m �4.0 ' 122.3' r, �p0 1�6 _ 5� 88C 1 CgNDSCr4AED 38.7 �� �3 ' \i s- S DOS111VG SEPTIC' TANK _ w x�\ 1/2 w PLC 6,) THE PROPER Y LINE IIE0RMA110N SI10MM S BASED ON CURRENT AVANABLE RECORD IWORAN710N i ' TO REMAIN F.F.E.=4'1.0'� >> �o TREES _ OON.SIS MSG OF PLANS AND DEEDS. ri 133.3 I PICKET�,ENCE r' i Ntk� I 6 o C \ \ 0 THE DOS W FEARIRES SHOWN HEREON WERE OBTAINED FROM AN ON 7HE GROM FED 3 2.8 ,' •� A/C\ 5.3, s 3 - SURVEY PERFORMED BY BAXTER NYE E�IGNEERNVG 8 SINZVEYING ON NOVEABER 10 11, 2011. GATE 1 1 r 8.g 5. t �32.9; '33.1 _ 2 STo#8j 5 ao.,' BIIIDIrG AND OFFSET DIMOVSIONB SFIONIN ARE FROM 1RMl BQ,RI>5. VV .... D CCU WOOD ,% ' 7.) COMA(#W PANEL NUMBER: 250001 0016D 33.3/r 34.1 / ' ' I / � TP #2 ft, �� NG x / 40.2 THE FLOOD INSURANCE R47E MAP DEFINES THIS AREA AS ZONE C, A NON-HAZARD AREA ' © 'x � 33.0 , S5� ,� i \ F.F.E.=39.8' x % r x 35.2 1 I TP #, B 4 3 '1 4 r ,' 8. 1 ' -�' ^` , 1 �• .41 * PROPOSED y10d110N 'N' 8.3 F.F.E.=40.9' a to p ) C 1 \ ! r O �o10 / x 36.6 ' -- paREFN q ; , / o c � • SITE IS NOT WITHIN AN A.C.EC. (AREA OF CRITICAL ENVIRONMENTAL �). 0 m MIN. '� CM DEMOUSH DOSTNIG 9dlEEN RCH 20'0 i 40.6 "' N 0 • SITE IS NOT WITHIN AN AREA OF B MA70 HABTAT OF RARE WI.DL F'E PER � !' 36.3 .3 x 5 �� TP©3 ii PORCH AND REPLACNEW PORCH ���i WITH DECk 3 ,2 /��' 3 $ w Q NIESP MAP OCTOBER 1, 2010 'E5'i1MAlED HABITATS OF RATE WILDLME' .� MOMCRIRAI DF 1010)70 x 's / z FOR USE WITH THE MA WETLANDS PROTECTION ACT REGUUTIONS (310 CUR 10). ❑ ❑ pIGKtt •SITE DOES NOT CONTAIN A CEWO VERNAL. POOL. PER NFE'SP MAP OCTOBER 1, 2010 H Q' ;3.4 38.3 r EA�CE \ �` Q 'CERTIFED VERNAL. POOLS.' F- � O X 34.4 ! i I O ' ❑ ❑ / j i ^D Z a V W •.. E>osTING DE�lC TO REMAIN 3 ��` •SITE IS NOT WI1MN A PRIORITY HABITAT PER NHESP MAP OCTOBER 1, 2010 'PRIORITY UJ (� ` ' x 35.5 I r x 38!5 a° HABITATS OF RARE SPECIES' FOR SPECES UNDER THE MA<SACHUSETIS UAXWM x .9 cA , i �' � � x 37.5 ,/ x >' / v SPECES ACT, REGUU706 (321 CURIO). � h � ' __ _ 3 a w •SITE IS WITHIN A STATE APPROVED ZONE I QUM WATER RECHA M PR07ECRON AREA. a O I o ' TP _ ----_ / � x 37`6 ' G� o� � •SITE IS WIIFIMI A Z ---' __- __ �.� ,'3 ONE OF CONTRIBUTION 70 A SALTWATER ESTl1ARY (BARNSTABLE B.O.H. r j 37.4 T E REj p1N X\`---- '� �, 9.) UTM INFORMATION SHOWN HQtE1N: O x 38.4 i'� \ ''- 3 Chi ` --i ' 0 7HE CONTRACTOR SHALL CONTACT DIG SAFE (AT 1-8B6-DIG-SAFE) AND URITY COURANES TO LOCATE c a x�37.0 3 , , a O t n • ,' 1• / °� �, o ALL DOSM UTILITIES, AT LEAST 72 HOURS PRIOR 70 THE START OF CONS7RUC71ON. THE LOCATION OF - i I 5 Ap ' ' �' >*41.2 ', m DPI W LINDERGRO M 0FRASTRUCI Ar& U11L.I TES, CONDIATS AND LNES ARE SHOWN IN AN APPROXIN ATE o c� x 34.2 �� 1x 36.1 r �2 PRpMq , 39.7 , �, WAY ONLY, MAY NOT BE LN,NIED TO THOSE SHOWN HEREIN AND HAVE BEEN RESEARCHED BASED ON THE CO) ONC 1 ---_ i / , AVAN�IBLE U1ILJTY RECORDS`NOTED HEREON. THE OONIRACIOR AGREES TO BE FIAlY RESPONSBLE FOR 9 w ` �, '� ------ / ANY AND ALL QAMAGES WHICH tt IM BE OCCASIONED BY 1HE CONTRACTOR'S FAILURE 70 LOCATE S/YD IL o w PROJECT BENCHI ARK , AND UILRES EXACTLY. IF HELD CONDITIONS DIFFERS FROM PLAN MIFORMATtON, THE $ r' SPIKE SETS CONTRACTOR SHALL NOTIFY THE ENGINEER MNEDUTELY FOR POSSIBLE REDEMN. � EL=38.06 (NG�OD29) � � ' i� \ 1 w x 40.7 - ', • DOSTING SEPTIC SYSTEM INFORMATION OBTAINED FROM SEPTIC AS-BUILT PLAN PREPARED �' o TREES '� � BY STENBECIC & TAYLOR. INC., DATED MAY 25, 2005. w I �38.0 r ` . m 9.7 \\TV Batt- P'8SS;BL-Y BAN0MED) TOWN WATER SERVICE SHOWN ON THIS PUN FROM C-O-W WATER OEPARIM SKETCH 0-3M-N DATED 4/15/05. O x 37.4 ,rf Z 14 f RC • GAS FIELDULOCATED BY THIS OFFICE AND NATIONANE AND METER SHON ON PLAN IS A L SKETCH S02W OF � MARKINGS MNFIlCH WERE SHEET TITLE � � ro : / i i' `� a ` m ` • ELECTRIC LINE SHOWN ON THIS PLAN IS A COMBINATION OF FIELD LOCATED STRUCTURES AND Septic System & SKETCH PROVIDED�11N STAR WHICH STATES THAT LOCUS HOUSE IS FED UNDERGROUND FROM � � ^n 118/N 002 !� ' STOCKADE FENCE •33 41 F S Site Alterations Plan McCAR�EY -__ 118/119 8c CHRISTINE ' --- N/F , JOHN CORDON `AWRENCE M• & pAUUNE SHEET NO 0 L° 1 N 1 Ciso DATE : 1 24 2012 0 1 20 0 20 40 J SCALE IN FEET 1 SCALE : 1"= 20' c DRAWN/DESIGN BY: MTM CHECKED BY: WE N c JOB NO: 1 CADD FILE: 1 N BAXT'ER NYE 94 ENGINEERING & P" TYPICAL SYSTEM PROFILES z >NOT TO SURVEYING PROPOSED POOL GAZEBO Registered Professional Engineers and Land Surveyors 7. SET ALL MANHOLE COVERS TO WITHIN 6' OF FINISH GRADE. 78 North Street - 3rd Floor PROPOSED SLAB EL. = 37.9 EXISTING GRADE - 36.9f RISERS do COVERS SHALL BE WATERTIGHT Hyannis, Massachusetts 02601 N GRADE OVER TANK 36.8t �. �� Phone' - (508) 771-7502 Poo HOUSE WNW /-F GRADE » 36.3t Fax - (508) 771-7622 www.boxter-nye.com INV OUT - » 34.9 3r MIN. r .." 4' SCH 40 PVC F1 �F1MSH GRADE » 35.6 9 (min) Cover ,r 6' MM. 36" (max) Cover -f le MON.PVC - ,• FIRST 2• ('ro BE LEVEL) f-1 CONCRETE LE4C M CIWA1ER INV IN = 34.7 yNV ��•4 j STAMP STAMP PVC TEE (14- MIN.) ° r r GAS BARD 2. 4 SCH. 40 PVC 4 DUL PVC T '-h•�:-:,•�.,?='srr•.•�:�' 1 :aa a � REINFORCED �ONCREIE 14' t 6r CRUSfIED INV TIN = 34.21 6' SUMP ' �NV OUT=34.0 a'• . , o c1 o STONE EASE . .7.: -: _ �T� . f7.. � . t !"• 'J•'�- •P•• +!•+'r � 1.:.• • 11430M 12 •.v. • + � •••i •' :!~ 1.� y ~••• a. ` .1.•�.'y1.• r L 6' CRUSFIED ;Y4' - 190 LB- 31.8' 1500 GALLON SEPTIC TALC sTn1 BASE s' MIN 144DOLW SHED STONE ROTONDO ST5 x 10-15 OR EQUAL DIS 1 LITION BOX No Groundwater Observed O Elev. 25.9 CONSULTANT. UQUD DEPTH W SEPTIC TAN( DEPTH OF OUTUT TEE 811M FLOW UNE 4 FEBT 14 WM LEACHING CHAMBER (FLOW DIFFUSOR) 5 FEET 19 DiCFES 6 FEEr 24 kiCFES 7 FEET 29 DiCI£S 8 FEET 34 MiCFE'S CONSULTANT EXISTING HOUSE (PERMIT *2004-6361 PREPARED FOR : 45. � �F1NrsH c;RADE M �.7t 3sr (max) �� 1C.H. NEWTON BUILDERS, INC. PROPosEo FINISHED c�uoE OVER o►-Br»c = 3a1t . NE O U , IFIMM Qw or�rr w"" = no . 1 h12--i DING 919 MAIN STREET 4' DU. PVC r; •' .,,;..;c ;;Y` . . -� • -,,� •. OSTERVILLE, MA 02655 EXISTING-f EXISTING EXISTING , ' INV IN = 37.63 INV OUT-37.48 FIRST 2 IW=35.92 :, .•. + 0 0 0 0 EXISTING121 ; . • : ., INV. IN=34.3 12 =•.: •:.:-:.•• '• i �.. _: •, `!• .:- .:..'::' •• -•' EXISTING-� INV=33.92 r = ;t �' r: ••• .; ; .•} INV IN 37.0 ��j �IyOIJ�T=36.8 �� "f •• = :,.• EXISTING _ • ''• -Yr� _. - - INV IN=36.61 *DOUBLE - - 5 MIN EL 32.3' ..« ..,_•• - .'-`..' .•�., : ' •,,:..", DOUBLE EXIS'1'N6 LEACHNG EXISTING 1500 GALLON SEPTIC TANK NEW DISTRIBUTION BOX 1T0 BE FER ACED Wn LEACHM CHAN■s1 SHED STONE No caa,NOwATER OBSERVED o 25.9 (TO REMAIN) LEAC HM CHAMBER (FLOW DFFUSOR/H2O) PROPOSED RBR ACEWNT MANHOLE FLAME NO COVER TO UNDER PA�VDi1E M 4' 3GRACE oou�WASHED STONE WASHED 4.0' t•> 3 4 -1.5" WASHED STONE. '..4.0': / ,• 4' 4' '. ,, 2' CoOto 4 12 12 - 0 5 AMBERS 0 4.0 _ •• _ .' cc 1--=•� 12 }y y•� ., :•i. a:r i;r{ +. .•,-•.:�t r r_�.�,• �� •�. W 4 i•£:• r•..f...f • •1� :.•?•,r i• �• U- r_. r.. 4.6 - .. . . . .. •r• r .=7. :'$.. s t.•L�•f;',��5`L a••!. ;t+ :e 'i.:�.i xi.�•.':;•' J �r : ••r v - •,'4::,ai•K Y'i:•,}' ;.Y:' L.:: ..�M•• •a?.:4 a'.. •' ' l•� V�/I�V•fR/V NOTES' F- 16) EFFECTIVE DEPTH ..•.•�.:_y;:�r:is J. . S i .. .'~••�•!••L:t.+:Y'«+!�• :.. .r'.•a. s,+' `}sa^y•:•r:..,;i•�^_..i•.••: - i� •5•.• +.� ,r,"'• i, !; r. :+`%•:.mot+1 f '� .* f.t. CL ..� ...•-:fir•i.-v.fi•.�;,�•� •t. •} �:4t" ++ti,ai: .ft..•. _ "r 12 48.0' ;ac:}•;r't: •`.i �:P°1•:, +�•�'!'!,'.,11!a>t�.'•+.�:: � i:yf'i'Fo.Jr t��;H ti.':�•,:.y•jf_•„J,+` l,�,Y•:: 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH � m f 4' 4', 4' TITLE V OF THE STATE SANITARY CODE DATED APRIL 21, 2006, AS O PLLM OF SOL ABSORPTION SYSTEM IHOUSEI AMENDED THROUGH THE DATE OF THIS PLAN, & ANY LOCAL RULES & w PLAN OF REGULATIONS APPUCABLE. FLOW DIFFUSOR CHAMBERS OW) CONCRETE LEACHING CHAI[BER DETAII, cc 0 ~ PRECAST LEACHING CHAMBER scALE (FLOW DIFFUSOR) 2. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY THE a 00 Q Pool GAZEBO FOR POOL GAZEBO & HOUSE REPLACEMENT` fro BE H2O UNITS) ENGINEER. ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT (FLOW DIFFUSORS) No SCALE WRITTEN PRIOR APPROVAL BY THE ENGINEER. NO SCALE SOL LOGS DATE • V3/2012 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILUNG, NOTIFY o P-1$,662 BARNSTABLE THE BOARD OF HEALTH AGENT AND ENGINEER FOR INSPECTION. W 0 SOIL EVALUATOR: BOARD OF HEALTH AGENT: a 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4' SCHED 40 PVC. c, � STEVE MATSON, P.E. DOWD DESMARAIS, R.S. UNLESS OTHERWISE NOTED HEREIN. LEACHING AREA REQUESTS TEST PIT 1 TEST PIT 2 TEST PIT 3 TEST PIT 4 co 5. EXCAVATE INSURABLE MATERIAL AS NOTED, TO THE 'C HORIZON" , FOR u, NITROGEN LOADING LIMITATION: TOWN ORDINANCE - WASTEWATER DISCHARGE PROPOSED SLAB AT POOL GAZEBO 37•9 G.S.E. = 37.8f ' G.S.E. = 36.8f G.S.E = 36.9t G.S.E. = 36.2t • A HORIZ. DISTANCE OF 5 SURROUNDING THE LEACHING FIELD, AND 5 ALLOWABLE FLOW; 2.00 ACRES x 330 GPD/ACRE = 660 GPO (6 BEDROOMS) SEWER INVERT AT POOL GAZEBO 34•9 REPLACE WITH CLEAN SAND PER 310 CMR 15.255 TO THE TOP ELEVATION SEWER INVERT INTO SEPTIC TANK 34.7 OF THE SAS. N W HOUSE = 5 BEDROOMS (EXISTING: PERMR 0004-536) SEWER INVERT OUT OF SEPTIC TANK 34.4 POOL GAZEBO = 1 BEDROOM (PROPOSED) SEM INVERT INTO DISTRIBUTION BOX 34•2 6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN o TOTAL 6 BEDROOMS •0 Ap 1OYR 5/2 ; SANDY LOAM Ap IOYR 5/2 ; SANDY LOAM Ap ; IOYR 5/2 SANDY LOAM Ap ; IOYR 5/2 ; SANDY LOAM 3' OF COVER. SEWER INVERT INTO SAS 133.8_____j to POOL GAZEBO: 1 BEDROOM HOUSE 5 BEDROOMS BOTTOM OF SAS. 31.8 8• FRIABLE Be FRIABLE 12" FRIABLE 8' FRIABLE 7. THE SEPTIC SYSTEM DESIGN DOES NOT INCLUDE GARBAGE GRINDER. O x 11• GM/BEDROOM x 110 GPD f BEDROOM NO GROUNDWATER OBSERVED TO ELEVATION 25.9 TOTAL DESIGN FLOW = 110 GPD TOTAL DESIGN FLOW = 550 GPD g NO GARBAGE GRINDER (NO GARBAGE GRINDER) B ; 10YR 6/4 ; LOAMY SAND B ; 10YR 6/4 ; LOAMY SAND B ; 10YR 6/4 ; LOAMY SAND B ; 10YR 6/4 ; LOAMY SAND 8• CAUTION: THE CONTRACTOR SHALL CONTACT DIG SAFE (AT ( ) 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE ALL EXISTING SHEET TITLE 28" FRWeLE 20' FRIABLE 30' FRIABLE 28" FRIABLE UTILITIES, AT LEAST 72 HOURS BEFORE THE START OF CONSTRUCTION. THE Septic Detail Sheet PERC RATE = S, MIN. / INCH (CLASS 1) 550 GPD/ 0.74 GPD/S.F. = 744 S.F. CONTRACTOR SHALL DETERMINE THE EXACT LOCATION, BOTH HORIZONTALLY LIAR = 0.74 GPD/S.F C IOYR 7/6 ; MED. FINE FILL; IOYR 5/2 ; SANDY LOAM FILL; IOYR 5/2 ; SANDY LOAM C ; IOYR 7/6 ; MED. FINE AND VERTICALLY, OF ALL EXISTING UTILITIES BEFORE THE START OF ANY 17iMIN. LEACHING AREA OF SAS. REQUIRED: SAND SAND WORK. THE LOCATION OF EXISTING UNDERGROUND UTILITIES ARE SHOWN IN en 110 GPD/ 0.74 GPD/S.F = 149 S.F. MIN. 120' LOOSE 72' FRIABLE 60' FRIABLE 1200 LOOSE AN APPROXIMATE WAY ONLY, MAY NOT BE LIMITED TO THOSE SHOWN o HEREON AND HAVE NOT BEEN INDEPENDENTLY VERIFIED BY THE OWNER OR PROPOSED SYSTEM: ONE FLOW DIFFUSOR WITH SIDEWALL AREA: (12' + 48)2 x 2' DEPTH = 240 SF C IOYR 7/6 ; MED. FINE C ; IOYR 7/6 ; MED. 'FINE ITS REPRESENTATIVE. THE CONTRACTOR AGREES TO BE FULLY SHEET NO a, 1' STONE UNDERNEATH (2' EFFECTIVE DEPTH) BOTTOM AREA; (12' x 48,) 576 SF SAND 1 SAND RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED a H 4' STONE ON ALL SIDES TOTAL EFFECTIVE LEACHING AREA = 816 SF FOR HOUSE �� YM WIT PERC • 44' 120' LOOSE 132' LOOSE PERC 9 67 BY THE CONTRACTOR'S FAILURE TO LOCATE THE UTILITIES EXACTLY. IF SIDEWALL AREA 12' + 16')2 x 2' DEPTH 112 SF FINISHED FLOOR ELEVAWN EXISTING 41.0 ELEVATION INFORMATION DIFFERS FROM PLAN INFORMATION, THE ■ = 112 SF 816 S.F. x 0 74 = 603 GPD SEWER INVERT AT FOUNDATION EXISTING 37.9 CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE 1-4 BOTTOM AREA (12 x 16') 37 63 NO WATER OBSERVED NO WATER OBSERVED NO WATER OBSERVED NO WATER OBSERVED REDESIGN. AT UTIUTY CROSSINGS, VERIFY IN FIELD THE LOCATION / DATE : 1 24 2012 N TOTAL EFFECTIVE LEACHING AREA = 304 SF SEWER INVERT INTO SEPTIC TANK EXISTING SEWER INVERT Out OF SEPTIC TANK EXISTING 37.48 ® EL 27.8 ® EL 26.8 A EL 25.9 O EL 26.2 INVERTS OF ELECTRIC, GAS, TELEPHONE & DATA/COMM AND RELOCATE IF 20 0 20 40 SEWER INVERT INTO BOX PROPOSED 37.0 CONFUCTING WITH PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE CL 304 S.F. x 0.74 = 224 GPD pb CONTRACTOR SHALL PRESERVE ALL UNDERGROUND UTILITIES AS REQUIRED. SEM INVERT OUT OF DISTROLMN BOX ftfflm) 36.$ I CERTIFY THAT ON I HAVE PASSED THE SOIL EVALUATOR EXAMINATION _ SEWER INVERT INTO SAS PROPOSED 34.3 AFP ANA�WAS THE BY t�lE MENTALNT WITH REQUIRED D THAT THE ABOVE SCALE IN FEET o SEPTIC TANK SIZING: 110 GPD x 200% - 220 GAL BOTTOM OF SAS. PROPOSED 32.3 Iwo EXPERT BED nr 310 CIrfR 15.017 9. THE PROPOSED UTILITY CONNECTIONS SHOWN HEREON ARE SCHEMATIC. SCALE :A L E: 1 20' USE 1500 GALLON SEPTIC TANK FINAL LAYOUT SHALL BE AS DETERMINED BY THE APPROPRIATE UTILITY DRAWN/DESIGN BY: CHECKED BY: NO GROUNDWATER OBSERVED TO ELEVATION 25.9 SK;#IA7URE '' DATE ``� 12 -2 �Z COMPANY. o JOB NO: 11 CADD FILE: . 11 0 i 0 a 39.0t PfzOViDE ACCESS TO WITHIN 6" OF FINAL GRADE ALL PIPING TO BE 4" ,DI& SCHEDULE 40 PVC UNLESS NOTED ZONING o c ZONE: RF-1 � o 40.00 39.Oy 39.Ot 39.Ot 37.0 MINIMUM YARD SETBACKS: � � o FRONT. S1DE:15' REAR:15' �--i � 1:3 � ,� o GRADE TO DRAIN c,x � o � a,�, 4z sEAPurr RD DESIGN CRITERIA a.m �O.OL l�rtll J 5-�-0.01 MIN O 2 10' MIN. , Q .. ._ .d THE LEACHING SYSTEM SHOVE N ON THIS PLAN HAS BEEN DESIGNED z ++ -� 24LEACHING TRENCH `�' IN ACCORDANCE WITH THE MASSACHUSETTS STATE ENVIRONMENTAL �� � w 0 10 MIN. INLE TEE ,,, CRUSHED STONE CODE � 310 ChI 15.00 - TITLE 5 AND LOCAL BOARD OF HEALTH ZABEL FILTER 36.43 36.22 0 RULES AND REGULATION N✓ITH EXCEPTIONS, IF ANY, APPROVED BY ON SUPPORT S 36.00 THE Ft:*n'.ffT GRANTING AUTHORITY. �' a 36.26 �'i LOCUS FLOW COMPUTA TIONS �".+ � t N Cc a. 34.00 LOCUS MAP 1• BU'!LDING USE: SINGLE FAMILY. W o, oN„ PROVIDE 2. ���'' OF BEDROOMS: 5 cla �, TANK W1TH577IREE COVERS SEPTIC 6' CRUSHED STONE PROFILE ESHGW NO WATER TO EL 28.6 TP-202 3. DESIGN NO. OF PEOPLE: 10 !�,A �; r 5 OUTLET D-BOX NOT TO SCALE - 4. DESIGN FLOW. 550 GPD ; °? 5. TCTAL DAILY FLOW. 550 GPD 6. G✓RRAGE GRINDER: NO o t f s' V,y. E , _ - - R SEPTIC TANK CAPACITY � ® REMOVE ALL UNSUITABLE MATERIAL FROM EXIS77NG GRADE (EL. I�I ICI I ( 35- S I I i 1=11 11T E KEY PLAN 39.8) TO THE BOTTOM OF THE B HORIZON (EL. 36.4) AND E S 200 DAILY DESIGN FLO'N - _� �" ' "mot E ' 2 x 550 GPD = 1100 GALLONS " vvv vvvv . vvvv' -vvv v 72 eACKFlLL WITH CLEAN GRANULAR COMPACTED FILL TO EL. 12.5 IN � R °� USE 1500 GALLON SEPTIC TANK (TITLE 5 MINIMUM) � k vvv vvvv 5 vvv vvvv R +-• ACCORDANCE WITH 310 CUR 15.255. impFILL vvvv vvvv V vvvv vvv° vvvvvvvvvv E vvvvvvvvvv V �"�+{ '•-+ ��//►� �/ + �/►� vvvvvvvvvv vvvvvvvvvv E 7 11N 1. � EXCAVATION VOLUME � 2/Ot CU• !I.JS• O O O O O O O O O O r A O O O O O O O O O O � f I1 $ !• . ' PEASTONE ,°°,vvvv°° ,°°°°°°°vv SOIL ABSORPTION SYSTEM �/1 c r vvvvvvvvvv 24 vvvvvvvvvv A 41 PERCFILL VOLUME = 45t CU. YDS. vvvvvvvvvv, R vvvvvvvvvv (ADJ. FOR 15X COMPACTION) 3/4" - 1 1/2" °°°°°°°°°° E °°v°v v v v v v R 1. Dt+E��1GNr� PcE�RCOLATION RATE:-2 Min/ln. vvvvvvvvvv vvvvvvvvvv E 2. Strom CLASS: I vvvvvvvvvv vvvv vvvvvv is / NOTE-CONTRACTOR TO VERIFY PRIOR TO CONSTRUCTION. DOUBLE WASHED STONE o°a o 0 0 0 0° A v v v v v v v v v A o ©, �. Q _ ; . FREE OF FINES AND SILT 3. LCP�/v TERM ACCEPTANCE RATE (LTAR):, 0.74 GPD/SF j �! 4. TOr�IL AREA REQUIRED LOCAL CODE. 744 Sq.Ft. �9 �' �� IC 4' 12' 4' 5. TI AREA REQUIRED - TITLE 5: 744 Sq.Ft. ' 3 6. LEA;RING SYSTEM USED: LEACHING TRENCHES v BENCH.V4RK-A.lAG NAIL LOCATED EXISTING ~``' �3 ON NORTH SIDE OF SEAPUrr RD. 7. TO'-AL LEACHING AREA PROPOSED 752 SF , c .� 'v DRIVEWAY I s� . EL-35.10 8. TO"AL ALLOWABLE FLOW 556 �, q u' D-BOX �.�`= £ CROSS SECTION 'A''ER LEVEL: NO WATER TO EL. 29.0 TP-1 Z 1500 GAL NOT TO SCALE 9. 4'� o SEPTIC TANK Ab=2 TRENCHES x (4 FT' x 45 FT)=360 SFci �. Q M c �•! 31. J As=2 TRENCHES x 2 FT(4 FT+45 FII FT+45 FT)=392 SF Q v Crt �I 7 k O At=75' SF • Cri I 2-4'X45' SCHEDULE OF ELEVATIONS rr r LEACHINGcoo S ` TRENCHES PROPOSED AS-BUILT ° MI 40.00 9. TOP OF FOUNDATIONC ti ��o p 2 .g' 136.4' ''� A l� 00 32.50 '`u '� a .. �, EASEMENT � FLOW,.,: GARAGE FLOOR PROPOSED . '� INVERT AT FOUNDATION 37.39t °� PROPOSED - SEPTIC TANK - INLET 5 BEDROOM DRIVEWAY Q� /'p � -. OUTLET 36.94 1 W• ' , 61D-BOX - INLET 36.43 �� OUTLET 36.26 z s.9, , PIP INV, - BEG. OF SYSTEM 36.22 ,.. o Lot 17 ^N 3 � �a<5 j �I 87495 Sq.Ft. S� BOTTOM OF TRENCHES 34.DD n �w;� � N t 2.00 Acres O D O X '19 , WATER LEVEL NO WATER TO EL 28.6 TP-202 00 co N / �, 58 0 3 9. 0 C� 1 Q ,1 5 0 0 GAL "' -� ( CONSTR UC TIO N NO - /� 1 ;. SEPTJC TALK /' o �' 31 , C_ _� ;, a 1. CONSTIL'CT SEWAGE SYSTEM AS DESIGNED IN ACCORDANCE I 7 � �.` WITH THE STATE ENVIRONMENTAL CODE - TITLE 5 AND THE TO BE DEMOLISHED � / '�..,` I frzdl�0 RULES AND REGULATIONS OF THE LOCAL BOARD OF HEALTH. < / r / 2. THE SEPTIC TANK SHALL BE PROVIDED WITH PROPER INLET AND a ` C C1 2 - 4 �X45 OUTLET TEES. THE INLET TEE SHALL EXTEND A MIN1MUll OF A 10 0 » Gorage� 9 18 G 0 INCHES BELOW THE OUTLET FLOWLINE. THE OUTLET TEE SHALL a 51 E 8 LEACHING CONSIST OF A ZABEL FILTER MODEL A 100 OR APPROVED � ` � . ., � ��`V :..� EQUAL.0 � '-,Dec _ 2• �, 3 TRENCHEc ca O �'' 3. PROPOSED GRADING SHALL NOT CREATE A NUISANCE OR Z tn o o ADDITIONAL FLOW ONTO THE STREET OR ABUTTING PROPERTIES. W ✓� MIN .� 39. 0 o 2 ,9 ' -� Lot 18 Existing Cp �,� PO INSPECTION NOTES 248110 Sq.Ft. House eck CiLJ IT IS T'HE RESPONSIBILITY OF THE INSTALLING CONTRACTOR TO o 0 4 S.69 Acres NOTIFY THE LOCAL BOARD OF HEALTH AND THE DESIGN 7 Deck ENGINEER TO CONDUCT THE FOLLOWING CONSTRUCTION a PROPOSED INSPECTIDNS: PROPOSED N „ _ , \ 5 B ED R C�O M D R 1 V E WA Y 1. EXCAVAT;ON AND BOTTOM OF SYSTEM PRIOR TO SYSTEM SCALE 1 .0 INSTALLATION. 0 20 40 80 9 20 160 2. SYSTEM COMPONENTS INCLUDING INVERT ELEVATIONS PRIOR TO 1L DATA E WAIVERS /� �`` eACK FI[.ulvG SYSTEM. SD LOCAL COD SCALE 1 r 4' /"O LOCAL �C/�j/ 3. FINAL GPADI NG. � L L TITLE v � >P-2o1 REOULATION � REED PROPOSM o• 0.8 >P-2o2 GENERAL NOTES 39.4 _ o' .5 NONE Lot . 1�` '`1tL,,• <°.'t 3�•o y: �`��` 39. � 1. THE LOT IS LOCATED IN ,FLOOD ZONE C Q Rd:R 1D 38.� Loamy Sand R i-R LOCAL UPGRADE PROVISIONS , r � ,r,y Sand LOCAL TITLE y �4- AS ;SHOWN ON F.l.R.M. MAP 250001 0018 D � � � 11 3 7 1 36.4 F i!&�I BE II�E� RM IRED PROPOSER 8 jr 95 Sq.Ft, DATE�� DULY 2, 1992. ►C� 480 P.R.--2lVw.11H. 48r 4 NONE > �" `•� ''� ►--� 6t<• •3 Pam'--2 rr./r+►. Acres 2. THERE APE NO SURFACE WATER SUPPLY OR GRAVEL PACKED r c-m Sand 66 9 MA DEP VARIANCES00 WELLS I�'ITHIN 400', NO TUBULAR PUBLIC IVELLS WITHIN 250' c-m Sand AND PIO PRIVATE POTABLE WELLS WITHIN 150' OF THE � S' LOCAL REGULATION Brauim TITLE pROP'OSER PROPOSED SANITARY SEW.�AGE DISPOSAL SYSTEM. NONE f. 3. EXCEPT AS NOTED ON PLAN ABUTTER SEWAGE DISPOSAL / 40 SYSTEIa�S COULD NOT BE LOCATED. � 130' Bottom 29.0 / ----- r 130r 28.6 / ►.-a v 1 No Water to 130 Bottom 4. CHANGES TO EFFLUENT FLOW, GRADING OR LANDSCAPING Q No Woter to 130 EITHEP ON-SITE OR ADJACENT TO THE SITE OR FAILING TO Q Q S0.'L OEt?L�ATiC??`I HOLM Contractors are to PROPERLY INSPECT OR PUMP THE SEPTIC TANK MAY EFFECT SITE �-EM.122. 2O4 BID AND WORK FROM THE PROPER FUNCTIONING OF THE LEACHING SYSTEM. EXCAVATM VY: a4V1D P/ ALLWIM Evr�cua�,rm Br: tz1;�r,CE chAsE PEs?rsE-sr�r; r rAYL ►a BOARD OF HEALTH �, ► M1 1-c �M BY a,&M SrANT&l-DEP.tFWlW OF" REGULATOR?' SSRIVICES "' SCALE 1 - 2O APPROVED PLANS ONLY .5. THE O'NIIER SHALL INSPECT AND PUMP -THE SEPTIC TANK ' ANNUALLY. S IS LOCATED IN A WELLHEAD PROTECTION Job No. 6630 � o 10 .-'- .20 pro 6o €o s' THE LOCO N OVERLAY DISTRICT. Job No. 6630 Q