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0040 WOODLAND AVENUE - Health
40 Woodland Avenue 140-1.36 ®sterville i IIF,� f' 6 I�.1 I 1 Transmittal Lefler .To• Board of Heal th 200 Main Street Hyannis,MA 02601 Attn:. From: Stephen A. Wilson, P.E.' Subject: 40 _CA-�vo r�l� ►, Q� _dslr.-� /l� Date: �o We are sending ybu gi Attached ❑Under Separate Cover The following documents: ❑Prints❑Order of Conditions El Variance Approval❑Recording Slip ❑ Septic System Permit ❑Notice of Intent Other DATE QUANTTI'Y DESCRIPTION These items are transmitted as checked below: ❑ For Your Use ❑ As Requested For Your Files ❑ For Review and Comment ❑ For Recording As Required Other: Additional Distribution File No. 206 y— 09 Baxter,Nye&Holmgren Inc. . Phone: 508-428-9131,ext.13 812 Main Street Fax: 508-428-3750 Osterville,Massachusetts 02655 E-Mail:swilson@jkhohngren.com TransmittalLetteA.doc Town of Barnstable P# 0 6 6 �OFIHe r0y N„y Department of Regulatory Services- BARN STABLE, Publiellealth.Division- Date y MAM. 1639• 260 Main Street,Hyannis MA 02601 Date Scheduled Fcbr� Pin Zooy Time I '&V/J,'P7 Fee Pd. I UO Soil Suitability Assessment for Sewage Disposal , M\ Performed By: SkPhe'i A. W t(Sc'q Witnessed BY: Jf w� ✓I � I 1 o LOCATION & GENERAL INFORMATION Location Address 40 Gjo0c01QfVd. Air ork.v,/6 Owner's Name Ot-SIw ce Ca ashV41--e41 vp Address Assessor's Map/Parcel: Engineer's Name c5/e�/hew /a G1 i/Syi�pG INEW CONSTRUCTION X REPAIR Telephone# Sob —y2 ' 0//3/, erg/3 Land Use 0_bs'_0 Lour Slopes(%) /°lo Surface Stones P2 o.L2 Distances from: Open Water Body ft Possible Wet Area 11 Drinking Water Well . tt Drainage Way ft Property Line . ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) _ — — — — -. — -----�" - mud 0, f f ;f__-----------------=-------------------- - - q ----- _ ___-- WOODLAND-AVENUE -- ---- ---' AQ Parent material(geologic) Giaeul 004 ..Gxtj Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: In. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index W611level Adj.factor Adj.Groundwater Level— PERCOLATION TEST Date Z/11 Time //:3o0301 Observation Hole# 0 Time at 9" Depth of Perc S/o 4 Time at 6" /8:qS Start Pre-soak Time a Time(9"-6") _��►��� End Pre-soak //:y3 0 Rate Min./Inch Site Suitability Assessment: Site Passed f Site Failed: Additional Testing Needed(Y/N) 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 Barnstable Conservation Division at least one(1)week prior to beginning. Q:hEALTH/W P/PERCFORM DEEP OBSERVATION HOLE LOG Hole # Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent °o rave �I _ I D _2 •• • � � Sa 3 2LO �p Ior.M /6 �Q 1z /o - 20 b 40a 16 . DEEP OBSERVATION.HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel G.�2`' zN .�o,c �o s04�ey 1.09k W3 ?G)Q. S'o•i-Vy Xearrl DEEP OBSERVATION HOLE LOG Hole# Depth from . Soil.Horizon Soil.Texture Soil Color Soil Other Surface(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. - Consistency,% ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes r/ Within 500 year boundary No f/ Yes Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the' area proposed for the soil absorption.system? yes If not,what is the depth of naturally occurring pervious material? Certification I certify that on �s (date)I have passed the soil evaluator.examination approved by the Department of Environental Protection and that the above analysis was performed by me consistent with m the required training,expertise and experience described in 310 CMR 15.017. Date Signature 3 Z2 4 Q:H F A.VITI/W P/P E RC FORM Town of Barnstable P# 010f 6 7 oFTME Tod - N�p� Department of Regulatory Services _ IBA"nABLE, : Public Health Division � � Date y MASS. 039. 20o Main Street,Hyannis MA 02601 DM a Date Scheduled Fe-br„ary 191 Time 1! t0D4M Fee Pd. '00 Soil Suitability Assessment for Sewage Disposal ,erformed By S1�p e,, A. Q t�Sew (?� � F . Witnessed By: ✓� wr ✓I o . LOCATION & GENERAL INFORMATION' Location Address..440 4)o0c0IgA+d ,f1✓�r Os/rrdi//v Owner's Name "ISIv f4 Ce.rs/�d�hu� R m, /lore p Address pslZ.��/(e /Y!4 026SS O ` M Assessor's ap/Parcel• Engineer's Name O,46/2/t.en !t h?�p /��, tea.-<</ /36 - .. NEW CONSTRUCTION X REPAIR Telephone# Soa -yz-y, -'a// /3 Land Use Ube L•o rr Slopes(%) Surface Stones n 0.t.0— Distances ti"om: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line, ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands:in proximity to holes) lr j s � i TP - ----- _ -_ ----------- ---- - ----------- ---- ---.=WOODLAND AVENUE Parent material(geologic) Glacial d 4--•es� Depth to Bedrock _ 34 Depth to Groundwater. Standing Water in Hole; *'` Weeping from Pit Face µ Cstiniated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in• - Depth to weeping from side ofobs.'hole: in. Groundwater Adjustment ft. Index Well i{ Reading Dater Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date 'ZI/11 Time //-.3 A01 Observation k Hole# Time at9„ Depth of Perc- Time at 6" Start Pre-soak Tillie cr //:2$ 'Time(9"-6") ��►+•� End Pre-soak Rate Min:/Inch" Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) +. Original: _ ,. g `: Public I-lealth Division "Observation Hole Data To Be Completed on Back----------- ' "If percolation testis to be.conducted witliin 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week.prior to beginning. Q:HEALTFI/WP/PERCFORM DEEP OBSERVATION HOLE LOG Hole # 2. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (MnnSell) Mottling (Structure,Stones,Boulders. Consistency, /gavel) 2.n_ LO s 4e /o"- Zo" 1 L�a 26 y4 5�6 DEEP OBSERVATION HOLE LOG ' Hole# Z - Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mun.elI) Mot tling (Structure, re Stones Boulders. + Consistent °°Gravel) . G ^2" 10 a k DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent % ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil_]-lorizon Soil Texture Soil Color .• Soil Other Surface(in.) (USDA) (Munsell) Mottling I (Structure,Stones,Boulders. Consistent %Gravel Flood Insurance Rate Map; Above 500 year flood boundary No_ Yes t/ within 500 year boundary No f� "Yes Within 100 year flood boundary No ✓ Yes Depth of Natural) Oceurrin pervious Material Does at least four feet,of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? 'Certification ' I certify that on 9S (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. ' Date Signature Q:H BA.LTI-fw P/PGRCFORM Transmittal Letter To: Board of Health k 200 Main..Street - Hyannis, MA 02601 Attn: - From: Stephen A. Wilson, P.E. Subject: Va 6r'eva01ar�aQ i,,� 'zoo g-0 3,r Date: We are sending you Attached ❑Under Separate Cover The following documents: ❑Prints❑Order of Conditions❑Variance Approval❑Recording Slip ❑ Septic System Permit ❑Notice of Intent Other-,- - DATE QUANTITY DESCRIPTION 9/ ova r >i s 0"' C' e r e� o These items are transmitted as checked below: - For Your Use ❑ As Requested ❑ For Your Filrri - © . ElFor Review and Comment ElFor Recording As Required= w Other: ro w . ray . Additional Distribution Y14. C U�1�, J 1'6 96M Exc.. kri�. File No. Baxter Nye Engineering&Surveying Phone:508-771-7502,ext.13 78 North Street,3`d Floor Fax: 508-771-7622 Hyannis,Massachusetts 02601 E-Mail:swilson@baiter-nye.com TransmittalL etter5.doc Town of Barnstable �'"E Regulatory Services Thomas F. Geller,Director aAxxszaBi.E, # � 9� . leg Public Health Division Thomas McKean,Director. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 9 iy o 9 Sewage Permit# 2-0 0 9-03 1-1 Assessor's Map\Parcel Designer: 5 tR (-Z&5g, , R E.� Installer: JD4,9,61 mac,h�,4, Address: 13a x iz,. D u e- Address: P.a 13 o x t 2$-5 ifs' �(�r�r r5� . dl&a a eia s. 04 6,0/ 1=0+�c%Lc�Qo G Z. S/�! On y -3 2-009 &e-a g.Ah was issued a permit to install a (date) (installer) septic system at Vo ,-,le .4 based on a design drawn by f (address) S,-'-,o17 &A ism; R,--' dated -e. z�n (designer) I certify that the septic stem referenced above was installed substantial) according to -�- fY P Y Y g 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 iceguiations. Plan revision or certified as-built by designer to follow. - I(A OF 9 O� STEPHEN O�G ALLYN u' nstaller' lgnature) o WPLSON �i No.30216 Cn Q�� t AL esigner's Signature) (Affix DZWKITiamp Here) 1 'PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc C 2o09-0/6� wh.. � a x • � s E, �y U� r• -y- Town of Barnstable P# D 6 7 oFSHe row o Department of Regulatory Services i BAMSTABLE, : Public Health Division- Date V MASS. w v 1639• `0m 200 Main Street,Hyannis MA 02601 �AlFD MA't A Date Scheduled �cbr,,a�y I`i Z�o� . Time 1{ I&V 4� Fee Pd. Soil Suitability Assessment for Sewage Disposal c �,, Performed By: Sill-P Kell , w I S Witnessed By: fa✓!r��� ,) ✓I 'I LOCATION & GENERAL INFORMATION a Location Address 40 Le'o0cP1afyd 4.v OS/ /6 Owner's Name "IS/x U ec..zs<•^a hug `4 pm, /lox S'2S o Address Ass essor'sMap/Parcel: C. Engineer'sNameO yv/t.on /Y NEW CONSTRUCTION X REPAIR Telephone# 5*08 ^'/2V' --0//3/ CK/-/3 Land Use 0be,0 Ao,r Slopes Stirface Stones K Olt-0— Distances from: Open Water Body R Possible Wet Area' 14 Drinking Water Well ft Drainage Way ft Property,Line 11 Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) CD \\ O 1 U 1 < / ——— J_ WOODLAND AVENUE .�...., ---- =-- - ___" —�^ Parent material(geologic) Gldcul dok...cstj Depth to Bedrock' Depth to Groundwater. Standing Water ili Hole: Weeping from Pit Face Seasonal High Glot utdwater Estili�ated g DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: ilt•. ' Depth to weeping from side of obs:hole: in. Groundwater Adjustment N• Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date z f 1 Tune //:30i�^t Observation Hole# Tim ''e at 9 Depth of Perc S!o " Time at 6" Start Pre-soak Time a //:2$ Tiine(9"-6") /�•f "End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original`. Public Health Division "OUservation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division of least one (1) week prior to beginning. Q:HEALTH/WP/PERCFORM DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Coils istenc % rave D - 2 ,�. Saso 1119r DEEP OBSERVATION HOLE LOG , Hole # Z Soil Texture Soil Color Soil Other Depth from Soil Horizon , Surface(in.) (USDA) (Mmisell) Mottling (Structure,Stones,Boulders. C nsistenc %Gravel G -2 /0" All So lay kda'wr 10 +e- 41/3 /0°,_ Via. So�aPy �oarrl /O.`/R /lo DEEP OBSERVATION HOLE LOG Hole # Text ure Soil Color . Soil Other Depth i fi om Soil.Horizon Soil Te, P Sw l.'ace(in) (USDA) '(Munsell) Mottling (Stnichve;Stones,Boulders. Consistency.%° ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon. Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, %Gravel Flood Insurance Rate Man: w Above 500 year floodboundary No Yes t/ _ Within 500 year boiuidary '.No Yes Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material ^� •Does at least four.feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for thesoil absorption system? YES If not,what is the.depth of naturally occurring pervious material? Certification I certify that on 9S (date).I have passed the soil evaluator examination approved by the Department of Envirow-nentaI Protection and that the above analysis was performed by me consistent with the required teaining,expertise and experience described in 310 CM R 15.017. e Signature , Date _Q:HEA.LTI-I/WP/PERCFORM Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab . key to move your 1 Inspector. I b`05V cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service Company Name 17 Playground Lane Company Address Yarmouthport MA 02675 City/Town State 0 Zip Code-4 —A 508 362-3555 S 14454 -, Telephone Number License Number � � ""1 Co B. Certification I certify that I have personally inspected the sewage disposal system at this addrs and tha"i the information reported below is true, accurate and complete as of the time of the in pection. Tlae in�&ction. 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: 0 Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Ev I tion the ocal Approving Authority r J 8/30/13 Itispecto Igna re 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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•3113 Title 5 Official Ins n Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The 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): t5ins•3/13 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 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C 8r JENNIFER A Owner owner's Name information is required for every Osterville MA 02655 8/30113 page. City/Town 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 ❑ 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ 0 Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °t 40 Woodland Ave. Property Address CURLEY MARK C&JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Z Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑x Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑x Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑x Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] ❑ 0 The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑x 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 ❑ ❑ 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts IM Title 5 Official Inspection Form ki p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner owner's Name information is required for every Osterville MA 02655 8/30/13 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 ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? ❑ 0 Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? 0 ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑x ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? 0 ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ 0 Existing information. For example, a plan at the Board of Health. ❑ 0 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins.3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of W Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY MARK C&JENNIFER A Owner Owner's Name information is required fo every Osterville MA 02655 8/30/13 r 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 0 No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? 0 Yes ❑ No Seasonal use? ❑ Yes 0 No Water meter readings, if available last 2 ears usage d na 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes 0 No Last date of occupancy: 8/30/13 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? ❑ 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: t5ins-3/13 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 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 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: Was system pumped as part of the inspection? ❑ Yes ❑x No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑x 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts 1-NEW co Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components, date installed(if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): Depth below grade: 1' feet Material of construction: ❑ cast iron 0 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the building vents. Septic Tank(locate on site plan): Depth below grade: 1' feet Material of construction: 0 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 4 Dimensions: 1500 gl. Sludge depth: 3" t5ins•3113 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 40 Woodland Ave. Property Address CURLEY, MARK C&JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 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 33" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. Grease Trap (locate on site plan): Depth below grade: feet I 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 4 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 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: 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town 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 No 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.): Box is level.Box has one outlet laterals.No evidence of leakage. 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.): *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: t5ins-3/13 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 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is Osteryille MA 02655 8/30/13 required for every page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑x leaching chambers number: 6 300's ❑ 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.): Sandy dry soil.No signs of hydraulic failure.Leaching was dry at time of inspection. 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 t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts k1piTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C&JENNIFER A Owner Owner's Name information is Osterville MA 02655 8/30113 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form R Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY, MARK C &JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town 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 i i k (rr S F C i t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form lu Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments 40 Woodland Ave. Property Address CURLEY MARK C&JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8/30/13 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ❑X Check Slope FXZI Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 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) 0 Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations.Hand augered 5' below leaching.No groundwater observed. i t Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 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 40 Woodland Ave. Property Address CURLEY, MARK C&JENNIFER A Owner Owner's Name information is required for every Osterville MA 02655 8130/13 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ' 0 Inspection Summary: A, B, C, D, or E checked 0 Inspection Summary D (System Failure Criteria Applicable to All Systems) completed 0 System Information—Estimated depth to high groundwater 0 Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Fond:Subsurface Sewage Disposal System•Page 17 of 17 No. �O -V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Migont *pgtem Cougtructiou 'Permit ' Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. iYo L06UVI-AN-0 f V 116 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 110 9 Installer's Name,Address,and Tel.No. /v/l�te✓� T� Designer's Name,Address and Tel.No. E C%A 1Z91 F6Tv%--t0A0$. "7 9i N ar+n-o N beW�tis _ (Sa v -7- t -750Z Type of Building: Dwelling No.of Bedrooms Lot Size - G sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided Plan Date 6 - Z.Z.—p Number of sheets Revision Date Title Size of Septic Tank -/5 4rzr q Type of S.A.S. �-7 Description of Soil %L - L-ot Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure rue ion an mMm e f the afore described on-site sewage disposal system in accordance with the provisio rtle 5 of t mental Code and not t place the system in operation until a Certificate of Compliance has been i d by this�aCof Healt p Si Date ( y Application Approved by Date _ Q Application Disapproved by: Date for the following reasons Permit No. 9 0 Date Issued [ -3 `O �X No. �66 ! rx..." _ k- }. Fee Entered in computer: ✓ THE COMMONWEALTH OF MASSACHUSETTS Yes `'-PUBLIC HEALTH DIVISION,-- TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Mi.5pogal 64p tem Con tructiou Permit Application for a Permit to Construct Repair( ) Upgrade( ) ,Ala ndon( ) Complete System ❑Individual Components i Location Address or Lot No. -�b UJ60 PL,41,,V A t; Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. /775-t47ZT :y1'CA 01047"Designer's Name,Address and Tel.No. O B c-%A IZ IB I '1=cSi� !� `►t /mil -7 Q N OY-t'p' g T to`f dew Svc - La -o.�- 930b o - -7 t - S 0-L Type of Building: - ..-� - Dwelling No.ofhBedrooms -5 Lot Size . sq. ft. Garbage Grinder ( ) Other Type of Building No.-.-of Persons Showers( ) Cafeteria( ) Other Fixtures Ii I, Design Flow(min,required) 3 6 gpd Design flow provided S y — —gpd Plan Date G ZZ. -O Number of sheets i' Revision Date _< j _. - Title Size of Septic Tank /S u& = Type of S.A.S. LTF;e_ J Description of Soil ►l.._. L-O Nature of Repairs or Alterations(Answer when applicable). ) Q Date last inspected: t Agreement: The undersigned agrees to ensure the-eonstrucfion and mainte-nanee_of the afore described on-site sewage disposal system in accordance,with the provisions.ef'Title 5 of the-Environmental Code and not to,place the system in operation until a Certificate of Compliance has'been is zed by this Board of Health./ M; ' Signed Date h _ Application Approved by r Date 3 d Application Disapproved by: ; 1 Date for the following reasons Gy Permit No. 0 0 3 Date Issued / =3 0 I �_ -vim•m - - -�-• ...-m.r- .� � —— — ———--- ——— ——————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed (A) Repaired ( ) Upgraded ( ) Abandoned( )by PAST<m-v- at L10 tI.:)tsnnLak-NO AN'K C35- has been constructed in accordance C� with the provisions of Title 5 and the for Disposal System Construction Permit No. o-9 60q--a 3 q dated Installer PAS7ral"S "gX �- A.,/pa,--r' j3 Designer #bedrooms Appr•owed,design flow- v gpd .; The issuance of this per it s all not be construed as a guarantee that me system wile u�nctio•n a designed. Date / Inspector ry No. G I - -1 -- - Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �Digagal �&p5tem Construction Permit 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 recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date _3 -D ( Approved by », r ` TOWN OF BARNSTABLE LOCATION U ®�� �{ SEWAGE # VILLAGE S �''` ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. /0,96 ' kC0G1/G 1/4-e) SEPTIC TANK CAPACITY LEACHING FACILITY: (size) /A 4/4� NO:OF BEDROOMS _S � E'-IS BUILDER OR OWNER , PERMTTDATE: COMPLIANCE DATE: �7 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 , 3 q o wuvdji4j 5 p,�9 l �,��e o�•�l e, �. 7; 1.S I �ur� m�� i No. . � �:,. AFMASSACHAUSET o� Fee THE COMMONGEALTHI S •�, Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPlication for Mid ozal 4& item Cow5truction Permit Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) wrComplete System ❑Individual Components Location Address or Lot No.`l ®�� �� Owner's Name,Address,and Tel.No. 15-0O - As sessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Namel Address and Tel.No. 77/ 0270 f� l � '�- T A �`E Type of Building: Dwelling No.of Bedrooms S Lot Size . , sq.ft. Garbage Grinder (Nv o Other Type of Building W®D %24AIE No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �J�U gpd Design flow provided 7 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank �J��D �/� Type of S.A.S. z494--if1,06 e,44 w6o5p Description of Soil Nature of Repairs or Alterations(Answer when appli e 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. Sign A Date .Application Approved by Date r 'Application Disapproved by: Date 4brahe following reasons Permit No. Date Issued ------------------------- THE COMMONWEALTH QF' SSACHUSE TS BARNSTABLE,MASSACHUSETTS �9 Certif irate f cartre THIS IS TO CERTIFY,that the On-site Sewage Disposal Sys in Constructed (� epaired ( ) Upgrdded ( ) Abandoned( )by at 1,4A117 VE Id ha be n co truct i ordance Q> with the provisions of Title 5 and the for Disposal System Construction Permit dated Installerlop_T6Lr17f Designer #bedrooms 7 Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector -------- ---------- No. ® Fee HE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Migozal stem Construction Vermit Permission is hereby granted to Construct (`✓ ) Repair ( ) Upgrade ( ) Abandon ( ) System located at 1/0 W dt4l�5 j A4/,6 RV E o S`-E-P- "(44 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes-his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit.--- Date Approved by F No. i Fee •�'� �'~ "� THE COMM1NEALT` �OF MASSACHUSETTS Entered in computer: fi 3, i i Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS a ZIPPYication for Permit 1 Application for a Permit to Construct Repair( ) Upgrade( ); Abandon( ) Complete System ❑Individual Components Location Address or Lot No.`/O WA A4AAIn Owner's Name,Address,and Tel.No.�'Q� �460 j G5 2t1P� I/ Assessor's Map/Parcel �(jQ 115,6 /�( < r, �Installer's`Name,Address,and Tel.No. _ Designer's Name Address and Tel.No. -771 — 76 d? r- _ ( Ty e of Building: � � Dwelling No.of Bedrooms ''``��,��5 Lot Size c;J, sq.ft. Garbage Grinder (N tj Other Type of Building M/V F4 A MF No.of Persons _ Showers( ) Cafeteria( ) Other Fixtures- / Design Flow(min, required) gpd Design flow provided �7 7 + gpd Plan Date Number of sheets Revision Date Title _ Size of Septic Tank ���7 o f GLO Type of S.A.S. 449&N/-o 6 Description of Soil OIL, F Nature of Repairs or Alterations(Answer when ap 1'cahle) 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. 1____-.— Signe �/ ,, Date Application Approved by / 1 IV _>r � Date Application Disapproved by: r r , Date f for the following reasons ' A Permit No. Date Issued - -. _ _ THE COMMONWEALTH O ASSACHUSE` TS , _�- BARNSTABLE,MASSACHUSETTS --9 Certificate Qf Com-# tance � THIS IS TO CERTIFY,that the On-site Sewage Disposal Syst m Constructed ( Repaired ( ) Upgraded ( ) Abandoned( •)by ` ;q.h at VQ 044 _44116-- 4AF . Q 5 V I \ h ben gr�istructe a cordance \ v with the provisions of Title 5 and the for Disposal System Construction Permit No. �(�4r dated Installer Designer #bedrooms Approved design flow gpd y� , The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector. No. aw f% { C_� 1 HE COMMONWEALTH OF MASSACHUSETTS, PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS " %i5po!6aj �& item Construction Permit t Permission is hereby granted to Construct (v ) Repair ( ) Upgrade ( ) Abandon ( ) System located at y0 19V E Q 57'EW ✓�� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes-lusher duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date Approved by. '� r p No .�d 0� I o - Fee I�d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE,MASSACHUSETTS . ZIpplication for Miopaal &p.5tem Con.0truction Permit Application for a Permit to Construct(X Repair.( )Upgrade( )Abandon( ) Complete System ❑Individual Components. Location Address or Lot No. 410 1.t1 e(2Y;/biad ALL Owner's Name,Address and Tel.No. Cg.`ifrru;%lc S►cv�. Co51c Ilo . Assessor's Map/Parcel P G bye V 7 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.SC5-771-'7S4tZ•c 5izpha. A. WAsu,,Pe, Da,ct=_ Nyc 7S1 }. 624-CI Type of Building: Dwelling No,of Bedrooms _ Lot Size 2(r(2 e,, sq.ft. Garbage Grinder Wo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design now_l l o �'1rU1rr.,,,r gallons per day. Calculated daily flow 550 gallons. Plan Date 7, Number of sheets nnc Revision Date C� Title_.S_4 �Q Size of Septic Tank 156n A//6n5 Type of S.A.S.1c�,6h,,1w&a iY'.<02'Y 7t A-t. Des cri tion of Soil' � 1 .G cw J2$51,1 10 Nature of Repairs or Alterations(Answer when applicable) JJ� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certify-: t.. cafe of Compliance has been issued by this Board of Health. Signed Date -o Application Approved by Date 3-�/ o y i Application Disapproved for the fol owing reasons o O Permit No. A.O?-16 Date Issued 3 }I'a THE COMMONWEALTH OF MASSACHUSETTS nl� � BARNSTABLE, MASSACHUSETTS 'r � {�s*1 (Certificate of Compliance THIS IS TO CERTIFY that the On-site$ewer a Dis osal S stem Constructed g P . Y (. )Repaired_( )Upgraded( ) Abandoned(. )by vt � err 4 at O 5 e.r U+. has been constructed in accordance ! ; with the provisions of Title 5 and the for Disposal System Construction Permit No. �o '16} dated 3-3/ og. Installer Designer The issuance of this permit shall`not be construed as a guarantee that the system will function as designed. Date - Inspector --�—N—l ----------------------------------- No. 1 G Fee t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION.-BARNSTABLE&MASSACHUSETTS t w �Digomf bpgtem (Construction Permit Permission is hereby granted tQ�{,o�nstrt )Re air )Upgrade( )AAband System located at 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 m t be completed within three years of the date of thi ,rmit Date: 3- I-� Approved by L,-_D 0 i Transmittal Letter To: 1 Board of Health Po Main Street Hyannis, MA 02601` Attn• "�o� CGS Wlo�ral S From: Stephen A. Wilson, P.E. Subject: Z/o good/a.N /Zee 6S�zi►✓,//!� Date: 9��/Z069 We are sending you ®Attached ❑Under Separate Cover The following documents: El Prints❑Order of Conditions El Variance Approval❑Recording Slip ® Septic System Permit ❑Notice of Intent®Other DATE QUANTITY DESCRIPTION !O &6 7 These items are transmitted as checked below: For Your Use As Requested ® For Your Files ra C ❑ For Review and Comment ❑ For Recording ❑ As Required Other: µl —n n'_- ¢ . W Additional Distributions File No. Ze o5'—o/C, Baxter Nye Engineering&Surveying Phone:508-771-7502,ext.13 78 North Street,3'd Floor Fax: 508-771-7622 Hyannis,Massachusetts 02601 E-Mail:swilson@baiter-nye.com F TransnittalLetter5.doc No. �`s U Fee , T COMMONWEALTH OF MASSACHU ETTS �, Entered in computer: V, 'VYes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ZippYication for 0igpool *pgtem Construction Permit Application for a Permit to Construct( )0 Repair( )Upgrade( )Abandon( ) Dl Complete System ❑Individu Components Location Address or Lot No.4/0 Cda- P/aP ^v'c- Owner's Name,Address and Tel.No. 6X 1-c -Ui/L¢�7 M'S ka�e CG�St1^ It Assessor's Map/Parcel �c� , c{t�cJ kry p 0 S G /NO � /�aru./ !3(a i Ui Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.(5WA- O- +trek ST U EIJ 1c�heo, A wi l s��5� 8�L 1Y14i.� S rcf OSIZru to M2GS5 Type of Building: Dwelling No.of Bedrooms r-o u r Lot Size o2/,/Zo sq. t. bage Grinder4e>) Other Type of Building No. of Pe ons h ers( ) Cafeteria( ) 1 Other Fixtures Design Flow /Co nd /�dY ,�, gallons p/sk Calculated daily `13O gallons. Plan Date 3,31 Z a Y Number of she4Ke— N evision Date Title Lo Size of S tic Tank I5'CD0 Icy. Typ o S.A.S. l,e_a_cllw Ch4..t6,r,_ 121%3T' xZ'hf, Description of it Jo o' I to oY. lm (� b (o(D7 Nature of Repairs Alterations(Answer w n app 'cable) Date last inspected: greement: The undersigned agr s to en the onstruction and maintenance of the afore described on-site sewage disposal system cordance with the provi 'ons o Title 5 the Environmental Code and not to place the system in operation until a Certifi- c e Compliance has been i sued this B ar of Health. Signed Date 0 App ati Approved by Date Appli tion isapproved for the llowing reas n Pe\)by Date Issued 0 ------ -------- ----------- ------ ---- -TH COMMONWEALTH OF MASSACHUSETTS ARNSTABLE, MASSACHUSETTS Certificate of (Compliance TIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )UpgradedAbando at h constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector j � No. F F }-'i, �1 Fee Ente d in computer: �_ T COM NV(I�EALTIt /MAS ACHU ETTS :. : , f Ye ` PUBLIC HEALTH DIVISION - TOWN,OF.BARNSTABLE,. MASSACHUSETTS RpPlication for Di-4poear *p6tem �Con5truction J)ermit Application for a Permit to Construct(,)O Repair( )Upgrade( )Abandon( ) Complete System ❑Individu F'Components Location Address or Lot No.4fO (doo J- 4a -P "R�' Owner's Name,Address and Tel.No. r-�.r�Lc 'YY.1�S LtowC. CGnSFvuc4tivt . (y� `Assessor's Map/Parcel `- ��CY'di \� /t/O I�G/u �3�o po ��� / �.` Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.( V e_x} a EMte_ STFV-e,,j< S}c�,he„ A U iS&" ,P.e. z9 n�-, Nam. t-Iolr,grc�. 5 81 z Mr.,, S - C) -r,�I c.e W► puss N Type.of Building: Dwelling No:of Bedrooms r'oor Lot Size oR 1,/Zo su. t. bage Grinder4o) Other Type of Building No. of Pe rs h ers( ) Cafeteria( ) Other.Fixtures ' Design Flow /to dry,=., gallons p/S\Y. Calculated daily ��p glons. p e Plan Date- 3�/1 y Number of shee4le_ evision Date 2 � Title la Size of S tic Tank 1 S 1 Typ o I S.A.S. h c� Ch41u►y►s Description.of oil ld to !i►� to P O 6( -7 Nature of Repairs or Alterations(Answer wh n app cable) ;p - Date last inspected: Agreement: _ The undersigned agre s to ens a the onstruction and maintenance of the afore described on-site sewage disposal system cordance with the pfovi 'ons o Title 5 a the Environmental Code and not to place the system in operation until a Certifi- ' c e Compliance has been* sued b; this Board of Health. Signed .t Date 1641 b App ati Approved by ! � l Date Appli y don isapproved for the llowing reas n Pe No. Date Issued ek THcjCOMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS , Certificate of Compliance - THI\by TIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )"Upgraded( ) Abandoned( at f has en constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector ----.--- ---- --------------------, Fee 7 No. THE COMMONWEALTH OF MASSACHUSETTS l BLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ;Dioozaf 6potem Con6truction Permit Permission is hereby gra4tf;d to Co struct( p 'r( Upgrade( )Abandon System located at `7( o ( 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. t: Provided:Construe io must a com leted within three years of the date of thire Date: �- Approved by t_ a co m a Fa F" II II '-_-___ ,-D I :.,• II 1 6eq ?. .I Ik. ••E:f Ile a Lo a 15 I I i 3i` I ,� ;• I I L_ _ I I e ��� _ _ --1 L'_.}�y}}•}�•'yyj�r�;gtprJJ L- J I I—__ _ � I Cal J' 3 1 zz a�E 8# D y -0 rn 9' a I a I I 1 V: n .... ..... PROJECT: aRnrw e,: Q a .•,•a•aa..ds �ti..e GU3ko*n NomefoC: enekeenea sr: �i pb'I:S".LEy� PrQjectl79 —� �raVncL�A.. y J Lp(� / �/ rra...bmm:m.a w.D.a 3 + LE lert"7vwwdti.w:ti�F.ft'., MAr—And�.Ct4 V€.z+i-C/4 a �tsnrle.+h hadlsr A<tx:n+a.� LOCATION: 'w°a.".o.:°mw•. al-t t[ Pn4nnq OaNanr.s '�f=fess=mlhldhfing design-t� AA''"" µHad rlew PD.ro,eL..rlrro Y/B4Oo <f00dIIR,�dI/,ve F.•r+.d rLsll.ro,eleerrero Si:a,oa �I'"Iomme.[iil,reiAevlio�s�_ askerv'll e,A'f�r . B.a Rb••u CO s7�U,,o O� n _ W to to t. 'e °„ ug F� S11�5�� a11- l .l • I it Mr llll 3f ill u$ � � K. nnhrow pwmp� In _ .w> ::♦/.-,Y.p i/n I n 1 vtl'.� %lal ® °t ra , 1 � ��/� a t • �:a.G b4ek— O ... I I I I ra.♦ amp,m.lo vs jog •.'.. r £li lagflf � z,�a,.Qi _ !� l• l .,�f.�:.ww ap>>.p r'.lull q - ! ° x n --�—rl—�- i I I.d € � � °° 1 ♦ ® 1- I ._____—_—--- ' Mr;•p.w.1 • zi, C f a` 2 • _ y' zg.ffa� a V E a n b v n E o 3; �p j F 1/ j .../• r it� � R ° 9� 4EQx3�3 'D 1 3 uv yVn �'e�u�jd a�yA•�'C C,ou '°off + � gao_o9nV�9a 84� N�•� -_� - c y�u•�J3..�»1/ia nV m° L i1U _ 9• i ]I ly gryy�.pep�tylull»,iriy� DRAM BY Ln6flCeRLD EIY: PROJECT: Guskamlomefot': Pr4jeCt*1 793-q ( i 1 hd¢rlwwew..Gr.tl..r N I@ 3 - .-......,...a...wd.. 4 a LOCATION: ......... eons+h hwdlJf htta.:>+ac RLN910tt9: �' �— be,Otean..t.tb.er R ru le,[yo..y.../sp/ea -1pr=5csv=inlhlrilaielg design�t '+...e`..:...... V F+4¢d e4w y4ro/e4r,rYro>im/09 = RO Woodland Ave • - /.e.roede4wP4ro/e4rrbro>/la/o♦ =e n��[o er eial,redJential°•�s� me. e.,:rowa�.k.��.•,n..,.=/loo♦ •w=�..� ,. Pske.Cviller i-(,h .n:�n'anrw J t h � - 01. I _ ------- „- - - ----------------------- -------- - - ------------------ q i t I t, - J ii 1 •� %q�q X - L ,• i I i ! _ I 6-- oll i. .wa.w.wwalsa.wrso.of:a.era rruu � i uQ � i i II ..e..»."".w s n^ Io I� ala'm> f ; li `. 11 nL�v.o •.p'o�QV�v•J.�j� Fo Q j{ . _ i:a I �.w i P °e0oe°W rarl:frrl:�i� DRANK 6Y: r•nq• ,r•s.e PROJEG T: GUskOm Home, ensneeaev en d".Lnd'te, .qa::„4.trvaEn� Prgject4,17Z)3-� I K�Ner+onx�F . 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I. r - k; s a 1 ' 1 , s :. I i : - I g.. _ Im! - i , - . . +W, ��. d' t�q �; 1 . . �.� . 1, . . -, a " . .. as f. � 41. s a; f , 1 - .l. : (®•. `�� ,. __ 6 4. ° : I. 1 0 I 1 1 . z -- f - -� ``/ ti . - ... . . - - - .: .. .. , _ ._, . :- ... , +1 4 . - fir' 1 �' ! . . .. -.- { ;y k -. .. . �. S �.. i S ' .. - . - - - - _ - ! ,.. - . . .. . -- - .. it�a�� �It®. bD's1®PiE;1 14•f' , ?.: ® 11 twwlel a1Y®e9r� ®f®"R. ! Ibr,P"111911)� ®lo�olt �t> . i,�aa�r,'' :.- I�maBAm (M �D+1e11 :.: - om 4�41►' 1®-1ili;1�tls o� 1��. yers�. M p o°�ml . +oll:l" . , . . y e . ( . . . . . -. .,. , . . . . _ .. . . . �-. . - ,. . . . . . . - , . _ . . _ .. . . . . . . o.. _ . . . solL LOGS DATE:2/19n004 LEGEND/ABBREVIATIONS 12' --� DESIGN SCHEDULE ELEVATION #P-10,667 FINISHED GRADE TOP OF FOUNDATION 101.4 . :. - -• r : r `:8 a 36"MAX.-9"M N. \ \ / COMPACTED FILL FINISHED BASEMENT FLOOR -92.0 ENGINEER BOARD OF HEALTH AGENT: �_�h ') \ Stephen A. Wilson P.E. = UTILITY POLE/GUY WIRE ,• , ,�.. „ " p David W.Stanton,R.S. - ' �o • t 2 OF P��1 STONE ::::::::::::::::::•::::::::::::::::::::::::::::::::::::::::::::::.....::::::............... FINISHED GARAGE FLOOR 100.2 ® - ELECTRIC METER `,- ••' �� .. . '.A �`� °'� `'�` t � _ 3/4 TO 1 1/2 " SEWER INVERT AT FOUNDATION 98.3 TEST PIT 1 TEST PIT 2 o = CONCRETE BOUND _ u- •. - �_ _ - • • �, �? ,.-��_,�4 -1.5 WASHED STONw .�. 24 DOUBLE SEWER INVERT SEPTIC TANK 98.0 G.S.E. 100.1f G.S.E. 100.1f STAKE & TACK SET ••: :, ,:• +�-' ``'' r . '*. EFFECTIVE SEWER INVERT OUT OF SEPTIC TANK 97.7 MAG NAIL SET I. . « w ti ;• ..:h ,^ _ ga. 12 WASHED STONE 0 0 0 0 = TEST PIT - i s�N • ,• ••' ,• :;�'" R , ; �•: � _ 1 A f_ ._:"i ��s SEWER INVERT INTO DISTRIBU110N BOX 97.6 �" - r! SEWER INVERT OUT OF DISTRIBUTION BOX 97.4 2" 2' WOODEN FENCE \ nd b4 y ., fl • •.• .t � ris" i s�7�.�.Y�'•���.�jT t/�••.s��'+}yi'�,��•y3%i:T �"f=a M� CHAINLINK FENCE N. INTO LEACHING SYSTEM 97.1 SEWER INVERT AP AP rond �, ,•r M BOTTOM OF LEACHING TRENCH 95.1 = WIRE FENCE , Sandy Loom Sandy Loam -'-'-'-'-'"-'- s:✓ . '" PLAN OF LEACH CHAMBERS PLASTIC LEACHING CHAMBER DETAIL WATER TABLE: NONE OBSERVED AT ELEV. 89.1 10" 10 YR 3 2 10• 10 YR 413 TREE LINE b'• o°off'' ° eca. . •+ `' , }�� `' ,5 NO SCALE NO SCALE B B = OVERHEAD WIRES EOP = EDGE OF PAVEMENT •e a s ,, • a k a s Sandy Loam Sandy Loam . .• N _ fi s TYPICAL SYSTEM PROFILE r* k b TOP of 20" 10 YR 5/6 20" 10 YR 5/6 FOUNDATION GENERAL NOTES : '� FINISHED GRADE 100 = .5t • 8 NOT TO SCALE _ s { •o ti• ©"oa D.:;t t" e r, = 101.4 •-i FlNISHED GRADE OVER = C 1 C r ��..: • x _ TANK 100.4t FINISHED GRADE OVER D. BOX = Medium Sand Medium Sand � s ' ` _�,p�, ► ' `° ;r . , -::_, �... t00.4t 1H INTENT 0 IS N IS T DETAIL XI TING I CONDITIONS LOCUS ' FINISHED GRADE OVER LEACHING TRENCH = t0o.3f 42" 7.5 YR 5/s 132 10 YR 6/8 1.) E INTE F THIS PLAN O DE L E S SITE CO D TIONS AT L • a - ` 3- (min:}- LOCUS MAP , -` _ 9" (min) Cover C_1 PERC O 60• 2.) LOCUS AREA IS COMPRISED OF Scale: 'l 2�� 4" SCH. 40 PVC •-r ' 4" SCH. 40 PVC FIRST 2' (To BE LEVEL) . - 36 (max) Cover RATE= <2 MIN/IN ASSESSOR'S MAP 140 PARCEL 136 (TYPICAL) O 2.07E _ ,. (-- Medium Sand . t - r*L •• then O 2.OX NO PLAN DEFINES LOCUS - p 2 mi - 2"Lcyer 1/8"to1/2" 132" 10 YR 7/4 NO WATER ENCOUNTERED _- O 2.07E Peoatone CIIAM DEED REFERENCE: DEED BOOK 669 PAGE 414 CB DH FND L10- cp TEES GAS �E - r SUMP �. 0 Leaching Area (H�) FINISHED 7 CONSTRUCT ACCESS ,- 4 SCH. 4o PVC Leachuig Area Requirements OWNERS: ETHEL M. SHARPE o n / BASEMENT -: MANHOLE OVER INLET P.O. BOX 403 �t M - • FLOOR TO TANK TO AT LEAST �•.�. . ter+• a= WITHIN s" FINISH s" ® 4' PVC 4 BEDROOMS AT 110 GPD/BEDROOM = -440 GPD PEORIA, IL 61601 00 N -.�. REINFORCED CONC -f STONE °'°' �' FnonNG v - - • 3.) PROJECT BENCHMARK . DATUM ASSUMED NN X y9,5 •,�.;-; s_y}- :r •.' . ,a= NO GARBAGE GRINDER - IL to ^ _ - .•; - _-, MAG NAIL SET IN PAVEMENT AT INTERSECTION OF N N NECK POND RD & WOODLAND AVE. EL. 100.89 Y o IP FND PERC RATE = 2 /1 MIN. / INCH (CLASS 1 ) 4.) ZONING DISTRICT: RC S 5 MIN o (HELD) OVERLAY DISTRICT AP - AQUIFER PROTECTION m m 1500 GALLON SEPTIC TANK DISTRIBUTION BOX LTAR = 0.74 GPD S.F. RPOO - RESOURCE PROTECTION OVERLAY DISTRICT 24,17 S 7�14'4,S` E :•g0,4T •• No Groundwater Observed O Elev. 89.1 / a a / 12.01 D TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE 2 MIN. LEACHING AREA OF S.A.S. : MINIMUM CURRENT ZONING REQUIREMENTS C81 / laa,l r N/F MEYER MINIMUM AREA: 2 ACRES (RPOD) o, o 24.28. \ \ 440 GPD/ 0.74 GPD/S.F. = 595 S.F. , 99,£3 \ X I PLAN BOOK 150 PAGE 49 MINIMUM WIDTH: 100 PROPOSED SYSTEM . : MINIMUM FRONTAGE: 20' k lao,3 s 8rt3.41- lao.o SIDEWALL 12 +35 2 2 = 188 S.F. a E l00.3 9s,� 1 ( ')( ')O FRONT YARD 20' SIDE & REAR YARD = 10' v 0 x 99.S l00.0 / 7t'S4' X -` X -. 99, ioo,o / BOTTOM 35' X 12 = 420 S.F. 5.) A TITLE SEARCH WAS NOT DONE FOR THIS SITE, SHOULD ONE N x - _ _ DISTAL P X X X o 41 BE REQUIRED IT SHALL BE PERFORMED BY OTHERS. 0 c / ' LINE X 10a,� S 85.54.25" E ,� TOTAL = 608 S.F. (2to' PER D¢D� 210.40 --- • _- -- X X X -- f,, 6,) THE PROPERTY LINE INFORMATION SHOWN IS BASED a� • a� \ x 99.6 / X N N ro /• 1 x 99�� � -�-- X _______ ON CURRENT AVAILABLE RECORD INFORMATION !, 98,3'r 95.93' N/F WELO CONSISTING OF PLANS AND DEEDS. w h N , 99,z ,,'' S84.42'40` E 189.790 THE EXISTING 'FEATURES SHOWN HEREON WERE 0 / f ; CB DH FND 1&65. TO CB OBTAINED FROM AN ON THE GROUND FIELD SURVEY / l . 100,2 L r EXISTING ' �' 98`� 98,2(H�) FND 151.14' PERFORMED BY BAXTER, NYE & HOLMGREN, INC. CONCRETE BLOCK CONCR _ \ ; �..:\ x 99,6 / / 98'7 (SEE DETAL) CBNDH FEBRUARY 12 & 19, 2004 : ' r FOUNDATION (HELD) PLAN REFERENCES: 3 \ v qa rr ' _ TO BE REMOVED PLAN BOOK 224 PAGE 49 � � r 98,2 98.0 . .�r i r--" E O PLAN BOOK 226 PAGE 37 I x 96� x�STING WeoD PLAN BOOK 150 PAGE 49 r i / i• / , � S 84.42'40"r FRAME S E 169.79- PLAN BOOK 293 PAGE 70 �/• � TRUC x 99,4 r f) �\ TURE 18.65 R 99.9 , •151.14��""B r J TO BE REMOVED Z o ") 7.) COMMUNITY PANEL NUMBER: 250001 0016 D f: .6 • � Q" f � `1 t O - � THE FLOOD INSURANCE RAZE MAP DEFINES THIS AREA AS ZONE C, CB DH FND 100,4 x / . . x 100.1 ^ AN AREA OF MINIMAL FLOODING. - -- \ /r }� 8 7 , U o 8.) PROPOSED SANITARY DISPOSAL SYSTEM NOTES. LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND MUST 99 34 21 BE VERIFIED IN FIELD BY THE CONTRACTOR AND APPROPRIATE UTILITY N WOODED �` h COMPANIES PRIOR TO ANY CONSTRUCTION. 1 o, MIN' x q ^ ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH WOODED 'Y o TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 NY LOCAL RULES APPLICABLE. • �" � \\ x �38:5 - 1 {, ANYCHANCEPLANMUST BE APPROVED IN WRITING O x loa, �+ROppSE.O`WnOD N.T.S.985 DESIGNING NEE - �� F � , FRAME D1NFtL)NG ' `" 1?�TALL 5 - BY G ENGINEER 9 WHEN CONSTRUCTION IS COMPLETED, PR FILLING, MAP 140 PARCEL 136 21,12 NOTIFY THE ENGINEER & BOARD OF HEALTH r GENT BACK Of SO. FT. O 0.48t ACRES -. a 3 ' x 97,C FOR INSPECTION. WOODED% f'r ,n ' a i FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. tppOPOSEI,, ` w �•5 j A W -t-•- �� Z o 40 - , THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN lco, x 20' M►N. 1 x 9q,1 O J , - , �'. �` S N/F McCORMACK APPROVAL BY DESIGNING ENGINEER O 99. \ , .�� ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4 PVC., SCH 40 LLJ x 10059. x 98,7 2 r/ W77. \; `• 47� r EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING • _ r� SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5, PER r J 310 CMR 15.255. ^'y X 98,3 , 40 Woodland Avenue l01,0 X 99.9 r Osterville, Massachusetts x L' �. ,,� `•- - .. x qq,�; PREPARED FOR 1zo• r Ad - x 99,1 McShane Construction 101,5 N , PROPOSES DRIVEIMAY � �� Z 98 l TEST PIT 1 TEST PI 2 100,1 r � \ / �-1 al x 9p,6 `�� OF TITLE o ;< 10 0,5 x 100,4 x 100,4 ,\`.,\ �o��� HN Site & Septic Plan Elallo.ZIM .IS y 210.9r (210, DEED 99, ) - _ BAXTER, NYE & HOLMGREN, INC. lgl',1 N 84 54 1 1 w 262.19' x loa,l• 1a0,, Registered Professional ' N OF P,9,gs Oy 98.1 Engineers and Land Surveyors x 81 Main Street 0ster0le Massachusetts 02655 LL 100,8 Phone - (508)428=9131 Fax (508)428-3750 .3wo 4 • 100.E \ �o.�o�is / 101.1 1 r IBM: �_ 100.4 100,5 99.9 O 9 g . , 100,3 / t7i0-- ELy r ` MAG NAIL SET --�-- - � 100,E-' ( �py 100.89' 100.5 - - �,,.. �-- - -� 99,P / - - - 100.3 1o0.0 SCALE IN FEET '...*"- 100.3 1 a 0.5 i 1 1°0'z SCALE: 1" 10' DATE: 03/31/04 LANDVENUE _ �� � � ` 6 � � --u- A _ _100.9 100.2�- 40' 101 - wlDs « - ..._. 7� 9< .9 - P1�O� WAY (UNDEFINED SET Sp�ERLY SIDELIN ` I SHOWN HEREON ISFY TMT TO IN COMPLIANCE W OF M1f �IT'HTHE APPLICABLE BARNSTABLEE THE PROPOSED � 100,: _ PLAN BOOK 293%PAGE 70 _, E PER \ ZONING DISTRICT SIDELINE AND SEMACK REQUIREMENTS, IS n / 100.2 - _ - SET WIDTH AT 407 LOCATED IN RELATION TO THE MONUMENTS SHOWN. AND IS NOT _ LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA oo,l - - _..... - 100 l HOLD SIDE LINE PER PLAN - N0. BY DATE REMARKS DRAWING NUMBER � �• ---- - � THIS PLAN IS NOT To BE RECORDED NOR Is IT BE USED TO ESTABLISH PROPERTY LINES. 4, �• �- - - eo 293 PAGE 70 0: 2004 2004-009-8 SURV wr-ksht 2004-009-B-SP.dw a1,1 ta..,. Oa R ISTERED FESSIONAL LAND SURVEYOR DATE 2004-009-B .. �_ . :: • w �,° �� 12, DESIGN SCHEDULE ELEVATION son, LOGS DATE:2/19/2004 LEGEND /ABBREVIATIONS FINISHED GRADE #P-l0,ti67 �- .• r ,� �►- ,.. ,, . O • °••• "` /' s 36"MAX.-9 N. COMPACTED FILL 101.0 ENGINEER: BOARD OF HEALTH AGENT: �---�. _ / UTILITY POLE GUY WIRE o • 1 »> .� ;. L_ Stephen A. Wilson P.E. David W.Stanton R.S. ® = ELECTRIC METER • TOP OF FOUNDATON , • 2 OF PEA STONE FINISHED GARAGE FLOOR 100.5 -- ',,� .•,� a � i11 B `Y .rY " OR FILTER FABRIC :.::...:......:.:................................................................................. .................................................................................................... •. SEWER INVERT AT FOUNDATION 97.1 TEST PIT 1 TEST PIT 2 0 = CONCRETE BOUND a TO 1 _ _ _ �'••.' `�- 4• 96.9 G.S.E. - 100.1 t G.S.E. 100.1 t STAKE ,fit TACK SET o. i •.' t"t/4 -1.5 WASHED STO - " _� 3/ 1 2 • a •. �•• :•••. .<� �, .,.• {` .' ~-�•�;�' 24" DOUBLE SEWER INVERT INTO SEPTIC TANK � _ • S ,'1, . •� `" s : r 12' WASHED STONE _ TAG NAIL ET - EFF'ECTNE SEWER INVERT OUT OF SEPTIC TANK 96.6 {ly- oap 1 SEWER INVERT INTO DISTRIBUTION BOX 96.4 _ TEST PIT ,`• "�� •' ''�' `=�' k•t;,M�%' "wrai;� : :c�a SEWER .INVERT OUT OF DISTRIBUTION BOX 96.2 » •.* + 'p y r 2 2 - WOODEN FENCE SEWER `INVERT INTO LEACHINGAp Ap CHAINLINK FENCE �;_ �, .�k'• ,. -44 SYSTEM 96.1 Sandy Loam San Loam _._._._._._._._ PLASTIC LEACHING CHAMBER DETAIL BOTTOM of LEACHING TRENCH 94.1 �, = WIRE FENCE ry PLAN OF LEACH CHAMBERS WATER TABLE: NONE OBSERVED AT ELEV. 89.1 10' 10 YR 312 log 10 YR 413 = TREE LINE a;• ©, - •, ti "r ` " CULTEC 330 OR EQUAL a o o y•' '° ' :' , ', I NO SCALE NO SCALE 8 = OVERHEAD WIRES o . o EOP EDGE OF PAVEMENT , • d , _ it CONSTRLUMAI 0 T Y T M PROFILE 20. 10�YR 516 20. 10 YR 5/6 , TOP OF TO TANK TO AT LEAST TYPICAL S S E FOUNDATION '� F NISHEU GRADE - 100.5t WITHIN 6' FINW GRADE NOT TO SCALE GENERAL NOTES • s i' N, �e� • 1D1.D L�Mcyr� .N'I GRADE OVER TAW = 100.01 F7INS1#D p�DE 0� ADdt1ST COVER 1D 6' BELOW GFaADE C-1 C , Medium Sand • . ,. ' 1 BOX - 100.0f Medium Sond . . .. D cwADE OVER LEACHNG TRENCH • 100.Ot 42• 7.5 YR 5/6 1 `�• 3 BELOW GRADE T° 320' 10 YR 6/8 . _3• (m 1.) LOCUS AREA IS COMPRISED OF . LOCUS MAP Scale: 1" � 2000' 47 SCH. 40 PVC 9' (min) Cover Pam 0 �� �' ' 4' SCH. 40 PVC C-1 ASSESSOR'S MAP 140 PARCEL 136 -) O 2.07G FIRST 2 �° ) 36' (max) Cover Medium Sand RATE- <2 MW/W then 0 2.Ox NO PLAN DEFINES LOCi1S / CB DH FND . ;'j O 2.OX r t 2_ I Peone /8'tot/2' 132• 10 YR 7/4 NO NEATER �VCOl1NIERED DEED REFERENCE: DEED BOOK 22974 PAGE 274 (HELD) ,� : 10 14 BAD ' s�MP Leaching Area Requirements FINISHED4' PVC OWNERS: MARK do JENNIFER CURLEY tM / FLOOR ' 4' PVC 5 BEDROOMS AT 110 GPD = 550 GPO 154 PRINCE AVENUE 6 / MARSTON MILLS, MA 02648 In.a `r •r' REINFORCED CONCRETE... STONE 2.) PROJECT BENCHMARK • DATUM ASSUMED FOOTING - . • ' 99.6 - - •• �•• •�• NO GARBAGE GRINDER ,�,„ MAG NAIL SET IN PAVEMENT AT INTERSECTION OF N N x {• :. .•:..- :• -s NECK POND RD do WOODLAND AVE. EL - 100.89' (HELD) 5, �N PERC RATE = 2 /1 MIN. / INCH (CLASS 1 ) 3. m99 m _ ) ZONING DISTRICT• RC - OVERLAY DISTRICT. AP AQUIFER PROTECTION S �8'14' » 1500 GALLON SEPTIC TANK DISTRIBUTION BOX RPOD - RESOURCE PROTECTION OVERLAY DISTRICT 24,17 4S � LIAR = 0.74 GPD S.F. E:�•4r : No Groundwater Observed o E]ev. 89.t / / TO BE WTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE 12-02• MIN. LEACHING AREA OF SAS. MINIMUM CURRENT ZONING REQUIREMENTS / 100,1 MINIMUM AREA: 2 ACRES (RPOD) 99.8 24,28• \\ � k fNIP MEYER PLAN BOOK 5o PAGE 49 550 GPD/ 0.74 GPD/S.F. = 743 S.F. MINIMUM WIDTH: 100' & 100.3 I loco PROPOSED SYSTEM MINIMUM FRONTAGE: 20' , 4r \ X S 82'1341 N x 99.8 ------E� 0�_ 99.6 1 SIDEWALL (12'+44�(2')(2) = 224 S.F. FRONT YARD = 20 SIDE do REAR YARD = 10 100.0 , 71.34• X X 99.8 100.0 ' BOTTOM 44' X 12 = 528 S.F. 4.) A TITLE SEARCH WAS NOT DONE FOR THIS SITE; SHOULD ONE c/ ^ 1or DAE '-'• -- X X____._ X �� BE REQUIRED IT SHALL BE PERFORMED BY OTHERS. •STY X 100.2 TOTAL = 752 S.F. (210 PER ��� 210.40' "----�1C -- _ X _.__._.X�'b4 2S E 5. x 99.6 , �� X X _ ) THE PROPERTY LINE INFORMATION SHOWN IS BASED ISTING OF PLANS AND DEEDS. / x 99.8 �\\ , -7`- X N� crap ON CURRENT AVAILABLE RECORD INFORMATION h N % 3x e �� 3 IW42'40• THE CONSEX STING FEATURES SHOWN HEREON WERE �N N " 1�• 1oo.z , � x 99.2 _� („S DH FND 1a�,E t�'� TD •� 1p CB OBTAINED FROM AN ON THE GROUND FIELD SURVEY ? / m& ' ex ♦9e.7 9E.2(H�) i31.14• PERFORMED BY BAXTER, NYE do HOLMGREN, INC. x 99.6 CB DH FND . 9s.7 FEBRUARY 12 do 19, 2004 ` � (SEE DETAIL)' �) x 99.8 H 9 .2 x x 98.0 I / REFERENCES:PLAN PLAN BOOK 224 PAGE 49 PLAN BOOK 226 PAGE 37 x 9i`4 PLAN BOOK 1510 PAGE 49 P WPOSED'FOOT"" FOR i j `� PLAN BOOK 293"PAGE° i0 / §99.9 _ �x 9,4 ARCH ; � �\ S 84.42'4p' E 169.79' • MAP 140 PARCEL 136 18.65' 151.14' �:) COMMUNITY.PANEL NUMBER 250001 0016 D \ 0 21,120t SQ. FT. TILE;FLOOD�..WSURIAN'CE,,RATE MAP .�EF'NIE - THr- AREA A AS ZONE r, CB DH FND 100,4 x x 100.1 0.48t ACRES x 98.7RV AN AREA OF MINIMAL FLOODING. HELD) 8. I—, O 0 ` c r � 7.) PROPOSED SANITARY DISPOSAL, SYSTEM NOTES: 1Q'A#N, \ , ---__ 98,6 •3 z LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND MUST BE VERIFIED IN FIELD BY THE CONTRACTOR AND APPROPRIATE UTILITY �N COMPANIES PRIOR TO ANY CONSTRUCTION. �N.• 1 x 99,2 ` y, ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 ANY LOCAL RULES APPLICABLE. M� x O 98.5 N.T.S. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING x 100.5 �� x 98.9 BY DESIGNING ENGINEER 41100.2 / PROP b WOOD FRAME D1.UNC WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILUNG, i \ -. x 97.E FNOTIFY THE E OR NSPECTI NG NEER d BOARD OF HEALTH AGENT N. T O.F.. 101.0 .r / �� 3 / 1 Q / x 10 .0 FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. W910 100.4 x. 1 \ x 99.1 roN _ N McCORMACK i THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN / A /F / APPROVAL BY DESIGNING ENGINEER C� g ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC., SCH 40 x l00.1 1 x 99.9� \ x 99.5 / G+ \ / / x 100.5 \ Q • yb�Q� EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING • SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5, PER • � � .\` / 310 CMR 15.255. ` PROPOSED DRIVEWAY � 100,7 Ix lOLi � � � \ �\ x 98.3 i 40 Woodland Avenue i O 0 / 100.7 i �- ` 1 Lo x 99.9 \\`� i Osterville, Massachusetts PROPOM FOOTINGS FOR PORCH �-- --�_ • 12 i' /���. .� �'-•.� `` x 99.5 x 991 PREPARED TOR •• r f�/ Mark Curley x 101.5 j TEST PIT 1 \\` �,� : . , ' b +100.1 TEST PIT 2�100.1 F'j �� \ � � ,\ x 98.6 �� � �� , TIRE ' x 100.5 x 100.4 x 100.4 S v Situ & Septic Plan `\ cr 210.97- (210' PER 99,1 Dom) x t BAXTER NYE ENGINEERING & SURVEYING \� x 1gi✓1 N 84.54'it• W 262.19' TD x 98.1 Registered Professional Engineers and Land Surveyors q 100,7x 100.8 78 North Street- 3rd Floor, Hyannis,Massachusetts 02601 T Pon l00.7 100,4-• x s1.22' Phone- (508) 771-7502 Fax (509) 771-7622 10111 1 \ TBM: 100,3 x x 100.4 x100.5 99.9 9g - --- 30 0 30 60 MAG-NAIL SET �- 100.2 I �•„ / EL 100-89' 100,5 99.8 ._.... _ 100.3 X ,� 100.0 - + SCALE IN FEET ;� / �_ - - -x•-.. 100.3 x loos i 100 2 i - -•�-- - x SCALE: 1" = 10, DATE: 06/22/09 OD 0 � x 99,6 WOLAND _ _ 1 0.2 � , -- - _ AVENT j - .• �. I: _ - 100.9 100,2 - v « .•"" 99, �� x`_ 3 $a RI.Y SVE1 W PQt - -- IDUIMMNT TAP R0 81f ' OEPIIRIiMF.NT aF QMRONIrIENT�/1L�PROTECTION a 101 �- CERTIFY R •1Or4 --•�' AGE 70 - AND THAT THE ABOVE ANALYSIS WAS PERFORMED BY ME CONSISTENT WITH • 100.2 - i AT 401 � \ THE REOUIRED TRAINING. EXPERTISE AND DWERIENI DESCRIBED IN 310 CMR 15.017 OMNI N�` 100.1 ._.... -- °:1 `` sIGNATURE DATE 6 NO• BY DATE REMARKS DRAWING Ntl&M $ •._._ 4, \\ HOLD SIDE LINE PER PLAN 8001C 101.1 �3 P'�E 70 0: 2009 2009-016 SU wrksht 2009-016SP.dw Septic System Permit #2008.1 O7 2009-016 U, ,