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0032 STURBRIDGE DRIVE - Health
32 Sturbridge Drive 'f Osterville rj A = 166 034 qq F m m ° R o �F4 ,� DAVID A. OLSON 28 BARNSTABLE ROAD HYANNIS, MA 02601 (508) 775-4300 (508) 775-4300 Fax -Zl lo / o7 -o t4 rH - �- �� L- L SHE 1p DATE: /t 0 3 h� 0� FEE: L + BARNSCABLE, � 9 MASS. g' REC. BY AIFDMAtA Town of Barnstable CHED. DATE: Board of Health 200 Main Street; Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 32 S-�w-br 4a N.'oe ?S 4md ,Ile 47 Assessor's Map and Parcel Number: 46103y Size of Lot: /3 05 Y S f' Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: �c,�� S l one c%e ws1<" Name: Shy, Address: 32 54y,r r,-dap pr%�G, UT�erv�'l�r Address: Jyo te-,&yke sl kl�ys�r,,M�4 Phone: Phone: (7(0 SIT- 70 y Ce1L 61-7 6,fg- 3001 VARIANCE FROM REGULATION(List Reg.) REASON FOP,VA CE(May attach if more space needed) �less�2044 7�sAs y r H r - -�FQc�F 'd-) j.Qs� �ha .-1 �9r�v I.vti r p G, o, NATURE OF WORK: House Addition House Renovation I] Repair of Failed Septic System & An aVn U Checklist(to be completed by office staff-p son receiving variance request application) _T Four(4)copies of the completed variance request form I/ 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 r� 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) Nli� 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 VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Q:\HEALTH\Application Forms\VARIREQ.DOC TOWN OF-BARNSTABLE LOCATION �,�.. , �:,i��s,:�. n� C`1 SEWAGE # �vv 3 (�� VILLAG I ASSESSOR'S MAP &LOT l " b 3`1 INSTALLER'S NAME&PHONE NO. CZ' Vi e,f �.` t c �fl SEPTIC TANK CAPACITY ©� LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNS PERMIT DATE: 3 —COMPLIANCE DATE: 3 d Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by A- 31 3 Q o' c" f5 Fee V I.�Iv l� 6 :- .0 �{-s �/ d3 No. 1a`6 11 or THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZtppYication for Migooal 6p5tem Cow6truction Vermit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) `Complete System ElIndividual Components Location Address or Lot No. ^� Owner's Name,Address and Tel.No. J 2 ,S 7WA f3-f L✓r.Z !/ y�jh J / a Assessor's Map/Parcel OS Tte-vs / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �i2J 5,7�- / �On.tS"s�7:' !/�g-1a•rJ ,ef� �^ f y✓i/fir/Yl BiC o irC S S'�3 G Z Z z2&,s, 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 'S/�/D gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank o Type of S.A.S. G'/�/�F��s Description of Soil Oelzza112-6 A- 9'77,!V Nature of Repairs or Alterations(Answer when applicable) fi�G�.�c✓� Ss/�5i—E.�'I Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi %Bjo alth. Signed Date �' 3 Application Approved by Date 3 a Application Disapproved for the following reasons Permit No. 20 0 3--(02 Date Issued J No. Fee l 00 r THE COMMONWEALTH OF MASSACHUSETTS Entered in compYes uter: ✓ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS F . 2pprtcation for Migogar 6pgtem Con!truction Permit Application fora Permit-to.Construct( Repair( )Upgrade( )Abandon( ) omplete System ❑Individual Components Location Address or Lot No. Owner's Name,Address•bd Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Z-79/ e::C" j/�2 dc°'S-1a�t/ /-7J z Z s G /tom /i.vGs o23G�� S�-r Cie t- Type of Building: Dwelling No.of,Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type ill Building 14�o�s fi No.of Persons Showers( Cafeteria( ) Other Fixtures Design Flow .t ' y gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /low Type of S.A.S. 6W/lam s - re/7r, e- Description of Soil O�7zy�H/i S'�f✓ � (iP�,r� � �� _t `t p Nature of Repairs or Alterations(Answer when applicable) .3 i'F r,I 1 _ , - 1 � � Date last inspected: Agreement: �, 1 ' ( r 1 =5 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 issued by this Board o ealth. Signed f Date 3 -/8 -O 3 Application.Approve&by / Date 3 /5fa Application Disapproved for the following reasons Permit No. Z V O 3— (bSC Date 1 Issued .3 B R THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( Repaired ( )Upgraded( ) Abandoned( )by at g Z s jj_ . Gr-i A b j has been constructed in accordance 'k with the provisions of Title 5 and the for Disposal System Construction Permit No. ZOO 3-1 O? dated O 3 Installer I Designer The issuance of this p rmit shall not be construed as a guarantee that the system asCO'es/ed. Date 03 Inspector ----------------------------------------- No. Fee /0 V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS wi!6pool *pgtem Construction Permit Permission is hereby granted to Construct( )Repai )Upgrade( )Abandon( ) System located at g 2 ►- r n S 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: Con truct'on must be completed within three years of the date of this pe Date:_ . ( r,3 Approved by r i TOWN ORBARNSTABLE 11 2c�v3-(�g LOCATION S "�.�l1ac Jan �— SEWAGE # s, VILLAGE ���'a 2 ASSESSOR'S MAP & LOT l r d 37 INSTALLER'S NAME&PHONE N0. tLk c-o 5 L L . 6— (.- SEPTIC TANK CAPACITY i LEACHING FACIL=: (type)! b ✓ C t' (size) NO.OF BEDROOMS i BUILDER OR OWNS { 3 ®3 PERMIT DATE: 3 () COMPLIANCE DATE:_ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist - I within 300 feet of leaching facility) Feet Furnished by 31 13 ' , i I � i 1J O o' r NUMBER THE COMMONWEALTH OF MASSACHUSETTS FEE 191 THE TOWN OF BARNSTABLE $30.00 BOARD OF HEALTH This is to Certify that Joseph Casna Crystal Construction Corp. 140 Pembroke Street, Kingston, MA TEMPORARY IS HEREBY GRANTED A"DISPOSAL WORKS INSTALLER"S PERMIT'TO CONSTRUCT, ALTER,INSTALL or REPAIR Individual Sewage Disposal Systems This permit is granted in conformity with the State Environmental Code Title V, Regulation 2.2, .April l NWoard of HeAlfH Meet' and expiresunless sooner suspende�9br revoked. January 1 2003 Susan G. Rask, R.S., Chairman Wayne A. Miller, M.D. Sumner Kaufman, M.S.P.H. Agent: Thomas A. McKean, R.S., CHO Town of Barnstable • anatasrnsr E. "AS 9. ,� Board of Health tF0 MA'1 a P.O.Box 534,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. February 28, 2003 Mr. Thomas Fantozzi, IRS, CHO P.O. Box 1275 Sagamore Beach, MA 02562-1275 RE: New Addition, 32 Sturbridge Drive, Osterville A=166 -034 Dear Mr. Fantozzi: You are granted variances, on behalf of your clients, Paul Stanechewski, to install an onsite sewage disposal system at 32 Sturbridge Drive, Osterville. The variances granted are as follows: 310 CMR 15.211: To install a soil absorption system seventeen (17) feet away from the existing foundation, in lieu of the twenty (20) feet minimum separation distance required. 310 CMR 15.212: To install a soil absorption system with it's bottom 4.3 feet above the maximum adjusted groundwater table elevation, in lieu of the five feet minimum separation distance required. The variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. FantozziSta nechewski (2) The applicant shall prepare a properly worded deed restriction, signed by the owner, and recorded at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms. A copy of the recorded deed restriction shall be submitted to the Health Inspector prior to obtaining a disposal works construction permit. (3) The septic system shall be installed in strict accordance with the revised engineered plans dated February 18, 2003 (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans dated February 18, 2003. This variance is granted because physical constraints at the site severely restrict the location of a soil absorption system due to the size of the lot and elevation of the groundwater table. Sinc ely your , yne iller, M.D. Chair n Board of Health Town of Barnstable Fa ntozziStanechewski - j DFTHE Tp� DATE: I /` O 3 FEE: + BARNSTABLE, 9 MASS. qjp 1639. `0� REC. BY IFDMA'la Town of Barn stab l eCIiED. DATE:403 Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 67 Assessor's Map and Parcel Number: jb1,103y Size of Lot: /3 05"y S f Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON J ,r✓1 �rrn0 2 Z Name: Rj e clle wl/<, C rr Name: T�� � 0 Svrc, Address: 54v,rhr,,c1ap t)n.:L US Address:_ Yo erokjake S1 Phone: _ �� J`c 6 3 Phone: b'1 S - 70 V,S �c 1 61-7 6L�,�- 30o) VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) --41 #^ ' lPsi&— a0 fed.�SAS Glue r�wc �Pr _Se 12urFl l� a� �� 6rQ� INc r H NATURE OF WORK: House Addition House Renovation ❑ Repair of Failed Septic System ❑ & ��1 ,'N qn in route u Checklist(to be completed by office staff-p son receiving variance request application) �— Four(4)copies of the completed variance request form t/. 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) IV16 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 VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Q:\HEALTH\Application Forms\VARIREQ.DOC 1 � To: Health Department Paul Stanechewski 32 Sturbridge Osterville Ma, To Whom It May Concern: Joe Casna and Tom Fantozzi will be representing me concerning the Septic and Pool design for 32 Sturbridge in Osterville. Any questions please call my cell phone at 508-566-3526 Sincerely, Paul Stanechewski --Gati► ,st-r ; �fl��N� l^3t b M + �M 1 CLoor. WCA. ciA AGC/ CN�rtg �� C- X I Sti N S &Ucz%,A� cz) w.: s-c Floor .ml ,. New EN1Aru6P 73Rcetc-.r+�/gq� C X 1 St'1 .►5 Ma l w> (-1 ot..LSE GAa.APG ST �loptz vS�T C�ns�N� 9i. Moor -C'O::R�(ZcCLI�A Moo 2bunr� SNbre Oet c Vol'- �... .. gill 1 ZZ' l4 2''�'OtsT 7 d / r- 4 L VC— rt sz ,art,. ,F ZN a��x'rL S-l7v aS C-5) � ob 411A Mof —t�c- � i 9 Fantozzi Environmental Design P.O.Box 1275 Sagamore Beach, Ma 02562-1275 508-998-0275 (work) 508-998-0277 (fax) 508-272-4426 (cell) January 7, 2003 Public Health Division Environmental Health Services Town of Barnstable 230 South Street Hyannis, Ma 02601 Re: Paul & Lorna Stanechewski, 32 Sturbridge Drive Dear Board of Health, Enclosed please find copies fora septic system upgrade/repair for 32 Sturbridge Drive, Osterville Village. The existing home is being up-dated, and a new addition is being constructed, along with a new in-ground swimming pool. The old septic system has been removed to accommodate the new pool. The new proposed septic system is designed to accommodate 4 bedrooms. A building permit has already been obtained. In order to maintain the proper set-backs from the property lines, we will require a 3 ft. variance from 310 CMR 15.211, placing the SAS 17 ft. from the existing foundation. We have provided a 60 mil. rigid barrier designed by Miller Engineering for this purpose. The bottom of the proposed SAS will be 4.30 ft. above the maximum high groundwater table determined by soil redoximorphic features, and 5.3 ft. above observed water. We are requesting a 0.70 ft. variance to the 5 foot i . . =s separation distance for rapid soils, as outlined in 310CMR 15.212, and allowed under section 15.404(2). Please inform me as of the time and date of the Board of Health meeting to discuss this request, and please feel free to contact me if you require any further information. Sincerely, Thomas E. Fantozzi, .S., C.H.O. Environmental Consultant Cc: Paul & Lorna Stanechewski Crystal Construction Corporation oft►+e rqy, Towwof Barnstable p Department of Regulatory Services HAR ar,►saNA DIX ' Public Health Division Date" . g �pTE1 µ►'�� ' Street,Hyannis MA 0 01 ID ;200 Main 26 ��; f : Tune v :vo Fee Pd: Date Scheduled.. ►Broil Suitability Assessment fog Set age Disposal Performed By: S Witnessed By: ,y i, 6 NON '. ��. tl Location Address II Owners Name (►OQnI/4' 3a S�vr.br.��, oS1��'��a SI�`l4•IVFoffss41 9rrve ., . Address 32 STVRZR�Js�tZ a t . Fi9NT�Z Assessor'sMap/Parcel: -03V �, Engineer's Name ?f'byhyjs & NEW CONSTRUCTION REPAIR Y Telephone# ���'a7 Z y q 1p Land Use 0-0, � Slopes Surface Stones N O N_E /,,,lye ft Drinking Water Well !� ft Distances from: Open Water Body J /Y11L� ft Possible Wet Area_A� -- , / Drainage Way -�S�' ft, Property Lineft ° Other SKETCH:(Street nazne,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands inroximity to holes) ' Sim Ar. /64/W', o _ AN IBB/32' 19t.y1 r _3 _ - 1 C6° 'LOT .js< f AU roe PR OPOSAD ADDITION _ CA CONC AN / O N ,-lie PAD. .. 9•. - a v L4 M ,se1133 Ta7r� - � 109= I a 100,00, N8434'30"B � , BRIDGE DI�1 VE y . ST UR Parent material(geologic) G� �`s�f.579V Pth to Bedrock /✓� r7�G0l� JQ�D ' Depth to Groundwater: Standing Water in Hole: .q _. Weeping from Pit Face Estimated Seasonal High Groundwater F f S d H'sL4k Method Used: Depth Observed standing in obs hole: 'in Depth to soil mottles: _i��• Depth to weeping from side of obs.hole: in. Groundwater Adjustment `ft.' Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level INCISE I ii will •,x i M k' • v w e a Observation J Time at 9" Hole 11 §= ' J' /o:ob s �.� • Time at 6 Depth of Pere /mla Time(9"=6') ,• Start Pre-soak Time® 4 , End Pre-soak /O D 9 y 7 -ApdaeD �5 Rate MinAnch M�t(wJ Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(Y/N) N Original: Public Health Division Observation Mole Data,TO Be Completed on Back_ T..._...,, a I ' :. � �' i � '� .. -.i a� n r ., j Depth from Soil Horizon Soil Texture Soil`Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistency,%Gravel .ZMMYSAiJ /DYR yli .Z% fit✓ Ity 16-I20 /hay > FINE R-Yi, 90 vEi2 14alf 6flN� /a° �A�ELt , I 1. Depth from Soil Horizon ::Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistent %Gravel ,r � 4 ' v,:r i, ih,r �'' .ry,•; p! ! rvpi.:..i. 1. ll 111 fi Nu Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistency,%Gravel h N l! �{1, 1. '' i n' t L 'Iq ,. W n Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistent %Gravel Flood Insurance Rate Map: Above 500 year flood boundary No /Yes Within 500 year boundary No Yes Within 100 year flood boundary No ` Yes Depth of Naturally Occurring Pervious Material. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the .area,proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on // /7 9 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trainin ,expertise and experience described in 310 CMR 15.017. a;�,,,r„rF 'l�l� Di(sl[!' -:;CN* / Date --J s i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL (PROTECTION V Y TITLE 5 OFFICIAL INSPECTION FORM-'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 32 Sturbridge Drive Osterville Owner's Name: Re-Certified for 4th bedroom Owner's Address: Date of Inspection:913102 Name of Inspector: Timothy Lovell Company Name:Accurate Inspections Mailing Address: 550 Willow Street W.Yarmouth,MA. Telephone Number:508-771-3700 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 C.MR 15.000). The system: _X_Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority F • ' ; Inspector's Signature: Date:9/3/02 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments Suggest that Cesspools be replaced by septic tank,after site visit and conversation with Board of Health this system under the 1978 code will handle a 0' bedroom, Site observation showed vehicles may have driven over the piping there may be damage there ""This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Z 'd irZBE-Sail-BOG r Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:32 Sturbridge Drive Osterville Owner: Date of Inspection: 9/3/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CUR 15.303 or in 310 CNM 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A 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. N/A 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 infiltration 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: _N/A , 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: N/A 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: 6 'd bZt3E-SBb-BOS Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: Date of Inspection: C. Further Evaluation is Required by the Board of Health: _N/A 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: N/A_Cesspool or privy is within 50 feet of surface water -N/A_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: _n/a_ The system has a scptic 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. _n/a_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. n/a The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _n/a_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicatcs that the well is frce from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: b 'd �z8E-S8�-SOS r Page 4 of i 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: Date of Inspection: System Failure Criteria applicable to all systems: You must indicatc`Yes"or"no"to each of the following for all inspections: Yes No _x Backup of sewage into facility or system component due to overloaded or clogged SAS or ccsspool _x_Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _x_Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _x_Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow _x_Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped ' _x 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. _ _x_Any portion of a cesspool or privy is within a Zone 1 of a public.well. _ _x__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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No The system is within 400 feet of a surface drinking water supply The system is within 200 feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped'' Zone H 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 shalI upgrade the system in accordance with 3 10 CMR 15.304. The system owner should contact the appropriate regional office of the Department. I 'd �IZBE-qB�l-BDq Page 5 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: Check if the following have been done.You must indicate`yes'or"no"as to each of the following: Yes No _x T Pumping information was provided by the owner,occupant,or Board of Health x 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? _x Have large volumes of water been introduced to 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 NIA) _x _Was the facility or dwelling inspected for signs of sewage back up'l _x_ _Was the site inspected for signs of break out? _x Were all system components,excluding the SAS,located on site? x_ _Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the bales or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _x _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 x _Existing information.For example,a plan at the Board of Health. x_ _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)] z 'd �ZBE-S8�-80S Page b of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: FLOW CONDITIONS - RESIDENTIAL Number of bedrooms(design):_3_Number of bedrooms(actual):_3_ DESIGN flow based on 310 CMR 55.203(for example: 110 gpd x#of bedrooms):_330 Number of current residents:_3 Does residence have a garbage grinder(yes or no):_n Is laundry on a separate sewage system(yes or no):_n [if yes separate inspection required] Laundry system inspected(yes or no):_n/a_ Seasonal use:(yes or no): n Water meter readings,if available past 2 years usage(gpd): Sump pump(yes or no):_n Last date of occupancy:_current COMMEERCIAL/INDUSTRLU n/a Type of establishment: Design flow(based on 310 CMR 15.203): >rDd Basis of design flow(seatYpersons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records ` Source of information: Was system pumped as part of the inspection(yes or no): no If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _Septic tank,distribution box,soil absorption system _x_Single cesspool _x Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe):_1000Gal leach pit 2' stone surrounding it installed 8/8/80 Approximate age of all components,date installed(if known)and source of information: Up Grade 1980 Were sewage odors detected when arriving at the site(yes or no):_no_ E -d Btr-80s Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: BUII.DING SEWER(locate on site plan) Depth below grade: 32" Materials of construction:_x_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:____(locate on site plan) Depth below grade:_1' Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain) Block If tank is metal list age:_Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 6x8 Cesspool_ Sludge depth: 0" Distance from top of sludge to bottom of outlet tee or baffle: 0" Scum thickness:_0" Distance from top of scum to top of outlet tee or baffle:_0" Distance from bottom of scum to bottom of outlet tee or baffle:_0" How were dimensions determined: in the field tape measurements Comments(on pumping recommendations,inlet and outlet tee or baffle condition,struchrral integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Block cesspool was empty scum line show water level has be as high as invert out GREASE TRAP: n/a (locate on site plan) Depth below grade:_ Material of construction: concrete_metal_fiberglass_polyethylene other (Explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): � 'd trZl3E-SBt'-80S Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: TIGHT or HOLDING TANK: n/a (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX:_N/A (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.): PUMP CHAMBER:_n/a (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 9 -d 1,213E-S6f,-60S Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type _x_Leaching pits,number:—I— Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions. _x_Overflow cesspool,number: hmovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): No Evidence of hydraulic failure there were indications of overflow from cesspool leaching pit showed indication if having a few inches of water in it. CESSPOOLS: x (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 1 Depth—top of liquid to inlet invert: 0" Depth of solids layer: 0" Depth of scum layer: 0" Dimensions of cesspool: 01' Materials of construction: 6x8 block cesspool Indication of groundwater inflow(yes or no): no Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Cesspool was empty scum line shows that the liquid level has been as high as invert out PRIVY:_n/a_(locate on site plan) Materials of construction: t s Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): L 'd bZBE-Sat,-80S f Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: F9 Owner: Date of Inspection: 9/,?/0 z. SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. 3 CQAC,L Ce55 /GY1� 6A C zL.S�.pAC 20:39t�d 000T8Z9098 110Id8UW N0i9NIW6U-3:W0dJ S2:8T 20 TT-HUW Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_20'—feet Please indicate(check)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:_8/8/80 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Asbuilt shows no ground water 818/02 at 14' S 'd bZBE-S8�,-SOS LOCATION SEWAGE PERMIT NO. VILLAGE ` u" INSTA LLER'S NAME i ADDRESS 4 O U I L D E R OR OWNER_ DA T E P ERMIT ISSUED i I it DATE COMPLIANCE ISSUED __ r �, 4,,_, . ���� `` I ��� I '�-� ,tip °�° � � � � � �L�� �. No..- aa- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .........................T own.....O F........Barnstable....------------..................................... AVVIkatiou for Bhipoqa1 Workii Tomitrurtion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: .32. 1~urhridge.St_, Oste ille.r..A2b -------- -----------•---------•---••-•-------------•-•-------............................................ Location-Address or Lo N Harold F. Ham 32 Sturbridge St., Osterville 02655 A__! .B_.Cesspool Service _ 128• Bishops Terr_ aced yannis 02601 Installer Address Type of Building Size Lot..... ....................Sq. feet U Dwelling—No. of Bedrooms........3..................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons---------4................ Showers — Cafeteria Q' Other fixtures ---------------------------------- W Design Flow...........................................gallons per person per day. Total daily flow....................... ....................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter--.----......... Depth................ x Disposal Trench—No. .................... Width................... Total Length-................... Total leaching area....................sq. ft. Seepage Pit No------------------------------ Diameter.--..---.--------.-- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `" Percolation Test Results Performed by---------------- ......................................................... Date........................................ aTest Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water-.---.._.----.--....._-- G%, Test Pit No. 2................minutes per inch Depth of Test Pit--.----.......--.... Depth to ground water.....................--. x ------------------------------------------------•-•••-----••••.......-••••----•••-•••---•--•-.....••..................................-•-••.................•. ODescription of Soil.........Sand....••------••-•-•••---•--•----•----•-•--•••-•............•--•-•---••----------••-••--••••••••--•-•----•---•••-•------••............•--•-••-•-.--- . _ _ _ . W ------------------------- -------- ----- - --------------------------------------------------------------------------------------------------------------------.................... . V Nature of Repairs or Alterations—Answer when applicable------inst a7_lation.--of_.a._1,Il00---gal.....pre-rant, ....'q.9ne--p'aQkked._1eaQb_-pat...(DYerfi-QW).-----------------------------------------------------------------------------------------------------••------•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i i:?.•. y g g p y of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the b r of lieal�th. Signe ';i4 L 8f .}rba&0... � / C� Application Approved By..-••-.--• te /" • ••-••••0-.-�--� f•--•-••-••-••-•••--- ^---------8f �t 8a------------- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------•--------------•......••----•--- ---•-•.......................•--•-----•-.....•-•---•-----•-•••-•••---••--••••--••-••-•-----•--•---•••--•--••----•••••••••---•----•---...---•••---••••----------•---•-•---•----------•...••-•••---------- ` Date PermitNo..........80-....................................... Issued....... /..5/$Q................................ Date $...5AQ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... .....Town...._OF........B�xpstable .. ........ ................................................................. Appliration for Bhipasal Workii Tiamitrurtion "amit V Application is hereby made for a Permit to Construct or Repair (X ) an Individual Sewage Disposal System at: 2 .4265--------- -------------------------------------------------------------------------------------------------- Harold F. Ham Location-Address 32 Sturbridge St., obs'Uro-ville 0265 ................................................................................................ ..................................................................................5 Idt A & B Cesspool Ser�)Gg 128 Bishops Terrace, �6ni 8 OP-601 . ......... ......... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........3..................................Expansion Attic Garbage Grinder ( Other—Type of Building ............................ No. of persons---------4---------------- Showers Cafeteria ( P4Other fixtures ----------------------------------------------------------- ------------------------------------------------------------------------------------------ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width___..__._._..... Diameter__-_____________ Depth_....___._._.__. Disposal Trench—No. .................... Width...-_......_._...... Total Length_______............. Total leaching area--------------------sq. f t. Seepage Pit No_____________________ Diameter.............._..... Depth below inlet....__........._._.. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Per-formed by.......................................................................... Date--------------------------------------- Test Pit No. I................minutes per inch Depth of Test Pit___.__._............ Depth to ground water_-_______---____-_-____. (i, Test Pit No. 2................minutes per inch Depth of Test Pit..._.........._..... Depth to ground water..._....__......._..___. .............................................................................................................................................................. 0 Description of Soil.........Sand..................................................................................................................................................... U ........................................................................................................................................................................................................ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------I................... U Nature of Repairs or Alterations—Answer when applicable------ins_ta1l&t1_0n...of--,a.'-1.000--ga2,...prenoast., ---stone- h---gu---(Qyernoll)..................................................................................................................... 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 beard,of health. Signe 34-5/80------------- Qate Application Approved By...... .......ak- ...... . . . ..................... --- 51-80............. Date Application Disapproved for the following reasons:........................................................I........................................................ ........................................................................................................................................ ---------------------------------------------------------------- Date PermitNo..........pq......................................... Issued......PI-51 ................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. ...............T. )a..........OF......B6X.Ut/.atj6..................................................... (Intifiratr of Toutpliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired (X) rrace,....HY t by.. 2R.................................................__.......... MA 02601 128 Bishops Te ......................... ...... 271�? ........ at...32...St.urbr.i.dge..St....-.Osterv.ille-,,---1U....02�3 taller _5 -- Harold F. Ham ..................................................................................................... has been installed in accordance with the provisions of TIT LEE' 5 of The State Sanitary C�dels described in the 80 application for Disposal Works Construction Permit No.___80-_..dV..1_d................. dat ------------------------ ------- --- ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM..V�� F N SATISFACTORY... ...... DATE.-- . .. ........:.. Ins................................... pector........ 7------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OBa=StAbIA ................................. ......... . ..................................... ........ 0No ... . ... FEE......$"'50' Disposal Workii Tonstrudion "amit V Permission is hereby granted....A..&..P...Cesspool.-Serv.1ce...........................................I............................................. ... .. .................. .......... ...... to Construct or Repair (X ) an Individual Sewage Disposal System at -----02655 -- Harold F. Ham ...................................................................................................... Street as shown on the application for Disposal Works Construction Pe Nob_ Dated.. ....................... &--- ------------------------------ TEE.717 47�DA ........._.—.................................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS A.M. FOR DATE TIME P.M. t�L ' v M OF j �1 (J ONED �i RETURNED ` PHONE YOUR CALL REA rqO MEiER EVENSIO J LEASE CALF. MESSAGE`'L/+ WILL CALL - GAI C; E i EE YOU, �! SIGNED �nlVer al 48003 � � i � �� � I � �I, � ;�� N� I � �'i L 0 CATION ?'6 ° y SEWAGE PERMIT NO. V1CLkQE, k l INSTA LLER'S NAME i ADDRESS I UILDER i. OR OWNER GATE PERMIT ISSUED DATE COMPLIANCE ISSUED ` ` d I I i I \� kti ,Li Opp sr Soil log General Notes: TEST PIT # 1 EL.= Ge sal Notes 1. The construction of this on-site setrage disposal system shall be in compliance with 310 CMR 15.00, Titl<; V, and all Board of NORTH -- 'long. All work must be in cordance wi Massachusetts Department of PON YE DEPTH COLOR REDX STRUCTURE Environmental Protec on Re ations 310 CUR 15.00, and any and all b - impervious material must be excavated and removed �u1 A E 0"-6" 10YR4/2 F.S.LOAM ed with clean in Barnstable Board of Health Regulations. 30 and replaced th e an coarse sand OCUS 5 P pia 8 6-32" 10YR5/8 - MED. LOAM rith 310 15.255, if required. During installs , no mo one shall be made to any system " - �� t NOT designed for aarbege grinder. component, on tation,elevation, �• C1 32-120 10YR6/6 FINE/MED. of the soil absorption system shall be more than 3 p first distance, or any other aspect o! shed grade. the septic system plan without PRIOR approval by the ill Registered Sanitari aind1lam=8 le Board of Health Agent. All lines must be a mi�liimum of 10 feet from and 18VERIGATED 0 62" 11 components of the septic system. system components be in ed per manufacturer's LOCUS PLAN (N.T.S) MOTTLES m 9Q" EL.= 90 a soil absorbtion system below a paved area shall be recommendations and as s wn on this plan. DAMP m 102 = 99 ►grade and shall consist of H-20 loading Any unusual or unforeseen conditions encountered during the installation of this septic system shall be brought to the attention of the Test Pit # 1 Noveatber 2, wing is required before back-filling of the Design Sanitarian and Board of Health Agent. Failure to report or Pere at 48" -06" he contractor shall notify the Board of Health and timely notify F.E.D. and Barnstable Board of Health regarding these for the final inspections before back-filling. site conditions shall relieve the Design Sanitarian from responsibility for de flaws, failures or omissions,or other conditions which affect verily all utility lo�sations PRIOR to � � Relocated existing shed __....ace uy calling Dig Slate at 1-888-344-7233 operation of the system, or acceptance of the system by,Barnstable e. Contractor shall notify Design 8agineer of any on-site Board of Health. � LA cT discrepancies or omissions found prior to commencement of work. LA 10.11ll stones used in the construction of the SAS shall be the Design Sanitarian and the Barnstable Board of Health Agent must inspect double of triple washed and free from all fines, dirt, or dust. Approval of materials may be :required prior to use. system at all stages of installation required bt local approving ���• 52 - �� authority, and prior to back-filling. `'` ' 0 I �� Pipes in the soil absorbtion system (SAS) shall be 4" perforated 9L.� 1lC � schedule 40 PVC or better, and all other pipes shall be 4 solid schedule _ based on Reference datum.16'x 33' In-ground Pool - � ) �� 6` 40 PVC, unless otherwise shown on place. w/3' apron i -.-- _ _ �` There shall be no vehicular or heavy equipment driven over any part of d distribution lines shall be the proposed septic system. � <r � Test Pit#1 MAP 180/34 i All stone shall be double washed natural or processed, and contain no LOT 75 I lines irons, or any type of stone dust. AREA - 13,054 +/- S.Pr ` A reek to elevation and replaced with - -- -- -- - -- - c of Health Agent must approve This system is not designed for a garbage grinder. this septic system is PROPOSED e a e, t1L clean sand, prior to construction designed in compliance with 310 CM�R 15.00, and is not a guarantee as ADDITION c.o. 9B.3S It is recommended that p cn o: to the longevity of its operation or usefulness. • -T - w W only biodegradable detergents be utilized, and that the septic tank be to ppumped once every two to three ears, dependingon usage. 901 OD cn, NOTE A': THIS LOT IS SHOWN AS PARCEL 75 OF ASSESSOR 166/34. y GARAGE v' 4 NOTE 'B': THE DWELLING SHOWN HEREON DOES NOT LIE WITHIN A SPECIAL FLOOD HAZARD AREA N..� AS DELINEATED OF FEMA COMMUNITY PANEL NO. REVISED cS� t3 HOUSE 132 TO!' OF FOUNDATION ' N Miller Engineering EL-i60.oa (DOS11NG) Rigid Barrier PROVIDE RISERS WITHIN 6" w /' -FIN. GR.- +/- BELOW FINISH GRADE SCH N0'k 4 PE MIN. SLOPE - 2c PEAS70K ©OVER SLOPEi ,�4"54 30 E = "Z"...—. 12" OVER ELM PROPOSED I 100.00 0. W. to" ADDITION 1r 4"D. SCH.40 �: PVC INV.71-/0 / " 12.6" aSTURBRIDGE DRIVE CULTEC CONTACTOR Im MIST K NV.= 74,07 /STANDARD DUTY H-10 CHAMBER (TL.= ) WSNM.E NItH 6" , ' � ° 'rISHED GRADE NV.=q . a "9 Sz Bench Mark 2" PEASTONE COVER 'owl Top of Foundation 3/4" WASHED STONE - CULTEC CONTACTOR 6 UNITS (TL.= VVS'*) 1/2" ----�0'-r 1. x g'--&* Mk-----1 LEACHING FACNJTY - TOTAL AREA ��O SF. E1. 100.00(assumed datum) jj=fiitz 31 � I'` iP" `tCt fair q` 1,500 GAL. SEPTIC TANK NEW M n f , SECTION TMRU SYSTEM �,SH OF ��� r �k x m � ��y � �d� ��� T. S E. ��N ° , u �, NOT TO SCALE FANTOZZI -4 6" STONE BASE SOIL DATA CJSTEP 10' MAX. - FBntOZz1 En nmenital Design �gN1I ST Estimated High Groundwater Table - M. _ �o.°a -= rl n Board of Health Witness: Dave Stanton Barnstable Board of ealth Post Off.Ic Box 1275 Soil Evaluator: Thom" E. Fantoxxi, B.J. Sagamore Be h, Ma. 02562 Percolation Rate: 2 ,Minutes/inch Tel. 50 833-6185 8--998--027�' Deaa�n Data: Thomas E. Fantozzi, R.S.,C.H'.0. 10' V. z 50 L. Leaching Trench Note: There are no amisting waster supply walli within 100 feet of the proposed GRAPHIC SCALE Soil Clew I (medium sand, 2 min/Juch) Septic System Demon Plan septic system. 20' 0' 10' 20' ,4,0' 4 Bedrooms • 110 gpd/bedroom= 440 gpd 32 9'turbridge Drive, Osterville, Ma. Proposed dwa UAS is servioed by municipal water. (minimums design flow) Lot 75 Foundation Note: Leaching Area: Sidewall Area :10 +10 + 50 + 50 - 120 &L Kap 188/3#, This stale s�m�site plan = 500 s.f. e an does not and shall not be used as a Bottom Area : 10'. X 50' Owner: Paul A• Lorna Btanechewski step tic m foundation design nor for geotechnieal investigations with ( IN FM ) P.Man / no-/,y 620 s.f. Y 0.74 gpd/s.L- 458 gpd respeo to d foundation. i Inch a 20 ft bw It, saws (system capacity) 65R s Soil log General Notes: TEST PIT # 1 EL.= Ge ral Notes 1. The construction of this on-site setrage disposal system shall be in compliance with 310 CUR 15.00, Tit1( V, and all Board of NORTH All work must be in cordance wi Massachusetts Department of PON YE DEPTH COLOR REDX STRUCTURE Health regulations. Environmental Protec on Regulations 310 CMR 15.00, and any and all 2. All unsuitable impervious material must be excavated and removed Barnstable Board of Health Regulations. q E 0"-6" 10YR4/2 -- F.S.LOAM to elevation 0.30 and replaced with clean coarse sand in AN " conformance with 310 CMR 15.255, tt' required. OCUS 5P (::vFMO a 6-32 10YR5/8 _ MED. LOAMY SAND 3. This system in NOT designed for a garbage grinder. During instsua , j one shall be made to any system '�• C1 32-120" 10YR6/6 FINE/MED. SAND 4. No component o! the soil absorption system shall be more than 3 component, orl tatvalloa, ffaet distance, or any other aspect of feat below finished grade. the septic systemn this plan without PRIOR approval by the 5. Domestic water lines must be a minimum of 10 feet from and 18Registered SaaitariBarn le Board of Health Agent. All VERIGATED 0 62" inches above all components of the septic system. system componentsbe in ed per manufacturer's LOCUS PLAN (N.T.S.) MOTTLES O 9Q" EL.= VO-00 6. Any p� o! the soil absorbtion system below a paved area shall be recommendations aas wn on this plan. DAMP O 102 = g900 vented to abovegrade and shall consist of H-20 loading specifications. installation unusual or unforeseen conditions encountered during the installation of this septic system shall be brought to the attention of the Test Pit I 1 November 21, 2002 7. An as-built drawing is required before back-filling of the Design Sanitarian and Board of Health Agent. Failure to report or Pere at 48" -86" septic system. The contractor shall notify the Board of Health and timely notify F.E.D. and Barnstable Board of Health regarding these design engineer for the final inspections before back-filling. site conditions shall relieve the Design Sanitarian from responsibility for de flaws, failures or omissions,or other conditions which m affect 8. Contractor shall verily all utility locations PRIOR to � '� Relocated existing shed tJ� construction by callin Dig Safe at 1-888-344-7233 operation of the system, or acceptance of the system by,Barnstable �. 9. Contractor shall notify Design. Engineer of any on-site Board of Health. discrepancies or omissions found prior to commencement of work. 10.All stones used is the construction of the SAS shall be The Design Sanitarian and the Barnstable Board of Health Agent must inspect ,, �>p►„ o,� double of triple washed and free from all fines, dirt, or the system at all stages of installation required bt local approving %0 cn dust. Approval of materials may be :required prior to use. 6A.q�8 2' authority, and prior to back-filling. Pipes in the soil absorbtion system (SAS) shall be 4" perforated schedule 40 PVC or better, and all other pipes shall be 4" solid schedule 161x 33' In-ground Pool _ Elevations shown on this plan are based on Reference datum. 40 PVC, unless otherwise shown on plan. w/3.' apron _ There shall be no vehicular or heavy equipment driven over any part of J , All joints shall be water tight, and distribution lines shall be the proposed septic system. a. a Test Pit#1 capped at ends. MAP 180/34 � � All stone shall be double washed natural or processed, and contain no LOT 75 I fines irons, or any type of stone dust. AREA - 13,054 +/- S.F. _ ` All unsuitable soils shall be removed to elevation and replaced with -- -- -- ---- -- clean sand. The Barnstable Board of Health Agent must approve This system is not designed for a garbage grinder. this septic system is PROPOSED _ ® 0 excavation prior to replacement witl.i clean sand, prior to construction designed in compliance with 310 CMR 15.00, and is not a guarantee as ADDITION G.o, go,3S 0 0 of the SAS. to the longevity of its operation or usefulness. It is recommended that • - .- . . u .v, only biodegradable detergents be utilised, and that the septic tank be pumped once every two to three years, dependingon usage. tn00 , NOTE A': THIS LOT IS SHOWN AS PARCEL. 75 OF ASSESSORS MAP 166/34. 00 -yN NOTE 'B': THE DWELLING SHOWN HEREON DOES NOT LIE WITHIN A SPECIAL FLOOD HAZARD AREA GARAGE A AS DELINEATED OF FEMA COMMUNITY PANEL NO. REVISED a HOUSE # 32 _ OF FOUNDA110N Miller Engineering EL=140-coo (FASTING) • .- L Rigid Barrier I/ - PROVIDE RISERS 6 FIN. GR.- FINISH GRADE " w 4" DIA. CAT IRON OR �y= ' '0 4 MIN. st OPE- �c r r�EASmNE COM IF a �5 O"� SLOPE . .csx EL- 4, 12" COVER � 2% 8" 9. W. , PROPOSED ( 100.00 tag SCH 4"D." .40 t4 0 "L � _ ` __� � A. ADDITION INV. PVC a 6" � a f STMRIDGE DRIVE CULTEC CONTACTOR dI1 tEES MUST eE " NV= 9'G,0;r /12" STANDARD DUTY H-10 CHAMBER (TL.= ) NBMME MAItFt 00V8R fir. ° `� 6" FlNISHED GRADE NV.=q�• IA61110NED �9�Sx ` 4"-1-t " • -~ � �CULTEC CONTACTOR 6 UNITS (TL.= VVs'*) Bench Mark 2 PEasroNE COVER Top of Foundation 1/2" /4" WASHED STONE �� " ►- " �, 1 -----a0 a L x 5 8. M�-----I LEACHNR FACNJTY - TOTAL IVREA i Q SF. El. 100.00(assumed datum l & , �, `�I1, 1,500 GAL. SEP11C TANK NEW �u SECTION THRU SYSTEM L b � r NOT TO SCALE o TMOMA5 E. FA TO No. 831 y a. 3r 4,. 9 � 1\\-6" STONE BASE SOIL DATA _ QIST�A� 10' MAX. Estimated High Groundwater Table - El. Farah al Deems sgNIrAA1AA Board of Health Witness- Dave Stanton Barnstable Board of ealth Post 0f1�ic Box Soil Evaluator: Thomas E. Fantoxe , R.S. Sagaamtol•e Be h, ma. 0258E MW in CGr� Percolation Rate: 2 Minutes/inch Tel. 50 833--6185 8--098-0277 Design Data: Thomas E. Paantozzi, R.S.,C.H.O. 10' W. x 50 L. Leaching Trench Note: There are no existing water supply wells within 100 feet of the proposed GRAPHIC SCALE Soil Closer I (medium sand, 2 min/inch) Septic Syartem Design Plan se tic 20' 0' 10' 20' 40' 4 Bedrooms 0 110 gpd/bedroom- 440 gpd 32 Sturbridge Dative, Orterville, Ma. Proposed walk g,is servioed by municipal water. (minimum design flow) Lot 75 Foundation Note. Leaching Area: Sidewall Area :10 +10 + 50 + 50 - 120 s.f. i(ap 188/94, This septic system/sane plan does not and shall not be used as Bottom Area : 10". X 50' = 500 s.f. Owner: Paul a' Lorna* kanechewald dwelling foundation design nor for geoteohnioal investigations with 1P1I? ) Patna ♦ so616-/V respea to dw+slrli foundation. 1 inah = 20 6.20 s.f. x 0.74 gpd/s.L- 458 gpd �be r 1?, sons (system capacity) 0 sr Soil Joe General Notes: General Notes TEST PIT # 1 EL.- 7.5'o 9 1. The construction of this on-site sewage disposal system shall be in �TM compliance with 310 CUR 15.00, Title V, and all Board of N All work must be in accordance with Massachusetts Department of POH YER DEPTH COLOR REDX STRUCTURE Health regulations. Environmental Protection Regulations 310 CMR 15.00, and any and all k 1 - 2. All unsuitable impervious material must be excavated and removed Barnstable Hoard of Health Regulations. A E 0"-6" 10YR4/2 F.S.LOAM to elevation 0.30 and replaced with clean coarse sand in ,. LOCUS 5` AN B 6-32" 10YR5/8 - MED. LOAMY SAND conformance with 310 CMR 15.256, if required. During installation, no modifications shall be made to any system P 3. This "Stem in NOT designed for a gaxbage grinder. �• C1 32-120" 10YR6 6 -- FINE MED. SAND component, orientation,elevattoa,offset distance, or any other aspect of / 4. No component of the soil absorption system shall be more than 3 the septic system shown on this plan without PRIOR approval by the feet below finished grade. Registered Sanitarian and Barnstable Board of Health Agent. All 5. Domestic water Hues must be a minimum of 10 feet from and 18 VERIGATED 0 62" inches above all components of the e�eptic system. system components shall be installed per manufacturer's LOCUS PLAN N.T.S. MOTTLES O 9 " EL.= 9s•vo recommendations and/or as shown on this plan. DAMP � 102�= gq�.ao 8• � Part of the soil. absorption system below a paved area shall be / P vented to abovegrade and shall consist of H-20 loading specifications. .Any unusual or unforeseen conditions encountered during the installation of this septic system shall be brought to the attention of the Test Pit If 1 November 21, 2002 De Sanitarian and Board of Health Agent. Failure to report or 7. An as-built drawing is required before back-filling of the P Pere at 48" -06" septic system. The contractor shall notify the Board of Health and timely notify F.L.D. and Barnstable Board of Health regarding these design engineer for the final inspections before back-filling. site conditions shall relieve the Design Sanitarian from responsibility for 8. Contractor shall verify all utility locations PRIOR to design flaws, failures or omissions,or other conditions which may affect Relocated existing shed t1�; construction by oallingniff Safe at t-•888--3"-7233 operation of the system, or acceptance of the "stem by,Barnstable 9. Contractor shall, notify De Rngineer of any on-site Board of Health. w discrepancies or omissions ouand prior to commencement of work. 10.All stones used in the construction of the SAS shall be The Design Sanitarian and the Barnstable Board of Health Agent must inspect r „ o double of, triple washed and free froua all fines, dirt, or the dust. Approval of materials may be required prior to use. system at all stages of installation required bt local approving N6�•A8 52 - ► authority, and prior to back-flIling. Pipes in the soil absorbtiton system (SAS) shall be 4" perforated 1 schedule 40 PVC or better, and all other pipes shall be 4 solid schedule 161x 33' In-ground Pool Elevations shown, on this plan are based on Reference datum. 40 PVC, unless otherwise shown on plan. w. 13' apron There shall be no vehicular or heavy equipment driven over any part of I' ► All joints shall be water tight, and distribution lines shall be the proposed septic system. q Test Pit#1 capped at ends. MAP 160/34 so- All stone shall be double washed natural or processed, and contain no LOT 75 ( fines irons, or any type of stone dust. AREA - 13,054 +/- S.FC � ��- � ` All unsuitable soils shall be removed to elevation 914 3o and replaced with - -- --- 4- -- - -�-~~ clean sand. The Barnstable Board of Health Agent must approve This system is not designed for a garbage grinder. this septic system is PROPOSED excavation prior to replacement with clean sand, prior to construction designed in compliance with 310 CUR 15.00, and is not a guarantee as ADDITION C-0. 98.ss O to of the SAS. to the longevity of it's operation or usefulness. It is recommended that e w"„ .., . . 171 CP#s 1C0CT►oN N only biodegradable detergents be utilized, and that the septic tank be oa v, PI "1e um►ped once eve two to three ears, depending on usage. p � y no tn, � - 7 . u,! ,� WAA NOTE A: THIS LOT IS OWN AS PARCEL 75 OF ASSESSORS MAP 166/3�4. 01 NOTE 'B': THE DWELLING SHOWN HEREON DOES NOT LIE WITHIN A SPECIAL FLOOD HAZARD AREA -y GARAGE ic_Q � nn-.w ,e9ah �' AS DELINEATED OF FEMA COMMUNITY PANEL N0. REVISED .,� M of ,zA11-IVR el A/Fw g7,eAaf wits esE HOUSE � 32 1 TOP OF FOUNDATION '.► Miller Engineering ELF /6o-&v (E ASTING) Rigid Barrier PROVIDE RISERS WITHIN 6" I GR.� +�wBELOW FINISH GRADE Zf1N* �" E)IA. CAST IR OR ELEV. SCF O PVCPIPE WL SM. 2X PEASTONE COM f ©» SLOPE sv r .9s5x 12" OVER E L= 9S,8oj454 _ PROPOSED I 100.00 to Am " AQDI nvN ,� 4"DPVCSC�Ii.4O a a ^f INV.- Sri " a'TMRWGE ,DRIVE CULTEC CONTACTOR �NV.= vt-,0r 7iz g., STANDARD DUTY H-10 CHAM8ER (TL.= ) NAME VM OC1A:R "+� '� 6a FlNISHED GRADE NV.=71-0 IMAM . / gr Bench Mark z" PEASTONE COVER _. 1/2 3/4 WASHED STONE CULTEC CONTACTOR 6UNITS (TL.= Top of Foundation --aW-C 1. x 5'-a" W. I tEApNNG FAG I TOTAL LEACHMIa &F r, as7Q ' ri V�I�1.4►x ��QST�: EL 100.00(assumed datacn) ri � �f i., 1,5W GAL .SEPTIC TANK f NEW r 3110CMR /S:� r/a s-o seftw/lo,v fo w�►reR° SECION TMRU SYSTEM 819.. _ sI y,2q rterl....% NOT TO SCALD' of s 310cm/t iS%aii SFT8S+cIC Ms Fear►,_ .�� THOhAAS E. � EX�c.�7riMs Fcx9aalrTioN. at0 Pr R�h�irt£D, FANTOZZI No. 831 W 4r 6" STONE BASE DATA sF 10' MAx. Fantoaeaf EnWro entnl Deli CISTEA° Estimated iiggh� Groundwater Table - El. _ 90.0 ' '� A�iraA►AN Board of Health Witness: Dave StantonBarnstable Board of Health Post Office Box 127$ Soil Evaluator: Thomas E. Fantoassi, R.S. Sagexnore DeaOxt, 8. O '�iQ2 Percolation Rate: 2 Mutes/inch Tel. 508- 833- 61,65 Fair 508-998-0277 �_7 o Deealm Data: Thomas E. Fantoaai, R.S.,C.S'.O. 10' V. x 50 L. Leaching Trench Note: Theme are no exist water su gl ► wails wit GRAPHIC SCALE soil Class I (medium sand, 2 min/inch)n 100 feet of the proposed SITt ic Sysrtem DexW n Flan "�Puc 20' 0' 10' 20' 4 Bedrooms U 110 gpd/bedroom 440 gpd 3u brldg►e llri", Ostervl le, Ms. Proposed dw�e�►,.is serviced by mun c*pel water. 40 ( m design flow) Lot 75 foundation dote. M rn r4 imr4, • Leaching Area: Sided Area :10 +10 + 50 + 500 = 120 91. Map 106134, This septic sysmm/sIte ,pan does not and shall not be used as a Bottom Area : 10 . X 50' = 500 s.f. Owner: Paul dt Loma Stanschewsld dwaftw foundation dsrs nor for peoteohWesl Invosti getions with ' ) pun f xm-r,y reseot to dill fouaadation. .� 20 620 s.f. x 0.74 gpd/m.L- 458 gp ��• sy, 800 a". r: (system capacity) s�is/o a ...........___.