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HomeMy WebLinkAbout0010 LITTLE POND ROAD - Health 1 U Little Pond Road Marstons Mills — -- - - A7-065 - 015 s I n a TOWN OF BARNSTABLE LOCATION 4/�; ,^ SEWAGE #,O ✓J' dl? VIL LAGE y l�(Q� � ASSESSOR'S MAP & LOT INSTALLER'S NAME Cz PHONE NO. A & B CANCO 775-6264 -SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA r - �`an� i. a ,. 1 �fl �� n r--- _.._.�% `\` I 'j �.yn f y`:t''la 3i�, 'f�-1 �! COMMONWEALTH OF MASSACNUSETTS ", y EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTME\T OF ENVIRONMENTAL PROTECTIO ONE WINTER STREET. BOSTON. NIA 02108 Fl 7-292-5;00 \�1A. 11P, � 1 D WILLIAI`A F.WELD SFjO T Y COXE Govemot 350 MAIN STREET o is Secretar. ARGEO PAUL CELLUCCI WEST YARMOUTH, M yo�B jg DAVID=B.STRUNS Lt.Govemor 508-775-2800 �lyoFATI�I ,Co. missioner CP F � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO M PART A 9 5 CERTIFICATION PROPERTY ADDRESS: 10 Little Pond Road, Marstons Mills ADDRESS OF OWNER: DATE OF INSPECTION: September 15, 1997 John Sloane NAME OF INSPECTOR : James D.Sears I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 9310 CMR 15.000) COMPANY NAME: A& B Canco MAILING ADDRESS: 350 Main Street, West Yarmouth, MA 02673 TELEPHONE NUMBER: (508)775-2800 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X PASSES CONDITIONALLY PASSES NEEDS FURTHER EVALUATION BY THE LOCAL APPROVING AUTHORITY FAILS INSPECTORS SIGNATURE: DATE: September 18, 1997 The system Inspector shall submit a copy of this inspection report to the 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, 8, 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: NIA 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 b the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or NO). 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 is 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. Page 1 of 10 (revised 04/25/97) DEP on the World Wide Web:hftp://www.magnet.state.ma.un/d SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (CONTINUED) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Date of Inspection: September 15, 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 systern 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: N/A 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 the 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 and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER 1 (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Date of Inspection: September 15, 1997 D]SYSTEM FAILS: You must indicate either"Yes" or"No" as to each of the following: WA 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 over- loaded or clogged SAS or cesspool. Static I!quid 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/z 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 potion 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 surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 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. 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: Ycu must indicate either"Yes" or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: N/A The system serves a facility with a design flow of 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 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 the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Date.of Inspection: September 15, 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 nct 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 bui;t 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 back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components, including 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. The size and location of the Soil Absorption System on the site has been determined based on: X The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal System. X 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)] (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Gate of Inspection: September 15, 1997 FLOW CONDITIONS RESIDENTIAL: Design flow: d./bedroom for S.A.S. g 330 g p Number of bedrooms: 3 Number of current residents: 2 Garbage grinder(yes or no): NO Laundry connected to system es or no): YES Seasonal use(yes or no) NO Water meter readings, if available(last two(2)year usage(gpd): 1995 128,000/1996 153,000 Sump Pump(yes or no): NO COMMERCIAUINDUSTRIAL: 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 Title 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: N/A System pumped as part of inspection:(yes or no) NO If yes, volume pumped: gallons Reason for pumping TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known)and source of information: 1987 PERMIT#87-359 Sewage odors detected when arriving at the site: (yes or no) NO (revised 04/25/97) Page 5 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Date of Inspection: September 15, 1997 BUILDING SEWER: N/A (Locate on site plan) Depth below grade: Material of construction cast iron 40 PVC other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) 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: 1,000 GALLON PRE CAST Sludge depth: 0 Distance from top of sludge to bottom of outlet tee or baffle: 34" Scum thickness: 1" 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: 15 How dimensions were determined AS-BUILT&TAPE MEASURE 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.) TANK AT WORKING LEVEL, OUTLET BAFFLE, COVER 18" BELOW GRADE. GREASE TRAP: N/A (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.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane,John Date of Inspection: September 15, 1997 TIGHT OR HOLDING TANK: N/A (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: Design flow: gallons/day 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 cutlet invert: N/A Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc,) BOX NOTED ON AS-BUILT BOX DEEP UNDER LAWN DID NOT OPEN, ROCK HARD GROUND OVER BOX. PUMP CHAMBER: N/A (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.) (revised 04/25/97) Page 7 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane, John Date of Inspection: September 15, 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: 1 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.) 1,000 GALLON PRE CAST, PIT 42" BELOW GRADE, PIT COVER 18" BELOW GRADE, 18"WATER IN PIT PIT WALLS CLEAN, LOOKS GOOD. CESSPOOLS: N/A (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: N/A (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.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 Little Pond Road, Marstons Mills Owner: Sloane, John Date of Inspection: September 15, 1997 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100(locate where public water supply comes into house) R eAD 0 0 3,1 O 3b revised 04 25 97 Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 Little Pond Road, Marstone Mills Owner: Sloane, John Date of Inspection: September 15, 1997 Depth to groundwater 47,8 feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained fro Design Plans on record Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local 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 the High Groundwater Elevation. (Must be completed) USGS WELL DATA SOW 253 ZONE B (revised 04/25/97) Page 10 of 10 . � c� TOWN OF BARNSTABLE LOCAT �if � SEWAGE VIi:L'AGE d I �'ZI j ASSESSOR'S MAP & LOTA,96y',? INSTALLER'S NAME PHONE NO.Te&V/4 We(6 92 IoSEPTIC TANK CAPACITY 100c) &(t d k a LEACHING FACILITY:(type) tA Z A/. 2,t r (size) 6 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER WYl BUILDER OR OWNER' ?!� /k/ ':U DATE PERMIT ISSUED: . : DATE COZIPLIANCE.ISSUED: VARIANCE GRANTED: Yes No . '6y..)` `A v ® N,y`s` y ® 0 No.. ....._....�� Fxs.......... ................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH l �W............OF......BPkRILL S TPt-B L E.. Applutttiun for Disposal Works Tonstrurtiun Prrutit Application is hereby mad for pp y Permit to Construct (x) or Repair ( ) an. Individual Sewage Disposal System at �, _ POND RD._ R ftP-K15TA5LE_MA. LOT 7,�L I-[TLE :Pool ) E STATES ...................................•-....... -_------------•----•----•-----• - Location-Address No CAp{tIGOR1 CHI--T. `l` S ..!5-7 L1.'[T'1--F�_ POt�(D.. pAD --------------------------------•---•--- W Address { A A a ,. e caner _...Installer Address U Type of Building Size Lot-44+QDO_ .Sq. feet Dwelling—No. of Bedrooms............. ..........................Expansion Attic ((CIO) Garbage Grinder (No) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow..........5.'r�55......................... per person per day. Total daily flow....... .30..._..................gallons. WSeptic Tank—Liquid capacity.ItP gallons LengthJW4.._.. Width f 10... Diameter................ Depth-5___S.If x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No......I.............. Diameter....1.Q........... Depth below inlet.,..t6,.4a7.... Total leaching area.Z.5„a..7....sq. ft. Z Other Distribution box (Y, Dosing tank ( ) Percolation Test Results Performed by.C-AQ!.--- minutes per inch Depth of Test Pit-_1_._......I...... Depth to ground Test Pit No. 1...., ,_...... s O Test Pit No. 2..............minutes per inch Depth of Test Pit.................... Depth to ground�� rSTEPH-E4-.. ....................................................................•---•-••-_....._•••-••••-•• ALLYX....... l Description of Soil- 'P---•.L'�.7••.• --- -z4.....?bP50tl.#`S"isso14- �j x �� v ___.�1iLSON__ .h V �4 L�O!?') A�rT•..SI�.T GL ...._L. �ID�. 'Q No.30210 ire i� W (olo- ---14 F,AT/Fr �+ U Nature o= Repairs or Alterations—Answer when applicable............................................................ S/ANAL • --•••••••-•••••---••••••...--•-•••••--••••-•-•---••--••-•----------•...-----•-••••-•----••••---... Agreement: e c u c 4 3-4 P7 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sa itary Code— The undersigned further agrees not to place the system in er tion until a Certificate of Complia ce has issue by t board o ealth. Sign e F - .. .... c[•- D Ap is tion A proved By-••••-• . ... ....................................... .....12...1_'1-71.....•. Date Application Disapproved for the foll wi g reasons:...............................................................I.-M............................................... -----•-•------------•--------------•----..........-•---------...-••••••-•--••-••.....-•-----••-•--•-••••---••-•-•--•-•--••••-••-••-•-----•••••--••-•------------------------------------------- Permit No.......... ..�_---_3 S.L._.._..--•--...... Issued.............•-•-•....-•••••-........---•--Date Date � I ��T No................-....... FEs................:........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TO!4 SA...._.......OF......8 R!a T L E........... , pphration for 11ispas al Warks Tonstrnrtion ramit Application is hereby made for a Permit to Construct (A) or Repair ( ) an Individual Sewage Disposal System at: L.I Tr LEz P+oNo RD.-- _G`'ARdS5TA5LS AA _.Lo'�'.7,._�-:M LM PoN a F—VrA-rras...... . -............ -------------------•-•-•--- -• --- Location-Address Qgir.--------- _...Fa......................................._ --- ( Owner Address W ......� ....... �. . ;_ in. �' 1 ; 1 ETA I .E..�1' ,-� .... Installer Address �L Type of Building Size Lot.4.4,.O t.Sq. feet Dwelling—No. of Bedrooms............ ...........................Expansion Attic No) Garbage Grinder (No) a Other—Type T e� yp of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) A4Other fi tures •-----------------------•-•---.... -•-••--•--------.-•------•--•--••-•----•--------------------••--------•--•-----.......------•----••---•--------- W Design Flow....._..."-��........................gallons per person per day. Total daily flow.._.... 0......................gallons. WSeptic Tank—Liquid capac>tyl,#.QP.O.gallons Lengthg'4./.f._ Wldth.'�.-*lQ,". Diameter................ Depth.6 .S."... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.................._.sq. ft. Seepage Pit No.....I.............. Diameter_..j. ... Depth below inlet. + 7___. Total leaching area.7.66'-.7....sq. ft. z Other Distribution box (A Dosing tank ( ) '-' Percolation Test Results Performed by.CAINL ..` •✓ : SU[ AN7SDate_._4:7_ P a Test Pit No. 1.... .......minutes per inch Depth of Test Pit. ................ Depth to ground w t �r_____- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground • - " -----------•-•---------•-••-------------------•-•-•-•---•-••---•-•-•------------•-•-•-----•..................-•-•.......</ STEPHEN C. €' Description of Soil---_LG1~7----©-- 2� '..... t.¢` ...... SQEI.. -------•--------• �... ------ • -', x ZW-&C".C.cQmpAf.'r 5i t,.'Y_0..QLA_ /)�Y4oTt'l.. ----- " I�o J 4 �j`'}�{�� mow.(� �/+y .._ U Nature of Repairs or Alterations—Answer when applicable.................................................................. . -•------•-------------------•-----•-•-----•---•--•-------------------.....----------.....--•---------........-------------------•----------------------•---------- Agreement: u 400, 3-G_d7 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in ;?e ation until a Certificate of Compliance has been issued by the board of health. Signed............. ---- - -- D lition roved B {fin-.PP Y -----......... Date Application Disapproved for the f oll w- g reasons----------------•-------------------............................................................................. -•---------------------------•----•---...---.......----------......--------------•-•-.......--•••--••••- ._ ` . . •....--•••-••------------•-----• --•-•--- Date PermitNo......................................................... Issued...................---------------•---•--------•------ i t Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. L oF........ ................... ....... ................................................ Tntifirate of Toutplittnrr THIS.I5O GE-RTIFY,,Th t the Individual Sewage Disposal System constructed ) or Repaired ( ) b L...............31----------------------------------------------------------------------------------X—� ._ Installer at. Lt' ._... `•.....-�_�.............. �-N-1`------......-.=-=............ �f 1� �LS...--•------•--•..I-----------•---•--------- has been installed in accordance with the provisions of TITi�'E 5 of The State Sanitary Code as des in the application for Disposal Works Construction Permit No----- ............... dated....... .--_. --_-_- ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....................a-.-..` ..-. _ ............................... Inspector....................�...n---•-----------•--••-----•----•------•-•------- r THE COMMONWEALTH OF MASSACHUSETTS `I BOARD OF HEALTH No.. 3` jay N ................... FEE :�_'.---.---..... Dispas tl Workii Tnno uan rrntit Permissi is hereby granted..-•------ W to Construct ) or Repair ( ) an Individual Sewage Dis �o� System atNo..-•-•--T•---•--•......7.:.............L(_ ".� -•----.��4��....... - - -------------------------------------------------------•-------............---..... / - Street ?S as shown on the application for Disposal Works Construction Permit No 7a__3 ...-_•- Dated.._._G_......- ...........:. -----------• .............._........................r---••---•-- Board of health j' `•. ' DATE................................................................................ r FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS a da Ll : C d TOWN OF BAR®NSTABLE LOCATION ,al /Zl' G 1�J"�e ©�of SEWAGE # V?IL:LAGE /�l1/5/`d�?S �-r/1/ 6�ur' �0 S ASSESSOR'S MAP & LOT 4' INSTALLER'S NAME & PHONE NO. �dr'T`71LOZ�i' Go'yts7` y Z SEPTIC TANK CAPACITY /dCPCO LEACHING FACILITY:(type) �04 7cll (size) 4k3 NO. OF BEDROOMS_ PRIVATE WELL O PUBLIC WAT BUILDER OR OWNER 'gal DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 14 VARIANCE GRANTED: Yes No i • � � � ,� ��/ �j. � yg' a l a SEPTIC TANK DETAIL: <:; DISTRIBUTION BOX DETAIL: ACHING PIT DETAIL: REVISIONS. SOIL TEST PIT DATA: S C L �. �� ,� L . INDICATES INDICATES � PERC. OBSERVED NOT TO SCALP NO DATE NOT TO SCALE. NOT TO SCALE TEST GROUNDWATER NOTES: 1. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE CAST IRON, " NO. OF OUTLETS: 1 MANHOLE COVER LOAM 8 SEED - TP LOT 7 TP TP TP REINFORCED CONCRETE. SCHED; 40 PVC OR CAST-114-PLACE CONCRETE, TEES BROUGHT TO FINISH GRADE OR PAVEMENT TO BE CENTERED UNDER MANHOLE COVER. NOTES �rini�/C/,� i GRD. EL. 92. t GRD. EL- GRD. EL. GRD. EL. 2. SEPTIC TANK TO WITHSTAND H-10 LOADING - -�--- ' GW. EL. ►�� VV TFk. GW. EL. GW. EL. GW. EL. UNLESS UNDER PAVEMENT, DRIVES OR i I. DIST. BOX TO WITHSTAND H-10 LOADING 2'�MIN OF 1/!3 _ TRAVELED WAYS,WHEREIN H-20 LOADING I I UNLESS UNDER PAVEMENT DRIVES OR TO 1/2" 12"MIN. FILL J PRECAST I TRAVELED WAYS WHEREIN H-20 LOADING STONE D �r / SHALL'APPLY. F- 'TCDp­;6I L_ it I DIST. I SHALL APPLY. as a.;e'-' 3. ALL PIPE CONNECTIONS AND CONCRETE MANHOLE COVER 21 I _ b . _�y � d o,<�a . .,.•..:•.• . :' -�C3 h BROUGHT TO FINIISH GRADE I BOX r 2. PROVIDE INLET TEE OR BAFFLE WHERE SLOPE OF ��;r SuS�it . 97 {, CONSTRUCTION TO BE WATERTIGHT. INLET PIPE EXCEEDS O.OSFT./FT. OR IIN PVC INLET WIPE b o I� r o 0 o p ��aF� �fi I 1 PUMPED SYSTEM. d ,. - 'oj%APPtcT- SILT 12"MfN. L--- f c v cn =3 o 0 0 o a p• +L , '� NOTE: GENERAL NOTES: /t COVER r~--- 3. FIRST TWO FEET OF PIPE OUT OF DIST _ �° t ) ° n ' �- Y I O j' • LEACHING P►T TO L THIS PLAN IS FOR QESIGN AND ` -� BOX TO BE LAID LEVEL. a :. . ,. : • '.. .... . a e �o� WITHSTAND H-10 LOADING n • PLAN VIEW o U Q -ram o. c ca. o o a e 0 CONSTRUCTION OF THE SEWAGE •'- • UNLESS UNDER C►-A►� (MJTI-LEP� 's PRECAST • DISPOSAL FACILITY ONLY. NORMAL WATER LEVEL REMOVEABLE " N , n e. • PAVEMENT,DRIVE OR :_1 a. COVER 3/4 TO I-1/2 n a o 'cam Q a n n o \ TRAVELED WAY WHEREIN 2. ALL CONSTRUCTION METHODS AND , �, , DOUBLE LEACHING PIT ao H-20 LOADING SHALL:' MATERIALS SHALL CONFORM TO MASS. !oG 9�•� I I t u u WASHED a n` C3 C= = c3 c c c 0" o� APPLY. D.E.O.E. TITLE 5 AND LOCAL BOARD PEflC.; I PROVIDE ►.. .: . .. •:. ►•'. STONE t)6 OF HEALTH. REGULATIONS. INLET TEE ': WATERTIGHT 84" I I I „ JOINTSItYp) , 1,. •' I'.: w (n0 finest 8U ►RECAST — L ♦'-0" MIN. OUTLET ::: -B I,: I a O o o d o 3. ALL PIPES LOCATED UNDER PAVEMENT _ f•--1 SEE ,, s PTIC I• T Lil i\ I:` ©° �' � OR TRAVELED SHALL BE SCHEDULE I E / ,� LIOUIO DEPTH TEE 4 INLET 1 .NO E 2 _ I I TANK — I /(� _ / �� r tcYS O C C7 [� C7 b CJ p p — ` f , 40 OR EQUAL. tF'IE© I I 4 OUTLET I „L. 95 ,_,i? • a '% 5ANtD �f CRAVEt_ I I L------IJ L---------� - - - - - - - - - - - - - - - --� / t t ..; . BOTTOM ON LEVEL STABILE BASE .�fl, i� co -o,o oo -�OTTOM4 ON � DIA a "�„ ' d �.iE/! LEVEL STABLE CROSS-SECTION BASE /0 DI A. PLAN VIEW CROSS-SECTION VIIEW _e CONSTRUCTION NOTES: DATE: DATE: DATE: DATE: INVERT ELEVATIONS: !. -IF ENCOUNTERED, ALL UNSUITAELE SOIL ` B.M. EL. 100.00' (ASSUMED) Ct SHALL Et REMOVED WITHIN,A . W' TEST BY: : TEST BY: TEST BY: TEST BY: " �% C.B./D.H. �\ I/ 4 INVERT AT BUILDING �% - '`- �T ✓1 V�/I t sow FND �'�-1 ZOPJi= AROUND Tti`= LZ_ACNiftiu FACILITY BY. WITH WITNESSED BY: WITNESSED BY: 114 4" INVERT AT SEPTIC TANK(in) 75 - allo sHALr_ aF R1=�LACEa WITH C.L WITNESSED WITNESSED BY. I 4_ " ,�` ' SAND AND GRAVEL-IN ACCORDANCE W1','•, Tor+ti M.b, K>=A►• s 1 �, / 4 INVERT AT SEPTIC TANK(out) � _ - TITLE �. - PERC. RATE: PERC. RATE: PERC. RATE: PERC. RATE: ' ._. 9g '�-`� \\ N/F � �/. 17 4" INVERT AT DIST. BOX(in) �7. � MIN./INCH MIN./INCH MIN./INCH MIN./INCH CENTERVILLE OSTERVILLE `J�9 / T AT DIST. BOX(out) FIRE DISTRICT 4 INVER DA TUM: INVERTS AT LEACHING FACILITY: VERTICAL DATUM: ASSUMED 1 4 22,2i"� \\\ /i ,� // I` 1NvEP_T PST LEACH PIT (I") �(U.77 196> BENCH MARK USED: SEE PLAN19 Lo-r 7 t \ \ \ I I I / OBSERVED GROUNDWATER ELEVATION A10,61 ' I \ \ 1 ; 000 , cn co 1 1. 1 1 1 \ , cn _ I 1 \ I N I I ti 5 ZONE. RF - SETBACKS } I FRONT 30' , �.-_. I 1 1 I I ,t •. � ..r. ' ..�., �:.,. .ems .:.. SIDE � 15 , .__....-,_ �` r 5.:�.N:r. �--- / r DESIGN,FLOW: .: REAR 15 r; CAPR/CORN REALTY TRUS ,_ BEDROOMS AT 11 O G.P.6./D .».. G.P.D. r F 1 : _ T1 I The BSC Group G / rn 4 to mP �. I oo r I I , REQUIRED SEPTIC TANK: � _.. .. � goo � I x /so = �' GAL. I SEPTIC TANK PROVIDED: _ SE C O 1, 40(? GAL. NOTES. • Cape Cod Survey Consultants PROPERTY LINES SHOWN HEREON WERE COMPILED \ c :` ^� I / 1 7 I I SIZE OF LEACHING FACILITY REQUIRED: / / FROM A PLAN RECORDED AT THE BARNSTABLE DESIGN PERC. RATE: G MINJINCH REGISTRY OF DEEDS IN PLAN BOOK 429 PAGE 58 n i 1` , Y ' g, 1 / / I t I I 3261 Main Street /, I / / I I I I O G. p Route 6A I t �a' AND -DOES NOT REPRESENT AN ACTUAL SURVEY ON ; ',` ;� � � � � 1 I B rn THE GROUND. D /�'�ilro✓tiL, a stable Village MA / T02630 EST P� ` 1�'E SEE'- I I ' 617 362 8133 THIS TOPOGRAPHIC SURVEY WAS MADE ON �I h--' / / THE GROUND BY TRANSIT AND STADIA. METHOD PROJECT TITLE: ON MAY, I970 , } ! SIZE OF LEACHING FACILITY PROVIDED: 1 �0 1 p F ti I• / I l t ► Ir -�` Pi7-- h/ z s�"J,5- SEWAGE DISPOSAL SYSTEM DESIGN I I �• l f3oTT4it%' 79 S-F. X /. CJ 79 C PD / 2�.26' II I / II I I FOR n; ► / 1 N52• / I l I t I LOT 7 I � 2,9' 1 LITTLE POND I / t LOCUS PLAN. SCALE: 1"=2083'+ ESTATES IN PO ! I 1 1 I I . I (15D�W B.M.EL.=100.00' - C.B./D.H. AT N.W. ,. -< xDE - OAD I I I I BARNST ABLE, MA. WAYJ - , PR1V,4TE COR.OF LOT 7. I I (MARST ONS MILLS) PROPOSED PAVEME-N7- I I rn -.-,- r ¢ PREPARED FOR: DATE PROFESSIONAL ENGINEER - CIVIL 1 t , 1 � _ ', I � o --- LOCUS CAPRICORN REALTY ,,. I I 1 1 TRUST k LOT 5 I j I I Ir LITTLE POND RACE . LANE r N/F CAPR/CORN REALTY TRUST 1 I 1 \ LO7 16 • DATE FEBRUARY 27,I987 1 I 1 \ 1 1 0 FRANK ti�.; v , 1 \ ! COMP/DESIGN 1� WHITING ��A � � } I 1 ` `\ , , ----- --------- •,c• Alo• 2�8&9 of 0 Q` �� � MYSTIC LAKE , CHECK: 5,A,W. DRAWNR.CH / T.A.W. L_.F�. .. .: � .�� . PLAN VIEW , -------. 1-- - ----._ FIELD. W.B.---- ---- -- -- DATE PROFESSIONAL LAND SURVEYOR` SCALE: 1" ��" �--B.M.EL-63.81' - C.B✓DJ--1. AT N.W. COR. OF PLlSKIN LOT. FILE N 0 3/38606SS.2D_ DWG. NOI247-5 — SHEET D ID ��J �tv w�."' FEET --- .1oB No3J386.06 1 0FI