HomeMy WebLinkAbout0318 TOWER HILL ROAD - Health 318 Tower.Hill Road
Ostervtlle,
118 042 002 p# °
I
I
3� TOWN OF BARNSTABLE
LOCATION SEWAGE# jj0�F'�41 i
VILLAGE Q-i. ASSESSOR'S MAP&PARCEL I a
INSTALLER'S NAME&PHONE NO. �
SEPTIC TANK CAPACITY —:; ITT LL4,: 1C00 4,1el— O
0 r 0
LEACHING FACILITY:(type) ::IC "{� (size) ��q• '.3 ��-
NO.OF BEDROOMS
OWNER r L
PERMIT DATE: 7.;in•I '9,� COMPLIANCE DATE: �1 �-
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 ��P �i•• /
o
/I
.rs
4�wy
i
No. l�C� lr�I Feeta.
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplitation for 33i5pos"al 6pstem Construction Permit
Application for a Permit to Construct( ) Repair( j 4Upgrade( ) Abandon( ) ❑Complete System PKIndividual Components
Location Address or Lot No. 3 V$T mt,ae 14-Q Owner's Name,Address,and Tel.No. 7 j'7 41—
Assessor's Map/Parcel llg CAS 'vi(f- Cjht&ji _U Ar03'r' 0 -0 d fflJe_'
Installer's Name,Address,and Tel.No. 5O-64f) 1 - q 39 9 Designer's Name,Address,and Tel.No.
8040l ott L"or���e�®ate ,�r,c � ®c�lc�r�rnecn 31 S boa A �`k�'r! R�1
Type of Building: j�� f)g- -7 e_ — 41ZIW
Dwelling No.of Bedrooms Lot Size 0?0, r)9 0) sq.ft. Garbage Grinder(
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3y gpd Design flow provided 3C0 gpd
Plan Date/4 U.A&d 0�6 i Number of sheets Revision Date
Title //�� Sil c In 4 Sirs 1 SC11/ �
j f
Size of Septic Tank /1Sk'/'>r; /fJ Xi4 aj- Type of S.A.S. d I490-scz-,
Description of Soil 6e c,..e
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mai ce of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Enviro Co nd not to place the system in operation until a Certificate of
Compliance has been issued by this and of
Sigh Date /
Application Approved by Date i
Application Disapproved b Date
for the following reasons
Permit No. 271 Date Issued T, Zo ,
No. Fee (0•
f. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS
ftpfieation for 33i4pos Y ' pstem (Construction Permit
#4 s'.
Application for a Permit to Construct( ) Repair `Upgrade C Abandon( ) ❑Complete System RrIndividual Components
. - 's,x
Location Address or Lot No. 3 $r l.t -@/t 14,- `, ; Owner's Name,Address,and Tel.No.
CS{ rv'I C{11t SiAjtKSF1 Y1 �C��G.���7 /�Ond1,fLIS
Assessor's MaglParcel (g ., ,f
Installer's Name,Address,and Tel.No. 5-o�% 0 l - 939 9 Designe is Name;Address,and Tel.No.
d�ar4 v I G mu n 318-7&a se+ (-} i j Ad -
ir�, AAA
Type of Building: -77 4 �-
Dwelling No.of Bedrooms 3 Lot Size C�6 9 0 ' sq.ft. Garbage Grinder( )
Other, Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 30 gpd Design flow provided 3 3o:;, gpd
Plan Date A U p sA4 2 ,0�6 rty�K' Number of sheets �/ / Revision Date
Title � l
,., ti 6 ,n �t7�R 31 le�vim, d`�•t1f/ !Zr 05�lyj6._ I1?A
Size of Septic Tank e_XA• �;via ,l kr 4+ie�< Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Enviror,e t"al Code a d not to place the system in operation until a Certificate of
.� n
Compliance has been issued by this B and of Ijealth.
,-
• S"gne r L. Date ��l
Application Approved by Date (05 V zo / R
Application Disapproved b Date
for the following reasons
Permit No. col ? Date Issued 30 ?al
,g THE COMMONWEALTH OF MASSACHUSETTS
q } BARNSTABLE,MASSACHUSETTS _
Certificate of Compliance
THIS IS TO CERTIFY,,.that the On-site Sewage Disposal system Constructed( ) Repaired(,X) Upgraded( )
Abandoned( )by 801- 1G JJ QtJkl-4 i-,U e-4-i U11 I r)C.
.-®SL-erUt Mee has been constructed in accordance-
with the provisions of Title 5 and the for Disposal System Construction Permit No.�C S"241 dated 0 I 5o h-vo t®
nn 1 �
Installer &,41f `,0�'t-t (3y3nS,Yt Je-4 clvt Designer Cl&,,w own tmoo d-,ate
#bedrooms "Approve/ esi _ flow gpd
The issuance of this permit shall not be construed as a guarantee that the system will f ineti n de igned.
Date ") Inspector
-_ ----- -_---- - ----------------------- ------------------------------------
No.
�I Fee J,A 1 gJ
THE COMMONWEALTH OF MASSACHUSETTS '
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstem-construction V'ermit - _.__----
Permission is hereby granted to Construct( ) Repair(,I<) pgrade( ) Abandon( )
System located at g �(�}pfj_ �` Q �Y• fyj•`�
and as described in the above Application"for Disposal System Construction Permit. The applicant recognized s,&er to comply with
Title 5 and the following local provisions or special conditions. -= f
Provided:Construction must be completed within three years of the date of this permit.
Date 8l/?Q1?_,0"* Approved by
14-2018 23:22 From: To:15087906304 Page:1/1
'own of Barnstable
r+ r Regalato Cy Services
I DAM A Thomas IF. Geiler,Director
Public Health Division
71'lnomas McKean,Director
2001V1 to Street,Hyannis,MA 02601
Oface: 508462.4W' pax: 509-190-6304
Anstal9er di DeRigner CerdGcadorn Form
Date:. lit Sewage l)erMit# ao 1p— d 7 Assessor's MapWa rcel //,Lf ,Q` a
OL-Ov�, e ^PAW) lmsttaUer: 66rr-ilo �r�eldltc�a..,
Address: u k�( 0. St Address: ,0.
on da')" .J?�rl�� c was issued apeanzt to tau a
(date) installer)
septic system at based on a design drawn by
(address)
b6LY\PN ew OL r dated
sib)
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 bog and/or septic teak
I certify that the septic system referenced above was installed with major changes (Le.
-• 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-b ' designer to follow.
ESN Of� c
O
DANIELA. ,�
OJALA
i chstalki'sSignature) CIVIL N
No.46502
• A 0.� F�sISYER' `a�
� IONAL ENS
(Designer's %nature) Desiper's Stamp ere)
o?U/g - � �'�
Town f ow o Barnstable a stable
♦ k
= IBM.
MASS
Regulatory Services Department
Public Health Division
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Richard Scali,Director
FAX: 508-790-6304 Thomas'A.McKean,CHO
Feb 6, 2007
Rev. 5/11/16
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §360-44 and Title V: 310 CMR 15.000)
An"x" marked in the ❑ is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA
❑ Discharge or ponding of effluent to the surface of the ground
❑ Pumping more than 4 times during the last year not due to clogged or obstructed
pipe. -
ckup of sewage into the house due to an overloaded or clogged SAS or cesspool
ONE (1) YEAR DEADLINE CRITERIA ,
❑ Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool
❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation
❑ Any portion of the cesspool within a Zone 1 to a public well
❑ Any portion of a cesspool within 50 feet of a private water supply well with no
acceptable water quality analysis. (This system passes if the water analysis
indicates the well is free from pollution).
TWO (2) YEAR DEADLINE CRITERIA
❑ Single Cesspool
❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation
of a driveway due to H-10 components, etc)
❑ Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OTHER
Repair deadline:
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc
r � Commonwealth of Massachusetts ���'-O�fa-do.2-
�_ Title 5 Official, Inspection Formw
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
3
f. �%7 318 Tower Hill Road. it
V
Property Address
Charles Wildman
Owner Owner's Name
information is 6
required for every Osteryille MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
�y
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:when A. General Information c filling out forms I 3,�
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not ,James Ford
use the return key. Name of Inspector.
Ford Septic Services, LLC
Company Name
P.O. Box 49
Company Address
ena� Osterville MA 02655
City/Town State Zip Code
508-862-9400 S 12482
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000). The system:
❑ Passes ❑ Conditionally Passes ® Fails
❑ Needs Furt Evaluation by the Local Approving Authority
7/25/2018
Insp is Signature Date
The tem 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 should be sent to the system owner and copies sent to the
buyer, if applicable, and the approving authority.
***'rThis 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.
t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal system.page 1 of 17
Commonwealth of Massachusetts
,p Title 5 Official Inspection Form
5 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower HIII Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. CitylTown State Zip Code Date of Inspection
B. Certification (cont.)
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.
t
Comments`
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
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):
l5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ 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):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
l5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
` Commonwealth of Massachusetts
I'P Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Y ! 318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption'system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
'*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
® ❑ Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
EJ ® 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 'h day flow
15ins.doc•rev.606 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 17
c � Commonwealth of Massachusetts
/ Title 5 Official Inspection Form
m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® 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.
El 0 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 1 of a public well.
El ® 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 fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
El ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd:
® ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
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
❑ a the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area- IWPA)or a mapped Zone II of a public water supply well
If you have answered "yes" to any question.in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the'
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
i 318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Ostervllle MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ Were any of.the system components'pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® „ Have large volumes of water been introduced to the system recently or as part of
this inspection?
Were as built plans of the system obtained and examined? (if they were not-
Z El
available note as N/A)
❑ ® Was the facility or dwelling inspected,for signs of sewage back up?
® ❑ Was the site inspected for signs of breakout?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank.manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner)provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑{ Existing information. For example, a plan at the Board of Health.
Determined in the field (if any of the failure criteria related to Part C is at issue
r
approximation of distance is unacceptable) [310 CMR 15.302(5))
D. System Information
Residential Flow Conditions:
Number of bedrooms (design):. 3= '. Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 1'10 gpd x#of bedrooms): 330
t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower Hill Road
. v
Properly Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 2
Does residence have a garbage grinder? ® Yes ❑ No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
unavailable
Sump pump?
❑ Yes ® No
Last date of occupancy: currently
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? El Yes ❑ No
Industrial waste holding tank•present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
151ns.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
.. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: pumped 2 months ago-per owner
Was system pumped as part of the inspection? ❑ Yes M No
If yes, volume pumped:
gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool -
❑ Privy
❑ Shared system (yes or no)(if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) 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.
❑ Other(describe):
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
t') Subsurface Sewage Disposal System Form Not for Voluntary Assessments
v
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is
required for every Osteryille MA 02655 7/24/2018
page. Cityrrowrt State Zip Code
Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
installed - 11/12/1982 per as-built
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade:
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line:
feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 30"
feet
Material of construction:
®concrete El metal ❑ fiberglass ❑ polyethylene
El other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gal.
Sludge depth: 2
l5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Cisterville MA 02655 7/24/2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 23
Scum thickness ' 1
Distance from top of scum to top of outlet tee or baffle 5.
Distance from bottom of scum to bottom of outlet tee or baffle 15
How were dimensions determined? measure
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 Tees were present. The liquid level was even with the outlet invert. There was no sign of
Ieakage.The inlet cover was 5" below, recommend a riser be installed on the outlet cover..
Grease Trap (locate on site plan):
Depth below grade: N/a
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 ipumping: Date
t5ins.doc rev.6/16. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
�v Title 5 Official Inspection Form
r` Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
(�1
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade: N/a
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:.
Capacity: gallons
Design Flow:
gallons per day
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
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert even
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
The D-box had solids present.
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.):
N/a
If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS)(locate on site plan, excavation not required):
If SAS not located, explain why:
15ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. CityrTown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number.
1 - 1000 gal.
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
The pit was full and the liquid was backing up into the inlet pipe almost into the D-box. A camera was
used. *** Note the pit is under the cement pool deck. Approximatley 5 from the pool per
measurements from the as-built.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration N/a
Depth —top of liquid to inlet invert
Depth of solids layer
Depth of scum layer. -
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
318 Tower Hill Road
v�
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osteryille MA 02655 7/24/2018
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction: N/a
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
15ins.doc•rev.6116 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
�M Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
t ? � 318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. Cityffown State Zip Code Date of Inspection
D. System Information (cont.)
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:
® hand-sketch in the area below
❑ drawing attached separately
BACk
o �
boo I a
3 �o
l5ins.doc•rev.6/16, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
,p Title 5 Official Inspection Form
ISubsurface Sewage Disposal System Form -Not for Voluntary Assessments
w
� ! 318 Tower Hill Road
Property Address
Charles Wildman
Owner Owner's Name
information is Osterville
required for every MA 02655 7/24/2018
page. City/Town State, Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 25
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
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:
using topo and water contours maps
❑ Checked with local excavators, installers -(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
see above
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
l5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
318 Tower Hill Road
� ^J
Property Address
Charles Wildman
Owner Owner's Name
information is required for every Osterville MA 02655 7/24/2018
page. CitylTown State Zip Code Date of Inspection
E. Report Completeness Checklist
❑ Inspection Summary: A, B, C, D, or E checked
❑ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
❑ System Information— Estimated depth to high groundwater
❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17'
oFtKE r�
Town of Barnstable P#
Department of Regulatory Services
BARNSTABLE, : Public Health Division Date le
MASS.
1639• ��� 200 Main Street,Hyannis MA 02601 -
TFn rna'1 a
Date Scheduled I L Time G`L' Fee Pd.J /DD�
_!
,Soil,Suitability Assessment for ,S * ge is
Performed By: D� l e,J Goo S
Witnessed By:
LOCATION & GENERAL INFORMATION
Location Address �� �o k ✓ 66 K /a Owner's Name � I 'oe M aM
D� �✓1�11 Address
Assessor's Map/Parcel: �� — Engineer's Name J0
NEW CONSTRUCTION REPAIR / Telephone#
Land Use Land 5aApcd Slopes(%) V/ Surface Stones
Distances from: Open Water Body ft Possible Wet Area �f ft Drinking Water Well /O G ft
Drainage Way /
(�V ft Property Line (0 f{ Other g
SKETCH:(Street name,dimensions of lot,exact locations oftest.holes&perc tests,locate wetlands in proximity to holes)
TO
Jac ash,
Parent material(geologic) r Q I �� Depth to Bedrock /2 00
Depth.to Groundwater: Standing Water in/H-ole: Weeping from Pit Face
Estimated Seasonal High Groundwater A ^
- - IN .
+JVlINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. .Depth to soil mottles: I in.
Depth to weeping from side of obs.hole: in. Grourdwater Adjustment t ft,
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level '
PERCOLATION TEST Date Time
Observation Hole# Time at 9"
go J
Depth of PercTime at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak / \
Rate Min./Inch GZyri
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN)
y
Original: Public Health Division Observation Hole Data To Be Completed on Back------------
**If percolation-test is to be conducted within 100' of wetland,you must first notify the r
Barnstable Conservation Division at least one(1)week prior to beginning.
QASEPTIC\PERCFORM.DOC
t dY I
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc %Gravel
2 PAL` �� �j�y�j/
DEEP OBSERVATION HOLE LOG Hole#- Z
Depth from . Soil Horizon Soil Texture Soil Color' Soil • Other
Surface(in.) (USDA) (Munsell) Mottling. '(Structure,Stones,Boulders.
Consistenc %Gravel
Li
G� V :I•t 1 N� • � / �I�y ���
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders.
Consistency.%Gravel)
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No z Yes
Within 100 year flood boundary No V Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring perviou material exist in all areas observed throughout the
area proposed for the soil absorption system? y 5
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on 2 (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature
Q:\SEPTIC\PERCFORM.DOC
t✓f�.� j j� � �
L0CATIOFf R SEWAGE PERMIT nO.
4
VILLAGE
i
INSTALLER'S RAM-E i A.00RESS
BUILDER OR OWNER
DATE PEIt III IT ISSUED �� - � 7-
DATE COMPLIAM-CE ISSUED � �
_�
a�
,zd .��-
..�>`�
�d ,�'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................
..--..... - ..... ..............OF..........................................................................................
Aliptiration for Uhipati ai lgorkii Tnnwtrnrtinn umi#
Application is hereby made for a- Permit to Construct QV) or Repair ( ) an Individual Sewage Disposal
System at: C
......... r ?_ 1-4—ti....�.��Pyd --n .:..... ..................................................................................................
�cati Address or L No.
Owner Address
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms_______ ____________________ _Expansion Attic A Garbage Grinder (.414
P4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures __________________________________
Design Flow....................sue................gallons per person per day. Total daily flow..................3.0.._________.___gallons.
W Septic Tank—Liquid capacity/A® :gallons Length.Z.14...... Width..V!eh..'_._ Diameter__3K-!(0 i1-.
-------- ....
x Disposal Trench—No. y. ____
_._______. Width____________________ Total Length.._._.___.__.__.____ Total leaching area._.__ !__ sq.-ft.
Seepage Pit No----/®D!?_..... Diameter..........9___.... Depth below inlet.....A�_�___.___ Total leaching area.... ....sq. ft.
Z Other Distribution box ( X) Dosing tank ( )
~' Percolation Test Results Performed by_____________________________________________________.................... Date........................................
aTest Pit No. 1......- __._minutes per inch Depth of Test Pit.....A2...,..... Depth to ground water.A0 Ae4r"
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
.......................................................................................................................
0 Description of Soil........../. ............................................................................................................................
x
U ----•-••----------------•••----•-•-----•-•-•-••••---•-•-•-------••---••••---•-•••-•-.._.......•----••--------•-•----•---------------------•------•-....................................................
W ---------------------------------------------------------------------------- ----------•-•--•--------------------•---------------••-•-••-•------------------•-----•••-•-----------------------------•---
UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________
-------•••------------------•----------•---•-------•------------------------------------•---------------•---•-------...._-----------••-----.-.--------•------------•-----------------------•--•--_•----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Cpssd
The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been by the board alth.
Signed----..._... ..............................................
.•-- �� "
y� Dafe
Application Approved By.........�� =....1/ --•-•- --•.'..2�...................•------^- ate
Application Disapproved for the following reasons:-------•----------------------------•---------------•--------------------------------------------------.......--
----------------•----------•-•--------•-••------•--•----------------------•--•-----...-•---•------------..---..._..--•--•------------------------•-•-...................................................
Date
PermitNo......................................................... Issued-.......................................................
Date
At, L
No...... , ,� 1' Fiz$...........................
THE COMMONWEALTH OF MASSACHUSETTS R'
BOARD OF" HEALTH
............ . ....................O F...........................-.................---........._......---..............--------•-
Appliraation for Uispwial Workii Tnnitrurtiun ramit
Application is hereby made for a Permit to Construct ( ') or Repair ( ) an Individual Sewage Disposal
System at:
.............................•.................. •-•--•--••••...-•----•--•••...---•••--....---••-•-•--------•••---•-•-------------------...........
Location-Address r or Lot•No.
93 r*t'f).�.k4dJ -ST ,J P-4 Lv7?,-
.._......... .................... ... .....•------ ----..............---•-------
Owner Address
— G-- M
t/ �QfZ:G /STtIA /
7l
Installer Address
Type of Building Size Lot----------------------------
Sq. feet
Dwelling—No. of Bedrooms........ ...............................Expansion Attic (X Garbage Grinder (Alc)
Other-Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures
W Design Flow....................S._................._gallons per person per day. Total daily flow......................3 .................
WSeptic Tank—Liquid capacity_fM4!.gallons Length.X. .__.. Diameter_-- Depth,..............
x Disposal Trench—No. .......... Width.................... Total Length.................... Total leaching area__:___'_::'«...sq. ft.
Seepage Pit No.-•_/D(--O_--- Diameter.......... ...... Depth below inlet:.....4.......... Total leaching area..... ...sq. ft.
Z Other Distribution box ( r) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
,aaa Test Pit No. 1.......1:....minutes per inch Depth of Test Pit-____f Z......... Depth to ground water..yf?........9T E
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
W -------------------------------------------------------------------------------------•---•------•-..................------•-----.....-••••=•-••••......••---
D Description of Soil............ .......__
U ......................................_......------•--:......-------------•-----------------------------------------------------•-•-----•-••-•-••-••••-•.....
W
UNature of Repairs or Alterations-Answer when applicable...............................................................................................
•--....................................................=............................................------...------------------......•..----------------------------------------...._...•-•••.....••..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions•of TITiZ 5 of the State Sanitary no e— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b en sue y tho of health.
�y
Sig ...... ..... ....?.. ............................ --•---- .......1••---•--
ate Y.
Application Approved By..........-= = rt/'--�.....�....... -•--•-•---------•---•-- ------r` . �Af .......
Date
Application Disapproved for the following reasons-..............................................................=-----.-.------...................................
---------------------------------•--•-------•-----------------------------•-----......------.........................................--••••----•-••••-•••••-----•••...................................
Date
PermitNo......................................................... Issued.......................................................
Date J
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.....................................................................................
TrrtifirFatr of Tuntplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( Ll/or Repaired ( )
by................... --------•---.....--•--•------............... .. _ ...................................................................•.................................
'y r�/ Installew
at
has been installed in accordance with the provisions of TIT[E 5 of The State Sanitary Code as described in the
application.for Disposal Works Construction Permit No _ ,. ated__;/ .......................:...............
--- ------------
THE ISSU NCE OF THIS CERTIFICATE SHALL NOT BE CONST E AS 'GUARANTEE THAT THE
SYSTEM WIL FU CTION ATISFACTORY.
DATE...... .1 ..1....................................................... Inspector........... ---------------•--................---------.....---•-------•---
THE COMMONWEALTH OF MASSAC U E.TTS
BOARD OF HEALTH
1 4 �
r
..........................................OF...........--.-•--.................................................................1. --�/
N ..... /
r FEE.._..>. ?............
Permissions hereby granted............. .........................................................................................................
to Construct ( �_or Repair ) an Individual Sewage Disposal System ,
at No...........C •'_� �, C` C.. ��I�r t 2 0)
----.....• •--•-••....•-•••-•.................••-••••••---•.-••-•••----------••••-•••--•-•••-•---••---••••••---••••-•--•--••-----•-•--
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
- �
Board of Health
DATE.................................................................................
FORM 1255 HOBBS a WARREN. INC.. PUBLISHERS
451C� V�>1
5►NGLr- FAM►LY -- �s 13Eolz.00M IGo�'
NO GAtzgAGE •6j2ih1Ei2 `' `� HOC' �, - ti 'p
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EXISTING- EXISTING f
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j"CONCRETE ------ - -- - ---------
I /DAMP.PROOFING GSA. .-,
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yy MR E MRS WILDMAN yy��� PROPOED EXTENSION OF EXISTING M/BEDROOM. 108-09-06 � a9 I •a of � it ✓� �����'ns
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(� 2i iew errE C4,xoRWM0 M sore riff WE or WkW ORA.041e CW6 C40W7R WX PRAerrL6�aP LO.•UlJH.Cl/OML VFJPRI'pE'a'VlfYTN LCLAL ENGGffD2 nYIN LQ^aL EHGeffBt IND ew.Or+r+a¢ra e1
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SYSTEM -- -ALL
S SHALL
4" SCH40 VENT WITH
PROFILE SYSTEM MARK D WITH CMAGNETIC TTAPE OR BE NOTES
CHARCOAL FILTER AS
COMPARABLE MEANS FOR FUTURE LOCATION. SHOWN PLAN VIEW BUS s
(Nor To SCALE) 1. DATUM IS NAVD 88 Rl�e�
ACCESS COVERS TO WITHIN 6" OF FIN. GRADEF CONCRETE COVERS TO WITHIN 3" GRADE PITCH BACK TO SAS, n Ro
2" PEASTONE OR GEOTEXTILE NO LOW POINTS.
2. MUNICIPAL WATER IS EXISTING
TOP FOUND. EL. 38.0 FILTER FABRIC OVER STONE
\
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 37.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
c
PRECAST H-10 WATERTEST D'BOX FOR LEVELNESS MORTAR ALL BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST
MIN. 2" WALL THICKNESS COMPONENTS PRECAST RISERS rn
j RISERS (TYP.) UNITS TO BE AASHO H-20 a
34.17 4"OSCH40 PVC (n'P•) INVERT IN 31.5' o�
PIPES LEVEL 1ST 2' +�4 5' 2.5' Q Q
5
BET SIDES 32. 5. PIPE JOINTS TO BE MADE WATERTIGHT. Locus
10" 14 °° DaaO-O �Da o g$o 000® oD�O "EXISTING 6. CONSTRUCTION DETAILS TOBE IN ACCORDANCE*# T , °O p p O u u p O p 0 OI oo°o° 0 0 OO OTEE SEPTIC TANK EE 32.77f * o° 00 6" MiN. SUMP °° DU1UC-II-ILn[��ME1 ° ®�� �0� °0000 0 0° 0° Opp O p I o 0 o`° ° ° 12" MIN. INT. DIM. ° ��� ��1 °° ° 0o aaoaaaGAS BAFFLE; °° °°°°°° °°°°°c° 295' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND31 .77 31.6' ° °°°°o° o I
NOT TO BE USED FOR LOT LINE STAKING OR ANY N
OTHER PURPOSE. South o
H-20 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL.
3/4"-1-1/2" DOUBLE WASHED STONE (2) UNITS REQUIRED
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30' X 9.83' t'
COMPACTION. (15.221 (21) ( 9. COMPONENTS NOT TO BE BACKFILLED OR
CONCEALED(1.2 ) ( 1 % SLOPE) OF
HEALTH ANNDWITHOUT PERMISSIONPON OBTIAINEDYFROMRBOARD
P. SLOPE OF HEALTH.
FOUNDATION EXIST. SEPTIC TANK 80' D' BOX 12' LEACHING
FACILITY 10. CONTRACTOR SHALL BE RESPONSIBLE FOR
1 CALLING DIGSAFE (1-888-344-7233) AND
VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS MAP
24.5' BOTTOM TH-1 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF
**INSTALLER SHALL CONFIRM MINIMUM No GROUNDWATER FOUND WORK. SCALE 1"=2000'f
j *THE INSTALLER SHALL VERIFY THE SEPTIC TANK SIZE AT 1000 GALLONS
I LOCATIONS OF ALL UTILITIES AND ALL AND ITS SUITABILITY FOR RE-USE. VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 118 PARCEL 42-2
BUILDING SEWER OUTLETS AND BE IMMEDIA;TrLY GRANTED BY THE BOARD OF BE REMOVED BENEATH AND 5' AROUND THE
REPLACE WITH 1500 GALLON SEPTIC HEALTH AGENT OR BY HEALTH INSPECTOR PROPOSED LEACHING FACILITY.
ELEVATIONS PRIOR TO INSTALLING ANY TANK APPROPRIATE TO SITE
PAPERWORK'AND HEARING REDUCTION PROPOSALS PORTION OF SEPTIC SYSTEM CONDITIONS IF NOT SUITABLE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED
APPROVED BY THE BOARD OF HEALTH REVISED
E
DURING A PUBLIC HEARING HELD ON DEC. 10, 2013 AND REMOVED OR PUMPED AND FILLED WITH CLEAN
SAND.
LEGEND-
2) FOR.ALL ..SYSTEMS THAT HAVE NO INCREASE IN FLOW -
99- EXISTING CONTOUR SYSTEM COMPONENT INSTALLATIONS PROPOSED MORE THAT
THREE FEET„BELOW GRADE WITH PROPER VENTING (PIPED TO
X 99 EXIST. SPOT ELEV. THE ATMOSPHERE) AND WITH H-20 LOADING, BUT IN NOT SYSTEM DESIGN.
CASE SHALL THE SAS BE LOCATED MORE THAT SIX FEET
-[991- PROPOSED CONTOUR BELOW GRADE.
198 4] PROPOSED SPOT EL. i GARBAGE DISPOSER IS NOT ALLOWED
j TH1 DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD
TEST HOLE
USE A 330 GPD DESIGN FLOW
2'/.- SLOPE of GROUND
SEPTIC TANK: 330 GPD (2) = 660
C-0 UTILITY POLE
1�6 6'�' **RE-U,SE EXISTING 1000 GAL. SEPTIC TANK
FIRE HYDRANT
j NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING LEACHING:
SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD
BOTTOM 30 x 9.83 (.74) = 218 GPD
TEST HOLE LOGS
LAWN %� POOL TOTAL: 454 S.F. 336 GPD
DANIEL E. GONSALVES, SE #13587 ' USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
ENGINEER. i, WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5'
DON DESMARAIS, RS (BARNSTABLE) --- ��
i
WITNESS: r� �� BETWEEN UNITS
DATE: 8/17/18 �F + , �' o
RAMP
PERC.- RATE _ < 2 MIN/INCH o�
SOILS P 15757 `° TH1 DECK
CLASS # � cE MA
APPROVED DATE BOARD OF HEALTH
ELEV. ELEV. BENCHMARK: TH2 /
0>° 36.5' 0'° 37 0' CEMENT BOUND
=35.7' NAVD88
EXISTING °
A A , DWELLING
{ LS LS I Mpg 4, TOF=38.0
10" 10YR 4/2 12 10YR 4/2
j g g s / TITLE 5 SITE PLAN
LS LS X OF
PAVED ..
24„ 10YR 4/634.5' 26„ 10YR 5/6 34 8' p DRIVE is�.s�, 318 TOWER HILL ROAD
X LOT AREA OSTERVILLE MA
20,747t SF
C C o
PERC CB FN 37 / , PREPARED FOR
/ X X
Ms Ms 266.02' --� BORTOLOTTI CONSTRUCTION
�s ��N Of MA DATE: AUGUST. 23, 2018
PROP. VENT WITH CHARCOAL FILTER
2.5Y 6 4 2.5Y 6 4
/ / AND BUGSCREEN (FINAL PLACEMENT BY = .` r°\ jsf DAN!ELA
TOWER HILL ROAD / OJ�� off 508-362-4541
CONTRACTOR WITH HOMEOWNER ,�I...i�
fax 508-362-9880
� J ti U k^
CONSULTATION) \ u 409t « & IVlL I t
C \ \ , f�� o / d No 465i)7 / downcape.com
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down cope engineering inc.
144„ 24.5' 144" 25.0' woo, � sue. -
`r civil engineers
NO GROUNDWATER ENCOUNTERED
Scale: 1"= 20' land surveyors
939 Main Street ( R to 6A)
0 10 20 30 40 50 FELT DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
DCE # ' 8-288 18-288 BORTO-WILDMAN.DWG
1