HomeMy WebLinkAbout1676 SOUTH COUNTY ROAD - Health (Ll�s
TOWN OF BARNSTABLE /a7/r��
v RT �/,� -
LOCA ON �-Cd Y �iD SEWAGE # aCU�O
t"S
VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. RS Bctl I L. 1QG�S vexes JOff-81" �8?�
SEPTIC TANK CAPACITY ISoO "I WA
LEACHING FACILITY: ( pe —e-0�4h CNaAa,2S (size) .5-cd6 (A/
NO.OF BEDROOMS
BUILDER OR O
PERMITDATE: �D COMPLIANCE DATE: t .
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
3 3 4 .0
s 3&-. o
ar 141410:36a p.1
t
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is required for every Osterville MA 02655 3-13-14
page, Cityr'rown State Zip Code Dale of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important-When
filling
out forms
A. General Information ( )
on the oompu er, OF
use only the tab 1. Inspector .-,�_'06 yr,
key to move your p;' •.�G
cursor-'.do not James D. Sears = JAMES 1
use the'retum Name of Inspector =c>
key. #
CapewideEnterprises,LLC • C%-
Company Name � `
153 Commercial Street '��iin nail ,Pw`�a``���
Company Address
a� Mashpee MA 02649
Cityr'rown State Zip Code
508-477-8877 S 1623
Telephone Number License Number
B. Certification
certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection.The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
i ❑ Needs Further Evaluation by the Local Approving Authority SR
3-13-14 ::W= 'n
I or's Signature Datea
.
The system inspector shall submit a copy of this inspection report to the App loving Authority(Qoard
of Health or DEP)within 30 days of completing this inspection. If the system Is a shardWsyster r or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit�tT�e
report to the appropriate regional office of the DEP. The original should be sent to the'sistem owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
� L
t5i is-3l13 Title 5 Official wm .subsurface Sewage Dhposal system•Page 1 0/r 17
Mar 141410:36a p.2 .
t f
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is required for every Osterville MA 02655 3-13-14
page. Cityrrown State Tip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass'section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old' or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
El Y ❑ N ❑ ND(Explain below):
15ins•3Po 3
T41e 5 Official Inspection Form:Subsurface Sewag®Disposal System•Page 2 of 17
Mar 141410:37a p.3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
e Subsurface Sewage Disposal System Foam -Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Ownees Name
information is required for every Osterville MA 02655 3-13-14
page. CilyJrown State Zip Code Dale of Inspection
B. Certification (cont.)
❑ Pump Chamber pumpstalarms not operational. System will pass with Board of Health approval if
pumpslalarms are repaired.
B) System Conditionally Passes (conQ:
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or,uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are 'replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below).
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
f
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
4
F❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
hte system is failing to protect public health, safety or the environment.
1., System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
• Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
tSina 3113 Title 5 Offi"Inspection Forth:SubsLrfaca Sewage Oispoael System•Page 3 of 17
i.
Mar 141410,37a p.4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address --
Gail Martis
Owner Owner's Name _
information is required for every Ostervilie MA 02655 3-13-14
page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health(and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply. ,
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other.
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes' No
Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
El ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
El ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
® Liquid depth in aam*M is less than 6° below invert or available volume is less
g than Yz day flow fA01//1PG
tSins•3113 _ - TWO 6 OtficW hspection Fow Subsurface Sewage Disposal System•Page 4 of 7
Mar 141410;37a p.5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Maros
Owner Owner's fume
information is Osterville MA 02655 3-13-14
reqpage.
for every City/Town
State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOTdue to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
4. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis,performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd
10,000gpd.
El ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes'or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection
❑ Area—IWPA) or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes"in Section D above the large system has failed.The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304.The system owner should contact the appropriate
i
regional office of the Department.
t5in5`&13 Title 5 OMW tmpectlon Form:Subsurface Savage Disposal Sfstem•Page 5 of 17
E
Mar 141410:38a p.6
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owners!Name
information is MA 02655 3-13-14
required for every psterville
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done.You must indicate"yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner,occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® El available
as built plans of the system obtained and examined? (if they were not
available note as WA)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
Was the facility owner(and occupants if different from owner) provided with
® El information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS) on the site has
been determined based on:
® ❑ Existing information. For example,a plan at the Board of Health.
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable)[310 CMR 15.302(5)1
i
D. System Information
Residential Flow Conditions_
Number of bedrooms (design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330
!Sins-W3 Title 5 OMa;Inspection Fom%Sub�rtace Sewage Disposal System•Page 6 or 17
Mar 141410:38a p.7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road -
Property Address
Gail Martis
Owner Owner's Name
information is Osterville MA _ 02655 3-13-14
required for every State Zip Code Date of Inspection
page. Citylibwn
D. System Information
Description:
The system is a 1500 Gal tank D Box and two 500 Gal. dry well chambers.
2
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
2012-198,000Gal
Water meter readings, if available(last 2 years usage(gpd)): 2013-169,000Gal's
Detail:
Sump pump? ❑ Yes Z No
Present
Last date of occupancy: Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 C M R 15.203): Gallons per day(gpd)
Basis of design flow (seatstpersonslsq.ft, etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available: -
r t5ins•.5/13
Title 5 Official Inspection Form:subsutace Sewage Disposal system•Page 7 of 17
Mar 141410:38a p.8
Commonwealth of Massachusetts
dim Title 5 Official Inspection Form
w Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South Coun Road
Property Address
Gail Martis
Owner owners Flame
information is
required for every Osterville MA 02655 3-13-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cunt)
Last date of occupancy/use: Date
Other(describe below):
i
i
i
General Information
Pumping Records:
Source of information: NA
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped:
gallons
Mow was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box,soil absorption system
❑ Single cesspool
Overflow cesspool
❑ Privy
❑ Shared system(yes or no)(if yes, attach previous inspection records, if any)
El Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract ,
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ias•Wi3
Tine 5 Official Inspection Form:Subsurface Sewage Disposal System•Page S of V
i -
Mar 141410:39a p.9
Commonwealth of Massachusetts
Title 5 official Inspection Form
SubsurFace Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information isewired for every
Cisterville
AflA 02655 3-13-14
page. cKyrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
2000 Permit # 2000-549
Were sewage odors detected when arriving at the site? ❑ Yes ® No
i
Building Sewer(locate on site plan):
r
3-
Depth below grade: feet
Material of construction:
❑cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Pipeing is 4" PVC SCH 40.
Septic Tank (locate on site plan):
Depth below grade: 2'
feet
Material of construction:
®concrete ❑ metal ❑fiberglass ❑polyethylene ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500 Gal. Precast
Sludge depth:
Mns-3M3 Title 5 Ot4dal trlspectkm Fwm:Subwnface Sewage Disposal system-Page 9 or 17
i
j
Mar 141410:39a p.10
Commonwealth of Massachusetts
110 RIM Title 5 official Inspection Form
r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
r 1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information 6
required for every Osterville MA 02655 3-13-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cunt.)
Distance from top of sludge to bottom of outlet tee or baffle
28"
Scum thickness 0"
Sir
Distance from top of scum to top of outlet tee or baffle
11,
Distance from bottom of scum to bottom of outlet tee or baffle 8
How were dimensions determined? Asbuilt-Tape- Plan
Sludge Judge
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank at working level.Tank and cover's at 2' below grade,outlet tee. No sign of leakage or
over loading.
Grease Trap(locate on site plan):
Depth below grade:
feet
Material of construction_
❑ concrete ❑ meta ❑fiberglass ❑ polyethylene. lEl other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
' Date .
t5ets•Via
lllle 5 Official Inspection Farm:subsurface Sewage Disposal Syslefn•Page 10 of 17
Mar 141410:39a p.11
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M
1676 South County Road
Property Address
Gail Martis -
Owner Owner's Name
information is MA 02655 3-13-14
required for every Osteryille
page. Cityrrown State Zip Code Date of Impaction
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage,etc.):
Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain):'
Dimensions:
Capacity: gallons
Design Flow. gallons per day
{ Alarm present: ❑ Yes ❑ No
Alarm level.' Alarm in working order: ❑ Yes [] No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.).
`Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
15ins•3n 3 Title 5 Official inspection Form:Subsuface Sewage Disposal System-Page'11 e.17
Mar 141410:40a p.12
Commonwealth of Massachusetts
t Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form'-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is required for every Osterville MA 02655 3-13-14
page. city/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert D
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D Box is 16"x16"-33" below grade. Some scale on wall's. Box is solid wltwo line's out No sign
of over loading or solid carry over. Note: D Box is H-10 in edge of drive way.
Pump Chamber(locate on site plan):
Pumps in working order. ❑ Yes ❑ No*
Alarms in working order. ❑ Yes ❑ No*
Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.):
i
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS)(locate on site plan, excavation not required):
If SAS not located, explain why:
15ins•3113 Title 5 OTdel Inspectai Form:subsurtace sewage Disposal System•Page 12 of 17
Mar 141410:40a p.13,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is Osterville MA 02655 3-13-14
required for every
page. CityfTown state Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
leaching chambers number. 2
❑ leaching galleries number:
❑ leaching trenches number. length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching is two 500 Gal. dry well chambers. Chamber's are 50" below grade w/cover at 28".
1'water in chambers. No sign of over loading or solid carry over. No high stain line.
' Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indicafon.of groundwater inflow ❑ Yes ❑ No
t5ins•3113 Title 5 Oftidel Irkaction form:SuDsvrace Sewage Disposal Syatem-Page 13 or 17
Mar 141410:40a p.14
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposals System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is OSt@rville
required for every MA 02655 3-13-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
isms-3/i3 This 5 Olfical hmpedbn Form:Subsurface Sewage Disposal System•Pape 14 of 17
Mar 14 14 10:41 a p.15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis _
Owner Owner's Name
Information is required for every Osterville MA 02655 3-13-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
CARAC t
' r-fRoaT
y 3
n
B-� - 33
6tv
t5ins•3113 Title 5 Official Inspection Fain Subsurface Se%wMe Disposal System-Page 15 of 17
Mar 14 14 10:41 a p.16
• , e
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis _
Owner Owner's Name
information is Osterville MA 02655 3-13-14
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
eva 12'
Estimated depth toFigh ground water: feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: Date 86
Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
T.H.on design plan 10-22-86. No G.W. at 12'. Bottom of chambers at U-8"below grade. Bottom of
chambers at 5'-6"above T.H. Depth.
Before filing this Inspection Report,please see Report Completeness Checklist on next page.
t5ins•3113 Idle 5 Official tnspwAon Form:Subsu, Sewage Disposal System-Page 18 or 17
Mar 14 14 10:41 a p.17
N Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1676 South County Road
Property Address
Gail Martis
Owner Owner's Name
information is
fo
required for every M Osterville A 02655 3-13-14
page. Cityrrown state Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
3
15ins•3113 .. Title 5 Official Inspection Forth:SubsuAace Sewage MIxisel System Page 17 of 17
ri
0 No.� Fee ,
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PU IC HEALTH DIVISION -TOWN OF BARNSTABLE,. MASSACHUSETTS
j � l 01ppYtcation for Mtopool *paem Construction Permit
UU� �Ioica'tion for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components
Tel o
Location Addre; or of No. r / Ow is Nayne, ddre�4/n I��
Assessor's Ma c
• lnst� D"
doress,and Tel.No. Desig r y�t��Q d
• �(j
pip
Type of Building:
Dwelling No.of Bedrooms Lot Size 3S sq.ft. Garbage Grinder(h1IC)
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow WV330 gallons per(Jay. Calculated daily flow lln 0, gallons.
Plan Date ��-�a— t Nu ber of sheets Revision Date
Title �, p Sty Gn /7 U u, !)) L kfUr
Tm
Size of Septic Tank /SZ[7 Type of S.A.S. S� 116.7
Description of Soil LL Gt�1
Nature.of Repairs or Alterations(Answer when applicable)
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 itle 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss e y this Board of Health.
Signed Date
Application Approved by 1Z Date
Application Disapproved or the following reasons
Ic
Permit No. ® Date Issued
',� * } Al.
!
�444
e.. -✓ -NO ii +ter _ ' jv Fee V.
Entere r.
�. THE COMMONWEALTH,OF MASSACHUSETTS
PUBLIC HEALTHIDI.VISION_.-.T61 Yes OF`BARNSTABLE., MASSACHUSETTS N
ZIppri ratio n'for�Mig�oga[ *pgtem Construction Permit
Application for a Permit to Construct( .►/)Repair( )Upgrade(, )Abandon( ) ❑Complete System ❑Individual Components
7,F 3�r
Location Address or Lot No. U /� Ow er's Nagne, ddress and Tel.I1io/ y 7 C
�'�'Y' (�S C�//c_ .�rr�,% �7ZJ"/7fG jnL!y,
Assessor's Ma !P c
Instal A fts,and Tel.No. Designer's Name,Addres n T 1. o.
�lr,�w,/, / /?l'h(1'd'l'f �JY�/f iSi'�G/rlr'1J
(72
Type of Building: i
Dwelling No.of Bedrooms 3 Lot Size)1C? (3Sr sq'. ft. Garbage Grinder(V1
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures /
Design Flow 30 gallons per day. Calculated daily flow P%✓ t ,w7.Gr� gallons.
Plan Date �l ��-�7 t Number of sheets / Revision Date
Title ,�. i S(+,o,, A I i..brL
Size of Septic Tank 1_(ro Type of S.A.S. �cq 6"
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) /
' l
Date last inspected: - ,J
1� Agreement:
The undersigned agrees to ensure the construction andinaintenance 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 Certifi-
cate of Compliance has been iss"edy this Board'of Health. k
Signed i f Date
Application Approved by Date
Application Disapproved for the following reasons
ti
1
Per t No 1—T Date Issued
--�----------. -------------------------
,' THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
r
Certificate of Compliance
THIS IS TO CERTII�'1; than th'e n-s'te SewagelD`i`sposal System Constructed( ) Repaired ( )Upgraded( )
Abandoned r) r q/1! ff_
at ) �l has b constructed in accordance
with the provisions of Title 5 and the for Dispos 1 Syste Construction Permit No.A dated ;r
Installer. Designer n� t9 A ri
The issuance of this permit 'h 1 tilde cons ed as a guarantee that the 'tem will fupc�ton�as designed�.
Date � I Inspector c(,�_
p V\ 1
}
— /— ——— — ——— _ ---- ---------------------
No. (/� T/ 1 Fee
q
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS
mtgpogaf pgtem Construction Perron
Permission is hereby g ant d to Coct( Rep 'r( Upgrad ( Abandon-(
System located at \ //. Y1
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.
i
Provided:Construction must b compl ed within three years of the date oft ' e 41
Date: Approved by
l
Map Page 1 of 1
Town of Barnstable Geographic Information System New Search Home I Help
Parcel Viewer Custom Map Abutters Map Sue .■ ZOOM Out I I lln
_._—"-----._...................................................._................_...__..........._..._....._..._......____._._._..........._..__._........
_........
JPG Map: 098 Parcel: 064 Full
now— Property
Location: 1676 SOUTH COUNTY ROAD Info
O�Os2 Owner: MARTIS,JOHN R&GAIL GERMAIN
008013 N'41
N 1092
Location Information
Map A Parcel 098064
110111111,03 Location 1676 SOUTH COUNTY ROAD
025
Acreage 1.06 acres
Current Owner
ir.. Mailing Address MARTIS,JOHN R&GAIL GERMAIN
%MARTIS,GAIL GERMAIN TR
098064 MARTIS FAMILY REVOCABLE TRUST
01078 _ PO BOX 1089
- OSTERVILLE,MA 02655 1
A raised Value FY 2014)
o PP.
Extra Features $55,800
Out Buildings $10,100
Land $161300
�„ -- Buildings $300:100
c.. " 01N6086 Total Appraised $527,300
il
G�
Assessed Value(FY 2014)
oa 22001 Extra Features $55,800
M Out Buildings $10,100
Land $161,300
Set Scale 1" = 66 I April 2008 I MAP DISCLAIMER Buildings $300,100 J
Copyright 2005.2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS
BarnstableMA v1.2.5115[Production]
http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=098064 1/6/2014
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
LOCA ON SEWAGE# W0
T
VILLAGE Q�I�.et/ l ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO, R—T Set/1 l sots 509-93.2 11899
SEPTIC TANK CAP&rJJY (0
1
LEACHING FACILITY:( (size) .<16 ti/A/
NO.OF BEDROOMS—
BUILDER OR O
PERMITDATE: oD COMPLIANCE DATE: O
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
O
2 2� 3 Y1
3 3y.lo
y v(,y 4 ys• z
5 3S'.to
`l?•5
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=098064&seq=1 1/6/2014
TOWN OF BARNSTABLE
1're
LOCA ON -CD U IM( �iD SEWAGE # 0&20
VILLAGE Q5l e Q<l I ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. 91 �Rctl�AC_C2 .�O9-$33 Ve7;
SEPTIC TANK CAPACITY 15,00
LEACHING FACILITY: ( p C&,Clk CAari3eeS (size) .566 64/
NO. OF BEDROOMS
BUILDER OR O
YhRJPERMLTDATE: 6D COMPLIANCE DATE: Q .
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist-
within 300 feet of leaching facility) Feet
Furnished by
i
3
Y
_
,I
;I
TEST HOLES
ROUTE #28-
s BAXTER, NYE & HOLMGREN INC.
10/22/86
x ry N #P-6249
LOCUS
Gti PIT #1 PIT #2
_ ELEV. = 45.6'water level 5/30/90 = 24.00'
ELEV. 44.5
�F
LOAM & SUB SOIL
FILL ,
wetland -2.0
o'10 , _ '
ELEV. 42.7
TOP OF FND.
75
RAISE TO WITHIN 6 OF F.G.
WETLANDS FLAGGED BY
LOAM & SUB SOIL : : -4' PERC. TEST
49.0 F.G. 48t F.G.= 48f �� _
LOCUS MAP 8.7 FURGRO EAST INC. A3 , F.G.= 2.0
12/29/94 .\ % GC\�!\ F.G. 48t :... f
SCALE 1 25,000 INV. = C\ ,\ .\�
p� _ LEVEL \ .\ \ . �.�
46.0 Q MEDIUM
ASSESSORS �� A4 --__ 2' ::: _
1500 GAL. 4 DIAMETERI 4 PERC. TEST SAND
MAP 98 PARCEL 64' G 3 INV. =
SCHEDULE LEACHING CHAMBERS
�'� O' 45.8 SEPTIC TANK INV. - DIST. 4(0 P.V.C. 1.
o - INv. =45.4 Box x ..... i
ZONES N O� �``�. ... .
GP Q- 45.5 .......:::•:: INV. 45.2 INV. _
ci Op ...... 45.0 MEDIUM
R F 43• 33.2 is SAND
•� ........................... 6 STONE BASE
'�• '� \ 30.2
. MINIMUMS �, ,O �•',, � m
BOTTOM ELEV. EL 53.0
NO WATER
AREA 43,560 S.F. �' .� p �,. 31.0
--. -12.0I)
FRONTAGE 150' � Q�,�h.
X N = 33.6
FRONT SETBACK = 30' --' -_ ::..
31.3
�._ _ fir v �; o'' PROFILE
_._. r __ _,- �, :'fit,. !'
u
SIDE SETBACKS = 15' o/ -3 �-- -- ...�� - -.... 9
_-- r,�•, `" ..."� _. _ 2.7-- -12.0 NO WATER
REAR SETBACK = 15' J �i l 4� _ - X __ -- 31 6 `99, �O NO SCALE '
�.. 30 7'
BUILDING HEIGHT = 30' 39.8 `' x i:whl .y pines 16" -. �� -.. - 32
r�
o Ge' �p •,, /rJ:'�,��. .. ..` x x 32.
- 33..0. 34
.....
0 0i �s'9
l ~
5
X•"3$.4 �C
..y
R 45.5 39.7
46.4, \34.6
.
qg
439 Am
WTI"I
a
x x
LIMIT
UX N, e°d- `,•tv l.,, rtw{,z..,4"Y S`4 y e---;<.;.s a,.,- ..'. - -` V S , ` _
47.2 _ fi 7. n. ,,w,, RI DICT
FN OFF r_ • athFm
__
` ,�$ ,y��,; y ION x 39.8 1
49.6 r, L ,: x 31.4.� .,lyy . #y,�
9 .. ,, •. �,. � .'.,�..,�. �� <.fit:, C �..,,
_ 38 38 0
49.3 1 1
.5" WASHED STONE
. ,.
50.
.:
C.,
50.0
.
FND._
34.4
x. 40
". b
: e
\gyp
'• N
t-.
41.6
•
� .. 4t 4•'1„ :� 5. ">:' hF•<CFx.. f { ry x 41.E
.,,
.....
43 0
25 0'
F f :
O• • �., z, �.� r ��> x� '•i' a pine �16 _-.__ F HMA
�•p ,emu
� whit �._ BE C RK
r`
x TOPOF C.B.
fit- t•'��.. r EL. 38.00 PLAN OF LEACH TRENCH
, W,< 47.2 SCALE. 1 -
, r
x 46.70.
fi
x 48.4
- - : - -
49.6 TO BE REMOVED
S
holly
,T S
-r 50 12
`'. .O �. _ FINISHED GRADE
S.B. 4�:Z '9,�; "� 12 MIN.
50.7 '9'Q S/ �' 1, \/\/\ \ \ \ \\ \ \\ \ \ \ \
FND.OFF 49;4. O x 50. �A `'� " y�`�`�`/ / / COMPACTED FILL
#155/80 : �x �., �°' p -1 S p 36 MAX. \ /��
h G �, �, 2 _ .................
�` •'y J� q.......' PEASTONE
tK
5.. 13
" ° '• DOUBLE
LOT 9 �. • -. .°.
x 51.0
24
�y a
-.• ". .- '. ,. WASHED STOKE
46,135 S.F.
'
C>� - EFFECTIVE
1 .06 Ac. .
DEPTH SECTION v
NO SCALE
�.
18.s
x 50.8
z I
---
a PLAN AA,® 51.0 x Of
Sr I
FND. ti \�, r
ti SCALE: 1 :)' JO ��." o TEPHEN
I I• � F �A. �I � '9 _
s,, 9 C.B.
GRAPHIC SC/,I.- � � Lis y �_
FND. O b o. 2874 No nazis M
�L \ 0 20 40 ,� `
48.4' §.
� Z `SS��
D vAL� i
DATUM FOR THIS PLAN _ J.G.V.D. S Zs a-o
i ,
I
SEPTIC & SITE PLAN
„
I
#17 JUBILATION WAY
I
"
s..
,,.GN DATA -
IN ,� G
}
E?
SINGLEC•F �i 3 ' BEDROOMS OSTERVILLE
,
y < ,, �GE GRINDER NOTES:
110 X 3 330 G.P.D.DAILY FLC',N BARNS TABLE,
1 'REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL WITH E MASS,
GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT MORE
CLEAN G SEPTIC TAt`K , .�0 X 200� = 660 GAL.
THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED ON
w T: ...,: �__ I FOR
50 SIEVE, OF FRACTION PASSING No. 4, 107 OR LESS O PASS # 100
USE 1., GAL SEPTIC TANK
SIEVE AND 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO .BE APPROVED
CERTIFY THAT THE PROPOSED FOUNDATION
BY ,ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. LEACHII`%a_ ?.AMBER DESIGN
GAIL GERMAIN- MARTIS
SHOWN ;ERE ON COMPLIES WITH THE HORIZONTAL
LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS ,_
2. L & DIMER 3IONAL REQUIREMENTS OF THE LOCAL PIPES T BE `. -
FOR THIS PROJECT CONTRACTOR SHALL MAKE ALL E 0 .DUCE 40 PVC .:PERFORATED
PRIOR TO ANY EXCAVATION c
SCALE: 1„ = 2 0 DATE. NOV. 2
F 1-888-34�'r-7233 AND ZONING `3Y-LAW, AND THE FOUNDATION DOES NOT
THE REQUIRED NOTIFICATION TO DIG SAE ( ) IA F.E.M.A. FLOOD HAZARD AREA. - USE 1 - 4• DISTRIEJTI:"' IN PLASTIC LEACHING CHAMBER 2' 1999
APPROPRIATE WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. FALL IN ;4 SPECIAL
' REVISED AUGUST 8, 2000
IN A 12'X 25' W/,S"" .;TUNE TRENCH' AS SHOWN
3. FAR ALL ASPECTS OF THE SEPTIC SYSTEM THE CONTRACTOR SHALL COMPLY
BAXTER
310CMR DATE: 8�Q5 Z.00 R.L.S. LEAC'-a; =. A REQUIRED ` NYE OG .C1OL
WITH ALL GOVERNING CODES AND REGULATIONS. IN PARTICULA, -� MGREN INC
ENVIRONMENTAL CODE TITLE 5, ON SITE SEWAGE DISPOSAL
330 .7 4 = 446 S.F. INC ,
1S.000 THE STATE ,
REGISTERED LAND SURVEYORS I
REGULATIONS AND THE BOARD OF, HEALTH RECOMMENDATIONS FOR ACCEPTED
OFFSETS "`0 THE PRO ED FO DATION SHOULD 2 25+12 x 3 S.F. SIDIEWALL AREA
•
NOT BE I.SED TO ESTAB OPERTY LINES. CIVIL ENGINEERS
PRACTICE. (12 X 231 ) S.F. BOTTOM AREA OSTER VILLE, MASS.
448 �� �TAL PROVIDED
IS TO SECURE APPROPRIATE PERMITS FROM TOWN O
4. THE CONTRACTOREED R`_FERENCE: CERT. 89155.
AGENCIES FOR THE CONSTRUCTION DEFINED BY THIS PLAN.
5. ALL STRUCTURES. BURIED DEEPER THAN 4 FEET OR SUBJECT TO VEHICLE
TRAFFIC SHALL BE H 20 LOADING.
� .�
,�� -�a��.�-_,,..,<..�..�•- -sue.., � .,_.x�, _�. -
vat
TEST HOLES
BAXTER, NYE & HOLMGREN INC.
ROUTE #28 -
10/22/86
d�
soU #P-6249
ry LOCUS N
PIT #1 PIT #2
ELEV. - 45.6'
- = '
water level 5/30/90 = 24.00' LOAM & SUB SOIL
FILL
ELEV. 44.5'
.. -2.0'
wetland
A2 ALELEV. = 42.7'
�o
:. ::.
I TOP OF FND. RAISE TO WITHIN 6' OF F.G. LOAM & SUB SOIL -4' PERC. TEST
WETLANDS FLAGGED BY �I '� = 49.0 F.#a:= 48f F.G.= 48t
2.0'
LOCUS MAP 8.7 FURGRO EAST INC. A3 \ .�\ . \.\ :•.
.\\r\��• \ F.G.= 4a
12/29/94 48t'
INV. _ LEVEL \ .\ x MEDIUM
SCALE 1 25,000 -4' P
p 46.0 '
ASSESSORS 0� A4 _ 150o GAL 4" DIAMETER 2' I ERC. TEST SAND
LE!'kCHING CHAMBERS - :,'
INV. - SCHEDULE 40 P.V.C. 1 .......
MAP 98 PARCEL 64 �� G' � o0 45.8 sEPrlc TANK INv. = INV. =45.4 eox x
ZONES :• INV. = 45.2 INV. = 45.0 MEDIUM
cV p'� �. 45.5
GP O0� ,. 30.9 o w ,. SAND
?`•. x::. 6 TONE BASE
R F c� 43� 33.2 ...............•. S
J '\- ��' '� �30.2 m
MINIMUMS �\, �O BOTTOM ELEV. EL = 43.0 ,
- -12.0 NO WATER
AREA - 43,560 S.F. � �� O
31.0
FRONTAGE = 150' o/,�g• X�32.1 � .,ii, sus• N
. � � ... ELEV. 33.6'
FRONT SETBACK 30' _______ _ _ A•
4 31.3 �o,, PROFILE
15' �' -: -` ._ hey ��; 999 F -12.0' NO WATER
si`_ x 9.
' SIDE SETBACKS �..__, NO LE
. -
-�
__
REAR SETBACK = 15' 8 '" ► ` `~-� 2 7' 31.6 �O� SCALEELEV 30 7'
39.8 <��..- x » _ _ ~ _�_ 32 �j
BUILDING HEIGHT = 30',. ,, wt'�� pines 016 ` q �
x x 32.
0.4`
34 FSq
s a . 39.7
R 45.5
J 'X, 46.4•,\ ��` 43.9 � 4. � '` 41.9 ; .36 " 34.6
$ � 7
LIMIT
C.B. OF �URis p x 37.
x 47.2 c 1CTIQN x 39.8 .
FN OFF _..-__ 3 y �r .
49.6 �\ :;. .fx � ' x 3- 38 310
x
e 49.15
x 49.3 8 WASHED
44
`'' 3 ••... .5 TON
1 H
` ,.. 40
50.0 ,
N
CB
. F
1. x 36.
i
a: :
41.8 _ 42 �
� r X 43.0 25 0
: .:• - .. ,� pine 016 �__- BENCHMARK
-
6' x TO OF C.B.
45.4 PLAN OF LEACH TRENCH
EL. 38.00'
rW
S 20 x / SCALE: 1"
9.8
501
C+q. �p� •t.<x 48 4
49.6 s h.
12
TO BE REMOVED
• � holly
FINISHED GRAD F E
S.B. ti / / COMPACTED FILL
50.7 .�' SRO x 50. ti' -� ti� IP/ 36 MAX. /\\/\\/\\/\\/\\�\\/\\/\\/\\�\\�\\�\\�/\\/\\
FND.OFF #155/80 49.4. E9x •4J8.1 ,�°' ,h0 \�, M. s�'sz. , 2 PEASTONE
��� �J /O', a..� a 4 " 3/4!. TO 1 1/2
9a ti �3 5 3 .5
0 T �r n W. .°.' DOUBLE
Ap�`SQ ,,� LOT c7 x 51.0 �, 24 A. ':a WASHED STONE
46,135 S.F. E DEPTH E
- 1 .06 Ac.
� SECTION
NO SCALE
8.9
x 50.8
PLAN' ' ,N O{ ,
® 51'0
FND. '�� TEPHEiV
SCALE: 1 - 20' (ti Ja 1 , s
9
S�, 9 Ll
C.B.
o
FND. GRAPF�IC SCALE
o0.29874,
o
40 __-
' � 48.
DATUM FOR THIS PL.j'',N IS N.G.V.D.
a
T
c 1D -kT
>� T C p.r ,� n .T r TTT'
#17 JUBILATION WAY
i
DESIGN DATA IN
SINGLE FAMILY- 3 BEDROOMS
OSTERVILLE
BARNSTABLE MASS:
N 9 GARBAGE GRINDER
NOTES: DAILY FL'JW ',- 110 X 3- 330 G.P.D. ,
1. REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL WITH
CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT MORE SEPTIC T�NK 330 X 200% = 660 GAL.
15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 9)% RETAINED ON FOR
THAN TO PASS # 100 USE 1500 GAL. SEPTIC TANK
# 50 SIEVE, OF FRACTION PASSING No. 4, 10% OR LESS'
SIEVE AND 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED I CERTIFY THAT THE PROPOSED FOUNDATION LEACHjk4G CHAMBER DESIGN GAIL GERMAIN- MARTIS
BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. SHOWP, HERE ON COMPLIES WITH THE HORIZONTAL
2. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS & DIMi;NSIONAL REQUIREMENTS OF THE LOCAL
PRIOR TO ANY'EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE ZONING- BY-LAW, AND THE FOUNDATION DOES NOT ALL PIPES TO B:: SCHEDULE 40 PVC PERFORATED SCALE: 1" = 2O' DATE: NOV. 22, 1999
THE REQUIRED NOTIFICATION TO DIG SAFE (1-888-344-7233) AND FALL I; A SPECIAL F.E.M.A. FLOOD HAZARD AREA. USE 1 - 4" DISTRIBU:ION LINE IN PLASTIC LEACHING CHAMBER
APPROPRIATE WATER DISTRICT TO ,DETERMINE UTILITY LOCATIONS. IN A 12'X 25' V'ASHED STONE TRENCH AS SHOWNBAXTE REVISED AUGUST 8, 2000
3, FOR ALL ASPECTS OF THE SEPTIC SYSTEM THE CONTRACTOR SHALL COMPLY R.L.S. LEA;HING AREA REQUIRED
R, NYE & HOLMGREN INC.
DATE: : QS 2.00
WITH ALL GOVERNING CODES AND ,REGULATIONS. IN PARTICULAR 310CMR 330 G.P.D./.74 = 446 S F. REGISTERED LAND SURVEYORS
15.000 THE STATE ENVIRONMENTAL CODE TITLE 5, ON SITE SEWAGE DISPOSAL
OFFSET" TO THE PRO' ED FO DATION SHOULD 2(25+12) x 2 _ 148 S.F. sIDEWALL AREA CIVIL ENGINEERS
REGULATIONS AND THE BOARD.OF HEALTH RECOMMENDAThNS FOR ACCEPTED NOT BE USED TO ESTAB OPERTY LINES.
(12 x 2:5) = 300 S.F. BorroM AREA OSTERVILLE, MASS.
PRACTICE.
443 S.F. TOTAL PROVIDED
4. THE CONTRACTOR IS TO SECURE APPROPRIATE PERMITS FROM TOWN DEED DEFERENCE: CERT. 89155.
AGENCIES FOR THE CONSTRUCTION DEFINED BY THIS FLAN.
5. ALL STRUCTURES BURIED DEEPER THAN 4 FEET OR SUBJECT TO VEHICLE
TRAFFIC SHALL BE H-20 LOADING.
_.w.. H: 1999 99086 SURV worksht 9� � \ 9086ccA.dw
� 9