HomeMy WebLinkAbout0030 STEERE WAY - Health 71 Fairhaven .,-a n`C-
_ Marstons Mills
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a
a Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
A. General Information
� 1. Inspector.
Frank Nunes III U "J
Name of Inspector
saa
Company Name
Box 841
Company Address
East Falmouth MA 02536
City[Town State Zip Code
508.272.6433
Telephone 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
� I
11/14/13
Inspector'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.
d I DA"03
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15
Commonwealth of Massachusetts
a r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills ' MA 02648 11/14/13
Cityrrown 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:
Pumping suggested every 3 yrs to prolong the life of the system
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.
Answer yes, no or not determined (Y, N, ND) in the ❑ 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.
ND Explain:
n/a
❑ 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
❑ obstruction is removed
r 71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 or 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ distribution box is leveled or replaced
ND Explain:
n/a
❑ 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
❑ obstruction is removed
ND Explain:
n/a
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.
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
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.
71 Fairhaven Ln-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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 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:
n/a
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 %day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any 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.
71 Fairhaven Ln•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems(cont.):
Yes No
❑ ® 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 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
regional office of the Department.
71 Fairhaven Ln-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
°M 71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
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?
® ❑ 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)]
71 Fairhaven Ln•03/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 71 Fairhaven Lane
Property Address
Shuck
Owners Name
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
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
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available (last 2 years usage(gpd)):
Sump pump? ❑ Yes ® No
Last date of occupancy: seasonal
Date
Commercial/Industrial Flow Conditions:
Type of Establishment: n/a
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:
Last date of occupancy/use: Date
` Other(describe): n/a
71 Fairhaven Ln-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
General Information
Pumping Records:
Source of information: No pump history given
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How 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)
❑ 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):
Approximate age of all components, date installed (if known)and source of information:
Original septic tank n new d-box and chambers 2005 per BOH record
Were sewage odors detected when arriving at the site? ❑ Yes ® No
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 71 Fairhaven Lane
Property Address
Shuck
Owners Name
Marstons Mills MA 02648 11/14/13
CitylTown State Zip Code Date of Inspection I
D. System Information (cont.)
Building Sewer(locate on site plan):
Depth below grade: 2'feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: >10'feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 18"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
Outlet cover raised to 6" of grade
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
--------------------------------------------------------------------------------------------------------------------------
Dimensions:
1000g
Sludge depth: 2,.
Distance from top of sludge to bottom of outlet tee or baffle >12
Scum thickness trace-1/2"
Distance from top of scum to top of outlet tee or baffle ,21•
Distance from bottom of scum to bottom of outlet tee or baffle >21,
How were dimensions determined? measured
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
s 71 Fairhaven Lane
Property Address
Shuck
Owner's Name i
Marstons Mills MA 02648 11/14/13
Cityrrown State Zip Code Date of Inspection
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.):
Pumping suggested every 3 yrs to prolong the life of the system
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
[] concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
n/a
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
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
n/a
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):
n/a
71 Fairhaven Ln•O 08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
C l
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Tight or Holding Tank(cont.)
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.):
n/a
"Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
Distribution Box(if present must be opened) (locate on site plan):
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.):
D-box 2'6" below grade and in very good condition
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15
f �
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
I
71 Fairhaven M e Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
n/a
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
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.):
SAS was probed and soils are dry and compact, no indication of backup
71 Fairhaven Ln-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 71 Fairhaven Lane
Property Address
Shuck
Owners Name
Marstons Mills MA 02648 11/14/13
City/-Town State Zip Code Date of Inspection
D. System Information (cont.)
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
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.):
n/a
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15
rb
Assessing As-Built Cards Page 1 of 2
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TOWN OF BARNSTABLE
LOCATION ''/ SEWAGE# AM -"I
yaLAGFt ///• RIi IDS ASSESSOR'S MAP&LOT I
INSTALLER'S NAME&PHONE NO. jnr�l: r�r.r�i�� �7 8 Y9J�•
SEPTIC TANK CAPACITY /.cee Cc//
LEACHING FACILrrY:(type) 00 6-1 .[Idritrsr.(•..j Cp) (size) /0X 3r: 2 '
NO.OF BEDROOMS
BUILDER OWNER a
PERMITDATE: -1'r—O: COMPLIANCE DATE:
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 e 60 r i A=!Z n
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http://www.town.bamstable.ma.us/assessing/HMdisplay-asp?mappar=14815 7&seq=1 11/7/2013
Commonwealth of Massachusetts
F W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Fairhaven Lane
Property Address
Shuck
Owner's Name
Marstons Mills MA 02648 11/14/13
Cityrrown 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: >12'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:
per elevation of home
71 Fairhaven Ln•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15
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NO. OF BEDROOMS 3
BUILDER 0 OWNER �a
PERMITDATE: �0-1'>—a3� COMPLIANCE DATE: I �"�
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 i--
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THE COMMONWEALTH OF MASSACHUSETTS Entered in co ater:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZIpprication for �Digoq;al 4pgtem Couotructiou Permit
Application for a Permit to Construct( ) Repair(1� Upgrade( ) Abandon( ) ❑ Complete System [? Individual Components
Location Address or Lot No. `71 601*" r , Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel r
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size O �D sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min,required) gpd Design flow provided 3e� gpd
Plan Date 0 //lO3 Number of sheets Z Revision Date
Title ;1$%%0 l71 /_WA94e� dfl
Size of Septic Tank Type of S.A.S. Q 49,&14e,",$
Description of Soil
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 Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued b this Board of Hea th.
Signe Of
Date
Application Approved by Date
tinzMdZApplication Disapproved by: `` Date
for the following reasons
Permit No. Date Issued
4
No.. Fee 112
Entered in com uter:
THE COMMONWEALTH.OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplicatioh for �Btgoq;ar 6pgtem �COttgtrUction permit
E Application for a Permit to Construct O Repair(V� Upgrade O Abandon( ) . ❑ Complete System ✓ Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
4 771 ye yam`' . 3,t4z sy
t Type of Building:.
4 Dwelling No.of Bedrooms Lot Size 0,00® sq.ft. Garbage Grinder
Other Type of Building )qe,5/ �W4C 4f No.of Persons Showers( ) Cafeteria( )
. Other Fixtures
-Design Flow(min.required) 330- gpd Design flow provi&ed``'�� ,3 3(� - gpd
Plan Date Number of sheets Revision Date
j
Title 5.5/It. h � T 71
Size of Septic Tank / �®9Q� •�iY/S�`iilry Type of S.A.S. 7� �J��� 9,1;�'l C�0�1�aPrs
Description of Soil
• a
• 4
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
Zhe 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 b this Board of Hea th. !
SigneV Date
Application Approved by / / d/t' C✓ Date
Application Disapproved by: Date-
for the following reasons
Permit No. Date Issued
i r
———————————————— —————————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the//On-site
[Sewa e Disposal System Constructed ( ) Repaired Upgraded ( )
Abandoned( )by of
at '7/ / /� h j ✓ •�l/ ,$ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated sot o��O�p�f% �Oi1Sr Designer 00W/'! Cl�!\'e
#bedrooms r� Approved design flow, gpd
The issuance of this permit shalt'not be onstrued as a guarantee that the system w 1 functinri d sig,ed.
Date r'flaa 12 Inspector
O ——————————————————————— -- C/ ———
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
wigpogal 6pgtemc Cottgtruction permit
Permission is hereby granted to Construct y ) Repair ( ✓S. Upgrade ( ) Abandon ( )
System located at
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Constructio mus e co leted within three years of the date of thiie f
Date Approved by /
/ l ,
a
FO :down cape engineering inc FAX NO. :15083629880 Nov. 22 2005 09:46AM P3
Town of Barnstable
e' Regulatory Services
z Thomas F. Geiler,Director
s a"MMASUL
MM& Public Health Division
s63g. �
• Thomas McKean,Director
200 Main Street,Hyannis, MA 02601
office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: �l��✓f Sewage Permit# D✓ '� y� Assessor's-MapTarcel
�0 VJ� C /^2p.►� In
Designer: staller: eD✓'l U!�' '-®►'`a '�
t�
Address: V L/ ' Address:
1141 Alf
On A911-71 J� �� � /�0� was issued a permit to install a
(date) (installer)
r l /
septic system at r7/ 7`�c ✓e' -�• / 1• M'1l✓�based on a design drawn by
(address)
0144 dated
(desig r)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
✓ I certify septic that the stem 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.
\KN OF Mq,ss.
ARNE H c�GN
OJALA
(Im er's Signature) CIVIL W
No. 30792
A-
/A-,A .�/�7 F
NAL E,
(Designers Sign- SS1oature) (Affix Designers Stamp Here)
PLEASE RETURN TO BAR STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANC$ WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTAB4E PUBLIC HEALTH WIS(ON. THANK YOU.
Q:Health/Scptic/Designcr Certification Form 3-26-04.doc
4 4v
,'FROM :down cape engineering inc FAX NO. :15083629880 Nov. 22 2005 09:46AM P4
±N 2�
+5A to
0.5
1.0r 5 58 A7
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rho 71 �a A� \ q.
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6n ,.I 1 8.88
i'
6 An.ra , .•1 \
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EXIST. �kBD.
0 3l -o. 7 u. DWELL,
60.27 Li— 4�'; —'--k57 40
.75 +e0.3 \
GARDEN =- // POP rNDN
DECK 60.=8 \ \
+ae.20lvjrjq
u nB \
WOODSY FE�06 '0
00-3'�7
SEPTIC PTIC AS-B UIL T
LOCAVION 71 F'AIRHAVEN VANE
(MARSTONS MILLS) BARNSTABL. : PREPARED FOR:
SCALE : 1" 30 DATE : NOVEMBER 21, 2005 BORTOLOTTI CONSTR..
REFERENCE ASSESSORS MAP 148 PCL 157 �yttkOFMgS,
ARNE cyle
H
`ni
H.
OJALA
off 508-362-a�"7 0 No.26345
faM 508 ]57.-41180
FOR 6 0
down cape engineering, inc. lq v
/ 1 R .
(� CIVIL ENGINEERS _ _-- -- -- ~' - - --- `--
1� LAND SURV$NORS DATA. REG. [—AND SURVEYOR
elan maln st, yarmunth, ma
AsBuilt Page 1 of 1
r
TOWN OF BARNSTABLE
I.00ATION 7J_, ,,yy���.«- i.�ts1 /i SEWAGE # v'Wr-J-,Y-
'
'VILLAGE /�� A/ ASSESSOR'S MAP& LOT _ �
INSTALLER'S NAME&PHONE NO. i" �rurrr�ia �'S91G
SEPTIC TANK CAPACITY
LEACHING FACII..TTY: (type) gy a L r-ki d-0-i (size) A0 jc 3c. 'X 2
NO.OF BEDROOMS 3
BUILDER O OWNER �G>
PERMTTDATE: ` �D-2 V5 COMPLIANCE DATE: '
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5� Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) r' Feet
Edge of Wetland and Leaching Facility(If any wetlands exist �—
within 300 feet of leaching facility) Feet
Furnished by t�owJ 6pr `% .ems-•-ihg
V llrks� - J
0
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=148157&seq=1 3/27/2012
Ykp ?1,6/ iW 157
(0CA00N „ 71 S E W A G PEERMIT NO.
3,:: t'o �tLJLt/ �V� 6r
f VILLAGE
\INSTA LLER'S NAME i ADDRESS
.�
B UILDE R OR OWN ER
Viz-✓1 k-c r
DATE PERMIT ISSUED _ b��/
DATE COMPLIANCE ISSUED
l
6 cC.t� e.
s �
T
-- - � � .j
1 ,'
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-�i � ;r
�.�jr�,� _ ,•
... s .,
..��
No.._.. 6..�a-t 3 �! FiRm ......................��
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9F HE LT
/....aWe�7............O F...... ...... �r. � ...... . .
Appliratiun for Uhipouttl Workii Tunutrurtiun Vamit
Application is hereby made for a Permit to Construct (4-1"'or Repair ( ) an Individual Sewage Disposal
....:.G�1..... ............. .,1..a� lr.(5 ! .. ram. c l.C�. .s.:��'.... ... ......•..
Location-Addre
�-• --or --•o. I
Owner Address
W (yam I C^ Q
.........................
......._...--'�?.. .........:_`..._. ..--•-•-----•-.............................
Installer Address
Type of Building Size Lot QQ_/.._..Sq. feet
,. Dwelling—No. of Bedrooms......... ..............................Expansion Attic (old) Garbage Grinder (70
`4 Other—Type T e of Building No. of persons............................ Showers —
Gi yP g ---------------•--••----••-- P ( ) Cafeteria ( )
dOther fixtures -------------------------------------------------------•••------- '
Design Flow..............;..,.5..................gallons per person per day. Total daily flow..._.............. ........................gallons.
1:4 Septic Tank—Liquid capacity�QQ.0gallons Length................ Width................ Diameter............_--- Depth................
xDisposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area......._..._.. ..sq. ft.
Z Other Distribution box ( ) Dosing to )
Percolation Test.Results Performed by.......
-.�
Test Pit No. minutes per inch Depth of TesChit.__.. . C.. Depth. ground water..__.. ..�fj}
fs, Test Pit Nol, :minutes per inch Depth of Test Pit ------ ... Depth to ground water..../ /�`--G:_..
�. -----
® . _O Description of Soil...... ..
w
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
--------------------------------•---•-----------------------------------•--•-•------............------------•---------------------......------------------------........._...-----------......••••-•--•-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage,Disposal System.in accordance with
the provisions of iI'i 1� 5 of the State Sanitary Code The undersigned further-agrees not to place the system in
operation until a Certificate of Compliance has be sued by the b of health:
gne
Date
Application Approved By-•-•------•----........r . ... ... ----- ..... ........ `� r (�
Application Disapproved for the follow reasons-----------------------------•------•-------------------•------------------------•-•--• Da. ...
----------------------------------------------•••-•-••-----------••---........---•-••-------
Date
PermitNo...............................•-•••---•--••----•-------- Issued.......................................................
Date
- - - - - -- - ------_---.�...���..��. ---- ----- -
No................--....... Fmc..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOA!RD F HE LT
1
...o .5 ............0F.....: ,!°"7�' ....
ApV iratiun for DiiVuiitt1 Workg Tonstrnrtiun ramit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
Syst�""at ,�°�'r„ 'oc�,�$ ° f ✓'.
....:ro+�J...._' ..�.. .... .........�: ......... . ', _ .'.....---' ......i . ..................fi r C ....... ........
Loato Addre . .-......
----.... ......
Owmr 17 Address
................................................
Installer Address {
7 Type of Building 3 Size Lot:....�4...__.....1.._..Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic W9 Garbage Grinder M10
'A Other—T e of Building ._ No. of persons............................ Showers
YP g ---------------•---•--=-- - P ( ) — Cafeteria•(- )
Other fixture ,
w
Design Flow______________._ .....................gallons per person per day. Total daily flow............................................` gallons.
WSeptic Tank—Liquid capacitypp.0gallons Length................ Width................ Diameter................ Dept h................
x Disposal Trench—No. .................... Width.................... Total Length..... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area........... ...ssq. ft.
z Other Distribution box ( ) ...erf :Dosorming
ate_._ _.:? ::_:.... T
a Percolation Test Results m nute p e inchD.e,/tl�ii'of Tes"t .P� _ ._ r'!� Depth�� ound water..__. __ V
Test Pit No. 1 pL
f� Test Pit No,. /1' _minutes per inch Depth of Test Pit--'' -•-=••----__-- Depth to ground water..''
--------
•---------
-----•------------------------------
D Description of Soil...... "" ` �t .____.
ell
w
-- ---------------------
U Nature of Repairs or Alterations—Answer when applicable.__.............................................................................................
-------------------------------•-----------------•-•--------------------•------------•-----•---.....---------••-------------------------------••---------------•-••-•----------------------..__.........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—'The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be sued by the bb of health. .
Lned..
Date
Application Approved By..........................
Date
Application Disapproved for the follow reasons-------------•.------................-----------------...-----•--------•----------•-•-- • •----.0............
•-•-- ..............•---------•-•••.._........•-•---------...-----•-•-------------•-------•------... .............
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTHOF MASSACHUSETTS
BOARD HEAL ,,�
... Q� �........OF....4��...�� �"" �..5�ZolZj
.................
(fatifirate of Tomplinurr
T.,UU-IS TO CBS FY,, That tile t Individual Sewage Disposal System constructed �or Repaired ( )
......................... ........... ............... ............ .. --f----------------------
has been installed in accordance with the provisions of TIT The State Sanitary Code a described in the
application for Disposal Works Construction Permit No.......
.................. .1. ___. dated----------- _r7 r
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTA THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...........................................•-•-•-----••......._......----.------ - Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD JQF HEA H
No........•-----•--........ FEE... ... ..........
aifivog urkoT onutrirt� n V ermit
Permission is ereby granted ....... ....... .......................................
to Construct_
or Re air an vidual Sevyr Dis S st
//_5
--•---
Street
..ll •.......
as shown on the application for Disposal Works Construction Permit No..__��.__�.._...Dated__....._.
.......................................... . . ...__._.::.. ----•-
< �' 2G o d of ealth
DATE...............2.. ..Z_'_ ` +
FORM 1255 A. M. SULKIN, INC., BOSTON _ - -
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t
-Y x: \ l�0'7 SSS'�Y!�i}'t�' y.. p .+ i u�0 _977
J - J �O _�• �Op 1 rs } 7..,�'ft i %�. ,.., S f :.: I `,L�'$5 91,A)E b 2GT
rRgSEeYE y 4ii SOfL ri.`.:. 'f'.�
"+ eRf.,TfcT/uN ,PZ)Z
wy�^ O /s t t /I�ZT• SFCr.;�
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1� WEINFIERG 1/
LEGEND''. No •366. v 1 .
EX13TINQ SPOT . ELEVATION 0A0
E •r'IN� CONTOUR ---� ® -. CERTIFIED PLOT PLAN
1�
FINIONED SPOT . EI.EVATiON LaT ,�'S Fi4�2H.4VE�t/ D2
FINISHM CANTOUR
NOTE:,:The location of any. existing underground sew,c a&e#
r ,'.well�l� or;oth�r utilities shown-. on -this`,-plan is ,approx;
imate .only as. determined from-records and/or verbal: I3�2 ��S.'T�4
I information. ;The contractor is .xespons3tble for. the
v6ri,fi.c.ation- of the existing locations. inahe ;field. SCALE.:. :/_'
�r C4�LEAIT.-- 1 CERTIFY THAT. THE PROPOSED
!' EGkSTERE `. REe1: Tl�RRQ rear Jt�l�. 14 .. - BUILDING SHOWN ON THIS ' PLAN
v CIVIL . ' x LAND r f}..I;,� CONFOR.LMS. ,TO THE ZONING, :LAWS
R ? QRI bY 1 -�*- p F q�..!5i7st MASS
7I2 .OVIAIN'STREET,< 010.;BY ..�� a3 ----�'"
SHEET4f '2 QATE. REG. 'LAND SURVEYOR`
.,r1cF7, -5R'TN S�PT/G TAiV •C OR
per .�i/tE MORE TNA:�/ /2"BELON/i
COVER•
SXAL.L..B. ®BOUGHT TO.GF{AOE: r;,✓ EXTRA .4..
4"PVC PtPE `'
GONCR�TE. f N E.4✓y C/'1;S T /RO/Y C a�/FR. S/�.4 L L !3E U S Ev
M/N. P/TCiJ .1 IFl/V O V—F1?I AY
COXE
' "PP.Q FT.
--
co VER CL E,4N SAND
BACXF•/LL
IA. ;. �.
a '9 _ 2"LAYER
SC Um Ao
P/PE ` c 1000. • a o a°° G1F �8
bK M/N.:P/TCN Gi4L. - a D/ST o , . . . . • y ,. �•yASHEO 5MME
SEPT/C. TABOX
tVEC d
a o eD •.1 •EFFECT/VE • . .'. 3/4"
�_ a i • • ptPTJ� . �. • • o I�ASHEl� STONE �.
Z.S 377: b Q e. P ' PRECAST SEEPAGE I `
OF a • •. •fo .,.
�IVY.1r'RT �`.L EVA77OA/5
e a
y: / A7' BL!!LD/LAG
F�-
LAVER
//S/GET: `SEPT/C TANK :/0O'. FT FT: O/f1t+!- . LC
CSEE I I ATJON�
8LJ'TLET SEP_T/C zi N.,< FT
GROuNO W,4TER TABLE
fN/"=r D/STR/�Uj/oN,,BOX ' ffff:FT :.SECTS®N. ®F E `
n . hu.. : $
w ON7LETDI STRt 9llT/l1N 90Xe: 6 FT 1r
EACHIN :` ' FT SE1�VV�G�
G ?/T 7A4ffI1L.A?146 ` s.
LEACH11V6 P/ rnlr�E/,is/o/v X T.
r
JVSIaN F . .
'1��StGN Cq 7E°T1 —
a
N 41MO R OF'BEDROO JS t _ D/MENS/ON. T
SOIL' LOG
GAReAGE�/SPOSAL C/N/T ��.' v
TOTAL SST//y9ATEO: FLDv�f 3.�O.G.4L. DSO/G` TEST / SQ/L TESTp�,C •�O/.L.T> .ST
_ -
G�
N41MgER QF d:EACNINe. P/TS .DATE OF SO/L TEST
S/OE LL`ACH/LAG PEtZ PIT. . $4 �T. � _���Q��"(� ft ESt/LTS WITNESSED B�
O '
' 7 ,
60T'TO/y9.LE?4Cil1NG PER.P/T $!,j• Fr: Svt3S�i�
PelV COL AT/ON RATE,i'/ • --'G_ '_M/,4�, f NCH'
TO LEAG'H/LAG.AREA . ESQ FT fRCOLA�/ON/e.�4�'E
RES.E,TVE A.ASACIN /YG AREA
t a:
ZO
�V�tp`
.;4r ;} � ��` R4' • �` �e►�( 7/Z MAIN STD HYANN/9, MA.5S.
*ref �G./40[JND J'NiOTER ENCOU/VTE.E'�O CL
7
E.P i9TSHEET--ZOP` 2 _
i
• y ° ' fJC7YLE E�9G( J SOCIATE 1 NC
a7 MORM AV6'yt FALMOUTH MASSAt USETT'02336 TELEPHONE si7:5eoaai i
"N P.DOYLE,R.LS °
JOHN P.DOYLE III
+ TEPHEN J.DOYLE _.
*PERCH ATION TBSTS RWnTS
F - •.
i Location-on
N J��. Date's. 12�
I , '
TowrWPillaget i�-1��'�I�1� l�ll ,+ Torn" Inspector: G C%�c�
f r
~Applicants C�`�� :Back`Hoe • - �
Doyle Engineering Represenatives l.a
Deep Observation Holes,-Soils Xharacteristice
' ` Observation Hole.No:. Observation Hole N'o s-
� Percolation Rate
min- pez i�Clh�
5
. 00
o.00.
6&UM 40,
•0 ;—_.._� `Dotes
io
:p,
f ` I G.
Bawd on the above data suitable installation of a subsurface sewage disposal system
can or carnet = be designed in accordance with the vdnimnm..standards of Title
5 of the States Envi romaental Code.
Reason for.unsuitable." results.,if, applicable:
IiA OF A
jo
PATSIC3
y
E
SYSTEM PROFILE TEST HOLE LOGS
TOP FNDN. AT EL. 61 .6 NOT To SCALE)
ACCESS COVER TO WITHIN 6" OF FIN. GRADE ( PROVIDE INSPECTION PORT WITHIN
ACCESS COVER (WATERTIGHT) TO / 6" OF FINISH GRADE ENGINEER:
LYONS, RS
MINIMUM .75' OF COVER OVER PRECAST /` WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM RACE LANE
-- 59.0 WITNESS: D. DESMARAIS, RS o
2" DOUBLE WASHED PEAS ONE\ 10/6/05
ELEV. 58.3' RUN PIPE LEVEL /r DATE:
-r-* FOR FIRST 2' 3' MAX. PERC. RATE = < 2 MIN/INCH 3 oP3°
EXISTING 1000rp if m
GALLON SEPTIC 56 g�f* 56.9' CLASS I SOILS p# 11105 3
TANK 10 ) GAS �.. 56.15' I� CD � � O 0r700RE-USE - SEE NOTE BAFFLE 56.32' 56.06'/ IJ
MECHANICAL 0 0 ELEV. Al
Locus
6" CRUSHED STONE OR
0 2' DODO 0 OOCIt� 0 54.06' 1 z 9`�ti
COMPACTION. (15.221 [2]) � ,
DEPTH OF FLOW = 4' ( 2 % SLOPE) ( 1 % SLOPE) 3/4" TO 1 1/2" DOUBLE WASHED STONE opt58.9' OppA A 58.9
TEE SIZES: LS LS
INLET DEPTH = 10"
1OYR 3/6 1OYR 4/4
OUTLET DEPTH = 2" 39$ LOCATION MAP NTS
14"
I
EXIST. 29' D' 1 1 ' LEACHING B B
FOUNDATION SEPTIC TANK BOX FACILITY 6 6' LS LS ASSESSORS MAP 148 PARCEL 157
*THE INSTALLER SHALL VERIFY THE 10YR 5/6 10YR 6/6
LOCATIONS OF ALL UTILITIES AND ALL 16" 57.5' 18" 57.4'
BUILDING SEWER OUTLETS AND ELEVATIONS
PRIOR TO INSTALLING ANY PORTION OF
SEPTIC SYSTEM
C C
THE INSTALLER SHALL CONFIRM MINIMUM SEPTIC 47.4'
TANK SIZE OF 1000 GALLONS, AND DETERMINE PERC
PERC
SUITABILITY FOR RE-USE. REPLACE WITH 1500 GAL. 58.46 PERC MS MS
TANK IF NOT SUITABLE FOR RE-USE & ADD
REQUIRED TEES AND GAS BAFFLE N58.29
+58.�8 2.5Y 6/4 2.5Y 6/4
-58.03 I ,�
138 47.4 120 48.9
NGWE NGWE NOTES:
LOT 5 58.67
i
20,000 SF / 1 . DATUM IS APPROX. NGVD
SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) EXISTING
�k�sg493 _ _ 2 MUNICIPAL WATER IS
\ DESIGN �l ow: _3 _ BEDROOMS ( 110 GPD) - 330 GPD .
60.75 USE A 330 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. ,
R� �59.82 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10
ry BENCHMARK: USE CORNER �60.71 O \
.01 / SEPTIC TANK: 330 GPD ( 2 ) = 660 5. PIPE JOINTS TO BE MADE WATERTIGHT.
. CONC. BULKHEAD ELEV. 60.6' \ \ L
\ 60.19 \}-57.66 �\ RE-USE EXISTING 1000 GAL SEPTIC TANK (SEE NOTE) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
1.40 `4-6"6j%�0.55 \ Z ENVIRONMENTAL CODE TITLE V.
60.75 �60.53 \ 58,88 \ LEACHING: - 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT
2 30 + 9.83 2 .74 - 118 TO BE USED FOR ANY OTHER PURPOSE.� 0.17 � �60.36 4 \\ � SIDES: ( ) ( ) „
FE�'o 60.74 30 x 9.83 (.74) = 218 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC.
60.64 �0. 0 ,�-57.50 � BOTTOM:
9.71 + o.7s i 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
}�58.D0 TOTAL: 454 S F 336 GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
9 17
0.32 Exlsr. \k60 USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH.
59. 2 0. DWELL _ 10. PUMP & REMOVE OR FILL W CLEAN SAND EXISTING LEACH PIT
75 so 27t57 EQUAL) WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' ( / )
+60.3 BETWEEN UNITS NOTE: UNKNOWN LOCATION
GARDEN ,/ TOP FNDN \
6� +60.09 = 61.6' � \
60.58
0 DECK \
5 .95
0 \ LEGEND TITLE 5 SITE PLAN
+60.2 \` \
8.95 \ 100.0 PROPOSED SPOT ELEVATION OF
59.56 \ 7 FAIRS--IAVEN ROAD
\ 100x0 EXISTING SPOT ELEVATION
+59.20 +59.46 +59 7 ' \ IN THE TOWN OF:
9 os$ \ 100 PROPOSED CONTOUR MAR STO N S MILLS BARN STABLE
+58. 957.18
59.09 .8 z 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI CONSTRUCTION/WOOD
TH 59
33' 20 0 20 40 - 60
58.52
p, BOARD OF HEALTH
WOODSY F�NG� ,4 4.50 MA .. OCTOBER 11, 2005
-}- 7.93 APPROVED DATE SCALE: 1 = 20 DATE:
8.9
off 508-362-4541
fox 508 362-9880
5
OF M4S't9
down cape engineering, inc. ARNE MS111
cy�N
OJAIA H.
CIVIL ENGINEERS CIVIL of y
No,307 2 No. 8 N
LAND SURVEYORS ���� �9 �� , sow
05--228 939 main st. yarmouth, ma 02675
H. OJALA, :; P.L.S. DATE