HomeMy WebLinkAbout0036 SAMOSET ROAD - Health 36 Samoset Road, Marstons Mills
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SI-N Commonwealth of Massachusetts
Executive Office of Enviromnental Affairs
Dept. of Environmental Protection Jolm Grad
One winter Street,Boston,Ma. 02108 D_E.P. 'Title V Septic Inspector
P.O. Box 2119
Teaticket, MA 02536
(508)564-6813
WILLIAM F.WELD j
Governor 1 2
ARGEO PAUL CELLUCCI
Lt.Governor' ~
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR 1'PART A REcE1vEO �
CERTIFICATION p
DEC 1997
Address of Owner: T
t
36 Samoset Rd.Marsons Mills .f
Property Address: �, �INNOFBga+
Date of Inspection: 11/21/97 (If different)
Name of Inspector: John Graci Mrs.Horgan \\
I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000)
Company Name,Address and Telephone Number:
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:
This Inspection Is based on criteria defined In Title V
x Passes code 310 CMR 16.303.My findings are of how the system is
Conditionally asses performing at the time of the Inspection.My inspection does
_ Needs rt r Evaluation By the Local Approving Authority septic system and any of its components useful life.
Fai not Imply any warranty or guarantee of the longevity of the
Is
Inspector's Signature: �/ Date: 1212197
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this
inspections. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B, C,or D:
A] SYSTEM PASSES:
x I have not found any information which indicates that the system violates any of the failure criteria
defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below.
COMMENTS:
B] SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system,upon completion
of the replacement or repair,passes inspection.
Indicate yes,no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Colbpliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection,or
the septic tank,whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank
failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(revised OW7197)
One Winter Street • Boston,Massachusetts 02108 s FAX(617)556-1049 a Telephone(617)292-5500
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 38 samoset Rd.Marston Mills
Owner: Mrs.Horgan
Date of Inspection:11121197
_ Sew.acte backup or.hreakout or hiah.static water level observed.in.the distribution box is due to a broken.
or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if
(with approval of the Board of Health). Describe observations:
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
_The system required pumping more than four times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
_ Conditions exist which require further evaluation by the Board of Health in order to determine if the
system is failing to protect the public health,safety and 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 PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
_ The system has a septic tank and soil absorption system and is within 100 feet to a
surface of water supply or tributary to a surface water supply.
The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well.
The system has a septic tank and soil absorption system and 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 presense of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. Method usedto determine distance (approximation not valid)
3)Other
D] SYSTEM FAILS:
You must Indicate either"Yes"or"No"as to each of the following:
_ I have determined that the system violates one or more of the following failure criteria as defined in
310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be
contacted to determine what will be necessary to correct the failure.
Yes No
Backup of sewage in facility or system component due to an overloaded or clogged SAS or
cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
cesspool.
SAS is in hydraulic failure.
(revised 04127197)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 3a Samoset Rd.Marstons Mills
Owner: Mrs.Horgan
Date of Inspection:11121197
D]SYSTEM FAILS(continued)
Yes No
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Numbers of times pumped
Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone 1 of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"as to each of the following:
The following criteria apply to large systems in addition to the criteria:
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 a mapped Zone it 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 04117)971
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECLIST
Property Address: 36 Samoset Rd.Marston Mills
Owner: Mrs.Horgan
Date of Inspection:11121/97
Check if the following have been done:YOU must indicate either"Yes"or"No"as to each of the following:
_c_ — Pumping information was requested of the owner, occupant,and Board of Health.
x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal
— flow rates during that period. Large volumes of water have not been introduced Into the system recently or as part of this
inspection.
x As built plans have been obtained and examined. Note if they are not available with N/A.
x The facility or dwelling was inspected for signs of sewage 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, excluding the Soil Absorption System, have been located on the site.
x The septic tank manholes were uncovered,opened, and the interior of the septic tank was inspected
for condition of baffles or tees,material of construction,dimensions, depth of liquid,depth of sludge,depth of scum.
x The size and location of the Soil Absorption System on the site has been determined based on
— — The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of
Sub-Surface Disposal Systens.
x Existing information. Ex. Plan at B.O.H.
Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is
x
— — unacceptable)[15.302(3)(b)]
(revleed 04r27)97)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 36 Samoset Rd.Marstons Mills
Owner: Mrs.Horgan
Date of Inspection:11121197
FLOW CONDITIONS
RESIDENTIAL: d./bedroom for S.A.S.
Design flow: 220
g P
Number of bedrooms: 2
Number of current residents: o
Garbage grinder(yes or no): No
Laundry connected to system(yes or no): Yes
Seasonal use(yes or no): No
Water meter readings,if available:(last two(2)year usage(gpd):
nia
Sump Pump(yes or no): No
Last date of occupancy:8 Months ago
COMMERCIAL/INDUSTRIAL:
Type of establishment: nla
Design flow:U gallons/day
Grease trap present:(yes or no) No
Industrial Waste Holding Tank present:(yes or no) No
Non-sanitary waste discharged to the Title 5 system:(yes or no) No
Water meter readings,if available: nis
Last date of occupancy: nia
OTHER:(Describe) nia
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
Na
System pumped as part of inspection: (yes or no)No
If yes,volume pumped:o gallons
Reason for pumping: Na
TYPE OF SYSTEM
x Septic tank/distribution box/soil absorptions 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 Information:
1996
Sewage odors detected when arriving at the site: (yes or no) No
(revised oE127l;J7)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 36 SamosetRd.Marston Mills
Owner: Mrs.Horgan
Date of Inspection:11121197
SEPTIC TANK:x
(locate on site plan)
Depth below grade: V
Material of construction:x concreate_m eta l_FRP_Polyethylene_other(explain)
If tank is metal, list age o . Is age confirmed by Certificate of Compliance No (Yes/No)
Dimensions: L5'5"H5'T"w4"10"
Sludge depth:t"
Distance from top of sludge to bottom of outlet tee or baffle: 25"
Scum thickness:0
Distance from top of scum to top of outlet tee or baffle:5"
Distance form bottom of scum to bottom of outlet tee or baffle:0
How dimensions were determined: Measured
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.)
Septic tank and all components are structurally sound.Recommend pumping system every one to two years for maintenance.
GREASE TRAP:
(locate on site plan)
Depth below grade. nla Pol eth Iene_other ex lain
Material of construction: _concrete_metal_FRP_ y y ( p )
Dimensions: rda
Scum thickness:nla
Distance from top of scum to top of outlet tee or baffle:rda
Distance from bottom of scum to bottom of outlet tee or baffle: nla
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.)
rda
BUILDING SEWER:
(Locate on site plan)
Depth below grade: v6
Material of construction:_cast irony_40 PVC_other(explain)
Distance from.private water supply well or suction line?-
Diameter: 4"_
Qmments: (conditions of joints,venting,evidence of leakage, etc.)
(revised 04127197)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 36 Samoset Rd.Marston Mills
Owner: Mrs.Horgan
Date of Inspection:1'1121197
TIGHT OR HOLDING TANK:
(locate on site plan)
Depth below grade: Na
Material of construction:_concrete_metal_FRP_Polyethylene_other(explain)
Dimensions: Ne
Capacity: Na gallons
Design flow: Na gallons/day
Alarm level:_nta Alarm In working order?_Yes No
Date of previous pumping:
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
Na
DISTRIBUTION BOX:
(locate on site plan)
Depth of liquid level above outlet invert: Na
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box etc.)
Na
PUMP CHAMBER:
(locate on site plan)
Pumps in working order.(yes or no)No
Alarms in working order(yes or no)_Ye:
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
Na
(revised 04)27197)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 36 Samoset Rd.Marston Mills
Owner: Mrs.Horgan
Date of Inspection:11121197
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:
nfa
Type:
leaching pits,number: iA=gallon leach pH
leaching chambers,number:nla -
leaching galleries,number: nla
leaching trenches,number,length: nfa
leaching fields,number,dimensions:Na
overflow cesspool,number:Na
Alternate system: nla Name of Technology:_w.
Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.)
The overflow is structurally sound and functioning properly.It shows signs of being 314 hill,tt was empty at the time or lnspectlon.
CESSPOOLS:
(locate on site plan)
Number and configuration: Na
Depth-top of liquid to inlet invert: We
Depth of solids layer: We
Depth of scum layer: rda
Dimensions of cesspool: We
Materials of construction: Na
Indication of groundwater: nfa
inflow(cesspool must be pumped as part of inspection)
rda
Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.)
nfa
PRIVY:_
(locate on site plan)
Materials of construction: rda Dimensions: rya
Depth of solids: Na
Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.)
n!a
(revised 0417797)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
36 Samoset Rd.Marstons Mills
Mrs.Horgan
11121197
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)
6-1
P
0
6A �[
p -Sl �
Pays 9 of 10
(revlaed 04/27197)
n
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
36 Samoset Rd.Marstons Mills
Mrs.Horgan
1112 U97
Depth of groundwater 12.
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from design plans on record.
Observation of Site(Abutting property,observation hole, basement sump etc.)
Determine it from local conditions
Check with 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 Maps and Charts
(revised04)27197) lttgfi 10 of 10
i
LOCATION SEWAGE PERMIT NO.
l3 E
VILLAGE
IN ST A LLER'S ME ate �ID 0 R.F S-S
d UILDER OR OWNER
DATE PERMIT ISSUED _
DATE ✓ C0MPLIA.NCE ,VSS,U�E.,*
�„ E S-2,
t x
V -
No
. "
THE COMMONWEALTH.OF MASSACHUSETTS
BOARD- OF HEALTH
Town Barnstabl
. ....................OF..........................................................-----.........._................
Xpli iration for Disposal Works Tongtrur#iun Frrutit
Application is hereby made for a Permit to Construct (k ) or Repair ( ) an Individual Sewage Disposal
System at:
�,ot r,55,Samoset Rd. Marstons Mills MA
-••----j-......---1............... •------_......_.._......-•---•-•-----• -•-.........._............................. ......-----•--
Capricorn ReHi'9ey`'gust 765 Falmouth Rya,& NoHyannis
......................_........----.......................................-•-•--•••••......-•--• ..........•-......................................................................................
Steve Lebel Owner Address
W
Installer Address
UType of Building Size Lot...........................Sq. feet
Dwelling—No. of Bedrooms..3.......................................Expansion Attic ( ) Garbage Grinder ( )
`4 Other—Type of Building ranch ............. No. of ersons............_........_....._ Showers_ 2
C4 YP. g -•--•-•-•------ P ( ) = Cafeteria ( )
a, Other fixtures ------------------•--••-•-•••-•-
d ...................................••...............
Design Flow........55..:...........................gallons per person per day. Total daily flow........
it
W Septic Tank—Liquid"capacity1000_galIons LengtlP_'.6 Width............ Diameter................ Dept l .............
Disposal Trench—No. .................... Widt ___.........._..._.. Total Length....__... ... Total leaching area.... : . sq. ft.
x Seepage Pit Nol------------------- Diameter.... �.......... Depth below inlet......�.......... Total leaching area...
ft.
z Other Distribution box ( ) Dosin $$a ( )
l redge Engineering 11-25-81
Percolation Test Results Performed by....................... Date........................................
2!_0..._._minutes per inch Depth of Test Pit..1 !__-_ Depth to ground watePone encounter
,� Test Pit No. 1._.r s
l_A.._._....minutes per inch Depth of Test Piti............ Depth to ground water.�lti.....:__....f�, Test Pit No. .. e .
M ---•----•--------------------------------••----.................................----.........--••-----•-•-•-•----•----••---•----.......-•-•••---•--......... .
O Description of Soil.........0 ' - 2' loamc toPsoll
•. •-•--------•-•----------------------------------------------------.I........._..
x 21 - 10' Iviedium yellow sand
W 10' - 12' med. white sandltrces off' gravelono water at 12 '
x ----------------------------•---•--•--•••--•----•-------------•••----•---•-••-•---••••-•-•-•-------------------•------------•--......---...............................................................
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
Agreement:
The undersigned agrees to install the aforedescribed. Individual Sewage Disposal System in accordance with
the provisions of iITI.E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance h .been issired"th. ard o lth.
ed.. .... . ••. ..
e s 9� 2�8 ...
ate
Application Approved B
Date
Application Disapproved the lowing reasons:
--------------•------•----------..............--••-----------............----•-......---•-•---------...----------•-----••---•---•-----------------------••------•------•-•--•...............................
Date
PermitNo..........................••-•--•-----•-•---•-•••--•-••-• Issued.--------...-------•-----••••-•.................-----••.
Date
�.
------------------------
No.:: ..........._....... FEs..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barns t abl e
............. ........................O F..........................--...._............
Appliration fur Bi-4puiittl 111orkii Towitrnr#ion unit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
Tot � 559Samoset Rd. Marstons Mills h:A
.................. .....-----------------•--•-----........--•••-•---•••-••---•-•••-------•-••-------...........---•-•
Loc tin A ress or t N
Capricorn Rea��;y rust 765 Falmouth Road, �Iyannis
.............-•.......-.......................................................................... .................................................................................................
Steve Label Owner Address
---•..................................•---•-----•---.._................---•-...........-•-•••---•- ----•---•---•••--•••••...-•---........_..............••-••......................_.................
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms._.....................................:..Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building Y'anCr1............... No. of persons............................ Showers (2 ) — Cafeteria ( )
QOther fixtures ----------------------------------------------------------•--••-•--•-...•-•-------•--•--•-...._........-•-•--------••--•- : .........._..
W Design Flow........5-5................................gallons per person per day. Total daily flow.......33�.............................alons.
11
W Septic Tank—Liquid capacitv1000•ga]lons Lengtl _...... Widtl�_..10....__ Diameter................ Depth............
x Disposal Trench—No..................... Width..._.............. Total Length...... .......... Total leaching area......-...... sq. ft.
Seepage Pit NA---------------- Diameter.___6...._._...... Depth below inlet_._6....___.__-_. Total leaching area.z6......._..sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
tldred e En ineerin 11-2 81
Percolation Test Results Performed bY--------------------g...........-�._..._._.._.....•_-g-•----------- Date...----....__5-.....----.--....---..
Test Pit No. 12...0._..._.minutes per inch Depth of Test Pit-12............. Depth to ground watePone eneounter-
44 Test Pit No. �!_A.........minutes per inch Depth of Test Pit-V........._.. Depth to ground water�1!4............... e
D Description of Soil......... �..__- 2 loam•_• topsoil
2 1 -------------------•-----------•-•-------------
x 2' - 10' I��edium yellow sand
v ._..•--•••-•-...-•••...------•-••-----•-•••-......-•-----•-•......-•--------
10 - 12 med. white sand traces of g...........
.._.. ...
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
---------------------------••-•--•-•-•-••----•••--•------••••---•---••-•••-•-•-------••........•--------•---•-••-------------•----•••-•---••••-•-----•-•••--•-•-•-------•-..........•••...-•-•--•-----••
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a CertificXCo
as been issued by the board of Health.
Pres.
d ---------------•------------••--•---�^ y ` GApplication Approved B ------------------------------------------- •----•-----
Date
Application Disapproved for tasons:------•--------------•-----•----•---•----------------...------•----•-----------.....---•-•=•-••................
.................•-•••••--•..._.._...-••-•••---•••••---•---••-•••-•---•--•-•--•--••-------••-••----•-•---•----........_...••••-••------------•--...••-----•---••----•---•-•••-•--••-•-••--•-.......--•--
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........... otivn..................OF......�tarns tabl e
...................................................................
(9rdif irFatr of Tourpliatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( )
Steve Lebel
• Install�r�
at.........Lot fr. 559 Samoset Rd. �Iarstons Mills :P
-
has been installed in accordance with the provisions of � ��f<The State Sanitarb+'�- etas! ,ylcr�ed 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............................................ � Inspector......................r="---••----•--•----•----•-•---•---••---------....---......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town.........................OF...Barnstable
..............•--..................-••............
No......................... FEE........................
R.5poual Workii Tono#r ion amit
Permission is hereby granted... Steve Lebel
----- --•.........
to Construct (" ) r R� (S a�Individual Sewage Disposal System
at No..... ot..�f5�'_... e......... i iarsto_ns Mills
= -- ,'.
Street �d Z 7
as shown on the application for Disposal Works Construction Perm ....... bated............
..........................
j-d L 3 Board of Health
DATE.................................................................................
• FORM 1255 A. M. SULKIN, INC., BOSTON
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LEGEND CERTIFIED PLOT PLAN
EXISTING SPOT ELEVATION Ox0 �'-----
EXISTING CONTOUR --- 0 -- - =�y'' Of S-#,4 T
FINISHED SPOT ELEVATION
:..3 c �� M�1 �S TC�t�/S M I L �s
FINISHED CONTOUR 0 ;;ucE ,
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APPROVED BOARD OF HEALTH '
T.tiz T IF
DATE AGENT . `., ` �. SCALEe f 30 DATE c /v�/g 83.
- ' '
ELOREDGE ENGINEER/NG CQ IN CLIENT Fizq�Nco . I CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED JOIN N0. 8�6 BUILDING SHOWN ON THIS PLAN
CIVIL 4AND DR. A CONFORMS TO THE ZONING LAWS
ENGINEER SURVEYOR OF BARNSTABLE, MASS.
712 MAIN STREET CH. BYE R• B.E, // � !
HYANNIS, MASS.
SHEET/ OF Z DATE REG. LAND SURVEYOR
20 FT. M/N• NOTE /F E/Ti'/ER Tt/E SEPTIC TANK OR
LEACH//vG P/T ARE MORE THAN /2"EELVPV
/O f7: /H///• GRA OEM fi 24'p/A M E TER CONCR.F TE: CO P&44,
4 'PVC P/Pz SWALL BE BROUGHT TO 6/?AoE.�f1N E,;
Co,vc0t ne /y/N. P/TCN /XYEAVY CAST /RON CoV_4=R Sh1ALL &3= USED
e.. EL . �'Z+S CODERS �B�PFR FT /F//V OR/VEyVAy
o: 2% MlN. CO/VCRE TE
COVER CLEAN SAVO
CAST2•LAYER
IRON b T y • ` '�P/PE /8 - 18•
J �
MIN. P/TCN G .
d • • . • • • • ► o •A�
%4"Ptrt /7 SEPTIC TANK D/ST, o A : • • • • • • • • e a 4 IYASNFD ST27NE
.'.�•• BOX p • 1 B ♦ • ♦ • • � .•p °
• o • •EFFECT/VC ' • 0 3 4
• ° t • • DEPTH • • • • o WASNED STONE
z ,s 470 ° sQoo • • • • • • • ► ' op o
'7 8' x 1 0 = _ • e. • • • • • • • • • • p ••p PREG4.ST SEEPAGE
I AIVZA'-r &4 E✓AT/DNS P/T C�PA C/TT • o r • • • • • • • • ' e o P/7 DR EQUI V.
• p n � EL. 73.0
/NYERT AT QUIL.D/NG go,D FT 6 FT D/AM.
//1/LET SEPTIC Ti4/VK 7`7.fl FT, �_ /� FT. D/AM. •� C SEET�1BlJL�1T10N�
OUTLET SEOT/C TANK FT, r
INLET D/STR/6UT/ON BOX 717'`r FT. SECT/ON OF GROUND WATER 7AALE
O(lTLETD/STRIBI/TION BOX -7'7 z FT.
INLET LEACH/NCs /CNI/T 7 ,c) FT SZWAGE ,01SROrS'A L. SYSTEM
LEACH//VG /0/T 7?IBIJLATlON
DES/GN CR/TER/A scAL.E : %s" _ /= o D/MENS/ON A 2� FT.
DINKN5/aN 8 FT.
NUMBER OF BEDROOMS 3
GARe,4GED/SPOSAL UNIT &Z)A,'c SOIL LOG
TOTAL EST/M.•t7'EO FLO*v 33 O GAL.�DAY SOIL TEST #! SOIL TEST#2 SOIL TEST
NUMBER OF LE°ACN/NG ,o/73 / FL E y 9 0,-8 �..AL..y DATE O SOI
S/OF LEACH/NG PER P/T . F L TEST 9
BOTTOM LEACH/NG PEl? P/T `L U— 3 / RESULTS W/TNESSEO BY EB E `JA C y 3 /
�� S4• AT' LD A-M PEIVCaLAT/ON RATE At l ss !y/N /NCH
TOTAL LEACH/NG AREA Z GG SQ. FT. 6 S c�r350 �— PONCOLAT/ON RATE fk2 T A/t'
RESERVE LE4CNlN6 AREA Z G& SQ. FT. Z"D
3 �— l z
so/L T�sT P-z.s 3v
;►*°} Q ��,�ZH 0 F MAss9 M C-D /!J/YJ T SS 57A M O.S C--?" R L::,.
M
yi,\ N1�41?STyAs / / ILLS
RT Gi ALB rn C►lZ/� t/EL
m\ C3 0 SE
y
L;-DlRE rG .l No.10951 O Q
/ '/ 9� c,S,E ELOREDGEENG/NEER/JVGCO,/NC.
u0NA1 �\ CL, G 8� 7!2 MAIN ST., NY.4NN/9, MASS.
G';:.:; :,...':_�%�• NO OU y T<•R ENCOU/VTEREO CL/ENT: /iN OATE: D /��
R ND YA FR CO / / 83
G.1 GM0UVO WATER A*7 E4E1! .JOB ND, 83 Z S SHEET 2 OF �-