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HomeMy WebLinkAbout0052 SHIPS EAGLE LANE - Health I 52 ships Eagle Lane ._ Osterville P A = 164 02241N a I i I ti fi i a• t 1 f, I Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection 6' 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. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service . ICI Company Name t 17 Playground Lane Company Address Yarmouthport MA 02675 Cityrrown State Zip Code • 508 362-3555 S14454 Telephone Number License Number B. Certification ° 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: 0 Passes ❑ Conditionally Passes ❑ Fails Needs Further Ev uatio he Local Approving Authority i a . 8/28/14 Inspector's Signature Date l- The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow.of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner F and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at thetime 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. t5ins•3/13 Title 5 Official Insp Wlulsurfac'e Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,•''e 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: FZ I have not found any information which indicates that any of the failure criteria described i in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time 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. 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 ❑ N ❑ ND (Explain below): t5ins•3/13' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts ' e Title 5 Official Inspection Forme Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ey'a 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner owner's Name - information is required for every Osterville MA 02655 8/28/14- page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired: B) System Conditionally Passes (cunt.): , ❑ 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 F .Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N 0 ND (Explain below): r ❑ distributionrbox is leveled or,replaced ❑ Y ❑ N ❑,ND (Explain below): . t i . . t ❑ 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): . r ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name ' information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection ti B. Certification (cunt.) 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 apublic 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 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. 3. Other: D) 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 ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El or liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ FX1 Liquid depth in cesspool is less than 6" below invert or available volume.is less than'/Z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE CHARLES F 8r.DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection' B. Certification (cont.) . A Yes No ' Required pumping more than 4 times in the last year NOT due to clogged or El 0 obstructed pipe(s). Number of times pumped: ' ❑ ❑x Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ❑x Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑x 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.] ❑ ❑X-• The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ,N 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. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no" to each of the following, in addition to the questions in Section D. - u ' Yes No r ❑ ❑ the system is within 400 feet of a surface drinking water supply El ❑ 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. t5ins•3/13 a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 52 Ships Eagle Lane ' Property Address DOE, CHARLES F& DEBORAH J Owner Owners Name information is Osterville MA 02655 8/28/14 required for every , page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: ' Yes No j ❑x ❑ Pumping information was provided by the owner, occupant, or,Board of Health ❑ ❑x F Were any of the system components pumped out in the previous two weeks? ❑ ❑x Has the system received normal flows in the previous two week period?'* 0 Have large volumes of water been introducedto the system recently or as part of this inspection? , ❑x ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) , ❑x ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑x ❑ Was the.site inspected for signs of break out? ❑x ❑ Were all system components, excluding the SAS, located on site? _ 0 ❑ 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? 0 ❑ 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: _ _ ❑x ❑ 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)] D. System Information Residential Flow Conditions: . Number of bedrooms (design). 11 Number of bedrooms (actual): 1 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms). 1210 t5ins•W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 52 Ships Eagle Lane + Property Address DOE CHARLES F& DEBORAH J Owner Owner's Name information is Osterville MA 02655 8/28/14 required for every • page. Cityrrown State Zip Code Date of Inspection D. System Information Description: - Number of current residents: NA Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes Z No information in this report.) Laundry system inspected? ❑x Yes ❑ No h Seasonal use? ❑ Yes ❑x No Water meter readings, if available last 2 ears usage d na g ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ❑ 'No Last date of occupancy: NA Date Commercial/Industrial Flow,Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): canons,per day(gpd) Basis of design flow(seats/persons/sq.ft., etc,): Grease trap present? F ❑= Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is Osterville MA 02655 8/28/14 required for every page. Cityrrown State. Zip Code Date of Inspection , D. System Information (cunt:) Last date of occupancy/use: 8/28/14 Date Other(describe below): K. • I General information Pumping Records: Source of information: Robert Paolini Septic Service Was system pumped as part of the inspection? 0 Yes ❑ No If yes, volume pumped: 2500 gallons How was quantity pumped determined? 'Measured Reason for pumping: Maintenance , Type of System: : ❑x 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 l/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J y Owner Owner's Name information is Osterville MA 02655 8/28/14 required for every page. City(rown state Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components, date installed (if known)and source.of information: Were sewage odors detected when arriving at the site? El{ Yes IxNo Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ❑X 40 PVC ❑ other(explain): F Distance from private water supply well or suction line: 10+ feet , Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the leaching chambers. - 4 Septic Tank(locate on site plan): -32 Depth below grade: feet feet Material of construction: 0 concrete El metal El fiberglass El polyethylene El other(explain) . Y r If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ ,Yes ❑ No Dimensions: 2500 gl Sludge depth: 511 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection , Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 -8/28/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) , _ 11 Distance from top of sludge to bottom of*outlet tee or baffle 39 Scum thickness 5„ Distance from top of scum to top of outlet tee or baffle 10, i Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured Comments (on pumping recommendations, inlet and-outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.):: Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound.Tank has zabel filter which should be cleaned yearly. J 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 t5ins•3/13 ; Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address ; DOE, CHARLES F& DEBORAH J Owner Owner's Name information is Osteryille MA{ 02655 8128/14 required for every - , page. Cityfrown State . Zip Code Date of Inspection D. System Information (cunt.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: - Material of construction: El-concrete ❑ metal ❑fiberglass , ❑ polyethylene ❑ other(explain): Dimensions; , R Capacity: .gallons Design Flow: gallons per day 4 Alarm present: ❑ Yes ❑. No Alarm level: Alarm in working order: ❑ Yesk ❑ No Date of last pumping: Date Comments(condition of alarm.and float switches, etc.):` a "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No ' t5ins•3113 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 , + Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is Osterville `MA 02655 8/28/14 required for every , page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): s Depth of liquid level above outlet invert No 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.): Box is Ievel.Box has six outlet Iaterals.No evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms.are not in working order,system is a conditional pass,, Soil.Absorption System (SAS) (locate on site plan, excavation not required): R - If SAS not located, explain_why t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address a DOE, CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. Cityrrown ' State Zip Code Date of Inspection D. System Information (cunt:) r Type: L- .❑ leaching pits number: ❑x ^leaching chambers ,number: 12 ❑ leaching galleries „ number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system " Type/name of technology: r Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy soil.No signs of hydraulic failure. Leaching was dry at time of inspection. t Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow. ❑ Yes ❑ No t5ins=3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding;condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 17 l- Sa cc, Town of Barnstable Geographic Information System ------------- 4w" ............ 41 ................ le 49, N�6 ............... r Commonwealth of Massachusetts Title 5 Official Inspection Form,, Subsurface Sewage Disposal System Form -Not for Voluntary.,Assessments 52 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. Cfty Town State Zip Code' Date of Inspection D. System Information (cunt:) Site Exam: Check Slope ❑x Surface water ❑ Check cellar ❑ Shallow wells - Estimated depth to high ground water: Bottom of leaching 3.5' feet . Please indicate all methods used to determine the high ground water elevation: ❑x Obtained from system design.plans on record If checked, date of design plan reviewed:. 7/4/2004 Date ❑ Observed site(abutting property/observation hole within 1 h50 feet of SAS) ' 0 Checked with local Board of Health -explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ' ❑ Accessed USGS database-explain: You must describe how you established.the high ground water elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater . elevations. Y Before filing this Inspection Report, please see Report Completeness Checklist on next page. ` t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts ; Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 52 Ships Eagle Lane Property Address DOE CHARLES F& DEBORAH J Owner Owner's Name information is Osterville MA 02655 8/28/14 required for every " page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist 0 Inspection Summary: A, B, C, D, or E checked 0 Inspection Summary D (System Failure Criteria Applicable to All Systems) completed 0 System Information—Estimated depth to high groundwater, 0 Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file • ' k i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 J TOWN OF BARNSTABLE -1 c SEWAGE # a W b GE C I�.r�:`�I e. ASSESSOR'S MAP & LOT R STALLER'S NAME&PHONE NO. L`^I AC e_ L.I. C ) SEPTIC TANK CAPACITY _EACI-UNG FACILITY: (type) (size) NO. OF BEDROOMS 'f1�, tjj vT����1I�GGN✓�15 yr � t ; t r;?DFg OR OWNER i)�e l�c l e r PERMIT DATE: Jul" COMPLIANCE DATE:�`I��V V S-eparation Distance Between the: Maximum'A`djusted 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 L Furnished by o .. .+ Y' ... .... i ., r ok .. a. i _ , i 4, ti >. n a No. 6 61 _ 1 a � y � �11' Z I r�i S�U�U�UQ�}j l?'�(°, Fee�_--• THE COMMONWEALTH OF MASSACHUSETTS �� Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppYication for Zigogal *p5tem Construction 13ermit Application for a Permit to Construct( ()Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 57 J W 1P EA(j LG Ij� Owner's Name,Address and Tel.No. DOS I 04 P Assessor'sMap/Parcel ®`�rjLvdJAZ MA y o 'c-�-Q- Installer's Name,Address,and Tel.No. PAv:-,T rVT_ A " esigner's Name,Address and Tel.No. Q3 bowzou;�Y rzo ��Q3fliN1 e,1Q �� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) M A i 1J L-1 IJG Cr_?Me+;T_ 1ROM AO Or,l dV -rd —m-pj) . 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 Title of e E vironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss b t i th. Sig d Date Application Approved by ~ Date Application Disapproved for the following reasons Permit No. Date Issued i No. 2 � I�i� 5�17�IU,UPo� r� �¢ Fees s THE COMMONWEALTH OF MASSACHUSETTS' Entered in computer: J` Yes i PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplicatton for Mtq;pool *p5tem Con!truction Permit r Application for a Permit to Construct(DO Repair( )Upgrade( )Abandon( ' ) ❑Complete System El Individual Components Location Address or Lot No. 5 Z .S 141 P EA6 LG Owner's Name,Address and Tel.No. D O Assessor's Map/Parcel O S rtR Q I ULZ 1-40 � y ova Installer's Name,Address,and Tel.No. PASTOVb GW_A0 1 esigner's Name,Address and Tel.No.. k �fl#JDwtC > M>a Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) - Other Fixtures i Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title t Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) M N N U NG Y M(Z—P G& -Mt*A A001T1 dV Tv -TIqt,)K. , Date last inspected: F Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the prAisba e vironmental Code and not to place the system in operation until a Certifi- ;, cate of Compliance has b th. -Sign Date 6-Zy_� Application Approved by� Date Application Disapproved for the following reasons r Q _ Permit No. '\ Date Issued Q --—————————---————————- —.———————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE TIFY, that the On-site Sewage Disposal System Constructed( )Repaired O( )Upgraded( ) Abandoned( )by A �\j pm at )2 S ZIPS "EA �fJ 'Z55�V 1 LL r-- M A- has been construc ed i ac ordance with the provisions of Title 5 and the for Disposal System Construction Permit No. J Uu Lj S b dated 1 u d u C' Installer 'Designer n The issuance of this`emut shall not be construed as a guarantee that the sy tem�w 1 function as desi ned. Dated '?I �� Inspectors No.��! �� �3 �----------------------------- Fee �`�SC9 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Migw5al *p5tem CCon5truction Permit Permission is hereby _janted to Construct )Repair( )Upgrade( )Abandon( ) System located at 2 S N 19S b 05 fL V ILLS Y _. 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 con difions. Provided: Con/struct'on must be completed within three years of th date of this\pe i . Date:_• / O Approve bye It p . 27q Y! A I - A n. 4wyefi�_ NAOO� L Vf - Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Zigpogaf *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(.),()Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. Sd2 S'/f-'�°S &X cPr_4-'F 4,gW6_ Owner's Name,Address and Tel.No. 0.37&mzzle4e - �ttAeG�S t ��3oes4H �10� Assessor'sMap/Parcel S Sif�oS GGE 441 s� /&y Z L QSY��i�icc�� W.47 OZG Installer's Name,Addres ,and Tel.No. Designer's Name,Address and Tel.No. gyp,. Ey -ls��c+d �o�2ia ,Z.gn i�0.iN7k ei 1'a) Type of Building:Dwelling No.of Bedrooms // Lot Size t3.s_'+Cv sit. Garbage Grinder(j) Other Type of Building VA f INaeOA thZNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow t Z 1 O i gallons per day. Calculated daily flow i Z a 6-fb gallons. Plan Date Number of sheets O Revision Date Title su8s-ueF_1q c= S�7Jf►GE �lsPoS� ( •y Size of Septic Tank as'od 2a-e Type of S.A.S. C44-e- �/C Description of Soil .s€c caG's d t Nature of Repairs or Alterations(Answer when applicable) C77W S 2 t A16' S s T�`-107 I.rll 'rff T74 L 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 this B and Of Health. Signed o Date la Application Approved by ate Application Disapproved for the following reasons Permit No. AgoDate Issued No. F�= i ; Fee �Uff THE COMMONWEALTKOF MASSACHUSETTS Entered in computer: Ye IC HEALTH DIVISION --TOWN"OF B,ARNSTABLE., MASSACHUSETTS Rppficatioi fo:r Migp ,!64 p em Cow6truction Permit Application for a Permit to Construct( . )Repair(k)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. J.'I s H"°S Eft GGE <�vE Owner's Name,Address and Tel.No. 3 CtSTE2�1ict HAe c�S -r_106';&C es4/r, �Ae-• Assessor's Map/Parcel /(0'1' Z Z. QST= ViCc e-1 W q e7ce,- Installer's Name Addres,� and Tel.No. 1 Designer's Name,Address and Tel.No. Lr��,�Nc.�c.= G�,z<�. , �<rcF= v.r} Cl t� �93 9 IN"*/,(/ Sr. 4,-,wa"rtr s../,e -Type of Building: 1 Dwelling No.of Bedrooms t Lot Size't3"�' gq-t. Garbage Grinder( ) r. Other Type of Building SFR t iNa�» �No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 7- 1 0 G-6 gallons per day. Calculated daily flow o � gallons. Plan Date �'" Number of sheets / Revision Date Title ``+Size of Septic Tank a � Type of S.A.S. Descriptiain oASoiA -Wei cr-c s 0,1c -c4 XI- [� !! 11 r Nature of Repairs or Alterations(Answer when applicable) i� f __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 oftCompliance has been issue this Board Health. ' t Signed t A11/ o Date & 14//Cl0* Application Approved by ate r V }`, `Application Disapproved for the"followingg reasons t` f I Permit No. " Date Issued , 5j� i✓�1C �%sr��' �'� 1) THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS j sr�SJ�y Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired O Upgraded( ) Abandoned( )by + a�tre S.2 SH r!� G C L cA •VC-- �)G r c �9/e-c c-" has„ a onstructed in accordance the provisions of Title 5 and the for Disposal System Construction Permit No. � ated �l staller Designer n �`Ihe issuance o is pe tfshall not be construed as a guarantee that the sys will�f unction a. d si ned. Date ��!�' ( Inspector —� ------'=----------------------- No. _ Fee r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 'Wig ogal !gtem Cou5tructiou VtffmiYit } "`:161 Permission is hereby granted to Construct( )Repair(�)Upgrade( )Abandon( ,) z System located ata r 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: Constru ttion m st be�"ompleted within three years of the date( f this permi Date:_. jb�� Approved by --�'� f TOWN OF BARNSTABLE a LOCATION` S� S L, SEWAGE # Z Oy 7 '.3YF VILLAGE j,c e+� /*- ASSESSORS MAP & LOT / INSTALLER'S NAME&PHONE NO. L,._ r :x "a SEPTIC TANK CAPACITY LEACHING FACILITY: (typel (size) f Cam''C1b vr ��/ 1 �l�GYt''^T�F► NO. Of BEDROOMS BUILDER OR OWNER 3 (�� PERMITDATE: J COMPLIANCE DATE: �3'� �t� �' 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet of leaching facility) Furnished by I I f AUG-09-2004 09:32 A.M.WILSON ASSOCIATES 5084209795 P.03 Town of Barnstable 4 Board of Health P.O.Box 534,Hyannis MA 02601 Susan G.Rask,RS. ofw- SOs•s624644 Sumner(Caufinan,MS FA)C: 509.790-6304 Wayne Miller,M.D. July 16, 2004 Ms Arlene Wilson A.M.Wilson Associates 20 Rascally Rabbit Road, Unit 3 Marstons Mills, MA 02648 RE: 52 Ships Eagle Lane, Osterville, A=164-22 Dear Ms.Wilson, You are granted permission to construct a soil absorption system designed foille. eleven bedrooms proposed to be constructed at 52 Ships Eagle Lane, The septic system shall be constructed in accordance with the submitted plans dated revised July 9, 2004. SiAyne you iller, M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE F Q:FIDALTW►VP/s;ceeas PUG-09-2004 09:32 A.M.WILSON ASSOCIATES 5084209795 P.04 Page 1 of 4 Town of Barnstable Nag Board of Health 200 Main Street,Hyannis MA 02601 Office: SOS-W4644 Susan o.Rask,R.S. FAX: 5*79"304 Sumner Kaufman,MSPH Wayne Millet,M.D. RESULTS OF THE BOARD OF HEALTH MEETING Held On Tuesday,July 13, 2004,6:30 PM i RESULTS II. Application for Massaue Permit: DENIED Jing Jiang of Wakefield—Proposes to practice massage at 29 North Street, Hyannis. Applicant failed to submit any documentation of passing and/or taking the National Massage Certification Exam. } Ill. Disposal Works Installer's Permit Application: APPROVED Joseph Good of Middleborough- Currently licensed in Bourne and . Falmouth, passed the local septic exam. IV. Continued Items from Previous Meeting: REVIEWED A Joe Capraro, Mom's Apple Pie-573 Main Street, Hyannis, existing grease recovery device provided,variance granted at previous meeting pending test results. EXTENSIONS B. Jeffrey M. Spilman, Spanky's Clam Shade- 138 Ocean Street, GRANTED 168 seats proposed (113 inside and 55 outside), existing 1,000 gallon capacity grease trap, outside dining was approved previously for prior owner, no mechanical air screen provided for outside dining. A grease recovery device(GRD)shall be installed within 45 days, an air curtain shall be installed at southern doorway(closest to Ocean Street) on or before April 1, 2005,and at the other two doorways within 60 days. NOT PRESENT C. Sheila Maher, Erza Gottheil,and Megan Lanzillo—Two mobile push-carts proposed, one for coffee drinks and the other for smoothies at 541 Main Street, Hyannis. AUG-09-2004 09:32 W J A.M.WILSON ASSOCIATES 5084209795 P.06 Page 3 of 4 APPLICANT E. Mark Furtado-Youth Festival Show-Down Event at 142 Corporation WAS NOT Street, Hyannis, Jamaican jerk chicken, fried fish,cote slaw, and french PRESENT fries proposed. Applicant must request permission 60 days in advance of any event in future. VII. Disposal Works Construction Permit Anpllications (Six or More Bedrooms): GRANTED A.- Matthew Eddy, P.E. representing Jon*Baker-- 180 Carriage Road, W/CONDITION- Osterville, Seven (7)Bedrooms'proposed. 'Applicant must submit a revised plan showing variance needed as' required. GRANTED B.. Sarah Ojala representing Barbara Sklarew 2400 Meetinghouse Way, West Barnstable, six(6)bedrooms proposed. N GRANTED C. Arlene Wilson representing Charles Doe- 52 Ship's Eagle Lane, Osterville, eight(8)bedrooms proposed. GRANTED D. Peter Sullivan, P.E. representing John Cannistraro-488 Eel River Road, Ostenrille, seven (7)bedrooms proposed. Vill. Variance Reauests (New Business): DENIED A. Paul Shnsider-81 Victoria Street, Centerville,granted a variance to 1 construct a two bedroom home on a 15,000 square feet tot per letter dated December 30, 1999,variance requested from 310 CMR 15.214. CONTINUED B. Martin Moran, P.E. representing Garret Reagan—74 Murray Way, Hyannis, failed system,variance requested regarding setback distances to foundation and property line. (a) Need confirmation from Conservation Division regarding wetland location(b) Plan shall include notation that a polyethylene liner to be installed. GRANTED C. Daniel Turner-25 Centerbrook Lane Centerville, proposed addition, W/CONDITION foundation wall proposed approx. eight feet away from septic tank. Polyethylene liner shall be installed. GRANTED D. John Churchill, P.E. representing Amy Mayfield Waters—264 Bay W/CONDITION - Lane Centerville,voluntary upgrade of septic system,variances requested regarding setback to coastal bank. The applicant shall record a properly worded deed restriction, signed by the property.owner,at the Registry of Deeds restricting the number of bedrooms to three at this property, before obtaining a disposal works constriction permit. l SEP-14-2004 01 :58 PM DOWN CAPE ENGINEERING 508 362 9880 P. 01 i down cape engineering, inc, Y CIVIL ENGINee�S & LAND SUI:V� OIZS 939 MAIN 5t / Un 6A YARMDIJ FOkf, MA 02675 (508) 362-4541 FAX (508) 362-9880 tOtAL pA e5— INCI,U M WVER TO: O-A) FAX M . FROM: 0 V\, CN �7 w m SEP-14-2004 01 :58 PM DOWN CAPE ENGINEERING 508 362 9880 P. 02 Town of Barnstable $ Regulatory Services $ a Thomas F.Geiler,Director NAM Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 9 ! e pGy M Designer: �Owo, (I'e /nePrj'k Installer: ZA%.o,9&tee ( Ly.#d-H Address: wjl� Address: '3 U�rPIV � GuMn� row � �� �INtQwY'� Mt. OdU�O On er Q Y „�8Ir&ec L A16A1 was issued a permit to install a (date) n (installer) septic system at k VPJ C t4leL based on a design drawn by /► (address) dated D�' (di-signer) 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. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. SH OF ACMW (Installer'sSignature) ' oI241A11�1 `,'. CIVIL �+ No..3.0762 , 4 (Desi er sSignature) x p Here PLEASE RETURN TO 13ARNSTABLE PUBLIC H VISION. RT T OF COMPLIANCE WML NOT BE ISSUED UNTIL B THIS YOWAND AS- RUILTCARD ARE RECEIVED BY THE$ARNST J1R11 IC HE A I TUMVISIOX THANKYOU. Q;HoaltWSepticMcsigner Certification Form Town of Barnstable �pWE Tp� yo Regulatory Services Thomas F. Geiler,Director • BARNSTABM • 9 MAS& Public Health Division rEo Mop Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Y Fax: 508-790-6304 Installer & Designer Certification Form ` Date: l e nti ZT t / Designer: �00& C e (NeOI Installer: �, �r��rG+£ L��►c Address: aj ►, v V Address: yalrlmn On a' / d T 11 ZAk-v eC.4.X c LYAfeP was issued a permit to install a (date) (installer) r ��t septic system at �°t pi �q�p based on a design drawn by dad ss) w✓�- /a.ICL dated �O (designer) t 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. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 'I"OF (Installer's Signature) �° ; (01V L (Designer's Signature) (Affix "p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PU LIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form cj 66 ryRENCE NCH CORP. CONTRACTORS DANA S. FARLAND 396 Gifford St.Falmouth,MA 02540 P.O.Box 913,Falmouth,MA 02541 508-548-1800 FAX 508-457-1825 IN MA:1-800-352-7188 , j Q� Town of Barnstable 11 Y DMA am > ` Board of Health P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MS Wayne Miller,M.D. July 16, 2004 Ms Arlene Wilson A.M. Wilson Associates 20 Rascally Rabbit Road, Unit 3 Marstons Mills, MA 02648 RE: 52 Ships Eagle Lane, Osterville, A=164-22 Dear Ms. Wilson, You are granted permission to construct a soil absorption system designed for eleven bedrooms proposed to be constructed at 52 Ships Eagle Lane, Osterville. The septic system shall be constructed in accordance with the submitted plans dated revised July 9, 2004. Sin rely your , yne iller, M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE Q:HEALTH/WP/Sixbeds OF ZHE Tp� DATE: FEE + BARNSCABLE, • . vp sti39. REC. BY TEDMAIA Town of Barnstable SCHED. DATE: ' Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. t Ralph A.Murphy,M.D. REQUEST FOR BOARD REVIEW LOCATION - Property Address: Sa SA, PS G CC C_Pc,, Dar-&-y2_v�u.. Assessor's Map and Parcel Number: l c q Iz z Size of Lot: = 3�S y',C7 • ` Wetlands Within 300 Ft. Yes X Business Name: u/ No Subdivision Name: u/ APPLICANT'S NAME: + Phone Did the owner of-the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: C",AxZce6 'b a,-- Name: j-t A- Ok Lji`SO A-1 t4SSUC�_ Address: Sa 5f4i Ps• ekGeu L_Aj 0sr&-K�,;jrc(6 Address:' 2cg Rs450AcGy ve-A331 - 1�C Y�2,5 t G N S' r't•L�c[ ,�j� i�t 1�' OZG:�� Phone: Phone: (, d g) y 0-C VARIANCE FROM REGULATION(List Reg.) REASON FOR RcV i.&LJ-. 'May attach if more space needed) Al0 yLktZ�( eti('C�S �3L—�iL7�L j [d S3��r2� YZ�ZJtr=c�t FDA S Al wtZ—H plc_�_ 94 MCA c QC—h - E NATURE OF WORK: House Addition 1)� Huse Renovation El- Repair of Failed Septic System ❑ G� Checklist(to be completed by office staff-person receiving request application) 1l Four(4)copies of the completed: - -equest form Four(4)copies of engineered plan submitted(e.g.septic system plans) 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 . Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only)- _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) ; ' Variance request submitted at least 15 days prior to meeting date DJN VARIANCE APPROVED Susan G.Rask,R.S.,Chairman wlk NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. - F > Q:/WP/VARIREQDi/P ► CA►� d� 3 G 5: A.M.Wilson Associates Inc. LETTER OF .TRANSMITTAL TO: 'TOM ��-� �( ��Qc2' DATE: PWA 1--7h FILE NO. Z Zg z .o RE: Etc- s >T-Iz�wt CAt ,We are sending you the,following item(s): Copies [7Date De.kription � . m COMMENTS: . TTA-s-1H-4E b 9Ar--y r 5 e^V pCAYS A;S - Te�) 2 cltic ►�����c. 5 7v S RS f ►S"C'cic.''S �� wcGT Please do not hesitate to call us with any questions'.' If enclosures are not as noted,kindly notify. us at once. , j Signed: 20 Rascally Rabbit Rd. Unit 3 508 420-9792 Marstons Mills, MA 02648 Sn4 n)n 0170C A.M. Wilson Associates Inc. February 11, 2004 Charles and Deborah Doe 52 Ships Eagle Lane Osterville, MA 02655 RE: Pool House Project (Our File No. 2.21282.0 , 0 Dear Chad and Deb: As a followup to our meeting of last Monday, I wanted to confirm our discussions relative to permitting strategy and scope of services for your new pool house. For the Wetlands Permitting, in the hope of saving as much time as possible, we will proceed with two alternative application tracks at the same time. As soon as site plans are ready we will request an amendment to your existing pool permit and file a new Notice of Intent.-'The amendment request will be heard first. Should we be able to convince the Commission to authorize the work as an amendment, we will withdraw the NOI. If not, we would proceed with the NOI hearing. t, Mb In order to get started with conceptual site planning, we have provided Ivan and yourself with print of the Town "GIS" topographic maps for your property. As we noted in the cover memo, these maps have both vertical and horizontal error ratios which make them unsuitable for actual design work. They are, however, a good planning tool. We have scheduled the percolation test for the septic system design. That will be undertaken at 11:00 a.m. on Monday 3/08/04. We have also added the field survey to our schedule. We hope to get a start on that week after next, weather permitting. Field survey will include lots 16 and 17 from Land Court Plan 26700D which corresponds to Assessor's Lot 22 of Map 164; your existing house lot. We are coordinating this work with Ivan's office so that inaddition to , locating property line and topographic information, the survey will show the location of existing significant trees,the actual location of the driveway, walks, patios, and planting beds, and provide spot elevations,for stairs, floor grades and other elevations required for architectural 20 Rascally Rabbit Road Unit 3 508 420-9792 Marstons Mills, MA G2648 FAX 508 420 9795 design. Ivan's office will map the interior layout of rooms in the house; information we will require for the septic system permit proceedings. The Scope of Services represents a joint venture between A. M. Wilson Associates, Inc. and ^ Down Cape Engineering, Inc. This will maximize the staff available to work on the-project and minimize production time. Down Cape will bill the client directly for their services in order to minimize administration markup. Tasks we believe to be required for your project are outlined below. 1.0 Survey 1.1 Research —Research will be performed at the Barnstable Town Hall to obtain, as available, copies of relevant plans and permits for the site's onsite septic system and historical data. 1.2 Wetlands Identification _A wetlands specialist will visit the site to identify the limits of vegetated wetlands based on requirements of MGL Ch. 131 sec. 40 and the Town t Wetlands Ordinance. A field report and observed species list will be prepared for use in later permitting.- y 1.3 Field—A field crew will visit the site to:, establish horizontal control; establish vertical control tied to National Geodetic Vertical Datum (NGVD); and, within the limits of the house lot, locate significant man-made features including buildings;fences, above ground utilities,pavement and driveway limits; locate significant natural features including previously identified wetland resource areas,topographic information,-significant trees and vegetative groupings or cover types; locate additional vertical information as"required by;. project architect. 1.4 Base Sheet—Sufficient office work Including calculation, plotting an'&drafting will be performed to generate an existing conditions work sheet and ink-on-mylar topographic base map suitable for later engineering design. Electronic files will be made available to the project architect in addition to hard copies. 2.0 Engineering 2.1 'Percolation Testing—The project engineer will supervise excavation of two observation pits. Soil and groundwater elevations will be logged. One percolation test-will be performed and the results recorded. USGS theoretical high groundwater will be ' calculated as necessary. (Although we are happy to arrange for a backhoe and operator to undertake excavation, we cannot be responsible for delays should they fail to meet • k. schedules for any reason. Further, the client will be directly responsible for fees to the excavator). 2.2 Site/Septic Design —Utilizing plans provided by the architect, an engineering site plan will be prepared showing: existing and proposed grades; existing and proposed building footprint; septic system location, profile and sizing calculations; work limits; and other relevant information. The plan will be suitable for use in later permit proceedings. Up to 6 hours of meeting time is included under this task for meetings with the architect and/or clients. 3.0 Permitting 3.1 Wetlands—A request to amend the existing Order of Conditions for the pool will be, prepared and filed. Appropriate staff will attend the Commission meeting on the request and provide expert testimony on behalf of the project. At the same time and in accordance with the requirements of MGL Ch. 131, Sec. 40 and the Barnstable Town Ordinances, a Notice of Intent will be prepared and filed with the Barnstable Conservation Commission.' Work will be rough staked for viewing. If necessary, appropriate project personnel will attend the public hearing on the project and offer testimony on your behalf. Prior to the ± hearing, the proposed pier will be marked in compliance with the requirements of the-- Commission. Up to 6 hours of staff time is included for meetings under this task. 3.2 Board of Health —A Disposal Works Installation Application will be completed and filed with the Board of Health on your behalf utilizing site plans prepared by our office and floor plans prepared by your architect. Because the system services more than 6 bedrooms, Board review is required. Appropriate project staff will attend the Board hearing and offer testimony your behalf. Four hours of meeting time is included under this task. Additional Services A. M. Wilson Associates, Inc. will provide any of the following services upon request. Fees for additional services will be charged on a per diem basis in accordance with our current fee schedule. • Meeting and negotiation time in addition to that specifically noted above. •' Environmental design services related to landscape, non-structural drainage design or other mitigative measures. • Assistance with other environmental studies and permitting procedures including wildlife inventories, archaeological or historic inventories, ZBA assistance. • Plan changes required.by any reviewing board or agency or by the client. I r . r • Appeal assistance. • Construction services. • Other services not specifically noted above. Fees and Billings Fees for our services will be billed on a time charge plus expenses basis. Reimbursable expenses will be charged at cost. Terms for payment are net ten (10) days from receipt of invoice. Any balance outstanding for more than 30 days will be charged interest at 1.5%per month, or 18% per annum. Invoices outstanding for more than 45 days may be deemed cause to suspend work on the project. Billings for services will be at the close of the month for work-in-progress, and,the balance upon completion of the above services. It is understood that this is a professional engagement on a fee-for-services basis consisting of the personal services of the staff of A. M. Wilson Associates, Inc. The fees for these services are those customarily charged by A. M. Wilson Associates, Inc. and are not in any way contingent upon the findings of any.Board or Agency, nor of our own findings as to the developability of the subject site. It is further understood that because of the nature of this engagement and the uncertainty of the time required by others,that this work and the fees therefore are essentially open-ended. However, we believe it is important for all business agreements to have some mutual understanding of the costs, and thus we provide the following estimate for labor costs associated with services outlined above: ESTIMATE Tasks 1.0 through 3.0 . . . . . . • • $ The client will be directly responsible for any and all filing fees associated with Wetlands and other Environmental permitting for the project. These fees are not included in the above quoted project estimate. - Authorization Work is ongoing on the above project'ori the basis of your verbal authorization. We would; however, appreciate your signing and returning a copy of this authorization for our files.' a r i We look forward to being of assistance to you with this project.' If you have any questions, please do not hesitate to call our office. Yours, - A. M. WILSON ASSOCIATES, INC. t Arlene M. W lson, PWS Principal Environmental Planner I AUTHORIZED AND APPROVED POOL HOUSE (C ient signature (Client name-please print) Title (billing dress) /01 /0 Date BA Reference (telephone) (fax number) 204AW06/csp a. Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands MRN . WPA Form 5 - Order of Conditions sE3-4286 Provided by DEP 1639' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 AlED MP'1 A and Town of Barnstable Ordinances Article XXVII A. General Information ; Important: When filling From: out forms on Barnstable the computer, Conservation Commission T s, use only the F tab key to This issuance if for (check one): move your cursor- do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions «n To: Applicant: Property Owner(if'dfferent.from applicant):' Charles & Deborah Doe Name - _ _' Name 52 Ships Eagle Lane Mailing Address Mailing Address Osterville MA 02655 City/Town State Zip Code " City/Town State Zip Code 1. Project Location: r 52 Ships Eagle Lane Osterville Street Address City/Town 164 022 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Barnstable County Book Page 165432 ., Certificate(if registered land) 3. Dates: _ w May 13, 2004 June'8, 2004 JUN 2 4 2004 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved Plans• and Other.Documents (attach additional plan references as needed): Site Plan `• June 2, 2004 ,. Title Date Title _.._..._• . ... ate Title ' Date 5. Final Plans and Documents Signed and Stamped by: Arne Ojala, PLS Name F 6. Total Fee: , $165.00 - (from Appendix B:Wetland Fee Transmittal Form) Wpaform5.doc•rev.6/18/04 w •Page 1 of 7 f oFt"E�eiiti Massachusetts Department of Environmental Protection DEP File Number: ..RBureau of Resource Protection - Wetlands ' WPA Form� 5 — Order der of Conditions �- SE3-4286 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP TED MP'�a and Town of Barnstable Ordinances Article XXVII B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: ❑ Public Water Supply ❑ Land Containing Shellfish ® Prevention of Pollution ❑ Private Water Supply ❑ Fisheries ® ,Protection of Wildlife Habitat ❑ Groundwater Supply ® Storm Damage Prevention ® Flood Control Furthermore,this Commission hereby finds the project,as proposed, is:(check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect-those interests checked above. This Commission orders that all . work shall be performed in accordance with the Notice of Intent referenced above, the following . General Conditions, and any other special conditions attached to this Order.To the extent that the following conditions modify or differ from the plans, specifications, or other proposals-submitted with the Notice of Intent, these conditions shall control.' Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above.Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which,provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. I This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable,federal, state, or local statutes, ordinances, bylaws, or regulations. Wpaform5.doc•rev.6/18/04 Page 2 of 7 s �t„E> Massachusetts Department of Environmental Protection• DEP File Number: Bureau of Resource Protection - Wetlands snnxsrnBle WPA Form 5 - Order of Conditions SE3-4286 v�i°rEDMA1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain,no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such- an appeal has been taken, until all proceedings before the Department,have been completed. 8. No work shall be undertaken until:the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which theproposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, VA DEP"] "File Number SE3-4286 10. Where the Department of Environmental Protection is requested to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission]n writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order,and may require the submittal of any - data deemed necessary by the Conservation Commission or Department for that evaluation. Wpaform5.doc•rev.6/18/04 Page 3 of 7 r Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands > ASS. = WPA Form 5 - Order of Conditions sE3-4286 Mnss' v t1 $ Provided b DEP �pTi°39 a`� Massachusetts Wetlands Protection Act M.G.L. c. 131� 40: y fD MPS and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the . property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland; the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers.shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore,the Barnstable hereby finds (check one that applies):' Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set'forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Article 27 of Town Ordinances Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. Wpaform5.doc•rev.6/18/04 • Page 4 of 7 SE3-4286 Doe Approved Plan=June 2, 2004 Site Plan by Arne Ojala,PLS Special Conditions of Approval I. Preface - 7 r Caution: Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your compliance. II. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8 (recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms'A and B shall be completed and returned to the 4 Commission prior to the start of work. 3. General Condition 9 on page 3'(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice 1 week in advance of the start of work. 5. A project work linut line shall be arrived at in consultation with the conservation agent. 6. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer 1 and shown on a revised plan. 7. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line. Effective sediment controls shall remain until the site is stabilized with vegetation. 8. A sequence of color photographs showing existing landscaping seaward"and to the SW of the proposed pool house shall be submitted to the Conservation Commission p.a.t III. The following additional conditions shall govern the project once work begins.`Note especially special condition no. 14.requiring verification of the locations of the foundation and strawbale line. 9. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 10. The work limit shown on the approved plan shall be strictly observed. 11. There shall be no disturbance of the site, including cutting of vegetation, beyond the work limit. This restriction shall continue over time. 12. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 13. This permit is valid for 3 years from the date of issuance, unless extended by the Commission at the request , of the applicant.Caution: a future Amended Order does not change the expiration date. _ 14. Upon completion of the foundation,the project surveyor or engineer shall verify in writing or by plan to the Commission any discrepancies with the approved foundation and work limit line location. If verification is in the form of an as-built plan,the plan provided shall be drawn at the same scale as the approved plan. 15. Any fill used for this project shall be clean fill. Fill shall contain no trash,refuse,rubbish,or debris. 16. No CCA-treated or creosote-treated materials shall be used. 17. Drywells or graveled trenches along the drip lines shall be installed to accommodate roof runoff. i 18. Pool disinfection shall be by ozone injection or alternate as approved by the Conservation Commission. Drawdown water from the pool shall be sent to the area of the proposed tennis court;that is away from the i coastal bank. j 19. The 24"Norway maple shall be preserved. 20. No area shall be left unvegetawd for'more than 30 days.All areas disturbed during construction shall be revegetated immediately following completion of work at the site: Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. 21. All lawn areas to be restored shall be underlain witli a minimum of 4 inches of loam. 22. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer(with 30-50%water insoluble nitrogen or`W.I.N')shall be applied. Over-fertilizing shall be avoided. p.4.z IV. After all work is completed,the following condition shall'be promptly met: 23. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a - Certificate of Compliance for the work herein permitted.-Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape, architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance.At the time of the request for a Certificate of Compliance an updated sequence of color photographs of the undisturbed buffer zone shall be also submitted. i p.4.3 - N 1 ' t p.4:3 , Massachusetts Department of Environmental Protection - DEP File Number: Bureau of Resource Protection - Wetlands > 3 = WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c 131, §4O • Provided by DEP . `�fD MAC A . and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: see attached This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of issuance. Date This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant.A copy also must be mailed or . hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office (see Appendix A) and the property owner (if different from applicant). Signatures: r On DA Of Day Month and Year s before me personally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Vol Notary Public My Commission Expires k This Order is issued to the applicant as follows: ❑ by hand delivery on ® by certified mail, return receipt requested, on JUN 212004 2004 Date Date Wpaform5.doc•rev.6/8/04 . Page 5 of 7 Massachusetts Department of Environmental Protection P DEP File Number: Bureau of Resource Protection- Wetlands WPA Form 5 - Order of Conditions ' SE3-4286 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and Town of Barnstable Ordinances Article XXV11 " C. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. D. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission r , Wpaform5.doc•rev.6/18/04 Page 6 of 7 r Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection,- Wetlands MASM _ WPA Form 5 - Order -of Conditions SE3-4286 ,639. v� `��' Arf a Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 , Provided by DEP and Town of Barnstable Ordinances Article XXVII D. Recording Information (cont.) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------------------------------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission „ Please be advised that the Order of Conditions for the Project at: 52 Ships Eagle Lane, Osterville SE3-4286 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: - ,,• • F Property Owner i and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued'on Date , If recorded land, the instrument number identifying this transaction is: - Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant Wpaform6.doc•rev.6/18/04 Page 7 of 7 ' DATE: 4/29/02 PROPERTY ADDRESS: 52 Ships Eagle Lane ( -Cottage _ Osterville ,Mass .' ------------------------- On the above date, I Inspected the septic system at, the above address, This system consists of the following: MAP 1 . 1-1000 gallon septic tank . PARCEL ' ®�Z 441'? . 1-Distribution box . LOT ',° �* ' � -1000 gallon precast leaching pit . ( 6 ' X 10 ' ) � * ,�k. RECEIVED, :rk . Based on my Inspection, I certify the following conditions: 4t� n , its is a title five sepyic system. ( 78 Code ) MAY 0 3 2002 'iR,,"F '. .The septic system is in proper working order "^� at the opresent time . - TOWN OFBARNSTABLE 6 ." Pumped the septic tank at - time of inspection . HEALTH DEPT. Heavy scum & solids layers were present . �Z4- SIGNATURE:, _ Name:_ _ Macomber Company: Joseph_P _ Macomber-& Son , Inc , Address : Box 66 , --Centerville ,_ Ma ,-02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P, MACOMBER & SON, INC.- Tan ks-Cesspools-Leachf lelds Pumped & Installed Town Sewer Connectlons P.O. Box 66 Centerville, MA 02632-0066 775.3338 775.6412 f COMMONWEALTH OF MWSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS, DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 52 Ships Eagle Lane ( Cottage ) stervi le , Mass , - _ Owner's Name: William L . Brown Owner's Address:80 Black Oak Road Weston . Mass . O 19i Date of Inspection: 4/2 9/0 2 Name of Inspector: (please print) Joseph P. Macomber Jr Company Name: J. P.Macomber & Son Inc . Mailing Address: Box 66 CPntPryJ11e ,Mass , 02632 , Telephone Number: Sng-775333$ 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`DE.P approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:. � r I Passes r Conditionally Passes Needs Further Evaluation by the Local Approving Authority F ils Inspector's Signature: /�` Gu '. Date: The system inspector shall s mit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate,regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. 'Notes and Comments F ****This report only describes conditions at the time of inspection and under the conditions of use at that r r' 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 Page 2 of l l OFFICIAL INSPECTION FORM= NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 52 Ships Eagle Lane ( Cottage ) Ost_erville ;Mass ." Owner: William L Brown Date of Inspection: 4/2 9/0 2 Inspection Summary: Cbeck A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ,. L� I have not found any information hich indicates that any of the failure criteria•described in 3 10 CMR. 15.303 or to i CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the resent time . - _ - 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. N'D explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will.pass inspection if(with. approval of Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced ND explain: ,�)e) 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 l 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) . Property Address: 52 Ships Eagle Lane ( Coyya�ge ) stervi e , ass . , Owner:William L. Brown Date of Inspection: C. Further Evaluation is Required by the Board of Health Conditions exist which require further evaluation by the Board of Health in order to'.determine if the system is failing to protect public health, safety or the environment.- 1. System will pass unless Board of Health determines in accordance with 31,0 CMR 15.303(1)(b) that the System is not functioning in a manner wbich,will protect public health,safety and the environment: Alt 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 µ 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:: ,Ut) The system has a septic tank and soil absorption system (SAS) and the SAS is within 1'00 feet of surface water supply or tributary to a.surface water supply. , 4,0 The system has aseptic tank and SAS and the SAS is within a Zone I of a public water supply. •.jP 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 t 50 feet.or more from a private eater supple 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 faciliry and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the.analysis must be attached to this form. , 3. Other: 3 I Page 4 of I 1 OFFICIAL. INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Properry Address: 52- Ships Eagle. Lane ( Cottage ) Usterviiie ,Mass . OwnerWilliam L. Brown Date of lospection:4/29/02 D. System Failure Criteria applicable to all systems: You must indicate "yes"or"no" to each of the following for all inspections: Yes No/ _ i/ ackup 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 Klogged SAS or cesspool Static liquid level-in the distribution-box above outlet invert due to an overloaded or clogged SAS or cesspool j, —�Q�p 6'XIle j Ruid depth in c"spee is less than 6" below invert or available volume is less than 'h day flow equired 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. _ �/ y 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.1 40 (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. E. Large Systems: To be considered a large system the.system must serve a facility with a design now 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 _ _z the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drirt,king water supply the system is located in a nitrogen sensitive area (interim Wellhead Protection Area— IWPA) or a mapped, Zone 11 of a public water supply well 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 sianificant threat under Section E or failed under Section D.shall upgrade the system in accordance with 310 CMR 1 5.30a. The system owner should contact the appropriate regional office of the Department. 4 V Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 52 Ships Eagle Lane ( Cottage ) sterv'i e , ass.. Owner:William L. Brown Date of Inspection: Check if the following have been done. You must indicate`yes"or"no" as to each of the following: Yes No _ZPumping information was provided by the owner, occupant, or Board of Health 'ere any of the system components pumped out in the previous*two week`s? _4/Has the system received normal flows in the previous two,week period? r Zave large volumes of water been introduced to the system recently or as pan of this inspection71 ? �. Were as built plans of the system obtained and examined? (if they were not available note NIA) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out ? , _ Were all system com onents'',.�. W w_ ~p eluding 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,detefmined•based on: ` Yes no/ f/ 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 appioximation of distance ' is unacceptable) (310 CMR 15.302(3)(b)J 5 f Page 6 of 1 1 OFFICIAL INSPECTION FORM —,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM-INFORMATION Property Address: 52 Ships Eagle Lane ( Cottage ) stervilTe ,Mass . Owner:William L. Brown Date of Inspection: 4/2 9/0 2 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): ?l Number of bedrooms(actual): ✓�DESIGN flow based on 310 CMR 15.203 (for example:_110 gpd x of bedrooms): Number of current residents: - Does residence have a garbage grinder(yes or no):A;o Is laundry on a separate sewage system (yes or n_o):W_[° f if yes separate inspection required), Laundry system inspected(ye or no): Seasonal use: (yes or no): Water meter readings, if available (last 2 years usage(gpd)): 2 000-16 7 , nnn gallons-=1005 . 48 GPD. Sump pumfoccupp(yes cy: ,2001-440 , 000—Gallons=1205 . 48 GPD , Last date of occupancy: This is from water pit that service 52 & cottage . Sprinkler system is COMMERCIAL/INDUSTRIAL p resent . -F` Type of establishment: AIA -- - - Design flow(based on 310 CMR 15.203): gpd ' Basis of design flow(seats/persons/sgft,etc.): _tI Grease trap present(yes or no): Industrial waste holding tank present(yes or no): AI J Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: /1 OTHER (describe): GENERAL INFORMATION Pumping Records Source of information:Ajhe 4144J Was system pumped as part of the inspection (yes or no): If yes, volume pumped: 0 all s- How(w, q antiry pumped determined? AbA6',lfe.,54 Reason for pumping: 4��/ ��• -7 TYPE OF SYSTEM OF tank,distribution box,soil absorption system . Single cesspool . r Overflow cesspool r Privy Shared system(yes or no).(if yes, attach previous inspection records, if any) Innovative/Altemative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) &d Tight tank d/&Attach a copy of the DEP approval Other(describe): ,( Approximate ase of all c m onents,date installed (if known) and source of information: fir, Were sewage odors detected when arriving at the site(yes or no):,-ee 6 Page 7 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i • PART C SYSTEM INFORMATION (continued) Property Address: 52 Ships Eagle Lane ( Cottage ) Osterville ,mass . Owner:William L. Brown Date of Inspection: 4/2 9/0 2 BUILDING SEWER(locate on site plan) Depth below grade: F-y Materials of construction: cast 'iron _40 PVCit/othe (explain): Distance from private water supply well or suction line: 10 Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight _-No evidence of 1*eakage ° The system is vented through the house vent .,,,)�____,,,, SEPTIC TANK: Zlocate on site plan) /Gt'V Depth below grade: / Material of construction: rconcretu.4)metal.IwfiberglassyGrPolyethylene etfdother(explain) If tank is metal list age:,V,t Is age confirmed by a Certificate of Compliance(yes or no):40 (attach a copy of certificate) ri '-1 Dimensions: d',�w/� /d ll llcl Sludge depth: Distance from top of sludge to bottom of'outlet tee or baffle: _ Scum thickness: O Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle Ho", were dimensions determined: Pumped at time of inspection . Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid.levels ras related to outlet invert,evidence of,leakage, etc.):, '- �Pumn the ceptir tank ever; 2-1 years - Inlet & outlet tees are in 'place . :The tank is s,truc:titra11y sou.ttd _ and Ghew,S, nn evidence of leakage . GREASE TRAPA&*(locate on site plan) Depth below grader + Material of construction:la concrete 40 meta LtL9fiberglass,�olyethylene444other (explain): Dimensions: t 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: ,6rW 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.)c Grease trap is not _present . y 7 Page 8 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 Ship EWagle Lane ( Cottage ) Osterville . Mass . Owner:W; 1 1 ; am L . Brown Date of Inspection: 4/2 9/0 2 TIGHT or HOLDING TANKA06(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: VA Material of construction:AJ _concrete 0f metal ,WY fiberglass polyethylene A119 other(explain): Dimensions: Capacity: allons _Design Flow: NK gallons/day - Alarm present (yes or no): Alarm level: �4 Alarm in working order(yes or no): Date of last pumping: lf)4 Comments (condition of alarm and float switches, etc.): Tight or holding tanks are not present DISTRIBUTION BOX: r Zif present must be opened)(locate on site plan) . Depth of liquid level above outlet invert: VO Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): , Distribution box has one lateral . No evidence of solids carry over . No evidence of leakage into or out od the ox PUMP CHAMBEW1/ptlf,(locate on site plan) Pumps in working order(yes or no): A)19 Alarms in working order(yes or no): TW Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present ' 8 r Page 9 of I 1 4 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM.INFORMATION (continued) Property Address: 52 Ships Eagle Lane stervi e ,Mass . j Owner-. William L . rown Date of Inspection: 4 2 9 02 SOIL ABSORPTION SYSTEM (SAS): locate on site plan, excavation not required) 1—LP-1000 6 6 ' X 10 ' 1 If SAS not located explain why: Located see page 10 Type leaching pits. number: )O leaching chambers, number: D AV leaching galleries,number: 0 , leaching trenches,number, length: D A16 leaching fields, number, dimensions: D AJO overflow cesspool, number. innovative/altemative system Type/name of technology:// � Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Loamy sand to medium fine sand . No signs of hydraulic failure or ponding . Soils are dry . Vegetation is normal . Waste water is- 26" • below the invert pipe . CESSPOOLS21(X/L(cesspool must'be pumped as part of inspection)(locate on site plan), Number and configuration: Q Depth—top of liquid to inlet invert: AM Depth of solids layer: Oda Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): 41,41 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspools are not present•. PRIVYZ�(locate on site plan) Materials of construction: Dimensions: 22V ' Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy is not present :. 9 f Page 10 of I I OFFICLAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORJv1ATION (continued) Properry Address: 52 Ships Eagle Lane ( caretakers' cottage ) stervi e , ass. Owocr. William L . Brown Dstc or lnspcctioo:4/29/02 SKETCH OF SEWACE DISPOSAL SYSTEM Provide a sketch or the sewa4c disposal system including tics to at ]cast two permanent reference landmarks or Dcnelvnuks. Locate all wells within 100 (cm Locate where public water supply enters the building. k � 1-F - 7 t , 10 f Page I I of 11 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Ships Eagle Lane Osterville , Mass . Owner:William L. Brown Date of Inspection: 4/2 9/0 2 , SITE EXAM , Slope Surface water ; Check cellar Shallow wells - - s 1 - . Estimated depth to ground water feet " Please indicate (check)all methods used to determine the high ground water elevation: /tJ0 O ed from s stem design plans on record-If checked, date of design plan reviewed: di41 /Y_Cd& Observed site(abutting propek7i bservation hole within 150 fee of S�� Checked with local Board of Health-explain: 1zJlr Checked with local excavators, install (an h documentation) Accessed USGS database explain: You must describe how you established the high ground water elevation: " Used ; Gahrety & Miller Model . 12/16/94 Grond wntPr Plevarion ah0jr6'-js6a lovel . Ysed ; USGSObservation Used ; Technical BitIIPtin _ 97—OOn—f11 Plate #2 Annual ranges o group water , e eva ions . Top of Ground Leaching Pit ifs :eet ' Groundwater Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the bottom x of the leaching pit and the adjusted groundwater table is feet. • t I 1 -. Larrnrw.�rtlT�*-T�7n.-mr•nmrr�-e.R rnr.mr.:•.�.'+-�mr:mrn*mn mrt�u.+a�rrar:rra� .�T�v-n.•-:..-•.r-. •, TOWN OF Barnstable WARD OF HEALTH SUBSURFACE SF.WA(;E DISPOSAL SYSTEM INSPECTION FORM ,- PART D.- CERTIFICATION 1 •••T^1 T••.••' -T.111.�.�T T T.T1'f1.Tll Tlt'.4i7T TT�T't-t•I."IITI'R:7>tIR1C/"'TTTRRIO�R�fORR�eA7R� rVW74mrmr, ..1 -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 52 Ships Eagle Eagle Lane Osterville , Mass . ' . areta ers cottage . ASSESSORS MAP, BLOCK AND PARCEL # 164/022 OWNER# S NAME William L . •Brown PART D -- CERTIFICATION NAME OF INSPECTOR Joseph P . Macomber Jr .. COMPANY NAME•J . P .Macomber & Son Incre COMPANY ADDRESS Box 66 Centerville , Mass . 02632 _ Street Town or City State LIP COMPANY TELEPHONE (508 ) 775 _ 3338• FAX ( 508 ) 790 - 1578 >R CERTIFICATION STATEMENT ' I certify that I have personally inspected the sewage dieposa7 system at 4 this address and that the information reported -is true', accurate , and omplete as of the time ofjinspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training 'and experience in the proper function and maintenance -of on- site sewage disposal systems , ' Check one : �y S stem PAS Y SED The inspection which I have conducted has not found any information which indicates that .the system fails to adequately protect public healLh or Lhe enviroliment as defined in 310 CMR 151303 , 'Any failure criteria not eval,unted are as stated in the FAILURE CRITERIA section of this form , System FAILED* \ The inspection, which I have con trcted has found that the system fails to protect the t)ublic health and the environment in accordance with Title 6 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this ,inspection form , Inspector Signature Dat: ne copy of this rt.ification must be provided to the OWNER, the BUYER ( where applicable ) and the DOARD OF HEALTH, * If the- inspection FAILED, the owner or"'operator . ehall u pgrade ' the eyetem within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 . 305 . partd . doc DATE: 4/29/02 PROPERTY ADDRESS: 52 Ships Eagle Lane Osterville ,Mass'. ------------------------ 02655 On the above date, I Inspected the septic system. at the abao address, This system consists. of the following: PARCEL • 1 . 1-2500 gallon septic tank. LC T 2 = 1-Distribution box . Rtutivtu 3 . 2-1000 gallon precast leaching pits . ( 6 ' X 10 ' ) Based on my inspection, I certify the following conditions: MAY 0 3 2002 4 - This is a title five septic system. ( 78 Code ) . 5 - The septic system is in proper working order TOWN OF BARNSTABLE at the present time . , HEALTH DEPT. 6 . Both of the leaching pits are dry at the present time . Stain line on # 1 pit is 36" Stain line on 4U pit is 0 ' _ SIGNATURE:� _ Name:_J _F_ Macomber _;ram Company: Joseph-P_ Macomber-& Son , Inc . _ Address; Box 66 __Centerville , Ma , 02632-0066 Phone: 508_775_3338 -THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P, MACOMBER & SON, INC. Tanks-Cesspools•Leachflelds Pumped & Installed _ '• Town Sewer Connectlons P.O. 'Box 66 Centerville, MA 02632-0066' 775.3338 775.6412 COMMONWEALTH OF MA,SSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM } PART A CERTIFICATION Property Address: 52 Ships Eagle Lane -U—sEervilie ,Mass . Owner's Name: William L . Brown Owner's Address: 80 Black Oak Road Date of Inspection; 29 0 Name of Inspector: (please print) Joseph P,Macomber Jr . Company Name: J. P . Macom er & Son--Tn—c . Mailing Address: Box 66 . 02632 Telephone Number: bU8-775-3338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system ai 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 Funhcr Evaluation by the Local Approving Authoriry Fails Inspector's Signature: l i Date:` The system inspector shall mit a copy of this inspection report to the Approving Authority(Board of Healtb or DEP)within 30 days of completing this inspection. if the system is a shared system or has a design now of I o,00ci 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, irapplicable, and the approving authoriry. 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 differeot conditions of use. Title 5 Inspection Form 6/15/2000 page I i Page 2 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 52 . Ships Eagle Lane Ostervi e ,Mass . Owner: William L. Brown , Date of Inspection: 4/2 9/0 2 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passed `. , �havet found any information�.vhich indicates that any of the failure criteria described in 310 CvIR 15.303 o 15.304 exist. Any failure criteria not evaluated are indicated below., Comments: The septic s sytem is in proper working order at the present time , Both of the leaching pits are presently ry . B. System Conditionally Passes: ,t%J 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: �1D The system required pumping more than 4'times dyear due•td broken or obstructed pipe(s),.The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain 2 Page 3 of 1 I OFFICIAL INSPECTION FORM -,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) , I Property Address:52 Ships Eagle Lane k stervi e , ass Owner: William L. Brown Date of Inspection: 4 29 02 C. Further Evaluation is Required by the Board of Health: .UB 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. I. 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: .fie 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. ., 'c_._,!� 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. JGd The system has a septic tank and SAS and the SAS is less than 100 feet bu 50 feet or more from a private %{ater supply well". Method used to determine distance �.L-iZCL� '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. A 3. Other: 3 Page 4 of l l OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A k CERTIFICATION (continued) Property Address: .52 Ships Eagle, Lane Osterville ,Mass . ; -- Owner.William 4, Brown Date of Inspection: Z9/u D. Svstem Failure Criteria applicable to all systems: You must indicate "yes"or"no" to each of the following for all inspections: Yes No r' Backup of sewage into facilin,or system component due to overloaded or clogged SAS or cesspool ' ischarge or ponding of.effluerit to the surface of the ground or surface waters due to'an overloaded or iClogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or _ �esspool �iquid depth in eessp tit is less than 6" below invert or available volume is less than 'h day flow " equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number /of times pumped _ ✓ 4ny 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 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 trom a private water supply well with no acceptable water qualiry 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 br less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) 1,10 (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 o , Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no/ •. ✓ the system is within 400 feet of a surface drinking water supply ��the e system is within 200 feet of a tributary to a surface dru*ing water supply system is located in a nitrogen sensitive area(interim Wellhead Protection Area—'IWPA)or a mapped Zone 11 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 .�es" 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 !5.304, The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART B CHECKLIST Property Address: 52 Ships Eagle Lane Osterville ,Mass . Owner: William L . Brown Date of Inspection: 4/2 9/0 2 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No umping information was provided by the owner, occupant, or Board of Health 1/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? YWere as built plans of the system-obtained and examined?(If they were not available note /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-cluding the SAS, located on site ? a -Z- Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the bafflesor 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 _yExisting information. For example, a plan at the Board of Health. P _ 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)j 5 Page 6 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION , Property Address: 52 Ships Eagle Lane stervi e , ass•. M Owner: William L . Brown , Date of Inspection:4 29 02 FLOW CONDITIONS RESIDENTIAL ` Number of bedrooms(design): 2 Number of bedrooms(actual): n /J DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 77U 49r/9 Number of current residents: Does residence have a garbage grinder(yes or no): S , Is laundry on a separate sewage system �yes or no):�Ae (if yes separate inspection required) . Laundry system inspected or no):' . Seasonal use: (yes or no): Water meter readings, ifavatlable(last 2 years usage(gpd)):2000-367 , 000 gallons=1005 . 48 GPD Sump pump(yes orno):�i�Z3� - gallons=1205,. 48—GPD Last date of occupancy: +�� This is from well pit thservices caretakers cottage #_5.1 COMMERCIAL/INDUSTRIAL `Sprinkler 'system, •is present , Type of establishment: Design flow(based on 310 CMR 15.203): gpd 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:r + OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: 1JI'� Was system pumped as part of the inspection (yes or no): _c If yes, volume pumped: C:1 gallons - How was quantiry pumped determined? .11/4 Reason for pumping: TYKE OF SYSTEM L/ Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy t' 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) .K Tight tank �Attach a copy of the DEP approval �L Other(describe): Approximate age of all compor4e2lpte ' stalled (if kno a d source of igfprm io Were sewage odors detected when arriving at the site (yes or no):412d j f Page 7 of I I qy, OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 52 Ships Eagle Lane . Osterville , Mass Owner: William L . Brown Date of Inspection: 4/2 9/0 2 BUILDING SEWER (locate on site plan; Depth below grade: Nil Materials of construct_ion: cast iron �0 PVC other(explain): Distance from private water supply well or suction line: /1/- Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear ti hg t . No Qvid n -of 1eakage Th��� system is vented through the house vent . SEPTIC TANK: Zlocate on site plan) Depth below grade: b" u Material of construction: Zconcrete A metaIA2 fiberglass,c polyethylene other(explain) 'eO If tank is metal list age: 4,0 Is age confirmed by a Certificate of Compliance (yes or no):446 (attach a copy of certificate) , I) I t / Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:At_tL 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: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of-leakage, etc.): (Pump the septic tank annually on year round useage very 2-3 years rif used seasonal y Tnl et R out tPPR arP in pl arP 1hP tank i s, structurally sound and shows no evidence of'l-eakage . GREASE TRAPIt/Ulocate on site plan) Depth below grade: Material of construction:Aq concrete jgmetaW fiberglas polyethylene W other (explain): Dimensions: ,4 Scum thickness: Distance from top of scum to top of outlet tee or baffle: �9 Distance from bottom of scum to bottom of outlet tee or baffle: �139 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.): _--_r_ease trap is not nr.pspnt . 7 Page 8 of 1 I OFFICIAL INSPECTION FORM-- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 Ships Eagle Lane s ervi e , ss . Owner: William L . Brown d Date of inspection: 4 2 9/0 2 TIGHT or HOLDING TANKtIAtle, (tank must be pumped at the of inspection)(locate on site plan) Depth below grade: _. Material of construction: concrete 10 metal fiberglass ti Polyethylene 4),f other(explain): " Dimensions: Capaciry: gallons Design Flow: gallons/day Alarm present (yes or no): " Alarm level: XtJ Alarm in working order(yes or no): Date of last pumping: otY Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not present . DISTRIBUTION BOX: ,!(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: ` Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any.evidence of. leakage into or out of box, etc.): Distribution box has two laterals 'No evidence of solids Fcarry • over . No evidence of leakage into or out of the box PUMP CHAMBEWX)6? (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no):.�f� M Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): - Pump chamber is not present Page 9 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:52 Ships Eagle Lane Osterville ,Mass . Owner: William L . Brown Date of Inspection: 4 2 9/0 2 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required) 2-1000 gallon nrerast leaching_ nits _ 6 ' X 19 ' Roth of the leaching pits are dry . If SAS not located explain why: Located see page 10 Type leaching pits, number: .2 AL leaching chambers, number: 7 leaching galleries,number: P leaching trenches,number, length: (� Z,?o leaching fields, number,dimensions: to overflow cesspool, number: eD � p 73 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.): Loamy sand to medium fine sand . No signs of hydraulic failure or ponding . Soils are dry . Vegetation' is normal CESSPOOLS64)C (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: A)A Depth of scum laver: 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.): Cesspools are not pr�tit . PRIVYA/4)6 (locate on site plan) Materials of construction: ,w9 Dimensions: AA Depth of solids; �✓ Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy is not present . 9 page 10 of I I y' OFFICLAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORINIATION (continued). Properry Address: 52 Ships Eagle Road ` _Ostervilie . Mass . Owocr: William L . Brown Datc of lnspcctioo: 4/29/02 SKETCH OF SEWACE DISPOSAL SYSTEM T Provide a sketch of the sewage dispos+l system including tics to at least two permanent reference landmarks or ocncrvnuks. Locate all wells within 100 fcct..Loe,atc where public water supply enters the building. � 4 V I :. \ \ rw O it 10 + Pace I 1 of 11 OFFICIAL INSPECTION FORM — NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Pro,pe:rtyA:dd.ess: 52__Ship.s. Eagle Drive O.sterville,. , asS . Owner: William: L. Brown Date of Inspec.,tion 4/2 9/0 2 SITE EXAM Slope Surface water Check cellar Shallow wells P , Estimated depth to groundwater$® feet 1 Please indicate (check)all methods used to determine the high ground water elevation: ti0 am=N=6bservation system ns on record If checked, date of design plan reviewed: ,eW hole w hin 150 feet of�S S t Checked with local Board of Health-explain:A Z-- , I Checked with local excavators, installers each documentation) e Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used ; Gahrety & Miller Model 12/16/94. Ground water elevation above sea evel . Used ; USGS ; Observation well data . June 1992 Used ; USGS ; Technical ^bulletin 92-000-2 Plate # 2 Ann„al rnUgpsof Q,rouad water 1 Pvel .G _ roun Leaching Pit 'eet T r ,Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Fhmpter Method Therefore, the vertical separation distance between the bottom f of the leaching pit and the adjusted groundwater table is J11 feet. 11 ` 'rt*nrw.-nr�*-Tt� rnrmnTiTrsTnrert.rarer:•.T•*er�rr:lr'rmm�.rrrSlet na'Tl'Tim rrT .�T� -. TOWN OF Barnstable WARD OF HEALTH r j SUIISUI?FACF 9FNAGF DISPOSAL SYSTF,M INSPFCTION FORM - PART D.- CERTIFICATION I .•••T•• �T•••••.-T.11�'•.�T�1I.Tn'n.1TiTTQTTTtTR'r�•.•1•"'111TR\1TR1CT'�1'RT'RTI►R�'A•Rr\ Tn .•.-'If'rT'T•1. �..A TYPt OR PRINT CI"EARLY•— PROPERTY INSPECTED STREET ADDRES$ 52 Ships Eagle Lane Osterville , Mass . ' ASSESSORS MAP , BLOCK ANU PARCEL # 164/022 OWNER' s NAME William L .' Brown PART D - CERTIFICATION NAME OF INSPECTOR Joseph P .Macomber Jr . COMPANY NAMEJ . P . Macomber & Son Incew COMPANY ADDRESS Box 66 Centerville , Mass . 02632 Strev.t Town or city state tIP COMPANY TELEPHONE (508 . 775 3338. FAX .( 508 ) -790 - 1578 R CERTIFICATION STATEMENT. I certify that I Have personally inspected the sewage disposal system at this address and that the information reported is true ; accurate ) and omplete as of the time of :inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair' are consistent With my training and experience in the proper function and maintenance of on site sewage disposal systems , Check one : w . Z' systeci PASSED ` The inspection which I have conducted has not found any information Which indicates that the system, fails to adequately protect public health or the environment a.s defined in 310 CMR 15 , 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of lLhis form . ' System FAILEll* �\ The inspection whichI "have c'on 'Octed has found that the system fails to Protect the public health and the environment in accordance with Title 5 , - 310 CMR 15 , 303 , and as specifically noted, on PART C FAILURE CRITERIA of - this- inspection form , Inspector Signature Dat. � ne copy of this rt.ification must be provided to the OWNER, the BUYER ( Where applicable ) and the BOARD OF HEAL1'II• * If the inspection FAILED, the owner oroporator shall upgrade ' the he within one year of the date of the inspection , unless eyetmallowed or required otherwise as provided in 3.10 CPIR 16 , 305 , partd : doc TOWN OF BJARNSTArBLaEi�, >� ' SEWAGE # V,--i!AGE b ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY -LEACHING FACILITY: (type)60�� /o (size) NO. OF BEDROOMS a BUILDER OR OWNER z A..L,,L2 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet LEdge ater Supply Well and Leaching Facility (If any wells exist or within 200 feet of leaching facility) Feet etland and c ' Facility(]fan etlands exist300 of cFeet b 1 t � TOWN OF BARNSTABLE LOC A770N � �f" CC r) SEWAGE #. 'ILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY !VJ- f /14A _ LEACHING FACILITY: (tygpe),e- lao d/Ald / (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 ching F ility(If we ands exist within 300 f f e c I cility) Feet Furnish d by r " Commonwealth of Massachusetts I EXEMPT Asbestos Notification Form-- ANF-001 i Asbestos Abatement Description 1. Facility location: Chad r•D:.Q.e..3_.. .. l � ' _...........S 's_Lane.. flµ --.--.....-_ INSTRUCnoks 'ra e Address —-__---- 0s.t-e'.rv.ille'-`,'MA ; , cr026'55'° rLa-�L!-: 3.::�508-962-6742 •AII Sections of this form .......__..._ ........__ .......-....... ......:.:::...........p----must completer)in oroer Cpy/Town Zip code `Telephone +.o comply with the ,4 b a_s e_m_e n t + y a Department of What is the voresire location?building name./,wing,floor,room Environmental Protection notification 2. Is the facility occupied? A Yes ❑No re,quirem itts of 310 CMP. ' %.15(ten working days t )rio(nolihcarion is 3. Asbestos Contractor: reouued of any aoatemer,; S Hancock & C o Inc P 0 B 6 0 5 61 xojecb;and the el Department of Labor n_ Address — _--- and Industries_iGtifiCZtion reQUiqui rErnem;01 ;c)rc._e"-ter MA 01606. 508-595-9000 -_' ;;CIAR 5.1"l ,fen days '�'tyr�4'"n Zip code Telephone. error notification is C O g 0 136 6 W r it t e n �uiredolANyaoe!emenl _............._......................._.._.........._....._...._.....--.._.._........_...._........._._.._.._._._.._..._.....-_._......_._..._.........._...................._........._..........._...........__._.._...._.....-------- -- x0jecl greater Ina.',tnr- DOGcens:{ Contract Type(wrinenA2rbal) - linear or square Icq. 4. On-Site Project Supervisor/Foreman:, 2. Submit Original Form c iwinfield S Hancock.__ AS30582 Commonwealth of came-- --- oucenihcalionOr — Massachusetts 5. Project Monitor. Asbestos Program P.O.Box120087 ---- 1 Boston,MA ;ame DLIcertification/ 02112-0087 6. Asbestos Analytical Lab: a 3:This form may be used Northeast Environmental labs. AA000153 for notifying the U.S. Name ---- - --- DlI Certification/ --- Enyiionmental Prolecftn .. ._.... - '.' ..... .._ _ -E ApencyRegior tot 7. Project startdat 7 r O'2enddate7 0 pecitic work hours(Mon.•Fri.) tam WQMc-(Sat Sun.):% asbestos oenort , fi enovation ope nn. _... a.. subject to NESiA?S(a:, 8. h/tier type of project is thtS? (circle one): T demolitiony repair Y i renovation/' other(explain) CFR Subpart t:.l. For r 9. Describe•tfie'asbestos abatement procedures to be used (circle) (glo eoa� enclosure 1full containment 1 cleanup �. encapsulation ,disposal only other(explain) - -- lyae�em 10. Is the job being conducted r,indoors '_1 outdoors? 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) —or other sudaces(square ft.) 50 10 be removed,enclosed or encapsulated: i linearlsquare feet boirer,breacnmg,dud,tank surface coatings...— /5 0 thermal,solid core pipe insulation..... - roNugared or layered paper pipe insulation....3 0 Q/_ nsulating cemen!........:....... .' spray-onfireprooling.....................�_ tfowellsplayer coatings.,............. / uoihs,woven fabrics................: ... /_ transits,board,wall board........... _J_ other(please describe). ........... 12. Describe the decontamination system(s)to be used: cecon with shower 13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): 't.sotalos removed and handled wet , double haggari in 6 mm hags o f=d d o tJ In 1 P t o-pZ d_f ans.pjDt tp__d_i n c 1 a s e� u a n 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: r ._-..._. •.- _ :^ta:2 .�DEo pr,icmP - �.....— ---^ - -,Title .a. :Ott t2 '--._—..------------------ -Title --- c,ins '77 Waiver{ ---- • - _ . 15. Do prevailing wage rates apply as per M.G.L.c.149,§26,27,or 27A-F to this project? C1 Yes No Facility Description 1. Current or prior use of facility: Residence 2. Is the facility owner-occupied residential with 4 units or less? 9)Yes O No s 'I Facility Owner: -Chad Doe — - Ship's Lane Name Address _ osterville_,. Ma _ 02655 _ Cfry/own Zip code Telephone -' 4."-Facility's Owner's On-Site Manager: Name Address .......--..............................................................................................._....,,...-......................................._..............._.................__._......._..___^--._...--..................._...__.............._......................................... Ceyjown Zip code Telephone 5. General Contractor: ..............................._.............................................................._........................._......................._......................._..........._..........-- .._... ............----------........................_._......_..... ...... Name Address .........................._....._........_..__..._......._....._.................................................._.............._-......._...........-....._.._........�-----.....__._.._._........._..---........_...._...........................__............ Ciry/rown Zip code _ .Telephone - Contractor's Workers Comp.Insurer Policy I Erp.Date 6. What is the size of the facility?1 4nn0 (sq ft) 3 (#of floors) 13 Asbestos Transportation and Disposal 1. Transporter of asbestos-containing waste material from site to temporary storage site(if necessary)to final disposal site: W......5....._H.a_ _ .ok......_&.._.._C_R.......I..n_ ....................................G_e.. _t._r._a_1......_N_...E Warehouse- - ......-4.Q..._._Pullman.._._ . _ ......_5-r...- Nane Address !rorcester , MA 01606 508-595-9000 Ciry/rowa Zip code Telephone 2. Transporter of asbestos-containing waste material from removal/temporary storage site to final disposal site: Service Transport Group Inc 28 Privilege .St __.-___........ — — tiane Address Woonsocket , RI 02895 401-766-1824 ..._.....___—_... --.___.._._._..__.._....------...._..__..--_.__._._.....__.___.__.-- --------- Note:Transfer Cdy/rdwn Zip code Telephone Stations must 3. Refuse transfer station and owner(if applicable): comply with the Solid Waste Division regula- Name Address Lions 310 CMR 18.00 — C,VTows Zip code Telephone 4. Final Disposal Site: Greenridge Reclamation, Division o.f Republic Waste Services Inc . Location Name Owners Name RD # 1 Bos 716 Landfill Rd Address ——_— Scottdale, PA 015683 724-887-9400 Ciry/rown Zip code teleohone Certification The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts Regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. ni ,t 1d 5 fancock / Ilo4,tf Prim Nave Authorized Srpnaiure Date Note:Contractor must sign this President W S Hancock & Co Inc 508-595-9000 ................. ...._............:._............._.............................._....................................................................................................................................-... ...._._.................................................... ...._.... .... form for DLI Posiroc/rine Representing telephone notification purposes POB 60561 Worcester, MA 01606 .............................................................................:....................:.............................. .................._._..._......................._................_.................._....................._.. ........................................................................... ..._. Address City/Town Zip code Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less)?5�yes no Sticker a(from front of form): 759495 f Diane,Wilson t IKE 'o s C_Jy MASS. V Qp 16;9• ,�eb Home: Departments:Assessors Division: Property Assessment Search Results 52 SHIPS EAGLE.LANIE .'. • Owner: . DOE,CHARLES F c Property Sketch,11. " Map/Parcel/Parcel Extension 164 /022! Mailing Address DOE, CHARLES F ; ;®g' =; DOE, DEBORAH J . 1 52 SHIPS EAGLE LN 2240 a OSTERVILLE, MA.02655 FA 2004 Assessed Values: Appraised Value Assessed Value ' " ' F Building Value: $ 1,954,700 $ 1,954,700 Extra Features: $7,200 $7,200 F `` Outbuildings: $ 150,000 $150,000 " '• ." -. Land Value: $2,874,600 , $2,874,600 : Interactive Property Map:Ma requires Plu in: Totals:$4,986,500 $4,986,500 1 have visited the maps before r 1tCI .UP First time Show Me The Map Click'April 2001,photos available Sales History: Owner: • Sale Date Book/Page:, Sale Price: BROWN, WILLIAM L 9/15/1988 C115594. $ 1 DOE, CHARLES F 5/31/2002 ' .15216/314 x `$(i,000,000, (� 2004 Tax Information: Tax Rates: (per $1,000 of valuation)' Town Tax $32,960.77 Town Fire District Rates _ Other Rates r 6.61 Barnstable. 2.01 Land Bank-3%of Town Tax C.O.M.M. FD Tax $'5,485.15; C.O.M.M. ',1.10 „ Cotuit. 1.52 ' . Land Bank Tax $988.82 Hyannis 2:03 West Barnstable 1.36, Inane Wilson Total: $39,434.74 dDue to rounding differences these values may vary _ ry Land and Building Information y Land Building Lot Size(Acres) 3.53 , Year Built Appraised Value $2,874,600 Living Area 12241 Assessed Value $2,874,600 Replacement Cost$3;554,045 Depreciation 20 Building Value 1,954,700 ; Construction Details Style Conventional interior Floors CarpetHardwood Model Residential Interior Walls Plastered Grade Superior Heat:Fuel Gas, Stories 2 Sty WFAT Heat Type .,Hot Airidl AuExterior Walls Wood Shingle_ AC Type ' Centralr Roof Structure Gable/Hip Bedrooms 7 Bedrooms °�- �" - _ ► ^ Roof Cover Asph/F GIs/Cmp Bathrooms 10 Bathrooms' { , Total Rooms_24 Rooms p '- Extra Building Features y } Code Description Units1SQ ft Appraised Value Assessed Value FPL3 Fireplace 3 $7,200 DCK2 Dock-Avg Const 1 $.150,000 $ 150,000 Property.Sketch Legend .,. BAE� First Floor, Living Area FST Utility Area(Finished Interior) ' UAT Attic Area(Unfinished) BMT• Basement Area(Unfinished) FTS Third Story Living-Area(Finished) UHS Half Story(Unfinished) CAN Canopy 6Fus Second Story Living Area (Finished) UST Utility Area(Unfinished) r K . , FAQ Attic Area(Finished) GAR Garage UTQ' Three Quarters Story(Unfinished) , FCP Carport GRN" Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio., UU$ Full Upper 2nd Story(Unfinished)_ FHS Half Story(Finished) $FB ' Semi Finished Living Area WDK Wood Deck;. FOP Open or Screened in Porch TQS '_Three Quarters Story(Finished) z • _� is .e Commonwealth of Massachusetts f? City/Town of Barnstable IV. Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important` A. Site Information When filling out forms on the computer, use Code Realty, LLC,"52`Ship's Eagle Lane Osterville;`MA 02655 only the tab key Owner Name to move your Samantha Drive cursor-do not Street Address or Lot# use the return key. (Cummaquid) Barnstable MA 02637 Cityrrown State Zip Code John Hutchins Contact Person(if different from Owner) Telephone Number B. Test Results 0/0 10"oo-y", Datb I Time Date Time Observation Hole# Depth of Perc Start Pre-Soak End Pre-Soak SM r)v 'Al Time at 12" (� Time at 9" r Time at 6" n4 /J 2 � yYt %V Time(9"-6") � /vcvN /nail/ Rate (Min./Inch) AV9 /xd- Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ David D. Flaherty Jr., R.S. Test Performed By: Don Desmarais, R.S. Witnessed By: Comments: t5form12.doc•06103 Perc Test•Page 1 of 1 (9 Commonwealth of Massachusetts QwTown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal P-k* 1139?7 DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information 1. Facility Informationede, " 5"Z b' s&a& Owner Name [/c/ 51fm/ff'y/g D2e1/C Map/Lot (/(— Q f Street Addres City/Town /( State Zip Code B. Site Information 1. (Check one) New Construction Upgrade ❑ Repair q❑ 2. Published Soil Surveyavailable? Yes No ❑ If yes: l 3 2s MOV QQ Year Published Publication Scale Soil Map Unit Soil t4ame Soil limitations 3. Surficial Geological Report available? Yes No ❑ If yes: ' 1 U0) D 0 O �+ Year Published Publication Scale Map Unit Geologic Material Landform 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes No ❑ Within the 100 year flood boundary? Yes ❑ No 0 Within the 500 year flood boundary? Yes ❑ No Pd Within a Velocity Zone? Yes ❑ No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 1 of 7 Commonwealth of Massachusetts QtwTown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal 6. Current Water Resource Conditions(USGS) U/Ucfi Month/Year Range: Above Normal Normal ❑ Below Normal ❑ /. ��� � �k 7. Other references reviewed: / I� � ��s �-� G✓� 60/V ,(� ®� C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: Date( Time Weather 1. Location t ,�1 Ground Elevation at Surface of Hole 3 A]�V 0 Location (Identify on Plan ) 2. Land Use: bimy-O LV+� 0 1 70 _ (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) w1w�g in&k, Lar iz,- a—AI& - vegetation Landform / Position on landscape(attach sheet) >��) L,[ 3. Distances from: Open Water Body/ f vv Drainage Way `Q Possible Wet Area !W �{{e t feL'-� fee t'y � Pro �� perty Line U f Drinking Water Well Other >Z� ;;; / Jy �v✓ S 1�� feet feet 4. Parent Material: �(� ra.� Unsuitable Materials Present: Yes ❑ NoX If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock[] 5. Groundwater Observed: Yes ❑ No 7[ If Yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater. � ! DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 2 of 7 Commonwealth of Mas sachusetts 6+tyffown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal inches elevation Deep Observation Hole Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil Depth Horizon/ Color-Moist (mottles) Texture %by Volume Consistence Other Layer (Munsell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles &Stones 0 - 3 0 Additional Notes ) kj f" DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 3 of 7 Commonwealth of Massachusetts Q44Town of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Cont.) _ Deep Observation Hole Number: l O(o l� ;6V 6 D toI Time Bather 1. Location 2 Ground Elevation at Surface of Hole J Location (Identify on Plan ) 2. Land Use: RC" (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) 5cro 6 0y�/F_ Vegeta ion f V Landform /f Position on landscape(attach sheet) 3. Distances from: Open Water Body- Drainage Way 60 Possible Wet Area,N670 �et t > Beet ,L' S� " Property Line Drinking Water Welll �� Other / eet feet 4. Parent Material: Cr� � Irk Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑ 5. Groundwater Observed: Yes ❑ No r If Yes: Depth Weeping from Pit Depth Standing Water in Hole it Estimated Depth to High Groundwater: inches elevation DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 7 Commonwealth of Massachusetts Gi#ylTown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole.Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil Depth Horizon/ Color-Moist (mottles) Texture %by Volume Structure . Consistence Other Layer (Mansell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles &Stones 0- /0 33 Ili / -67 --------------- Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 5 of 7 commonwealth of Massachusetts GWTown of Barnstable Form I I - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B. inches inches ❑ Depth to soil redoximorphic features (mottles) A. B. inches inches ❑ Groundwater adjustment(USES methodology) A. B. inches inches 2. Index Well Number. Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturajly occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes No❑ b. If yes, at what depth was it observed? Upper boundary: Lower boundary: • inches inches F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis h been perfor ed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. I further certify that the resu s f my oil lua' ,a.011ndicate 'n the attached Soil Evalu tioZ orm,are accurate and in accordance with 310 CMR 15.100 through 15.107. 71 nature of S ' valu r Date yped or Printed Name of Soil Evaluator Date luator Exam Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with Percolation Test Form 12. DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 6 of 7 Commonwealth of Massachusetts GitfTown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Use this sheet for field diagrams: DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 7 of 7 r , o \ 4 % .\ 1� 1 -- \ 6B� - PATS I TH- SO '� F 79 cn -a T 3 _ _ BEN HARK: MA NAILS? 55 0 NOTE: T 7 TO Area /t}3,97 ' ELEVA ION = 79. 1 ;'- \ p HOUSE UTTERS AN / \ DRIVEW I Y DRAIN 0 r TE ORYWELSD TO // P�> / -/ \\ \ \\ fin 7S tv PROPOSED_lR�O ION CON T OL: \ TH3 J / \ \ v 1 It& FENCE & Y.4. ° PROPOSED P CE �JNTIL\ / TH1 LEA HING PIT \ \\ \ N STABILI TYP� / / / DRAINAGE� � \ 74 TY ) LEACH G THE C \ o CL R 40 EASEMENT 14 .09' 4-2/— (TYP)743 +CLE IMIT - C EAR.LI�AIT 1D CLEAR_LIMI)'ll-I�j \ 74, - �I ;LOPE 1 \ \" 739_-44.7 A .. : — -- A;., R I IT ^� • • 3EMENII j _ t: . � . P P : 'P 1 744 E' SEM �7� 761 9' '0289 14Vy IMIT �6� +. —�eae� / 9/ 7 .95 +75.� 1 + 1 OFF TT OF \ 11'OFF 1' \FF / 11 OFf�\ 11'OFF - ------- '-- -------- ------ -- - ------- - ----- --- `----- ------ -----= ------ --- / 2 701 1 o cL / / �o 'L�� + �L IIIV � WIDE MIND B���A� cL—tow / -W OfiEEA 1'OF�I.EAR_UTAIT R "' ':'. c • • 7g ! MIT o / • ..,,e s .•.i10 4'ROPOSED-2JD!— S / :v.•:\,n\ 26 1 .097/ 70 \ ._.. 15 44. 714 \ L 0 \ CLNR�IMIT CLEAR ■ • 40 LEARVILIMI \ \CLEA J.IMI WIDE PAVEMENT -/ �� 1• � �� CLEA _UMI \ \ � f \ � (�8' +' BE�M�' / ,�, \ o ) O,�� 1 CROWN 2�l -1 o z} \ I 1 ` 0 0— L DRAINA 16 0 \ �x �. RS / o rnx � \ / ) l1 �1LEIS IT 8�' NC 111cn EASEMENT / `ti \ �� 8rEL R I ANT/ �zl o a3 VARJ�MIT \ 1 71��2 7 N � \\ \\ I TAP E 'ISTI�Nyt� 8" �1 � �o / CL AR-umprO.00' CLEAR-LIw I CS 'X8',' &G I SLOPE \ 1 / �- \ \ / v1 7 Q ASEMENT / IR OMI7 1%� -4 \ ) ) I // BENCHMARK:: TOP OF CONC. BOUND r ELEV. = 89.47 25 - \ - - - - - - — •LEAR�IMIT - - - --- -47-05- T NOTE: CONTRACTOR O , \ OVIDEA SPEED HUMP & S4IN ) \ N HAMSTEAD LANE AS SHOWN Commonwealth of Massachusetts G4yFfown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information 1. Facility Information J /� 5-2 S � �S��G� /'Z/� Owner Name C [�i.�� `'/ / O J V E Map/Lot L Street Address S , C if lJ�'yrrn K.� �_l City/Town State Zip Code B. Site Information 1. (Check one) New Construction ;5- Upgrade ❑ Repair ❑ ' 2 �Oro2. Published Soil Survey available?. Yes �- No ❑ If yes: 1 Ye/arPublished Publication Scale Soil Map Unit Soil ame Soillimdations �7 / / 06 L !/ l S ice) 3. Surficial Geological Report available? Yes � No El If yes: Y r Published Pu lication Scale Map Unit � 5�fS Geologic Material rLandform 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes No ❑ Within the 100 year flood boundary? Yes ❑ No Within the 500 year flood boundary? Yes ❑ No Within a Velocity Zone? Yes ❑ No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 1 of 7 Commonwealth of Massachusetts G y Town of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Jotj�_' Ran e: Above Normal Normal ❑ Below Normal6. Current Water Resource Conditions(USGS) 9 � _ MonthNear / 7. Other references reviewed: &ed4i � �`cU C. On-Site Review (minimum of two holess required at every proposed primary and reserved disposal area) T Deep Observation Hole Number: 3 ld 16& a4-7-� Date Time Weather. 1. Location Ground Elevation at Surface of Hole Location (Identitffy" on Plan ) 2. Land Use: Surface Stones Slope(%) (e.g.woodland,agricultural field,vacant lot,etc.) Vegetation '505+--rY" Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body- Drainage Way f Possible Wet Area/>X�_V fee_t __ j S Property Line-3Sfget� Drinking Water Welle Other �''rn feet feet �6ry - 4. Parent Material: L"I"I' Unsuitable Materials Present: Yes ❑ No Z If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑ 5. Groundwater Observed: Yes ❑ No If Yes: Depth Weeping from Pit Depth Standing 9 Water in Hole Estimated Depth to High Groundwater: DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 2 of 7 Commonwealth of Massachusetts FTown of Barnstable Form 11 Soil Suitability Assessment for On-Site Sewage Disposal inches elevation Deep Observation Hole Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil Depth Horizon/ Color-Moist (mottles) Texture % by Volume Consistence Other De p Layer (Munsell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles &Stones r g C� r s. n 36' C Z-5 �S �� l� Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 3 of 7 Commonwealth of Massachusetts Gity Town of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Cont.) Deep Observation Hole Number: 7 IU d 6 P` Date Time Weather 1. Location j_ ,�� II Ground Elevation at Surface of Hole / !/ f vv6-Vf) Location (Identify on Plan ) 2. Land Use: wqnw �,+�'�✓� [ /0 ( ✓' G (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) 'Vegetation (OC(-4 7— Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body' Drainage Way Possible Wet Area e feet fee Property Line Drinking Water Well �� Other feet feet 4. Parent Material: "Le'4j Unsuitable Materials Present: Yes ❑ No[R^_ V If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑. Weathered/Fractured Rock❑. Bedrock❑ 5. Groundwater Observed: Yes ❑ No [R- If Yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater. 5� inches elevation DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 4 of 7 Commonwealth of Massachusetts Gityffown of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil Horizon/ Color-Moist (mottles) Texture %by Volume Structure Consistence Other Depth Layer (Munsell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles &Stones D - 0 7 u A3 G 7140 �d 1 C, Z�S lS� C, Ms Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 5 of 7 Commonwealth of Massachusetts GAy/Town of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method used: ❑ Depth observed standing water in observation hole A. B. inches inches A X ❑ Depth weeping from side of observation hole A. B. inches inches ❑ Depth to soil redoximorphic features (mottles) A. B. inches inches ❑ Groundwater adjustment(USGS methodology) A. B. inches inches . 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. 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 No❑ b. If yes, at what depth was it observed? Upper boundary: Lower boundary: inches inches F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. I further certify that the results my soil&,,/. eva ation s i dicate1 d i the attached Soil E, - �71; �;v(,o rm,are accurate and in accordance with 310 CMR 15.100 through 15.107. Siqpqture of Soil Ev luator Date UAN Ty or Printed Name of Soil Evaluator "Date of oil Ev uatoorr Exam Name of Board of Health Witness Board of Health • Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 6 of 7 Commonwealth of Massachusetts City Town of Barnstable Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Use this sheet for field diagrams: DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal• Page 7 of 7 i I CLEAF2_L( \ — r r Liinu-� V GAK..LI[d� Al M1. 'a t,�MYIH ( E �"`"' / IT LOPE \ 739 44.� , >EMENII j / AR_uM _ -p -P 74a E' 'SEM �7� i 761 Q '02 {$��C0 LIMIT / _ g0 53 I / 1750F 1 + l'OFF I 1 FF /1i3 +ll'OFF- �160FF / 2 "glop 0 CL �W/ / co 'L 'o WL jj !/ WIDE MINA SaF cL�ow ---------- - oFFtEARJIMIT--- -- + 0. - :1 S E . 7 ` MIT a+ o •�\ 2tS �•` a Ls 44. 714 \ PROPOSED,20' — S 0 '' I 7 \ CLF�4R11M1T L[EAR ■ • 40 1419 LEAR�IIMi. '\ \CLE JJMI WIDE PAVEMENT / P CLE JIMI \ ' . T 2 '. o \ \ (18 + BERMST � 16 , CROWN 2& / -�,C,77 f � ;x `� \\ ' I= ) / / oI NO— L DRAINA �1 ��� o TT \\ 8" RS / chi o � EASEMENT i �. ,� %gZ EL R ANT/ —I Q �(�233 F /"�LEAR�+Ir \� � � � �,� � 7 N \\ \\ I TAP 1Ea21STI�Nyi(/ 8" x(m ��\ J r ' CL AR—UMPrO.00' LLER-IMIIL5'X8" &G. S SLOPE \ / / / J TH \ \ / l h +7 . 5 EASEt�1ENT )xLq,l / / / 3 A / / / J, ea-4 7- - S ` / `� r r92 I ti / / / bt'1H� 2 —4 I'm, BENCHMARK: TOP OF' II •// / f / -�>o tvv ` I I 0.� I / CONC. BOUND 25 80� I •LEAR—OMIT _ .■s.. �— I f ———— — — I T(lJ —I—�— —;— \ — — —— — — I — ? / � I 1 MOTE:- CONTRACTOR TO Py�OVIDE A SPEED HUMP & SA ungecrFen I WHIP A-, SHnW� No..5 r �"-�J: THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH V 1 S k'.�� ,�� lu filan �nr i� u tt1 Marks Tonstrnrtion ramit ®5 Application is hereby made for a Pernpit to Construct ( _1'or Repair ( ) an Individual Sewage Disposal System at, A ....... ----------------------------------•----..l��__................................................ a r No. J �1�............ 11�3--� '� 1-�C.i��i ► v — 1 - r.. �• -- ---- ------ ------ - Owner Address W ••••••• ••••-••••---. -•------------- ................._............. Install Address 4. ,� t Q Type of Building I Size Lot.......................AAq. eet— Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Ga Other fixtures ------------------------------•• - W Design Flow............h*........................gallons per person per day. Total daily flow...._..___1 `2----_ -----------_gallons. WSeptic Tank—Liquid capacit ?o.gallons Length...11-®_ Widthio'-k.,`".... Diameter................ Depth- °-a". x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........1----------- Diameter._4L.q....... Depth below inlet--�al--�.`�._. Total leaching areal A1t.-`_?sq,,0Kt-Gf'P Z Other Distribution box Dosing tank ( ' aPercolation Test Result Performed by.� � �- ` 1D''-6---1� Date. l�7�8 ,4 Test Pit No. 1................minutes per inch Depth of Test Pit..__�.....________. Depth to ground water.-1..10I,,!�..._. rZ Test Pit No. 2...............minutes per inch Depth of Test Pit.......1........... Depth to ground water........................ a .............--------------- ------------------------ x Description of Soil'�' .:' •c�aUt .�O��.......'��_-%V � a ---- .. --0.................. 11 U --•-------............................................................................................................................................................................................. .. .................................................................................................................. ._._...........- - . ....- .- 1�1 L 1 .J 1' n Y I1'�i U Nature of Repairs or Alterations—Answer when applicable.-____________________ - — T -. :1t�bi..�Y�rLc:i_.: .,. ..-----•----------------•----••-------------------•-----•-----------.............------.................-•-•--••------------------------------ •..... ....................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITILL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed........................------ =•-----• ----•-•------- Dt Application Approved BY `�.... = �J-.�'-- --- ---------- Date Application Disapproved for the following reasons---------------------•---------••-----------------------••---------------------------....._......------....._.... .........-•......................•-••----••-•---•-•---------....---.....-•-------•-----.....---.................................-•--------------------------------------••-----------•-----••-----------. Date Permit No.- 7 � .... .... Issued -•--•- - Date No.. -�.. � - FEs...7�.. y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f1.°�.1 OF........ .........:`' ..?: ................................•--- ApplirFation for Disposal Works Tomitration tirrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at a _........®:.. f _!.--- t Lgcat,on tad saV - orrj No. _ ....-•-.•-•�� ........ .... : ' .......,�..- *�� .-------•---- ::._.. .:...................�` � ,.... .<�s. --- / Owner Address a ......••.. ............._4 -- ---,------•-•----------------------------•- Install Address Q Type of Building f Size Lot 4-37_+-..,&G..�€eet Dwelling—No. of Bedrooms...........................•....•..........Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ................•........... No. of persons............................ Showers ( ) — Cafeteria. ( ) al Other fixtures ............................ W Design Flow__________. °al------------------------gallons per person�p�eer°day. Total daily flow__._....._I ........................gallons. WSeptic Tank—Liquid ca.pacrt} � "�-r�•.gallons Length...::___ =_ Widthw?._: ?.._._ Diameter................ Depth._ ."........ x Disposal Trench—No..................... Width.................... Total Length..... .......... Total leaching area.........._...;_-.sq. ft. 3 Seepage Pit No--------I_..__.:__.. Diameter.. ._ '_._.___ Depth below inlet-. ..:: ..__. Total leaching areal ...:__�.s t., Z Other Distribution box ( Dosing tank , Percolation Test Results Performed �-1 by. - ?� _. 1 1 � �%.._ �'- Date......�'_T'_ ............. Test Pit No. I...... .._._minutes er inch De th of Test Pit .4 s1`........_ De ground � a p p Depth to ound water...._..___+J _.__. 01 fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit......`:.._...._._. Depth to ground water...................... W `J ; .�p ` Description of Soil..... -. ...........1!4- t.................................. -- ---------------•-••. U .•--.•-•.•._:•-•-•---_-----•••-••-•-•••.-•----•_•---------- ----------- -•--•-----••---•--••------•_•-•-•.............•-•-•-----.____--. W U Nature of Repairs or Alterations—Answer when applicable._•__________________•______•••-.-:-----__-___•_._.._.-_.._-.-.-.------.---------------- ....___. ----------------------------•-------------------•-•-----•--•---•--...---•----------•--.....------............-•---------------------._....------......--•---------------------------.........__...•--••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of. Compliance has been issued by the board of health. Signed -�------------ ------ ... `. 1- . Date Application Approved By-••••• . ........ •-•-•..............•-•--••-•...._._... Date Application Disapproved for the following reasons-------------•--------•-----•--••----•--...--•-----------------•--••-••--...........-•--•--•••-•------•.--•••- .............................................•--•--------...,..----------•-•--------------••--------•-------•--.........•••-••••••-•••••••••••-•--•----•-•••-•-•••-••----•••••••----•••••--••••••••-••-- Date PermitNo..&p ---`-5---.....--------•---------_.... Issued........................................................ .Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 OF... .. �'�'+� . ...:... TnrtifirFate of ft om liatnr�e THIS IS T CERTIFY, That tt I di idual Sewage`Disposal System constructed ( ) or Repaired ( ) by....................... ............................ ................- ....-•••••--•--••-•••-•-•----•••-•-•..........._....••••.............••••..........•--••-- Installer at - 5 `'` --------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in. the application for Disposal Works Construction Permit No..___ .7_-.../S:..!�:........... dated------- .'7.•...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED ASA GUARANTEE THAT THE SYSTEM WILL- FUNCTION SFACTORY. DATE.............ck .... - ••-•......:........••-•..._.. Inspector....------••----•-•-•-••-••........•. , THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' - J...OF....... . ` .. .....................................:.. . No. Z-/S_� FEE....- .5--r. ....... ir�a �t ork Tolo ion ranfit Permission is hereby granted.......... ` .............. .----...------------•--•----.......-----................---...... to Construct (x) or Repair. ( ) an Individ_uewage Disposal System at No......... = .......ra Street as shown on the application for Disposal Works Construction Permit No?'2_S 9.... Dated.._'3_::_��_'...�..�.......... ....................... .......... " Board of Health J DATE........... - J ?.....I_/.........._-•--- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I - ate nub(1 ASSESSOR'S MAP NO. PARCEL,e.. 6 LO CAT ION FZVjjti SEWAGE PERMIT NO. / V I L L A G E 'iLL E t I N S T A LLER'S NAME i ADDRESS 8UILDEIt OR OWNER: DATE PERMIT ISSUED i - ! DATE COMPLIANCE ISSUED 31 ` TEr Hof TR:Tod f T'OWN OF BARNSTABLE i OFFICE OF i BABISTABLt - MAlt BOARD OF HEALTH 367 MAIN STREET HYANNIS, MASS. 02601 Sewage Permit # Applicant : JW • �tp,� Proposed Installer: The plan for the on-site sewage disposal system at Lo4 I o has been approved with the condition that the design engineer must be on-site and supervise installation as well as certify in writing that the system was installed in strict accordance to the approved plan. Approved By Date CG� ND(rn Cam Cana, 22�TOWN OF BARNSTABLE M /P /�L, T`off a LOCATION S� � `ps �� ��� SEWAGE# 97- VILLAGE 0 S4eAJ;`lL,- ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. E L. l s 13l_OS.CB_ph 5T'. SEPTIC TANK CAPACITY o2,5,o© q a[Lom S LEACHING FACILITY:(type) (size) NO.OF BEDROOMS` ' OWNER W M &OW(J PERMIT DATE: COMPLIANCE DATE: —fil—87 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 leachingfacility)ty) Feet FURNISHED BY �-ASSESSOR'S MAP N0. , PARCEO��� r � • LO CAT ION T�Z-e-j 1 � SEWAGE PERMIT :NO. o 5ou-t w moo to V I L LA G E-Key,u�v-&6 r,a„ � �- ►s — r— INSTA LLER'S NAME i ADDRESS 15t-&d 4130--os e"or��a BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED _-L.$ 31` I i OBSERVATION HOLE DATA NO. OF OUTLETS: 3 yt ( 1 _ z- --� � I:: .�' ---- '_ Revisions iNIET .� O�iTLET C0�•ERS TC BE I I gROu;Ni T q' pc r:h'Sh TRADE. NOTES: Jf / --3 F--• 1r 3'-0�-- 1)DISTRIBUTION Box TO WITHSTAND H-10 -1, t' i GRND ELEV.= 15.5 t0--------' S- LOADING UNLESS UNDER PAVEMENT, DRIVES -� - -4 - ,r, `•%v ti i_._r` _r PI OBSERVATION I MIN I I OR TRAVELED WAYS VMERE13Y H-20 LOADING - 3.5 TESTED 8Y: OOWNCAPE ENG. INC. I co�Ea ( _ - SHALL APPLY. �--,._-'� -- ~ �-�� t; !r- >' ~ 1 1k HOLE M1 GW ELEV.- - _ - _ T ! �, A - i 2)PROVTDE INLET TEE AS SHOWN WHERE 3 8 04 WITNESSED BY: RAVE STANTON � 24' pia MANHOLE COV"? --r __ '•-0'-' I I . SLOPE OF INLET PIPE EXCEEDS O.Oe fT/fT . _ I l�•' DATE: _- MOTTLING ELEV - =, „� ZABELOFIL1ER -OP OfT 'T I TEE ' OR IN A PUMPED SYSTEM. Ty-� - T'' hJ �--J]�O�a'1 i'•' 1 _ ti 1 Ja /Ns�. ELEV SURFACE SOIL SOIL SOIL SOIL - - - I I (A10o, I ?o'- ' ( I�„o,�,I j �)f1RgT TWO FEET of PIPE OUT of rHE 117`; ; s, 1 _ I - r! , '1 1 p51R19UnON BOX TO BE LAID LEVEL V' mil'"' 1 ', r�� OUTLET TEE W/ExTE S10N t 1 _ - ♦ COMMENDED MANUFACTURER- - -S, --�� `ti �'- 15.5 DEPTH HORIZON TEXTURE COLOR MOTTLING/OTHER - - , - ",' � INL T 2" �0U6L� WASHED PEASTONEL ` 1rEET L Ou0 DEaTH /2' E PAN VI W ROTUNDO OR APPROVED EQUAL ' 1; -�-�- S STIRBUTION Box TO BE WATER TIGHT _ - _ 0"-3" FILL i i r 5' WIN 3/4- TO 1-1/2 STONE -J i I AND rD BE REINFORCED CONCRETE i' �' I' �'Lww 15.3- - -- FRI7(_'AST CON;RFTE SE_'T TAK, ---- c'6UT UM GN I=vEI STABLE BAS p' 2• _ REMOVABIC COVER J__► -1 AL.S. 10YR 2/1 I2t� I ;IiC.ED `I.H c rI E '�.,:-'`� .Y- �` r * �-Arm-`1F ."'�_ `-�� 5' DI OU LE (S) 01A. 3" 2' L I/+' �" - I I A. T T n iLF.T 14.5 _ PLAN VIEW I CROSS SECTION VIEW �, WATERTIGHT PROVIDE N T S j INLET AND CUTLET TEES TO BE CAST IRON N JOINTS (TYP) C E I 2' INLET AW 1 -44' IOYR 4 6 1) SEPTICTANK TO WIT�ST%^.D H- L:ADIN,� t- SCHEDULE 4C PVC _ I I 4' OUTLET O 2' 8 L.S. / _..S '0 DE CENTERED UNDER NAt�HOL COVERS L UNLESS UNDER PAVEME`aT, -;?'•,'�j,•:`,R TRAvEI E^ 8" 2 I6• 00000 � � �.)O �,' �/ ., ``•�y L,_ - ""{ I ' . 11.8 WAYS. WHERE BY H-.0 _0 . 4� SHALL A_PL Y _I I O 00 , tocus 2) ALL PIPE CONNECTC1'1S -'J. CC",(RE TE CUN - NO J� 'ALtC"�S. 2500 - •�.� BOTTOM ON STR�ICTION 0 BE +Va'E 1 -t 2 1/Z • LEVEL. STABLE . •' , T �' �� > BASE L44":156- C M.S. 2.SY 5/4 CROSS SECnON VIEW 6_,�i' sroNEiOoog0 ' East2.52 00C] C� a aaaa , , ,SEPTIC TA DETAIL ' . - - - DI�TRIBUTiON 80X DETAIL � �i B a GROUNDWATER OBSERVED ® 144' TOP OF PERC - PERC RATE _-di `� y (_LEV.=3.5) HOLE O ELEV. - - NOT TO SCALE NOT TO SCALE - 3/4" TO 1 1 /2 " DOUBLE WASHED STONE r+�E 1 _ _0 =a. Tu EE E'RC - - To : -; MIN./INCH ';. _F `I � �- FIt1 S� G?4C'E 2? MINIMUM FIN SHED GRADE OVER LEACHING AREA-7 ti TF ', H '",F'a.,r OBSERVATION HOLE DATA = 12' S-27i - a - - _- . ----- -- - --------��a'- - - - �-�- �. - a 16.D _ 4.. p(TYP) 4O r _ r' i,= 79' C_M,x i �F_ _ L LEbt_ /1JuxA" .A �,� LOCUS MAP ` i 1 GRND ELEV. �^--� - y� 'F t ) OBSERVA ! N \ 23.0' TO _ - 500 ;�aL. H - %0 LEACHING C��A.MBER NOT TO SCALE GW ELEV. TESTED BY. DOWNCAPE ENG. INC. 24.0'- - 2� 44' 22_27'-_ o 0 0 o o o HOLE #2 s - - - - t _ - - 4. - « �7 0 0 a 0 0 0 � do wn cape engineering, inc. r / r PAVE ST,%KiTON I ,. 0CAC .� 0 CJ0CJ0 A� r;Vl� ��f� � �UAL� ,^ 3 . n4 _ _ WITNESSE F?Y: __-.- _-- I' Assessors Mo: t% rc-Eel DATE. _ /8/ - 1a0TTUNrG LEV - 1 �:�. 5 1 2 or7l-1_=� _t_ 7' __ a era 20.1 a r EI_E♦'. :iRCAC -�-- J�!L SOIL -S1,fL 3,L• rr, 1 112" •xr:3Ll WASNED ST�r+E f CIVIL_ ENGINEERS 111; 0 DEPTH I� P!ZDN TEXTURE CvLJ', ►A'DTII_IN ;! ) h_ 2 I ---�--- =-1 -__-_-----� - Y T M _PRO�L LEA, yING DETAIL , _ I � - - � .• OBs +ATEP �r'r'a; - � LAND SURVEYORS SIGN ANALYSIS 15.1 !..._ NOT TO SC4L.E M - - -- INFLUENCED) t. , l l SCALE 339 r;'Cir•. St. �Cfrn.�l�l" r� t I;• J . , ---�- } - -- •� DESIGN FLOW: 11"-28" L.S. 'oYz( 3 [ I .T `V 11 BR (110) = 12 0 GPD _ SUBIONTRACT SER�ICE'� . ?. *THE INSTALLER SHALL /ERiFY THE :>< � SEPTIC SYSTEM DESI rd 13.7 1 _ - - _ NnT,•;N AFEa jM�ji, L U LI:TAP,LE Ma'ER!AL (A do B LOCATIONS OF All. U?ILITIES AND ALL ___-- 1 HORIZONS) To eE R iV . r_D AND REPLACED WTH SOIL EJILD:NG SEWER ^' ITL`-1S AND ELEVATION; SEPTIC TANK RE UIREMENTS: CONSISTING CF CLEAN FaM�LaR SAtiL�. FREE: FROM ORGANIC PRIOR TO INST�,LLiNG A�Jt' PORTION OF 28'-68" C3 L.S. 10YR 4/G I I. 5' REMOVAL OF UNSUITIF, SOIL �t D (2) - 24?0 - ---- .------ Project Title MATTER AND DELETE RI S SUys aNCES. M XTUR.ES AND LAKRS SEPI IC SYSTEM ANC REt C GATED AS REQUIRED AROUND PERIM`�R OF ` I -1 ,(� Cp 10 3 OF DIFFERENT CLASS_! :)C" 5�II_ SHALI, NIT OF USED. THE FILL NECESSARY. BOTH LEACHING FACIunE'. ')OWN SHALL NOT CONTA,N t'.Y MATER,AL LARDER THAN 2 INCHES. A TO SUITABLE SOIL LAYER. _ 4 -- SIEVE ANALYSIS, US+N( A y4 SIE�r SHA L BE PERFORMED REPLACE YNTH CLEAN ME' iAND. (/\ ( USE A 2500 GAL. H-17 SEPTIC IA!JI'^ 68 158 L.S. 2.5Y 5 '6 I c NTA*�� :?MF-E rF THE ;I P TO 45X T PLUMBING SHALL BE RAISED TO MEET THE _ Cj i ON A REPRE_E E LL BY �^'E'cH' PROPOSED TANK INVERT ELEVATION SHOWN. (TYPICAL) - � _ LEACHING FACILITY REC�UIREMF N TS: 2,$ �,,F THE FILL SAMp�_E t��•'r RE F_TA'NED ON THE y4 SIEVE. _ ' SIEVE ANALYSES AL';O i"AII.L BE PERFORMED ON THE FRACTION OF TO BE CONFIRMED 8'( PLUMBER PRIOR TO i GROUNDWATER 09SERVED ® - TOP OF PERC 36" PERC RATE iNSTALLAi'ION, � / � _ SIDES: 2(55 + 10.83)2(2)(.74) = 389 GPD_ T>^+E FILL SAMI�LE F'/+S', 'IG 1tiE r4 SIEVE, SUCH ANALYSES MUST ^ '`� ' � (ELEV.=- ) NIA HOLE ® ELEV. 13.0 < 2 DEMONSTRATE THAT Ti-E MATERIAL MEET', EACH OF t I BOTTOM: 2(55 X 10.83)(.74) = 881 GPD #5� t.IIN./INCH THE FOLLOWING SGECIIIC:TiONS: r i"r1' Post P l o n i s 1 PROVIDE VENT VN1Ti CHARCOAL y / \� 1 TOTALS: 1 716 SF 1 270 GPI ZONING SUMMARY EFFECTIVE R THAT MUST FILTER AND 3UGSCREEN FCR rive Ships Eagle SIEVE SIZE oaaTlrLE SIZE PASS SIEVE r• utility Boxes ; 0 I"xs' Post @ ">~ LEACHING FACILITIES. (E'IIaLM 4 4 75 MM 100% PLACEMENT IMTH HOMEO'NNER --� � � J`• C:rch e35,� LEACHING FACILITY PROVI ZON;N, DISTRICT RF-1 RESIDENTIAL DISTRICT , 'uo 0 15 MM 11°% - 20�0.' CCNSULT4T!ON) i �, �� =►a �c--- �� /� _ PROVIDED 200 0 075 MM OR - 57G Benchmark r USE 2 LEACHING TRENCHES, EA,,H Lane MIN LOT SIZE 87,120 S.F. PROVIDE APPROX 70' OF 43 M'L �t� ` ('e? Oq Bolt Hycrh�t cl �\ - CONSISTING OF 6 H-20 500 GAL. MIN. LOT FRONTAGE 20' LINER OOWrT4 SLOPE OF AND 5' � I IEIe�_ _ 40 C4 uSCI.&Sl \ Ground L�flhf ) MIN, LOT WIDTH 125' OFF CIL�ESOTH AS SHOWN TlX' A' � \ �-='- '� ` � �Gotth Bosin � �� q� r MIN. FRONT SETBACK -� V' ELEvanoN 23 0'. BOT ^M AT `° !4` ,y,� �� _ R=�e.to �� } I LEACHING CHAMBERS, WITH 3 STONE AT JNT SE BAC 30 , �\ 0� cote / MIN. SIDE 7TBACK 15' �` ` ) - 05terville /A�i �� contra SIDES AND 2.5 AT ENDS �'. ''•�--��� ELEV 19 U' (TYPICAL) `� ' MIN. REAR SETBACK 15' "� �a Oy �� ' f. A s�� /�ydrontGreund 1�9/+t \ J t - NOTESMC7 SI TE IS LOCATED WITHIN RESOURCE 1 2` NOTED,OVERLAY DISTRICT. F �"` �• 'g' ? t L.Iv .I , �► LESS OTHERWISE NOTED, ALL CONSTrUCTiC a S, :y'., 5 �. �� P \, r METHODS AND MATERIALS ' .. � c 1 � '+/� �\ •�h �..- � •� c ? ianrs 0 TER LS SHALL .� AiTITLE V 0 THE STATE ENViRONVENTAL CODE 4NI7) FtP.1A ZG1Vc V16 �tL.15) & A13 (EL. J W 13ILy IV /o ' \ �. / TOWN OF BARNSTABLE RULES AND REGULATIONS. a RESERVE AREA - 1OR �N� �.. ` 6� R�(/,y -! w N` N v: J Z a - fR << �� \ o 2. GROUT TO BE USED AT ALL POINTS WHERE PIPES NOTES N✓i�R't' t� t�IL < 27. 7 a0' >< 20.5' ��' R 4� ENTER OR LEAVE ALL CONCRETE STRUCTURES INoN'r ,�', .� 1 10 PROPOSSED S '` \ \�� ORDER TO PROVIDE A WATERTIGHT SEAL. 1. PLAN REFERENCE: SEE LAND COURT PLAN 26700 F & .D t-2a �2� U ��•=' _ 1 'D /- _D Box , , 'E"o 3'X ?' �TyG w 1n _` `, 3. ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL BE Prepared For USACE PERM:T MA-HYAN-79-255. Zo �/� O �svSP�� W�E><Is1 gee f ` `�� -I�� „� SEALED WITH NEOPRENE GASKETS OR ASPHALT 2. ELEVATIONS ARE BASED ON N.G.V.D. / � �21 PPL�POS� � �eenhou I \ + CEMENT TO PROVIDE A WATERTIGHT SEAL. ,^ !� 0 1W� •• ` ,;` F , 4. PRECAST CONCRETE SEPTIC TANK, DISTRIBUTION CHARLES F. al 3. APCHITECTURAL CESIGN & LAYOUT BY IVAV �?E;''E.Z.^J�' .III � ti� _, - - ; �,_ 14� \�`t BOX AND LEACHING FACILITY TO WITHSTAND H-10 DEBORAH J. D ASSO':IATEs. - OE _u r 1 , ST ��,: ' 11 LOADING UNLESS UNDER PAVEMENT, DRIVES OR �p.J�1�44 Ly�L �� iL ,�` j W F 1;` 1 , 1 TRAVELLED WAYS WHEREIN H-20 LOADING SHALL +� ti',. 4. STRUCTURAL DESIGN, GEOTECHNICAL ASPECTS ANC - ` ` APPLY. RETAINING WALL5 TO BE DESIGNED BY OTHERS. �, v � �t� � U ,_ 5. ALL 4" PVC PIPES IN THE SYSTEM SHALL BE rF 2 _ �\ �.� 1 I . SCHEDULE 40. 5. THE EXISTING CONDITIONS SHOWN HERE ON ARF T'4 `SHOE/ass / ,r ,E ,` Er.=rho \ �� - i' 1 q. I y 9p Y 4 l\ 6. WASHED CRUSHED STONE SHALL FREE OF .ALL vor;t-rc, V'IT,, V A �t? RESULT OF A SURVEY PERFORMED ON THE GROUND BETWEEN ARNE H. ti� c r' � - � � � '- � t � - ,� p m 1 PROPOSED LEACHING DIRT, DUST AND FINES. MARCH 1 & MARCH 5, 2004. y` c`' OJALA �, o cow � ,/ � � '"J � CHAMBERS wTTH STONE ^ c� CIV L Cn i r PROPOSED , q r e 11D \�o k�:' \, N 7 f' AREA DRAIN E�Ev.s. ` A r e ` 1 1 (TYPICAL) 7 AT ALL POINTS OF INTERSECTION OF WATER LINES rr DESIGNED BY o t e ` tdP�ERS AND SEWER LINES, BOTH PIPES SHALL BE CON- OTHERS (fYP), E x c G +I►�'Ve�t O EkISTIN LEACH PIT STRUCTED OF CLASS 150 PRESSURE PIPE AND ARE TO IN L E`'G O ! RESN`tE��r<� �V `�Pl �, � BE PUM D AND �► BE PRESSURE TESTED TO ASSURE WATERTIGHTNESS. I A. M. Wilson Associates Inc. ,- ✓ TT' vioosl00 9E O CE vl1► ---RESERVE AREA REMOVED �, / �t ,J / f�N 1 , O ,VO b' c �- / ! 8. SEPTIC TANK, DISTRIBUTION BOX, ETC. SHALL BE 508 420 9792 ; FAX 420 9795 )) oncrete ) . 9 ( / rAA.NUFACTURED BY FiOTON00 OR AN EQUIVALENT r Bound �' ` 10 / �'O �.. % ' round P 1A �' �r LP` Conho/ !.- ;�c F i a n r s MANUFACTURER. - N IP r / ` A Ei-155 � '�h•i� J Drawing Titis EDA/UND F. OE9CRA M rZ� / / Z� � ROOF {�N_OFF •j0 9. EXCAVATE ALL UNSUITABLE MATERIAL IN LEACHING hECCE✓ /t , 1 /- - iG I E DIRECTED TO TOr'� �� ��� TIE INTO '9/ / AREA AND BACKFILL WITH MATERIAL AS DESCRIBED °' / f 14 OR OR - � OI ( I EXISTING `"' / ON PLAN. ASSESSORS Ms1P r6' PA'. EC r9 f. ...� fX STiNC TANK TO ` SEWER /•' �!1• t �'+ ` STRIP DRAW .�� BE PUMPED AN Genero(or - �`- „!, Are -"L ■..., .�� �.� "r t r1 REMO n t ! H \ EOM M• , c:ct � ��,� 10.HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO w n P,r-�ED BUILDING ZQO F f .�, - � /� OPERATE OVER THE LIMITS OF THE SEWAGE DIS- - L - ••�. e rE�IE � `� `T F. ELEV. 34. 25---� POSAL SYSTEMS DURING THE COURSE OF CON- , Cyr c �' , 26- PROPOSEPTICSED 2,500 GAL Desk �` n STRUCTiON OF THE SYSTEMS. INVERT ELEVATIONS S ti" �eTr ,�� P 1g _ T 0' 11. NO FIELD MODIFICATIONS TO THE SEWAGE DISPOSAL Subsurface ELE >^,Pe =�\ t r e e I " .'s� _ o G ° o '`, Porch Porch SYSTEM SHALL BE MADE WITHOUT PRIOR WRITTEN MATCH o `. _ j t 2 x0- `� El.=.7gJ APPROVAL OF THE ENGINEER AND THE LOCAL Sewage 4" INVERT AT BUILDINGEXISTING - r ; '� t BOARD OF HEALTH. -- - 25 _ . c; - _ - Fin,Sn n� ----- - - \ - +` �' - r E/er-3B.y 12.THIS SYSTEM SHALL BE INSPECTED AS REQUIRED BY _ .. - STons wok __� Porch Exist.. Inv Disposal4" INVERT AT 2500 GAL. TANK (IN) 24.0' � - L] 0 n D o 13 O ❑ o ° �_. - EZ=29't 7. TO BE REMC'tp o n TLE v. .- s 4" INVERT AT 2500 GAL. TANK (OU F) ^23_75' - .� �� Ai'/''t%� lie ��, ., - _ ,. �••"'' t Exisr%n9 Owe//iny 13.A CERTIFICATE OF COMPLIANCE AS REQUIRED 8YIwrj i TITLE V AND AN AS-BUILT PLAN De5ign I 4" INVERT AT DIST. 80X (IN) +: _ 4` '`` = ? _- OF THE SYSTEM MUST BE OBTAINED BY THE CONTRACTOR UPON COMPLETION OF THE ABOVE WORK. 4' INVFRT AT DIST. BOX (OUT) 14. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE INVERTS AT LEACHING FACILITY: �' ? cCr,u,ny ; � DISPOSAL UNIT. 4" INVERT AT BEG. Concrete .` 19 I , JL_ . '---.'L :'----_-- .--- ;!- ---' rot,o Fn;y, f7�, 15.ALL UNDERGROUND UTILITIES SHOWN WERE COM- / _ PILED ACCORDING TO AVAILABLE RECORD PLANS LEACHING FACILITY � Bound � �\` •; C o w n A r e o � J. " � � I E._,T.S .i' £lev.•JB.O AND ARE APPROXIMATE ONLY. SEE CHAPTER 370 22.17 Found 1 O -.J d t -- - -- --,`-,r- -�l~-- 1 yl' LO l L� 4 INVERT AT ENO �.I L ` _ ...!,PROPOSEDr - � - ? � �1..• • ' � PAnO__t��7�3Aon' ACTS OF 1963, MAS5ACHUSETTS GENERAL LAWS. LEACHING FACILITY N/A --- _•+, Tr, \ {� .5 c, �( i i'- ELEV. 32'�'~'!:I(•-; - P1on1s _ Land Court Plan 2670OF WE ASSUME NO RESPONSIBILITY FOR DAMAGES A Pla-t s OF TILITIES TED O ,~ INCURREDr - �' "T"'-' '• 3.5E Acres INACCURATELY SHOWN. THE UAPPROPRIATE TPUBL CR Dote June 2 2004 ELEVATION AT BOTTOM SHALL BE CONTACTED AS D�owin No. OF LEACHING FACILITY 2�_' 1 _ _ ► :'� Mom" `�:.,'E L i� :sr. Srone w a-� -�- �� - � �""' '� o Map 164 Parcel 1:2 ENGINEERING DEPARTMENT 9 Assessors ru Ei.=J88 .� WELL AS DIG SAFE (PH. NUMBER 1-800-322-4844) Design D.C.E. OBSERVED GROUND WATER ELEVATION MOTTLES 3.S (T'JAL) `' -- - --- �' ..+ r Check A.M.W. TP#1 - - \ �"` �+,� r�►r..�.����t'�e,lefQt: "•� - --- Drawn J.V.B. eel �e f - - -- �-- 0 10 21) 30 4C :0 'tET Job. No. 2.1282.00 Lost Rev. of 1 Doe S-10 cf.q TEST PIT -*1 TEST PIT #2 ,,� : GENERAL NOTES ELEV.= < 1 ELEV= 17+ 2= ' M r I. ALL ELEVATIONS SHOWN ARE BASED UPON I 2. PITCH ALL LINES A MINIMUM OF 1/8" /FT. UNLESS 000 0 0 U s 0 000 OTHERWISE SPECIFIED. 9 I I Za ~ 000000 0 O 0 000000 3. ALL PIPES TO AND IN THE SYSTEM SHALL BE CAST N - - - - - - - - - _ - - - � o_ 00003 (D O 0 000000 IRON OR SCHEDULE 40 PVC. 00000 0 0 0 0 0 0 0 000 _ro o 1 4. ALL SEPTIC TANKS, DISTRIBUTION BOXES, AND �o ,�o i 000 0 0 0 O (D000000 ,� LEACHING PITS SHALL BE DESIGNED FOR H-20 WHEEL F,:Me- ,' \ 000000 0 O 0 000000 00000 � O ® 000000 LOADINGS WHEN UNDER PAVING. 10„ 24 000000 (DO 0 000000 5. REMOVE ALL UNSUITABLE MATERIAL BENEATH THE 3, 0 001 @ O (D 000000 INVERT ELEVATIONS OF THE LEACHING PIT FOR r) 4'-a" ti TYPICAL DISTRIBUTION BOX 0000 0 u @ O 0 of) 0 000 A DISTANCE OF 1OFT AND BACKFILL WITH CLAY- 4 LEVEL FREE SAND 8� GRAVEL HAVING A PERCOLATION RATE "1 NOT TO SCALE- 6'-0'I OF 2 MINUTES PER INCH OR LESS. NOTE- DISTRIBUTION BOX AND 6. THE lap BOARD OF HEALTH MUST GAL. REINFORCED SEPTIC TANK BY BE NOTIFIED WHEN THE SYSTEM IS NEAR COMPLETION OBSERVATION PIT TYPICAL \r2o UGAL. SEPTIC TANK ACME PRECAST OR EQUAL. TYPICAL LEACHING PIT AND PRIOR TO BACKFILLING. 7. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS PERCOLATION RATE NOT TO SCALE NOT TO SCALE SHALL BE INSTALLED IN ACCORDANCE WITH TITLE Y OBSERVATIONS BY-* NOTE-.- TANKS REINFORCED THROUGHOUT WITH OF THE STATE SANITARY CODE AND ..ANY LOCAL BOARD OF HEALTH ELECTRIC WELDED WIRE WITH 24-1/2is RULES WHICH MAY APPLY. ENGINEER. ARROW ENGINEERING INC. EMBEDDED STEEL RODS IN TOP & BOT- 8. CONTRACTOR IS TO NOTIFY ENGINEER, PRIOR TO THE TOM. CONCRETE IS 4,000 PS.i. TEST. INSTALLATION OF SEPTIC SYSTEM, OF ANY DISCREP- DATE- /-7- 87 \ ANCIES BETWEEN TEST PIT RESULTS AND FIELD L` CONDITIONS. 9. ACCESS MANHOLES TO SEPTIC TANKS AND LEACHING PITS TO BE BUILT UP TO 12 INCHES BELOW FINISH l � GRADE. /10.PIPES FROM DISTRIBUTION BOX WILL BE LAID T ' i`, I TOP OF � '. LEVEL FOR THE FIRST 2 FEET. "n,r \ FOiUNDATI F`J - . ELEV. �---FINISH GRADE r— FINISH GRADE FINISH GRADE OVER LEACHING—_. FINISH .GRADE OVER TANK OVER D BOX AREA ELEV. 5 r ) 't i �. ELEV= ELEV. 4 : EXI Et-EV.= �--( r ST. GROUND i L 1 4 ,ob'G INV= _ _ INV.=_t — _ ,:>: o; WASHED STONE // INV. , - . � INV. TT" GA '� �a _,_.o..�....., r-. ____________ x••�, � ,�,d- � � .�, �J 15 T BOX ,. o� •;•;•; • • ' ':::.. o �i x 3/4 i�x 11/2 -- i RE INF•ORCED .. CONCRETE (TO BE t EVE o WASHED STONE B STABLE) •. ... > PT!C TANK ...... .. .. ....... BOTTOM OF PIT TO BE 1.FVF( Q ;TABLE ; V= iL:: � ELEV.= �. . - ' -; , "�t,..t„t r..� TYPICAL SEWAGE SYSTEM PROFI LE PRECAST LEACHING PIT CTO BE LEVEL a STABLE) or�)_ NOT TO SCALE . ,-." X° -'� ` __ � \ L n{-L 1•'rcrcu ':: �M Y S,Ai�.�i� nc2c� .1 Tara Vl_W L j E GEND MAP SECTION I PARCEL I LOT I ADDRESS Q EXIST. CONT{ UR _ - _ _ 8 w J PROPOSED CONTOUR �5 6 � ; E;X I S T SPOT E L E VAT I 0 N 8 X 0 �-, tee.,, -----=----------- -� PROPOSED S"OT ELEVATION 8 + 0 �, PIERCOLATIOr� TEST m ZONING DISTRICT FLOOD) HAZARD ZONE a _ _ �t 018 T Ord PIT r DE`"'IGN CRITERIA " `� �" °` ' � PROPOSED LOCATION OF DWELLING _- / NUMBER OF 3EDROOMS �' w' PIERSON PER BEDROOM �o�' ROBERT� - _, a SEWAGE DISPOSAL SYSTEM _ 2 � � - -- -- GALLONS PE-3 PERSON PER DAY _58__ " t �� U_l LEACHING R 7QUIRED x 4 I4,,; LEACHING PROVIDED 0` ;r AP L � P , I CLANT: ENGINEER ' r1 z r^ �. ► '� `�+� ARROW ENGINEERING INC. SEVER DESIGN �`�' aF:w��y' �o u���v ON6 V-v• 10 CAPE DRIVE' SUITE B ;� ROBS `A���� t�A. • t . +-- r '' .�/ ��.� ✓` S I DE WA L L � ' Y.if , 7 � . 7 v r� Y �w X fit• SCALE, DATE: SHEET B�OTTO!'.i - r" x `7 .L x � - � �> _ 'r -- 9p M1�o . .��o o- TOTAL= 8t3.'/, c,��u/�►T �u�, � '" �aj� AS SHOWN : �7 1 OF E - l...°<lt� x l� 7. �,,�o DRAWN BY CHECKED BY: APPD. BY: PLAN NO. FZZttV" t"1aLE = I'' LL 30 ' :'a r SEE/SEM ,JTH RER 2'-6" _ NOTES: INLET & OUTLET COVERS TO BE I 2'-C" I - � }1'' OBSERVATION HOLE DATA BROUGHT TO 6^ OF FINISH GRADE 1. CONCRETE - 4000 PSI MIN. -� j1 � Revisions yy _ �-A- ---- A STRENGTH 0 28 DAYS 7/9/04 RELOCATE PROPOSED TANK, - �` -----;.r- J'� r •� l ADD EXIST. WATER SERVICE OBSERVATION GRND ELEV.- - _-- - Cr ---- 6"' y MIN `�s� E 0 2. STEEL REINFORCEMENT -.` _ ei;;l i r' /� P cT W V.= -- D�WNCAPE EItiG. INC. _-`--- _-_-- -- ASTM A-615, GRADE 60 ,,, �� -�- t_ i AND PRO OSED Di�tRl81_ITiON TESTED BY: - _ I COVER , I I �+5�-� -+' / r r rr__ s�r� �, ti LINES. I�OI_E #� G E LE 3.5 --- -- - _ -- 1 N � -� �_ti ti �' � I ®i�1 �+r� D.AVE STANTON ,'_o , �- AIR SP.4Cc 3. COVER TO STEEL - 1" MIN. _ it lF cr { 5 DATE: 3/8/04 MOTTLING ELEV= _- WITNESSED BY: - 24" DIA. MANHOLE COVER 1 _ _ �- I i -� Fond 6" FLOW-1 P F T TY 1 L- W D' 3^ _ ZABEL FILTER - - ti i -�- I SOIL SOIL SOIL - - - (Aloo> I �o' -� --- I '' -� rd y s�1 , L III - ELEV. SURFACE SOIL I OUTLET TEE W/EXTE SION ! 4_ 15.5 DEPTH HORIZON TEXTURE COLOR MOTTLING/OTHER - - - INLET 5'_3^ PLAN VIEW �� f Wr�f� fir, sn £ e _�!' �` f 2� DOUBLE WASHED PEASTONE �- -''�`` �"�`� rl - � f io TEE LIQUID DEPTH �. 7 1/2" DIA. KNOCKOUT / C °� r „ � I LLr 6" MIN, 3/4" TO 1-1/2"STONE i 18^ DIA TYP 15.3 0"-3" I�_I_ -- I I I COVER 7 j.. ( ) - PRECAST CONCRETE SEPTIC TANK BOTTOM ON LEVEL ST 7 BASE �'_ I I~ �-- I� `G" 3"- 12" + L.S. 10YR 2 fi REINFORCED WITH STEEL q -�-� fi 5* DIA. KNocKouT �I ✓ f III ce<r;'! f CROSS SECTION VIEW t f' I i-4-5 ---- -�- PLAN VIEW 0+ 'l 3) INLET AND OUTLET TEES TO BE CAST IRON d NOTES OR SCHEDULE 40 PVC. lot - IQ 44" E? L.S. lOYR 4/6 1) SEPTIC TANK TO WITHSTAND H-20 LOADING TEES TO BE CENTERED UNDER MANHOLE COVERS. + �vo� «� ❑ ❑ �- -� ❑ L ❑ opo ,1"ti LOCUS ?' 1 -- -- 11.8 _ 2) ALL PIPE CONNECTIONS AND CONCRETE CON- SECTK)N A-A ELEVATION VEW �r - STRUCTION TO BE WATERTIGHT. NO. OF GALLONS: 250 - East � 44"-156" M.S. 2.5Y 5/4 DIISTRBUTION BOX DETAIL 0 8 0 2' ❑ ❑7 ❑ ❑ I❑ ❑ ❑ ❑ ❑ _ ono `{�1 � 2.5 _ __ _ SEPTIC 'SANK DETAIL ------ -- - __ GROUNDWATER OBSERVED ® 144" TOP OF PERC - PERC RATE DB-9 CH-20 LOADING) �, � Bay � NOT TO SCALE - „ „ Z t-�~ 5) NOT TO SCALE 3,/4 TO 1 1 /2 'DOUBLE WASHED STONE (ELEV.- 3-.� HOLE © ELEV. - INLET & OL'TLE, COVERS TO BE BROUGHT TO MiN./INCH FINISH GRADE 14% MINIMUM FINISHED (GRADE OVER LEACHING AREA `WITHIN 6" OF FINISH GRADE? L �_�� 2 1_-�- - 7 i- S-2$ 6. _ _ - / - - - � - - - - __- --� - --�� i; off. SUB-362-454t OBSERVATION HOLE DATA 4" PVC SCH. 4 - - - - - (�� c (TYP•) I L-79' S=M1z FIRST 2 FEET /:^ £ ""°"`"'" OMB LOCUS MAC' � fax 508-362-9880 GRND ELEV.= 16.0 d BE LAID LEVEL / 23 0' NO! TO SCA.!.E OBSERVATION 500 GAL. H- 2.0 LEACHING CHAMBER TESTED By: DOWNCAP'E ENG. INC. ?4 0� 1I �22.44' 22.27'_ �� 0 a a a o 0 BOLE #2 GIN ELEV.= _ - \•� • ------- 1 250o GAL. - 22.t7 C�OW/7 Ce'9j.3@ @PJt��'in@�@�'%�t,�', inc.. 29't 1 0 0 0 0 01 0 0 0 0 / I Assessors Ma 164 Parcel WITNESSED BY: DAVE STANTON SEPTIC TANK • L- 0 0 0 0 0: 0 0 0 0 (ACME OR EQUAL) P DATE: 3/8/04 MOTTLING ELEV= - �3.75' / _z' 0 0 0 0 01 0 0 0 0 20.17' CIVIL ENGINEERS 3/4' TO 1 1/2" DOUBLE WASHED STONE t ELEV. SURFACE SOIL SOIL SOIL S01 L 6 FOUNDATION / LEACr.lr11_ LAN® SURVEYORS 16.0 DEPTH I HORIZON TEXTURE COLOR MOTTLING/OTHER � LEACHING DETAIL �� i �� r--- Lf0 BE INSTALLED ON A SYSTEM PROFILE OBS. WATER (TIDALLY DESIGN' ANA` YSSI 939 main st. armouth, r-,U 016 - T TEST PIT #1 3•5 ___ INFLUENCED) NOT TO SCALE Y LEVEL & s�Ae_E BASE. NOT TO SCALE DESIGN FLOW: 0"-11" FILL / SUBCONTRACT SERVICES FOR: 15.1 4(� C------- - ;' 11 BR 110) = 12 i ,; G P U - - --- - --. 11"-28" �\ L.S. lOYR 3/2 *THE INSTALi_ER SHALL VIERIFY THE -" SEPTIC SYSTEM DESIC3N I 13. 1 WITHIN AREA SHOWN, UNSUITABLE MATERIAL (A & B LOCATIONS OF' ALL UTILITIES AND ALL : 'SEPTIC TANK REQUIREMENTS: -------- --- HORIZONS) TO BE REMOVED AND REPLACED WITH SOIL BUILDING- SEWER OUTLETS AND ELEVATIONS ��, { CONSISTING OF CLEAN GRANULAR, SAND, FREE FROM ORGANIC PRIOR TO INSTALLING ANY PORTION OF I Project. Title 5' REMOVAL OF l NSUII ABLE SOIL �`� 28'-68' L.S. 10YR 4/6 SEPTIC SYSTEM AND RELOCATED AS REQUIRED AROUND PERIMETER OF 1210 GPD (2) = 2420 B MATTER AND DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS 10.3 I OF DIFFERENT CLASSES OF SOIL SHALL NOT BE USED. THE FILL NECESSARY. BOTH LEACHING FACILITIES, DOWN - --� SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A TO SUITABLE SOIL LAYER. r / 1 USE A 2500 GAL. H _ iQ �Er'TIC TAtvK.__- SIEVE ANALYSIS, USING A #4 SIEVE. SHALL BE PERFORMED REPLACE WITH CLEAN MED. SAINT) - ^ �.SY 5 PLUMBING SHALL BE RAISED TO MEET THE ���jjj / 68"-158" (` L.S. /6 ON A REPRESENTATIVE SAMPLE OF THE FILL. UP TO 45% BY WEIGHT T ` (TYPICAL) / LEACHING FACILITY RE�UIPEMENTS: 2.8 OF THE FILL SAMPLE MAY BE RETAINED ON THE #4 SIEVE. PROPOSED TANK INVERT ELEVATION SHOWN. I TO BE CONFIRMED BY PLUMBER PRIOR TO i I 1 �--- - SIEVE ANALYSES ALSO SHALL BE PERFORMED ON THE FRACTION OF 1 / I i SIDES: 2 55 + 10.83)2(2)(.74) = 389 GPD GROUND WATEk OBSERVED 0 - TOP OF PERC 36" PERC RATE THE FILL SAMPLE PASSING THE #4 SIEVE, SUCH ANALYSES MUST INSTALLATION. / (ELEV = -) N/A HOLE ® ELEV. 13.0 < 2 DEMONSTRATE THAT THE MATERIAL MEETS EACH OF / P l a n t s 3�1 / /I / BOTTOM: 2(55 x 10.83)(74 = 881 GPD #5� MIN./INCH THE FOLLOWING SPECIFICATIONS: PROVIDE VENT WITH CHARCOAL 4 ir4" Post / - I TOTALS: 1716 SF 1270 GPD EFFECTIVE % THAT MUST FILTER ANC BUGSCREEN FOR Utility Boxes a�� Drive 4`x4" Post i I I3n1ps ZONING SUMMARY SIEVE SIZE PARTICLE SIZE PASS SIEVE BOTH LEACHING FACILITIES. (FINAL. Gr I F L?y 4 4.75 MM 100% PLACEMENT WITH HOMEOWNER ---'. Catch Basin I LEACHING FACILITY PROVIDED 50 0.30 MM 10% - 100% ,,, CONSULTATION) \ R=38.10 � • � I I Lane 'ONING DISTRICT RF-1 RESIDENTIAL DISTRICT 100 0.15 MM 0% - _0% y �'o, Benchmark I I I USE 2 LEACHING TRENCHES, EACH 200 0.075 MIM 0% - 5% r # PROVIDE APPROX 70' OF 40 MIL I y 3�'i Tag Bolt Of Hyrdl tSnt I I MIN. LOT SIZE 87,120 S.F. M LINER DCWN SLOPE OF AND 5' ;� __\_-__�- 0o / Elev. = 40.04 USCG&S� I ' Ground Light "ONSISTING OF (6} H-20 500 GAL. MIN. LOT FRONTAGE 20' OFF OF BOTH LEACHING -`�� j Cot;h BasinMIN. LOT WIDTH 125' FACILITIES FS SHOWN. TOP AT x�ir b,� Approximate I I T e }Ieod � ; R=•8..10 I LEACHING CHAMBERS WITH 3 STONE AT ,� ELEVATION 23.0% BOTTOM AT - _ S qL� �Wate. Servic Yq / -_ Si tk^. A/ MIN. FRONT SETBACK 130'5' _ Q Gvnetna/� I LE ��' �r MIN. SIDE SETBACK, 15' ELEV. 19.0' (TYPICAL) - \ ` ,. �' \�` G/aJnd hP I \ I -SIDES AND 2.5 AT ANDS___- _-. 0 MIN. REAR SETBACK 15' 13 - - r ; kldrant--- x sy r - �.9 {/q} ��q " \ 3 �V �( `` 1 I , UNLESS OTHERWISE NOTED, ALL CONSTRUCTION SITE IS LOCATED WITHIN RESOURCE ��SNOFMq,gso ,."- 0•C1y4 �- \ Fop ¢ \�ae '�� 6 / - METHODS AND MATERIALS SHALL CONFORM TO PROTECTION OVERLAY DISTRICT. o?� ARNE ��, -�y S / ,!' w - PJonts � \ ` 1 \ TITLE V OF THE STATE ENVIRONMENTAL CODE AND o FI JJALA 1�' �25 - �` <<�-� TOWN OF BARNSTABLE RULES AND REGULATIONS. --EMA ZONE V16 (EL.15) & A13 (EL.11) I No JP,LAB CIVIL = OF W�W� - ?Eo ��� �� w ��\ �� .. <<\` � v, o / 92 RESERVE At3EA p �°� \ 1 �j� -� <U 1p �� (°Y� \ �\ \ �. 2. GROUT TO BE USED AT ALL POINTS WHERE PIPES \ Oj° L��\ ` e,� \ \ \ ENTER OR LEAVE ALL CONCRETE STRUCTURES IN 80' x 20.`6' SAPS y `� � NOTES: �{-luSS,RV%- c Crc �ENa�L ����y�f2�1 - - Y� Q"1 \ a r�' �11 PROPOSSED \o �` \\\\\ 1 ORDER TO PROVIDE A WATERTIGHT SEAL. 2'� '^ \ v I 1 . PLAN REFERENCE: SEE LAND COURT PLAN 26700 F & o �s , r� < �� \ ALL SH PLAP JOINTS IN SEPTIC TANK. SHALL BE �. - - -� ��/�/ �pWN� tfn o i �\ ��� ��� SEALED WITH NEOPRENE GASKETS OR ASPHALT Prepared �C>r USACE PERM( MA-HYAN 79 255. %' ., _ - - ��- :n �� � ��Exts se \- .- � � �, � �. � \ 1 � \ CEMENT TO PROVIDE A WATERTIGHT SEAL. 12 2. ELEVATIONS ,ARE BASED ON N.G.V.D. r' rr kST� �rn 4. PRECAST CONCRETE SEPTIC TANK, DISTRIBUTION CHARLES F. .� __ _ , � �1 � •� BOX AND LEACHING FACILITY TO WITHSTAND H-20 3. ARCHITECTURAL DESIGN & LAYOUT BY (VAN BEREZNICKI ��- �` \ _ ,` '� \ \ \ �� LOADING. DEBORAH J. DOE ASSOCIATES. \ _ ' \ ALL 4" PVC PIPES IN THE SYSTEM SHALL BE Cl,4. STRUCTURAL DESIGN, GEOTECHNICAL ASPECTS AND �o \ ^ { _ �6•/ ! •` ` } C `� \ , \ ;/lam, `` �� o SCHEDULE 40. RETAINING WALLS TO BE DESIGNED BY OTHERS. ti/ % / e ` SEA ►'a / �/�--' o ' ' 6. WASHED CRUSHED STONE SHALL FREE OF ALL r� IP 26.0 „� o )`4\ DIRT, DUST AND FINES. -� LQ Rascally Rabbit Road 5. THE EXISTING CONDITIONS SHOWN HERE ON ARE THE Marstons Mills, MA Q2648 �);; , � '\ ev \ � C` 1 t� � 1 _ '. AT ALL POINTS OF INTERSECTION OF WATER LINES RESULT OF A SURVEY PERFORMED ON THE GROUND BETWEEN / / / i / / / // , 1 PROPOSED LEACHING SHALL 1 & MARCH 5, 2004. / // / / / / � b' o "' �' AND SEWER LINES, BOTH PIPES �t,ALL BE CON- CHAMBERS WITH STONE `� / / PROPOSED / ,A e 2 0 1 \ Y 1 STRUCTED OF CLASS 1.5(1 PRESSURE !PE AND ARE ,,J AREA DRAIN / BEN \ A r e o + (TYPICAL) c T r WATERTIGHTNESS. c d �. BE PRESSURE TESTED O ASSURE WATER TIG ITN` Landscape /! / / / / / / / � � DESIGNED AY a I e O� R � EXiSTIN LEA PET- ' ` � Re Wol/ / 1 OTHERS TYP C 0 W N f i ! i l l / ( ) E x WrW�NG EO 6 3�� �- B PUM�D AND '� �` / ' 4 - - 8. SEPTIC TANK, DISTRIBUTION BOX, ETC SHALL BE l / / I REAP �SW�"- tiW \ ti �, A. M. 'Wilson Associates Inc. Pa Ep �p SIP ' REMOVED rn- I r / MANUFACTURED BY ROTONDC OR AN EQUIVALENT on Crete/ ( I pR4 S ZD F�NGE �N 2 RESERVE AREA �� l /l 2 f�•Q �,��i �" / MANUFACTURER. 508 420 9792 FAX 420 97:35: cq� Found 1 I \, pROp05� rrJntroln( P l a n t s f/ a EXCAVATE ALL UNSUITABLE MATERIAL IN LEACHING N� / / / / 1 AREA AND BACKFILL W!TF; M A'TEPIAL AS DESCRIBED Drawing Title 0 E1.=15.5 ' PROPOSED 2,`00 GAL x u`* ON PLAN. EDAfUNO F & DEBOR„!� M. e ! T -_2�_ / ROOF BE pIRL o D TO S PTI(;,'TANK '^TIE INTO E ��' S I KELLEY �' r, / ; / / \ •2 � � r' � � EXISTING 1 � ASSESSORS M.AP 764 DAPCEL 19 tia' / e� -r ___ = 2� DRYWEL LS QR _. EXISTING TANK TO w / � +� STRIP DRAT .r r S'tWER 10.HEAVY EQUIPMENT SHALL NOT BE .ALLOWED TO ago- BE PUMPED AN _ A r e a�� .ems' �� �� � REMOV y �` i �� Generator - - - I I I OPERATE OVER THE LIMITS OF THE SEWAGE CIS- a w n _ - ;A ram M �y,: L L L- POSAL SYSTEMS DURING THE COURSE OF CON- w PRQPC3SED BUILDING F ble- _._ r F. ELEV. - 4 / \ / iApron- L_ '- STRUCTION OF THE SYSTEMS. - - 2 Approx. Clonc Pod Deck L- P ! e , '1. NO FIELD MODIFICATIONS TO THE SEWAGE DISPOSAL Suhsut � 20_ Septic r tl_��D P I a n t s � _o SYSTEM SHALL BE MADE WITHOUT PRIOR WRITTEN \ \ Ton* o -o -_ - 6" Vent \ \ INVERT ELEVATIONS \ ` - "-- ' � _--_ - - - - � - --? - --__ -`-� _ --- � a a �J�---� � o c � APPROVAL of THE ENGINEER AND THE LOCAL - \ \ \ r-e t !� -e_- - - - - - - ;u O� ` Porcih Porch , BOARD OF HEALTH. \ \ L _ - - - - - 26x0 Cb MATCH \ \ \ \ '� / , - - - _ -- _ - __ - - �G„ P Cb C 12. THIS SYSTEM SHALL BE INSPECTED AS REQUIRED BY Se wage, 4' INVERT AT BUILDING EXISTING \ \ \ \ ___ _ 25 - - - - - ----- } � '- E/Wish Floor TITLE V \ \ Stone Woik Exist. i<nv. ev.=38.7 �� ' /� _ - EJ C�� O ❑ ❑ O_Q ❑ ;� D -� TO BE REMOVED El.=29't 13 A CERTIFICATE OF COMPLIANCE AS REQUIRED BY 4" INVERT AT 2500 GAL. TANK IN 2 4.0 \ \ / - _ -- - - ( ) - _ O ,¢S� V/sp TITLE V AND AN AS-BUILT PLAN /Limit Archway Existing Dwelling YSTEM UST B OF THE 5 M E OBTAINED BY THE 4" INVERT AT 2500 GAL. TANK (OUT) 23.75' v \ 01` Rive�f�U,�f-- y CON TRACTOR UPON COMPLETION OF THE AGOVE WORK. Design INVERT AT DIST. BOX (IN) 22.44' -�� \ ' �i _ 1� Knee wale 14. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE �+ , ( \ ❑❑U`-I DISPOSAL UNIT. \\ 4" INVERT AT DIST. BOX (OUT) 22..27' 1 � \ ' .� \ _� -� � _ � _.--- _._._ _/ _._._ --_ / 3/ d ❑❑ X ❑❑ i-- ------- Plonis � _ 30 Plants / 15. ALL UNDERGROUND UTILITIES SHOWN Wh-RE COM- INVERTS AT LEACHING FACILITY: \ ` _ - ❑ - L �� \ _- PILED ACCORDING TO AVAILABLE RECORD PLANS �; \ - , c __ - ❑❑ Existing AND ARE APPROXIMATE ONLY. SEE CHAPTER 370, 4" INVERT AT BEG. Concrete ` - _ a ` - - - - - -- -- _ - �� \ _ (� Patio Finish floor ACTS OF 1963, M.ASS,ACHUSETTS GENERAL LAWS. LEACHING FACILITY 22..1 7' _ Bound _ C o w n A r e o E/.=35.J' Elev.=je.o - - - -_ ❑n�' - Lot 25 WE ASSUME NO RF-SPGNSIBILITY FOR DAMAGES found ? acie L-! ❑ INCURRED AS A. RESULT OF UTILITIES OMMITTED OR PROPOSED PAT10 Plants 4" INVERT AT END - _�� } \ �� \ -- - - � "'�r�r- INACCURATELY SHOWN. THE APPROPRIATE PUBLIC N /A - _ - - / l 32 t X - Plants Land Court Plan 26700E LEACHING FACILITY -'`_� row Of \ .�\ _ _ - - ` ��(r ' I ! J L❑ ❑ -J a 35 4 ELEV. ENGINEERING A LN SHALL A ' A co _ ❑� _ 3.5� Acres WELL AS DIG SAFE (PH. NUMBER 1-800-32.2-4844) Date June 1, 2004 I . �oSi'o/ \ -35 ❑ _ T-� Drawlr i.c,. ELEVATION Al BOTTOM - - _ _ --_-- _ - - -._.. _ -m__ _ _ � Bong � ---�,. �< r,,,, ..•• Assessors Map 164 Parcel 22 Design D.C.E. OF LEACHING FACILITY 20.17 �h 35- - - - Exist. Stone Wo1! �.,. .+ Top EL=3S.B Ohl ec k A Pv.W. - -- 3.5' (TIDAL) .`? _ _ OBSERVED GROUND WATER ELEVATION (MOTTLES) Scale: - - - _ - - - _ TP#1 -_�- - 30-- � - - � , _ - - �\ i ce7 e _ - - r ` - ,Joc). No. 2.1282.0Q, - �_ ---- - - - - J V "J ._ � 35 _ �� -�� r Last Re %%9; , 4 0, 1 NOTES: INLET A OUTLET COVERS TO BE ROUGHT TO 6" CIF FINISH GRADE. 2'-0" Re-is:ons OBSERVATION HOLE DATA 1. CONCRETE - 4000 PSI MiN 15.5 A STRENGTH 0 25 DAYS 7/g/0,4 RELOCATE PROPOSED TANX, OBSERVAT1074 GRND ELEV.= 9" MIN 2. STEEL REINFORCEMENT - U-1 ADD EXIST. WATER SERVICE 5. ASTM A-615, GRADE 60 AND PROPOSED DISTRIBU T`10 HOLE #1 GW ELEV.= 3.5 TESTED BY: DOWNCAPE EN�. INC COVER T DAVE STANTON 3 -�F AIR 4A�L(Typ.l Olem LINES. ILL-ic-poa WITNESSED BY: - 24" DIA. MANHOLE COVER 1 .01 3, COVER TO STEEL IA.IN, 'ATE. 3/8/04 FLOW-TOP OF TEE(T MOTTLING ELEV.= 6" FLOW ZABEL FILTER 20' SURFACE SOIL SOIL SOIL (AlOO) J ELEV. SU SOIL OUTLET TEE W/EXTE11ON L 15.5 DEPTH HORIZON TEXTURE COLOR MOTTLING/OTHER I 0 INLET -73-- PLAdN VFW 2" DOUBLE WASHED PEASTONF 0 TEE LIOU15D DEPTH 6 MIN, 3/4" TO 1-1/2-STONE 7 1/2" DIA 18' DIA KNOCKOUT ILL 15-3 __j F COVER (TYP) PRECAST CONCRETE SEPIK", TANK BOTTOM ON LEVEL STABLE BASE 15- DIA. KNOCKOU4ti ,tk, Typ) 3"-12" L.S. 10YR 2/1 REINFORCED WITH STEEL T 14.5 CROSS SECTION VIEW PLAN VIEW + 3) INLET AND OUTLET TEES TO BE CAST IRON I_ „�' ' a 1 V. r \ -"' y OR SCHEDULE 40 PVC. AF�0 NOTES 12"--44 1 OYR 4 '6 TFES TO BE CENTERED UNDER MANHOLE COVERS. F-_� C\ L q 1�ocus B L.S. 1) SEPTIC TANK TO WITHSTAND H-20 LOADING 5 <=> 2) ALL PIPE CONNECTIONS AND CONCRETE CON- SECTON A-A t�,Sc__ STRUCT10N TO BE WATERTIGHT, NO. OF GALLO 2500 ELEVATON VEW h NS: __j = El 44"-156" M.S. 2.5y 5/41 L Ea s t C:Dc I I P_ 21 L 5 DISTREUTION BOX DETAL J SrPI-IC 16 DFTAII GROUNDWATER OBSERVED 0 144" TOP OF PERC PERC RATE DB-9 (H-20 LOADING) Bay NOT TO SCALE NOT TO SCALE (ELEV.=3.5) HOLE (OD ELEV. H F D STONIF MINJINCH INLET & Oli COVERS TO BE BROUGHT TO FINISH GRADE M-N,MUM FINISHED GRADE OVER LEACHING AP, 4 TO 1 1 // 2 ' DOUBLE WAS -\WITH i,4 6" OF FINISH GRADE L -- S=2% . \, _ -26.V 25.0'_ OBSERVATION HOLE DATA 4" PVC SCH. 40 ---1 - (TYP.) 1 L=79' FIRST 2 FEET off. BUYS -362-4-t.) J1 IX LOCUS MAP fax 508-362--988," GRNID ELEV.= 16.0 .11�BE LAID LEVEL OBSERVATION 24.0'* 210, 2 r� ILI M_ 0 ED P;!�- NOT F0 SCALE I HOLE i2 GW ELEV.= TESTED By: DOWNCAPE ENG. INC. \•29 ± 2500 GAL. r 500 GAL. H­ 20 LEACHING CHAMBER dc wn c ape engeryee-ang irc. 2-1 i cj u 0 0 '4 Parcel 22 WITNESSED By: DAVE STANTON AN 23. E-0 C3 C3 0 = I-] (ACME OR EQUAL) Assessors Map 16 DATE, MOTTLING ELEV.- SEPTIC TANK 1�1 2` 1 0000 0 0 0 0 _�?n 17' CIVIL ENO31NFEERS 1/4* TO 1 1/2' ELEV. SURFACE SOIL SOIL SOIL SOIL r­1 DOUBLE WASHED STONE IF 16.0 DEPTH HORIZON TEXTURE COLOR MOTTLING/OTHER FOUNDATION LEACHING LAW SURVEYORS I ACHIN ETAIL t /TO BE NSTALLED ON A YSTEM PROFILE I OBS. WATER (TIOALL-T S2 DESIGN ANALY"ZIS LEVEL & STABLE BASE. T E--I-T PIT #1 3.5' `)_39 main St. yarmouth, rna 0267" 15.1 0"_11" FILL NOT TO SCALE --- INFLUENCED) N 0,T TO 'SC-ALE Ut'-SIGN FLOW: A I BR (11 -0) = 1210 GFD SUBCONTRACT SERVICES FOR: 11"--28"T /A L.S. 10YR 3/2 THE INSTALLER SHALL WERIFY THE 'Y7 13.7 WITHIN AREA SHOWN, ALL UNSUITABLE MATERIAL (A B LOCATIONS OF ALL UTILITIES AND ALL TS <'1717"TIC -,TFM DESIGN HORIZONS) TO BE REMOVED AND REPLACED WITH SOIL BUILDING SEWER OUTLET'S AND ELEVATIONS SEPTIC TANK REQUIREVEN 28'1-68" 10YR 4/6 CONSISTING OF CLEAN GRANULAR SAND, FREE FROM ORGANIC PRIOR TO INSTALLING ANY PORTION OF 5' REMOVAL OF UNSUITABLE SOIL B L.S. MATTER AND DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS SEPTIC SYSTEM AND RELOCATED AS REQUIRED AROUND PERIMETER OF 1210 GPD (2) = 2420 10.3 OF DIFFERENT CLASSES OF SOIL SHALL NOT BE USED. THE FILL NECESSARY. BOTH LEACHING FACILITIES, DOWN SHAH NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A TO SUITABLE SOIL LAYER. USE A 2500 GAL. H-10 SEPTIC TANK SIEVE ANALYSIS, USING A #4 SIEVE, SHALL BE PERFORMED REPLACE WITH CLEAN MED. SAND. PLUMBING SHALL BE RAISED TO MEET THE 68"-158" L.S. 2.5Y 5/6 ON A REPRESENTATIVE SAMPLE OF THE FILL. UP TO 45% BY WEIGHT (TYPICAL) Ci 2.8 OF THE FILL SAMPLE MAY BE RETAINED ON THE #4 SIEVE. PROPOSED TANK INVERT ELEVATION SHOWN. LEACHING FACILITY REOUIREMENTS: 1E TOP OF PERC 36" PERC RATE SIEVE ANALYSES ALSO SHALL BE PERFORMED ON THE FRACTION OF TO BE CONFIRMED BY PLUMBER PRIOR TO r� GROUNIDWAT R OBSERVED 0 THE FILL SAMPLE PASSING THE #4 SIEVE, SUCH ANALYSES MUST INSTALLATION. SIDES: 2(55 + 10.83)2(2)(.74) = 389 GPD IT �rl% (ELEV.=--) N/A HOLE 0 ELEV, 13.0 < 2 DEMONSTRATE THAT THE MATERIAL MEETS EACH OF P a n t s BOTTOM: 2(55 x 10.83)(.74) = 881 GPD # 5_ 2 MIN,/INCH THE FOLLOWING SPECIFICATIONS: PROVIDE VENT WITH CHARCOAL 4"X4, Post /I 1 .1 . 11, 1 �_ _1 *� TOTALS: 1716 SF 1270 GPD el I a EFFECTIVE % THAT MUST FILTER AND BLIGSCREEN FOR ut'lity Boxes- orive SIEVE SIZE PARTICLE SIZE PASS SIEVE e' 4'.y4"Post .101MP5 7 . ZONING SUMMARY BOTH LEACHING FACILITIES. kFINAL V 1 4 4.75 MM 100% PLACEMENT WITH HOMEOWNER catch Bas#7 LEACHING FACILITY PROVIDED 50 0.30 MM 10% - 100% CONSULTATION) ll 10 100 0.15 MM 0% - 20% ZONING DISTRICT RF-11 RESIDENTIAL DISTRICT # 200 0% 5% erichmark 0.075 MM Tag Bolt 0' Hydrdht USE 2 LEACHING TRENCHES, EACHa/ ?c PROVIDE APPROX 70' OF 40 MIL- I MIN. LOT SIZE 37,120 S.F. Iev Ground Light MIN. LOT FRONTAGE 20' LINER DOWN SLOPE OF AND 5' 04 USCG&S CONSISTING OF (6) H-20 500 !/ I GAL. OFF OF BOTH LEACHING Ca% Basin I i I R 8.10 Approxltncr Woe er 5 MIN. LOT WIDTH 125' FACILITIES AS SHOWN. TOP AT ELEVATION 23.0', BOTTOM AT e ter ervic LEACHING CHAMBERS, \MTH 3' STONE Al MIN. FRONT SETBACK 30' (TYPICAL) -or, MIN. SIDE SETBACK 15' ELEV. 19.0 AND 2.5' AT ENDS 05tei Ground Light MIN, REAR SETBACK 15' 3.Og'- If e, - I !14t NOTES V 1. UNLESS OTHERWISE NOTED, ALL CONSTRUCTION 1-24 SITE IS LOCATED WITHIN RESOURCE .0 PROTECTION OVERLAY DISTRICT. METHODS AND MATERIALS SHALL CONFORM TO INE A Plan t-v _Z1 RNE H H TITLE V OF THE STATE ENVIRONMENTAL CODE AND OJALA I TOWN OF BARNSTABLE RULES AND REGULATIONS. FEIVIA ZONE V16 (EL.1'5) & A13 'EL.11 ) OJALA CIVIL No 92 1 RESERVE AREA- 0 2- GROUT TO BE USED AT ALL POINTS WHERE PIPES 8 2 0.5' N CS ENTER OR LEAVE ALL. CONCRETE STRUCTURES IN cts NOTES: 1, :)ROPOSSED ORDER TO PROVIDE A WATERTIGHT SEAL. 1. PLAN REFERENCE: SEE LAND COURT PLAN 26700 F & Sir D-BOX ��� ` \• 3. ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL BE .4, 9�3 -ed For USAGE PERMIT MA-HYAN-79-255. Existin SEALED WITH NEOPRENE GASKETS OR ASPHALT Cap CEMENT TO PROVIDE A WATERTIGHT SEAL. 2, ELEVATIONS ARE BASED ON N.G.V.D. //rA HARL1=S F. & V 4. PRECAST CONCRETE SEPTIC TANK, DISTRIBUTION 3. ARCHITECTURAL DESIGN & LAYOUT BY (VAN BEREZNICKI BOX AND LEACHING FACILITY TO WITHSTAND H-20 LOADING. DEBORAH J. DO"E" ASSOCIATES, 14- V 5, ALL 4" PVC PIPES IN THE SYSTEM SHALL BE 4. STRUCTURAL DESIGN, GEOTECHNICAL ASPECTS AND SCHEDULE 40. RETAINING WALLS TO BE DESIGNED BY OTHERS. 7P 2 6. WASHED CRUSHED STONE SHALL FREE OF ALL 1 20 Rascally R 1"t"l. 5. THE EXISTING CONDITIONS SHOWN HERE ON ARE THE El. 16.0ti DIRT, DUST AND FINES. )a Marstoi,s Mills, MA 0264� RESULT OF A SURVEY PERFORMED ON THE GROUND BETWEEN L 7. AT ALL POINTS OF INTERSECTION OF WATER LINES \ \ J-­7" - PROPOSED LEACHING ' f MARCH 1 & MARCH 5, 2004 PROPOSED - \�// A , --_ 1 1, / �, '' .1 CHAMBERS WITH STONE AND SEWER LINES, BOTH PIPES SHALL BE CON- AREA DRAIN t�; - I I STRUCTED OF CLASS 150 PRESSURE PIPE AND ARE TO A TYPICAL) Landscape BE PRESSURE TESTED TO ASSURE WATERTIGHTNESS. DESIGNED BY v ___ 0 - LEA Ill Re WC/1 *l:,V j 0 )�STIN I PI OTHERS (TYP C UM D AND r 8. SEPTIC TANK, DISTRIBUTION BOX, ETC. SHALL BE N7 -:V50'i k� 1 3 k M. Wilson ASSod 7 )7 EMOVED -RESERVE AREA MANUFACTURED BY ROTONDO OR AN EQUIVALENT n�relte, MANUFACTURER. 150 F0 42f, 9-79o:- U8 4`0 9792 4?ound S \ ' G i ,RI A . -1 n "'0 1 o nd P a n t s 9. EXCAVATE ALL UNSUITABLE MATERIAL IN LEACHING LP\I ?rol rp 1 AREA AND BACKFILL WITH. MATERIAL AS DESCRIBED Title? 1�j PROPOSED 2, GAL-1'500 EOMUNO F. & DEBORAH Af. ROOF R'JN-OFF ON PLAN. SEP TH;elrANK INTO KEL L E)' oo TIE TO 'BE DIRECTED TO &WOW ASSESSORS MAP 164 pARCE-L 19 ,te _____ I Ill EXISTING TANK S EXISlTING DRYWE'LLS OR G / 1 �� �� '> 10.HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO --STRIP DRA - SEWER BE PUMPED AN A r e 0 REMOV OPERATE OVER THE LIMITS OF THE SEWAGE DIS- ICobble 0 �A L L_ POSTAL SYSTEMS DURING THE COURSE OF CON- FrOr' W PROPPED BUILDING 200 (Apron STRUCTION OF THE SYSTEMS. F. ELEV. 34. 2 I�PP't 7,n, Pad Deck P C n 11. NO FIELD MODIFICATIONS TO THE SEWAGE DISPOSAL._20- septic 0 1 Plan t s renk 1 INVERT ELEVATIONS 6 Ven t - _ -1 SYSTEM SHALL BE MADE WITHOUT PRIOR WRITTEN CD C3 C3 C, APPROVAL OF THE ENGINEER AND THE LOCAL Pipe T-.r--e LF t_* X0 Porch Porch BOARD OF HEALTH. El.=58, 12.THIS SYSTEM SHALL BE INSPECTED AS REQUIRED BY 0/ag e MATCH EXISTING 4" INVERT AT BUILDING 25 nA Floor L Ele M 7 TITLE V. Vofii Wolk -h Fxist. In v. ► 4 INVERT AT 2500 GAL. TANK IN 24.0' 0 0 11 1-1 13- Ca 1:2 Porc E-1.=29,Y TO BE P N4 0,VF 0 Q� 3. A CERTIFICATE OF COMPLIANCE AS REQUIRED BY D&p o.4,�a -------, 1:1� -BUILT PLAN Arct,w,7 #52 TITLE V AND AN AS INVERT AT 2500 GAL. TANK (OUT) 23.75 \4 Y- Existin(7 Dwelling OF' THE SYSTEM MUST BE OBTAINED BY THE 1 , En try E CONTRACTOR UPON COMPLETION OF THE ABOVE WORK Design 4 INVERT AT DIST. BOX (IN) 22.44' \-Knee WO// EZ=Jt 7 14. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE 4" INVERT AT DIST. BOX (OUT) 2 2.2 7' DISPOSAL UNIT. --30-- Plants Plants 15.ALL UNDERGROUND UTILITIES SHOWN WERE COM- INVERTS AT LEACHING FACILITY: PILED ACCORDING To AVAILABLE RECORD PLANS AND ARE APPROXIMATE ONLY. SEE CHAPTER 370, Existing 4 INVERT AT BEG. Concrete - IFC,, LJ Lj E E PGtiO 22.17 ACTS OF 1963, MASSACHUSETTS GENERAL LAWS. LEACHING FACILITY F7 I Bound L a w n A r e o Finlsh Floor Found L r--] WE ASSUME NO RESPONSIBILITY FOR DAMAGES LT -LIDEEIF e 6ev=J8 Lot 25 El 4 1:1 i 1. INVERT AT END L__j iPRdPO§b Al 12M Plants INCURRED AS A RESULT OF UTILITIES OMMITTED OR LEACHING FACILITY IN/A zJam 32'±t' Land Court Plain 2670OF INACCURATELY SHOWN. THE APPROPRIATE PUBLIC 11 ! I I A q Plants 1 ENGINEERING DEPARTMENT SHALL BE CONTACTED AS mollJu,�(? 2, 7 717 3.5 Acres WELL AS DIG SAFE (PH. NUMBER 1--800-322-4844\ _35 ELEVATION AT BOTTOMr'S j DrawIng No. ft;* Mon- I ASSP-S I - Pcrcel 2z'? OF LEACHING FACILITY 210.17' All.5 _;�0112�_ - sors Map `64 t. Stone 4 TOP 1 A A, 35 (TIDAL) OBSERVED GROUND WATER ELEVATION (MOTTLES) Scale: 1 20' 14� rciwn TP#1 F 0 H 7 oc off. b5 2244 A I 0 ------- -t-e-1 - b. 1\,k,. 2.1282.00 20 50 FEET Lest Rev. 7/9/04 of 1 Doe Site d%c,,