Loading...
HomeMy WebLinkAbout0123 TOWER HILL ROAD - Health 123 Tower Hill Road ®sterville A- = 142 006 �a q 0 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TIT LE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM FORM, PART A CERTIFICATION Property Address: 123:Tower Hill Road Osterville, MA 02655 Owner's Name: John Nicolas Owner's Address: Date of Inspection: September 28, 2009 Name of Inspector: (Please.Print) James M.Ford .Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 0265540,49 Telephone:Number: . (508) 862-9400 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. F am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CNM 15.000). The system: Passes Conditionally Passes Ads Further.Evaluation by the Local Approving Authority Inspector's Signature: Date: September 30, 2009 The system inspector.shall sub 't a copy f 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 systerr owner and copies sent to the buyer, if applicable,and the approving authority. . Notes and Cornrnents ****This report only,describes conditions'at the time of inspection and under the conditions of use at th at 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 I r Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: . 123 Tower Hill-Road Osterville..MA Owner: - John Nicolas Date of Inspections September 28 2009 Inspection Summary: Check A,B,C,D or E/ALWAYS.complete all of Section D A. System Passes: ✓ I Have not found any.information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B.. . System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The s stem upon completionP P y of there P ]acement or rep air,air,as approved b the p PP y Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in'the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank-is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: ! . The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken ppe(s)are'replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 123 Tower Hill Road Osterville MA Owner: John Nicolas Date of Inspection: Sedtember 28 2609 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 CN M 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public.Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply: The system has a septic tank and SAS.and the SAS is within a Zone I of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50.feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ara nonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: - 3 ' Page 4 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 123 Tower Hill Road Osterville. MA Owner: John Nicolas Date of Inspection: Septenme 28:2009 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each.of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above.outlet invert due to an overloaded,or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than 'lz day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I'of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is'free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or.more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System:: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each Hof the following: (The following criteria apply io 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 Hof a public water supply well If you have answered",yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any'large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 f Page 5 of 11 OFFICIAL INSPECTION FORM _ NO T VOLUNT ARY ASSES SMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B 4 CHECKLIST Property Address: 123 Tower Hill Road Osterville MA.' Owner: John Nicolas Date of Inspection: September 28 2009 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant, or Board.of Health ✓ Were any of the systein components pumped out in the previous two weeks? ✓ — Has the system received normal flows in the previous two week period ?. _ ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ Were as built plans of the system obtained and examined?.(If they were not available note as N/A) _ ✓ Was the facility or dwelling inspected for signs.of sewage back up? ✓ _ Was the site inspected for signs of break out?. ✓ - Were all system components,.excluding the SAS, located on site ✓ Were.the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees, aterial of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(arid occupants if different from owner)provided with information on the proper maintenance of subs urface,sewage disposal systems The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No Existing information. For example,aplan,at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part.C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5.. . Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: . 123 Tower Hill Road Osterville, MA Owner: John Nicolas Date of Inspection: _ September 28, 2009 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):' 330 Number of current residents: n1a Does residence have a garbage grinder(yes or no): n1a Is laundry on a.separate sewage system(yes or no): n1a [if yes separate inspection required] Laundry system inspected,(yes or no): No Seasonal use(yes or no): No Water meter readings, if available.(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currentiv COMMERCIAL/INDUSTRIAL - Type of establishment: Design flow(based on 3.10 CMR 15.203): gpd Basis of design fl ow.(seats/persons/sgft,etc, ): Grease trap present(yes or no): . Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Never pumped-per owner Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank, distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes,or no) (if yes, attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation 712412002 per as-built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 123 Tower Hill Road Osterville MA Owner: John Nicolas Date of Inspection: September 28 2009 BUILDING SEWER(locate on site plan) . Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting;evidence of leakage, etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 11" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) . If tank is metal,list age: Is age confirmed by a Certificate of Compliance(yes or no); certificate) (attach a copyof Dimensions: 1500 gal. Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 12" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 1011 How.were dimensions detennined:. -Measuring stick Coments(on pumping recomvnendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,,etc.): Cen.zent tees were present. The liquid level was even with the outlet invert There did not aPP ear to be an)LK si ns of le ka Recommend punzpunQ the tank — _ GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain):. Dimensions: Scuin thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and.outlet tee.or baffle condition,structural integrity, liquid levels as related to:outlet invert, evidence of leakage,etc.): 7_ Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 123 Tower Hill Road Osterville, MA Owner: John Nicolas Date of Inspection: September 28 2009 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:. _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: eallons/day Alarm present(yes of no): Alarm level: Alai-in in working order(yes or no):_ Date of last um in p p g a. Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: J (if present.must be opened)(locate on site plan) Depth of liquid level above outlet invert: ` Even Comments (note if box is level and-distribution to outlets equal, any evidence of solids carryover,any.evidence of leakage into or out of box,etc.): The D-.Box was normal PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alanns.in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,.etc.): - - 8 Page 9 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 123 Tower Hill Road Osterville MA, Owner: John.Nicolas Date of Inspection: September 28 2009 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: ✓ leaching chambers,number: 2-500 QaL chambers 13'x 25'x 2'per'as built leaching galleries,:number: leaching trenches,number, length leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil, condition of vegetation,etc.): The chambers had 6"ofwater on the bottom There did not appear to be any signs of failure The cover was 16'below grade CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer:.. Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of:hydraulic failure, level of ponding, condition of vegetation,etc.): s PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids Comments (note.condition.of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 123 Tower Hill Road Osterville MA Owner: John Nicolas Date of Inspection: September 28 2009 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. G�rAg " a aEO 3 3 L3 y� a, 10 i Page 1 l of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO RM PART C SYSTEM INFORMATION(continued) Property Address: 123 Tower Hill Road Osterville, MA Owner: John Nicolas Date of Inspection: September 28 2009 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35+/- 'feet Please indicate(check)all methods used.tu determine the high groundwater elevation: Obtained from system design plans.on record-If checked,date of design plan reviewed: Observed site(abutting.property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health explain: Tovograyhic and water contours snaps .Checked with local excavators, installers-(attach documentation) .Accessed USGS database-explain: You must describe how you established the high groundwater elevation: Using Barnstable toyoeraphic and water contours inansi the maps were showing approximately 35'+% to groundwater water at this site. This report has been prepared only for the septic systenrand components described herein..This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the.future. There Have been no warranties or guarantees,either-expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic systein which have not been located and inspected. - • j.l r TOWN OFBARNSTABLE LOCATION O W L r H t 1 t I SEWAGE# V'2-�LAGE O S 1 V V I AC ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY SW LEACHING FACILITY:(type) e) a-Sx i3x� NO.OF BEDROOMS 3 OWNER n 1 (_,Q I A5 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet AM FURNISHED BY S T Dal r� CO f O qq �w TV Q 31 t to 1 L ao 3 a 3� a3 TOWN OF'BARNSTABLE ECG LO( P Tll I o�c3 /t9l vC"2 /7�' 1 c�✓ SEWAGE # VU,L-AGE S eta .�� ASSE'SSOR'S MAP & LOT Daly INSTALLER'S NAME&PHONE NO. CZrs lc1' �oZ -b caQ SEPTIC TANK CAPACITY /50 0 LEACHING FACILITY: (type) 50 0 6& C .9M` (size). 625-<x t 3 NO. OF BEDROOMS 3 BUILDER OR PWNER I c 1 c'v/141 PERMITDATE: 3 uk 2 3- O COMPLIANCE DATE: 2 pZ 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 �5 p. G era Aw 317 017 45`� first- �6 r `6 No. 31� Fee 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: VYesL,,-/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for Migpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) 11 Complete System El Individual Components Location Address or Lot No. l a,3 l oW ele Y,7141, Owner's Name,Address and Tel.No. Q&'%err, /1c JJAM Ni r d�f1S Assessor'sMap/Parcel /a3 70"" /ya o06 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. r LJ,uCe Z)-Z(e (�SSoC�AIeJ h4. 0 S/ Type of Building: 3 Dwelling No.of Bedrooms Lot Size /?3S<' sq.ft. Garbage Grinder(11-1 'Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow _>3 0 gallons per day. Calculated daily flow gallons. Plan Date Zrt�­K!,&)a00Q Number of sheets Revision Date Title Size of Septic Tank i30 o G,9/, Type of S.A.S. a C Description of Soil /e,0M 4,�_-_vo75 a 9 -43 z_;(OA,, 10 ao, JJ - (3ot = Mey,, ., S.yo Nature of Repairs or Alterations(Answer when applicable) 4l .J�_Plel /Sy o T 3 -5-0 e cot, ettA1V%6 s-s — 5`X )a`/d r` !`�ch — S` LAC—©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 is ed by this Board of ea th. Signed Date ^� Application Approved by Date Application Disapproved for the following reasons Y Permit No. Date Issued ILIW. _ i iVo. / � h Fee THE COMMONWEALTH OF MASSACHUSEnS Y Entered in computer: tt w too#/' • PUBLIC HEALTH DIVISION=TOWN OF BARNSTABLES MASSACHUSETTS r„ Z(pprication for �Digpogar bp�tem Construction 3permit Amp licafion for a Permit to Construct( . )Repair(V)oUpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. !a3 7o cw ce-t/;V Owner's Name,Address and Tel.No. Assessor's Map/Parcel i,�3 i a w« !/7r/?t✓ Installer's Name,Address,and Tel.No. _ ° Designer's Name,Address and Tel.No. i Type of Building: Dw�ell_ng No.of Bedrooms Lot Size /-23-5'c9 sq.ft. Garbage Grinder ,r Other Type of Building No.of Persons Showers( Cafeteria( ) r Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date R, �I oo a Number of sheets / t Revision Date Title Size of Septic Tank 15 a o Gam/ Type of S.A.S. --,0 a frl- - '� 4 Description of Soil 0 /0 A,ti 4 �c a%s y 1. flA,, fu q Nature of Repairs or Alterations(Answer when applicable) Af R,P1 I i-To 4_C`AI• d� D":V•t -- o�`SUG CPf�. CFtA�►�t�crl -• '� Date last inspected: Agreement: t The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system `F 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 iss ed by this Board of ealth. Signed +4 Date 3-o .1 Application Approved by 1f r Date "Application Disapproved for the following reasons Permit No. f Date Issued W It- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS r Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( `)Repaired(K')Upgraded( ) Abandoned( )by 5\ �`fit°,� ���i yr ti(�� 1_4rco1A at /c �'bwc f-ITt &v has n constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No,- � dated Installerrvc� C.C(L\1', l=r` Designer t�`i e�errYt n The issuance of pe t shall not be construed as a guarantee that the system s signed. r Date L z/ IL Inspector - ---------------------------------- . x •"� j,/� f No Fee_�+ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mopogaf *potem Construction Permit Permission is hereby granted to Construct( )Repair(ell�Upgra`de( )Abandon( ) 4 System located at ©.s/cz�� /A>,�', ,���t 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: Construct io must be completed within three years of the date of th' pe it Date: CJ Approved by i f TOWN OF BARNSTABLE EL ` LOCATION a 3A&,Ze2 �l SEWAGE # oZOOA j VILLAGE 5 e �� ASSESSOR'S MAP & LOT 1 qt ov6, j INSTALLER'S NAME&PHONE NO. �/a.c�.✓�s/cr yd -cSa7 SEPTIC TANK CAPACITY /,-5-0 0 LEACHING FACILITY: (type) J®©6&1, C-'ly4i'P,0 (size) 622 f)c t 3 NO. OF BEDROOMS 3 BUILDER OR PWNER A 1A A c Alt Co/A! PERMITDATE: -�u��+ �3- Oa COMPLIANCE DATE: Z 0� _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 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. G 9eA8 e 3#�� OuT(c7- (93 >S -36-� Y o 716 1 - j . ', 't 5'O/L S TEST �ESC/L7 , . .0 . O^ ,L.*1.3 F/M/sH F,40,O 61, 44.91 - LOAM 5yR s12 %ST A " S�WA'6 E. . WIR007S 24 to- EL- 3 9.3 F/A/, 6 IC4.0 6 M/A/, s<-oPF OP Z %6 °_ �'' MAk. S.AN-b y 9"MIN, T B 7.sYR � .�",­�.-�.�_.::,�-,-,"--.�',I,�,":..-.,.,l�,-�_'-�,,,�.m,,1�'_,�1,.�',-1:,­I,­�.i�,1_.,'1­.:,1,�_,p..�.,,_,�-,'I,�I_�`�,�.'1,,�.­.­-,�,'-­4.I,`,.l.-�;o�,"-.:�'_,.�_'_-",1.1-1,,_�:_�"1'­":'�_-�.I1I---�_�,,'"-I-''-��r�:;���I:!.l­!!''_,t�I:;I--I__,,I,Y�'-"!-.-_,1,`,..�lI,,l,,,�-,"�.,�'%�l__�"­".;,-��-".,:IL,�1�;..4,�..,,,"-,_l.��.-���­I�1..1.:,,',�I�,,­­..-'_;�.���­,�Z,I-��_"'­I�.�,."I ,1�-.,,�-�,�I-1,"1��.I�-'.�!,1,,�."�.:­,,1.��.�.1,_,_,,.,�;,.I'L,­'�_,�,�1_1�.�,�.rI�1--'-�'�,I._1�_1���,I�-,�_'�,��--,I1�,,�I-.,�;��.�--,�-��.:T--1",,,".,-'I,�1,,,-�,,.1-��I-�I-,,p:..1",-,�,,',_,-,_�"',,���.�,.�1_-,..'-II,I�"*.��:r�',:."r-_��%,_-,,,"I,-�,1__',�,::..�-I:_,__�,,�.�,%�,�-��',',-�_,,_,l:2,-,,._,`_1�I�,.,�'�I,,��,,,�,,��,,I_1,�I.,,,:'�l��"I1-.�-�,.;,..-`...�_I I,�,, "�_I�I.,,^�-m,',:"--_"_,-.,r,�,7 r�,L1�,_.-�I',l,.,r"_i1,-,,,L,_,ll��,"1�� 11��1.:..I:7:":..1I r`,�I,, -�,�;,�1l.,-,.I,�1.'I,���\..:�-,,-_,��,.,�I:�':�"I_�,I"­��.__­,�:.,'.L.�,.�"-1�-,,�- ,,-�­k��,.-,.--­­-.-,_,,",-�,;:...-,II,-=-r 1_',I-���'�:,-,'� r�,_�,"_,__l­,.�0,--,',��-;�,_l�"._,,,;I'-I,-.,��,-,,,-�,/Z��-_-,,'�,:�-I-,;,�,*,-,..r'e�.I_, ---TI,,_-,,­-"-,,'���. .,,",1-�,��1..,!--,r,.��,1�.--.1-I�,"�.-._,�,�-I,,I,,,p--"��,I, I­!,,F�_V,�-�­1�',_ _I­:Il�:>:Q:I,­�I�,��4'::.-_II��;'_=�,_':__`-�!i��,;:r'.."-:I�.L�1Ii,.:� �.I.,�,,-�­-�I",,-"'-�II,�3__,:��.1wI�.-�,'',.:-_'I 1­�F�?I,,. �v[�- ! 3G"MAX, .DIST. 4OX W1 C_"SUMP INVERT 6 MAX, 5' M/N. ,40AM 12"MIDI• INA/FR M69SURE EL. 38. 28 361MAk" Z"caVCR of %4"-yi' sToNE 53" EL- 36. 9 ScH•40 pvc ¢" O ScN. 4 D PvG L 14u 1D LEVEL 4" ¢5 ScH..Qp vC ---)A- ._ _4„ Pl /wv 10'. i �-,-'� 11vv. Iwv, . a INV. 37,eo ' MIN, i 3g.7S �� 39,46 ' 3,9,4-3 3/4•'-�`Z" E � = � � n 3k,_tyZ `, . .-10./L 4 �P5 G BED OF �.� ':',_ STUN 500 G• c H/r M SERS 5'TbNE P+� CRusHED , c d 0 Q a o c o 2 Eif_CT1 VE Z6PTf-1 M,5D/UM /O y/7 �4 �- STONE o . a o USE pR�957 GO/YG 1990 6,4L. SEPTIC - o ---- --- 40/0"-- 4- _ 5,9ND 7',4ivK W lTN /N L ET1 O u T[_ET 71=E 5 �-- -- 12` 16"-- - - -----4 CoNsT, ac-rC-D PER 310 CIJR /5. 227 , �'g' . SOILS .19_'22 APT/Onl �Y,5`TE M EL. 30.3 No7z : C/A1Sa1-r,A.3LE MATE'/AL 51-IALL QE f5A4oV2 c� ,EOM 77-At S,A• 5. AR4" ,667T6M _ of TEST PIT 132' E1 . 30-3 /rNa 5 FEET LAT'C 2AbLy ,QEYO,& D iOWAI j U ?NE S.4/VA L AY6/? CXNII ZWATEi2 /VoT _i1Co[11V75REI6 ✓ 0726 . 77AE EXIST/NC CC-S1040L 5 5_RA41 ,CSE PLIMPEd AT 4PPRO,C, d5L . 36.9 Al,lb iEE01 ,4C54 Y✓17N CLEA/J GRAA1c/1i9R S//✓b AND REM9VL6 01Q /LLE D W/TN SA>vo. /N AGCO"ANCE Wl-rI4 3/O CMS /5. 2S5(3). 7Z67 047E : 7- 3-02 SOILS Ev4z_L1, 7-O&. ✓ONE/ .DOYLE 5XC.9✓.47o R . , Rl1 CE A►,1,4 0.9LG./sTEl . 0E2G• N.47E 2 M/A11/ivcE{ P�Xe, AEPTf/ : 53"- 71 " r .SO//,s 7EX7c.//2XZ CLASS OA/E - _ VJASFJ-'b• 5T0/.l6 -' • ' " . N , . v , (z) 5-00 G CHRAIBIQS. sa /',o e/7-E )2l0 1 u z8 5 ' Lf1TEiQi9L SOIL 1?6PLACLe146W7- 4 S'6' �I 4. ; _ AA, - i ' 2 �`A /3o, oo k PLAN V/Etiv of S,A. 5. C 5<. . , _-.. ______ _, _ v CALF l" : lD` o� ,' - v 21 , , . /014Tc'EZ ,' ,' .5"D/A S 2 35 S. F. \ SE V./A G c SYSTEM DES/G/�/ C'/1 L C[JL.�TI ON S �N .19,8soRPTioi�/ / ,, , T SysTEM B G16 o vQ . - f, ,DES/G/%l p'4/Ly FGOY✓ = 0 a 0 - ` /3 " 15,f . ,0EA/Z40Ms" X //O GP1� - 330 GPA bit 1) . SE/'T/c N TANk Z, /?EQc1/RED A/350�P T/O/,/ lliPEA MfJ/A/ 12r� . - - - - - -- p' ST I , ` cz5AIC ��7E 3 3 O 6 Pb - 0.74 G/5F114 y - 6 S,F g P \ ` ( _ _ _ .9T/o % Q J. RISE !w0 SOO 6,94, F'PEC.45T G ,-_4C- 1 CNANrBE-.RS y4fsS'f Bpi "9•(, /Z, 93 � 'f• ,,� U► U! 0 \ � � do , -- �X15 �s e-. 0 °\ V✓/TN 4' of .bov8Z_E- WAS, /mob sTOwE AVOZIAI-D_ 1 % T Op V G � W h �' �. rj oRP TiD/v ,4/�E�9 P�Pa V/S/oN = I w zo. , +� w�TE _�,�►.,�E -I ljOT7"OM = /2.83 X z S = 320 I4QI _ . . � W * Q q , -bE5, �25 G 6-f.So, X Z = /.�/ L O G�JS /YAP S'G'AL- / " -3aDo r h � SENG/./ MyAK= 13 " ti Q I '. TOTAL- ' I?,A = 47/ -S%/ To P of ,B./S',.B. Q . ELEV. - ¢2. 38 _I EAv //VG S. DES/GN Fd/e /t/O .G�12,SAGE ,b/sPD�AL. ANC 5�W/I G E /�G.4N . S/T . , .'JR/Y.CWf y _ /2 ' . • , _ P12EP14 Rlelb rOrS' O . - /30, 'o . Ati ,� a S / a ,�,vG y /tf/C ,9 , . , , , _ 5' E STEM UPGRADE „ f',POIPO_ F� �WA6 SY - or: _ �``�. _ O arc' G /� H d . . . y 9 -- of 0 N:: . /�!6 H L.L _ l' Ed w „. t B R D .I� o _. .. _ s G I _.: ✓� r _: s Pr,. ._. _ .. , NIL.LUM f r _.. H G .D LffBERY1IN ,. O E/'e /L OA 3 /-/ /e . ._ .. . „_ , -„ :,, No.33389 Z ? lt/ . . .. , v 971 � . s _ _, f E r :: 9 p : Q N �l E D o 1 f.. „ . E _ S R s -, f : s _ t �/ L Zoo_- ,:. . , ,, . 0 4� , , sc 1 - I ; 20 LJ Y 8 d _. , 2 . . t .. M1.. a ,�.., - ..,.... , . ,..� - .e.: _,. .. ... _. _ .. u,. . ,. _ .. r: ' . r -: :.,,: - , , , w .. , ... , „ r ' __ _ • S .4GE FE _ .. _ ., .. t. N E _,:. r L l ,:...i ..i::: r- a. . ,., �. „ O D _ ,, _ ,. ,. _:. -_ t, a s, ., r ..� .::- ro. n .. .. ...., _ :,..., .. .f 'r z -. ,. } .- / O L� Ss C/ 7�S �., ?�L % 5'OB S6 3• 99¢ _: : _. ", r . .O• O,BD S D U .. n-..::.. .. .a. .-. .. y _ w 14 o-.. r i , ,. > '� r' 'x .... t- k:; r .: ....., ,- ,,. . :., •fie ."} . . ,�, " _� ,_ ,�ff ,:.,.4"- ..... .. , ". v r a, .. ,,r o -'a : ,w „'_, , ,