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HomeMy WebLinkAbout0108 DEVON LANE - Health 108':DEVON LANE MARSTONS'MILLS �I i� I � ` ti0NT- EA SSACHU SETTS M� T LA s= � EXECUTIVE OFFICE OF ENVIRONMENTAL AFF.�I:RS. �! DEP_ARTMENT OF.ENVIRO tMENTAL PROTECTION T?TLE 5 OFF ICLA,L INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ST:TSUR_FACE SEWAGE DISPOSAL SYSTEM F'ORIM PART A RTIFI CATI ON Property Address:16 i?&9� i Yip/Y . Y "A Owner'slame_ / aft �`�G -�L�2Q✓� �' � � �3U Owner's Address: f ZV �.e �-1sq c:�,-;) 77'� ���� Date of Inspection - � S Name of �Inspec#, '- plea e print, �• cr1 Company Name:� p eL°2v Mailing Address: Telephone.Number: kd 7�1 I'• CERTIFICATION S T A TEMI EN T i certiry that I have personally inspected the sewage disposal system at this address and that the information reported below is t-ue, accurate and complete as ofthe time of the inspection. The inspection was performed based on my training and ,-perience 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 Needs Further Evaluation by the Local.Approving-Authority c Inspector's Si� al_1 Date: �}NO The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health ors DEP)within 30 days of completing this inspection.If the system is.a shared system or has a design flow of l 0.006 rd or greater,the inspector and the systern owner shall submit the report to the appropriate regioj ad office of the DEP:The oriaizial should be sent tc the systern owner and copies;sent to the buyer, if applicable, and the approving author t-Y. v Motes and Commer_ts k xxx*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. Title,5'Inspection Form 6/15/2000 page I Page 2 of I l OFFICIAL INSPECTION FORA-NOT.-FOR. VOL TN TARY ASSESSNIENTS SUBSURFACE SEWAGE'DISPOS.AL SYSTEM INSPECTION FORIYI PART A CERTIFICATION(continued) Property Address: / �1' 1 Owner. ,�d ✓�n� r°raaT Date of Inspection: Inspection Summary:. Check A,B,C,D or E f ALWAYS complete all of Seftion D A. System Passes: 1'have not found an information which.indicates that any of the failure criteria described .Y � i . . in 3:I0 CMR 1-5.303 or in 310:CN1R 15.304 exist.Any failure criteria.not evaluated are indicated below. Comments: B. , System Conditionally Passes: . One or more system components.as described M`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. Answer yes,no or not deternined.(Y,N;ND)'in the for the =ollcwina statements. if"not Petermined please . explain. _ The septic tank is metal and:over.2.0 years.old- or the septic tank(whether metal.or not)is structurally unsound, exhibits substantial infiltration or ekliltration 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. . ND explain: 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 distrib.utionbox.System will pass inspection if(with approval of Board.of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Paee ; of 11 OFFICIAL INSPECTION.FORIM -.NOT FOR VOLUNTARY ASSESSMENTS SUBS-URR'-.ACE SEWAGE DISPOS':4L SYSTEM INSPECTION`FORNI PART:: ,M CERTIFICATION(continued) Pro.perty dress: Owner. `� Date ofInspection C. Purther.Evnluntion is Rea.uired by the Board.of Health: Conditions exist which require further evaluation by the.Board ofPTealth in order to determine if the system Is fa11L7ia't0 protect public healuh. safet%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 furictioning in a manner which will protect:public health,safety and the environment: _ Cesspool or privy is within.50 feet of a'surface water _ cesspool Cr pr v r is v/ithin. 50 f et of a bordering vegetated wetland or a salt marsh ? Sys.ten: wilt fair!-unless the Board of Health (and Public.Water ,Supplier, if any).determines that the system is'functionin2 in a rnnnner that:protects the public health:safety and environment: _ The system has a septic tank and soil absordtion system (SAS)and the SAS is.within 100 feet of surface water supply or tributary to a surace water:supply: _ The system has 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 supnly.well"*. Method used to determine distance "This system passes if the well water analysis;performed at aDEP certified laboratory, for coliforin bacteria and volatile organic compounds indicates that the well is.free from pollution frori that facilit and the presence of amuron'ia nitrogen.and niiate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are't iggered. A copy of the analysis must be attached.to this form. 3. Other: 3. � Paze=: of 11 QFFICIAL Ilr`SPECTIO�i'.F©RM-.NOT FOR YOL.I1NTARY:ASSESSMEl*iTS SUBSURFACE•SEWAGEDISPOSAIJ.SYSTE Ii SPEC.TION.FORM PART A CERTIFICATIOI (continued) Property.Address /0_ "Owner a .4e h,/V Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate•"ves"-or"no"to each.of the-following for an inspections: Yes- ` N ; , , , . . �: .:' ," • ._.� :. ,. Backup of sewage into.facility or system component due to overloaaed or clogged SAS.or:cesspool Discharge"or ponding of effluent to the surface of the Around.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 V. Required pumping more.than='. times in.the last year NOT due to clogged or-obstructed pipe(s).Number of times pumped y _ Any portion of.the.SAS,cesspool or privy is below hi ground water elevauon. : .. U Any:?onion of cesspool'or.priv . is:within 100"feet of a Surface water supply or-tributary ta asurface _ Vwater supply_ , Any portion of.a cesspool.or"priyy is within a Zone 1 ofa".public well. y p_ Anortion of a cesspool.orprivy is within 50 feet"ol a.private water supply well. Any portion of a cesspool or privy is:less than 1.00 feet out grearar`l an 50 feet:fom 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,fo.r.coliform.bacteria and:'volatile organic compounds indicates that the.well is free fr.cm.pollution.from that.facilitgand the.:presence.of ammonia nitrogen and nitrate nitrogen is-equal:to or less than S pptr, provided`that no::other failure criteria are triggered. A copy-of the analysis..mus.t.be,,attached to this form:] (Yes/No)The system falls. I have determined that one or more of the above failure criteria.exist as described in 3.10 CMR.15 303;.therefore-the system fails. The.system owner should contact the Board of Health to determine what will.be necessary to�correctthefailure. E. Large..Systems.: h, To be considered a:large system the system must serve a facility-with a design flow of 10.000 gpd to 15,000 gpd. 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) . yes no; ` the system is within400 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 sens;five area,(Interim wellhead Protection Area-IWP.A)or a mapped Zone:II of a public water.supply.well. If you have answered"yes"to any question in Section.E the.cyst rn.is considered a significant threat,or answered "yes"in SectionD"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 3,1.0 CMR 15.304.The system owner should contact.the appropriate"regional office of the Department. Page S of 1.1 . OFFICLAL INSPyCTION FORM—NOT FOR V.OLVNTARY ASSESSMENTS SUBSURFACE SEA AGE DISPOSAL-SYSTEM INSPECTION FORM PART E CHECKLIST PropertyAddrvss:)0 Owner. Date of Tnspectian: 1(� Check if the following have been done.You-must indicate`Yes"or"no" as to each of the following: Yes. o � . Purnp ng.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 largevolumes of water been in—Lioduced to the system recently or as.part of this inspection ? r�=.. Were as bsilt plans ofthe system obtained and examined?'(If they were not available'note as NIA) _ Was the acility or dweIlina 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 baffies or tees, material of construction, dimensions, depth of liquid;.depth of sludge and depth of scum? . <✓ Was the facility oviner(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: Yes no Existing information. For example, a plan at the Board of Health. Determined`in the field.(if any of the failure criteria related to Part Cis at issue approximation of distance is unacceptable) (310 CtiIR 15:302(3)(b)J 5 Page 6 of 11. OFFICIAL INSPECTION FORM NOT FOR VOLU T ARC:ASSESSMENTS SUBSiRFACE SEWAGE DISPOSAIIYSTEI"rI I:�SFC CIOiti FORM PARI'.C SYSTEiM INF.OR1KATIOiv Property Address: — Owner: J Date,of Inspection: 44. r -' FLOW CONDITIONS RESI-DENTIAL t Number of becrooms(design):..3" Number of bedrooms(actual): DESIGN flow based on 310 C iR 15.203 (for•example: 11.0 gpd x T of bedrooms): Number of current residents!, �. Does residence.have a garbage ;cinder(yes or no): Is laundry on.a'separate sewage system (ye or'no):W(Jiif yes separate.inspection required] Laundry system inspected(yes. r no):. O �/Seasonal use: (yes or no): 6. . Water meter readings; ifXable(last 2 years usage(gpd)): - QG�e) d 5 Sump-pump (}'es or no): r Last date of occupancy:. tl � ,� ���.�e%�%'� ���b'� )&?U 60 eA COMNIERCIALIINDUSTRIAL/ 0 Type of estaKshment: Design. flow(based on 310 CMR I5.203): gpd Basis of design flow(seats/persons/s.gfL,etc.): Grease trap.present(yes or no); Industrial waste holding tank present.(yes or no): Non-sanitary, waste discharged to the Title 5 system(yes or no.); Water meter readings, if.available: Last date of occupancy/use: ' OTHER(describe): GENERAL INFORMATION Pumping Records >,1 Source•of.information: �12 �' / _Ar ,/g A- G/911 Was system pumped as par of the in'specti'vr, yes or no):_ , If yes, volume pumped: gallons --How was-quantity pumped determined? Reason for pumpinlg: TYPE OF SYSTEM .i,Septic tank, distribution box;soil absorption•system . _Single cesspool Overflow cesspool _Privy Shared system (yes or no)(if yes, attach previous inspection r ecords, if any) _Innovative/Alternative technology.Attach a copy ofthe.current operation and maintenance contract(to be obtained from system'owner) Tight.tank Attach a copyof the DEP approval. _.Other(describe): Approxi. ate age of all co -installed known) and source of inf n:.ormatio ' _ems; Were sewage odors;detected when arriving at the site(yes or no) 6 Page7ofII OFFICIAL INSPECTION FOZ:M—NOT FOR'VOLUNTARY ASSESSMENTS SUBS�liRF_�CE SEWAGE DISPOSAL SYSTEM INSPECTION•FORM. PART C SYSTEM.JNFORMATTON (continued) Property dress Oe : ;DA Owner: ��'✓ �✓ Date bf Inspection: !1,- BUILDING SEWER (locate on site plan) Depth below grade: Materials'ofconstruction:_cast.iron _40 PVC other(explain)- Distance-from private water supply well or suction.Iine: Comments (on condition`of joints; venting, evidence ofleakaQe, etc.): SEPTIC TANK: ocate on site plan) Depth below grade: Material of construction: concrete_metal_Fiberglass Polyethylene —other(explain) If tank is.metal listage:_ is age confirmed by a Certificate of Compliance (yes or no):_(attach a copy.of certificate) Dimensions:. Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top o_scum to top of outlet tee or baffle`: fi Distance from bottom of scum to bottom of outlet tee or baffle: How were .dimensions determ,iced: r Comments (on pumping recorimen rations; i+"nlet and outlet tee or baffle condition,structural integrity, liquid levels - related to outlet invert, eviden. of leakage, etc,): -4 14 GREASE TRAP t \' �� l ✓ � � (loca�.,o on site plan) Depth below grade:_ Material of construction:_concrete metal_fiberglass oolyethylene_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 1ast.pLmping: Comments (on.pumping recominer_dations; inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,-evidence of leakage, etc.): 7 l Page 8 of I OFFICIAL.INSPECTI.ON FORK-NOS FOR.OLUINT.A- .Y.ASSESSI .ENTS. SUBSURFACE SEWAGE DISPOSAL, SYSTEMI NSPEi CTIO ,ORtiI PAIN C SYSTEINI INFO INIATION(continued); Property_Address: 062s-Ifix—, Owners °t r�P'e. r Date of Inspection: -07 TIGHT or HOLDING TANK (tank n.ust be pumped at time of inspection)(locate:op site plan) Depth below grade: Material of.construction: -concrete metal fibergiass polyethylene other(explain): Dimensions: Capacity: gallons. Desian Flow: gallons/day Alann-present.(yes or no) Ala,-m level: Alarm in working.order(yes.or no): Date of last pumping: Comments (condition of alarm and.float switches, etc.): DISTRIBUTION BOXN: (i`presen.t must be opened (locate on site plan) Depth of liquid level above outlet invert:. Comments (note if box is.levet and distribution to-outlets equal,.any evidence of solids carryover, any evidence or 4aeaVae into or oy t ofbox,etc.): t PUMP CHAMBER:. .(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.): Pace 9 of 1 1 OFFICIAL INSPECTION FORM:—?`SOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM, INT GRNIATI OIV(continued) Property Address: awn er: _.' Bate of Insuectiori: SOIL ABSORPTION SYSTEM (SAS): {locate on site plan, excavation not required). If SAS`not located explain wby: Type .Ieaching'pits., number:_ leaching chambers;number: leachina. all"eries. number. china trenches, number; lenath: leaching fields nur__ber, dimensions: �/ - / overflow'cesspool,number: innovative/alternative sysiem T,ypelr ame of technology: Comments(note ccndition of soil, signs of hydraulic failure,'Ievel of ponding, damp soil, condition of vegetation, tc.)� rA .Y r' A CESSPOOLS. &(eesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth'—top:of liquid to inlet invert: Depth of solids'laver: Depth of scum!layer: Dimensions ofcess000l: -Materials.of construction: Indication of:gr.oundwater inflow(yes or no): Comments (note aondition•of soil; suns of hydraulic failure, level ofponding, condition ofvegetation, 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.): 9 Page l0 of 11 OFFICIAL INSPECTIONTORiYI—.NOT FOR VOI.LIN 9 AR C ASSESSMENTS . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATION(continued): Property dress: Owne - Z. Lt�JA Date of)inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the.sewage disposal system includin&ties 'o at least two permanent reference.landmarks or benchmarks:Locate all wells within 100 feet.Locate where public water supply enters the buildin01. . o s�0 Pate I of I I OFFIC.IAL INSPPI'C T ION FORIM—NOT FOR VOLLrNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) . Property Address: Owner: A Date'oflnspection: s SITREXAM Slope Surface water Check.cellar Shallow wells Estimated.depth to:ground grater s fee: Please indicate(check):all methods used to dete-Inine the high ground water elevation: Obtained fron.system design plans on record -If checked, date of design plan ieviewed: Observed site (abutting property/observation hole within.150 feet of SAS) Checked with local Board c,Health-explains Checked with.local excavators; installers- (attach documentation) Accessed USA=*S database-ext}lain: You must describe how you established the high ground water elevation: R II Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: AP ,he 1,1,9,1 6a g e- Lot No. Owner: Address: Contractor: !J Address: 19 J STEP 1 Measure depth to water table -- P p to nearest 1/10 ft. ............ 'Date /Z< 2 month/day/year STEP 2 Using Water Level`Range Zone and Index:.:Well.:Map locate site and determine: J,401 ? � O Appr4.Priate index well.................................................... OB Water-I:evel range zone ..................................................... STEP 3 Usiing monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... 77— month/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) �f determine water-level adjustment ........................................................................:................. ' l STEP 5 Estimate depth to high water ..by."subtracting.the water- level adjustment (STEP 4) from measured depth to water level at site STEP 1 Rgure 13.—Reproducible computation form. 15 i ....... � , 41 7 . !? s� FERR Wk;ASSOCIATES 131,.Spring Bars Road 5 F. FALMOUTH, MA 02540 f DATE• °. it .JOB'NO. � (508) 540'3699." ATTENTION .. - TO r t RE: .. - WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter 0 Change order ❑ COPIES DATE NO. DESCRIPTION r � t WA- THESE ARE TRANSMITTED as checked below: ,❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use, ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS 000, r — COPY TO I RECYCLED PAPER: ' �p Contents:40%Pre-Consumer•10/Post-Consumer SIGN /f enclosures are not as noted,kind/ ify us at once. . ' �9pU�,E I y�lABCE ~roTti 28 N 2 p22 SSG`E LOT 6 ~ 52, 952 S. F: u Bul cojys s� / LOT 7 I Eck No F r o p N d-box tank g �ourE2e •� 256 sidewall areax. 74 = 189gpd ti 3zr 240 bottom area x. 74 = 178gpd z bends ry' 496 total area = 367gpd I N h provided AZW 7e � LOT 5 y Zeaohing (existing septic system -„� trench r +o_ (60 'x 4 ' ) 46• /0 •00 0 I 113.00 ,q�g). '17 ; TOW REFERENCE.' S 5.9'4B'22`M q�,g)5.0 ASSESSOR'S MAP 40 PARCEL 130 0 LOT 6 HOUSE SOB DEVON (50.00 MME) -LANE (Revised 715196 showing 'as built ' ) PLOT PLAN OF LAND TO THE BEST OF MY mOMLED6& THE FOUNDATION L OCA TED IN SHOI✓N ON THIS PLAN IS AS IT ACTUALLY EXISTS AND BARNS TABLE — MASS. THAT IT COWaWS TO THE TOW OF BARNSTABLE Q� � LtH ZONING RE6ULA TIONS, RESARDIN6 YARD SETBACKS PREPARED FOR . THE IRENE TRUS T ZA 7r#uxwll 1 DATE.J1A4IE 24 1996 SCALE' FERREIRA ASSOCIA TES FLOOD ZONE C ovow-HAZARDI 13l SPRING BARS RD. FALMOUTH-MA. D-QP DLLMMCIP 1 "kR 4a4 E A'lOTy 28 N LOT 6 _ 52, 952 S. F. t 100 FT But INs S O� �� FT / LOT 7 I j « = ' N0,4ccFss T AO 0 d-box 1500 g uTE 2e 256 sidewall areax. 74 = 189gpd ti 3z tank �O 240 bottom area x. 74 = 178gpd bends Ory 496 total area = 367gpd ry . provided Fay. I 7e 6xisrrna, `► LOT 5 (existing septic system leaching trench /— (60 'x 41 ) 46' / 0.o V Si3.00 ,q�97: 67 :', TOW REFERENCE.' S 53-449'22'I✓ R�975,00 ASSESSOR'S MAP 40 PARCEL 130 LOT 6 HOUSE SOB DE VON MO.00 hXM LANE (Revised 715196 showing 'as built ' ) PLOT PLAN OF LAND TO THE BEST OF MY KNOML.EDBE THE FOUNDA TION L OCA TED IN SHOI✓N ON THIS PLAN IS AS IT ACTUALL Y EXISTS AND , . BARNS TABLE - MASS. THAT IT CONFQF s TO THE TOW OF BARNSTABLE ZONING RESULA TIONS, REGARDING YAAV SETBACKS' PREPARED FOR cu , • .I�JDVE 2 MHAW THE IRENE TRUS T REI P.L.S. $$3 DA TE&A##v M .I-qw SCALE t'-�60 FT. FERREIRA ASSOCIA TES FLOOD ZGwE C ANON—HAZA/aoDl 131 SPRING BARS RD. FALMOUTH—MA . D-DP QLMNC/P TOWN OF/BARNSTABLE l LOCATION �,y� � �1�1z/ L � SEWAGE # VILLAGE d r�� tZ.0'ASSESSOR'S MAP & LOT �—!3D INSTALLER'S NAME&PHONE NO. ,l��� A � A� � � SEPTIC TANK CAPACITY G LEACHING FACILITY: (type) NO.OF BEDROOMS OR OWNER Via'' CT6'-O!zz A et PERMITDATE: COMPLIANCE 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 wetlands exist within 300 feet of leaching facility) Feet Furnished by jow go e � i 5 v O No. � FEE b® THE COMMONWEALTH OF MASSACHUSETTS Barnstable MASSACHUSEITS pfiration for (gonstrurttion jhrmit Application is hereby made for a Permit to Construct (X ) or Repair( )an On-s:te Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Lot #6 Devon Lane The Irene Trust House #108 P. O. Box 599 Mash ee MA 02649 477-0023 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ferreira Associates �( 131 Spring Bars Road (' t , Falmouth MA 02540 540-3699 Type of Building: Dwelling No. of Bedrooms 3 Garbage Grinder(n 9 Other Type of Building No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 55 gallons per day. Calculated daily flow 330 gallons. Plan Date 6-1 1-9 6 Number of sheets 1 Revision Date Title Sewage Disposal System Plan prepared for The Irene Trust DescriptionofSoilTest #1 : 0 "-3 " (0) , 3 "-6 " (A) loamy sand, 6 "-24 " (B) Joamtq sand, 24 "-132 " (C) sand. Test #2: 0 "-3 " (0) , 3 "-6" (A) loamy sand, 6 "-24 " loamy sand, 24 "-120 " (C) sand. No groundwater encountered. Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed 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 Complianc been issued by th' and f Health. Signed Date�Application Approved by -nn"4 � Date � Application Disapproved for the following reasons Permit No. * Date Issued No. ,� Fee L3© . THE COMMONWEALTH OF,MA_ S$ CHUSETTS f � Barnstable`;, „t:-�- � MASSACHUSETTS yfirMiun for Pioy' veia-1„ *vs#era"C onotiudhurt I�V�t #{, . ' z Application"is hereby ade for a:Permit to.Construct-(X;);or'y Repair-( )an On-s.te,Sewage Disposal System at: Lo.cation Addre or Lot No. Owner's Name,Address and Tel.No. Lot V 6 Devon Lane,.•= The- Irene Trust �. House #108 �_ P. O. -Box "�5,,99� Mash pee, MA 02649 477-2023 Installers Name,Address;ad4q-pi Io f4 j r Designer's Name,Address and Tel.No. - '.Fe ira Associates c, fr` 131,. Spring Bars Road 1 =Fa'lmo.uth, MA 02540 540-3699 Type of.Buildings ;a Dwelling' No.-,of Bedrooms - S.�_ GarbageGrinder(9 Other Type of Building No. per Peons Showers( Cafeteria( ) Other Fixtures //1 , Design Flow gallons per day. Calculated aily flow 3?0 gallons. Plan Date 6-1 1-9 6 Number of sheets Revision Date Title Sewage Disposal System Plan prepared for. The Irene Trust Description of Soil Test #1 : 0"-3" (0), 3 "-6 " (A) Ioamy sand, \'-6 "-24 " (B) koamy sand; 24 "-1321" (C) sand. Test #2: 0"-31, (0), 3 "-6" (A) Ioamy sand, 6 "-24" loamy sand, 24"-120" (C) sand. No groundwater encountered. Nature of Repairs or Alterations(Answer when applicable) Lr• Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance wtt tRe,/Vrovisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Complianc&&U been issued by th' oard of Health. Signed - Date Application Approved by Date Application Disapproved for the following reasons Permit No. �� 7 y Date Issued THE COMMONWEALTH OF MASSACHUSETTS , MASSACHUSETTS Cer#tfira a of (fontpltttnre THIS IS TO CERTIFY, that the On-s'te Sewwa e Disposal System installed( )oSi aired/replaced,( n b i Xv-7717 ,,r.< , o.a� for �a at La G Y vra :Zc,'7u e1 h s b constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. FF'' dated 6 g 9 � Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. This _ Certificate expires on y DATE Inspect V THE COMMONWEALTH OF MASSACHUSETTS No. 9� -27L/ ,. rr , MASSACHUSETTS FEE Disposalf 1Sgstent Q-11IInstrurtton fernti# Permission is hereby granted to ( 11 to construct( or repair( )an On-site Sewage System cated at .a? r0 �'� Zvak L.Al Ah A, and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. DATE16 -7"& Approved by FORM 1255 Rev.3/95 A.M.SULKIN CO.-BOSTON,MA - AREA PLAN SCAL E• 1 .1a 50 . S YS TEM PROFILE FINISH GRADE NOT TO SCALE Gl. r� FINISH G.9AOE FINISH GRADE SOIL EVAL UA TIONS OVER TANK ovER rRENCHEs G o. o DUNE 41996 TOP FND :s� �T /r r�r a� �T/ ;�� rr r /i/T / ii EDWARD BAARY TOWN: OF BARNSTABLE ''•'' '•"'" '- '''•'" � �1 SCH 40 PVC '.t: ... .i:'•.-..... � /�� OR CAST IRON TEES TEST HOLE 1 TEST HOLE 2 B$M'T FLR 6 j _ a j; 0 �° o o a • o o •°°•o:'ao 04 CAP ENDS i o GAL. EOUALIZERS $Qpog°o° °o° aAT O" o vo a s °9E a a ° p v o.°o •o• °. O' " •� �;: REINFORCED •. SAS S'7' o °e a o0o v•°oo•oa°o. a —0— —O— r "' CONCRETE BAFFLE DIST.BOk ¢0 p4 0 ¢o°,0 po 0 " o0 3• _— .__ ¢ ? 3• .•i..►►a° •.°.. ,u,a•.. ., �• ao0•°f •aa v°o°oo o°ae000•o o °po . r-......:. .., TO BE INSTALLED ON A o°p°°°°poaa° '°o°o o°o o°o°a:a;o• LEVEL STABLE DASE Q°oo LOAMY SAND LOAMY SANG oo° o, 10YR 3/2 10YR 3/2 SEPTIC TANK S•�' TRENCH L ENGTH 6• 6- TO BE INSTALLED ON A -e- -e-LOAMY SANG LOAMY LEVEL STABLE BASE 4 MIN.HEIGHT 10 YR 5/4 D OYR 5/4 NO TE: DO NO T RUN HEA V Y EGUIPMEN T O VER S YS TEM ABOVE OBSERVED r 24' ; 24• GROUND NA TER r i L EA CHING TRENCH SEC TIOIV 2.5Y 14 1 2.5Y"14 NO ro ScaLE SOIL AND PERCOL A TION DA TA I FOR FINISH GRADE 120• SEE SYSTEM PROFILE APPLICATION N0. P-8702 132• PERC. RATE 'c 5 HrN/IN I NO SROUNDh'A TER PERC'D AT 72' 12"MIN. TAKEN BY RICHARO FERREIRA -�- WITNESSED BY EDaARO BaARRY :.: MIN.2" - 1/8"-1/2" DA TE JUNE 4• 1996 4 DIA.PIPE TEST PTT ELEV. 60.3 ''/ WASHED STONE TEST PIT ELEV. 60.5_ --NATURAL SOIL-'A 2'MAX. .EFFECTIVE DEPTH N DU NO TES: R r`C• -- . 3/4„-1 1/2" 9 —O WASHED STONE 1. EL£VA TIONS BASED` ON MSL /vA `'` MIN._ 3x �1 GCE r�zHl EXCA VA TED SIDEWAL L 3 -0 EFFECTI VE WIDTH 2. TOWN WA TER ON SITE - 3. FLOOD ZONE PC It c2 OR DEPTH N 6 J-- 2g EFFEC TI VE WID TH NUMBER OF TRENCHESL et, rRt?lJntQHA TER EL EVA TION 20. 7 UA iA f=R0t4 TEST Wt�LL 6 NI ao 33 E _ IN SUBDI VISION C 4 LOT 6 52, 952 S. F. �n DESIGN DA TA t y Sg 280 S. F. SIDENALL AREA . 74 GALS/SF 207 GALS. No.of BEDROOMS 3 2 --,too ,rr Buj 142 DISPOSAL N0 -� �ojNs � � � 192 S. F. BOTTOM AREA . 74 GALS/SF GALS. cv ��y ssrB # y1e F EST. TOTAL DAILY EFFLUENT 330 GALS. ti -w AC� �- _..✓ J 472 S. F. TOTAL AREA 349 GAL S. SEPTIC TANK 50 GAL. LOT 7 -. .+ O tj , N j ro N - _sd- Ao�rE se o Z 41 A` �.. �` o GENERA L NOTES r SEPTIC rAM1 O I o �,, ,' ,` � �`� ,�' ry•i� NO TE: 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN PRO. �`- - °v - -- tIL B� IP AV ., ,� �'t ACCORDANCE WITH TITLE` 5 OF THE STA TE SANITARY CODE EXCA VA TE TO ELEV. M� -OR L OW ER N REQUIRED DATED MARCH 1995 AND ANY'LOCAL RULES APPL ICABL E ('"£I�Q°� �" •�" h LOT 5 TO REMOVE ALL LOAM AND CLAY CONTAINING I PROPOSW (3) �— -'`L' MATERIAL BENEATH THE LEACHING AREA.REPLACE 2. ANY CHANGE IN THIS PLAN MUST BE APPROVED 32 LOW 3•N z DEEP TREWHEES es EXCA VA TED MA TERIAL WI TH CLEAN° CLA Y FREE GRA VEL BY THE BOARD OF HEAL TH (SEE PRafIL&? /N_ MECHAIVICALL Y COMPACTED IN PLACE I _ 4s �'' 40 00 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BA CKFIL L ING (o SIN NO BOARD OF HEAL TH FOR INSPECTION o I E E'sr 4. FND. EL V. MUST BE CHECKED WHEN COMPL ETED� � p 11��•8 F 113.Do A-97. ( LEGEND 5. THESE ELEV. MUST NOT BE CHANGED WITHOUT S 53'4B'22"W __. .._.A- �5,oo THE BOARD OF HEALTH APPROVAL 6. BOARD Or HEAL TH INSPECTION REO D WHEN EXCA VA TED DEVON (50:00 WIDE) BEnrWf► C _ �A/,/`' mow q "' 40 — EXIST.6ROUN0 ELEV. CATCF% 4IV 4 co ' FINISH GROUND ELEV.UNDERLINED SEWAGE DISPOSAL S YS TEM PLAN PIPE INVERT ELEV. PREPARED FOR TEST PIT LOCATION RA SEPTIC TANK THE IRENE TRUS T 0 DISTRIBUTION BOX LOT 6 DEVON LANE 4"C.I.DR SCH 40 PVC BA RNS TA B'L E -- MASS. {{{{ } !!!"lam! 4"BIT.FIBER PIPE-TIGHT JOINTS ` `p "'�"'�•�9�°0� — PROPERTY LINES :�� -9 D, � harle p DESIGNED : SAP DA TE : ✓ 11. 1996 MIN.CODE DISTANCE No°7468 ,� FERREIRA ASSOCIA TES 40 130 6 108 DRAWN : HP Sc,AL E.•AS SHOWN 131 SPRING BARS ROAD ►: ���`� FALMOUTH — MASS. MAP SEC PCL LOT HSE CHECKED : COS DARNING NO.• ost196