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HomeMy WebLinkAbout0173 WEST STREET - Health 173 West Street Osterville _ A= 139-002 / ��t IL'1'o'V471 O BARNST LE. LC?CA'X'iON ' l 73 e 5� SEWAGE:# VI. C` INSTfhLLI 'S NAlltis pedi'm wo. Ssc i�� cAcrrx 1 � I LEACiMga'`.P�AC1ILYfY .(i (size) `` � ....,. 3HJIL.IC HR OR© 1R.....: PBR�IigT' 'fE; COWVAM.lGiL DAM. .,.V.... : :...�. Sapaitson ?�sPmnu 8stvieen Maxi ►umAd�us6edGrou�a�fwnterTabletothaBOU aFS hi ty �eei PdvaSu UVat4- Sadly W g1r, �ci t uapl4ia )?acdety .dtf mnY_delis axtst on site oR�INo 2w feat aR 1000905 faGiiit}�) Edge ai t»ledand an wetlands exist MOO 300 feed 1Fu;► hed by '^ __ `C __,_ __-_ __ _ _ _.: L—L `\\ 6 CMG 1 v - - - - - - - = - -p o a Olt -t- js Q�� �d 6• oresJ C-3-ao 0-3 - / 7rec W P-if- 7 Ve,l 4- ,'S 5 ' o free Vev►l— tO TOWN OF BARNSTABLE LOCATION / /`� We-5C Sq-�� SEWAGE# VILLAGE ngre--,- k, e- ASSESSOR'S MAPS&y PARCEL M /35 /° 2- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY A 11M r LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER /1A✓' PERMIT DATE: 7 7 /0 COMPLIANCE DATE: G Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility eet 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 o ' � ✓ / 20` I6y 1 1 1 N - /'� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ��' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYication for Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(4 E]Complete System ❑Individual Components Location Address or Lot No. %7:1`4igi5e s f /n� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �krrudl e "I ep?, Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �,A,�3rc�v=i-�c t Cc:elacc�S Cc�r�t;,X::t� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. { Description of Soil Nature of Repairs or Alterations(Answer when applicable) A o- xistqc4 1 ' P L Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this B f Health. el Sign Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. AD& Date Issued �• �e ii.� _ � mot.. • C / i fFee ��✓ - THE COMMONWEALTH OF'MASSACHUSETTS ! Entered in_computer: r t,. PUBLIC..HEALTH DMSION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes }, 01ptlYlcatlon for Misposal 6p_Btem Construction Permit" Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon{ 0 Complete System;:, E]Individual Comp diients �t Location Address or Lot Nyo.. /71���,,�o 5,"` 1e +y Owner's Name,Address,and Tel No 0 Assessor's Map/Parcel l Installer's Name,Address,and Tel.No. Designer's`Name,Address,and Tel.No. �,A i Dad C«tf x"' Type of Building: ' Dwelling No.of Bedrooms Lot Size sq.ft. : Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plaanf Date Number of sheets Revision Date / Title i Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) rv*j� "' k 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 RoardotQealft, Signed Date Application Approved by Date ` Application Disapproved by Date for the following reasons Permit No. ,+ "' Date Issued I JV C,'*X J - ' - - ---•----•---------------------- - - = - - _= = _- =_ -- ----- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS { Certificate of Compliance THIS IS 0 C`ERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) - Abandoned(� )by at t7 raft C.� 'I'ch) 1° has been constructed-in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No `""/ ?`7dated CC U t19_) Installer Designer #bedrooms Approved design-flow-. "�^. gpd The issuance of this ermi 'shall no 'e onstrued as a guarantee that the system will function as de Date .r� ���/ / � Inspector `4 1 __ ' - - --- ----- ------------- --- No. C 4 ! ! 't Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Bisposal 6pstem 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 Title 5 and the following local provisions or special conditions. Provided:Constructio(�nmust be completed within three years of the date of this permit. """ . . Date tt� / Approved by F No. " Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppricatiori for TD' po!6a[ 6y5tem Construction Permit Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon O El Complete System El Individual Components ,� e Location Address or Lot No. I!/3 r Owner's Name,Addr and Tel.No. Assessor's Map/Parcel ��3c� ��." `�� Installer's Name,Ad ress,and Tel.Ng, Designer's Name,Address and Tel.No. �e � C.6 Type of Building: �� Dwelling No.of Bedrooms Lot Size `7��� sq. ft. Garbage Grinder (O)v Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.req tired) gpd Design flow provided gpd Plan Date Z g �� Number of sheets�_ Revision Date -� Title f/ Size of Septic Tank „ Type of S.A.S. 1,3 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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this oard of Health Signed ,kt.► Date L�l 1D Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ®` �' 1 Date Issued V < .. .-+.�.•--,.�.--,.. ram* y.�--,r J. . .. t � � � - ., Zr i No. Fee VVV r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '. . PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS, es Application f:�Rp.ir( '�po�al.*p�tem Construction 3dermit Application for a Permit to Construct( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. k�E'�r g�tr ve ?3 Owner's Name, 'Add re ,and Tel.No. OSterV AQ,, Assessor's Map/Parcel .f5� ��,1�-- Installer's Name,Add css, nit Tel.Na Designer's Name,Address and Tel.No. l- foV9-q(9t�Z 3$ `�s4. �qr� �-� e..h�S �o�.►v. � � 3bZ-ASV � Type of Building: �- Dwelling No.of Bedrooms Lot Size 'rAS sq. ft. Garbage Grinder i Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures 1 Design Flow(min.req fired) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank a„ Type of S.A.S. 1,3 XAY SZ -w Cl- Description of Soil i Nature of Repairs or Alterations(Answer when applicable) I Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this,,Board of Health Signe A...,�• Date 1-5) ITo r" Application Approved by Date Application Disapproved by: Date i I for' the following reasons Permit No. Date ` e Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired ( ) Upgraded ( ) Abandoned( )by �A \e_`4-■ Crsv4Qom► at ")S (/�--%F— O A`G. has been constructed in accordance ✓/ with the provisions of Title 5 and the for Disposal System Construction Permit No. �- 19 dated 1, Q Installer _� tLo trey ���+C Designer #bedrooms `� Approved deli n oV�djned.., 3� gpd The issuance of this p rmit shall not be construed as a guarantee that the system will ,me Date "7 d Inspector ------------ No -'t _.Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Di5po5al *pgtem Construction permit Permission is hereby granted to Construct Repair ( ) Upgrade ( ) Abandon System located at /713 k)e1Qi S-r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be co pleted within three years of the daL f this pe t Date r/ Approved� .. s -_ i � � Town of Barnstable , Regulatory Services t r Thomas F. Geiler, Director * BARN BIZ, MASS. a, Pubinc Health Division 'Thomas McKean, Director 200 Main Street,Hyannis,DVtA 02601 Office: 508-862-4644 Fax: 508-790-6304 Innsta ller & Designer Cerfficationn Form Date- 7136110 sewaGoe hermit# a0/0- aa� Assessor9s MaplParcel Designer: J'AA ahW (-0U d0�__ Installer owyl e- E'er Address: L30 La_� Address: 9L3c�i.-� t/ " On 7 a /o \ r tl�� � ( ���` -lick-as issued a permit to install a (date) ' l (in�sCtalle septic system at 73 VV 4 (, based on a design drawn by / / (address) VJ Ct n 2! � a f-E.1 4 f dated (desW er) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. H OF AfAsq DANIELA, o OJAIA S:(I�ns2talElear'sSignature CIVIL 1 No,46502 �F � S T -7I*IO S TONAL E I gner's Signature) (Affix Designer's Stamp Mere) PLEASE RET"URPi TO 13ARI'gS T ABLE, PUBLIC HEALTH -DIVISIQ_N. CERTIFICATE OF COr,V1—rLJA1,4CE WILL NOT BE !SS- IED Uf-4—1 1, BOTH TINS FORM A_ND AS-BUILT CARD ARE RECEIVED BY THE BA NSTABLE PUBLIC HEALTH I MSION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc Commonwealth of Massachusetts .��l RW Title 5 Official Inspection Form .1► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address + -� Marjorie Lewis Owner Owner's Name crx information is r, required for every Osteryille MA 02655 12-4-19 page. City/Town State Zip Code Date of Inspection Cf r C�9 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. A. Inspector Information 514 1430a- Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that] am a DEP approved system inspector in full compliance with Section 16.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty 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: 1. ® Passes R 2. ❑ Conditionally Passes s 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 12-4-19 Inspector's 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 Commonwealth of Massachusetts Title 5 Official Inspection Form ") Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St 1 •T,�• Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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: System is in good working order with no sign of failure. 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts , 3, Title 5 Official Inspection Form. �"i' bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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): o ❑ broken pipe(s) are replaced ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ 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 El ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: a ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 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, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 I Commonwealth of Massachusetts 3 Title 5 Official Inspection Form i-�► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 p Y rY 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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: 4) 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts 3, Title 5 Official Inspection Form lr ri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville s MA 02655 12-4-19 . page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) , Yes No Static liquid level in'the distribution box above outlet invert due to an overloaded s r - ® •t. or'clogged SAS or cesspool ❑ ® Liquid depth in cesspool is'less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. " ❑ ® Any portion of a cesspool or privy,is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for 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.] ❑ ® 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 16,000 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form i>�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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 ❑ ® 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 available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe 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 approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts 3 Title 5 Official. Inspection_ Form, ,i Subsurface Sewage Disposal System Form Not for Voluntary Assessments v r( r•I 173 West St Property Address Marjorie Lewis Owner Owner's Name information is Osterville MA 02655 12-4-19 required for every • page. CityTTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 C.MR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 0 Does residence have a garbage grinder? " ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal used ❑ Yes ® No Water meter readings,if available (last 2 years usage (gpd)): Detail Sump pump? ❑ Yes ® No 2010 Last date of occupancy: Date Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts -' Title 5 Official Inspection Form • I,�M Subsurface Sewage Disposal System Form Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is Osterville MA 02655 12-4-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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? ❑ 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: N/A 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 3 Title 5 Official Inspection Form ,tom �?Ci Subsurface Sewage Disposal System Form -Not for-Voluntary Assessments fC1 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 " 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. . ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2010 Were sewage odors detected when arriving at the site? ❑• Yes ® No 5. Building Sewer(locate on site plan): �� Depth below grade: feet 18et 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.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 p Y rY U 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 12"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 Dimensions: 1500 gal 311 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 0 611 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 f Commonwealth of Massachusetts r� Title 5 Official Inspection Form: -li Subsurface Sewage Disposal System Form -Not for Voluntary,Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of,outlet tee or baffle Date of last pumping: - Date 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):- Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.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 C�'i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments g p Y ry 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Cisterville MA 02655 12-4-19 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): Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and no sign of back-up. 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 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required.for every Osterville MA 02655 12-4-19. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): r Pumps in working order: ❑ Yes ❑ No* Alarms in,working order; ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. - 11. Soil Absorption System (SAS) (locate on site plan, excavation,not required) If SAS not located, explain why: t Type: ❑ leaching pits number: ® leaching chambers number: 2-500's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts - p Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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.): Leach chambers in good condition and empty at inspection with no visible stain lines. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts 3, Title 5 Official Inspection Form w_, i�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is Osterville MA 02655 12-4-.19. 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:' Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form ! hI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 page. City/Town 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: ® hand-sketch in the area below ❑ drawing attached separately r 1 ,0 / 7 (Q� Zo26 0 ­3 C - '- 44. .40-Af - .. eel e 011 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Ins ection Form 11;4 Subsurface Sewage Disposal System Form-Not for Voluntary.Assessments . 173 West St Property Address , Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 - 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: 12 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: ® Checked with local excavators, installers- (attach documentation) El Accessed USGS database- explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 173 West St Property Address r ; Marjorie Lewis Owner Owner's Name information is required for every Osterville MA 02655 12-4-19 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 ® 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.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 1 rustable ILE 1D43a`1'ilncllt of gegul story Se rwices' ' It \ /BARNErrAEM iMAEkL "s 200 Main Street,Hyanuis MA 02601 7 Date Scheduled_ a 3 U Time �G �' Fee Pd. ,, Foil Suitability Assessmentfor Sage G t , ,[ ram' Pcrfonned By: N I GL A. 0 4► ��y��G 1Vlutessed By.: `'V l w' v y ]LSD CA ON-x'�:V EN ER&L`]CN O�IATION i r Location Address �y / 1 (� —O.wner's Name- /`= t j: tr y �� ✓1 e '1 tk 4 4 % Address Assessor's Map/Parcel: �3J/�oZ Cnoineer's Namc JQ Wei �� NEW CONSTRUCTION REPAIR � Telephone ff Land UseilaH' 10.� SIOpas(%)• •y Surface Stones v f Distance's from: .Open Water Body i-- ftF Possible Wet.Are;I }ft Driuking Water Well ft Draihage Way r` ft Property Line _.��ft 011ter �� ft • t i SKETCH' (Street name,dimensions of lot,exact locations of lest holes&p,rc tests,loc¢le wetlands 4n pro)cintily to holes) 're W^ , 'Zoo.av� . . c.,o . Jzfj 07 _ o 33 • �. r 3 k y qr CIO Parent material e010 tc / (g g )_ ���� Depth try Eecb•oelt Depth to Groundwater: standing Water in Hole: N(/'t Weeplhg,l'ranl Pit Pflt e Estimated Seasonal High Groundwater IV.DlE7CE][� INA.7CION FOR SEAS O NA]L J� IGrM,WAT WATER TAB LE th Meoel Used: -- ;_ 1g1(t�( ' _ ������ + Depth Observed standing in obs.hole: Deptli°lu,sctll 1k14ULC3!��_-.,;���•�III. Depth to weeping from side of obs.hole: - I!L -GroutlrlwaterAdJu9hTlent a_ Index Well M. Reading Date: Index Well level AdI,factoi,_ A41,Gr0L1I)dWater UVel [Depth servation a It :'..`J' Time to 9" n �) of Perc _` 0 Time at 6" Start Pre-soak Time @ .� , Ti no(9"-(i") �L- '_0 t�— ice( sal L 9'a 4:00 End Pre-soak • ,,,..._....,.., __ Rate M i-7------- site suitability Assessment; ;;ire Yasseil_�(�Site Faileti:�` Additional Testing Nccded(Y/14) Original: Public Health Division ObsePVation Holt;Data`1'o Be Completed on Back----------- ***If percolation test:is to 9)e conducted }wltilin 100' of Wedand, you must[irslt uloltify fille Barnstable C'onselrvatloll I)i1YISlo1) it least one (I) wech prior to beg➢H1➢.11ng. QASEPTICTCRCroRM.DOC DRI PlfD.OBS E]f��Tr TIO Depth from Soil 11062on 4O1e # Surface(in.) Soil Texture Soil Color "' Soil- • (USDA).. Other /� (Munsell) Molding (Structure,Stones;Boulders, `�^ Z on istenc L � ravel � Depth from 013S]ERVATION HOLE ]LOG Soil Hodzon Hole # I Surface(in.) Soil Texture Soil Color (USDA). t' ,: Soil. f :a(]vliinsell) Motflin Other ! (Structure,Stones, Boulders. ^ � Consistency %C xvel -- =--- p�. "tC7"J �p•-� �T HOLE 'p�1 �v F �1-1�. E,P OBt�lL,R�vtA��lL,�O AJL®9�.fl� ®�fi Y . Depth from - Soil Floriznn ][�[®]� # Surface(in.) Soil Tcxhirr Soil Color. ' "-- -- (USDA) Soil Other (Munsell) Mottling (Structure,Stones,Boulders. CollsistericV 4o Or velt • t . is IJE till OBSERVATION HOLE LOG Depth from Soil Honzo t n HD]�,_ - Surface ! SatfTcxture,a -i. ®. (in.) _ v Sail Co to r :.y So , I , • II (USDA Other h (Munsell) Mottling ' P, (Structure,Stones;Boulders, j P. 4 e [f ]CNood Insurance Rate 14a . .. , •t Above 500 year flood boundary No Yes ` Within 500 year boundary No T Yes Within I00 year flood boundary No ✓ Ye51 � ,,t. ',' `"' i JDellt9u_._o Nflteutrally,��.ung Pe�'Vlous 1Vi�atoril�➢ Does at least four fe©t of naturally occurring pervious material exist in all areas observed throughout the area proposed fo`r the soil abso ption system' •e IP not, what is the depth of naturally occurring p rvious mat6ri'017 (t eICt91�i��Q9oPB �p I certi that on "lam Denartme� nt of Frsvlr ,q.,f S (date)I have passed the soil evaluatorlexaniination-approved by the _ on • .•�.«,Pi'GicCtlOii'and rnat thelagove analysis',was perfnrined.by me consistent with the Regttire tise and e�xperienee « n CIO CMR 15.017. i Signature_ F" 7.12.�/��V Date Q:\S.E PT IC\PE R Cr0 IZ M.D O C i ; I _ I I SYSTEM PROFILE _ SYSTEM COMPONENTS SHALL BE NOTES MARKED WITH MAGNETIC TAPE OR (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. ASSUMED L LPK� R�• 1. DATUM IS ACCESS COVERS TO WITHIN 6" OF FIN. GRADE " H-20 CONCRETE COVER TO WITHIN 3" GRADE 2 PEASTONE OR GEOTEXTILE VEM � CR`(STA 2. MUNICIPAL WATER IS AVAILABL_ TOP FOUND. EL. 26.8' FILTER FABRIC OVER STONE \ 20.7 2% SLOPE REQUIRED OVER SYSTEM 21.1 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. I_ m MINIMUM J5 OF COVER OVER PRECAST - 4. DESIGN LOADING FOR ALL J PROPOSED PRECAST LOCUS PRECAST H-10 BLOCKS OR UNITS TO BE AASHO H-2Q- (EXCEPT TANK H-10) RISERS ( •) PRECAST RISERS TOP 18.1' 2'� H-10 4"�SCH40 PVC MORTAR ALL m .. . - H-20 PIPES LEVEL 1ST 2' �EN COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. k' H-20 4 (TYp) INV'S EL. 17.1' 4' CRTAL:•: :. •.. . DS,- SIDES *19.4' 10" 1500 GAL H-10 14, ., °o ° o o°° .•. °°°•°•°°°°°°°° CONSTRUCTION DETAILS AC DAN WITHPv o°°�°°�°�°�, 6. CO TRUCTI TO BE SIN COR CE ANNO '~ 18.08' TEE SEPTIC TANK TEE ° ° ° ° E=mm ®®L�® ®®®® -�®®® ;°o°o°o00 310 CMR 15.000 TITLE V. F\F� 17.83 1°°°°°°°° ®®®®®®®®®EJ® ®®®®®®®®®�® >°o°o°o°° ( ) GOLF �o°o°o°o°o°o >°o°o°o°o >° ° ° ° >. o 0 0 0 0 o O o 0 0 0 00000000 GAS BAFFLE::: ° ° ° ° ° ° ° ° ° ° ®®®®®®®®®E ® ®®®®®®®®®®® COURSE ,_o�a„q,o o_ �; °°°o°o°° ° ° ° ° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND SLAB ELEV. 20.0 °°°°°o°o ®®®®®®®®®L3® ®®®®®®®® imm °°°o°°°o 17.39' 17 22' °a° NOT TO BE USED FOR LOT LINE,STAKING OR ANY N I : 4' LIQ. LEVEL (ACME OR EQUAL) .' ° ° ° ° OTHER PURPOSE. OVRM P . L r H--20 500 GAL LEACHING CHAMBER BY ACME PRECIAST OR EQUAL 8• plpE FOR SEPTIC SYSTEM TO S on000O°O°O°O°O00000000°000000000060000°°°000� " °°°°°°O°O°O°O°O°O°O°O°o°o°O°°°O O O O o 0 0 0 +,o,o o_o_�_�_+_o 0 0 0 0 0 �_.o„o„a�o�00000. 3�4"-1-1�2" DOUBUE WASHED STONE 4' MIN. - CIH. 40-4 PVC. DEPTH OF FLOW 4 (2) UNITS REQUIRED ALL AROUND PRECAST STRUCTURES 9. COMPONENTS NOT TO BE BACY,FILLED OR LOCUS MAP TEE SIZES: 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83' iv CONCEALED WITHOUT INSPECTION $Y BOARD OF INLET DEPTH = 1.� HEALTH AND PERMISSION OBTAINED FROM BOARD ' COMPACTION. (15.221 [2]) NOT TO SCALE ,ri OUTLET DEPTH = 14" OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR ASSESSORS MAP 139 PARCEL 2 8O 1 1 NO BOTTOM TH-1 CALLING VERIFYING ITHE LOCATION OF ALL UNDERGROUND & ( ° % SLOPE) ( % SLOPE) ( % SLOPE) NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF LOCUS IS WITHIN FEMA FLOOD ZONE C H-20 FOUNDATION 16 SEPTIC TANK 44 D' BOX 12' LEACHING (ADJACENT eVW WATER LOWER THAN ELEV. 6) WORK. NOT A FLOOD HAZARD ZONE FACILITY 11. ANY UNSUITABLE MATERIAL ENCOUNTERED NOT" ))-I Z'°NT 2.. SHALL BE REMOVED 5' BENEATH AN1D AROUND THE 40-r t;nl 0Ve7VLLAy *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL PROPOSED LEACHING FACILITY. . UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS aT' "PIC-1rJ Cnr�`i">� 1DfU � PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 12. EXISTING LEACHING FACILITY.SH,ALL BE PUMPED LEGEND � AND REMOVED OR PUMPED AND FILLED WITH CLEAN � SAND. I 99- EXISTING CONTOUR i X 99.1 EXIST. SPOT ELEV. 99 PROPOSED CONTOUR (9g 4] PROPOSED SPOT EL . TH1 FLAG EXIST. DWELL. 1 5 26.88 TEST HOLE 6.06 7.66 2� SLOPE OF GROUND x 26.40 SYSTEM DESIGN: UTILITY POLE / I r� x 7. 8 { 200.00' 60 I ' ` _0 GARBAGE DISPOSER IS NOT ALLOWED , _ I FIRE.HYDRANTRES..WA ROCK l x ' �6 / x 6.91 WM- NOT Nl'SYMMS MAY APPEAR IN DRAMANG x 18.5 TIE IN o \ DESIGN FLOW: 3 BEDROOMS 0110 GPD = 330 GPD C'� .3t ° CAST ON INVERT EL �, 35 26.99 - FLAG \ 116.13 \ sg #4 �` \ 25.01 4 OFF UILDING FACC•�(V.LF.) USE A 330 GPD DESIGN FLOW x 3 a TEST HOLE LOGS FLAG s �' I N/ x 26. t� SEPTIC TANK: 330 GPD (2) = 660 #3 I? 7.25 1$.1 0 x 26.30 25.99 USE A 1500 GAL. SEPTIC TANK DANIEL A. OJALA PE, PLS, SE#1805 -�-ENGINEER: i x 33 0 12.7 2 x2 w _-- w °' LEACHING: ' � w---- w WITNESS: DAVID W. STANTON RS 7-23-2010 evw 7.71 z.74 o x 21 Z6.79 SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD DATE: FLAG EXISTING 3 I BOTTOM 25 x 12.83 (.74) 237 GPD FLAG BEDROOM• x 26. 8 PERC. RATE _ < 2 MIN/INCH #1 #2 100• 2 DWELLING #t73 ro -19.03No TOP FNDN. _ TOTAL: 472 S.F. 349 GPD CLASS I SOILS p# 12998 "' J EXIST. EL 26.8' 3.16 INS ALL ILT NCE N_ 100' NE GAR.`• I S� W„�k ��o�l PORCH USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) ELEV. ELEV. ' 20 o 0 / 26. 2 < WITH 4' STONE ALL AROUND 4 4 , 0 7 2f.4C>x 26.3 6.00 I 0" 19.9 0" 20.2 0 25.08 X LOT AREA 151 1 .65 / x 19.93 25:08 5. 3 AP p` 19,785 t SF 20.37 0.66 C,0NC' 26.05 1.09 T MA II LS LS fl. RF e�oc � APPROVED DATE BOARD OF HEALTH � , „ 10YR 3/2 C�jr,� 10YR 4/2 ^ 14" 4< . a,«„ ti 1.33 ' 1y9��f 25.23 12 (/i 5.84 OAK p ,� �f B e 20" �. t. s TITLE 5 SITE PLAN '`.� TH2 s'` x 22.15 GRAIL 0{21VE 24.55 LS LS ' H1 1 .97 o OF 10YR 5/6 10YR 5/6 #173 WEST STREET ' 28" 17.56 28 17.9, 9' `o o \ i x 18.41 16.8 193.75' 3\ �i BENCH MARK - CONCRETE OSTERVILLE MA SLAB AT GARAGE EL = 19.9 7 C C / PREPARED FOR PERC �4ZN OF MgSS �(N OF MgSS9 DANIEL 9cycN � DANIELA. oyG� HICKEY CONSTRUCTION M/C S MS / o A. OJALA CIVI ` No,4A� A .4 020 DATE: 7-26-2010 2.5 Y 7/4 10YR 7/4 GOLF COURSEPR° off _ _ 4541 jl� fax 508-362-9880 I LDANIELdowncape.com A. OJALA OJACIVIL downcope ellgiaeering iac. No 40380 No.465 120" 9.9' 120" 10.2' ° Fss\o PJ n� c� rE�` civil engineers Scale: 1"= 20' SURVE S/9" Y N�� .- land surveyors NO GROUNDWATER ENCOUNTERED -Zbr 1(� ° y 939 Main Street ( R to 6A) DCE # �- > 55 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L. . YARMOUTHPORT MA 02675 10-155 HICKEY BASE.DWG I {