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HomeMy WebLinkAbout0253 TOWER HILL ROAD - Health 253 TOWER HILL ROAD Osterville _ A = 118 - 093 �y a u 4 ry �1 '�F F a P P is F k f r Commonwealth of Massachusetts TO �e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address fi Angelina Gomez Owner Owner's Name ' information is required for every Osterville V Ma 02655 9-15-2020; page. City/Town State Zip Code Date of.inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 67 1W(� on the computer, Daniel Hawkins use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name key. ' 374 Route 130 Q Company Address Sandwich Ma 02563 City/Town State Zip Code 6A (508)477-0653" S114324 Telephone Number License Number B. Certification , I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: j 1. ❑E Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority I 4. ❑ Fails Dan Hawkins Digitally signed by Dan Hawkins Data:2020.09.1608:07:16-000' 9-15-2020 Inspectors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 ti r Commonwealth of Massachusetts Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑■ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The system was in working order at the time of inspection. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): l 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 J. c Commonwealth of Massachusetts Title 5 Official Inspection Form { Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 253 Tower Hill Road k. Property Address Angelina Gomez Owner Owner's Name - information is required for every Osterville Ma i 02655 9-15-2020 - page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ' 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑. N ❑ 'ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y, ❑ N ❑ ND(Explain below): , ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced „� ❑ Y ❑ N ❑ ND(Explain below). ❑ obstruction is removed , -, ❑ Y :❑ N ❑ ND-(Explain below): . 3) Further Evaluation is Required by the Board of Health: f. ❑ Conditions exist which require further evaluation by the Board of Health in order to determine'if the system is failing to protect public.health,safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, E safety and the environment: t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 i r . t ' , f c Commonwealth of Massachusetts - - title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t - 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: f 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No 11 El Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ~ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name - information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ D Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ 0 Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow ❑ a Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ El Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ a Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ El Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ El Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El Any portion of a cesspool or privy is less than 160 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence 1 of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ El The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5lnsp.doc•rev.W26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered'yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes"or"no"for each of the following for all inspections: Yes No ❑ Q Pumping information was provided by the owner, occupant, or Board of Health ❑ El Were any of the system components pumped out in the previous two weeks? ❑ El Has the system received normal flows in the previous two week period? ❑ El 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? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge and depth of scum? ❑ 0 Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: 0 ❑ Existing information. For example,a plan at the Board of Health. ❑ a Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 151nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments t 253 Tower Hill Road v" Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every St page. City/Town ate Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 2 2 Number of bedrooms(design): Number of bedrooms(actual): 348/GPD DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes 0 No Does residence have a water treatment unit? ❑ Yes 2] No 4 If yes, discharges to: ,Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes No Seasonaluse? ❑ Yes ❑. No 'Water meter readings;if available(last 2 years usage(gpd)): 'See below Detail: { 2018- 2,000gallons 2019- Ogallons Sump Pum ? ❑ Yes No P _ ❑ 2 years Last date of occupancy: Date t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 16 / Commonwealth of Massachusetts �:- Title 5 Official Inspection Form t -- i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments — � 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Cade Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- date of last pump is unknown Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts n.- Title 5 Official Inspection Form !� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °r � 253 Tower Hill Road '' Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town `State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ❑ Septic tank,distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ' ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. 0 Other(describe): Pump chamber, tank, d-box and SAS Approximate age of all components,date installed (if known)and source of information: 5-13-14 per COC Were sewage odors detected when arriving at the site? ❑ Yes ❑■ No 5. Building Sewer(locate on site plan): 3' (at pump chamber) Depth below grade: feet Material of construction: ❑ cast iron ■❑40 PVC ❑other(explain): Town water Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): t51nsp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y� 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 6„ Depth below grade: feet Material of construction: ❑■ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1000/500 gallon H-20 2 compartment Dimensions: 411 Sludge depth: 32If Distance from top of sludge to bottom of outlet tee or baffle 1n Scum thickness 611 Distance from top of scum to top of outlet tee or baffle 1611 Distance from bottom of scum to bottom of outlet tee or baffle measured How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): The tank was in working order at the time of inspection. The tank is not in need of pumping at this time but should be pumped every two years for maintenance. t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 253 Tower Hill Road Property Address .Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every St page. City/Town ate Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): NA Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date i Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): NA Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches,etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): 0'r 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.): The id-box was in working order at the time of inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez L Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) t 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber,condition of pumps and appurtenances,etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: 1 Type: ❑ leaching pits number: (2)500 gallon chambers 0 leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: . ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS)(cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was in working order at the time of inspection. Leaching was dry when viewed. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 15insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): .. -Materials of construction: NA Dimensions Depth of solids Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I t , f ` C tSinsp.doc-rev.7/26/2018 , Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts J p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: 0 hand-sketch in the area below ❑ drawing attached separately 74 %"QF MAIRNSTABLE LOCATION J&4j3., 7,OS r c• H i1\ Cam.. SEWAGE# 4Len,A. VILLAGE r It2tl '� AnSSESSQR'S'MA'PBc PARCEL , INSTALLER'S NAME.&PHONE,No.ROi+1lC c'S' CL,2 sGr SEPTIC TANK CAPACITY L:E.A•CHII!Noa FACILITY->(type) NO.OF BEOROOMS OWNER l4n� _e��s PERMIT DATE. .. SF �,31,.y COMPLIANCE DATE;. i • i Separation Distance Between the, Maximum;Adjusted Oroundwater Table to the Bottom of Leeching Facility /L t/ Feet. Private Water Supply Wc1l1 and Leaching.Faeility(If any wells exist.on site or within 200 fact of leaching facility) Efte of Wetland and Leaching Facility(fir any wetlands exist within 300 feet of leaching facllity) / Feet FCJRNI57-3ED SY �!�1,� ��,�� ( 'gi',Il,.br'y • .c •: - �'l°i rt"•.$fs t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 253 Tower Hill Road - Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑� Check Slope ❑■ Surface water ❑■ Check cellar ❑■ Shallow wells Estimated depth to high ground water: No GW @ 120"feet Please indicate all methods used to determine the high ground water elevation: . El Obtained from system design plans on record 4-8-14 If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: A plan on file at the local Board of Health was used to determine high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 c Commonwealth of Massachusetts Uw Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Tower Hill Road Property Address Angelina Gomez Owner Owner's Name information is Osterville Ma 02655 9-15-2020 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: A. Inspector Information: Complete all fields in this section. ❑■ B. Certification: Signed&Dated and 1,2, 3,or 4 checked ❑■ C. Inspection Summary: 1,2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6(Checklist)completed' F■ D.System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE LOCATION 4943 _TpC*c r H»:1 lkd, SEWAGE# VILLAGE%TEA j/1) ASSESSOR'S MAP&PARCEL / ) ri 3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ( 1 LEACHING FACILITY: (type) (size) SQCz A, NO. OF BEDROOMS OZh OWNER ANC'r�LI�J� Gyc) "�� PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /V Feet Private Water Supply Well and Leaching Facility(If any wells exist on i site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within Feet 300 feet of leaching facility) Feet FURNISHED BYU0 I I �7 hl w t i TOWN OF BARNSTABLE LOCATION 3 T'cuorr 141ti1 IkeL SEWAGE# d,6tq— 1S3 VILLAGE%T�__fjl)Y�. AnSSESSOR'S MAP&PARCEL i 1 t( C3 INSTALLER'S NAME&PHONE NO.NCO++J f VT 001Z C0•(�t)32 is 3l, SEPTIC TANK CAPACITY l tt L LEACHING FACILITY: (type) Cv 4 n r-S (size) 506 CAL_ (;_A k NO. OF BEDROOMS O� OWNER A JCte.C1.JA CY6r^(_;Z PERMIT DATE: s ).31)LJ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /V 0 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) At 146 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) )a0 Feet FURNISHED BY— -✓/ � > . n � 0 3 yea ©K ' v� � e No. � 153 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS tt)� 21ppliCation for Misp0sal 6pstim Construction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. D.53 �L»L H l:)'1, �r Owner's Name,Address and Tel.No. /9 0 qe-,p.Al�'i, (j'4 n� Assessor's Map/Parcel 1 � E� �� tJ , _ ,��f�� : I c�•-- � �• y`�." Installer's Name,Address,and Tel.No.5 '6 f ry'd ti DesI per's Name,Address,and Tel.No. `- �' _ Type of Building: dc ) 1 I Dwelling No.of Bedrooms r Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 6 9�+ 1 1'�'� Number of sheets Revision Date q� Title Size of Septic Tank r w%f 10 N Type of S.A.S. ) 00 (—a L_ G111�e y 66 C 4 J 1 Description of Soil Cc,,&w�. .q ��,A!��1tr' i,` c i�, �.n��:wt.Y C /91t.r Nature of Repairs or Alterations(Answer when applicable) i,+j iiY3NI Y)n t)tx.� }. ' Lf, f? �[�,�.N7) .`r1. [ ovrvlr) �`Z �' ' .. `� �f°3 ° �1 Cif_.) QQ L4t}mine�T7 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 Certificate of Compliance has been issued by this Board of Health. o Signed � � (�,��'' " Date Application Approved by Date 7 —� Application Disapproved by Date for the following reasons Permit No. I L Date Issued "t \ v J No. 'LI 1 - Fee l THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN-OF BARNSTABLE, MASSACHUSETTS application for ;Di8t108*aY pBtQttt onstrUction ermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.02 53,�:,owe r Hill [?-CA- Owner's Name, S1: � ��U Address and Tel.No. A N 9e-L i Aj A CTo m EZ- d �. Assessor's Map/Parcel I I O Ol 3 © J h� �, I aT�►,�.J . N , 000 3 a 1 a--'9 0 Installer's Name,Address,and Tel.No.SG% 13a.-®S ZO Designer,s Name,Address,and Tel.No. 5 of-3(a—Z)3a Rober-r f3 ,OUc CD.�Nl- SrepthcN R NfaRS \ CeA'c 2SS�R r/ 1'tG(• S1.l9ulc� _ 3U Iir(j \/AQO C1o� -Type of Building: C)OAO-)'S� Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) //() gpd Design flow provided 00 D gpd Plan Date U C I a ( l�� Number of sheets 01, Revision Date CJ Title Size of Septic Tank p o G G t l-D tv Type of S.A.S. (a-) Soo Cl a L_ CIAA p,be f 1 AJ S pc Description of Soil O AM S�JJ� d QAA f=41 I ^1 S _ Nature of Repairs or Alterations(Answer when applicable) Pv Y P c.hA YV16e -r- , � S oc> c G h r)ri T,JK --- C o^O P Ar' oo G ce ILA) ytjbCr-S I� CAP (5 Date last inspected: Agreement: f; 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 Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date 7�� _.Application Disapproved by Date for the following reasons Permit No. C) I L Date Issued / TH E 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 2`� 3 6:26=9 _ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 0 /Cf- I Gated Installer Designer #bedrooms - Approved design flow �� P, C) gpd + The issuance of this permit shall not be;const t ed as,a guarantee that the systemwill functi�ofi as designed. 1 � � A Date 5�3 O r` Inspector \�` -x✓' f'-- --------------------------------------------------------------------------------------------------------------------------------- No. G 'L1 ' I Fee �L THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction 3permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Iu Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permi�.�� Date �' �' Approved by Town of Barnstable P# I T Department of Health,Safety,and Environmental Services o�TME Public Health Division Date 367.Main Street,Hyannis MA 02601.` rr;^ BARNBrAer.e,A. ;` t _ /{� i1 f."}^y}�/.r'" : �'1'`1- . ✓_ MASS. 'tf Y J4, Ifs' F �ArECMpr"�� Date Scheduled ¢, Time Fee Pd. Soil Suitability Assessment for S "Dil Performed By: {er7" . iwwWitnessed.By: LOCATION &.GENERAL INF.RMATION: .: _ Location Address r' .j"eh:ic°c�. /+t LC.. .jZ Owner's Name / sCPZ �,A �r,+lZ Address N� } Assessor's Map/Parcel: /4 810��, "Engineer's Name NEW CONSTRUCTION' REPAIR i�. Telephone#_ ��Y�`? tY�.mtC�,��• .tom; Slopes(/°) 3& �/� Surface Stones ,w Land Use /������� ° Distances from: Open Water Body' A_� c ft Possible Wet Area /G:> ft Drinking Water Well -- ft Drainage Way :.'"" -ft Property.Line "� ` ' + .� ft Other ft SkETCH:(street name,dimensions.of lot,exact locations of test holes'&perc tests,locate wetlands in proximity to'holes) r �` m4 d-% ' '' Parent material(geologic) '<'f1 �•''I a�'! Depth to Bedrock i Depth to Groundwater: Standing Water in Hole: ' Weeping from Pit Face Estimated'Seasonal Hi " Groundwater DETERIYINATtON FAR SEASOlAY�HtOI'WAT TABI u Method Used: . � Depth Observed standing in obs hole:' ' . ` in. Depth to soil mottles:` in. Depth-co w epmg from s"e of ob hole: in- Greundwater Adjustment ft. index Well# __ Reading Date:.,..__ Index Well level.,,_.__ Arll:factor Adj.Groundwater Level pE�tCOLATTO-N TEST pate: Ttme Observation Hole# Time at 9" Depth of Perc D?! Time at 6" y M Start Pre-soak Time @ C Time(9"6';)°" End Pre-soak I S 19n' Rate Min.Mch Z 2- Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant DEEP OBSERVATIQN hIQ+L LOG Mole# Depth from Soil Horizon Soil Texture Soil'Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° Gravel) n � . DEEP OBSERVATION HALE LOG <Hole# ; Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° Gravel) �r DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) DEEP OBSERV ATIOI�HALE LOG Hole#< Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° Gravel) l Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No '� Yes r Death 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 i/ l Se/ (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training pertise and experience described in 310 CNiR 15.017. Signaturet `�-- -._.- Date I 1 IK-S C a � OF SHE rp� 34/0 � DATE• �� * BA LE,MASS ASS 9 M 0q - �p sb39•. �0 �> REC. BY Town of Barnstable SCHED. DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 „ y, ` 1r Wayne A. Miller,M-D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: ZS3 To e,>ER- !/ALL R-6 A-h e s 7-Lc�,e✓/LZ.0 Assessor's Map and Parcel Number: //8/9 3 Size of Lot: /3,oeo t S,,= Wetlands Within 300 Ft. Yes ✓ Business Name: No Subdivision Name: APPLICANT'S NAME: RA-45 Did the owner of the property authorize you to represent him or her Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: AA.76 ECi.yA GoA-/&Z O Name: Address: ?? E. ILA' ST- /1 D; A.)V,.,UV /6o03 Address: Phone: Phone: VARIANCE FROM REGULATION(List Reg) REASON FOR VARIANCE(May attach if more space needed SECTiDN /S. ZII-�� JtrT�SA��E-S L.ifrtTEc'� Roo�•I A-.v� �kCE-ssivC � c3 S LoOES oA-) &V-i S 777,c-i* LdT NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System X Checklist (to be completed by office staff-person receiving variance request,application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page checklist confirming review of engineered septic system.plan by submitting engineer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified.by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for.grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/lessee 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 Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:.\cache\Temporary Internet Files\OLKAE\VARIREQ.DOC I 1 �r Town of Barnstable Barnstable Board of Health L&BAMSTAB � 200 Main Street, Hyannis MA 02601 1639. oMP" 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi April 9, 2014 Mr. Stephen A. Haas Haas Engineering, Inc. 923 Route 6A Yarmouthport, MA 02675 RE: 253 Tower Hill Road; Osterville '.-` ` ' �� A =118=093 Dear Mr. Haas, You are granted variances on behalf of your client, Angelina Gomez, to construct an onsite sewage disposal system at 253 Tower Hill Road, Osterville. The variances granted are as follows: 310 CMR 15. 211: To install the soil absorption system three feet away from the property line (street line) and five (5) feet away from the side property line, in lieu of the ten (10) feet separation distance required. 310 CMR 15. 211: To install a septic tank three (3) feet away from the property line (street line), in lieu of the ten (10) feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a pump chamber fifty. (50) feet away from the edge of a pond, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than two (2) bedrooms 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. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to two bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. Q:\AddressesOftenUsedBOHLetters\Haas2Ol4.doc { (3) The septic system shall be installed in 'strict accordance with the revised engineered plans dated April 8, 2014: (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 April 8, 2014. It is recommended that the property owner consider the purchase and installation of a generator to provide power to the pump chamber during severe weather events (i.e. blizzards, hurricanes) or other events/causes resulting in a loss of electricity. These variances are granted because the. proposed plan appears to meet the maximum feasible design standards contained within the_State Environmental Code, Title 5 and local Health.Regulations. Sincerely yours Wayn Miller, M.D.; Chairman . QAWPFILED253 Tower Hill,Rd Ost Haas Apr 2014.doc 1 i NOTICE: The Town of Barnstable recommends that the applicant seek legal advice to prepare a properly worded deed restriction document. DEED RESTRICTION WHEREAS, AtJ4 E Ll i+J k . G,Of-I,.E Z• of (owner's name) 77 G"T 1 ZT~ ST.. I& 1110 , � K)4- 1 000'3 MA (address) is the owner of ZS 3 'T'a w E H l t-L ?_o AX> located (address) at 0 sTEg-V I L LE i M k. MA (hereinafter referred to as AAA: and being shown on a plan entitled "Subdivision of Land in 0sT1:xytLt.E,ZAW3TA8W MA, Property of 7014ty A P&IZ. et al,DATEb:Au40Tl` F, Ig4Z duly recorded in Barnstable County Registry of Deeds In Plan Book f- 1 to � Page �`�i0 ; Or on Land Court Plan Number WHEREAS, A N(A E L-I N�A C PM C Z as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the. number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Mininnum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system In compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr NOW, THEREFORE,A04EL1 JJA 4Ok6Z. does hereby place the (owner's name) following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. ZS'N T4XJEP- 141 LL ROAD may have constructed (address) upon the lot a house containing no more than TWy (Z) bedrooms. AL-X,e -wA C.40m ez- agrees that this shall be permanent deed (owner's name) restriction affecting Ae.EA located on c4ZEW%LLE,RAeu=tABtf MA, and being shown on the plan recorded in Plan Book 171 , Paged 1571 Or on Land Court Plan For title of AS.EA seethe following deed: Book I L4 7 to , Page Zq® . Or Land Court Certificate of Title Number Executed as a sealed instrument _�. day of Am I Owner' signa ure Owner's signature Owner's signature COMMONWEALTH OF MASSACHUSETTS 11�M AMss ;� , 20j, . Then personally appear d the above-naMAd n Lr°vr2Z Gom'e,h known to me to be the persoh who executed the foregoing "acknowledged the same to be free act and deed, before me, , _ � � P a ' ®,�o U O Notary�.;�i ��aE, Public My Commissi expires` " r "' le► a?-, P (date) p 'CHELLE R.MONTGOMERY deedr , rJ Public,state-of New York No.01 M06270814 --,rfliifed in New York County /� r miss ors Expires October22,201-` BARNSTABLE REGISTRY OF DEEDS Town of Barnstable Regulatory Services do Richard V. Scali,Interim Director BARNSTABM 9 MM% Public Health Division i639. AlF�►�`'�'' Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer &Desi2ner Certification Form l Date: OS Sewage Permit#, 6 L 9- 1 Q Assessor's4ap\Parcel Designer: -!�f e pk av, . ,VAAs, c� T c Installer: R66r-T R._ ()Ur Co a Address: , ` ,c2 3 1eo u,f 4 r9 Address: Iq G ru..T- oa6 5 - On was issued a permit to install a (date) (installer) septic system at a$3 rower 1 .P c W based on a design drawn by (address) e j e— �,, x dated-- � 1.2 Jo/5/ (designer) ✓ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral"relocation of the distribution box and/or septiclank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the_SAS or any vertical relocation of any component of the septic system) but in accordance with. State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. a I certify that the system referenced.above was constructed.in fiance with the terms of the I\A approval letters (if applicable) 01 (Installer's Signature) (Designers ignature) (Affix `sign r s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. - Q:\SepticOesigner Certification Form-Rev 8-14-13.doc Stephen A. ' Haas Engineering , Inc. 923 Route 6A Yarmouthport, Massachusetts 02675 508-362-8132 r sahaas .comcast.net March 21, 2014 CERTIFIED MAIL RETURN RECEIPT REQUESTED Re: Septic System Installation, 253 Tower Hill Road, Osterville You have been identified as a neighbor to the above property. We are required to notify you that an application for variances from the Regulations of the Mass Department of Environmental Protection, Title 5 and/or the Town of Barnstable Onsite Sewage Disposal Regulations has been submitted to the Barnstable Health Department for approval. The following variances are requested: TITLE 5 MAXIMUM FEASIBLE COMPLIANCE Section 15.211: (1) MINIMUM SETBACK DISTANCES: 10' is required between the Soil Absorption System and the property line, 3' is provided to the street line, a 7' variance is requested, 5' is provided to the property line, a 5' variance is requested. 10' is required between the septic tank and the property line, 3' is provided to the street line, a 7' variance is requested. TOWN.OF BARNSTABLE ONSITE SEWAGE DISPOSAL REGULATIONS PART VIII, SECTION 1.00, The "100 foot"regulation: 100' is required between any portion of the sewage disposal system and a wetland. 50' is proposed from the pump chamber to the edge of the pond, 'a 50' variance is requested. A public meeting has been scheduled for April 8, 2014, at 6:30 pm to be held in room 300D at the Barnstable Town Office, 367 Main Street, Hyannis, MA. You are invited to attend should you have an interest in this matter but you are not required. Sincerely, STEPHEN A. HAAS ENGINEERING, INC. cc: Barnstable Health Department i DfYl/.�(Yl s • Ln 1► 1 ► � r r ' ► r•r m ru OFFMIAL USE Ir Postage $ .49 C3 Certified Fee Cp Return Receipt Fee $2.74 P stm Here 0 (Endorsement Required) !OZ C:3 Restricted Delivery Fee $0.00(Endorsement Required) o $6.49 C3 O 0 Total Postage 0 G —Sent To Prop ID:118094 � Ir YUNKER,DONALD E& { o sneer,) 263 TOWER HILL.RD '------ 0 or Pot OSTERVILLE,MA 02655 cry,Si I a Certified Mail Provides: o A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years p, Important Reminders: ; o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is)notiavailable fog any class of international mail. Zvu o NO INSURANCE COVERAGE,ISi,PROVIDED with Certified Mail. For valuables,please consider Insureftr Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt sdrvice,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USP,%postmark on your Certified Mail receipt is required. a For an additional fee;fdelivery",)imay' be restricted to the addressee or addressee's"auttior"ied dgent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". - a If a postmark on the Certified Mail receipt is desired,please'present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry.. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 . - ' rq ..D ro ru 19KIPP 13CIAL US ru Q" Postage $ $0.44 O Certified Fee $330 fL . Pos�lark � Return Receipt Fee � tdebe O OQ (Endorsement Required) "$2.7Q W 1 r N Restricted Delivery Fee M r3 (Endorsement Required) $0.00 03 J 13 Total Postage 8 Fees $ $6.44 03 p —� . Sent, Prop ID:142161 t POTMIGER,JASON PRIESTETAL: orr? 87 OLD MILFORD ROAD I city; BROOKLINE,NH 03033-2413 1 Certified Mail Provides: o A mailing receipt n A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Important Reminders: ZHKO 141 3MJ)'!U':d o Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. o Certified Mail is goYayailable foi anj�class of international mail. n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured q ,Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt,pervipe,please complete and attach a Return Receipt(PS Form 3811)to the article,and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS&,postmark on your Certified Mail receipt is required. n For an additional fee,,jeIiveryrmay,,4 be restricted to the addressee or addressee's+aUthdrizetl'agant.AdJisidlhe clerk or mark the mailpiece with the, endorsement"Restricted Delivery°. a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 ma . ro .. • • . Ir a O m ru Ir Postage $ $0.49 O Certified Fee $3.30 ,� CO ReturnReceipt Fee $2•70 �101 Postmark N O (Endorsement Required) 82t� O Restricted Delivery Fee vd •�(Endorsement Required) O � y Total o,....�..,,o-.r.......,..Q _AU a tf9-- O _ Sent', m Prop ID:118092 -— D^ -----` LOVERIDGE,JANET M& O scree a ---.._..... O orpC /oLOVERIDGE,JANET M 243 TOWER HILL RD- - OSTERVILLE,MA 02655 Certified Mail Provides: a A mailing receipt io A unique identifier for your mailpiece c A record of delivery kept by the Postal Service for two years Important Reminders: a...) €; 13 j{;;;I o Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available forany Blass of international mail. to NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®p required. ostmark on your Certified Mail receipt is in For an additional-fee.,,delivery,may, be restricted to the addressee or addressee's'aitiihorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is-desired,'please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making in inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 p tPtiM . rO �. • . ..- . ••. rU rU � P T L3 1AL USE m ru Postage $ $0.49 0 9ZQ . s Certified Fee $3,30 ty ni Postmark p Return Receipt Fee J Z ere 5 O (Endorsement Required)•3� r3 Restricted Delivery Fee O (Endorsement Required) $O•w43 2 Total P^^•^^^ sent To Prop ID:142043Er - 4 M f DAVIS ELEANOR JANE TR ' -...... o Po E ELEANOR JANE DAVIS REV TRUST - 5625 REBECCA CT—- ------- c�ry,sn PANAMA CITY,FL 32404 P Certified Mail Provides: o A mailing receipt a A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: ktPcr J y ti T V) Amy Iq o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is notavailable for�anyclass of international mail. e NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt maybe requested to provide proof of delivery.To obtain Return Receiptserviee,please complete and attach a Return Receipt(PS Form 3811)to the article`and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USR postmark on your Certified Mail receipt is required. o For an additional,.fee,.delivery,,may,,be restricted to the addressee or addressee's-'autfioriied'a'ent.Advise'the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,-please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry.. PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 o Complete items 1,2,and 3.Also complete A. ature item 4 if Restricted Delivery is desired. ❑Agent o Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name)_ C. Date of Delivery n Attach this card to the back of the mailpiece, or on the front if space permits. G� 2 —DAYI S D. Is delivery address different from iterar;$? 's 1. Article Addressed to: If YES,enter delivery address bel wyi"" ❑No T`I I �w I I 1'�-Prop ID:142043 C. `p%qS"ELEANOR JANETR � ELEAIVORJANE.DAVIS REV TRUST 3. Service Type ���� W5 REBECCA CT ErCertified Mail ❑Express Mail PANAMA CITY,FL.32404 ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number t7pp9 0�8OQ�'Mj2f09`23', p228' ' ((transfer from service label) I PS Form 3811`. February 2004 Domestic Return Receipt © y 102595-02-M-1540 li IS'- I UNITED STATES P67ii f11 Et3�flbE' First-Class Mail I ,-F .;fir;15 Postage&Fees Paid USPS Permit No.G-10 j� • Sender: Please print your name, address, and ZIP+4 in this box • I I I STEPHEN A. HAAS I j ENGINEERING, INC. 923 Route 6A Yarmouthport, MA 02.675 i k tF 4i NUO rnAttach omplete items 1,2,and 3.Also complete A. Signat m 4 if Restricted Delivery is desired. Agent rint your name and address on the reverse X ❑Addressee that we can return the card to you. B. Received b (Printed Name) C. Dat of Delivery this card to the back of the mail iece,on the front if space permits. p �`�"� 2k#e- D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: lJo - PrOPIDa1$094 YUNKER,DONALD E& 263 TOWER HILL RD 4. OSTERVILLE,MA 02655 3. Service Type 0'6ertified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label ?1 7 0 9( 0!r0 8'0 PS Form 3811. February 2004 Domestic Return Receipt L O 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail - - Postage&Fees Paid LISPS Permit No.G-10 I • Sender: Please print your name, address, and ZIP+4 in this box • I I ' I I STEPHEN A. HAAS ENGINEERING, INC. 923 Route 6A I Yarmouthport, MA 02675 I I i i +�!��Ei,�}�t,��}zj���„t�d�!'.��►,,,"ill,'�f+lllEliflj�,lr��jr►�►� a <s40 s io Complete items 1,2,and 3.Also complete A. Si item 4 if Restricted Delivery is desired. ElAgent to Print your name and address on the reverse X ❑Addressee so that we can return the card to you. g, ewed by(Printed Name) C. Date of Delivery c Attach this card to the back of the mailpiece, or on the front if space permits. "' D. Is delivery addressndiff Yes 1. Article Addressed to: If YES,enter delivNo Kop m:i18092 rLOVERIDGE,JANET M& I %LOVERIDGE,JANET M .. 243 TOWER HILL RD 3. Service Type $ OSTERVILLE,MA 02655 R-Certified Mail® ❑Priority Mail Express'" ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) TO!0 9 o b Ed 0 b 6 9 2j3 4.'o! & ' � PS Form 3811,July 2013 Domestic Return Receipt / ? -lp(e k I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISP I Perms No.G-10 I � I I I • Sender: Please print your name, address, and ZIP+4®in this box* I I I I � EPHEN A. HAAS ENGINEERING, INC. j 923 Route 6A I Yarmouthport, MA 02675 Date: March 20, 2014 , To: Barnstable Board of Health From: Angelina Gomez I hereby authorize Stephen Haas from Stephen A. Haas Engineering, Inc. to represent me for the variance application required,for the upgrade of the septic system at 253 Tower Hill Road, Osterville, MA. a.;�4.�.,�a' ff:t:-~%i I.FSC'*� Ya Nam. 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F••:..%' - - ,,_ i,'_.m .;< r `'4 XA.,,Rw ^,{71�(i'�wV°" �• t a7,r•� w'"' §.:. x 5r r Zy �eNx►+yv tvr t `' '�'' —'. `; t, ,3 ' !I . f ` _'"!° ' 3`c•: w°�jr• �'�'i"S k�•,y0.�"'y�t"}r`,a`�•. ,.- � ':� vi AM No— .� • *�� � _ }waM '"�Y Mkt ^�«, '�'.� y,.n� b r b . .r ��� � � � l �f 9" MINIMUM. AccEss COVERS MUST BE wj-HIN INVERT ELEVATIONS : DESIGN CR I TER I A : GENERAL NOTES : SEE SECTION I5.229:f21y 3 MAXIMUM COVER 6' OF FINISH GRADE MIN 2" OF PEASTONE INVERT AT BUILDING: DESIGN FLOW: PUMPING TO SEPTIC TANKS. 6T. 14 FIRST 2' TO ' OR FILTER FABRIC INVERT IN PUMP CHAMBER: 66.9 2 BEDROOMS AT t IO G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION 69. 14 ACCESS COVER MUST BE BE LEVEL TO F l N l SH GRADE 4,v£Nr wI TH /LAVER T IN SEP T l C TANK: 96.6 BEDROOM EQUALS 220 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. If T e-94.O RCOAL F I L TER j/ 6 � INVERT OUT SEPTIC TANK: 96.35 INVERT IN DIST. BOX: 96.27 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS .s SET. SEE Sl TE PLAN. 4- DIAM PIPE 67.9 96.6 0 6 0 MILL POLY INVERT OUT DIST. BOX: 96. 1 2' SCH 40 PVC 96.35 2 H-20 SEPTIC TANK REQUIRED: 2 COMPARTMENT GAS BAFFLVAPOR BARR 1 ER FILTER 96.27 �c�B 96. / 5 INVERT !N LEACH CHAMBER: 94.0220 G.P.D. X 20OX - 440 GAL Is t COMP 3. ALL CONSTRUCTION METHODS AND MATERIALS AND 67. /4 SLOPE I o G �66 9 66•9 96,0 I J/2' DIA BOTTOM OF LEACH CHAMBER: 94•0 220 G.P.D. X 100% - 220 GAL 2nd COMP MAINTENANCE OF THE SEPTIC SYSTEM SHALL 3 OUTLET DOUBLE WASHED STALE EST HIGH GROUND WATER: 65.0 SEPTIC TANK PROVIDED: 1500 GAL 2 COMP CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL 2 COMPARTMENT 2-500 GAL LEACHING CHAMBERS 62.5 D-BOX _ 'BOTTOM OF TEST HOLE ol: 89.0 BOARD OF HEALTH REGULATIONS. 1500 GALLON H-20 W/4 ' STONE AROUND. l2.8'w x 25'I x 2'd 4'DIAM, H-20 SEPTIC TANK SOIL ABSORPTION SYSTEM REQUIRED: PUMP CHAMBER H-20 DESIGN PERC RATE C 5 M/N/I NCH 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER SOIL TEXTURAL CLASS - l AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER WATERTIGHT AND 6" CRUSHED STONE OR THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- FACTORY WATERPROOFED � EFFLUENT LOADING RATE - 0.74 GPD/SF COMPACTED BASE STANDING H-20 WHEEL LOADS. 220 GPD / 0.74 GPD/SF - 298 SF REQUIRED PROFILE :NOT TO SCALE01 14 PROVIDED: 2-500 GAL LEACHING CHAMBERS 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR Q�? W/4- STONE AROUND. A-471 S.F. APPROVED EQUAL. EXISTING DWELLING O 471 S.F. x 0.74 - 348 G.P.D. O� 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED 0SURVEY-MARKER �OQO SO l L TEST P l T DATA DATA& PRECAST CONCRETE OR APPROVED POLYETHYLENE. SM. CORNER STEP 0 INDICATES INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER � PERCOLATION = OBSERVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE "' 45 / I TEST - GROUNDWATER r TOB* 65.3 , SAM ,J �� --TAR FND f OUTLET. / / l / / I SECOND `FLOOR PLAN f � / CESSPOOL ) ! / / / / TP rl P•14213 TP •2 POND `'66.8+ � f • / p�gyp �� f f / I I % _ HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR 7. BEFORE CONSTRUCTION CALL 'DIG-SAFE". l i/ . SO'* / 'fi9'S 1 , / / 0" 99.0 0' 99.5 roaz / � \ � / / /° � LOAMY IOYR LOAMY IOYR / 888-DIG-SAFE AND THE LOCAL WATER DEPT. C MSER / / / ✓ / lP FND A A sa,/ / t0. / , / / UP SAND 3/3 sAND 3/3 FOR LOCATION OF UNDERGROUND UTIL I TIES. WATER EL-63.8 / / , / /' / / LOAMY IOYR p LOAMY IOYR 0 / / B SAND 4/6 D SAND 4/6 � / / 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE OHW ti // 26' - - - - - - - - - - - - - - - 96.8 24" - - - - - - - - - - - - - 97.5 / � ' DES l GN ENGINEER TWO DAYS PR l OR TO CONSTRUCTION MEDIUM IOYR MEDIIM/ lOYR TOB#1 65 p O Opa OHW SLEEW PIP / ° l h l O C l SAND 6/6 C l SAND 6/6 OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE \y CONSTRUCTION INSPECTIONS. CB/DH FND _ �. 6 // f/ / / / � o W l / // 40. / / 9. EXISTING CESSPOOL TO BE PUMPED DRY AND BRB Fn>¢ 1 BACKF 1 L L ED. F BRB FND �m / c000srRucfloN /� ; /0. ALL UNSUITABLE MATERIAL (A 3 B HORIZONS) ESS/ 3 / NO WATER t2o• 89.0 !zo• NO WATER 89.s ENCOUNTERED BELOW THE INVERT OF THE LEACHING DATE: DECEMBER 6. 20I3 FACILITY TO BE REMOVED FOR A DISTANCE OF 5' TEST BY: STEPHEN HAAS AROUND AND REPLACED W l TH SAND IN ACCORDANCE WITNESSED BY: DONNA MIORANDI W I TH ill TL E 5. PERC;_RATE: C REA yE AND IREALACE �, l J. WHERE `THE SEWER AND WATER L l NE CROSS. THE / STAIR AS NEEDED , CONSER VA T I ON NO TES : SEWER LINE IS TO BE SLEEVED WITH A LARGER �/ 3 / / DIAMETER PIPE FOR l0' EITHER SIDE AND SEALED 1500 GALLON 40 M/w POLY It 2 COMPARTMENT D-B �•;• 1. THE WORK LlDlT SHOWN SHALL BE FI TIED WI TH A SILT VAPOR BARRIER �I ON THE ENDS. SEPTIC TANK FENCE AS REQUIRED BY THE CONSERVATION COMMISSION. THE FENCED WORK LIMIT SHALL CONSIST OF A CONTINUOUS. 00 STAKED. DUG-IN FABRIC SILT FENCE. THE FENCE SHALL _.. 9� TP '!'•• Q/ REMAIN IN PLACE UNTIL THE DISTURBED GROUND IS BO U YA NC Y CAL CUL A T I ONS PARTIAL / ;..T 2 STABILIZED COMPLETELY. PROVIDE ALTERNATE SILT FENCE WL REMO�C G i' I a f SUCH AS STAKED STRAWBALES /F NEEDED AS DIRECTED BY THE PUMP CHAMBER: DISPLACEMENT - (65.0-62.5) x 18.5 S.F. - 46 C.F. ; i� /Q CONSERVATION COMMISSION. ��P�ZN�FMASS9cy 2-500 GALLON o� G� 46 C.F. x 62.4 o/C.F. - 28860. H-20 TANK - 6080# OK / TERRY LEACHING CHAMBERS 2. NO CONSTRUCTION RELATED ACTIVITY SHALL OCCUR ON THE ANN VA R l A LACES R EQ U l R ED • \ ` h W/4' STONE AROUND �e�� WETLAND SIDE OF THE WORK L IMI T. U WARNER N J 'cFiyLF aZ 8721 BM. MAG NAIL SET I 2 O J. SOIL STABILIZATION WITHIN THE WORK LIMIT SHALL BE EO T J TL E 5. MAXIMUM FEASIBLE COMPLIANCE o VEAL{ EL-!00.29 QO Op ACCOMPL I SHED BY THE APPLICATION OF A NATIVE SEED MIX ss SECTION 15.211: (l) MINIMUM SETBACK DISTANCES 6� �\v� WITH A BIODEGRADABLE EROSION CONTROL BLANKET. pN LOCUS l0' !S REQUIRED BETWEEN THE SAS AND THE PROPERTY LINE. 3' IS PROVIDED. G4A s/�� CB/AH Fl vo 4. REFER TO ANY ORDER OF CONDITIONS ISSUED FOR THE 4� G `� m ! OCONSERVATION A 7' VARIANCE IS REQUESTED. l 0' IS REQUIRED BETWEEN THE SEPTIC TANK - i PERFORMED WORK ACTIVITY BY THE BARNSTABLE COMMI SS ION. c THE PROPERTY LINE. 3' IS PROVIDED. A 7' VARIANCE lS REQUESTED. TOWN OF BARNS TABLE ONS I TE SEWAGE DISPOSAL REGULATIONS S E7 /' T / C S Y S T E M DES I ON V PART VIII. SECTION 1.00. THE '/00 FOOT' REGULATION l00' IS REQUIRED BETWEEN ANY PORTION OF THE SEWAGE DISPOSAL SYSTEM AND A BVW. 250 TOWER HILL ROAD . MA P l l 8 . PARCEL 90 50' IS PROPOSED BETWEEN THE PUMP CHAMBER AND THE BVW. A 50' VARIANCE IS REQUESTED. Locus IWAP BARNS TABLE . ( OSTERV I LLE- ) MA PREPARED FOR : PUMP SYSTEM NO TES: L EGEND ^ /'� 1. OR A t0 BE DYERS SEWAGE PUMP MODEL TON I HP SEAL WATERTIGHT A N ( E7 L I N A V 0 M L_ Z OR APPROVED EOUAL. 54 GPM w 44 FT 70H SEAL 0 CB CONCRETE BOUND 4' PVC /NLET COUPLING, --W WATER L l NE 220 GALLON STORAGE 2' PVC'OUTLET _ 2. THE PUMP SHALL START AND STOP AT THE ELEVATIONS SHOWN. ABOVE ALARM DEEP O HYDRANT SCALE l 2 O F E B R UA R Y l 2 2 O l 4 HOE GATE VALVE 3. THE PUMP SHALL BE INSTALLED IN STRICT CONFORMANCE WITH WATERY/GNT IwCK -G, - GAS LINE THE MANUFACTURER'S SPECIFICATIONS AND TITLE V REGULATIONS. SEAL ALARM ON PUMP ON LIGHT POST � VALVE 0HW- OVER HEAD WIRES REVISED: APRIL 8. 20/4 PUMP DISCHARGE SHALL BE 2 INCHES. PUMP SHOULD BE ABLE TO _ _ _ � T E P H E 1 V A H A A S ' -# BE DISCONNECTED AND LIFTED OUT OF THE PUMP CHAMBER WITHOUT NON AERMY �7 A . HAVING TO ENTER THE PUMP CHAMBER. PNIIP _ -E- UNDERGROUND ELECTRIC LINE PUAP OFF-}- FLOAT Sw/TCNES E N G I N E E R I N G INC � -T UNDERGROUND TELEPHONE LINE 4. THE ALARM SHALL START AT THE ELEVATION SHOWN AND BE 4' -' -CTV- UNDERGROUND CABLEV l S I ON L 1 NE � � r 9 2 3 R o u t e 6 A POWERED BY A CIRCUIT SEPARATE FROM THE PUMP POWER. +40.4 SPOT ELEVATION %/ � � / ��� Y a r mo u t h p o r t , MA . 02675 PUMP DETAIL :NOT To SCALE � 1 � 508 382-8 1 32 5. AN ELECTRICAL PERMIT MUST BE OBTAINED FOR THIS INSTALLATION. --•'40-•-- EXISTING CONTOUR ��\,� �� USING 4' D1AM. PUMP CHAMBER / WATERTIGHT AND WATERPROOF 40 PROPOSED CONTOUR ', 6. SEE SECTION 15.229:(2) PUMPING TO SEPTIC TANKS 0 /O 20 40 JOB NO: l 3- l 06 , 9' MIN/MUM. ACCESS COVERS BE. WlT"!" SEE SECT/ON 15c229:(2) 6" OF FINISH GRADE 3` MAX/MUM COVER l N VER T ELEVATIONS : DES l GN CR l TER l A : GENERAL NO TES : PUMPING TO SEPTIC TANKS. MIN 2' OF_PEASTONE INVERT AT BUILDING: 67. 14 DESIGN FLOW: FIRST 2' TO OR F I L TER FABRIC INVERT IN PUMP CHAMBER: 66.9 2 BEDROOMS AT 1/0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION 69. 14 ACCESS COVER MUST BE BE LEVEL 4'VENT WITH INVERT IN SEPTIC TANK: 96.6 BEDROOM EQUALS 220 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. TO FINISH GRADE CHARCOAL FILTER I NVER T OUT SEPTIC TANK: 96.35 18' MIN NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS 6 96.5 INVERT IN D1 ST. BOX: 96.27 SET. SEE SITE PLAN. 4" O/AM P1Pf 67.9 96•6 6 96.35 S 40 MILL POLY INVERT OUT DIST. BOX: 96. 1 2- SCH 40 PVC 2 H-20 �° VAPOR BARRIER SEPTIC TANK REQUIRED: 2 COMPARTMENT TGAS GAFF EFFLUENT 98,27 �°o� 96. l $ 94.0 INVERT IN LEACH CHAMBER: 96.0 220 G.P.D. X 200% - 440 GAL I s t COMP 67. 14 - SLOPE FILTER 92.5 J. ALL CONSTRUCTION METHODS AND MATERIALS AND Soo G 6.0 3/4" - l 1/2' D1A. BOTTOM OF LEACH CHAMBER: 94.0 66.9 66.9 .o 220 G.P.D. X l00% - 220 GAL 2nd COMP MAINTENANCE OF THE SEPTIC SYSTEM SHALL 3 OUTLET DOUBLE WASHED STONE EST HIGH GROUND WATER: 65.0 SEPTIC TANK PROVIDED: 1500 GAL 2 COMP CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL 2 COMPARTMENT D-BOX 2-500 GAL LEACH/LAG CHAMBERS 62.5 �® /500 GALLON H-20 W/4' STONE AROUND. 12.8'w x 25'I x 2'd BO T TOM OF TEST HOLE #l: 89.0 BOARD OF HEALTH REGULATIONS. 4'D1AM. H-20 SEPTIC TANK SOIL ABSORPTION SYSTEM REQUIRED: PUMP CHAMBER H-20 DESIGN PERC RATE ( 5 MIN/INCH 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER WATERTIGHT AND SOIL TEXTURAL CLASS - I AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 6' CRUSHED STONE OR EFFLUENT LOADING RATE - 0.74 GPD/SF THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- FACTORY WATERPROOFED COMPACTED BASE 220 GPD f 0.74 GPD/SF - 298 SF REQUIRED STANDING H-20 WHEEL LOADS. P R OF l L E :NOT TO SCALE 0��04 o� �o �o PROVIDED: 2-500 GAL LEACHING CHAMBERS 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR 0 W/4' STONE AROUND. A-471 S.F. APPROVED EQUAL. EXISTING DWELLING ° 471 S.F. x 0.74 = 348 G.P.D. o� 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED svavfr-MAaKEa SOIL TEST P l T DATA DATA& PRECAST CONCRETE OR APPROVED POLYETHYLENE: / 8M., CORNER STEP BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER E`C-69.45 y INDICATES _� OBSERINDICVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE PERCOLATION _ OBSERVED TO B#3 65.3 �i FND / TEST - GROUNDWATER OUTLET. SAM S l i -�:,,, SECOND FLOOR PLAN / / CESSPOOL ) / '��. / / / TP #1 P#14213 TP #2 POND Jn 66 8 �� / 9,S + ^� f f // / / / / / 0- HOR 1 ZON TEXTURE COLOR 9g 0 0. HORIZON TEXTURE COLOR 99 5 7. BEFORE CONS TRUCT l ON CALL 'DIG-SAFE'. l 1 Yl! 1 { . SO•t / PIyMP / / / / / c�IAMBER\ / // / / LOAMY IOYR LOAMY IOYR /-888-DIG-SAFE AND THE LOCAL WATER DEPT. j TOB#2 64./ / t0 j // / / / l P FND UP Q SAND 3/3 '4 SAND 3/3 1 v WATER EL-63.8 // / / // // // // // / / // /. g- - - - - - - - - - - - - - - - 98.3 9 - - - - - - - - - - - - - - - 98.8 FOR LOCATION OF UNDERGROUND UTILITIES. o / // / // // 0 ,� / / B LOAMY IOYR B LOAMY IOYR °off wAtK / / / / / / / / / / saro0 4/6 SAND 9/6 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE (Ot W j j // MEDIUM IOYR MEDI UV IOYR DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION TOB#1 65.0 p �00� OHW/ UP / / / SLEEVE• PIP /I a /l Q C l SAND 6/6 C l SAND 6/6 OF THE SYSTEM TO ALLOW FOR SCHEDUL I NG OF THE / / I ,Z� / CONSTRUCTION INSPECTIONS. CB/DH FND / / i / / / -�7" -W / 40" / / I '� �/ 9. EXISTING CESSPOOL TO BE PUMPED DRY AND ORB FN 1 ti 1i l/ �I BACKF I LLED. �� / F/ / i / FG X / / ( BRB FAQ p� / / l' / 9PF / / 9R / / // // ` // // �m / �COOSTRUC/PION / /O: ALL UNSUITABLE MATERIAL IA 3 B HORIZONS) 120- NO WATER 89.0 120- NO WATER 89.5 ENCOUNTERED BELOW THE INVERT OF THE LEACHING t FACILITY TO BE REMOVED FO A DISTANCE OF 5' Ck4 TEST BY: STEPHEN DATE: DECEMBER 6, 20J3 R. A AROUND AND REPLACED WITH SAND IN ACCORDANCE WITNESSED BY: DONNA MIORANDI PERC-RATE: f 2 M/NIINCH WITH TITLE 5. RE YE AND�E`PLACE / �y / I I. WHERE THE SEWER AND WATER LINE CROSS`. THE S/TA I R A5 NEEDED 3• / CONSER VA T l ON NOTES : I500 GALLON SEWER LINE IS TO BE SLEEVED W1TH A LARGER 6 ` DIAMETER PIPE FOR l 0' EITHER SIDE AND SEALED .91 O 40 MlL/POLY Q 2 COMPARTMENT i VAPOR BARRIER D-BOf( - to I. THE WORK L!M/T SHOWN SHALL BE FITTED WITH A SILT ON THE ENDS. 3 SEPTIC TANK FENCE AS REQUIRED BY THE CONSERVATION COMMISSION. THE FENCED WORK LIMIT SHALL CONSIST OF A CONTINUOUS. O �/ / 5 // STAKED. DUCT-IN FABRIC SILT FENCE. THE FENCE SHALL 0 i i 0 / / i 9S TP -!•• -• •• Q ,l J/ REMAIN /N PLACE UNTIL THE DISTURBED GROUND IS B0 U YA NC Y CALCULATIONS : , PARTJA2 / T 2 ® STABILIZED COMPLETELY. PROVIDE ALTERNATE SILT FENCE ;"L REMOFC G Al SUCH AS STAKED STRAWBALES IF NEEDED AS DIRECTED BY THE PUMP CHAMBER: DISPLACEMENT = (65.0-62.5) x 18.5 S.F.' 46 C.F. CONSERVATION COMMISSION. 46 C.F. x 62.4 #/C.F. - 2886#. H-20 TANK 6080# OK / 2-500 GALLON LEACHING CHAMBERS 2. NO CONSTRUCTION RELATED ACTIVITY SHALL OCCUR ON THE VA R l A LACES R EQ U l R ED • \\` W/4' STONE AROUND MEMANO SIDE OF THE WORK L IMI T. „ �F BM. MAG NAIL SET 'YC<< _ O 3. SOIL STABILIZATION WITHIN THE WORK LIMIT SHALL BE ry VEI� EL•100.29TITLE 5. MAX/MUM FEASIBLE COMPLIANCE ; ° P ACCOMPL J SHED BY THE APPLICATION OF A NATIVE SEED MIX Y' SECTION 15.2/I: (l) MINIMUM SETBACK DISTANCES \ z \Vv WITH A BIODEGRADABLE EROSION CONTROL BLANKET. � = 10' IS REQUIRED BETWEEN THE SAS AND THE PROPERTY LINE, 3' l S PROVIDED. -o 'i CB/Dw F L OCUS o g4cF')G 4. REFER TO ANY ORDER OF COND 1 T IONS ISSUED FOR THE A 7* VARIANCE I S REQUESTED. l 0' IS REQUIRED BETWEEN THE SEP T l C TANK / PERFORMED WORK ACTIVITY BY THE BARNSTABLE CONSERVATION l COWISSJON. THE PROPERTY LINE. 3' 1S PROVIDED. A 7' VARIANCE IS, REQUESTED. TOWN OF BARNSTABLE ONS 1 TE SEWAGE DISPOSAL REGULATIONS � � P T / C S Y S T E M � E S � G N PART V111. SECTION I.00. THE "l00 FOOT' REGULATION l00' 15 REQUIRED BETWEEN ANY PORTION OF THE SEWAGE DISPOSAL SYSTEM AND A BVW. 50' IS PROPOSED BETWEEN THE PUMP CHAMBER AND THE BVW. A 50' VARIANCE IS REQUESTED. 253 -TOWER H / L L ROAD . MA P / / 8 . PARCEL 03 LOCUS MAP BARNS TABL E . ( OSTERV l LLE ) /UA PUMP SYSTEM NO TES: LEGEND P R E P A R E D F-O R 1. TO BE DYERS SEWAGE PUMP MODEL AM•l ! HP WATERTIGHT 0 CB CONCRETE BOUND OR A A G L� L / / V f-� G I V l L� OR APPROVED EQUAL. 54 GPM w 44 FT TOH SEAL LN STORAGE 4- PVC INLET COUPLING -W WATER L I NE 2. THE PUMP SHALL START AND STOP AT THE ELEVATIONS SHOWN. ABOVE220 GAL AN WEEP 2' PVC OUTLET 0 HYDRANTHOLE 3• 7HE PUMP SHALL BE INSTALLED IN STRICT CONFORMANCE WITH WATERTIGHT CHECX GATE VALVE G GAS LINE S CA L E : i • a 2 O ' F-E B R UA R 12 2 O l 4 THE MANUFACTURER•S SPECIFICATIONS AND TITLE V REGULATIONS. SEAL ALARM ON - VALVE - OHW- `OVER HEAD WIRES PUMP DISCHARGE SHALL BE 2 INCHES. PUMP SHOULD BE ABLE TO PUw ON 4F L IGHT POST S T E P H E N H A A BE DISCONNECTED AND LIFTED OUT OF THE PUMP CHAMBER IV1 THOUT - vuwP NON wftcwY -E UNDERGROUND ELECTRIC LINE HAVING TO ENTER THE PUMP CHAMBER. Pb w OFF _ _ _ _ FLOAT SWITCHES E N G I N E E R C -T- UNDERGROUND TELEPHONE LINE 4. THE ALARM SHALL START AT THE ELEVATION SHOWN AND BE 4' -CTV- UNDERGROUND CABLEV I S I ON LINE. /� i 923 Ro e ut 6 A a�o ~�Y/ , , POWERED BY A CIRCUIT SEPARATE FROM THE PUMP POWER. +40.4 SPOT ELEVATION /�� �''/�� 1 � \�1� Y ca r mO u t h p O r t MA . 02675 PUMP DETAIL :NOT TO SCALE 5. AN ELECTRICAL PERMIT MUST BE OBTAINED FOR THIS INSTALLATION. EXISTING 508 362-8 1 32 ••40....... CONTOUR �� �� USING 4' 0/AM. PUMP CHAMBER ........ 6. SEE SECTION 15.229:(2) ➢LIMPING TO SEPTIC TANKS WATERTIGHT AND WATERPROOF 4O PROPOSED CONTOUR o Io 20 4o JOB NO: I3- 106; -- T