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0019 STAYSAIL CIRCLE - Health
Staysail Circle arstons Mills s '` - F0058rA — 016 -005 i a., TOWN OF FdA3tNSTAl3Y.0 VAG s i� G�s �. sss®>z�sx� i,f77rL's ., _Ua INSTA.I. 'S NA- LACIiItG F+AFL2 "Y: (QYpn) (sirms e) r BUILDER ER OR oaN1�T.CR 17.7 tvtexreaurm l cljusfkd Groan clwateele40 the i3OUbm ol: Paiv Bcs .c supjjly V1CR1`mtc3 Lea.6�in� ?ae ty Cw"y vof s t:xEsf OW SAO ab:Mt hin 100 feet uk le�zctuol frir:.11tt�) k7p�yq �jL��;t"67�i���;f.�2lZlt�Qd1d'l,pc�Cdl.tti(;iFacill�y���altly wel6atic14 G�YY$f G T_r <7 '; � '°,.- i r f;r;;'-. ;t_ �l/ V O C- a3 � �-�- � 7 � ;Q- ��' � -,D - a8 ' ''° I d► TOWN OF BARNSTABLE CATION a rG G. SEWAGE# 201 - 3 Z3 VILLAGE rq;l Is ASSESSOR'S MAP&PARCEIM -0/61OOS INSTALLER'S NAME&PHONE NO. _A 4e R F-xccay0A i o,% q`1'1. OLeS3 SEPTIC TANK CAPACITY J Ono 4a. LEACHING FACILITY. (type) SOO I Lac- (�Z) (size) I x ZS A 2 NO.OF BEDROOMS 3 OWNER R;JkcxrJ. P l oa s ko S PERMIT DATE: 9-8-JG COMPLIANCE DATE: /O• - /G 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 Al - oe 132.. Zz,- , B 3- A4-39 '/O q Q C5 0 No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for BispoSal *pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address.pr Lot No j QY,�0 C/e&.4 ner's Name,Ad ess,and Tel.No. b%-®1 b—b v7 ;P',w11�"J�1 char1� /05 k4s (6,08) W 9 -33 q Assessor's Map/Parcel In ller' N e,Address,and Tel.No. Designer's Name,Address,and Tel.No. A�3 KxcavCtf1en 669-4177-0&6,3 1_-/®h f.�Vrr,9nrn&n1a13&z- �7 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � gpd Design flow provided s3qg gpd Plan Date Number of sheets 2 Revision Date Title Size of Septic Tank e�� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) H 2U n x, C2- 14 w 5 in pal L,dnrabepis 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 He h. Signed Date cl —V`1 Application Approved by � Date �/q —r Application Disapproved by Date for the following reasons Permit No. .110l 6 — J�� Date Issued No. Fee C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplicatlon for Disposal 6pstetn Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 9 Q C��c.L�.. wner's Name,Address,and Tel.No. d5g-or's Map P y� c-har.D P105ka,5 �508) 7k9 -33 97 Assessor's Map/Parcel In ller' �M e,Address,and Tel.No. Designer's Name,Address,and Tel.No. gv�/- +G x 0& lahee� 362- /&�j r Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33o gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank'eYl�j Type of S.A.S. Description of Soil r.Nature of Repairs or Alterations(Answer when applicable) i 1 u 2U J (Z N'o 5 Qo Q ( bus ,w 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 He 9th. Signed Date ell Application Approved by Date Application Disapproved by Date ' for the following reasons Permit No. �d 16 �/ Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Prtificate of Compliance THIS IS TO CERTI Y,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by �f� �.x(,[(�/CIA 1(� at I q S A O\j S I L C-I ("� has been constructed in accordance G' with the_p 'sions of Title 5 and the for Disposal System Construction Permit No.a6/6''3�/ dated "O p —6, 1 �—' 0 � Designer nhPet�I /U 01 e1 :F' -, Installer ,, ���(��` #bedrooms Approved design fl w Q gpd The issuance iof t is a it shall not be construed as a guarantee that the system 1 at o deb- ned. Date + Inspector t ----------------- ------------- No. -- Fe i ==3�-3 ------------------- --- cy o(� THESOMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS AI�tlosal 6pstem Construction Permit Permission is hereby granted to Construct .:Rep k( ) Upgrade( ) Abandon( ) System located.at Sup i �- and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 date of this permit- Date P�� Approved by " - Town of Barnstable o�?HET Regulatory Services ' • Thomas F. Geiler,Director URNSrAst e - Public Health Division prEo �" Thomas.McKean,Director -200 Main Street, Hyannis, MA 02601 Office: 508-862-4644' Fax: 508-790-6304, Date: Sewage Permit#:ZoLL -323 Assessor's Map/Parcel G Joo$ Installer& Designer Certification Form Designer: D=c-- Installer• ,B 4,a Address: p Address: 1y Tea�'��rr•�, L� On', E XCC,.VQA i o n was issued a-permit to install a (date) (installer) septic system at •t. based on a design drawn by (address) �S dated 9- `7- )L (designer) I'certify that the septic system referenced above was installed subs t antially according to the design, which may include minor approved changes such as lateral relocation of the distn4ution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes :(i:e. greater than 10' lateral relocation of the SAS or any vertical relocation of any.component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. Ii+OF Mass 9 DAVID o�GN D. staller's Si t eu ) FL.AHERTY, JR. No. 1211 /STE��o Designer's Si ature �Ar► ��a (Affix esigne s t2hp Here) PLEASE.RI±;TURN TO,.:BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE, OF COMPLIANCE NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- B11 UILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. - THANK; .0 q office forms�desipercertification fonn.doc s . Town of Barnstable w 1 Department of Regulatory Services � = .. Public Health Division Date,��/ (�o tdg 20 M-1114 Slftet,ktyanms'MA 02601 � / s� Date Scheduled Time—4.1 4®Vl N,Pd. Soil,S� .> _ u tabili; f sse sment or ewa e has resat _ i/Perforned Hy: { 4" Wttneme:i 6.v: I.CICATIOhi.&��3yriVEItAL IfgRMA lt7 J Location Address ^' ,. Owner`s Name .,1 t'f31t(S }'irj Address ' t j;' Assessor's ivtip l arcel: T Equncer's Name 0` TvFW CONSTRGCTiO\ REPAIR Tbleplmne N '7` Land Use-- _ Slopes(%)-[ r .,. ,. Surface Stones Distances from t3lrcu Wager rix#y -/aQ t9 Pori4€e bt'ec.AVrra�l�ft ppnht.t�Water Weil 0 Drainage WaySJfc Pmpery:.Line T 2 a:R Otl+,er.., ft SKETCH:(Street name,dimenSKxtS of for,exact locations of lest hales&We tests,.locate werla xt8 it proxiinit to holes) ParetH matetinl,.�etr€o iu ��`�p OepthinBedrock.. Ueplh tofrouadwater Sta di 11 Waea'n Hose; p ' �... tieeptngframi'ttFacc�._fi.J Estimated;Seasonal High Grn.odvratva,, TDETERa1lIl A"1'.IC)N OR 5l 15(314AL HIGH WATER TABLE Method Used: €)etnhOl+serte3sfa.edir�intrbs.lmfe' ._in.. Depth to soilmonlcs in. t)epth to wcepme i`r,�mside efobs hole: it, Ground atc;Adjustment Index well Recstgire!)ate.^ €ndex'Weti€e•tid1 Adj factor_. Ad1 Groundwater Lew] P; RCOLATIO TEST nttte /hoe .. Obsemation - t(oles ilw Time at 9" Depth ai'Perc Start Arasaak.T., a '/•0 Time i9'-67) _ End'7'rC•saaY. Rate 4rmAnch Site St n Miit.1 ma men Site 3 asse<t.._._ _W .. Site Failed ...... Additional Te fmg,Alceded(Y.r\) w. O,iginal: Public Health 3yt.•is on Observation Hole-Dtata'I'o Be Completed on liaek--- ---- Percolation test is to be conducted within 100'of wellhil 1,You must first notify the Haritsta le Conservation Division at,least one(l)week prior to beginning G:lSEFTIC:";.PRCFptt?.�:AO(' wry :.. w M.. . . __.................. _. � �. • 0 43 Certified Mail Fee Er $ 3!tC M Extra Services&Fees(check box,add fee as appropriate) ❑Return Receipt(hardeopy) $ ❑Return Receipt(electronic) $ Postmark O []Certified Mail Restricted Delivery $ �{ Iry�•ere a� 1-3 []Adult Signature Required $ �"�`? ❑Adult Signature Restricted Delivery$ �V O Postage m $ Total Postage and Fees (J$(3 UI Sent To lzd..P JlAXvs : lc2ab�/-i.=�------------ �trset and JAp IV�o.�r�Py,��cox Nq I /))//lG�le CiryStaie`ZIP..�I SS d_[...401 ice -------i-------------- ©a Certified Mail service provides the following benefits: e A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail u A unique identifier for your mailpiece,,. associate for assistance.To receive a duplicate n Electronic verification of delivery or attempted return receipt for no additional fee,present this. delivery. USPSO-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. j signature)that is retained by the Postal Service- Restricted delivery service,which provides [—for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the L. ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®;First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which n Certified Mail service is notavallable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified a Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the a To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items: USPS postmark.If you would like a postmark on a For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion., of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardoopy return receipt or an appropriate postage,and deposit the mailpiece.r y electronic version.For a hardcopy return receipt, r complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530a02-000-9047 COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A�Signet re item 4 if Restricted Delivery is desired. ❑Agent ■ Print your nre aid address on the reverse X ❑Addressee so that we carrreturn the card to you. Received ry(Printed arse) Date of Delivery ■ Attach this card to the back of the mailpiece, P%C- k,q-4 Lor on the front if space permits. I D. Is delivery address different from item 11 [3 Yes i 1. Article Addressed tcti If YES,enter delivery address below: ❑No rIGha(d D-PIRsKus��l��zab�� S fn jl5)#7 3. S rvice Type t"I Certified Mail® ❑Priority Mail Express"' Registered Return Receipt for Merchandise ❑Insured Mail E3 Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. (Trj ' '17d:V5'1730 'd3Q1 49891:'0359 �. PS Form 3811,July'2013 Domestic Return Receipt 1 UNITED S 'RO to ZgwPaid Sender: Please print your name, address, and ZIP+4®in this box* Town of Barnstable I O Health Division 200 Main Street I Hyannis, MA 02601 I I I Town of Barnstable Barnstable ftv . .�° Regulatory Services Department 1 e'cac I.F MRNSTAHM "� i639' Public Health Division ��� rFD"A0YA 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1730 0001 4989 0359 July 21,2016 Richard D. Plaskus'&Elizabeth M. 19 Staysail Circle Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 19 Staysail Circle, Marstons Mills,MA was last inspected on 07/11/2016,by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. - �McKean, OF THE B ARD OF HEALTH R.S., CHO. Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\19 Staysail Circle Marstons Mills.doc Town of Barnstable an�uvsrnsce, + Regulatory Services Department iDTfp�C4� Public Health Division 200 Main Street, Hyannis MA'02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool' ONE 1 YEAR DEADLINE CRITERIA Static liquid level in.the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit or cesspool with high liquid level, <12" below inlet(per Town Code §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) ` OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc i Commonwealth of Massachusetts 06-9-07(a-Do<S' � ^ r Title 5 Official Inspection Form 1, IPI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name t7r? information is a required for every Marstons Mills ✓ MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection W Inspection results must be submitted on this form. Inspection forms may not be altered in any 00 way. Please see completeness checklist at the end of the form. A. General Information > 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification 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 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 16.000).The system: .. ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 7-11-16 I spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system 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. t5ins•3/13 - a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts ' lay Title 5 Official Inspection Form ypi Subsurface Sewage Disposal,System Form Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page,+ City/Town State Zip 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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection, Form , ' .A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � Fr 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) • .❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 public health, safety or the environment. e j 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts =1 Title 5 Official Inspection Form 1'.1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town 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 ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Iaa Title 5 Official Inspection Form Wl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !�` 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due 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. ❑ 0 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. [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. ® ❑ 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 16,000 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 regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 II Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town 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? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ 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 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)] 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 l_ Commonwealth of Massachusetts t+,+ Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 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 Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 7-2016 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 1i;I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,4!✓ 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--pumped 2015 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance 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) ❑ 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): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form, ' , W-I Subsurface Sewage Disposal System Form Not for Voluntary Assessments- ;t,' 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1991 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 20"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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 14"feet I Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) r If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth:, 12,E t5ins-3/13 ,t + °' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts 011 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments N A /I ��.. 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape 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 is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts �`+ f Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is Marstons Mills MA 02648 7-11-16 required for every , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) i 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 t5ins-3/13 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 V Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box if resent must be opened) locate on site plan): ( p p ) ( P ) Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and stain lines above inlet invert. 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.): * 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts ++ Title 5 Official Inspection Form k!, �� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r_IV, 19 Staysail Cir Property Address Richard Plaskus - Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ 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.): Leach pit was filled to capacity at inspection with inlet invert under water. I 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 Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 , Commonwealth of Massachusetts - Lr p, Title 5 Official Inspection Form i-1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1!• 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts �+ LI Title 5 Official Inspection Form 1.4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � tr �.e��✓ 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town 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 13 / 7 - - t -3� s,t tin t rl n , t5ins-3/13 < Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 l , Commonwealth of Massachusetts " lal Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i.;¢,�✓�° 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 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 ® 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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 l_ Commonwealth of Massachusetts �.Z Title 5 Official Inspection Form 1' it Subsurface Sewage Disposal System Form Not for Voluntary Assessments ;�_;;!✓ 19 Staysail Cir Property Address Richard Plaskus Owner Owner's Name information is required for every Marstons Mills MA 02648 7-11-16 page. City/Town 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE f � e LOCATION L;�t ��g v ,SGt x �,`!^ SEWAGE # eI VILLAGE Afa0'Stb s /"�/llS ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ToA n A I, SEPTIC TANK CAPACITY _S LEACHING FACILITY:(type) pi (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATEVpcW,.G BUILDER OR OWNER AfeS14A1 DATE PERMIT ISSUED: ll—k S 7 DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No i �� .o•. t. . \ >,. :� �Ja;�, ��; � � � _ � a mt � ��` � � �1��1 �� l� � , �� �� _ 3�' � . ............. ....... Fxs .... ITHE COMMONWEALTH OF MA•SSACHUSETTS BOARD 5F HEALTH Sc �-�' TOWNOF BARE -.__._/:©.w N.....-----.....OF................... 77�_,V .......o Appliratiun for Diupuual Worku Tunutrurttun rrmi# Application is hereby made for a Permit to Construct (X) or Repair ( } an Individual Sewage Disposal System at: �3 _ ... Jrop6tion-1 k or Lot No. e" ._.....-----•............................... tt Address � r. .:.. ... .......................................... Installer Address Type of Building Size Lot_Z 3-r!_/.._..Sq. feet �-, Dwelling=No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers � YP g --------•-----------------•• P (---)--- Cafeteria ( ) dOther fixtures ....................................-----------------.-•---•---•-•--••----•--••----.................•--•----- .......---- W Design Flow...........................sr___gallons per person per day. Total daily flow_-__-___-_-_•_•-^ ...... .........gallons. WSeptic Tank—Liquid*capacity?Oeogallons Length._F�..--v`_."Width'r. .!_ 'Diameter................ Depth_.s 7..`� Z Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------/---------- Diameter_�� �.`�.. Depth below inlet.�..G.`.._. Total leaching area... _sq. ft. Z Other Distribution box (X) Dosing to ( ) `'" Percolation Test Results Performed by.____-_-- -.-5_-_-.---------------------•-•----------.---_-_--_.... Date..._ __.. Test Pit No. 1.....:Z......minutes per inch Depth of Test Pit----- Depth to ground water----- -----............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------ 0 Description of Soil........... ........ ........................... 11.-•--5� ....../_----•-----•-•-••--•--------•-----------•-•-••-•------------•---•------- --••- V -•-•-•-••---•-••-•••-•---•---•--- '��. -`--7...----=sue V Nature of Repairs or Alterations—Answer when applicab�le.----------------------------------------------------------------------------------------------- --------------------•---------------------------------------------------------------------------------------•-••--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iiTi 11 5 of the State Sanitary Code— The undersigned`furtl:er agrees not to place the system in operation until a Certificate of Compliance has been is�su b the board of 1 . �th. Sned------ ----••. - ------.......-. ......---)-- Application Approved By------- ------------------ -- ------------------------------ .......---------- D Date Application Disapproved for the following reasons:-----------•--•-----•---••------•-••---------•--•------•------------------------••--•---•-----•-•••-•----------. f --------------••-•------------•-•-----••----•---••-•-•••---•-•-•----•-•------•---------.....-•------•--...-•------------••-•-••-•---•••••---•-•-•--------•••......•------------•...------.............. / Date Permit No.- .................................... Issued........ �� /--` Date l No......................... Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD TF HEALTH ..r�.w.!' .................OF..................c, .r_ f��...!../_P Appliratiun for BispaoFal Works Tonstratrtiun Prrutit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: /�' r / ...: � ......5..� t-:cv P / ....r:`.�l!_ �� � �f�:�. �7�.��s.............. .... dress or Lot No. (O" e Address a ............... E `.................................................. .................................................... Installer Address U Type of Building Size .....Sq. feet Dwelling_—No. of Bedrooms............--�..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons................_----------- Showers ( ) — Cafeteria ( ) a' Other fixtures ............................................. - W Design Flow ..........................:� - �0 . n .............................................gallons. WSeptic Tank—Liquid capacity"ovuallons Len h.E.Z . Width.:K�!e Diameter-_._-. De s x Disposal Trench—No............:........ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...... ........... DiameterZ©� .... Depth below inlet__... .....•... Total leaching area... ..sq. ft. Z Other Distribution box (k ) Dosing t ) } Percolation Test Results Performed by........ _............................................................. Date....... 1-....G.................... P a Test Pit No. 1.....0-------minutes per inch Depth of Test Pit----!_z......... Depth to ground water.._ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �0 Description of W Soil____________ .____ ;... . _ --...-----• � ................6s o. / ......................................................................... y .. /c� �........................•.............................. ?.................._.. %........ ................._.. ...------............---.........................._.... •._._ x Nature of Re or Alteration------------------------•. ----•-• r �__. �/- ~...........�..............' =-=� Repairs ------- UP s—Answer when applicable----------------------------------------------------------------------------------------------- •-------••-•-•-------------••-•--._....••--•--••-----•--•-•-•----•-----------•-•-••-•-••••--•-••-----•--------------------....---•-•--•--•--------•-----•---.-----------------------------------.------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE .5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ---.y-_ Signed......-- .................................................. ---•----•--•---••-•--- Z7-947 Zt ---. Application Approved By... --------- •---------- -------------- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------- �- Date Permit No.��. ......C__/..' Issued.....// r�� /`���7 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH tj = C c 6!y yA..................OF............................. ..5...........�.�..........:...._.............. Aer�ifirtt#r of f�unt�rfi�tnrr THIS�.S;TO CERTIFY That tree Individual Sewage Disposal System constructed ( ) or Repaired ( ) by --. -------------� ! e ---- Installer ( j'S -- at.-----Z- !---------- ..._....4.._--�.�..y..�.----•-•---•--•-=�-•------------------------------- -------------------------`---t-- -----------••--------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cod as de cribed in the application for Disposal Works Construction Permit No..... dated-....�_�� `��.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................•-------••..-------••---......-•-••-••--••...... Inspector----------------------------------------- .......................................... THE COMMONWEALTH OF MASSACHUSETTS _—. BOARD'_OF HEALTH 2 ................<t7Lvv OF. ............' '�(\) S......................................................... 1`�'PG.-.. FEE Diu uu,urkT, Tunu#r ion �eruti# Permission is hereby granted...............7.I,n --t---�(- •�,�•---------------------------------•------------......------------ to Construct ) or.,4*air ( an Individu4-Se�>�ge eispo S stem �� C 1 at No.--------•----•---•--•....................•--..._..�...:�...------ c----•-G--.------ - �---------- M - .... Street as shown on the application for Disposal Works Construction Permit No.. ..�' 72 Dated....../ 6/f 9_..._._.__. 27 ........................ ...--- - ------------------------------------------........ DATE_ . �!_/ - ------- Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS lei 4? TOP OF FOUNDATION COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM PROFILE BROUGHT TO WITHIN 6" OF FINAL GRADE Flaherty Environmental Services EL. 56.0' EL. 55.U' (not to scale) INSP. PORT W I 3" OF GRADE CLEAN SAND P.O. Box 81 2" of a" to 1" DOUBLE WASHED PEASTONCOR GEOTEXTILE EL. 54.0, Yarmouth Port, MA 02675 il 4" CAST IRON or•EQUIVALENT FILTER FABRIC 508.362. 9657 MIN. PITCH 1/4" PER FOOT 4 SCHEDULE 40 PVC PIPE r 4"SCHEDULE 40 PVC PIPE ' VENT REQUIRED FLOW LINE (f<rst2'tobe/avp/) a', ° 17 10' 18/o --► $' 1% " e;• .. EL.51.7'f L• EXIST. 14 -� p•aLJLJ�� o 'pp��p °000000°c --v o 0 0 0 0 0 0 0 0 0 0 EL. EXIST EL. 52.5' 000000 0° o o°o° '®� p p p' p o°o°o°o°c EL. 50,53' 4 000 0 0 0000000o p p p p p ® C7 0°0°o°0°c 0 0 0 0 0 0 o �� a�e' ° o 0 0 EL.50.T 0 0°000°0°0°°°o U'a�LJ GAS BAFFLE EL.50.5' 0000000000 000000 0 0 0 0 0°0°0°0000 00000° a e 000000o°c o. a e .. 'oo°o°o°oc EL.48.5' (D-e I SOIL ABSORPTION SYSTEM :•'g:''•.;`;:?;,;.a?' : 6" CRUSHED STONE OR INSTALL INLET TEE 1 MECHANICALLY COMPACTED �� (2) 500 GALLON H-20 CHAMBERS ' ' • 1000 GALLON SEPTIC TANK ABOVE OUTLET INVERT 5.5' (EXISTING) WITH 4'STONE AROUND IN A (DATUM: ASSUMED) h" to 1;" DOUBLE WASHED STONE 12.83'W X 25.01 X 2'D CONFIGURATION LEL. 43.0' 2, BOTTOM OF TEST HOLE EL. 43.0' LOCATIONMAP 54 _7 �- a USGS ADJUSTMENT: N/A /�°^®�C '� GROUNDWATER ELEV: N/A N TH !J 1 ' ®� OO `Sp0 52 50 48 Rt.28 C R o < STON f 207,53, DRrV c. 54 T -1 , ':f.O .<•.. \ Ay tie 9) LP ;• O \ LOCUS SLEEVE WATER LINE 5' GARAGE LOT 5 NTS 15. WITHIN 10' OF SYSTEM O 23,511 SF± 48 VENT MAP 58 LOT 16-5 2,3 EXISTING F* 3 BR DECK �� D I qy DWELLING ,'ti FGtSTER� w 52 SgNITA N . BENCHMARK: G TOP OF FNDN EL 56.0' DATE.•9/7/2016 REVI ED: 50 t SITE AND SEWAGE PLAN FOR B & B EXCAVATION, TNC./ RICHARD PLASKUS 19 STAYSAIL CIRCLE ' SCALE : 1 „ = 30' BARNSTABLE, MA 'I REF*P8 466 PG 55 PAGE 1 OF2 f ..................................................................................................... ............................................................................................................................................................... ...... .............. ......................................................................................................................................................................................................................-...................................................I....................................................................................................................................................................................................... GENERAL NOTES DESIGN CAL CULA TIONS Flaherty Environmental Services SYSTEM DETAIL 1. ALL PRECAST COMPONENTS TO-BE H-1 0 P. 0 Box 81 RATED UNLESS OTHERWISE SPECIFIED. Yarmouth Port, MA 02675 NUMBER OFACTUAL BEDROOMS 3 ALL COMPONENTS WITH ANY 774.994.1166 ANTICIPATED VEHICULAR TRAFFIC TO BE GARBAGE DISPOSAL UNIT NO H-20 RATED. �2. THE DESIGN OF THIS SYSTEM DOES NOT , TOTAL L ES TIMA TED FLOW w ALLOW FOR THE USE OF GARBAGE 010 GAUBRIDA YX 3 BR) 330 GAL./DAY GRINDER, REQUIRED SEPTIC TANK CAPACITY 660 GAL, 3. MUNICIPAL WATER IS AVAILABLE., 4. ALL CONSTRUCTION To CONFORM WITH SIZE OF SEPTIC TANK 1000 GAL. (EXISTING) 310 CMR 15.000 AND ALL OTHER APPLICABLE LOCAL, STATE AND FEDERAL SOIL CLASSIFICATION CODES AND REGULATIONS. 25' ---j 5, INSTALLER/CONTRACTOR TO REVIEW& DESIGN PERCOLATION RATE <2 MIN./INCH VERIFY ALL ELEVATIONS AND DETAILS EFFLUENT LOADING R4 TE AND REPORT ANY DISCREPANCIES TO 0.74 GAL.IDA YIF T2 DESIGNER PRIOR TO CONSTRUCTION OR LE4CHINGAREA ASSUME ALL RESPONSIBILITY, 0 0 12,83' (2)x(25.0'+ 12.839(29 151 SF 6. INSTALLS RI CONTRACTOR IS 25.O'x 12.83' =320 SF RESPONSIBLE FOR MAINTAINING SAFE 471 SF x 0.74 348 GPD WORK AREA, VERIFYING ALL UTILITIES AND NOTIFYING "DIG SAFE" USE(2)500 GALLON H-20 CHAMBERS WITH 4'STONE (1-888-344-7233) 72 HOURS PRIOR TO AS DIAGRAMMED INA 25.0'X 12.83'X2'CONFIGURATION CONSTRUCTION. 7. ANY CHANGES TO OR DEVIATIONS FROM THIS PLAN MUST BE APPROVED IN RESERVE LEACHING CAPACITY NIA WRITING By FLAHERTY ENVIRONMENTAL SERVICES AND LOCAL BOARD OF HEALTH, 8. FINISH COVER OVER COMPONENTS is NOT TO EXCEED 3'PER 310 CMR 15.000 (NTS) UNLESS SHOWN PER PLAN 9, ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE PUMPED DRY AND SOIL EVAL UA TION FILLED WITH CLEAN SAND OR REMOVED TEST HOLE#1 PW15154 TEST HOLE#2 F#15154 AND REPLACED WITH CLEAN SAND. Evaluator David D.Flaherty Jr.,RS,REHS OF A%.Evaluator David D.Flaherty Jr.,RS,REHS 10.ALL COMPONENTS TO BE PROVIDED SE#2755 SE#2755 BOH Witness: David Stanton,RS DAVI WITH WA TER TIGHT ACCESS PORTS BOH Witness: David Stanton,RS Date: September 7,2016 Date: WITHIN 6"OF FINISH GRADE. September 7,2016 D. 11.ALL SEPTIC TANKS, DISTRIBUTION F E R. TH-IELEV.&CO' TH-2 ELEV.54.0' 0 2 BOXES AND PIPING TO BE INSTALLED 0--10' A LS IOYR312 WATERTIGHT. 1 01-10" A LS 10YR 312 S T Ea 12.NO KNOWN WETLANDS OR WELLS SaNi ARk WITHIN 100 FEET OF PROPOSED 10"-42"' 8 LS 10YR 518 10%40" B LS 10YR 516 LEACHING. 13.THIS IS NOT CERTIFIED PLOT PLAN AND UNDER No CIRCUMSTANCES IS THIS PLAN TO BE USED FOR ZONING OR BUILDING PURPOSES. 42'-132' C CS 2.5Y614 PERC--r2 m"111"Ch 40--120" C CMS 2.5Y 614 SITE AND SEWAGE PLAN 14.LOT IS SHOWN AS ASSESSOR'S MAP 58' 7 M141Y that on November 12,2002,l have passed FOR the examination approved by the Department of LOT 1610 Environmental Protection and that the above analysis B & B EXCA VA TZON, INC. 15.LOCUS PROPERTY IS NOT LOCATED has been Performed by me consistent with the RICHARD PLASKUS G.W.EL E V.NIA required training,expertise,and experience described WITHIN AN AQUIFER PROTECTION G.W ELEV.NIA in 3 10 CMR 15.018(2). .19 STAYSAIL CIRCLE DISTRICT(ZONE II).. BOTTOM TH-I ELEV. 43. — BOTTOM TH-2ELEV. 44.0', BARNSTABLE, MA PAGE 20F2 ...................... . . .................................................... ............... ........................... ............. ...................................................................................................................... ...............................................- .......................................................................-........... ................................... ................. .............................................. .............................................................. ................................... ...... ... .........