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HomeMy WebLinkAbout0024 CHESLEY ROAD - Health 24 Chesley Road jMarstons Mills -- - - r A = 101 061002 : E i I a TOWN OF BARNSTABLE LOCATION Sq L�'zrX VILLAGE ASSESSOR'S/MAP&PARCEL ti NAME&PHONE NO). &rri c-Ic l Z`n 11 vt t SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS 3 OWNER c e PERMIT DATE: 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 ds exist within 300 feet of leaching facility) Feet FURNISHED BY 4 4 t 4'\ \ 4 4 \ 4 \ .t ♦ t \ \ \ t 4 ! f f f f r l f l f f f r r ? 7 r r J f f f f r f f r 4 4 \ 4 t \ 4 4 \ \ 4 4 4 4 4 4 4 4 4 4 4 4 L \ 4 4 l♦�4 f r f r f r f f f / ! f f f f I ! f r f f f r f ? ? r 4 \ 4 4 4 \ \ 4 4 \ t \ 4 �. 4 \ \ ♦ t 4 Back of \ \ ttt4ttt � House4 t-4 y ♦ 4 4 4 \ 4 J f 7 J l l f r r f f r f r r r f f 27 21 5 25 Vent .................. :.:......�.ti�3g:��el�# Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for rY every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms the computer, r,use 1. Inspector: only the tab key to move your Patrick M. O'Connell _ cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508.428.1779 SI 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails Needs Further Evaluation by the Local Approving Authority -r.r "1 ii AA February 8, 2011 Job# 11-14 In ector's ignature Date i The system inspector shall submit a copy of this inspection report to the Approving Authority(Board' of Health or DEP)within 30 days of completing this inspection. If the system is a$hared system ors has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the U2 report to the appropriate regional office of the DEP. The original should be sent to the system owri- and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future undler the same or different conditions of use. t5ins•09108 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 1 of 17 V v �I 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Recommend pumping tank in next year, leaching system shows no signs of surcharge. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes","no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying.septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and,if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): I I t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box duly 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 (Explan:below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"*. Method used to determine distance: *" This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® 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 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The! system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 Februa 8, 2011 required for ry every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ .® Were any of the system.components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 — DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 _ t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owners Name informationis Marstons Mills required wir for for MA 02648 February 8, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage N/A irrigation g ( Y 9 (gpd))� system. ystem. Sump pump? ❑ Yes ® No Last date of occupancy: Currently Occupied. _ Commercial/Industrial Flow Conditions: Type of Establishment: — Design flow (based on 310 CMR 15.203): Gallons per day(gpd) — Basis of design flow (seats/persons/sq.ft., etc.): — Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: !Sins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley iRoad Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for rY every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Tank pumped one year ago. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: — Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official inspection Form Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Compliance date: 10/18/09 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): ' Depth below grade: 1 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 6"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: 10.5' long x 5.8'wide- 1500 gal_ Sludge depth: 4" — t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is required for Marstons Mills MA 02648 February 8, 2011 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees were intact and clear, liquid level was found at bottom of outlet invert. Recommend pumping in next year and every 18-24 months with use of garbage disposal. Grease Trap (locate on site plan): Depth below grade: feet Material of construction.- El 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 (Sins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 cJ 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, 9 Y. liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M y 24 Chesleyy Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 il 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.): No solids or high stains present. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09108 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Chesley Road Property Address Joseph Kremer Owner Owners Name information is MarstonS Mills required for MA 02648 February 8, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: Four infiltrators. ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of pon ding, damp soil, condition of vegetation, etc.): Infiltrators show no signs of surcharge or saturation Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration — Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-09108 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February required for ry 8, 2011 every page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments �« 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA_ 02648 Februa 8, 2011 required for _ ry Mills-----., page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawinq attached separately \ \ Back of House \ 27 21 5 25 Vent '` ke ftii Ole Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20+feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ 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: Low point at rear of property is considerably lower than SAS. Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Chesley Road Property Address Joseph Kremer Owner Owner's Name information is Marstons Mills MA 02648 February 8, 2011 required for ry every page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, 8, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BM NSTABLE `�`.7CATION ec1 SEWAGE # �`�S -LA w,TLAGE ��CS'�p� �\�A ASSESSOR'S MAP & LOT M It 1 —)CA C� INSTALLER'S NAME&PHONE NO. J G/i � SEPTIC TANK CAPACITY 1S_C0 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNE \ O\ ��- PERMITDATE: `� I3 U COMPLIANCE DATE: D / Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility O`_.-- 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 '°ae m • � 9�s31 1�; 1,8!�1 1 � tTOWN OF BARNSTABLE . LOCATION \'� SEWAGE # VILLAGE (r��S'<C�� ��� ASSESSOR'S MAP & LOT M 1 1 — CA 4 INSTALLER'S-NAME&PHONE NO. J C:/y �e,� SEPTIC TANK CAPACITY--- ✓ SSG 6 •P LEACHING FACILITY: (type) G�' -• `�� ? (size) NO.OF BEDROOMS ,3 ` BUILDER OR OWNE C)L PERMITDATE: 41 O COMPLIANCE DATE: l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility obf e4,Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) L- Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by hoe 1�a1 kN � No. +' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprf cation for Mtgpozal *potem Construction -ermit Application for a Permit to Construct(>O Repair( )Upgrade( )Abandon( ) KCompleteSystem ❑Individual Components Location Address or Lot No.o244 Clus/c'I Owner's Name,Address and Tel.No. llsi"s/Lycs 4w//s p,p , is l,,>J Assessor's Map/Parcel qal 0,4,0 16/ /1'-Z 16, m4 62.C64, Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.c5o%j y2$f7/3 c Kl-13 S ,tuv, A. W�1Sth na �S .I 130-xk ,tip.4 1-1of r.,-j,�Vk VUo - t/ g ? a r sr Ds _rut I N Type of Building: 13 Dwelling No.of Bedrooms Thrcc Lot Size �d 3 Me sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow I Co gallons per day. Calculated daily flow 33 O gallons. Plan Date y^/Z- Number of sheets e,"e. Revision Date Title 5rpI L(_ s Iz^ Q s 9 -2'el C124s!4 1 /mooC-00 Size of Septic Tank Z5crn //cns Type of S.A.S. I-ceati,�) C�tay,/�vs 25/,cl 2 �x2'h� Description of Soil t" P I C-t s Le), L16 7 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the fore on-site sewage disposal system in accordance with the provisions ftPe 5 of the Environmentao an oft a th ystem in oper tiop until ertifi cate of Compliance has been ' b oar '` e pv/J Signe D �Dat Application Approved by` Date Application Disapproved for the following reaso Permit No. Date Issued .ry,... -44 ,,, J a hY i .: 5 • Y/S 1. - �� ,j �, _`•�..`:t f-'.Fee W No. THk COMMONWEALTH OF MASSACHUSETTS t Enteied in comp Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS` Z(P piication.for �Digogar *pgtem CowAruction Permit .F Application for a Permit to Construct O0 Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No.s??q CAL s/c�.�r,�� Owner's Name,Address and Tel.No. 0O/F/6n5 ^//s -Tkaww.s Cfl000Q Assessor's Map/Parcel 10.0 • rsC-K 1gR1 /JfiR P /O/ �prc c/ lo/`Z i'J�. (a l v►+o.�Hnj 1414 624a 56 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.(5o6)`/Z 1}—c1/3 c><I /3 vo - �S Syotu,. A. 1-101 (5by) qq q7 �glL Mnm Sf- OsfrrucIlg 02Gs5 a Type of Building: Dwelling No.of Bedrooms Th.r« Lot Size �{9 3�� sq. ft. Garbage Grinder �( Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 (n !jjacPj 6ggJrtrc*-i gallons per day. Calculated daily flow 33 O gallons. Plan Date `/--/2- Number of sheets c*zc Revision Date Title Sc,,h-L SMshz«, /eocctO Size of Septic Tank Type of S.A.S. 1 ce_c4,,2 Chor,lxrs 25�,ct Z4x2'hf 't �C Description of Soil !� ~ fa+ o g 5 5n °i L p J rrn g p- 10, -`- Nature of Repairs or Alterations(Answer when applicable) i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of�e4o re s 'bid on-site sewage disposal system in accordance with the provisions o pit el 5 of the nvironmental.Code and, f to 1 -e the'system in per tion until ertifiJ pate of Compliance has bee t b oar. Hea L- _ o 12�U v'c Signed / C~ 4 Date 1 Application Approved b,,y Date Application Disapproved for the following reason - (+ - Permit No. Date Issued ' --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS 1 ' BARNSTABLE, MASSACHUSETTS' '_. Certificate of Compliance THIS IS TO CERTI�X,-that the On-site ewage Disposal System Constructed(X)Repaired( )Upgraded( ) Abandoned( )by J � (Yi► f at P .. M Y h 0n constru t d in accordance with the rov//is.'ons f itl and�the for Dis oral S stem Construction Permit No. dated �J a L Installerp�-/ p y Designer The issua ice of thi pe �t stth11all not be construed as a guarantee that the r toeiill fyn ton as d signed. Date Ill i j( U�I Inspector- -—————————— ——————————— ---- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS -Migpogar bpgtem Construction Permit Permission is hereby granted to Construct( epair( )Upgrade( )Abandon( ) System located at L/ f�,o f 1 P 0 Ian J oSr fL �nY�s,rA and as described in they above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this perfmit� Date: ' ! 0 LI Approved by 1 Town of Barnstable IHE Regulatory Services *: Thomas F. Geiler,Director * snBx3TnBLE, MAS& Public Health Division 1639. ♦0 '°rFo wad° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: /o fff orl Sewage Permit# ZOGq- /(.b Assessor's Map\Parcel M 101 (01-2 Designer: -Sh»Irun A.W l t s. t?c. Installer: U' Address: Cia,c1��� N�f kalft%yws Address: 3,6- 1Wt S� On was issued a permit to install a date (installer) septic system at ZY &,.d- W,rs m IM15 based on a design drawn by (address) SbW6&. A. L16 �; Rtf, datedT/zaoy (designer) ✓ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. J 1 j WV OFI.g ys� STEPHEN G J` (Installer's Signature) o YN WI SON l/ No.30216 � Rer. FSS/pA L E � (Designer's Signature) (Affix e s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form 3-26-04.doc Z) i //� 1 2�( V'rS�.! \� �� f 1 COl- ��� � VV C� U# / Town of l3arnstanie 1 Department of Regulatory Services CF 1NE 1 Public Health Division Date -�3 200 Main Street,Hyannis MA 02601 BAANSPABIA MAN. t639 O$ y I /I JJ En��► Date Scheduled � ,� "l �� Time_1D A��(— Fee Pd. r � Soil Suitability Assessment for Sewage Disposal Performed ts1 i ISM Witnessed By: BY: G .d II11 :lil,'.II:II. : tl II hllnl.l: .'!II ! I 11 :II .I m. :e•�:� a rlrl I:Ili.I d: ^I ' I,;I II,:. 1, f II rN. i � } I.Y I I �,1, ,I�''.� . l�I y'II'�,'.yi•ul p��.,.I!!N !' I. dh' I: : I!L�r�iM"I�pF 11'li�.'I I0!;1i!!III�', �R6,.,, �1'1 ,IM .t.. d a 1 1.1' h 1, : 4,1� Owner's Name 7"o,t �roaaQcation Address Address V.O. i r). Fck•+•.e,JK , ma GZSCf. N Engineer's Name $k#tu, A W 11 Se., 17W. Assessor's Map/Parcel: 101-" 0(D(—001 O NEW CONSTRUCTION a/ REPAIR Telephone# $OSr — IV2.V— 913� K �J Land Use Slopes NOU&a�� Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well It ft Drainage Way ft Property Line —ft . Other :a SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) \ r R' � a'� `�•`\.`\``\ Qf\� � t 1 , I e b f 4, ` �• I ' I l r l 1 i ! ( /r .f r r l r (r/ \ \ / + 't,1",t 11Pt1J, /*y� i I t I r I t 1 1 1 1 f r i t,n1,t;1 d„,t i I I I I 1 1 1 1 1 11 1 1 i 1 1 1 t Na t 1 � 11 t t 1 I 1 {1 1 I t.tt 'S't�l le+iQ,t . ' � l / 1 \ 1 t t 1 i „ i l r , 1 1 1 1 { I I 1 r I �. 'tr a t ,Y.n1c ` ,1 1 1 4e, 1 I a / hrlu` tt t �''+�} `,t 1 t t�•t 1 t I I i I 1 ! I 1 ' , ' I 1 ' I + � �! ir' J { +\ ` Wryr �� // /�1`l'1 t�111'1(� ' rrj �l + {' 1 , / it ' •' �d:1i,• t'�t1'� 4,111,1 �iillr i t /tl4 1 i 11' pp ' ��/ •it i // / j ��/ i///ij�i l''/���'�i II i 1 �\"'� /' k ' t'rj�rlu) rlrl� / �' j j rr % i %//iiril i i' i I '1•' I i i ' % + � irrillir' 1111 I' 'i ON it'll ii it sir ill "J", :S �•� 9' / I �� I'' ,1 r 1 " t 1 ` •. x � r ' I Irlraf 1 ry r �1• + `� �—'•� �1 i I 1 r r 1 1' V t 1 � t \ r� 1 � f �f�n, irfr i't. .7ir Irl 1';;�r rllrrr �t'a � ' a .,,".-•��"/ �'t`�\1,i\I\,,\`\\`��``�`\'a`t``�i\�'``\t`'\,�j j'' 1/ i 1 i .bl l�1!!lii�� ��Iiii / Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater '•.k II. ,� 1� ��..r,mm¶I��;�:11n1'I'(nn Ilm�ll r y111 cII �,1.!o!II j1 11�I!j�'�•,� I1.uPj{iI�° I'1� l��'4'Ph`� r mnp•.� 'I"1 .m I 9 ' fkT7lh�1J'I�IINf�l6'Y�xiBIdi��I� wtlllNNtiy P::dqT�•. �'t 1� �61�s IM74 B1 i1'dp l°illlad I.,:1::n'm a t r !IL®!!yuN.:.iu 1 Method Used: in. Depth to soil mottles: in. Z Depth Observed standing in obs.hole: in. Groundwater Adjustment R. Depth to we from side of obs.hole: _______r_ L0 Index Well# Reading Date: Index Well level _ Adj.factor Adj.Groundwater Level W „aI'�1 1 't'.•:I'�l::11:..I�:LI:,I;,..h!, •1 om1 I'''"" ''�ll:rl.el I'�• '1;Pi�'1! �pf!@! SZ '?tl�'I'a14'�"�I;'�'���ld��i�l ugta:,l�,tl4r UJ gObservation Time at 9" Z J Hole# UJ boy Time at 6 >- N cr Depth of Perc z,H to;33 Time(9"-V) Start Pre-soak Time LU End Prc-soak CC Rate Min./Inch less }t„a Z w►tN r r+e(. Site Suitability Assessment: Site Passed � Site Failed: Additional Testing Needed(Y/N) �.:,:.,,I• e Data To Be Completed on Back D,d,liC Health Division Observation Dol - her Depth from Soil Horizon SoilTexture (e Soil )Color Soil Mottling (Structure,Ot Stones,Boulderes. Surface in.) (USDA)' w �t1 �fl -Sw Ld41e'1 lU �/� SA. :y:Y:i::`:�?::i::'•.`•f::i::9�Si::>�:;:•OWNED :.� .'� .. .>':;''•:.::,. :: ..;;':: :.. ::. ..;; ..... � :rt:f52:: !:�::2:: ::>���•'::::;i'••::>•:::;;;:?;'•si2?:3ii•::i ::U� ........ Other •Soil• :::.:..........:.....:....:..: Depth from Soil Horizon Soil Texture, Soh Colon Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. A `��3 6I$—I ts'`' rowdy I Of it 5/6 S64 C r G 10 Yke.5/6 roll- 12o' C YYl cell. sonj to foe 740 2 ::: �'�t'•:•:ii'is ,...i:::rij}::i:!v4:}:i: .1. }. ,'! : :!C;+{;;}:ji7'titi•ti}:C'.•.:$:S?'2�S$ '.:1':' :, •... ;r '.i: <:� :::: $: 2:.:;.:;:y ...�. :;::•`i:%>::�:4ir:?J::J::L:4$::!fP:�i ''}}„�;;��`�}r.�:... ...��[[��''��rhf•��};1,���. .; ��:::::Y!!:.:... .. ......... .....:...n.......:.. :w.:�:.�••.�::::::•:::•n::•.v•��1!N.T••:::�.�7^: •.,•.,:::::i�i::!iL:^:•'ry}:: w:n�.�;•'•::v... .......... Depth from! Soil Horizon % Soil Texture Soil Color Soil Other Surface(in.) .(USDA) (Munsell) Mottling (Structure,Stones,Boulderes. �<:•`; . T:TDB :+�:�E�<��......,:......<.: :::::.:. .... Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. e Flood Insur>ln,cp Rate Matt: • Above Soo year flood boundary No_ Yes ✓ year bound No,/ Yes ` Within Soo y a�' Within l oo year flood boundary No l� Yes Depth of 'atttrally dccu'rrine Perv�io�ts Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious',material? ' �ertlfl tIQIl I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection'and that the above analysis was performed by me consistent with the required training,a ertise and'experie a described 3 G3 5.017. � � 1 / Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS i�tlOgAY *p$tem Con6tructio" Permit Permission is hereby granted to Construct( ) epair( )Upgrade( )Abandon( ) System located at o and as de cribed in th' above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons cti n must be completed within three years of the date of Date: p Approved by . r i 1.2 FTI . �- 0 LLIJ Ctmp-" y _c33S'. 0 h�Lt M TkG21�4�0 2 Acp H Xi�7. 5 Elm 1 0 �.�� '1'ftli w SUM Co F , oI�1 t �. Tw 7Mi �p ",Ytid-T�lSQ4t0 4o90 4g'10 I kunr-4 I TT I I tt �$;. 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TO COMPFY YrITH Alk RULES AND 0 „SuvFbPT SPIMLZLES f � REGUOTI(NIF THE CONSIRUCTIGN I2 , OF TfiIS B G _1.ti8 r>=•11lNCr .Jokers �C. �� � � Vz Inc, --s = (EST xb S ruDS iL1 12— 10 w-v'EnIT ; $EA.t� -4 j JZ id,T c H E1-4 At D4-4Lt.!7 - w QSs �' 6 •:.;I -5 717Z �Lt:YPa"� g.N T _ STEPS yl' - f4 i 1 IF I -LA9&QlUL�_.. a ?—oY�A F. ' L 47�1 c, Q a i z i o tG_'SZC 4®-0 l2=0 !o-o Qo-b fL�/3 1 NC. i' ° 1 Y 1 2x8 w-2x10 � ar �r5 :i: - r F3RIll G I PtG i E 2-14"J-vL g�ssrt�uC4 fJ F� �zc 8 inls r5 ��"o,c, T12P�.loxJo MI Wonam C "i-V B=.rS N L @GI_ oLTS dM PKT r 3 r Jco �srsr/ N ���5 �o acH tYi 1 ' �icS FL•.1G�ST5 l Cj 2--t4"L V L. ow TOPoFSt is I i -wo . BEQQIu 4x� s•1LL. m 4r�srLG e•.. ' s NO "G?2CF_C.Frlru r ABOVE C214 F_L=sq 2-- - _ L ,BtrL. 0/-1a x 33 1 �Y w 1 _' SRIDGINC W-P o1z 1 -19 i ' - - I"O' Ain 3�e-1 ZY B.. �_(... J.DISSS .1(rz_-C. .. N[7TE Qlt F t 00— .2x4c. 1"o" pT�L r= 1i131.Dlj.tn�l.GT ��__ �211]G1;�5 �"F2AMIu(� aSMEET ),1.Q.+ /Q�'O '2 -o 419.0 i I � I Bu p,M• � 8"a•H .rto •,z... '' '..... .,�,^-1F( h:w.-rr'.a.. -^—a'+.'gh!+9a[-.,� �.... 'sdsS� '.:.' roatb�"" j51 �' " 2•K�.,�='tJ6 WgLL k � rc� �7 10 I� W • i - r1 .� I rn y Ito z 8E'iii2lN� ."�•- x$. ult]. $Ik.�,r zX_�QT�..23�..[�.L'Z.'Wi3L 'r t ti �' �as &••©:rI• sirro�� �LQA� ���nte. Q� �►�, 24-a 2.g-o �r�i �^ �" =L,o°. �LW_r�i ,b.,o• �33�_,3_-.-2 ° t 4 - I io-o CAAL r I- - 1 � 4 B C•H o- & O,H s' o ,t C, 7 41 x t Y �4 - ---Al 2 o•N� - t RL�_ _ .. .•:^:�. � , 'may -��j`fq�-GI�Ps 2�i"' �.72 2SF7T�iiP�.-�3.'F.'_:F'�b._Z�7HL.L. REFS $ a +;0 A61 �G''�DE -- _, B�F 'sae7nn�tiir �I_gf.l ...:E .,. . QR fZ-G 24-0 Sc,aLE; _l !a PI-A 14 Np,. .��3--Z 46-G LEGEND X \\ \�\�� \\\ `\ EXISTING PROPOSED z •'. f rca \\ \♦ \ \ prr ? a'Y 4ryv ' r A \ \\ \ \ S `` \\ \ \\\� \\ \ \\ SOB. LOGS DATE:January 8,2003 t i1 L"sLl�r� r 1 �`: S.; s \ v \\\ ` \\\ X \ \\ \ F=P 10 407 r yr �^utr �: E \ \\\\`�`\\\\ \\`�\\ \ ' A Stake d[ Tac Set/Found ENGINEER' o PK Nail Set/Found ��S�e��rf•,,,2�'`si�` • � # �'+.. ).,• � R 'r4 BOARD OF HEALTH AGENT o Concrete Bound \\ Stephen Wilson,P.E. Sam White ��_. ., �. - Q..;: o � � p' '" f ' � -�,� • ,;�_ \ \\ \\ \X TEST PIT 1 TEST PIT 2 \\ � \\�\� \ m Electric s Gate \ Meter \\ \ \ \ S \ \ \ Q. : ►e n : r ,•t � G.S.E. _ 73.Ot G.S.E. 71.5E Catch Basin �?C 483 / x o `\ \` \x'1 \\\\ \ TV Cable Box t dk., v. a ,a 14 0 i -{Yp $D \\ \\ \ \ \ \47.3 Water Gate • oY. ,� .�`�* __ _ , �,\ \487 ON Telephone SANDY LOAM SANDY LOAM Phone Riser ® • :„• : f. _ I �\\\ \\\\� \\'\N 4" 10 YR 4 2 6" 10 YR 4/3 -O- Utility Pole \ \ \\ Contours i O u , 421 \ �\ \\ 4" B 6" B 2OD" Spot Grade Q �• -•.,, ��: � i ,�) \ rnX SANDY LOAM SANDY LOAM Test Pit •• n o , r, �� .Z ! i \� \ \ \\ \1 \ \\ 20' 18" •• 4. •r. . , ;• � \ W \ \\\ \\\� \\\\ \ \\` 10 YR 5/6 10 YR 5/6 a \\\\ \\;N \\\\\\\\ C MED. SAND do GRAVEL • '. '; o .; i� 1 1 ! I ► ) \ \ \ // \\ & GRAVEL \ \ \ SAND •Q' Fri, "' O • . .... .� ` , ! i 1 \\\\ \ \\\ 126" 10 YR 6/4 80, 10 YR 5/6 Q ti.• o ,:+ 1 1 1 t I / / �/ \ 48.31800 r 4 /+ TW-t _ r--,i r.�.'Li' t t \ \, X s7.� 1 �1 I t // / / \ \ ` \ ,\\\ \\ \\\�` uN�BtF in sA�ic MED. SAND \ 1l co \1\\\\ \ \ \ 120" 10 YR 7/4' LOCUS MAP • 1\ �\ \ �� \ l t X lslt\ ' N �---- __._ �� \\�\ \\\\ „ \ , , , , , \ LOT , \ PERC o 60r 1 = 2000 \\ `\ \ \ \ \ \\ \ \\ \ \\ \ 1 \\ \ \\ 0 �/ / \ � \ \ \\\ \\ RATE- <2 AIIN/I!V l \ > > \ \ \ �, \ \ 49 378E SQ. FT. X o ZONING DISTRICT: RF, RPOD 6S \ \ t, \ 11 1` \ \ \ \ �\ \\, 6 1 \ 48.6 C0 / �.� \ \\ \ UNABLE 70 SOAK OVERLAY DISTRICT GP \� \ 1 t , �� �� \ \ \ . 6 ( ► 1 .1 3 f ACRES MINIMUM LOT AREA: 2 ACRES _ \, \ \ \ \ ` \ \ , �` \ p\0 \ q 1 j . ,� X 4 5\ MINIMUM FRONTAGE 150' FRONT YARD = 30 SIDE YARD = 15 REAR YARD = 15 -- ., \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ t / ► i �� LOCUS PROPERTY IS SHOWN AS: -' 70 \ \ \ GENERA!. NOTES ASSESSOR'S MAP 101 - PARCEL 61-2 ,\ \ \ \ \ \ \ \ \ \ \ \ \\ \ \ \ \ \ \\ \ \ \c LOCUS DEED: ' ' \ ` \ \ \ \ \ \; .\ \ \\ \ \ \ \ \\ \ \ \ \ \ \ / ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH DEED BOOK 5409 PAGE 311 ' 7212 \\ N� \� \ \ \ \\ \ti� \\ \\ ` \ \ \ \ \ \ I l x 46.7 TITLE V AL THE STATE SANITARY CODE DATED MARCH 31,1995 PLAN REFERENCE: 731 73.1 ANY LOCAL RULES APPLICABLE PLAN BOOK 419 PAGE 89 - \ ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING \ �\,\ �� � \ BY DESIGNING ENGINEER COMMUNITY PANEL NUMBER 250001 0015 C \ \ �°Qs, \\\\ \\ \ \\ \\ \ \ \ \ \\ \\ \\ \ \\ \� \ l\ ,t �' \\ \ \ THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C, `\ 1 \ \ \\ \\\ \ \ \ \ \ \ \ \ \ \ \\ \ \\ tt \\ \ \\ AN AREA OF MINIMAL FLOODING. Q . 1 \ ,� \ \ \ \ \ \ \ t \ \ \\ WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFlLLING, / /• 77.3 \\ Y�v 1 \ ` \\ �* \ \� \�\ \ \ �\ \ \\ \\ \\ \\ \ \ \ \\ i i r --- `\ \ NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT FOR INSPECTION. \ \ x3 4=1.5"WASHED STONE=•d 00 \ \ \ \ \ \ \ \` \ \ \ \ 50 6 \ t ^ h ` \ \ \ \\\\ \ \ \X 571N, \ \ `\ \ `\ •__� / /�/ \ '• 2' 12' FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. Q � \ � 1 \ 71.9 ��. � 65. \ \ \ \ \ \\ \ \\ \ "�-....,-._J / �,t�� �_�1.�i�y,:%:� ;�Y.:�r•f;��;�:r:'•-:��• T T PIT 1 t -� I I �� \ \\\�\ \ \ \�\ ``\��`- ---ram ��$ \ \\ 'Y%r:"�i•►%� {• • ;'+r -�,7�:ra'r-�! is f THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN 75r2 74y 74.4 �t # �� t t `� 'r o } t \ \ \ \\ 00 25' APPROVAL BY DESIGNING ENGINEER O t jl�' I t 1 1 \ \ \ ` \ \\ \ \ 76.1L \ �\ �7h _, PLAN OF LEACH CHAMBERS E 7 /6.3 / 75.2 \ ` t % x �€ �{ t I ! ' \ \ \ \ �� \ \ `- - \ 73. s i- .' \` 5 �' 1 ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC., SCH 40 75.8 \ TEST `PIT #� ,< F+� ;` ;, I i \ � ` � \ X 15+- NO SCALE E'464.4 74.s \\ \ I tom'jE nit �' , r�r. j I I t \, - ___1 . _�_---� \\ EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING 2 \ \ k' S� n x. I t �+ \ \ SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5, PER 75.6 75A6 ?0//�� 09• {_, ! 7 , ` , _` (' `\ \. --__ '- - _ \ \ \ 310 OMR 15.255. / 'VO, 7 74.7 / 7S 7 v. a s. �. \ \ ."- _ �b.o �= -x�\ PROJECT BENCHMARK DATUM - ASSUMED .:: .75.7 75.4 \ _ \6 TBM DO' 74 744� \1r rT, ��s � +r \\ �\ S, \ _�\ \ \\ �\ \ \\ 74.8 4n8 7 `\ \ \ \\ \ \ � ` - ;0+00 O ELEV.- 72. r i•cY r r \ \ \ \ \. \ \ 72.6 i2" \� t ` 4.6 \ \\ �s� \ �f o��'T \\ �� ~`'"' \ \\ " \ \ \\ \ LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND 13 E�.176.1 q ,�5 74.6 �\ \\ \ \\ \ FINISHED GRADE SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE \\� R�0• V 75.7 \ \ \ \ i r-1 \ \ \ \ \ \� 36"MAX.-9" IN. / COMPACTED FILL UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. `N\ 7 \� 4.,za \ 2" OF P STONE /\ r r \� 75,2 ' s 1 \ \ \\ ry. \ `� X 6.7 7a I \\ \ 3/4 TO 1 1/2 \ \ \,J \ 24' DOUBLE \A OF hfgs \ 7 � \ / EFFECTIVE WASHED STONE s9 --77. �` \ 73.8p� STEP EN cyN 7.1 1 \ ✓ m-i "� 76.5 NO SCALE 0.30218 y \ 7s�s \. 75.5 S `, PISTE 73.6 \ \\ PLASTIC LEACHING CHAMBER DETAIL �0NAt- 75.0 ` r. \\ �9, 73.9 i \\1 1S �(Q4 t ,., l \` 8 9• 24 Chesley Road •�9• '�� `" OF 76.6 76,6 2.1 N !Afarstons Mills Massachusetts i � I •�� � � dOH �� � t � �7 7� � 4 H PREPARED FOR 72.5 {. •�9• 7' E` �$��° Thomas Good -76 TITLE / 13.9 \ O , 73.9 73.1 \\ I CERTIFY THAT TO THE BEST OF MY KNowL.�c; THE FOUNDATION . ■ N Septic system Design a\o DESIGN SCHEDULE ELEVATION HEREON T SIDELINE COMPLIANCE SE � M � Tt7P of TYPICAL SYSTEM PROFILE roc .N �'°T�TMEMor�+u Sow , AND IS Nor � FOUNDATION _ FINISHED GRADE = 66.0E _ �4D •--:. NOT TO SCALE TOP OF FOUNDATION 740 LMA70 WITHIN A SPECIAL ROOD WARD AREA. 3 - FINISHED BASEMENT FLOOR 66.5 THIS PLAN IS NOT TO BE RECORDED MR IS If 7O BE USED 7n ESTABLISH PROPERTY LINES. BAXTER, NYE & HOLMGREN, INC. FINISHED GARAGE FLOOR 73.0 Y SEWER INVERT AT FOUNDATION 62.0 Registered Professional •: : FINISHED GRADE OVER TANK = 66t SEWER INVERT INTO SEPTIC TANK 61.8 =FESS� LAND SURVEYOR DATE Engineers and Land Surveyors FiNw Nr _ FINS WAX OVER D. Box = 6st c AOE � 812 Main Street; Osterville,Massachusetts 02655 BASWFIN�Hm FINISHED SEWER INVERT OUT OF SEPTIC TANK 61.5 OVER LEM•'HIING = FLOOR .z:• 8'UIIN. _3• 0n; V T SEWER INVERT INTO DISTRIBUTION BOX 61.3 Phone-(508)428-9131 Fax- (508)428-3750 -_• 4' SCH 40 PVC 4' SCH. 40 PVC FIRST 2' (TO BE ILEVEL) SEWER INVERT OUT OF DISTRIBUTION BOX 61.1 a FOOTING (TYPICAL) _�( O 2.OX 9' (min) Cover SEWER INVERT INTO LEACHING SYSIEM 0 2 min - then O 2.Ox 36" (max) Cover 61•0 Leaching Area Requirements CN O 2.OX - BOTTOM OF LEACHING TRENCH 59.0 20 0 20 40 t0' _ 3 BEDROOMS AT 110 GPD BEDROOM 330 GPD O CST ACCESS � � GAS BAFFLE � 6' StI1dP,,� 4' scH. 4o PVC WATER TABLE: NONE OBSERVED AT ELEV. 43.8 / MQMLE OVER INLET •' • . 2'Layer 1/8'to1/2' TO TANK TO AT LEAST' :- •• . Peastone SCALE IN FEET WITHIN s' FINISH ��' '•= ADDITIONAL 5OX FOR GARBAGE DISPOSAL _NA�-NA Y - 6' CRUSHED `a v REINFORCED .. _ 3 - STONE ` ` r _ ,• •- r PERC RATE �. MIN. / INCH (CLASS 1 ) •,•. �: - ;:..'��,,.,,::. ..:;,• :t--. 4 PVC - SCALE:1 =20` DATE: 04-12-04 LIAR = 0.74 GPD/S.F REV. DATE: REMARKS MIN. LEACHING AREA OF SAS. : Af 330 GPD/ 0.74 GPD/S.F.= 446 S.F. MIN. 1. 5-18-04 Bid. & Septic Location N 1500 GALLON SEPTIC TANK DISTRIBUTION BOX 5' MIN PROPOSED SYSTEM 12' + 25' X 2' CD TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE SIDEWALL AREA : (12' + 25') X 2' X 2' = 148 S.F. DRAWING NUMBER i No Groundwater Observed O Elev. 43.8 BOTTOM AREA 12' X 25' = 300 S.F 448 S.F H: 02 02-116 surve worksht LOT2 2002-116SP_LOT2A.dW 2002-116 ,o