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Home My WebLink About0075 BRIGANTINE AVENUE - Health 75Brigantine Avenue Marstons Mills P A = 098 047 -- — --- - - --- _ - 'J r TOWN OF BARNSTABLE LOCATIO�j ` TLLIJL ,AGE ASSESSOR'S MAP&PARCEL a INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:( e) size 'k NO.OF BEDROOMS OWNER PERMIT DATE: g COMPLIANCE DATE: o 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) f Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of 1 hing facility) / Feet FURNISHED BY 1 t s.. TdcJ../�, � o��4J��Q► 01 33 3 go -► a3c Yr '` :J y cs 11�� TOWN OF BARNSTABLE LCYCIATION �` SEWAGE#��© VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. r SEPTIC TANK CAPACITY LEACHING FACILITY:(type) cA..,`% a., ( e) NO.OF BEDROOMS OWNER v:, / PERMIT DATE: )a ( t?(:�) COMPLIANCE DATE: E� 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) j Feet FURNISHED BY k C.AU;Z5 �, �' '�; T � a X'A JLB A 63 = A t ° No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rl Uratlon for Disposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair(V�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.-IS � Owner's N Address,and Tel.No. Assessor's Map/Parcel 4::k13? Installer's Nar4e,Address,and Yel.No. Q� �6� Designer's Name,Address,and Tel.No.,5111,`�--3012�1"93/Z' Type of Building: Dwelling No.of Bedrooms Lot Size `/ ire-..isgfl. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) j gpd Design flow provided C4 SR, gpd Plan Date hL'p©Q 0 Number of sheets Revision Date Title Size of Septic Tank � ,� � 1 �^�1 ] Type of S.A.S.Cd Description of Soil `) 1-40 Nature of Repairs or Alterations(Answer when applicable)r� 'C� `� � �� .1��,�C�1✓�. \�+��C� lam, � �yaal w.,�`es �� -v� 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. Si a Date -7 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued -------------- J � P � -0, No. Fee vo THE COMMOf.f,I AL H OF MASSACHUSETTS Entered in computer: �. PUBLIC HEALTH DIVISION . TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIptJYlcation for Disposal *pstpm (Construction Permit Application for a Permit to Construct( ) Repair( pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.-I S- 1Ae_ � C Owner's Name, and Tel.No.? - a3C- a'771Y Assessor's Map/Parcel , Installer's Name,Address,and fel.No. Designer's Name,Address,and Tel.No.S�d'•3G�-33/l Type of Building: Dwelling No.of Bedrooms Lot Size �(� �1�.�,,Ssg.fr. Garbage Grinder( ) _ Other Type of Building Q No.of Persons Showers( ) Cafeteria( )- Other Fixtures Design Flow(min.required) t `� gpd Design flow provided gpd �.. Plan Date e ,�,c p�� Number of sheets Revision Date Title Size of Septic Tam( �� j Type of S.A.S.Cam. Description of Soil ti" e it 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 Board of Health. Si Date - . -Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 6 / .�--- � Date Issued C' --------------------------------------------------------------------------------------------------------------------------------------- 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 - --� at '7 A`� o has been constructed in ccor ance with the provisions of Title 5 and the for Disposal System Construction Permit No.. I-dated Installer,,,&".p c T—� ,r1-r-' Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system (ill functio Date Inspector -\ No. or_ Fee eft/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal i�pstem Construction permit Permission is hereby granted to Construct( ) Repair( X,) Upgrade( ) Abandon( ) System located at ��, sk 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:Construction must be ompleted within three years of the date of this permit. Date Approved b( own of Barnstable - Ria hard Ve S@a% Intarlm D�@dor $� Pubfic H@o-tth Division Nn 200 Main Ift-d,Hyannh,MA 026.E s. Wee: 508=8624644 5084KW04 r, Dates ID sewilge@ Ass@ssor;a i a�p4pair@@ D@aatp@r. Address: Addr@ssa O e - sued a permit to Ifloidn it mptic sy5tem at N 6 WtI I E ftvL:-: based on it dosip drawn by -BPI 2Z X— I @With that the fia ptic system referenced above was installed a ubitan{tmIli �� to the d@§i which may include minor 11 roved oban a� o h a t �iofdlto . ow.161 orb distribution box and/or a�eptio tom: All out.(if requk@) was I'llopected and the jo la were i'oand aaitismryd _ I gortifythat the e- _ st abovewas instalkidwith ffi or @hain o (i.e. , water n 101 14 rdl re ocation of the SAS or any vemleal felociffloo @ my @Ompofiefi# of the�� a� system)but In �a�ea anae with State& Local Regulation& plan Wiloh or c iflea a=built by degiper to follow. Strip out(if figuired) wa§ impede and the§oIl were found jai isfact r: 1 that the System Above wns constructed i_n ea plIMN nth the tefffib of tho_ approval Wtor5 ( f applicable) 51gature PLRARR R TO RA ftBLEC _ W. R No ^/ �L/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliLatlon for VipoBaY 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System 2 Individual Components Location Address or Lot No.'3 ie k , �,�T'.v\•P, q Owner's Name,Address,and Tel.No.'77�.`Z Assessor's Map/Parcel p 5Tr�y� Installer's Name,Address,and Tel.No. S �g��oQS'�' Designer's Name,Address,and Tel.No. jam 366 ::cS✓`Sti� c.� Type of Building: Dwelling No.of Bedrooms Lot Size Aa r^CS f Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Q gpd Design flow provided 34ea gpd Plan Date (9t ` ` Number of sheets Revision Date Title Size of Septic Tank (CSC C� '� �, Type of S.A.S. Description of Soil ./-,.j Nature of Repairs or Alterations(Answer when applicable) 2— Datelast 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 byCthis ?rd Health. S Date A,,=� Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued cry ---- - - - - ------- - --- ter... Y$J♦ � lay - t T No,__-1!' � J ! ..` Fee THE COMMONWEALTH OF MASSACHUSETTSEntered in computer:�^ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, IiASSACHUSETTS Yes ;' 9pplication for V'spOsa 6pBtem Construction jhrmit Application for a Permit to Construct( ) Repair( ) Upgrade(,,Abandon( ) ❑Complete System. ndividual Components Location Address or Lot No:<'(4-� .� ,n� P Owner's Name,Address,and Tel.No. Assessor's Map/Parcel p F, Qksl ' Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. S-o 7- 3C6 —33// ��-�SZ�\ �,ca�-fi✓.J" �c...��c� `nn-c�.l�..r--t-Sc��S'�s'..C . Type of Building: Dwelling No.of Bedrooms �� Lot Size , ,��r�4i*. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ' gpd _ ,b Plan Date �� ` �7 Number of sheets Revision Date Title- ` Size of Septic Tank ` �(�,- � -* N Type of S.A.S.C��__ Description of Soil —k Nature of Repairs or Alterations(Answer when applicable) r ��v's�-. � =a � a� J Date last inspected: Agreement: • t 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;nbt.to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed 1 it — Date - r- Application Approved by Date Application Disapproved by { Date for the following reasons Permit No. � y ` Date Issued ----------------------------------------------------------' ---------------------- ---- ---------------------------------- THE COMMONW;,EALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(V�r Abandoned( )by_ `Z at has been constructed in accordance ` } with the provisions of Title and the for Disposal System Construction Permit No_`,2=1�5�dated Installer tf.�.a��.� '��--N �-- - Designer tom/\�i .�_r tr #bedrooms Approved design fl god The issuance of this ermit shall not be construed as a guarantee that the system c ioas des i "ed. Date /_ Z�I 7 D Inspector ,.� `t No. n J Fee )-A THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction permit _-- Permission is hereby granted to Construct( ) Repair( ) Upgrade( v-, Abandon( ) System located at �. C Qc ,Jam. 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:Constructiio must be completed within three years of the date of this pe it. Date CY��} /chi/ Approved by�_ Town of Barasta e, Regulatory Services ,. chord V.SM4 Interim Dirogtor Public HoWth :division 410 Strout,t yamilb,MA 026,01 orm Data Addrema _ to r@s§R A SiMed a PMWI to atall a Oil t for) §Ptie,gY t t �t _. - - -.bead on f d ftft drakyn by rg g r 5 t _ t the t1 y t r e d dbovig w4 1rl ta►i I t t1 11 try of tj@ tb@ j : 1t1g1� MAY 111 14d Ot a r cf? lat a1 � ati n 1 tt t PA WO pti tam. �t 1 1 way mp t o gt�i1h w@re,fbjjr?d @atIsf-h-iL--tory4 1 t �e ti t �a 1 ove wtcs fiasw d With or a MI gg 4,q, try 1 § 1Y�1 r � tia SAS or are .vie- ��1tt tit df di'� 6 €i � Btgnt) b4t in P.ocoy tinge -1--t t t t. al 1atl tp . rt1i d s a 11t 1 t elf Strip (if fc-quifed)wag 1��t�� 1f� wtrig found at18f tO . 1 g ti that tl t f'c-Teric 1 t � li with the t of tlio- RA fll ljr v letters(if applicable) 40 T `R. ,._ ; s x igmf Cof i Aqm Olin Rey I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments s� 75 Brigantine Ave 01 Property Address Goulet m Owner Owner's Name s information is required for Ma 10-20-18 every page. City/Town State Zip Code Date of Inspection Qj 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: A. inspector Information S�- 13 ��{ When filling out p 1 forms on the computer, use Douglas A Brown only the tab key Name of Inspector to move your D.A.Brown Inc cursor-do not Company Name use the return key. P.O.Box 145 Company Address Centerville Ma 02632 Cityfrown State Zip Code 508-420-4534 S14297 ' " Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 10-20-18 Insp tor'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 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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: At time of this inspection this system met all passing requirements. This report can not predict the future performance under the same or increased usage. This report is not to be used for bedroom count determination. 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 P Y 9 Commonwealth of Massachusetts _ l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ 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: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts 9 y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Citylrown 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 or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/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 CM 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Y� Commonwealth of Massachusetts (P Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedreoms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: According to as-built card this system consists of a 1000 gallon septic tank-dbox-and 2 500 gallon chambers with 4 ft of stone. Number of current residents: 1 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 use? ❑ Yes ® No Water meter rea6ngs, if available (last 2 years usage(gpd)): Detail: 16-----198 17---234gpd Sump pump? ❑ Yes ❑ No Last date of occupancy: currently occupied 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 to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w� 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osteryllle Ma 10-20-18 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: Owner stated pumping in August of 2018 by Wind River Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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: 9-17-03 per as-built Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): 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 la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 2 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: 1000 gallon Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was pumped in August of 2018 so it was clean at time of inspection. There was a zabel filter that was completely clogged so we removed and cleaned it. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 I c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityfrown 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.): D-box was functioning properly. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments L 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osteryille Ma 10-20-18 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *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: Type: ❑ leaching pits number: 2 ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .V� 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. City/Town State Zip Code Date of Inspection D. System information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Chambers were functioning properly with no signs of failure at time of inspection. I recommend installing a riser on s.a.s due to depth. 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 (P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osteryille Ma 10-20-18 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 c o, Commonwealth of Massachusetts Title 5 Official Inspection Form �' le Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately 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 Inspection Form I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments uv 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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: greater than 5 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: 10-20-18 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: owner supplied design plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 75 Brigantine Ave Property Address Goulet Owner Owner's Name information is required for Osterville Ma 10-20-18 every page. Cityrrown 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 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 'Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LAN tlA,40 SEWAGE q5,. 7 • VILLAGE M M ASSESSOR'S MAP&LOTE3 _' _ t INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACIIT LEACHING FACILITY:(type) r (size) NO.OF BEDROOMS 3 BUII DER OR OWNER r ai,,C�— U T— PERMTTDATE: �f F C'I COMPLIANCE DATE: G' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply WeU and Leaching Facility (If any weUs 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 AS, Qa, ! http://www.townofbamstat•le.us/Assessing/HMdisplay.asp?mappar=098047&seq=1 10/21/2018 • Assessing As-Built Cards Page 2 of 2 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=098047&seq=1 10/21/2018 TOWN OF BARNSTABLE LOCATION �� '-1� SEWAGE # mD VILLAGE ASSESSOR'S MAP & LOT ` INSTALLER'S NAME&PHONE NO. 1 SEPTIC TANK CAPACITY S`ClAn LEACHING FACILITY: (type) �( G��CS (size) U NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: 47 09 COMPLIANCE DATE: 03 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 �LV Ala, No: 0-0 3 `( ` ' FEE�- - j COMMONWEALTH OF MASSACHUSETTS Board of Health, '—jbtCn TeC�Qk , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) RepairX Upgrade( ) Abandon( ) - ❑Complete SystemAndividual Components Location .S �� Owner's Name Map/Parcel# 04,8 O M Address Lot# 'F Telephone# Installer's Name "C Designer's Name Address. S �C Address O Telephone# (Dq Ps - 1 Telephone# d q V ( d �R -1� �53 Type of Building '`RQ,\ Lot Size� %!S sq.ft. Dwelling-No.of Bedrooms C Garbage grinder Other Type of Building &IQ No.of persons _Showers (4,Cafeteria Other Fixtures 0- UaV Design Flow (min.required) U�J� gp Calculated design flow��3� Design flow Alided 3'�1• S gpd Plan: Date (of CIA 16 S Number of sheets Revision Date Title � p s U A ®sek;c S,a Ike^- U yr-crV Description of Soil(s) (2�Qn V Soil Evaluator Form No. Name of Soil Evaluator cwP1nQ11 Sklate of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS !�)A Or-,. �:�siuiviivu i i � W Y.rr"Lry !'\STALLATION AND CEFITIFY IN W.RiTii:- SYS 9-1 The undersigned agrees to install the above described Individual Sewage Disposal System m a co a `��mv lions ofTITLE 5 and further agrees to not plac cyst operation until a Certificate of Compliance lias�been�issuedx y the oard of Health. Signed Date —' D� q_,?-03 Inspections .—.�.h,«.i.y.,l�n<'� t 7 c)..r��/`'�•°�.....+`+'`.....-- .,fa�`r j"` �`�'^''""." Z J...•.�,-ti'"r•"r..,�,..,.�,.ua.J'y"'�-'�—"C�'"bc�.,;^'`L+�e.,..-''-..'S -� No. 17\ �Q 3 FEE d ra ! Board of Health, n� �e MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT;' Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - ❑Complete SystemA(IIndividual Components Location Owner's Name v.. Map/Parcel# Address Lot#---- + Telephone# Installer's Name t�Z r° S C U�CR Designer's Name S h ��J��pf,S`�9lY�G\— . # : Address. 5 '�c�c�4��. Address l t� `'fees .� C �� 1XJ•�,� Fl Telephone# Co'C.'.'' _ �, Telephone# ,� C) ` Type of Building Y'�r�a� �` Lot Size 490 I sq.ft. ""Dwelling-No.of Bedrooms """C�c�S��_ �� Garbage grinder OyJ/f}• -,_.Other-Type of Building �t � '�' � n'one No.of persons c7a Showers (V�,Cafeteria (`y1.) Other Fixtures A C vc✓1 i (1 L-C V Design Flow (min.required) c) gpd`" Calculated design flow Design flow Avided gpd Plan: Date Number of sheets 1 f Revision Date Title ,' i' f'ia k g�I 5�Q 1 U rcc Description of Soil(s) 5'�c Soil Evaluator Form No. Name of Soil Evaluator C-C° fY32P ate of Evaluation,`(-0 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place�PN:KF ' eration until a Certificate of Compliance has been issued by the Board of Health. Signed la,w, Date 36 4- tF 03 Inspections ' No. quo 3-N�sy COMMONWEALTH OF MASSACHUSETTS FEE S Board of Health, t'S A`Q-►V S l AW �. , MA. CERTIFICATE OF COMPLIANCE k Description of Work: 41 Individual Component(s) ❑Complete System The undersigned hereby certi that theSewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (L)!'Abandoned ( ) by: n k..t ieS L. `�' e4(y'�4__ at d 6,en C4 Ar.,-y Y Yt Q IA VY°_. BSI F ',J\�� has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No.c?u03 US9 dated . Approved Design Flow (gpd) Installer y Designer: Inspector: jo V Date: a The issuance of this permit shall not be construed as a guarantee that the system will function as designed. ' No. eo yS7 FEE �y " COMMONWEALT14 ®F M SSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; U Construct( ) Repair.( pgrade( ) �Ab—a-n�don( ) an individual sewage disposal system at aj rk ►�'rry�s i�L-�. jj G) as described in the application for Disposal System Construction Permit No. ho7-Y51 ,dated �X/U t Provided: Construction shall be completed within three years of the date of this p "mit. Al local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA (-Date, /It 0/U Board of Health . � t � ' ' � V TOWN OF BARN-STABLE LOCATION SEWAGE # VILLAGE �� - ASSESSOR'S MAP & LOT t-- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY STr j LEACHING FACILITY: (type) f C (size) o251's r Icar i NO. OF BEDROOMS I j BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: r. 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 j Edge of Wedand and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 5W IQ .0149 1 tot( i - I l t rLevi- 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304 I P . u'L i I � I , NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. _ PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM t � , hereby certify that the engineered plan signed by r^ie dateC 2.3 03 concerning the property located at 6 `klZmeecs all of the T Ioi'owin, c:nteria-- • This failed system is connected to a residential dwelling only. There are no :ommercia! or business uses associated with the dwelling. • The soil is ciass:;ied as.CLASS l and the percolation rase is less than or equal to 5 -rLnut:s per inch. The applicant may use historical data to conclude this fac, or ma •_onduct pre!irrurary tests at the site without a health agent present. • There :s no increase in flow and/or change in use proposed • i here are no vanances requested or needed. • The bottom of the proposed leaching `acility will not be located less than fourteen fee; aoove the maximum adjusted groundwater table elevation. �Adiust the j nunc!wwer table using the Ecimptor method when applicablel Please complete the following: I r�,.) "fop of Ground Surface Elevation (using GIS information) _ �C Y--) 2 I B; t].u' !e at:or, ad;ustment For in;gh G.W.,J3.3.. _ --_. •3o j �)`FFFRENa. . WEEN A and BS'GVED DATE: NOTICE t 3asec �pta e above information, a repair permit will be issued For bedrnomsl �,n ,tdiuonat bedrooms are authorized to t`se future without engineered ;ept.c s_/;(em plans. -. __--- )caih!C:du paccamp I R_N. J ' Permit Number: Date: , Completed by: HIGH GROUNDWATER LEVEL COMPUTATION I Site Location: /1.r,�`TS1p. ��2�t1t ',V__ Lot No. 82421 Owner: Cpnrgd, �py�'� Address: G Contractor: `,,��('�� UtCbt�lY�.c�1�� Address: �• i air Notes: i STEP 1 Measure depth to water table (� 03 vc� tonearest 1/10 ft. .............................................................................. .Date mo h/d /year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OAppropriate index well.................................................... S3 OWater-level range zone ..................................................... C STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... 51 — a-a mo h/year STEP 4 Using Table of Water level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water level zone (STEP 2B) determine water-level adjustment ...........................................:..:.......................................... 13.3 STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to.water levelat site (STEP 1) ................................................. ' ........................... I; Figure 13.—Reproducible computation form. 15 j r CARMEN E. ,SHAY (508)-548-0796 ENVIRONMENTAL SERVICES, INC. P.O.Box 627,East Falmouth,MA 02536 September 19, 2003 RE: Certification of Title V Septic System Installation: Residential Property—75 Brigantine Drive, Osterville, MA Dear Sir or Madam: On September 18, 2003, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 75 Brigantine Drive, Osterville, MA, based on a design drawn by Shay Environmental Services, Inc., dated, June 22, 2003. �s 4N/N I Certify That The Septic System Referenced Was Installed Substantially According to the Plan I Certify That the Referenced Above Septic System Was Installed With Changes but in Accordance With State and Local Regulations, Revisions or As-Built Plans/Sketch will Follow. The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is Required. If you have any questions, please do not hesitate to call the undersigned at (508)-548-0796. Sincerely, CARMENE. SHAY ENVIRONMENTAL SERVICES,INC. OF 4f4ss9 C ARMEN sN E. SHAY Carmen E. Shay, R.S., C.S.E. ��L Ti 0 President �Fs ir�sPEc� 12 ECO-TECH Toto`eg 9 199?ENVIRONMENTAL q .�` �Ty^cNojTgB(f. '10 THIS FORM IS A FACSIMILE OF THE STANDARD SEPTIC INSPECTION FORKISS,UED BY THE MASSAC SE,"TS DEPARTMENT OF ENVIRONMENTAL PROTECTION (revised 4/25/97) 's �� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FFORM PART A CERTIFICATION Aid a-,t LL S Property Address: 75 Brigantine Avenue,�6)sterville- Address of Owner Date of Inspection: September 19,1997 (If different) Name of Inspector:David D.Coughanowr,R.S. I am a DEP approved system inspector pursuant to Section 15.340 of Tide 5 (310 CMR 15.000) Company Name Eco-Tech Environmental Mailing Address 43 Triangle Circle Sandwich,MA 02563 Telephone Number: (5081 888 0185 CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper don and maintenance of on-site sewage disposal systems.The system: X Pa ITN OF Mqs �[tt ally Passe, Furt%Ygalu un the Local Approving Authority GHDA�N Inspector's Signature v ]d v' Q•�, Date: I G 1 19 d! GEP Inspector's Note=_> AN /ST IAO to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below.The s - h een evaluated according to the conditions observed on the day it was inspected.No estimate or guarantee o m longevity is made or implied by a passing determination. The System Inspector shall submit a copy of this report to the local Approving Authority within thirty(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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B,C,or D: A]SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined", explain why not The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 7.5 Brigantine Avenue,Osterville,MA 02655 Owner. Betty Walton Date of Inspection: September 19, 1997 B] SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced. The system required pumping more than four 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 obstruction is removed 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 the public health,safety and environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water. Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm.Method used to determine distance (approximation not valid) 3) OTHER SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner. Betty Walton Date of Inspection: September 19, 1997 D) SYSTEM FAILS: You must indicate either"Yes"or"no" to each of the following I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 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 Soil Absorption System,cesspool,or privy is below the high groundwater elevation. Any portion of a 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.If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen E) LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following. The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of systems is 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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. The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00.Please consult with the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant or Board of Health. X _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection. X _ As built plans have been obtained and examined. Note if they are not available with N/A X _ The facility or dwelling was inspected for signs of sewage backup. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. including X _ All system components,excludin the Soil Absorption System.have been located on the site. X _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. X _ The facility owner(and occupants,if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. The size and location of the Soil Absorption System on the site has been determined based on: existing information.Ex.Plan at B.O.H. X _ Determined in the field(if any of the failure criteria related to part C is at issue,approximation of distance is unacceptable) [15.302(3)b)] SUBSU RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 FLOW CONDITIONS RESIDENTIAL* Design flow:_g.p.d/bedroom for S.A.S. (design plans not available from Board of Health) Number of bedrooms: 3 Number of current residents—L Garbage grinder(yes or no): no Laundry connected to system (yes or no): yes Seasonal use(yes or no): no Water meter readings,if available(last two(2)year usage(gpd): 1995:220 gpd 1996: 134 gpd 1997(first hal : 104 gpd Sump Pump(yes or no): no Last date of occupancy: current COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no): Industrial Waste Holding Tank present: (yes or no: Non-sanitary waste discharged to the Tide 5 system: (yes or no): Water meter readings,if available: Last date of occupancy: OTHER: (describe): Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System has not been pumped in recent past(owner) System pumped as part of inspection (yes or no) No If yes,volume pumped: gallons Reason for pumping.-- TYPE OF SYSTEM: X Septic tank/distribudon box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes,attach previous inspection records,if any) I/A Technology etc.Copy of up to date contract? Other APPROXIMATE AGE of all components,date installed(if known)and source of information. Age: 14 years System installed by Spiro Theohaddes(BOH permit#81-521) Sewage odors detected when arriving at site: (yes or no)_ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 BUILDING SEWER: (Locate on site plan) Depth below grade: 18 in Material of construction_cast iron —X—40 PVC_other(explain) Distance from private water supply or suction line 2 5+ feet Diameter 4 inch Comments: (condition of joints,venting,evidence of leakage,etc.) Sewer is vented through roof and appears structurally sound with no evidence of leakage or backup into dwelling SEPTIC TANK:—X (locate on site plan) Depth below grade: 18" Material of construction:—X—concrete_metal_Fiberglass_Polyethylene_other(explain) If tank is metal,list age_ Is age confirmed by certificate of compliance_(Yes/No) Dimensions: 8.5'x 5'x 6' Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle: 22" Scum thickness: trace Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 10„ How dimensions were determined: Probe to top of tank Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) Pumping recommended within 12 months,but not required at this time, Liquid level at outlet invert.Tank and tees appear st ucturalty sound and functioning as ntended No evidence of leakage in or Out. GREASE TRAP: none (locate on site plan) Depth below grade: 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: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 TIGHT OR HOLDING TANK: none (Tank must be pumped prior to,or 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 Alarm level: Alarm in working order Yes No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert: at outlet invert Comments: (note if level and distribution is equal,evidence of solids canyover,evidence of leakage into or out of box,etc.) D-box appears structurally sound with no evidence of leakage in or out.Effluent level at outlet invert PUMP CHAMBER: none (locate on site plan) Pumps in working order, (yes or no) Alarms in working order, (yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 SOIL ABSORPTION SYSTEM (SAS):_X (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods). If not determined to be present,explain: Type: leaching pits,number I leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number. Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Soils above leach pit appeared sandy and unsaturated.No evidence of surface ponding.breakout,lush vegetation or other evidence of hydraulic failure was observed.Leach pit contained 28"of effluent in a 6 foot pit. CESSPOOLS: none (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY:none (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner: Betty Walton Date of Inspection: September 19, 1997 . SKETCH OF SEWAGE DISPOSAL SYSTEM: include des to at least two permanent references,landmarks,or benchmarks locate all wells within 100' (Locate where public water supply comes into house) LEACH PIT D-BOX 3 4 p SEPTIC LOCATIONS 0 TANK B U A B 1 23.5' 13.5' 2 27.5' 15' 3 35' 19.5' 4 29' 39' A BEDROOM DWELLING # 75 W _Z J W W 3 BRIGANTINE AVENUE NOT TO SCALE SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 75 Brigantine Avenue,Osterville,MA 02655 Owner. Betty Walton Date of Inspection: September 19, 1997 Depth to groundwater: 15+ feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site(Abutting property,observation hole,basement sump,etc.) Determine it from local conditions Check with locale Board of Health Check FEMA Maps Check pumping records Check local excavators,installers X Use USGS Data Describe in your own words how you established High Groundwater Elevation. (Mm be completed) Comparison of USGS Topography maps and surface water elevation data 17'5 L0CA I N SEWAGE PERMIT NO. VILLAGE INSTA LER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISS E D DATE COMPLIANCE ISSUED /� �3 -1O f � o pRf�E wky THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH e »J.....................oF-:... .. ��._ .. ..��.-ant-----------Ac.�........................ Applira#ion for Mivnnal Workti Towitxnrtinn ranfit Application is.hereby made for a Permit to Construct j< or Repair ( ) an Individual Sewage Disposal System at: . . max........ �.✓.S ,nt .<e✓.�'.. �lJ. .....-��......---•--..... -- . Loca on-Address or Lo o. Owner Address .................................. .................. ... ...................................................................... Installer Address U Type of Building Size LotSnn.A_.f_ _..Sq. feet �-, Dwelling—No. of Bedrooms. .................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building yp g No. of persons_._._..:............... Showers ( ) — Cafeteria ( ) a' Other fixtures --------------------------------- WDesign Flow......._:�.........................gallons per person per day. Total daily flow.._.....�.;.36......................gallons. WSeptic Tank—Liquid capacity/cx`_.gallons Length/0.,. . -. Width-7.......... Diameter................ Dep1h-(n•'.'3- x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......!------------- Diameter..._. 1_3....... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by...... ®!rt° __._� . =5. i✓.......... Date... _6_, �Rj.............. Test Pit No. 1----Q7.......minutes per inch Depth of Test Pit-_/_c?.-._....... Depth to groun water_.. - __ L14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................-------- . -•-------•------- -------------;. ---•-------•--•--------------- O Description of Soil-- A.---sya_� . �tuo 4e...., ------ 01 ---- --------•-- -------------------------------------- x w ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- M. Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------•-----•-•---•---•••••-•••------•-•-•----••---•••-•-••-------•....••--•--------•.......--•--•••------••----•-------•-•-•••••-•••---•--••--••------•--•-•••••-••-••••--••••••-----.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITl.s:. 5 of the State Sanitary Code—The undersigned further agrees not to place the s stem in operation until a Certificate of Compliance has bAis by the boar f health. 9Sign d ...--_..... ..... l Application Approved By......�--- �_ �,? �--- .... ...................... �°� Date Application Disapproved for the following reasons-.........................................--................................................................... - -------•-----•----•-••---....---••----•••--•-•......----•••-----•---•-•••-•••-•-------••••••-•-•--•••...... Date PermitNo......................................................... Issued......................................................... Date • cd THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH v1/----------------- OF.... -�'`:�!F!r�-al�i'�� ✓ Appliration fur Disposal Works Tonstrnrtiun Prrmit Application is hereby made for a Permit to Construct 'F' ) or Repair ( ) an Individual Sewage Disposal System at: •• :: .......r?'��.:..:�dr�Ir T•:au ....:.J.......:. ..��:S ✓'�� Locatlion-Addres -, ,- or Lot-No. _-,...:e:: ......t�... :..�p....._:...::7. ............................................... ............. ff...S.l.� l'....... ........� ....... ...._..... `,(JU f Owner _....... Address J_r.)._. .................................. ...............•.............._. Installer Address d Type of Building Size Lot` ' _ ✓`__ ....Sq. feet Dwelling—No. of Bedrooms-___`` .................................Ex ansion Attic � ,rp ( ) Garbage Grinder ( ) a Other—Type of Building No. of persons__.__i�................... Showers ( ) — Cafeteria ( ) d Other fixtures .. �..: W Design Flow._...___-_.-_...........................gallons per person per day. Total daily flow........ gallons. WSeptic Tank—Liquid capacity`9 ___gallons Length�,.___�........ Width_S_........... Diameter________________ Depth.�?___�....... x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......------------- Diameter........_.F_........ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by.____yd........_..�r.:r_`-`.-�.. .. ......... Date.... ��/a _ Test Pit No. 1---- .._.__._minutes per inch Depth of Test Pit_`,;;'........... Depth to ground water........................ 44 Test Pit No. 2________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ .....................................................---------•----------------- .. D Description of Soil. h:t...... n:_K ........ Div.�� U =•••-•-•-•--•-----•••--•------••-•-•--••-••--•--...•••-•-••••••._......--••-...._..----•---•••----•••---.........••--••-----•-•-•-•---•-•. W x ----------•-----•------------------••------•--••••---------------•---•-----------•----•••••-----••----••---•-•-------------•---•-•---•-------•-••-•-•••••....------•-•••----•-•-••...•-•.....----•-... U Nature of Repairs or Alterations—Answer when applicable...................................................................................I....___.__.. •-----••---•-•--------------•------••-----------•--•---•--------------•-------•---••--------•-•••--•-_..__...--•--••-------••••-•--•------••-•-----•---------•-••---••--•--••••-••-•---.........--••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of A.i:1,;. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board'of health. Signed—_ ---------- •j J D t Application Approved By.... i- Date Application Disapproved for the following reasons-------------------------------•------------------------•---•-------------------•-----------------------•...... ..-•-._...._..-••••..............•-•-•••----••--••••••-•-•-•••---•--•----_._...--•----•-•-••-•.••---•.--_..__...•-•---••.....--•-••--•••---•-•-----•----•--............................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1...................OF.... !� %''�,✓i ....................... Trrtif iratr of Toutplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed )'or'Repaired ( ) bY = ----------- :------------- .............-5_ -------•-•------......_...........-•---....-•---._......---......_............._..._.....__... ..!,_ ..... Installer has been installed in accordance with the provisions of TIT E 5-of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. _____________ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE9 AS A GUARANTEE THAT THE SYSTEM WILL F 'NW ION SATISFACTORY. DATE...........%�/y d .................................. Inspector..-•-rCHUSETTS ---------•------••---------------------- ...... THE COMMONWEALTH OF MASS BOARD OF HEALTH ................................0F.....36�.. . a%il1 N .tl'.. ........... FEE..... ............ Disposal Vorks ntrnrtinn Pirrutit Permission is hereby granted- ------- ranted_`elf.......... __ %"............. .........r � r.................................................................... to Construct ( �S or Repair idual Sew ,-(� ) an Indiv :e Disposal y,em ------------•-----------•-•------------------•-••---•------•.._...._......... at Street as shown on the application for Disposal Works Construction Pet No..................... Dated ...................................... �- a of Health DATE-- ;f FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS LEGEND OSTERVILLE 4,5 50 I PROPOSED CONTOUR J I / ® PROPOSED SPOT GRADE 98 —— EXISTING CONTOUR J + 96.52 EXISTING SPOT GRADE FALMOUTH ROAD I W— EXISTING WATER SERVICE 3 I. \ TEST PIT cy Np GAR' ro � SCALE: 1"=20' LOCUS \ N rrAAQ' l 94 BRIGANVN AVE Q) \ / LOCUS MAP o LOCUS INFORMATION PLAN REF: 528/045 AAA �LiC, 47.G TITLE REF: C150032 �O• �Cl� F \ PARCEL ID: MAP 098 PAR. 029 � O PROPERTY IS IN ZONE II, IS IN ESTUARIES PROT. '9T \\ \ FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE SEPTIC SYSTEM F 45.7 \ REPAIR PLAN O• v \ \ LOCATED AT: '�• �. 4 .5\ \ \ 94 BRIGANTINE AVENUE \ OSTERVILLE, MA EXIST. 1000G I PREPARED FOR SEPTIC TANK I DENNIS PERRY I 41 .3 I READY ROOTER EXC. L O T 8 \ JUNE 18, 2020 I AREA = 0.46 acres of ass y + + -2 I I A TBM = EL. 41 .3 1 1 I ` No. 1140 y 85MT. 51-A8 @ `' I I cJ 0 sr TP SLIDER OHO 9NIN • ,� I I MEYER & SONS, INC. P.O. BOX 981 EAST SANDWICH, MA. 02537 I t� PH: (508)360-3311 40 4� I � FAX: (774)413-9468 Q meyerandsonstitle5®gmail.com 44 V 4 6 SHEET 1 OF 2 J 1894 S ELEV. TOP NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS + FOUNDATION: BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE I (upper) FINISHED GRADE (42.0) 48.50 F.G.EL: 41.50 F.G.EL: 42.0 F.G. EL: 41.80 4 A MAINTAIN 2X MIN SLOPE OVER LEACHING AREA am Sol a• 2" OF 3/8" DOUBLE WASHED F.G.EL: 40.0 3/4" - 1-1/2" . . :; STONE OR FILTER FABRIC DOUBLE WASHED STONE 4" SCH 40 PVC 1o"f s ®®®®• O ®®®® 14 ® S= 1 7- (MIN.) ®®®®®®®®®®® a: TEES ARE TO BE INV. 38.35 F ®®®®®®®®®®® :a 4" SCH 4o Pvc 2 E F. DEPTH ®®®®®®®®®®® U. •1 INV. 38.70 Jim= INV. 38.15 4' 2 X 8.5' 4' BAFFLE PROPOSED DB-3 EXISTING OUTLET B ., .. . .... . , DISTRIBUTION BOX EFFECTIVE LENGTH = 25' INV. 38.95 (H20) INV. ELEV.= 38.0 EXIST. 1,000 GALLON SEPTIC TANK OF GAS BAFFLE TO BE INSTALLED ON �� Mgss9� BREAKOUT OUTLET TEE AS MANUFACTURED BY �� do TUF-TITE ZABEL, OR EQUAL DAR N M. ' -4 TOP CONC. ELEV.= 39.0 ELEV.= 39.0 , NOTES: � IM 1) CONTRACTOR SHALL VERIFY ALL EXISTING N 4 INV. ELEV.= 38.0 ®PIPE INVERTS PRIOR TO CONSTRUCTION �. E3 E3 2) D-BOX SHALL BE SET LEVEL AND TRUE TO �PE�/S ®®®®®®GRADE ON A MECHANICALLY COMPACTED SIX �a� ®®®®®® INCH CRUSHED STONE BASE, AS SPECIFIED IN lC� BOTTOM EL.= 36.0 3.75' S FT. 3.75' 310 CMR 15.221(2) I u 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK EFFECTIVE WIDTH = 12.5' WITH 1500 GALLON SEPTIC TANK IF FAILED, SEPARATION 5.20 FT. DAMAGED OR UNDERSIZED. SEPTIC SYSTEM -PROFILE 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 30.80 _ SOIL ABSORPTION SYSTEM (SECTION) GAS BAFFLE AS REQUIRED (500 GALLON LEACH CHAMBER) SOIL LOGS P#: TPT-20-119 GENERAL NOTES: DESIGN CRITERIA **IN ZONE II AND ESTUARIES PROT.** DATE: JUNE 15, 2020 1. ALL CHANGES To THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOM DESIGN BOARD OF HEALTH AND THE DESIGN ENGINEER. SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) SOIL EVALUATOR: DARREN MEYER, R.S., CSE 1614 # 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS WITNESS: DAVE STANTON, BARNSTABLE HEALTH DEPT. OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. DAILY FLOW: 110 G.P.D. X 3 BR = 330 G.P.D. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR GARBAGE GRINDER: NO not designed for garbage under Elev. TP-1 D� Elegy. TP-2 TO INSPGN ECTION D APPROVAL BY THE BOARD OF HEALTH AND THE ( 9 g g grinder) 41.80 A 0" 42.00 0" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING SEPTIC TANK: 330 gpd x 200% 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK LOAMY SAND '4 LOAMY SAND FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. tOYR 3/2 10YR 3/2 ENGINEER BEFORE CONSTRUCTION CONTINUES. 41.13 8" 41.25 9" 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. B B USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4, LOAMY SAND LOAMY SAND 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF , , , , 10YR 8/8 1oYR t36 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF STONE ON ENDS & 3.75 STONE ON SIDES: 25 L x 12.5 W x 2 D 39.55 C 27" 39.B7 / 28" HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. SANDY LOAM C spy LOAM BOTTOM AREA: 25 x 12.5= 312.5 SF 2.5Y 7/2 2.5Y 7/2 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 38.0 46" 38.0 48" TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF C2 C2 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING J e PERC TEST MEDIUM MEDIUM CONSTRUCTION. DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd A EL 36.30 SAND SAND 10. EXISTING LEACHING TO'BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 2.5Y 6/4 2.5Y 6/4 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 30.80 132" 31.0 132" 12. THIS IS NOT TO BE BE 6SED A FOR SEPTIC SYSTEM NE SURVEY ONLY PROPOSED SEPTIC SYSTEM UPGRADE PLAN AND PERC RATE <2 MIN/IN. (•C2" HORIZON) 13. NO PRIVATE WELLS WITHIN 150. OF PROPOSED LEACHING. 94 BRIGANTINE AVENUE, OSTERVILLE, MA NO GROUNDWATER OBSERVED 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. Prepared for: Perry/Ready Rooter Exc. 15. ALL PIPING TO BE 4" SCH 40 O 1/8%FT (UNLESS SPECIFIED) • Darren M. Meyer. R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 Design and Site Plan by: SCALE DRAWN DATE conduct soil evaluations and that the above analysis has been performed by me consistent with the ' MEYER&SONS,INC. N.T.S. DMM 06/18/20 uirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam in October, 1999. �: PO BOX981 E4ST SANDWICH,MA 02537 REV DATE CHECKED SHEET NO. 50"2--2922 DMM 2 of 2 50 LEGEND OSTERVILLE \ PROPOSED CONTOUR moo' \ I� PROPOSED SPOT ,GRADE cy EXISTING CONTOUR �Q e n + 96.52 EXISTING SPOT GRADE 5 2 �e \ W EXISTING WATER SERVICE FALMOUTH ROAD \ ?so \ TBM = EL. 52.0 TEST PIT ly o c�R' BULKHEAD FOUND. SCALE: 1"=20' \\ LOCUS n_ O N 7513RIGANTIN AVE, \ LOCUS MAP 0 \\ 50.9 TP-1 \ LOCUS INFORMATION® PLAN REF: 38071-A \\ 14 . \ TITLE REF: C219171 TP-2 PARCEL ID: MAP 098 PAR. 047. \ \ PROPERTY IS IN ZONE II, IS.IN ESTUARIES PROT. \ OOL ® FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE LOT 26 \ AREA = 0.46 acres \ \ SEPTIC SYSTEM \ REPAIR PLAN 53.9 52.5 50.9 \ LOCATED AT: \ oo 75 BRIGANTINE AVENUE EXIST. 10000 OSTERVILLE, MA SEPTIC TANK 52.3 �• PREPARED FOR 53.5 \� / JOSE GUEVARA/ / oe, READY ROOTER EXC. JULY 30, 2020 53. O qA / of ,yqs 4N s J M YER No. 1140 e� NI TARP cs MEYER & SONS, INC. P.O. BOX 981 GM EAST SANDWICH, MA. 02537 • �`J PH: (508)360-3311 5 . FAX: (774)413-9468 meyerandsonstitle5@gmail.com 5Q SHEET 1 OF 2 J 1.894 ELEV. TOP NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS FOUNDATION: BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE (upper) FINISHED GRADE (51.0) = 52.0 �•a -F.G.EL: 50.90 ' F.G.EL• 51.7 F.G. EL: 51.3 � '-' VENT MAINTAIN 2X MIN SLOPE OVER LEACHING AREA a N �' 2" OF 3/8" DOUBLE WASHED F.G.EL• 50.2 4 3/4" - 1-1/2 STONE OR FILTER FABRIC DOUBLE WASHED STONE x 4" SCH 40 PVC a ammm• O mama ' TEE'S ARE TO BE 14 ® S 1 (MIN.) aa®®®aa®®®® :r 4" scH 4o PVC INV: 48.0 2 EFF. DEPTHJ lalam®mmm®m®m INV. 48.85 " INV. 47.80 4' 2 X 8.5' 4' GAS PROPOSED DB-3 EXISTING OUTLET BAFFLE EFFECTIVE LENGTH = 25' DISTRIBUTION BOX INV. 49.10 (H20) INV. ELEV.= 44.90 EXIST. 1,000 GALLON SEPTIC TANK OF GAS BAFFLE TO BE INSTALLED ON �� sJ''�y BREAKOUT OUTLET TEE AS MANUFACTURED BY a o DAR N.M. ELEV.= 45.90 NOTES: TUF-TITS, ZABEL, OR EQUAL R�\ TOP CONC. ELEV.= 45.90 1) CONTRACTOR SHALL VERIFY ALL EXISTING j No. 1 40�/ INV. ELEV.= 44.90 - ®®� ®® , PIPE INVERTS PRIOR TO CONSTRUCTION \ E E3 : 2) D-BOX SHALL BE SET LEVEL AND TRUE TO '(-ST ®m®®mm® mmmmmmm GRADE ON A MECHANICALLY COMPACTED six INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM EL.= 42.90 310 CMR 15.221(2) 3.75' S FT. 3.75' 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK f EFFECTIVE WIDTH 12.5' WITH 1500 GALLON SEPTIC TANK IF FAILED, 1��(`) SEPARATION 5.10 FT. DAMAGED OR UNDERSIZED. SEPTIC SYSTEM PROFILE (SECTION) 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 37.80 SOIL ABSORPTION SYSTEM GAS BAFFLE AS REQUIRED (500 GALLON H-20 LEACH CHAMBER) SOIL LOGS 'P#: TPT-20-148 GENERAL NOTES: DESIGN CRITERIA +eIN ZONE II AND ESTUARIES PROT.•• DATE: JULY 28, 2020 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOM DESIGN BOARD OF HEALTH AND THE DESIGN ENGINEER. SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF) SOIL EVALUATOR: DARREN MEYER, R.S., GSE #1614 2. ALL WORK AND MATERIALS SWILL CONFORM TO THE REQUIREMENTS WITNESS: DON DESMARAIS, BARNSTABLE HEALTH DEPT. OF.THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. EXCEPT AS REQUESTED BELOW: DAILY FLOW: 110 G.P.D. X 3 BR = 330 G:P.D. - 310 CMR 15.405 (1) (B): Elev. TP-1 Depth Elev. TP-2 Depth 1) A 2.1 Fr. VARIANCE FROM.310CMR15.221(7) TO Allow LEACHING GARBAGE GRINDER: NO (not designed for garbage grinder) 50.30 0" 50.30 0" TO BE 5.10 Fr.(MAX) BELOW GRADE VS REWD 3 Fr. (H2o/vm PRONDm) SEPTIC TANK: 330 gpd x 20OX = 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK LOAMY 3/2D A LOAMY SAND 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFl ( )/LLED PRIOR LEACHING AREA REQUIRED: 330 0.74 = 445.94 S.F. A IOYR 1OYR 3/2 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 48.97 16" 48.97 16" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING e a USE TWO (2) 500 GALLON H-20 PRECAST LEACH CHAMBERS W% 4' LOAMY SAND LOAMY SAND FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN IOYR 5/6 r 1GYR 5/6 ENGINEER BEFORE CONSTRUCTION CONTINUES. STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 47.30 36 47.30 36 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. C SANDY LOAMC SANDY LOAM 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF BOTTOM AREA: 25 x 12.5= 312.5 SF 2.5Y 6/6 2.5Y 6/6 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 45.30 60" 44.97 64" HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF C2 C2 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED PERC TEST MEDIUM MEDIUM TO A CONDITION AGREED.UPON BETWEEN OWNER AND CONTRACTOR. DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd O EL. 45.0 SAND SAND 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 2•SY 7/3 2.5Y 7/3 THE LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO BEGINNING 37.80 150" 37.80 150" CONSTRUCTION. PROPOSED SEPTIC SYSTEM UPGRADE PLAN f� 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PERc NO GROUNDWATER B"EIS°N) 75 BRIGANTINE AVENUE, OSTERVILLE, MA 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED.A PROPERTY LINE SURVEY Prepared for: Guevara/Ready Rooter Exc. • I, Darren M. Meyer, R.S., CSE, hereby certify that 1 am currently approved by MADEP pursuant to 310 CMR 15.017 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Design and Site Plan by: SCALE DRAWN DATE to conduct soil evaluations and that the above analysis has been performed by me consistent with the 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. MEYER&SONS,INC. N.T.S. DMM 07 0 requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. 15. PIPING TO BE 4- SCH 40 O 1 8" FT UNLESS SPECIFIED �3 /20 ALL / / ( ) Poeox9sf EAST SANDWICH,MA 02537 REV DATE CHECKED SHEET NO. 508-362--2922 DMM 2 of 2 ,.�.;; ,, :,• . � � S�--dt,..l,.. Er..-��/. ��-�cw,.,� AR.� M�.,�.�..1 5E A t...��1E ti... `�• � ---- - - - ^ ---'=' Bo.SE't� C7� U S. � �{ G.5 . C3AI�c'v>-� �.I.►..I fc. t._c LJES A M trJ t Mvm, OF G�'l r• � Ur..l L,,�S'S c�T�+E?vJ t5� �f�E.Gt�t E�. •��•rij,• y. At_L_ 4 'tP�5 T© 4,►.sID ioJ T'� SYSTEM Sµ0►.t 3_ a r r d :;� �. ,• Z� �.� � '�' ,_.. '� }( � -' 0 � A�.t.._. �EPT�c:.. T�«•.:ttic.S, PtsTi2rt5c.T'��:o+-•� 'pyox, A►...rtZ 0C) �11 -- - REMc"�Jlrc AL-i- Un15i1tTA -(c MATE121At.._ �E+JE�.?1-1 -C'� 1 �! ...� :-- .-.� T�� A. C'.Js.1" 4 QS OF "'0 A#30 5640K.Pk LA.- \'Lj tTti-1 Ct.A`� T. 'O; `ate 1Q A.d,.iU a '�C.t"A='t - . � �/~� �� t t-�CSTt F t E 4t -4E.►J T�+ 54 STE M tS rl E.A1� a E } ► 3 } i PL_ET b r.J A+, t� PtZt off'- "TO .�+t..u..>►..t Q C } io• 1 � � � � `'� � � ''t�--- V+...i�..E.S"S oTl--lE�?w t'�E t�..tc3T��, A L..i. �`l. '"��`�I = s4o.1 t rA e � � �M pc��t..rt� �H a t__.t:_._ �E ►►JS-t"a.�,..�...�to t w.1 �({ ' . 1 (`+ G \' 3 i l.1 TYPICAL. D V STR. ltAJT► o�J P—)0 x I + a � a+.rr-tOLA emu. A,.so to oco Tap .cam.�_ � r��a �-,�.tr Sr�r tc. r��.�1� � F't C All Sit-i C 'Ct•,11Z 8y AMFJ: i C^° - 1 -SCA L- C7�- E Q t,►p..t,. . i.k`�'Y�: z'A.*.t+�5 2�+��C•cC,E C.� rG+2c'�c..a�,N o�.j"� • ' Su£�,.1otC.. � � �=iti-�,�,-� �7c,ZAt:� f=-t,,S�`�iA ta�� r�. fr I ` �4►.Slsr� :�QA'DE- = GCS X' `� ��1E2 T"Av....�K..4..j..t .,.. �"klEe ��-,�3��p t-�A<__�ie-.1�=� pti'ei�!�7j �% ��. _._.._ � i � 1 - 1 �_ _ ZZ.�..Z ,'� �° ti✓ l�� ° j-"� ��NEU ST4�.��e �' -`�_-�--- `•� o � � �44�rJ �__!-6-,,� �.,� � t C. T�-'',.ems �� d i�" � �, • ��'iti! = 21�_ Al 3 �/Q C.�.v'•4TG�i��.-.' � LL._. "�('? ��, (....��..�.C '�J�al.$i-� . `ti � .� � v 17 b tax•, � ' � � � _..__ -� ____. � �y(�I GAS L. 5 E wrA� ` , '�s2C c: fi�' a a �T 2 j r•� , i ti tii %4 — � 6, Ac 0 �� Q�ox LF'+�'�':sx? CY�`3� �'_L�h,�"-;�1,►-_i� �``� . .PQw�At.�__�L"`"�$RZ� /1/$S'TJ9$E.E ---30mr PROP05ED 5F.\.LJAC L DISPOSAA. SVSrEM Lc> ' 61A t_t--O7 J S Gt PeO_Wk. ee PAY ��.. � ��tz_c c��i tot 7z5-t- U, �� z' E �,ATE ,�� Tle -- t �.a "" �, .A 'T MASS. �..�'... � _ ,._...��.-.-,.. pcc�kIt C S C A l_E � A 5 r. Crr F_0 J V t J 1 �✓�7/T l..r �\�1 t A;,4,IS S;-,q,�e Cly,t/g"nv C � Or w 0,F �`'° .�+ l..�� D Et.��9G G AQ .9 d C Sf= 3 T? G'F Z? P L 0 1 N�Jftrv?IA�i �'• .sG$tYE v e^ r 1 a 1�9-e46 ' 3' Is �.(..�' {• +� 30 7277/'QL 4 Z7 CT �'-_!%. `v, trG; / �t f rl `o p �� ------ -- ---- Ir _ 2000' IM *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. VENT PPE •Least 24 itohea tall) ou�LET°em Fltoti K �house ta' min. front schedule 40 PVL w/Charaoal odor FlIter SECTION A -A 9ET WW AAT►�aWT2 FT.to septic tank 12` CONCRETE ceR Existing Foundation s oorere PROFILE VIEW OF LEACHING SYSTEM tir K"MW�i. ,, •�,_1->. 2 trwtltt 6 i,, of fir"Ied Wove Grede ever Septic Tads - 99.25 01,13de over D-Box - ".00 / + over SAS - ELEV- 99.00 Z / f/ �•r 1 r/t'9irA.t 01yeAd.lrw. 'd�/r- //)i' /erlM A�iwr 5'S• WAET ,�� 1Y RIFT Z>3 ROUTE c Q S: 0.02 3 HOLE H-10 3, tioeMvaen (over T of SAS-Elev.-93.75 y y 3 N ,r ExlsTlt+G S-a.,o pST. sox s- 0.010• per toot f tas• 4` - scH. 4o T ;as' c y C% SITE +� W EXIST. PIPE-- 1,000 GAL. ,o, OR 70 + I o o > FRW FO4-#&IIDN 0 SEPTIC TANK , Effective Depth c, ozo 0 0 o PLAN SECTION CROSS-SECTION a Q II H-,0 PVC TEE n 20 0 o G b, yowl � - pj O o i? P 8.5' - + one B. tram - 19' "d U q� � F -erg REQUIRED STY M o -----f9' 3 THOLE H -10 DISTRIBUTION BOX = r w D-90x I M I I 3. A 5 3.5' a 0 8'� 3. SYSTEM PROFILE 6 in.of 3/4`-1 ,/Y m 0 12 a --- ------25' ll LOCUS MAP N If NOT TO SCALE compacted clans O o Effective Vida+ 'o iJ'fective Length _ Not to Scot 5 5 � e SOIL ABSORPTION SYSTEM (SAS) 6 it of 3/4•-1 1/2• m° 500 - C H-20 LEACHING UNITS / WIGGINS PRECAST compacted stole GENERAL NOTES �atts»_sl I�ttisls_1_aoir.=6s.� Not to Scale 1. Contractor is .responsible for Digsafe notification and protection of all underground utilities and pipes. 2. The septic„tank anq distribution box shell be set level on 6 of 3/4 -1 1/2" stone. 3. Backfill should be clean sand or gravel with no z-te•aA►r. ACCESS MANHOLES LOT #30 stones over 3" in size. 4. This system is subject to inspection during installation ® .. ca by Carmen E. Shay - Environmental Services, Inc. LOT ##29 Q 0° 1 5. The contractor shall install this system in accordance j��: - .�'• .:;_: �:`. =!`4 LOT 28 ) I k # t 36d 04� I J�7�� E with Title V of the Massachusetts state code, the approved plan r' ; I N �� _ and Local Regulations. ,I•le ACCESS cotes FOR W SEPTIC TAW, , 6. If, during installation the contractor encounters any traET - 1DISTRI eaoc,,�LEI1ptMtG T ---- '--- ' I soil conditions or site conditions that are different w ► TMA++ B S�O' T 25.27 , 1 from those shown on the soil log or in our design GRAOE SHALL BE RAISED TO MITHMt a OF IFONSHED GRADE. - t I tt installation must halt & immediate notification be 1 f 1 INSTALL TUF-IM GAS BAFFLES OR EQUALS Off`` ; s made to Carmen E. Shay - Environmental Services, Inc. :-; - 747 - . No vehicle or heavy machinery shall drive over the j t, septic system unless noted as H-20 septic components. STEEL REINFORCED PRECAST CONCRETE t \ t t 8. Install Tuf-Tate gas baffles or equals on all outlet tee ends. PLAN VIEW ', ', t , 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. 3-24• REMOVABLE COVERS 0 10. All solid piping, tees & fittings shall be 4" diameter Schedule 40 NSF PVC pipes with water tight joints. % ` 4• 11. Municipal Water is Connected to The Residence and Abutting t T a' trtr T-Jr.mM. raet to ousel e• outtET Ir �}"`� t i �t Properties Within 200 Feet. :4 E7a -�}- r m s -7. 41 E * 4'-0• min. t1 ,� THE PROPERTY LINES ARE APPROXIMATE AND _ e..w. uQdd deptht r _ � PROJECT BENCH MARK COMPILED FROM THE SURVEY PLAN GENERATED BY TOP OF BULKHEAD FOOTING BARNSTABLE SURVEY CONSULTANTS OF BARNSTABLE, MA ' I I� -----25*- ELEV. = 1010.00 (Assumed) ENTITILED "Subdivision Plan of Land in Osterville, MA" i -�• s„'=, - "-`f O + t, -f-- -;:-: BATED FEBRUARY 20, 1973, L.C. PLAN 38071-A (Sheet 2) e'-o• 4' -to , L ,j Failed t AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN > k. EACH • :, t Leach Pit 1 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN CROSS SECTION END-SECTION o 4 AREA t I I, , ; _ THE SEPTIC SYSTEM INSTALLATION. USE EXISTING 1000 GALLON H- 10 SEPTIC TANK ,� °-Box f --' ,'` I � j O # NOT TO SCALE LOT #27 j �`E� �Septic a90� rr LOT 25 LEGEND 27.5' r -PERCOLATION TEST TEST HOLE 0,' ,' EL = 99.00 / DENOTES PROPOSED Date of Percolation Test: (NEW PERC TEST) SEPTEMBER 18, 2003 '� DECK �\ 1 ,rr �� SPOT GRADE Test Performed By. CARMEN E. SHAY, R.S., C.S.E. Results Witnessed By. WAIVER( Per Barnstable B.O.H.) ��/ \` it X 104.46 DENOTES EXISTING EXCAVATOR: Roberts Septic Services, Inc. ' r SPOT GRADE Percolation Rate: Less Than 2 MPI ® 72" Below Land Surface EXISTING PL PROPERTY LINE Test Hole GARAGE 3 BEDROOM Ir No 1 I HOUSE 9; � _ PROPOSED CONTOUR ----- _ 0 99.00 EXISTING CONTOUR Loamy Sand CODEEP TE=ST HOLE & to rR 3/2 A, a.2sl to i i I I i i h PERCOLATION TEST LOCATION Loamy 100__ Sand 10 rR 5/6 ------ !!ASPHALT I _ --- LOT #26 /� - 6 FOOT STOCKADE FENCE e"- 40• 6, 94.661 DRIVEWAY 20,125 Square Feet Slit i I cn t 2.5 Loom /6 j If � �� Rev.: 9/18/03 - Performed new perc test to prove 5' separation. An"_ G fc of I 1 Loamy 98 _ I 13 ( I 2.5�;4 125.00' „ , PLOT PLAN G 93.00} Perc #1 PL S 39d 50 20,E Ij{' 60`- 72 OF PROPOSED SEPTIC SYSTEM UPGRADE Depth to Perc: 72" to 90" _ Medium Perc Rate= Less Tha 2 MPI � � Sand Groundwater Not Observed ----------------------+-------�� -----------------t_________-- --------------------- 1 PREPARED FOR 25 Y 7/4 No Observed ESHWT I 172 166 G ADJUSTED H2O Elev. = None B R I GA N TINE �4 VE1V LUE M R . C O N RAD G Cl U L ET AT --- �m (40 FOOT RIGHT OF WAY) �\ __--- #75 BRIGANTINE AVENUE s8 ""�~ OSTERVI LLE, MA Design Calculations �ZHOFM,gss PREPARED BY: Number of Bedrooms; 3 Equivalent to 330 Gal./Doy (330 Gal./Day Min. per Title V) �e � Garbage Grinder: No Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. {ter Title V) E' Septic Tank : - 2 x 330 Gal./Day = 660 USE 1,500 GAL,'Septic Tank. AV 'NVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch 0 20 40 50 10 P.O. BOX 627 Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. = 222.00 gallons Sidewall Area: 0.74 gal./sq. ft. x 148 sq. ft. = 109.50 gallons EXISTING LEACH PIT TO BE PUMPED & FILLED IN PLACE GrsTER� EAST FALMOUTH, MA 02536 Providing: = 331.50 gallons OR REMOVED IF FOUND TO BE NECESSARY TO INSTALL NEW SAS. - SANITARtP� TEL/FAX 508-548-0796 -- �- Use: (2) PRECAST 500-C UNITS, HAVING A 2' EFFECTIVE DEPTH, NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE SCALE: 1 „=20' DRAWN BY: CES DATE: JUNE 22, 2003 TO BE USED MATH 3.5' OF WASHED STONE ON THE SIDES AND SCALE: 1 "=20' FROM THE EXISTING LEACH PITS/CESSPOOLS TO BE DISPOSED 3' OF WASHED STONE ON THE ENDS AND 2 FEET IN BETWEEN 2 UNITS. OF AS PER BOARD OF HEALTH SPECIFICATIONS. PROJECT#SD437 FILENAME: SD437PP.DWG SHEET 1 OF 1