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HomeMy WebLinkAbout1125 OST.-W.BARN. RD - Health l 125 Ost; 1VMarstons Mills A= 125-043 — -- - -- - - --- — - -- - < TOWN OF BARNSTABLE BOARD OF HEALTH (� ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date v Time: In �Out fl ` -15 Owner N/�- Tenant Address , t �—;� C)S ULv � Address 1 4 Comp' nce Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 0 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service approved: ,� f 11. Space and Used 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 34 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) s &q- P-5 Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here oF�� Town of Barnstable P# 12 Department of Regulatory Services STABLE, Public Health Division Date l a te7a �a� 200 Main Street,Hyannis MA 02601 Date Scheduled (C u Time Fee Pd._j U Soil Suitability Assessment for Sewa e is g posal Performed By: Ma A4FL, PiMiw i EK Witnessed By: w_ LOCATION & GENERAT, Location Address i.Z INFORMATION 5V t4A,* 05�2tuMe- Lz. 13Ar✓►st-,Az4(ak)0wne1's Name 5 Ulu Address 1 1_L 7 O S r, ►jed Assessor's Map/Parcel: ( Z,� R�AS�w`` Engineer's Name NEW CONSTRUCTION REPAIR 1/ " Telephone# � vb�2� �p Z g ' Land Use S,Nta{ FgvU�Y 11o6aT1Al, Slopes(%) 1 7-110 Surface Stones Distances from: Open Water Body 1�_ft possible Wet Area 715D _.^_ft Drinking Water Well 7 00 ft Drainage Way 10 ft Property Line >10 -- ft Other ft SHE (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in Proximity ty to holes) SE4 ArtACHED ?LAN EAITITLEO Ab$Ep $ePrIG n z5 ost�IWucs: -w. 9A9nlsrP �� Vk,4AW_^ 1 oemo Ar &-� Roq� A,%0 M,4lrrro Parent material(geologic) UureuR „ Depth to Bedrock 1� 3G5 Depth to Groundwater. Standing Water in Hole: 136--, G-s Weeping from Pit Pace �i 13o" 3CS Estimated Seasonal High Groundwater 1'Sp" aGS DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: "DWa 4Q Depth Observed „n*,,, standing in obs.hole: ►30" s Depth to weeping from side of obs.hole: 7 130� �G$ in. Depth t0 soil mottles: )1�" F(.$ In, ©roundwaterAdJtistment [ndex Well# Reading Date: Index Well level �^ ft Adj,factor.,,,,,,_ Adj.6ruuntlwaterlx �-vel Observation PERCOLATION TEST bate ►414161 Time A,� Hole# j _ Time at 9" Depth of Pere Time at 6" ` Start Pre-soak Time @. t0:15 ��- Time(9°6") End Pre-soak 10:23 � Rate Min./Inch <2 kIF1 Site Suitability Assessment: Site Passed 1/ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. ,Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTlCIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil. Surface(in.) (USDA) Other (Munsell) Mottling (Structure,Stones;Boulders. on istenc % ctvel • an► ip Y� s/6 yO"�3o C. �►�auwt SM►o . y ��` DEEP OBSERVATION HOLE LOG. Hole# � Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) SIG-I�r �`, MBAounn SAwO 6' _ ------------------ -------------- Z.Sy • 1 DEEP OBSERVATION HODELOG Hole# Depth from Soil Horizon Soil Texture t Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. CMi2tency,%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten I Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No '� Y Yes Within 100 year flood boundary No✓ yes :Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? A Y" If not,what is the depth of naturally occurring pervious material? Certification I certify that on 9q (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, cxputise,61 experience described in 310'CMR 15.017, Signature Date Q:\SElYrlC\PERCFORM.D0C l i TOWN OF BARNSTABLE LOCATION IN (( r� SEWAGE# •Z Q JrA VILLAGE t, A SiNSOR'S MAP&PARCEL l INSTALLER'S NAME&PHONE NO. c.rJ e by i �',,� �{2 g- q c)2-9 SEPTIC TANK CAPACITY LAC lk LEACHING FACILITY.(type) Zu .h CG.n size) NO.OF BEDROOMS OWNER Alt 2 2 Qn. P &F vt Pf PERMIT DATE: (_©_ 61gq COMPLIANCE DATE: /® "2`-J( '7-&o Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility "Ve 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) q �� Feet FURNISHED BY �'r-�49P.Lt�i ex� j"G 4d-P�f'S 5 LLC— r - u 33 �jS �S •l� � � � -1QI�1 8� ao o y 95 .33 S No. —� 'Fee V THE COMMONWEALTH OF MASSACHUSFTTS Entered in computer: PUBLIC HEALTH DI` 45ION .- TOWN OF BARNSTABLE, M ►SSACHUSETTS Yes Application for Mioont *pgtem Con0truction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. 1 i OS a.va eSI"j3 st03P,_t4 Owner's Name,Address,and Tel.No. f t/L�t✓1 h f. SJiI t e r�r4r�c1 7--1 o Te Assessor's Map/Parcel 17 i J7 (lY�( /k*w fW1y Installer's Name,Address,and Tel.No.(�,dJo aq �yk,. os e� Designer's Name,Address and Tel.No. ✓mod Type of Building: Dwelling No.of Bedrooms Lot Size 30.OCC) sq.ft. Garbage Grinder ( ) Other Type of Building 5't.4ie. 1 Y No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 10`L4( —ZOQ'l Number of sheets 1 Revision Date Title ill.!;- ®-ST• We JK &AVol Size of Septic Tank 1000 1 Q t y Type of S.A.S. all c?IS Description of Soil IL V 1�ek Qv4g, 0 o Nature of Repairs or Alterations(Answer when applicable) GXA Ti"kk r- AQ t.J To C2 o) - i o - 20 Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S'gned Date C)0 Application Approved by Date Application Disapproved by: Date "for the following reasons Date Issued No. r�I4;3 - _ ee lJ 1_ i ny53 1 r y �- - ,+ Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS. Yes PUBLIC HEALTH P-!ITS1 N -TOWN OF BARNSTABi:P-- MASSA"CHUSETTS Application/for Th5po5a[ i§p5tem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. t%Z.S PST-.t,J •,T(34,-1sfvh3/. r4 Owner's Name,Address,and Tel.No. 5 u z A✓t n..e e r yt&,,c/ Assessor's Map/Parcel 1 Z ���� ` •11V1( � /lt�Hs I ta,,� el­ Installer's Installer's Name,Address,and Tel.No.0,j17c,,),o v dap l rp,SPS Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms —3 Lot Size 30,000 sq. ft. Garbage Grinder ( ) Other Type of Building 1%�, (1-�Yti R No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date ( l�' l�( —204I Number of sheets Revision Date Title j L S O 5 • L4,e yZ Size of Septic Tank wo P•wa >I�� Type of S.A.S. 'G 0W e,6 t3 itr itl �S t Description of Soil SeQ p I 4-o (F,) L4 a Nature of Repairs or Alterations(Answer when appl-icc�able) t rG x-'S i `h 17"M k To �ta&j -0--3zy _To U 1 1 "JQ4,I IL, I G Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until,a Certificate of Compliance has been issued by this Board of Health. Signed s Date to— 7,16 Application Approved byK11__ Date Application Disapproved by: Date for the following reascns J- i / Permit No. `7J Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (y) Upgraded ( ) Abandoned( )by G.,ra,QR.►J cQ Q 7 , �(1 � l..l.C._ at -11.1 pJ 1t«q� we,T Gy)-► s o*' /C flzpgtlt has een constru"c�ted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer C„(A-fI ,Zt e �.{f ai" PS Designer J�km t H #bedrooms Approved design flow 0 gpd The issuance of this t shall not be construed as a guarantee that the system—ill-furretion s designed. Date (� / /�"/ Inspector., No. )CXJ 17 Fee p C) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS )Digozar 6p!5tem Con6truction Permit Permission is hereby granted to Construct ( ) Repair O Upgrade ( ) Abandon ( ) System located at it 2L5 ��(�i�L� Y l� J�fZ.S lZ�x a ✓h.�11 � and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must.be completed within three years of the da4�f this plerri it. Date IV J r?/ Approved by, x l own of narnstame Regulatory Services Thomas F', Ceder, Director SAINT~ RLr' MAN& Public Health Division Thomas McKean, ]Director 200 Main Street,Hyannis, MA 02601 Oft'!= .508-862-4644 Fax 508..7,(F•6304 11gstaller &RysigneE rti atio For [late: 10- 36-09 Uesigper: Iustailer: LlQ`'u',& �nher �tSt�.a Address: _ 2 .S'1 <<�L7o,bNcry f-( uJc�v Address: 0'4 -7 3 _..�.- on w�0 d2�- dc( C o,,a�c �s�� � was Issued a permit to install a septic system at _ 112`6 0Sk'zr'j,tte_ -wese C�4�rr�stabte.. (z� based on a de:iigla drawn l.ty dated Ge.to\per vocj _ ✓ 1 certify that the septic: syrrtem referenced above was installed substantially accorchn r to the design, which may include minor approved change; such as lateral relocation of the distribution box and/or septic tank. T certify that the septic system referenced above; was installed with rrxajor changws (; e greater than 10' lateral relocation of the SAS or any vortical relocation h. M pone of any comnt of the septic system) but in accordance with ate& I1c�ea1 RegulKtions, .flan revisiott I,- certified as-built by desi&gier to follow, CHkiRC"1'.L. (.Ues)'gnt;r's Si - ' essgner's rrnplerej PLEASE RETUNV A NW& ll'° C I.I CF IL . OT E 'IF ytk I IV B E S C1N, Q Health/Septic/Denigner Certification Form 100d L920 2LZ 809 ONI2J33NION30f WO 6t,: LO 60OZ-02-100 � t T , . t 1 TRANS. NO.: CITY/TOWN: Osterville APPLICANT: Ca ewide EnteEprises ADDRESS: 1125 Osterville-W. Barnstable Road, Osterville DESIGN FLOW: 330 gpd REVIEWED BY: DATE: N/A OK NO GENERAL ' Legal boundaries denoted [310 CMR 15.220(4)(a)] X Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] X Locus Provided [310 CMR 15.2204(t)] X Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] X Easements shown [310 CMR 15.220(4)(b)] X System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] X 4Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] X Location all buildings existing and proposed 310 CMR 15.220(4)(c)] X Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] X System Calculations [310 CMR 15.220(4)( ] X daily flow X septic tank capacity(required andprovided) X soil absorption system (required andprovided) X whether system designed for garbage grinder X North arrow [310 CMR 15.220(4)(g)] X Existing and ro osed contours [310 CMR 15.220(4)(g)] X Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] X Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] X Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] X Percolation test results match loading rate? [310 CMR 15.242] X Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] X Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] X Address 1125 Osterville-W. Brastable Rd.,Osterville,MA 02655 Sheet 1 of 7 t T i I N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4)(k)] X within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply X within 250 feet of the proposed system location in the case X within 150 feet of=he proposed system location in the case of private water supply wells X Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] X Water lines and other subsurface utilities located [310 CMR 1 5.220(4)(m)] (if water line cross see 310 CMR 15.21 l(1)[1]) X Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] X S amp of designer [31C- CMR 15.220(1) and 310 CMR 15.220(2)] X Stamp of Registered Land Surveyor (required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] X Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] X Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] X Test Holes adequate to confirm adequate groundwater separation? F310 CMR 15.103(3); I X Benchmark within 50-75' of system [310 CMR 15.220(4)( )] X Materials specifications noted? [various sections of 310 CMR 15.000] X System components not> 36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405(1(b)] X Address 1125 Osterville-W. Branstable Rd., Osterville MA 02655 Sheet 2 of 7 Y �. ' N/A OK NO SEPTIC TANK r> Size OK? [310 CMR 15.223(1)] X Inlet tee located ten inches below flow line [310 CMR 15.227(6)] X Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] X Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X Note regarding installation on stable compacted base [310 CMR 15228(1)] X Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] X Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] X Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(0] X Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] X Access to within 6 " of grade - one port for systems<1000gpd, two for systems >1000 gpd [310 CMR 15.228(2)] X All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] X > 10 ft from building foundation [310 CMR 15.211(1)] X Buoyancy calculation Required/Done [310 CMR 15.221(8)] X H-20 Where appropriate? [310 CMR 15.226(3)] X 'Setbacks from resources [310 CMR 15.211] X Multi-Compaitmkit Tanks Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] X First compartment 200% daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and (3)] X "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] X II Address 1125 Osterville-W. Branstable Rd., Osterville, MA 02655 Sheet 3 of 7 r N/A OK NO BUILDING SEWER AND OTHER PIPING _ Located at least ten feet from any water line? [310 CMR 15.222(2)] X Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) X C-;eanouts required/provided ? [310 CMR 15.222(8)] X Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] X Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] X Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] X Siphon problem/ (leachfield below pump chamber) X Endca s or vent manifoldspecified? X Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] X '_Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) X ;DISTRIBUTION BOX . P Stable compacted base [310 CMR 15.221(2) and 310 CMR i 15.232(2)(a)] X Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] X Riser if deeper than 9" [310 CMR 15.232(3)(0] X Inside minimum dimension 12" [310 CMR 15.232(2)(b)] X Minimum sump 6" [310 CMR15.232(3)(e)] X Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] X PUMP CHAMBERS Capacity(emergency storage above working=design flow)? [310 CMR 231(2)] X Proper setbacks [310 CMR 15.211 same as septic tanks)] X Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] X Service components accessible (not too deep with piping, disconnects accessible) X Alarm floats - alarm on circuit separate from pumps specified? X Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and (8)] X Stable Compacted Base [310 CMR 15.221(2)] X Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)] X Address 1125 Osterville-W. Branstable Rd., Osterville,MA 02655 Sheet 4 of 7 N/A OK NO SOIL ABSORPTION SYSTEMS(SAS) GENERALS ,, Calculations correct? X 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] X Required separation to groundwater? [310 CMR 15.212)] X Aggregatespecified as double washed [310 CMR 15.247(2)] X System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.2411 X Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] X Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] X GALLERIES,PITS,CHAMBERS 31'0.,CMk 15.253 Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] X Each structure with one inspection manhole (if>2000 gpd must be tograde) [310 CMR 15.253(2)] X .Aggregate 1' minimum- 4' maximum. [310 CMR 15.253(1)(b)] X 2' sidewall credit maximum [310 CMR 15.253(1)(a)] X In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] X TRENCHES 310 CMR 15.251 Width T minimum 3' maximum [310 CMR 15.251(1)(b)] X 100 feet - maximum length [310 CMR 15.251(1)(a)] X ,Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251 1)(d)] X Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] BED SAS Maximum size of bed ar:field 5000, d, ( minimum 2 distribution lines [310 CMR 15.252(2)(a)] I X Maximum se aration between lines 6' [310 CM RI5.252(2)(d Maximum separation between lines and outside of bed 4' [31 CMR 15.252(2)(e)] 1 Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] I X Separation between beds 10' minimum. [310 CMR 15.252(1(01 X Bottom area used in calculations only [310 CMR 15.252(2)( ] R \j Address 1125 Osterville-W. Branstable Rd., Osterville, MA 02655 Sheet 5 of 7 N/A OK NO DID THE PLAN INVOLVE Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] X Pressure dosing required on all systems >2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] X If used in gravelless system - make sure jet is directed as not to scour soil interface [Guidance Document] X Inspections once per year (systems< 2000 gpd) or quarterly (>2000 d) good to note on plan [310 CMR 15.254(2)(d)] X Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? X Irnpervious barrier and/or retaining wall ? [Guidance Document] X Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] X Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] X Side slope not exceed 3:1 ? 310 CMR 15.255(2)] X Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] X At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] X -Gravelless System[I/A'Approval Letters) Check DEP Approval letters for credits and design conditions X If used with pressure dosing do not allow pressure discharge to scour soil interface X Alternative Se tic System[I/A,Approval LetteNs/. Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? X Is the technology being properly applied and does it meet all DEP Approval Conditions? X Is there a note on the plan regarding the requirement for perpetual maintenance agreement? X Any alarms involved on separate circuits X Did the applicant submit an operation and maintenance manual? X Has applicant submitted a copy of a maintenance X Variances,— Are the variances listed on the plan ? [310 CMR 15.220 (4)( )] X RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] X New construction or increased flow proposed - [Refer to 310 CMR 15.4141 X Address 1125 Osterville-W. Branstable Rd., Osterville, MA 02655 Sheet 6 of 7 N/A OK NO Nitrogen Sensitive Areas - Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] X Is the system proposed on the same lot as served by private well ? [3 10 CMR 15.214(2)] X Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] X Miscellaneous Pumping to septic tank ? [ 310 CMR 15.229] X Shared System [310 CMR 15.290] X Address 1125 Osterville-W. Branstable Rd., Osterville, MA 02655 Sheet 7 of 7 I I 2-3, 'OC6 112 ) (V56 villell Vj-N(f-lu*. I?-ea►d FoRrn 30 C&W HOBBS 8 WARREN'" THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN W kf,*L-u W DEPARTMENT AD ESS �4��0�✓4 TELEPHONE Address 2� Q�7. �` �9�5?(��L i Occupa t + 0,0,vA,+ 1—4 S&o Floor Apartment No. No. of Occupants 'Z No.of Habitable Rooms S_ No.Sleeping Rooms_ No.dwelling or rooming units No.Storie,S -- Name and address of owner .SC-,2/J,v� 5 a71 x_ i /2 O.5� w` - 4,S?41V_� 90. &WAS?O,,j M/Ce-S Remarks Reg. Vio. YARD Out Bld s.: Fences: Garba e and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches.- Dual Egress: and Obst'n.: C. B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation.- Chimney: BASEMENT Gen.Sanitation: J Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten., Sta lues,Vents,S f e . Kitchen Facilities ink ( eo Stove Bathing,Toilet Facil. Vent., Plu ash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'm General Building Posted CJ S 1 Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECT ON REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES ERJURY." ! ` INSPECTOR TITLE / A.M. DATE 3' L01 TIME (oCO D ^ ,, A.M. THE NEXT SCHEDULED REINSPECTION � �/` P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure.and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide.a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the'obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning#acilities.in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0). Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. X, I.- . (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR"410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. • FoRrA30 C&w HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOW N w �f4L7N 0 DEPARTMENT ADDRESS HESS (SO&) 86e- 416 4/4/ 1449l'u_s TELEPHONE /Z OS7. 4r. .�J.c.cs o�v + />otitiA- Lg S i(CG Address — Occupant Floor Apartment No. "— No. of Occupants ?- No.of Habitable Rooms No.Sleeping Rooms 3 No.dwelling or rooming units""' No.Stories -- I Name and address of owner Su 2/�,..,�L. 5,/ r11L� LAn-Q 1/2 7 0-5-7- �Y��S��/ � SO M/LGS Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches.- if Dual Egress: and Obst'n.: I❑ B ❑ F ❑ M Doors,Windows: Roof / Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen. Sanitation: t n, Dampness: 1 Stairs: ZX ` \ Lighting: j .? STRUCTURE INT. Hall,Stairway: vJ Obst'n.: AA Hall, Floor,Wall,Ceiling: \ Hall Lighting: Hall Windows: HEATING Chimneys: °} Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: ` PLUMBING: Supply Line: ❑ MS LIST ❑ P Waste Line: `V, H.W.Tanks Safety and:Uent s;.�r ELECTRICAL Panels,Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Coils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 • ` Bedroom 2 17,44 Bedroom 3 13!r� Bedroom 4 Hot Water Facil. Su .Ten.,G.as-eilyvEtecJ6 Stacks-Flues,Vents,Safeties. Kitchen Facilities Zink !D Stove Bathing,Toilet Facil. ( Vent., Plumb Safrit'---W—ash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted O Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTLESK'ERJUAY.','_ INSPECTOR ` � TITLE �ItAt.'?1� 1.. 2G'7 of— M. DATE 3 TIME V/.'a O P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. Az 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements'of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. 4 Failure to maintain a safe handrail or protective railing for ever stairway, porch balcony, roof or similar lace as O P 9 Y Y, p Y, p required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. TOWN OF BARNSTABLE I /�W6 fA 1 .vo i� � UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS (/ AS S S ORS MAP NO. PARCEL NO. ruby P .: oo v ADDRES �ti1 4� VILLAGE: gft-&rj-�> 14 CONTACT PERSON 4 PHONE NUMBER Z$ - LMATION OF TANKS: . CAPACITY: TYPE. OF' FUEL AGE: TYPE: LEAK OR CHEMICAL: DETECTION SYS �I .xf ,a r.t DATE OF PURCHASE OF EACH: 1. ? 2. 3. 4. 5. DATE OF FIRE .DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. (���„� i � ,�,�. oawu,,,y PROVIDE PRECAST CONCRETE , 4"SCHEDULE 40 PVC MIN. SLOPE 1% PROPOSED PVC VENT _ GENERAL NOTES T.O.F. EL.= 65.5± EXTENSION RISER WITH CONCRETE INISH GRADE OVER D-BOX= 64.2'�' FINISHED GRADE OVER BIODIFFUSERS= 63.2' 64.1 COVER TO WITHIN 6"OF F.G.OVER SLOPE @ 2% IMIN. INLET AND OUTLET COVERS. REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE RISER TO WITHIN 6"OF FINISHED GRADE ACCESS BOX TO WITHIN METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL, 65.0'± FINISHED GRADE OVER TANK EL.= 64,7'-I- 5"DIA. OUTLET(S) 3"OF F.G. (ONE PER ROW) CODE AND ANY APPLICABLE LOCAL RULES. } 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. EXISTING 4" PROPOSED 4" 9p MIN. 9"MIN. , 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL --A PVC SEWER PIPE 36 MAX. 48 MAX. TOP OF SAS/B.O. = 60.1 Q SEWER PIPE (SEE NOTE 21.) SYSTEM UNLESS OTHERWISE NOTED. 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN ---- �--�" 3"DROP MAX p p � I � PROVIDE WATERTIGHT 6 3 2p DROP MIN 3 9 MIN.SLOPE 0-,% �`JOINTS(TYP.) ELEVATION =60.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A I !; I 4"PVC IN FROM �' 1F71 .33' 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10" 14" 51 , `-i- SEPTIC TANK 4"PVC OUT TO (TYP-) 10.75 P 1130THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. --- • LEACHING FACILITY TT 0.9U [EMIEUtu (TYP) 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 12p 6p CONTRACTOR CONTRACTOR SHALL , I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. " VERIFY CONDITION OF OUTLET TEE 61 .17 MIN. 61.00 59.6T 58.7T (laid flat) 2.875'(34.5")�I (STONELESS SYSTEM) SHALL VERIFY SIZE 48 5.01 (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES 22"ZABEL FILTER 6"CRUSHED STONE (T 14.375' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS MODEL#A1801-4x22 OVER MECHANICALLY 5'MIN. NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY (GAS BAFFLE ON BOT.) COMPACTED BASE 20.0'(TYP FOR ALL 5 ROWS) AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON AN APPROXIMATE M.S.L. DATUM OF 65.00' TO BE INSTALLED ON A LEVEL STABLE GROUNDWATER ELEV.= < 52.17' ESTABLISHED ON A NAIL SET IN THE PAVED DRIVE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 20 - BIODIFFERS PROFILE BIOIDIFFUS'ER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES TO THE DESIGN ENGINEER. '`CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL 20 - ARC 36 H C (#3616 B D) H-20 BIODIFFUSERS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE NOTE: ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE II. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING t "' TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM M .,� • c APPROPRIATE AUTHORITY. ID �►♦ a e PERC NO. 12724 INSPECTOR: David W.Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS z o • • LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE ra EVALUATOR: Michael Pimentel, EIT CSE ► • s x # ' _ THEY SHALL WITHSTAND H-20 LOADING. C.S.E.APPROVAL DATE: Oct. 1999 ` 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT DUST AND FINES. DATE: October 14,2009 ' TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. ELEV TOP= 63.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV WATER= <52.17' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). LOCUS' ;'Y 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE_ <2 minJinch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. Co z / / �� =r s r DEPTH OF PERC= 40"-58" 16. PROPOSED PROJECT IS LOCATED WITHIN: a Di�,id✓ • .°'7 TEXTURAL CLASS: 1 ASSESSOR'S MAP 125 PARCEL 43 OWNER OF RECORD: SUZANNE R. SUTHERLAND \,p �, SS)o " ADDRESS: 1127 OSTERVILLE-WESTBARNSTABLE ROAD o =r ♦ 0 63.00 PROPOSED PVC VENT PIPE f > >Sj ` `- ,' = Fill MARSTONS MILLS, MA 02648 (LOCATION PER OWNER) SO00,`'�F 6" 62.50 PROPOSED TOTAL 20 ARC 36 HC(#3616BD) 11 FEMA FLOOD ZONE C _ � �� Sandy Loam .p H-20 BIODIFFUSERS IN FIELD * r � �' B COMMUNITY PANEL# 250001 0016 D / CONFIGURATION 14.375'x 20.00' k: .. 10Yr 5/6 TP 2 63.0' EXISTING 1000 GALLON SEPTIC TANK TO `� ° ��� '"�"'� � � 40" .� 59.67 17. DEED REFERENCE: LAND COURT CERTIFICATE 163605 � N\< 63.0` BE UTILIZED AS PART OF THIS DESIGN / � � " � x� � Perk _ 18. PLAN REFERENCE: LAND COURT PLAN 30384-D Asr• PROPOSED 30 MIL. IMPERVIOUS f 58 58.17 1g, ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. PROPOSED DISTRIBUTION BOX ryp ° ° GEOMEMBRANE LINER o - , N emu} r.. ' •-J I/ Q! '' ii''� 20. PROPERTY LINE INFOFIMATION IS ONLY APPROXIMATE. THIS PLAN' 15 TO B' USED ONLY ' FOR SEPTIC SYSTEM UPGRADE. JG ENGINEERING WILL NOT ASSUME ANY LIABILITY C Medium Said FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. I ! .5Y 6/6 1• E 2 2 IN ACCORDANCE WITH 310 CMR 15 401 -15 405,THE FOLLOWING LOCAL UPGRADE LP APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7)AND 310 CMR 15.211: . o �h. � y � Y�,, - ,;. .,. , �h (1.) A 1.0'WAIVER(3.0'-4.0')FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. / (2.y A 5.0'WAIVER(20.0'-'15.0')FOR THE SETBACK FROM THE PROPOSED LEACHING Ia FACILITY TO THE EXISTING FOUNDATION. LOCUS i e PLAN A' 22. THE FOLLOWING LOCAL VARIANCES ARE REQUESTED FROM THE TOWN OF BARNSTABLE'S APPROXIMATE LOCATION OF EXISTING j V V V 1 A V CHAPTER 397: WELLS REGULATIONS; SECTION 397 2: LEACHING PIT E BE PUMPED AND / MA P (1.) A 20.5'VARIANCE(150.0'- 129.5')FOR THE SETBACK FROM THE PROPOSED LEACHING FILLED WITH GLEAN COARSE SAND �� .Z �- 9 2 SCALE: 1"= 1000' I 1 0 0' w� h, MAP 125 130" 52.17' ROAD. TO THE EXISTING WELL LOCATED AT 1125 OSTERV1LLE-WEST BARNSTABLE I, cO r�� � e� � O�S�3 PARCEL 2 No Mottling, Standing or Weeping Observed I rrr SHRUB M)� '� #1125 \ f 63� f� - EXISTING N/F suTHERLAMID DESIGN DATA TEST PIT DATA LEGEND 3-BEDROOM � PERC NO. 12724 DWELLING INSPECTOR: David W.Stanton, R.S. 50x0 EXISTING SPOT GRADE I' TOF =65.5'± NUMBER OF BEDROOMS(DESIGN) 3 - � DRIVEWAY� � EVALUATOR: Michael Pimentel, EIT,CSE - 50 - - EXISTING CONTOUR / DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E.APPROVAL DATE: 1999 1 / GARAGE ` MAP 125 TOTAL DESIGN FLOW 330 GAUDAY DATE: October 14,2009 Oct.ct. 50 PROPOSED CONTOUR N PARCEL 43 DESIGN FLOW X 200 % = 660 GAUDAY / rn E/T/C EXISTING UNDERGROUND UTILITIES \ �' � 30,000 S.F. opt po TEST PIT#: 2 4 USE EXISTING 1,000 GALLON SEPTIC TANK I f ELEV TOP= - 63.00' SWING-TEES w W EXISTING WATER LINE \ I Benchmark SCALE: 1"=20' ELEV WATER- <52.17' / Nail in Paved Drive TEST PIT LOCATION Elev. =65.00' DESCRIPTION HCA HC-2 PERC RATE= Approx. M.S.L. INSTALL 20 - ARC 36 #3616BD H-20 BIODIFFUSERS DEPTH OF PERC L EXISTING LEACHING PIT - BIODIFFUSER CORNER(1) 15.3' 18.7' ) TEXTURAL CLASS: 1 BIODIFFUSER CORNER(2) 25.2 31.4 SYSTEM CAPACITY �' 01 EXISTING 1,000 GALLON SEPTIC TANK BIODIFFUSER CORNER(3) 39.8' 30.T I PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE BIODIFFUSER CORNER(4) 34.4' 17.4' (TOTAL L.F.OF BIODIFFUSERS&COUPLINGS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD , (100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING/DAY 0 Fill 63.00 PROPOSED 30 MIL. IMPERVIOUS GEOMEMBRANE LINER 6" 62.50' )o PROPOSED DISTRIBUTION BOX tiS Sandy Loam TOTALS: B " 10Yr 5/6 ® PROPOSED ARC 36HC(#3616BD)H-20 BIODIFFUSER 40 59.67 (�O' `/Q TOTAL NUMBER OF BIODIFFUSERS: 20 ck,,I (3) TOTAL NUMBER OF COUPLINGS: 0 TOTAL LEACHING AREA: 480.0 SQ.FT. REV. DATE BY APP'D. DESCRIPTION �rF� � TOTAL LEACHING CAPACITY: 355.2 GALJDAY qy ° (4) PROPOSED SEPTIC SYSTEM UPGRADE J \ ° ° NOTE: C Medium Sand PREPARED FOR: EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE 2.5Y 6/6 CAPEWIDE ENTERPRISES \ (2 HC 2 DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER NOTE: '`� "MODIFIED CERTIFICATION FOR GENERAL USE"ISSUED TO \ ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST LOCATED AT 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE (� MODIFIED JUNE 30,2009). TRANSMITTAL NUMBER=W000052 1 125 OSTERVILLE-WEST BARNSTABLE ROAD TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. OSTERVI LLE, MA 02655 HC 1 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE I LOCATION OF THE PROPOSED LEACHING FACILITY TO ENSURE 130" 52.17, SCALE: 1 INCH = 20 FT. DATE: OCTOBER 19,2009 CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. No Mottling, Standing or Weeping Observed o s 20 4o so FEET REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS �,t„oF,� PREPARED BY: RESERVED FOR BOARD OF HEALTH USE ��°� JO N L. cyGm JC ENGINEERING, INC. ck c�+L` 2854 CRANBERRY HIGHWAY ARE NOT CONSISTENT WITH TEST PIT DATA. JR. 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE SITE �4 a ' EAST WAREHAM, MA 02538 WATERSHEDS. SI 1 E PLAN 508.273.0377 SCALE: 1"=20' Drawn By: BSM Designed By:MCP Checked By:JLC JOB No.1701