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HomeMy WebLinkAbout0149 SEAPUIT ROAD - Health -149 Sea.ruit Road Osterville A= 095 013 005 \ 1 0 4 1 { 5 M EAD No.2-153LGN UPC 12134 tiAsMM aw iT No. -------------- Fee---- -------- BOARD OF HEALTH TOWN OF BARNSTABLE Application-for Well Construction-permit Applii,cation is hereby, a4e for ergiit to Construct '), Alter ( ), or Re air ( )an individual Well at: Location — Address Assessors p and Parcel f/ Owner , Address Installer — Driller Address Type of Building Dwelling Other - Type of Building—= --____—_____ No. of Persons--- -.---_-.._____—_—____. Type of Well �� _. �� Capacity----_-- _— Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certi ' to .o ce has been issued by the Board of Health. Signed 'n date Application Approved By ' ,,�` J_�_ date Application Disapproved for the following reasons: date Permit No. Issue d- ---- ------�---�---� — _----_____----------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CE TIFY, ThaIt the Individual Well Constructed (�Altered ( ), or Repaired ( ) � c� 14-�. Installer .._4.y0Uj t , le(:� at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -----__________Dated------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE __ ____ _ - — Inspector-------------------------_____—__�.---____-- "a. 04 No. -------------- Fee----q.5--- BOARD OF HEALTH TOWN OF BARNSTABLE ZippIicat ion JbrWell Co 0ructionAermit ApplJ'cation is hereby Viade fora ezit to Construct ')_, Alter ( ), or Re air ( )an individual Well at: Location — Address Assessors Map and Parcel ---- ��� Address ress O ---'— ' — - Installer Driller Address Type of Building Dwelling --__-- -- -- - --- — i Other - Type of Building-=--__—__—_______ No. of Persons--- _.—____ Type of Well---��=� ______ Ca acit - Purpose of Well----�----_ !y""-' -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to lace the well in operation until a Certif'c to Wof P P �nce has been issued by the Board of Health. rSigned - y ----------- " t7'�/— It' -- I' date Application Approved By r ` 1 —! - date Application Disapproved for the following reasons: date Permit No. ( J 66`7 --- Issued----��- _------- date ------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS,p CE TIFY,?T4t the Individ al Well Constructed (/-f Altered ( ), or Repaired ( ) � Installer at_ __ V!_-L SC'f1 Ur 2 has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. _—_—_____—____Dated----..--------------. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE ---- --— - Inspector---------- -------__ -_-- ----------------- BOARD OF HEALTH _ TOWN OF BARNSTABLE Yell CongtructionAermit Fee- ` Permission is hereby granted to Construct (Alter ( ), or Re air ( ) a In Well at: No. 5' _ SP . Street as shown on the application for a Well Construction Permit 01 No.-- (2 _--___ Dated---- -____--.----7-__------------------------------- DATE �� -- Board of Health a FROM :RJ Bevilacqua Construction FAX NO. :508-833-6359 Apr. 13 2006 01:40PM P1 04/13/2006 10:40 FAX 508 233 6700 COASTAL ENGINEERING 11001 FROM :RJ 8evilacqua Congtructicr+ rAx No. :308-833-6359 Apr. 13 =6 08:10AM P1 ATr. PAJL RECEIVED , APR 13 2006 Town of Barnstable gUktory Serview NMI Engineering Co.,Inc. l Thomm 1f.Genert Director Public Health Diva OU Them=McKean,Director 200 Xgn Stl&t.$ym2h,MA 02601 pint; so&790.6304 . pipe; �-aBZ46Ad 'lneealla D,asiaasr Ceti do�arffi Date: ►3 6 ` 1 > nc Nat rt J ' cat) . D� Aderua: f16 0 ,adding: ��x on a was imamd a pe mlt to inSW a —rTary - o�ryt ll a , qwt,c mum a: qS o based on a fl dsa drawn by c Sg rra fit' 4tt) --- I Q tiue �pda wyaDaai d abed was �m 'dwal reiocati o�the �^ ���bax MUSH tank• I to approved a M i I o.ft that*a system:o Ged above wa0 iasfalled Whh major cb=9= (i.o. �oa�than t -,Idgml rolocedw of&a SAS or ate►vetrtiral ielocaoa of aoy oomopon� at 1Le ptic bat In accordance with 8tats dL lAm w] Regntsdona. Plan mvik6n or se Y =dasi�to fouaw. SN OF a Cw0. 1�.4�tss roMlll, e e� G�� TS D "AY113 It WPM Cr Hesl�f Ea/A Q Ctedlbsdaa 04/13/2008 7-TU 09:12 [TX/R1 NO 63.17] 14001 --�" TOWN O�F BM, NSTABLE ��S_3 7 YWtAnON / y 9 Sea �f ` O O a SEWAGE # 7 VILLAGE O S U ►Il ASSESSOR'S MAP & LOT 5 " f 3,QOS INSTALLER'S NAME&PHONE NO. -1 4262 I aC (wn ru on SEPTIC TANK CAPACITY p9LOS�o LEACHING FACILITY: (type) sa (size) S"3 X200 NO.OF BEDROOMS 1 BUILDER OR OWNER �1t4 + S) Ive of 56 O Cf A 4 PERMIT DATE: 2A0 OMPLIANCE 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 9000 9 14 a� f 06 y. � w q. 6,� 6 20,5 3 ! 6 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS N, 0[pprication for Mi5po5ar *pgtem Con5truction Permit Application for a Permit to Construct(J Re air( )Upgrade( )Abandon( ) El Complete System ❑Individual Components S u Location Address or Lot No. Z/ Owner's Name,Address and Tel.No. ��c t3s, �12y«c.� Assessor's Map/Parcel Installer's Name,Address,and Tel.No.'SO.?' 33 ' o Designer's Name,Address and Tel.No. �2 d2Co '4 Type of Building: Dwelling No.of Bedrooms Lot Size Z.o�5�. sq-€t-- Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7VY gallons per day. Calculated daily flow 7 7-t!!, gallons. Plan Date >3 2 � Number of sheets , Revision Date Title':�1r)_,_ Size of Septic Tank 2—es.:::58 Type of S.A.S. Description of Soil 14 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is ed b this Board of Healt t., Signed Date 10 -V Application Approved by =qM /2 Date :7 2 a—ar" Application Disapproved for the following reasons Permit No. :2 f — Date Issued- '7-- m &J ' No. �0 0S7t� �IO 'x.. % ;Fee 'R 1 1 4 THE COMMONWEALTH OF MASSACHUSETTS _ Entered in computer: i Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,, MASSACHUSETTS -C �0 rA (1m" ppYicatioft for Mioaal bpoter Corgtructtor Permit r c9 Application fora Permit to Construct(�/`Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Sn „ Location" /�Address or Lot No. ! IP" Zoo Owner's Name,Address and Tel.No. Assessor's Ma /Parcel ° 19. i Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. t / �.V, ��y/ dfS" �,,,.���r7r�+�^i�/�Y'' ��1►�-vf*,Rl-L � �'���^ �..�J J '�r's�� Type of Building: Dwelling No.of Bedrooms-. Lot Size ., 5 Jam. sq:. Garbage Grinder( ) Other Type of Building l; No. of Persons Showers( ) Cafeteria( ) Other Fixtures I ' Design Flow gallons per day. Calculated daily flow '� ��__- gallons. Plan Date / v�2 A51, Number of sheets Revision Date Title-2 T' ;d�4) 'P444-41_ Size of Septic Tank Type of S.A.S. L. ,E,I F-/ 0 Description of Soil L:A,4d2l " k \ Nature of Repairs or Alterations(Answer when applicable) t Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on=site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system nloperation until a Certifi- cate of Compliance has been issued by this Board of Health.... Signed (" "0, . 4- � _"'a ! / i Date y " ApplicatiodApproved by 3 ot/a% �S y Date _2 a- ar-' Application Disapproved for the following 'reasons Permit No. :2 u- L/G Date Issued ——— ——————————————— ..w4—————————————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS s Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed Repaired Upgraded( ) Abandoned( )by lej a i c.f mac1 i r at 1 Y n. U � 'Ve has been constructed in ac prdance� ` with the provision o itle 5 and the for Disposal System Construction Permit No. a LAv 6 ,dated Installer �1QN� l�Le Designer (,e?ct_A The issuance of this permit shall not a construed as a guarantee that the system wi1�1 f ction as designed. Date Inspector ( 1 f ———————/————————————————————————`——————— No. 9: U G S�.`� G, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLL MASSACHUSETTS Ii!6pognt bpgtem Construction Permit Permission is hereby granted to Construct(k)Repair( )Upgrade( )Abandon( ) System located atl14- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this,.permiC. Date:_ Approved by ( - Town of Barnstable Board of Health � A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. July 14, 2005 Mr. Roy E. Okurowski, P.E. Coastal Engineering Co. 260 Cranberry Highway Orleans,MA 02653 RE 149 Seapuit Road, 0"stervhe A 95-13.005 Dear Mr. Okurowski, You are granted permission, on behalf of your client, PVRJ,LLC c/o Floyd Silvia,to construct an onsite sewage disposal system designed to be connected to seven bedrooms at 149 Seapuit Road, Osterville. The septic system shall be constructed in accordance with the submitted plans dated June 15, 2005. Sinc e y your , Wayn Miller,M.D. Chai an BOARD OF HEALTH TOWN OF BARNSTABLE e Q:HEALTH/WPfbedrooms OASTAL NGINEERING - '•f ;�, T. `E OMPANY, INC. 0 N4 2 9 260 Cranberry Highway Orleans,MA 02653 Orleans 508.255.6511 Provincetown 508.487.9600 ■. Hyan'js 5,08._7.,78.-9.60.0 08.255.6700 ■ www.ceecapecod.com June 20,2005 C16536.00 Board of Health By Hand Delivery Barnstable Town Offices 200 Main St. Hyannis,MA 02601 Re: Board of Health Request Form Filing Package Proposed Approval of 7 Bedroom House PVRJ LLC,c/o Silvia& Silvia 149 Seapuit Rd. Osterville,MA Map 95 Parcel 13.005 On behalf of our client,PVRJ LLC,we are submitting an original plus 3 copies of a Board of Health Request Form Filing Package,for the above referenced project. The following items are enclosed: • Board of Health Request Form • Authorization for Representation Letter . • Plan entitled,A-1 "First Floor Plan",prepared by Silvia&Silvia Assoc. Inc.,dated 5111105 • Plan entitled,A-2"Second Floor Plan",prepared by Silvia&Silvia Assoc. Inc.,dated 5/17/05 • Plan entitled, SS-1 "Site& Sewage Disposal System Plan",prepared by Coastal Engineering Co.,Inc., dated 6/13/05 Please schedule this for the July 12,2005 public hearing. If you have any questions or require additional information,please give our office a call. Thank you. Sincerely, COASTAL ENGINEERING CO.,INC. Beth Hays Enclosures:As Stated cc: PVRJ LLC,c/o Floyd Silvia Roy E. Okurowski,P.E.,Coastal Engineering Co.,Inc. D:IDOCICI65001165361PermittngIBOHIBOHApp Transmittal Letter.doc ■Providing solutions for the benefit of our clients and community■ L%�^� f Psi s � IM s OpIKE tp DATE: 0-b 6 s' o� FEE: A04 BARN STABLE, MA88. REC. 'BY Town of Barnstable, -1 CHED. DATE: O Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. REQUEST FORM LOCATION Property Address: 149 Seapuit Rd., Osterville Assessor's Map and Parcel Number:Map 95 Parcel 13.005 Size of Lot: 2.37 Acres Wetlands Within 300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME:PVRJ, LLC c/o Floyd„Silvia Phone 508-420-0226 Ext. .101 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Same as Applicant Name: Roy E. Okurowski, P.E., Coastal Engineering Co. Inc. Address: PO Box 430, Osterville, MA 02655 Address: 260 Cranberry Hwy, Orleans, MA 02653 Phone: 508-420-0226 Ext.101 Phone: 508-255-6511 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) N/A N/A NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Approval of 7 Bedroom House X Checklist(to be completed by office staff-person receiving variance request application) X Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) X Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request _XI A Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) N/A _ Full menu submitted(for grease trap variance requests only) N/A Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) X --Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. C:\Documents and Settings\decollik\Local Settings\Temporary Internet Files\OLKFE\VARIREQ.DOC OASTAL NGINEERING OMPANY, INC. 260 Cranberry Highway Orleans,MA 02653 Orleans 508.255.6511 Provincetown 508.487.9600 ■ Hyannis 508.778.9600 ■ Fax 508.255.6700 www.ceccapecod.com June 2,2005 C16536.00 Board of Health Barnstable"o'wn Offices 200 Main St. Hyannis,MA 02601 Re: Authorization For Representation PVRJ LLC,c/o Silvia& Silvia 149 Seapuit Rd. Osterville,MA Map 95 Parcel 13.005 Dear Board Members: This is to notify your office that I hereby authorize Coastal Engineering to file and present plans on my behalf with the Barnstable Board of Health. Very truly yours, 000, Floyd Silvia for PVRJ LLC D:IDOCICI65001165361PermittingTOIPSilvia Rep Auth Ltr to BOH.doc ■Providing solutions for the benefit of our clients and community■ OASTAL NGINEERING a a , AT,IANSMITTAL A F, 10MIPANY, INC. 260 Cranberry Hwy.,Orleans,MA 02653 JUN 20 P141 2: f 508-255-6511 Fax:508-255-6760 www.ceccapecod.com To: Board of Health Date: t-IDMIWN Project No. C16536.00 Barnstable Town Offices .200 Main St. Via: ❑1st Class Mail[]Pick up ®Delivery❑Fed Ex Hyannis,MA 02601 Phone: Fax: Subject: Soil Suitability Assessment For No.of pages to follow: Sewage Disposal 149 Seapuit Rd. Osterville,MA Map 95 Parcel 13.005 - ❑ Plans ❑ Copy of Letter ❑ Specifications ® Other - We are sending the following items: Copies Date No. Description 1 6/l/05 Soil Suitability Assessment For Sewage Disposal These are transmitted as checked below: ❑for approval ®for your use ❑as requested ❑for review & comment ❑ Remarks: Enclosed please find the Soil Suitability Assessment For Sewage Disposal for the above referenced property. If you have any questions,or require any additional information,please give our office a call. cc: PVRJ, LLC c/o Floyd Silvia By: Roy E. Okurowski P.E. REO/beh D:IDOCIC165001165361PermittinglBOHlPerc Test Trans to BOH 6.20.05.doc NOTE: IF ENCLOSURES ARE NOT AS NOTED, PLEASE CONTACT US AT (508) 255-6511. Town of Barnstable P# l op'ta'� ' Department of Regulatory Services / n&nrterABra, Public Health Division Date 5 4 rbsy �� 200 Main Street,Hyannis MA 02601 EQ�t a Date Scheduled , Time t/V Fee Pd. Soil Suitability Assessment for Sewage Dis osal Performed By: A ay ���� V`� Witnessed By: a ' -.arq./ ,s LOCATION & GENERAL INFORMA Location Address Owner's Namey7p 0 V i //V— Address Assessor's Map/Parcel: ®� ��/ ` i Engineer's Name Ca \ �SIi1e•c ` NEW CONSTRUCTION REPAIR Telephone# Land Use e-51 / Slopes(%) �' Z Surface Stones �"p�1) Distances from: Open Water Body > zoo ft Possible Wet Area/ ZJO R Drinking Water Well ft Drainage Way /U'ft ft Property Line ZV R Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests locate wetlands to proximity to holes)_.-, 21 kµ;A 1001, o , o 0 / W, \o<c o 7 o \Lj ca MOO v�TM Parent material(geologic) C)USS^' t, Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping fhotn Pit Face l Estimated Seasonal High Groundwater � . z DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: f67 Depth Observed standing in obs.hole, in. Depth to soil mottles: in. Depth to weeping from side of na ob .hole: in, tJrnundwater dJustment `-- f� t Index Well#810 111 Reading Date: i l o� Index We11 level b Adj.factor ,-, Adj.droundwater Level l5 ZS - - PERCOLATION TEST Date I a 9tYtne SO Observation Observation Hole# Z Time at 9" Depth of Pere 6 Time at G' Start Pre-soak Time @ /Q IS J' Time(9"•6") End Pre-soak 11�'.10 I Lc 3 5�,1 0-N) owe `✓1 Rate Min./Inch �_ �Z- V.I\ `) � Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the, Barnstable Conservation Division at least one(1) week prior to beginning. Q:\S EPTIC\PERC FOR M.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. o i to vel A kto 165-cw'` CZso 5A " DEEP OBSERVATION HOLE LOG Hole# Z- Depth from Soil Horizon Soil Texture Soil Color Soil Other Mottlin Structure,Stones,Boulders. Surface(in.) (USDA) (Munsell) g C e % dAll SIZ,J. C - DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Mottlin (Structure,Stones.Boulders. Surface(in.) (USDA) (Munsell) g C i to c Oravell DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Mottlin (Structure,Stones.Boulders. Surface(in.) (USDA) (Munsell) g Co i ------------- 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 Naturally Occurrine Pervious Materlal Does at least four feet of naturally occuing pervious material exist in all areas observed throughout the rr area proposed for the soil absorption system? 25 If not,what is the depth of naturally occurring pervious material? -- Certification I certify that on ` '3 0 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date 6' " Q:\sE I'ICIPERCFORM.DOC r.r�sTiN6 Flov� Misr' Caf;�D� "i31�c t uo s" co4T P►4s+cAt -10 =ov�4Tie� 41i 1 � o� a Day P4aisr r 6 e J! Fl*4+so%► fig(ota GA�e F og leB efts 4AU w Sob M a e^. . �sasy7w� toF+Gato�.e .5��� r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED SEP 3 2002 TOWNO ABLE FTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 149 Seapuit Road Osterville, MA 02655 Owner's Name: Holbrook Davis Owner's Address: %... �..,e.......�. Date of Inspection: July 26 MAP 2002 PARCEL Name of Inspector: (Please Print) James M. Ford' LOT Company Name: James M. Ford Mailing Address: P.O. Box 49 Map: 095 Osterville,MA 02655-0049 Parcel: 013 Telephone Number: (508) 862-9400 Lot: 153 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that-the.information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs F her Evaluation by the Local Approving Authority ails Inspector's Signature: Date: July 30, 2002 The system inspector shall subm copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the. DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This'report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 r Page 2 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 y Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced-or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes,no or not determined(Y,N,ND) in the 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced. obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system (SAS)and-the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy cf the analysis must be attached to this form. 3. Other: i 3 Page 4 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 149 Seapuit Road Osterville, MI Owner: Holbrook Davis Date of Inspection: July 26, 2002 D. System Failure Criteria applicable to all systems: You must indicate either`yes"or"no"to each of the following for all inspections: r Yes No _ ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 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 I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or.more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. A E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead.Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat;or answered "yes" in Section D above the large system.has failed: The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 f Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions, depth of liquid, depth of sludge and depth of scum ? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example,.a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system (yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2001 - 76,000 gals.; 2000-84,000 gals. Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gnd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None on file-per treatment plant Was system pumped as part of the inspection (yes or no) No If yes, volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a.copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Approximately 1991 -per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 } Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 BUILDING SEWER(locate on site plan) Depth below grade: Approx. 28 Materials of construction: _cast iron ✓ 40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage, etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: Approx.,16" Material of construction: ✓ concrete _metal _fiberglass '- polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle: 27" Scum thickness: 10" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 6" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs of leakage. Recommend pumping. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: ' Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): i DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) J Property Address: 3149 Seapuit Road Osterville, MA Owner: Holbrook Davis Date of Inspection: July 26, 2002 r SOIL ABSORPTION SYSTEM(SAS): V (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits, number: 6'x 6'w/2'stone-per as built card leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number, dimensions: overflow cesspool;number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): The pit had approx. ]'of water on the bottom. The scum line was approx. 3'up from the bottom. There were no signs offailure. The bottom to grade was approx. 8. The cover was approx. 20"below grade. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 Seapuit Road Osterville, AM Owner: Holbrook Davis Date of Inspection: July 26, 2002 Map: 095 Parcel: 013 SKETCH OF SEWAGE DISPOSAL SYSTEM Lot: 153 Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I I GAr <__ !3 aa- ya 33 3 �o ' Y 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 149 Seapuit Road Osterville, AM Owner: Holbrook Davis Date of Inspection: July 26, 2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15' +/- feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within.150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: _The bottom of the leach pit to grade was approximately 8. Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 15'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system; the inspection and/or this report. 11 TOWN OF BARNSTABLE LGCT? N� � Peo SEWAGE #VILLAGE r �ASSESSOR'S MAP & LOT d Y-013 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �d I LEACHING FACILITY: (type) —S-,10 (size) AVell 3 cY NO. OF BEDROOMS oo BUILDER OR OWNER PERMITDATE: D' COMPLIANCE DATE: D U2 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 �. Lp 0) to, P OA aD I i l!/ CTOWN�F BA(�RNSTABLE L TI`OCAON ` l J-e V,1 I RJ - SEWAGE # VU.Lt GE o S71crV i ASSESSORS MAP & LOT 0' S Cll INSTALLER'S NAME& PHONE NO. SEPTIC TANK CAPACITY l UUU LEACHING FACILITY: (type) P,. e,X(? (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted,Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 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)—'('''r Feet Furnished by 7�1 wee ron -�• TO! r. GAr L Al- 3 A&- a9.(D a Qa- ya 'A3- 33 3 (33- g4y,(o r Aq 8LI- &0 Y No. 2 00-? — iY Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �,�✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migozal *pgtem Construction Permit Application for a Permit t one ct( )Repair( �rade( )Abandon( ) O Complete System O Individual Components ` Location Address or Lot V F 7- 2a-,J Owner's Name Address and Tel.No. l osrer✓, /fit, ® ( 6�-o0% /�aV t,S Assessor's Map/Parcel in99 1P i3•001 Installer's Name, ddress,and Tel.No. Designer's Name,Address and Tel.No. .?t Z— 14.Q_V�e�e &0 SrrvcTzO"-,) 3 br e0i e- DOad" c e t<1 Type of Building: Q Dwelling No.of Bedrooms�'� Lot Size 7 9j P�sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow _41YA gallons per day. Calculated daily flow gallons. Plan Date $ kt d L Number of sheets / Revision Date 'ter Title Size of Septic Tank Type of S.A.S. J &Q11an �1 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by this Board of Health. Signed Date 7 Application Approved by J 4j, AINL Date Application Disapproved for the following reasons Permit No. (71J a- 'L//S� Date Issued lEj ®2 No. d 0 '11,s `f4� k Fee -5 / ^ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ..r' Yes t PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYtcatton for ]Dtopool bpotem Congtructton Permit Application for a Permit toPCons ct( . )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components k,d� Location Address or Lot A W �/�i /2oa� Owner's Name Address and Tel.No. c.; pS/,-rv. Ile, Po 7,6/-ook pavt s Assessor's Map/Parcel f fn 95 /3.001 F / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 2 -�.c.k,ex how 1-70V0 y, rr +i. G dGdM C �+rt7 try/rI F Type of Building: Dwelling No.of Bedrooms 1 Lot Size 99/i-//sq.8. Garbage Grinder(M d Other,l Type of Building f No.of Persons Showers( ) Cafeteria( ) Other Fixtures >� Design Flow gallons per day. Calculated daily flowG� gallons. Plan Date g V O L Number of sheets / Revision Date Title Size of,Septic Tank Type of S.A.S.(q oa O 1lw- C p kr j - r' i Description of Soil seQ l I, Nature of Reps or Alterations(Answer when applicable) r- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- Cate of Compliance has been issue by this Board of Health. it Signed Date 5 )t 0 Z l Application Approved by ''I 4-14 V Datez- Application Disapproved for the following reasons t- Permit No. W Date Issued 17 012 ------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( )by e ic-e A,0 S4 at l see_ v !r 01C Ff#,K 114. has been constructed in accordance with the provisi s of�itle 5 and the for Disp sal System Construction Pe 't No. ae'"a "y�S dated��/'7�a�_. Installer Rt< cY �o.•.--d- DesignerNaLf" e44A - The issuance of s permit shall not be construed as a guarantee that the sy tern will unction desi ned. Date d LI I �" Inspector .> -- oo — —S_----- -------- ------- ————— -J No. Fee i THE COMMONWEALTH OF MASSACHUSETTS 8 PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mtzpooar *potent on!5tructton Permit Permission is herebyranted to Construct Re air Upgrade Abandon g ( ) P � Pg ( ) ( ) System located at l � ��- vt i� (�S t t✓v- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of t ' 5enmt� Date: t./a 2 Approved by I ` ` TOWN OF BARNSTABLE i ;,?+ - SEWAGE # LOCATI VILLAGE � L ASSESSOR'S MAP & LOT ����13 INSTALLER'S NAME.&PHONE NO. � �Y SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size)- NO. OF BEDROOMS BUILDER OR 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 Feet within 300 feet of leaching facility) 8 . Furnished by 8 6 • 1 V TOWN OF BARNSTABLE �C'C.k ION f y . J e A-y; ( SEWAGE # VILI,AGE r) S �f k d i I -( -ASSESSOR'S MAP &LOT QZ� -D INSTALLER'S NAME&PHONE NO. (R6U 0/7 j SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (;A (size) 6 )VQXo NO.OF BEDROOMS BUILDER OR OWNER C"m 14 A- Uhb( PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet ffVle hin f Feet Furnished by 1 � 5 o Pt p �1• / r a� . THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I m C(7- EL DATA TOWNPF BARNSTABLE LOC.A,..JIN ��` SEWAGE# VILLAGE O S-tr,�u i) L ASSESSOR'S MAP LOT INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) %Dn (sue) ,lam/n NO. OF BEDROOMS PRIVATE WELL OR BL WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No U< _.g .�, �� � . .� �y �� �� r �. ��' �1- �s �, ;� � _ f - pm J alJ + M FEs... Q r....._.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for DiiiVusal Works Tatuarurtiurt Frrutit Application is hereby made for a Permit to Construct ( ) or Repair (1,,I'an Individual Sewage Disposal System stein at: ................4 _---SE-IA...'�.!.?....--..... ........................................ ... ................................. QLocation-Address .. or Lot No.. J .K.• om. t. l�.v!S'---------------------•-------... Owner Address ................................................ ....c.. .. ....... Installer Ad ress d Type of Building Size Lot----------------------------Sq. feet V Dwelling—No. of Bedrooms... ....................................Expansion Attic ( ) Garbage Grinder ( ) PLI Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria•( ) Q' Other fixtures --------------------------------------------- d -------•----------------------------------------------------------------- ------------------------ WDesign Flow............................................gallons per person per day. Total daily flow..__.._......_..._._......................__gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width................ Diameter---------------- Depth--_--__--_.___.- x Disposal Trench—No..................... Width------------.------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No---_--------------- Diameter.................... Depth below inlet--.................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-___--_-----_-__-_-__ 1-4 4 Test Pit No. 2................minutes per inch Depth of Test Pit_______--...__---_-- Depth to ground water........................ P4 -------------------------------------...................................................................................................................... 0 Description of Soil............................................................................,--.....-`--------------------------------..._......---------------------------------------- x U ................................................,...................................................................................................................................................... ----•----------------------------------------------------------------------•-------------------------------------------------------------- --------- ------------------. UNature of Repairs or Alterations—Answer when applicable_TES'i �.t .J,P.. -c�4_.....�_/�lli-�l�__-�_a.a0>C _j°a.Q. ' w .'.....&!. - C Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envir tal Code—T e undersigned further agrees not to place the system in operation until a Certificate of Comp 'ante een issu d the board of health. Signed -- ----- --------------------- -------------------------------------------------------- ------ ----�^- 4 g ....... Dare ApplicationApproved BY - -- -- ------ --- ----------- --------- -----------------------------------------------------------------------------•-- ...... e"CC/ -... D.t Application Disapproved for the follo 'ng reasons- -------------------------- ----....... .....-- ---------------.......---------------...----...--------- ----- ------------------------------------------------ ----/----------....------------------- ---- ----.............------------------.----------- ------------------------- .---------------- ---------------------------------- .--- Permit No. jl _--6..� Issued ,�..=�..7�. � Dace --"------...----------------------'-' ----- Dace...........-----........................ n No._............!�/ Fps_..:_ .._ 1 THE COMMONWEALTH OF MASSACHUSETTS f - BOARD OF HEALTH f TOWN OF BARNSTABLE k Appl ration for Dit""VaAal Works Tonstrnr#ion 11amit Application is hereby made for a Permit to Construct ( )° or Repair (�) an Individual Sewage Disposal System at: f, -r-j Location-Address f or Lot No. Owner f ` / Q Address( ny�J7t ....... �i- 7S.... �.� ate.. .... .._ �Y-_0._R.._03�..:J 9." ..._Lu.:._—P R- ^','u"'"""•................ Installer Address d Type of Building i ' Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms--_s ...._-_____--_____________________Expansion Attic ( ) ` Garbage Grinder ( ) per, Other—Type of Building ............................ No. of persons................:----------- Showers ( ) — Cafeteria ( ) Other fixtures -----•------------------•-----.._...-----------•----•-. w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z, Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by........----------------------------------------------••--••---•--•----_. Date........................................ ,_l Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fTq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... W' -----------------------------------------------------------••--•--------------•---------------------......-•-•--•-----------•--------•-----.---------------' 0 Description of Soil........................................................................................•-----------------......-----....._...••----•-•-••......•------•--•-.......---• x w VNature of Repairs or Alterations—Answer when applicable..TN T_ -._l_06X5.-oG_•_____7pih4G_-_-__..1. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environr-rental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complriancce„sabeeen iss�u(d-,b'y the board of health. Signed `. .... te 9 Da ApplicationApproved BY --. .....-�--...--------------------------------------.......................... ='\--------------------- ------ ---- ----------------- Due Application Disapproved for the following reasons- -------------------------------------- ...........---•-------------------------------................ --------------- --------------------------------------------------------- -------------------------------- ----------------------------------------------------------------------------------------------------------- ........................................ ... Date Permit No. .. .al—!..6�--------------------- ------------- Issued -----5 " 4 ---------------------- Date \ F THE COMMONWEALTH OF MASSACHUSE7TS BOARD OF HEALTH } 1 TOWN OF BARNSTABLE gTertif ate uf,Grayltttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( {.�Y by -- ����� -- nst511er I w. f at ----------------------------------------------------------------- -------- -- has-been installed in accordance with.the_provisions of TITLE 5 of The State Environmental Code as described in /the application for Disposal Works Construction Permit No. .... �.-. .�.............. dated ...X7...'7.-..�z-------------._--- THE�ISSUANCE OF THK(CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY: DATE-� .�.. �C------------ --------------........................-------- ..... Inspector ----�1.�------ftk� -------- '` ---=------................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Disposal Works Tonstrurtion Virinfit Permission is herebyanted...... . . C.,6J C_!. ?.......................... t ...... .............. ............... to Construct ( ) or Repair ( dan Individual Sewage Disposal System at No......1. ...... t .",'r%�.:-''" !fly. ..._.._.. ..5_.!:. ?,.v�_cs.sf..........................................•-•---•-...........-----...... Street �T ...... Dated.._.�r�.� -• ! -..- • •-••-....... Board of � .............. -P,C..----•-••---......--•--•............................. FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS A7 ` A7 A] A] A] iS-Y 2-20M t 28410 28410 Lti to J a Y - i. 117CHEN a . _ < O FAMLLY ROOM t'%19' I •PANTRY LAUNDRY"- 1 I - S �•U S - { rs %21* 111E s' I b . p I rho ^y� 010 ii x _ 3.CAR GARAGE j b b I Fl. O�s ! e xFAST 11, t n'x1tY � i• , I I I I I '11i � , �I 7 ! ! MLE C CLOSET LOSET b ----:-: _:-:- : GREAT ROOM OWN ROOMis, a' / - _ \ t x 19' lXf H G F E j D I�---1 47 COVERED DECK Q CLOSET - t Y (J 77 r ^0 F-I Q � Q E L11 n ENTRY FOYER m it 'DRIVEWAY t-- A °�OW PROJECT NO: ' CLOSET 1 , i \J VASTER BEDROOM ` 111E `G A 11WTER x 19' q 1V MASTER BATH 1 UK •i 4•. CLOSET I _ REVISIONS: 1 b ----- I , I i DATE: 5/1i/zoa5 ,1 SCALE 1/4- = 1'-0- 0 2' 4' 8' DRAWING 1 e7-o' r-e b w - I o 1"j 162f 2621 lJl 3 - I ----------- -- - cdm -ti 4'-8 MALL a t F 3'-0•WALL —4-4 9� v O-00 BFDROOI 3 Ld1 4'MALL 66 14r X 1613• SATs e t lK o BEDROOM 4 IS'x 1CTT II CITL d - , - � —i 7l2f0 I 7e2I0 z _ I m b 1K-O• - - 1ST nears WALL LM 4 -� E_ FAIO.Y ROM Lj ,- # c` L:j bay RMWmBn.OW �' s ---------- -------- +10Fo,.st Sam 1 I ,J) O , -f 14-r i. 5�• 1 ` S- _ 4'-1,' 15-Y 7�-O• MMY ®ROS i Olaf' I t OT pp7 R € r f ,�•'� fag{i i ; � i If RE�iiS'ICNS: _._LK DAM -------------- \ v sr-o• j DRAWNG i tiv nnv nn.u• Ju .IVL W �� • III r / i. \Qov" 100, � ASSESSORS MAP: 95, PARCEL: 11001 `• 14 w• r ow I � 1 1 1 � 1 I ,",/ .�,pVrE"LLI G �"'�•, / I ,X , I . ' / • I 1 I�Q� 1 I �"TXDISg�RAISED AND;/.$� •1' I w , "REMOVE SEE NOTE LAM TREES 14.4 LOCAION OF SYM ASSESSORS MAN PARCEL 11006 AA ip \ / / .3 r BE ,ram.E,Ec,hc 1 '► �. � ScXtG i PROPOSED 1 Roar 01 / / 1. 2.1 } • . 1 � .' BE rQF].O lW ' wt / s.000 GA1 LON 20 10 0 ID .)So \ SEP11C TAN( 112 " ` `�\ \ JFRD (Mils AREA I 1 \ \ \ PROPOSEDRETAMG \ \ \ \ \\ (TYP'). PROPOSED \ \ \ \FOOL HOUSE8EN \ y Y \ \ SURVEY MARMARK KEER OF \\ "' _, \\ ' \ 1 EL- 19.28' v \ .\. '' \ F _ -� Ito. Wl 91-01 8._L. 7._6. 6._3. 7'_6' 13''T• - 6-4�• 13'-3' NCJ6'1 CG'n/ -1)b. �/" 'Y/�'11 11� • - 2-2034 of N r3 `�i J • J 2-7 3t 7-7034 6/8'GYP• Za N L In TCH _ 1 K L a E19N F� -- - yJ 107 PANTRY LAUNDRY Q I /106 I0 109 ILEFAMILY ROOM X TIL6 OA ITSiO UPe RI/FRS - .3 CAR GARAGE - o l T c .BREAKFAST / 1 I DOWN 11 Jl 108 o ... �YER •i UP 61 RISERS RISERS I. ' - N h IIl x OAKS- O I' TIE � 1-13/IL • 1-l/16"I T868 .1 -_---_ -1 -----.--. ---1 1 -------_---1 70 MIN. I I - 0 O °�iCEILING - o ® n ¢• I I I i I @)!J i m TILE BATH - - •1 CLOSET -.I 9'-6 'XJ ^u I I I I ! I — — pESK '-- ® - -_ 01 ALIGNS W/7N0 FL. ..— WINDOW �— — . — . GREAT,ROOM: I ( .. 110 1 SMOKE ETE TORS REVIEWED � Il'L'X 78, _. DINING ROOM r - OAK IOT 4o H - G•� _ F E H'X 19' \ OAK / A.l Q -A.l Al Al . — — . — _/ B BUILDING DEFT. DATE U COVERED DECKA. ui - - - - ® • o P c1 osET FIRE DEPARTMENT ® — D9TE ' - " BOTH SIGNATURES ARE,REQUIRED FOP, PERMITT1�,':. 0 LL UJN ® 3410 � O. ,pis •j (V N 19 ENTRY.FOYER ol -O S� TILE - tll _DRIVEWAY - ------ -� -- J , DOWN O U I S - 7810 CLOSET 1 - - PROMECT NO. -ri 4 20041-456 "MASTER BEDROOM112 - 18'1'X 19' OAK BATH EfU I 1 Lo LIN. r0 � TILE 0 I p CLOSET I I c n I m I _r, W m • DWG. NO. r - , A.1 Al A.1 A.l A.1. r. .tea L: w Q LWN (� Z J I .ca® Q �CN 0 Z:��s Z�_ . . . I - — I 1,, 00 \ // •tIN. I \. 9'-6" WALL - .... 79c8 \ S'-O" WALL 10'-e \ LIN. 9' WALL_elP r w - BEDROOM 6 Xl8'3•, c BATH M'L'� / IB OAK I I LIN. 1 / O O I BEDROOM 1 I-_ C v li. ®° I _^._ FA ILY ROOM O I5'X 19• Fr 9•_I. —_S•'O'I I 7968 ` ® ''` I OAK I - CLOSET U I I CLOSET I I p 708A ,. _ DOWN / C1 'L'9 :# \ 15'-S�• I 9'-I" I I J Il'-S� 9'_I�• / / -b _y .. - — CLOSET lz -- ----------� / / 9' W u : P ii 7834 I 7836 / 8 1 tIYP --- ] 710 870 - - O J.1 . I a IST FLOOR WALL LINE (i&B— (� - FAMILY ROOM12. iV _ - ® '� n7 709 x Is {`� OAK H. G F E .. D - r A.1 O Al Al Al A.1 g DECK V 1 J •� �g� OPEN TO c� LU �i GREAT ROOM `u BELOW O cr I B T•_O. - 1B._O.. S''le' 17'-48 i J - // /, a..�... B u BALCONY P0,Y•E I A.6 WALL ELOW 'I _ OAK r -- --------� I p � - DOWN - PROJEC'T. NO. fa 2004-456 13'-9' _O. CM OSET I I CLOSET - - I. 709A I 701ALo _ - - I I U ry I OAK I - A.G O LIN. \\ - ✓�' e 7OI u OAK, -------------.-\\ O O .mO� ®LU6. NO. / - \ LIN. C n - _ - • - _ f J O T + • - Ili ro 101 -4� S> a DATE: 0" 6/16/2006 ® ROOF CLAN REVISION: ! . Silvia, & Silvia ® Assoclai.es, Inc. z SCALE: �, � RESIDENCE g 149 BEAPU{T ROAD 1281� OS_ MAIN STREET ® 03TER/ILLM MA OSTERVILLE, MA . 5087920-0226 04 1 F"Wcv u Q>co / " W u / PLA E B DOOM 4 .BATHROOM 4 BATHROOM 6 - BEDROOM 5 4. NDING 1ND LOOK. -. I I- I 3' • L GARAGE 2ND FLOOR -G OR � Y ROOM BREAKFAST AREA ' _ KITCHEN GARAGE 7NO FLOOR -y L W I I _ GARAGE PLATE, 14' TJI 230•12'O.C- mool ® O GARAGE - - _ I n < l is � N O v - ' Ij 5/6'GYP. I5T LOOK - I I I. I b L _ GARAGE FLOOR 4p Q 'O '• I I ® ® A5EMENT o as ao II BAS MEN FLooR I I . .,. _ PROJECT, NO — r 2004-456 y (15ECTION C We W \ .� H \o Q QWG. NO. . 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EL. TOC. EL. 6' O _-- ——— ------------------------------_ L' 10 9'-10" T.O.0 EL. r *EL.-.20 3/6' - 10" ^ I (SITE EL,.21•I » . m ---- ----.---- --- — --- .. .O.C.'E L: I --- ---- --------------- ---------- ------------- ' I. I COL.UP - COL.UP - _ COL.UP -.�'EL. 10• I - T OTTE El II.I'1 I' a 11 ,an ../ {'REINF.CONC.> PITCH 1/6"PER FOOT - .� • OI I' _ X - , I UP.FROM GARAGE TOWARD DOORS. . a r I I 1 oxI O :I I T.O.C. EL.: - - ol I 4 c �I I ri I I `� 0 � I ; I o: 4 m r— —I a I' ' STEEL - : �------ -- COL.CUP W r -------- -------------J I T.O.C. EL. P - _ L— L, r ------, , I I I oI. c-------- --- - - ---- ------------ ------- ----------------- -- —J I DROP J2" ' 1 x 03. w I _.11 .. 2-11" •° 9'-C _.. 2'-11' I lao.. I I y� Jol o IUm. I ~ 3oi I N �� �r F . D E _ loI.Z.x F _ - I - �.• .AT zm A.l - A.l A.l _ A,I - al I I � r3 r - U x, -' oxl ' 1` 0� =Z I aTEEI - yml I// ITV - COL.UP » �o1 - p 00 > - _ • I I � I I .. uw _ o I I � , I I I 11 ^ I I I o I 3G'-0" I I • B s UP I I I v x STEEL - `O-.2 I I a VT o I to p a = I I _ xi I I E wEr 3 I m ; I I I • I I m m I I ' _ I I L--------- --------------- L--------------�BT---------A-- - =-- .-------gar, — —.— -- ; - y w>. F E p A.l A.1 Al A., it-o• W Pa c IL T.O.C. EL. 8 w/,r I- (V - I ExiST7nfC� -I' 2-3/8' m - W T IS, CO 00 0) r�p UP FROM GARAGE _ i U_ 3 - v - OI T.O.C. - m X t - in o — F �2 _ e j m 3 ►' j m sro�,lr o��c .o-..s..,•..,,•.n. r®r,..e«s• -.+ne.. zn.w....... '�.r.........,,..ptn C.OL.UP - �7 V '�, - DROP 12' 2'-11" 9•-G• _ 2._II. 9'-4' 2._4. VL z Al A.l A.l Al A.l .-^ m ►. w HALO, 1J.! �ggp . rl UP I �C j COL. 71� I PROJECT R4® 1P - 1 I � m a 2®o�4-4s6 LID r — N , .e DWG. NO. i I sWE VAI ESTIMATED HIGH GROUNDWATER CALCULATION OASTAL DATE OF TESTS- DUNE 1, 2005 (USGS/cxC METHOD) NGINEERING DEEP OBSERVA TION HOLE LOGS PERcoLAT10N RATE . LESS THAN 2 MINUTES PER INCH DROPZONE.- IN J INOEx WELL. ,�,ww 29 ► Q THE C HORIZON IN DOH # 1 AND DOH 02 � go { NO SCALE JULM BY : ROY OKUROWSKI, CEC DATE OF READING:_ -1270 . DEPTH TO GROUN (WATER-J3.25--- � .. � OMPANY, INC. DEEP OBSERVATION HOLE 1 EL = 20.0' DONALD DESMARIS, R.S., HEALTH AGENT GROUNDWATER LEVEL ADJUSTMENT. 1t �� GROUNDWATER ENCOUNTERED AT ELEVATION= 6.25' (DOH1) _S 260 Cranberry Hwy.Orleans,MA 02653 SE►�S��g'42" 1 �' DEPTH FROM SOIL SOIL SOIL COLOR SOIL 0 ACTUAL GROUNDWATER LEVEL 0 SITE: EL= , ;' ,�'_25 508.255.6511 Fax:508.255.6700 MUNSELL MOTTLING _ i ASSESSORS MAP: 118 b �� ESTIMATED (MAX.) HIGH GROUNDWATER LEVEL: ELms--5.75• OUSTING PARCEL: 121-1 ., Ap SANDY LOAM 7.5 YR 3/3 \ DOELL G ' NORiH BAY BAY TREET AIN sTREE OPOSED 12` - 2e B COARSE SAND 10 YR 6/8 NONE F ASS i b SEPTIC PROp06ED 1EU 24' - 165' Cl COARSE SAND 10 YR 5/3 NONE LOCATION OF 2' " LNG :' -�: . D WATER SERVCE i i ,� �. .,1.�� ^ \1w 170" C2 FINE SILTY 1 YR 5/5 NONE 1 / titi 10 On mum SAND PERC ATAPPROUMATE LOCATION OF / - PROPM ti CHMARK T0P OF6NOIINDWAtER ..ENCOIIIIIENED AT A OUSTING WATER SERVICE WIN of t135• CONCRETE BOUND KEY MAP CID DEEP OBSERVATION HOLE 2 EL = 17.0' w \ 00 / �, \ / / �. : � / /� / \�/ :, NO SCALE DEPTH FROM SOIL - S0�SURFACE HORIZON TEXTUREMUNSELL MOTTLING OTHER ,.,.. 1 11 // I. / / ASSESSORS MAP: 95 ,z---=� 1 I , / ROPOSED PARCEL: ,3.001 �p PLAN REF RENCES: 0` - 6 AP SANDY LOAM 7.5 YR 3/3 ` I I / �ti�14 w _ _ i ASSESSORS MAP 95. PARCEL 13.005 0 6 24 COARSE SAND 10 YR 6/8 \ I (r 1 .--- _- -- y NONE \ + LOT 162 rr&.jM MAP 95 � �. LC. PLAN 5725-57 24` - 132" COARSE SAND 10 YR 5/3 \ I 1 , . PARCEL 13-005 i NONE 1 I i \- _ ..C,P. 5725-52/57 132`- 144" C2 FINE SILTY 1 YR 5/5 Nq,� 1 II11 1 I ,, 1 I / 3 ` \ TOPOGRAPHY DOWN CAPE ENGINEERING, INC. �D PERC AT BO• I 1 I I NG D � /& I g IT ROAD •� 1 11 � 1 I �:ZOSaE RAISED AND,�, �� I I / SITE PLAN OF LOT 153-8 AND 153-C SEAPU �NtMWAIER � 2 EItC0UIt1ERm AT A� � W� 1 I •RE�,DVED iJ% ��, �`. I y. I ` c� I \ � �` ♦ (OSTERVILLE) BARNSTABLE PREPARED FOR: FLOYD SILVA DEPTH OF 13�' 1' I \ LAVMDATE: SEPTEMBER 9 2002 \ I w OCCASIONAL I %, ' !: ! . 1 I I I �` o REV: JULY 9. 2003 DESIGN CAL CULA TIONS TREES III 1 Ia •;, �� BY: DOWN CAPE ENGINEERING. INC. \ / APPROlOMA1EJ I 14.4 1 / f� 1 I I I \ �''� •.,..�..�•• H N�-3 ti QEsGN FLOW: 7 BEDROOMS AT 110 GAL PER DAY PER BEDROOM = 770 GIRD LOCAq OF 1 \ 1/ '% j, I I I \ Ass�soRs MAP: ws sey9� w }w•-2/� i 770 GPD X 200% = 1540 GALLONS USE 2.000 GALLON SEPTIC TANK 1 � sn�TE1I � � ' I I I �\ PARCEL: 13.00e •� -�, , DA TUM NOTE. A 53'L x 20'W. x 0.510. LEACHING FIELD CAN LEACH: 1 N0� . I `� ELEVATIONS SHOWN HEREON ARE BASED 1 /, . Vt = 53 x 20 x .74 784 GPD ` / / / I / 1 ; % 1 r I I �, ON THE NATIONAL GEODETIC VERTICAL ( ) �� E ,. c � w � INSTALL ONE ( 1 ) - 53 'L x 20'W. x 0.5 -D. LEACHING FIELD Vt = 784 GPD > 770 GPD REM). \ / � / ,� � 1 � l /% '� )•° � DATUM (NGVD) I PLAN ONE 1 - 2000 GAL SEPTIC TANK \ / / I/ ! I ,� ONE ( 1 ) - DISTRIBUTION BOX (5 OUTLET) \ / / d 3 I Ir. s - , , _ W FLOODNOTE: IRIC ;I I /� I � Xte � 1 ,; y ��• TEo 1 / _ FLOW ZONE A13 EL12 do C AS SHOWN °z / / , -►. �� I ON FEMA FIRM PANEL F50001 OW NOTES REVISED JULY 2. 1992 SEAL / I\ /x�. 1 1.. 1 PROPasm \ 1 ZH OF 1 GARBAGE GRINDERS ARE NOT ALLOWED WITH THIS DESIGN. zt`s ,` I G SIDE FOR ASSURING THAT COMPONENTS OF / �d � `:,., � � i.A '� I I i \ LEGEND � E 2) THE INSTALLER IS RESPONSIBLE / / +� 6 I THE SEWAGE DISPOSAL SYSTEM ARE DESIGNED MATH SUFFICIENT 1 I I \\ N STRENGTH TO SUSTAIN ALL LOADS TO BE IMPOSED ON THEM. ANY , / / SUBJECT TO VEHICULAR TRAFFIC MUST / \ COMPONENT OF THE SYSTEM � \ ti tvo.s»ae COMPLY WITH A MINIMUM STANDARD OF A.AS.H.T.O. H-20 MIFNEEI. LOADS. �• 2.1 ♦ / / 1 \ \� ■ BOUND o 9F �o 3) PRIOR TO SETTING ANY SEWAGE DISPOSAL SYSTEM COMPiAEN7, INSTALLER 0 .A r � � \ _ � iCIN BASIN SHALL VERIFY EXISTING CONDITIONS, INCLUDING ELEVATIONQv S OF EXIT INVERTS. , / ��.�"• / \ \;: \ ' v :• _ AND REPORT.ANY DISCREPANCIES TO THE DESIGN EI�Ip1R. �. 5 , _- •�, � �' � :, � _ D4 GAS VE i 4_�e.h r ■r.rp+ .n .... .. AF3ACJITEO .... .. ��, \ Q PLAN �y.Y. .. .. ... „... fC�. .� _a:a...14 a _ P. .•a.V1W6h� V'r �I�SF VAL t .2 .`" �L ,��0�� wv OF 4' ;x . 44"PVC SHALL BE 0.01 FT/�T. \ \ 20 10 0 20 60 �� WATER VALVE � 5) NO PART OF THIS DESIGN SHALL BE ALTERED WITHOUT PPJ'OR APPROVAL / GAUM �p�. r w .ice,. \ SEPTIC TA 12 _ �\ \\ HYDRANT a FROM THE DESIGN ENGINEER AND THE AGENT OF THE LOCAL. B3r'ARD OF ,� 1\ \\ .T_ HEALTH. ALL REQUEST'.;®F "�NANGES SHALL BE MADE IN WRITING PRIOR � \ � aI 1b CONSTRUCTION. i iaoh - � ft ® ELECTRIC METER a FOR SYSTEM COMPONENTS ( \ 6) THE USE OF ALTERNATE MANUFACTURERS \ \ `,�? \ \ � (THIS AREA IS SERVED BY T(iiNiV WATER) -p- UTILITY POLE SHALL NOT BE APPROVED IF THE USE OF THEIR EQUIPMENT REQUIRES � \ \ ,►\ PROPM CHANGES IN DESIGN. 1 \ \ \ ���\ ',� �, \ \ \\ W-3 WETLAND FLAG 7) THE INSTALLER SHALL ASCERTAIN THE LOCATION OF EXISTING UNDERGROUND \ TO EXCAVATION AND SHALL PROTECT UTWTIES WITHIN THE \\ (�•) PROF? \ \UTILITIES PRIOR \ \ �\ pEC1roC \\ \ � \ - EDGE of WETLAND WORK AREA DURING CONSTRUC�ION. \ \ �, \ LINE m \ SPOSAL SYSTEM INCLUDING CESSPOOLS) SHALL BE ` \ $) THE EXISTING SEWAGE DI ( �. // �? \POOL HOUSE \ � ° \ \ PUMPED, FILLED WITH SAND. AND ABANDONED; OR SHALL BE REMOVED BENCHMARK TOP OF \ Ole G GAS LINE WITH SURROUNDING CONTAMINATED SOILS AND BACKFlLLED WITH CLEAN SURVEY MARKER MEL- w WATER LINE COARSE SAND. ' V \ l \ O \ \\a \\ \ E , ELECTRIC LINE � Q IF APPLICABLE: 9) FIEL MATERIAL FCR S"S'�S CeN,0 RUCTM IN FILL SHALL BE CLEAN \ \ .J \\ \ \\ GRANULAR SAND, FREE OF ORGANIC MATTER AND OTHER DELETERIOUS \ D DRAIN LINE MATERIALS. THE SAND SHALL BE GRADED SUCH THAT NOT MORE THAN \ �` F` \\ ° y\\ '� \ \\ I BE RETAINED ON THE SIEVE. \ \ \ tp ., - -10-- CONTOUR ~ 45X OF THE SAMPLE, BY WEIGHT. SHALLQ THE ALL SHALL NOT CONTAIN ANY MATERIAL URGER THAN 2 INCHES. \ \ I THE MATERIALTHAT PASSES THE j4 SIEVE SHALL MEET THE0.\ u� \ \ I PO FOLLOWING GRADATION REQUIREMEtNTS . . \ W/OCCASIONAL \ e .: \ \\ \\ 1 ar PASSING TREES \ J.4 .. CONTOUR I \ \ \ 60 50 10-100% 100 Ox-20X \ \ , \ \ 1\ w WATER LINE 2D0 OX-5% \ \ 7.3 WILT OF Vm/ STALLED HAWALE 11 \ \ \\ c GAS LINE 4 , TOP OF SLAB SLTATION BANNER EL � 1t3►BO'f ` \ RAISE COM M WTHN a• ONE ( 1 ) 5SL• x 2D'W x CA �\ \ \ x23.a � \ ( \ E UNDERGROUND ELECTRIC LINE � OF FMMSH fNtADE LEAGM FELD N _ FINISH G 0 DIaUDwG TOPSOL 2' uYfR of 1/B' ro 1/2'wASFED STONE1XN WON1 .. .. _ .. . .. .. .. .. .. � � .. ._\.. _. _. .. � .. .. ..�, .. .... INSPECTION NOTE a 4 �' CAP PPE AT \ " " •a .. .� THE STATE ENVIRONMENTAL CODE, TITLE 5, REQUIRES INSPECTIONS) r MAX D'BOX IINNNM OrBO��M�E � � 4. OUl POW. � i 4• DL*SCH 40 PVC PPE 2• � - 3' �' 4• DU SUCH �0 P11C WE �' �' � � PVC OF THE SEWAGE DISPOSAL SYSTEM BY THE DESIGN ENGINEER. scAt.E AS NOTED INSTALLATION TRACTOR MUST NOTIFY THE DESIGN ENGINEER DRAWING FILE at FLOMI PtrO F1PE PRIOR TO THE START OF INSTALLATION FOR DISCUSSION ON C16536.dwg cr m �` /� REQUIRED INSPECTIONS. DATE 13►56 13.42 S�� 13.n t3.os 12.ae 1�2.n as' + 6-13-2005 w//sAwTANY TEES ALL NOTE DRAWN BY • a, . • COIPACIED BASE 3/,r TO MIT D'BOX � THE INFORMATION HEREON HAS BEEN PREPARED ACCORDING TO TLM 1HE•WUNI SLOPE FOR � � 12.eo I � THE REQUIREMENTS OF TITLE 5 OF THE STATE ENVIRONMENTAL �BY 4 OU SCH 40 PVC �� S1� ALL I �� CODE FOR SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND h PPE IS 1/V PER FT OOMPAttED BASE GAS BAFFLE W/•• LAYER of 'TUF-Tr1E' OR UNE(S) E10TNG DIM M W NEIIAN LOCAL BOARD OF HEALTH REGULATIONS. 8 CRLLSFED STONE APPROtiED EQWVALENT LEVEL FOR 2'-Or 9EFONE PITOWIG 1Z00 O Mt TO LEAI�IN�G FAMJTY b 0 ISA um DEPTH Boailff x F1�DW OWN 12't It't S.0' MWMBI THE LOT SHOWN HEREON IS AS DESCRIBED ON '" 4 FT 14 iM- L T fNJN I '� • � I" COURT 57. ss.� $� 5 FT 19 WCFt£5i $ 6 FIT 24 NM 7 FT Za MIgiES Elr Q�7� ESINIAIED HIGH cEtOUNDWATE1t 53.0r � >tApRK . ' •� r~ SCHEMATIC FLOW PROTILEY _ A DETAIL OF LEACHING FIELD DATE W 1 OF 1 SHEBTS �� ALL INSTALLATIONS MUST CONFORM TO THE MINIMUM IiE(IUIREMENI'S OF TITLE 5 NO SCALE a uR PROJECT NO. C16536.130 FIRST FLOOR = EL. 17.4' SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN, GRADE (NOT TO SCALE) ARNE H. OJALA, PE / ACCESS COVER (WATERTIGHT) TO ENGINEER: �� ��fr MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 16.2 WITNESS: DAVID STANTON EL. 15.1' RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: AUG. 8, 2002 FOR FIRST 2' z EXISTING 1500 3' MAX. PERC. RATE - < 2 MIN/INS l GALLON SEPTIC 13.7 �* CLASS I SOILS P NORTH SAY y� TANK (H— �Q) GAS 1 SE iPUfT R0, (RE-USE BAFFLE 12.7' "�74� 2'53 C� CI �7 C I� Cl 12.37 ED 0 0 1771 M M ID 0 i--I LOCUS 6" CRUSHED STONE OR MECHANICAL COMPACTION. (15.221 [21) o `� 2 ® � Q ' 1 L .r CP ELEV. ST'ISLAND DEPTH OF FLOW - 4 WN ,. „ Opt16.7' TEE SIZES: ( + % SLOPE) (__1_% SLOPE) 3/4 TO 1 1/2 DOUBLE WASHED STONE SAY STREET INLET DEPTH 10 O & A OUTLET DEPTH 14" 10YR 2/1 1 / 5.67' LOCUS MAP SCALE 1 "- 2000' FOUNDATION--- EXIST. SEPTIC TANK 91 D' BOX 18' LEACHI dG E FACILI FS 6., 10YR 6/1 P/0 ASSESSORS MAP 95 PARCEL 13.001 SEApjJjT BOTTOM TH EL, 4.7' B UTILITY LS POL ,. 109.75 137 S8 5'22 29 W _ 54.57' 30" 14 2' 1 , 48.18' 24.55 - 1 � C o MS f LOT 153-A 2,5Y 6/4 f ` 90,259 SFt UPLAND 8,952 SFt WETLAND 1�'a ' 4.7' 01 99,211 SFt TOTAL SLEEVE SEWER LINE FOR 10' NOTES: �`\ �cp, EITHER SIDE OF CROSSING WITH NO WATER ENCOUNTERED \ WATERLINE (OR RE-ROUTE) \O`\ /~b 1 . DATUM IS NGVD �~h SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) 2. MUNICIPAL WATER IS EXISTING Uj DESIGN FLOW: _4 BEDROOMS ( 110 GPD) = 440 - GPD - 3. MINIMUM PIPE PITCH TO BE 1/8 PER FOOT. USE /a Uv GPO vtS o-N FL04V D - r.rR of .R—�Ac7T I IlII ^ TO RF AA O — 10 �, �,. n T_ ,�H. N,�I'. I.��..J1�71�/ L�✓/'�UfI J'V l� ..-.L.� f" 7 _ ... ....__..�� R o SEPTIC TANK: 440 GPD ( 2 ) = 8$0 5. PIPE JOINTS TO BE MADE WATERTIGHT. USE A500 GALLON SEPTIC TANK (RE-USE EXIST.) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ENVIRONMENTAL CODE TITLE V. I of�' \1 -- LEACHING: _ 147 5 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT SIDES: 2(39 + 10.83) 2 (.74). ,. _ TO BE USED FOR ANY OTHER PURPOSE. 39 x 10.83 (.74) ^, 3312.5 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. f ) o ,' `. �� �\ �` BOTTOM: 621 _ 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT / It � TOTAL. S.F. 460 �GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 1 USE (4) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH, 10. PUMP & REMOVE EXISTING LEACHING FACILITY _ EXISTING EQUAL) WITH 2.5 STONE AT ENDS AND 3 AT SIDES \ LEACHING FACILITY AREA / EXISTING EXI ST ' r DWELLING (RE F LEG N D / '�'ATI i 'L6 ,i SPIKE HNA'RK OAK TITLE 5 SITE PLAN ELEV - 19.2' 100.0 PROPOSED SPOT ELEVATION "G OF �' 175 �.�APUIT ROAD , 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF: �N �, 6 4 • � `�` 100 PROPOSED CONTOUR (OSTERVILLE) BARNSTABLE © Slq� b 100 EXISTING CONTOUR PREPARED FOR; Cl HOLBROOK DAVIS ISOLATED B DG 40 0 40 80 120 WETLAND , n1 v�r`�^� ,'f BOARD OF HEALTH C f APPROVED DATE MA SCALE: 1" = 40' DATE: SEPTEMBER 4, 2002 C Nis' off 508-362-4541 \ F j t,�r )i,?e` fox 508 382-9880 0 0 IF � ISOLATED down cope engineering, inc. ��``" of '" �� ,� �ENE K WETLAND Po ARNE tiG oJALA >r"d NOTE: ISOLATED WETLANDS ARE UNDER H• �� CIVIL y LOCAL CONSERVATION COMMISWN JURISDIC 710N ONLY ---"~ CIVIL ENGINEERS O,12 y P1o. �� -: -" S�"''� �_ �f '�, PI"-7� LAND SURVEYORS �s fCISTER`�� a NAL 00-007UPGRl�,,, �� C` l[ j� �� w� 939 main st. yarmouth, ma 02675 AR N H. OJALA, P.E., P.L.S. DATE