HomeMy WebLinkAbout0060 CROCKER ROAD - Health le
60 CROCKER ROAD w
West Barnstable
A= 109 - 088
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�-` Town of BArnstable. P#
Department of Regl htory seMces
• Pa li ' d
� b c Heal�h Ihvision Date
MAIL 200 Main Saeek H"MA 02W1
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Date Scheduled Tmee�� Fee Pd /
roll SuitarbUity, Assessment for. Sewn e.MDivosal�
vQy tit?� �'�i; •.. ; Witnessed By: - .
LOCATION&GMMXL INFORMATION
LomdonAddrem'. rZZel ; owmesName Spyy�
i95 Sol, b`1.
:40esl s�y�� Add s� �,�. :(14/ eu qb
Assessor's MWP*M& �� Eoghimes IQacae
OD
rlsw�TiS1RtJd.'110N REPAIR —je-- 1t•]ephone# — 7. —
Lmd Use g/ 'lf�td/ scopes M sodkoe stones °?
l'to
Distances fratm Upon trr Ws Bode_ • l"IC We!Ana—.—.ft Making WaterNell / ft
jkaioage War '�� ,tft. Property line �ft Odw R
SSLTCHc(Bunt mme.dhmasioft%f Ice,matt locations of+holes&peic tests,locate ids in pnsdtoity ta'holes)
all
A j),('
Inc Illatdial(geblAgie) Depth t0 -74
Depdt m aronodwa�er Standing water in Aotc' !/ld�2t'_' weeping hom Pit Pkaa
Eatincmed Seasomt high Omondwatw
D TION FOR SEASONAL HIGH WATM TALE
Method Us� ngM � in. �pdt to di aot�
Itlo
dd M OnWe A�omat
Dep&tW gfuusi Of GhL to � �
ft-
hcd=welt#_...� Readies
Ar�rormnd}.v®tcsl.s�e1,,._.
PERCOLATION MT -
obsenatiat )_ I, 79ine.cs"
Hots 1l
Depdc of _? 0 IIittle at(P
start rm-soac'[ttne - Time
RimMin/(nrdr ' �/
site sttlabmfity Alb
Site Pfrsaed_.__i.� Sine Paila Additional Taft Needed(Y"
origmat.Poblic HeW DivWm Observation Hole Data To Be Completed on Back-
'. �
* pe��'"Lest is to be conducted within 100'of wetland,you mash first no the
Barnstable acvation DivMon at leSA one(1)we&prior to begim &g-
DEEP OBSERVATION HOLE LOG Hole#_..�
Depth 6om Soil ftimo Soil TUWre Soil Color Sal ' Otha
stirfaa(ia.) .' (USDA) (Mlms A.. mmbg (Sttw'^amcst Boob
AGniven
54.
X, d
Pf T . �'. 6
�.
/W v
DEEP OBSERVATION HOLE LOG ' Hole#_
Depth from 7 Sal Horizon Soil Texture sail Color Soil Other
` Surface(in.) (USDA) (MMOU) Mowing (Suucwm Sooner.BMW"&
DEEP OBSERVATION HOLE LOG• Hole#
Depth from' Soil Horima Soil Texture Soil Color. Soil • Other
Surface(in.) (USDA) (MuoseU) `" Mottling' (Sim n Staoes.Boulders.
•S
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DEEP OBSERVATION HOLE LOG Hole#
Depth ftnm Sal Horizon Sal Texdire Soil Color Sol Other
f Surface(in.) w.. (USDA) .___.__.. . (M�)_ ,',� fNottung_ (Swctirra Stoaea.Boulders.
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Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No—!!fol" Yea
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Depth of Naturally Oca rrina Pervious Material
Does at least four feot of>aattuslly otxWing pervious)Material exist.in all areas obsma througbout the
area proposed for the soil absorption system?
If ant,what is the depth of naturally occurring Pm6us materiel?
Certification _
I certify that on M, '(date)I have passed the soil evaluator examination approved by the
DeparMM of Enviro mental Protection and that the above analysis was performed by mt consistent with
the required training, and expeaic m described in 310 CMR 15.017.
Signature Date
TOWN OFF B�ARNSTABLE
LOCATION C4 U C RO190R. SEWAGE #
VILLAGE UlJt�S2rcJ•STAI`�Z� ASSESSOR'S MAP & LOT f0 S�fT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY-
LEACHING FACILITY: (type) G°�.�Sav (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
P� gout �d,n�
W,41 i3
10
S
o A/0asG
TOWN OF BARNSTABLE J
LOCATION GQ���Gl� er ��� SEWAGE# �/� u�?/
VILLAGE /?,a,,e r/, ASSESS,OlR'S MAP.&PARCEL
INSTALLER'S NAME&PHONE NO. 91 /c c.0- [4-,d
SEPTIC TANK CAPACITY 1 1� �� /� Sod'- 776^Cyw"®
LEACHING FACILITY:(type) �� ����6�C���(size) $fmtxg,
NO.OF BEDROOMS
OWNER /dh�
PERMIT DATE: S/`��� COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4/4 Feet
Private Water Supply Well and Leaching Facility(If any wells exist ow `..
site or within 200 feet of leaching facility) A I A Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY /? ��
rc
41
3�5
10 1
No.
I � � Fee �
THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: �
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
2pplitation for -MispoBal *pstem Construction Permit
Application for a Permit to Construct( ) Repai�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Addressor Lot No.lQ g� P fl,a ner's Name,Address,and Tel.No. _
,� �' c/ Tehe-,- Arm S J,�
Assessor's Map/Parcel �DU C �- GQ
Installer's Name,Address,and Tel.No. � A6 r 726 Designer's Name,Address,and Tel.No.
t.ei+cA Ca.�sr+.r4,t,-1 y �v , Uhf /�s�ocl 3's�i �, oaf
.S<iv G'�L^���4 O
Type of Building:
Dwelling No.of Bedrooms f ," Lot Size 3(� s
//-��MAq.ft. Garbage Grinder( )
Other Type of Building �;�/S`j ^ %� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ��! gpd Design flow provided ?�f d gpd
Plan Date y 4 113 Number of sheets C;�- Revision Date
Title °�
Size of Septic Tank ey(S i'w7 /(ADO j�pt� Type of S.A.S. ohs 9./i e6 //c` f ,"o
Description of Soil 'y0T /,�� �+ � j^c sl�
Nature of Repairs or Alterations(Answer when applica le) q bc.,C., �, +Sri+�;�, 1-• /7. n S,41
E
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 ealth.
Signed Date q
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. �6 Date Issued
No. d 13 - ,4e1 � �. :� • ' Oq 6 Fee O�
THE COMMONWEALTH OF MASSACHUSETTS Entered in cor(iputer:
A Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
4pfication for deposal *pstrm Construction Permit
t
Application for a Permit to Construct( ) Repaipgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. *�Q �� G� wnneer's Name,Address,and Tel.No.
Assessor'sMap/Parcel 6 ac,�t� �
Q GQ� /�/v� `�p�„� Jr
Installer'ss Name,AddessQand Tel.No. pb g6 y 724 I Designer's Name,Address,and Tel.No.
4!0-
776-cy,(Q s' /G✓ra�-� U�'f f yS�aC S 1 w¢c t� M4 s�3
Type of Building:Dwelling No.of Bedrooms �OC/✓ Lot Size % /V sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) Z/p gpd Design flow provided �7�f gpd
J
Plan Date 0,y 1,q �3 Number of sheets C-1Z Revision Date
- � Title �/
Size of Septic Tank e4t ivy 109a jjv)/4n Type of S.A.S. a.S �y✓C
Description of Soil 14
'%_Nature of Repairs or Alterations(Answer when applica le) A ♦ c-,J6, L•
S Alc .Z //c. Q ,may D-- 96A
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 Ifealth.
Signed Date o
11
Application Approved by , t11 �� r Date
Application Disapproved by Date
for the following reasons
Permit No. G - 1 Date Issued
TIC E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of (Lompliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by g• L• C.
at 6 D Cve ek, - rG A 4 4 S' has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit NJ-'-)� '17� dated /
Installer K,1(c/" t /Jd4—1 Designer
#bedrooms F�V� Approved design flow y �r gpd.
r
The issuance of th'� e . i hall • t be construed as a guarantee that the system w' 'n,tion-ass,,desig/fie
Date Inspector
/(/I/L__ �, F!� ` �/4✓� �-�J
�. p
� e /
-----------------------
No. �' ' 7 Fee o U -
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal *pstem Construction Permit
Permission is hereby granted to Construct ) Repaif(�� Upgrade( Abandon
p)� ( )
System located at L ti�C �!" rr, ( (.✓P 5--� V e✓y1 SA/ 47 J�
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. t
Date S- Cl Approved by U ✓�
a
Town of Barnstable
Regulatory Services
Thomas F.Geiler,.Director
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: . -16 -/,-'3 Sewage Permit# . 0/3 / 7/ Assessor's MaplParcel D 9 W
Designer. 1///XS /aft�i4iti/G1 I/d7f/7Ml?Installer:
Address: Address: M, 6X 7Z,�
On S _ P 13 was issued a permit to install a
(date) (installer)septic system at Ca'd C .V /2-A Gt4/ based on a design drawn by
(address)
,4 Q pdated
(designer)
V 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 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 Re tions. Plan revision or
certified as-built by designer to follow. OF
o AW y�n
VON HONE -4
(Installer's Signature) � , v � td 1068�� � `
� 4MlTARP
signer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
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Commonwealth of Massachusetts
upTitle 5 Official Inspection Form a� I
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. 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.
Important:When filling out A. General Information
,1
forms on the \ ' I
computer,use 1. Inspector:
only the tab key
to move your Michael Kellett
cursor-do not Name of Inspector
use the return
key. Aardvark Environmental Inspection
Company Name
VE] P.O. Box 896
Company Address
(� East Dennis MA 02641
�' City/Town State Zip Code
508-385-7608 S13742
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
LU M sewag?disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
C0 �' Title 5.(310 CMR 15.000).The system:
' o` ® Passes ❑ Conditionally Passes ❑ Fails
cra
� cw [7�Needs Further Evaluation by the Local Approving Authority
C; c 04/15/10
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.
l� /1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. Citv/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.
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 exfinration 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:
❑ 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
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
iB) System Conditionally Passes (cont.):
❑ distribution box is leveled or replaced
iND Explain:
❑ 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:
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.
r
N, Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
GSM
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cunt.):
❑ 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:
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.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. 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.
[1 ® 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 pnterim 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.
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done.You must indicate"yes'or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained'and examined? (If they were not
available note as NIA)
® ❑ 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)]
I
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required forWest Barnstable MA 02668 04/12/10
every page. Cityrrown State Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
Number of current residents: 2
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: current
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:
Last date of occupancy/use: Date
Other(describe):
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Bamstable MA 02668 04/12/10
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
General Information
Pumping Records:
Source of information:
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)
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (f known) and source of information:
07/24/79 per BOH
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's(dame
information is required for west Barnstable MA 02668 04/12/10
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
Depth below grade: 2.0
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.):
Septic Tank(locate on site plan):
Depth below grade: f.4
et
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: Years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
--------------------------------------------------------------------------------------------------------------------------
Dimensions: 1000 gal
Sludge depth: 3"
Distance from top of sludge to bottom of outlet tee or baffle
28"
Scum thickness
2"
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
16"
How were dimensions determined? measured
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. City/Town State Zip Code Date of Inspection
f cont.D. System Information n o at o (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.):
The tank was sound and tight with tees in place and liquid at outlet invert.
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
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:
0 concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
ww
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every page. CBty/Town State Zip Code Date of Inspection
D. System Information (cost.)
Tight or Holding Tank (cant.)
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
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
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.):
No box present
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Bamstable MA 02668 04/12/10
every page. Cityrrown state Zip Code Date of Inspection
D. System Information (cost.)
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
® leaching pits number:
1
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number,dimensions:
❑ overflow cesspool number:
❑ innovative/attemative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of
vegetation, etc.):
The system has a 6'x6' precast pit surrounded by two feet of stone.There was no sign of ponding or
failure in the stones.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for west Bamstable MA 02668 04/12/10
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cunt.)
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.):
i
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
i
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cunt.)
Sketch Of Sewage Disposal System: Provide a sketch 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.
`1 I
�A
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
60 Crocker Road
Property Address
Linda Sennott
Owner Owner's Name
information is required for West Barnstable MA 02668 04/12/10
every 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: 20.0
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 maps show an elevation of over 20.0 feet
LO` TIO/N ,( 9 v D/ SEWAGE PERMIT NO.
VILLAGE
l- 109-b
INSTAA LLER'S NAME & / ADDRE S
/ C'/70,-0/ ze .4�/7l7t
deck
B'U t L D E R OR OWNER
ce/ IA 4-S4 *
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED � � -7 -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH
........ .�...(7 t�11 l�.........OF............ .U. ..---------------••----....---.......----------------
AV�-*(6,Z Apphration for UWposFal 10orkii C om1rurtiun ramit
Application is hereby made for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal
System at:
......o t- 9 Z C 2 0 K e ....... c�_ ....................... ------------------------ •---------.................
.._._....-----•-- •--..........
Location-Addres or Lot No.
.................... j ... ....
Uner �. � � Jn Adr ss
Installer Address /
Type of Building !!__ Size Lot.!7`1'L/ .......Sq. feet
U Dwelling—No. of Bedrooms......r ..........Expansion Attic ( ) Garbage Grinder (/ d)
44 Other-Type of Building ...V!�nd___n__�_ No. of persons---------- Showers (Z) Cafeteria ( )
P. Other fixtures ----------------------------1-U_� 'e..........................................................................................................
d
W Design Flow............... ..................gallons per person per day. Total daily flow____._.,.3
..................................
WSeptic.'Tank—Liquid capacity.P-Q_Qgallons Length................ Width. ............ Diameter---------------- Depth................
Disposal Trench—No. ........L.......... Width,,0 :.G... Total Length....... Total leaching area--------------------sq. ft.
Seepage Pit No....:................ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) /
~' Percolation Test Results Performed by....., f X�: _._1+t-9.tVrR .Y......................... Date..... `7_ ........
aTest Pit No. 1....I..._.._.minutes per inch Depth of Test Pit.................... Depth to ground water.....................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
................. -------- ......................................................................
xDescription of Soil F �......--- --._.�- ..........------------........-..............................................._.................
.j Gz_&. -- -------------------------------------------------------------------------------------------------
wl� f - 7
UNature of Repairs or Alterations—Answer en applicable-----------------------------------------------------------------------------------------------
........................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI'i LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ��sue��byMthoo seal2.
D to
..........11....... ....70�0�5�-------
Application Approved By---= ---- •--:.._... -- - - -- 7................
Date
Application Disapproved for the following reasons-----------------------------•--•---------------------------•-•----------------------•-------....------........--
------•--•------------•-•-•--•----•------•---•------------------••---•----....--------•---.....-------------........---•-------------------------------------------'---------------------------.........
Date
PermitNo......................................................... Issued-.......................................................
Date
_ 4
No.: -...'►...._..... ;f FBB.... ...............
THE COMMONWEALTH'OF MASSACHUSETTS
BOARD F", HEALTH
.......................
App iration for Dhipsa1. larks To4strrartion' erutit
Application is hereby made for a Permit to Construct or Repair' an Individual Sewage Disposal
System at:
ocauon-Addres or Lot No.
f - all ! .. :....... ............................................
caner Address
Installer Address
Type;of ,Building ,AID Size Lot_2iL_8/", .......Sq. feet
Dwelling—No. of Bedrooms.____ rt �' "______________Expansion Attic ( ) Garbage Grinder ovo)
Other—Type T e of Buildiii ' :,_____'No. of ersons____________________________ Showers
� YP g ----------------- - P ('Z„)' — Cafeteria ( )
dOther fixtures --------- --------------------- --------•-----------------------------------------------------------------------•-----------•••---------
� DSestic Tank—Li uid ca -acit _�.�d_. alloo ss Len r h n er day..Total daily flow....... 3_�_______________________gallons.
lm .i g P P P
W
P q P Y � e Width-- ----------- Diameter---------------- Depth................
Disposal Trench—No. _______'__�:__.____ Width...f_______________ Total Length.......:_.......... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Other Distribution.,box Dosing tank
W Percolation Test Result f� Performed by:.._ ''�__AtY�°`i ' !________________________ Date '
,4 =,g Test Pit No.°1____P......minutes per inch Depth`of Test Pit _________________ Depth to , ound water ___.._______.__._____.
Test Pit No. 2_.__ minutes per inch Depth of Test PIt Depth to gr d water..........
' O / ! 1
Descri Description of-Soil_...._-- -. _ r `"... __,_•- ,__. 1
P �
/j/I wJ�y ........................................
. .:. •-
U Nature of Repairs or Alterations—Answer hen.applicable...................................................._.......................................... `I
lF
Agreement!,
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been,* sueA, by th o o eal
igrie � ____ •--• l'- ----
t .
. ._. ._. to __
D
Application Approved BY---- ........_-- ....._...--•- . _� : ......
A lieativn Disa roved or the Date
_.,.-
' PP PP f following reasons______________ __:._:__.
w 'Date
PermitNo......................................................... gF'' Issued.......................................................
Date
411
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH 4
.O.W,r ......... .OF...........: ! ........:'....................................
Trrtifiratr of Climplianr
THA IS TO CERTIF That the Individual Sew ge Disp sal System constructed ( ) or Repaired ( )
by ........ •.•••.. :_�_G. k �.. „�- �r ..............................................................................
H Installer
at......
...... ----------.Ao�_- .`..---- _ L.ki ----------k --------------------- --•........................................
been installed-in accordance with the provisi} ns of T 5 of The State Sanitary Bode as described in the
application for Disposal Works Construction Pe it N _-.: .______� > 'r_______.___. dated_...7`_'��,_/.%----71e__....________
THE ISSUANCE OF THIS CERTPI ATE SHALL NOT.-BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL fUNCTION SATISFACTORY:
DATE..............1_ ._�..1 _-.:#__._........--•=-.. pecto...-------. Insr............................................................ :.---- -•----
THE COMMONWEALTH OF MASSACHUSETTS' 4
BOARD OF HEALTH ti
001Y
.. 0.4�t�1Y�.....,.OF............. ,.30.101 !�.+...
_...N ..... FEE
Disposal Workii .TWnstrurtion."aunt
Permissionis hereby granted ........................................................................................................
to Construct (I4) or Repair-A( ) an Individual Sewage osal System
at No.=............. ;--•-...,4.02r..-0•,.---=--Ck c ctt-_-----� t __
--
S of
can on the application for Disposal Works Construction PI\10 as shown Dated...........
E `
"` ,N oard of
_..... Health ......................_
DATE----7 -�---I"................................
r•.
F&RM,'1255 HOBBS &WARREN, INC,. PUBLISHERShL
C/ 5 P OS,A L S Y5T E'M A A✓A
r`aR
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n/ S A�owILI�� MA
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f iu. fLIZ.
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0A1L T=-L o><! z / Io X 3 = 33p G.P, 0.
SrPiJt 7A1✓K (VOL Qmrq'o�
33o G .P.O . k !• S Z!r 9 9T G•AtS.
0
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C%«c T ivy 0 TP-Vy = G� L SA�,O, MA.
C.� Prly . _ f Tk 10 t G X -L. D ti 3 7 7 G1LL17
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
I M A�C(, C
DATA
SEW AG E .0) S-Po SAV- S11STet" Oe-S;C
/ SrV l7S Pe-ae_ -Tr-- Fat �+
R ;. G-A
W NA wlif-r1 � r1As3 ,
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on oil
I (LAILV )Lr J✓
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T ,1
87. 0 — — 43G.0
i FINS - moo. N?ERti A sso c. - H• L:. LA vTCr&i,P E.
84 o Co,✓s%ok\r. r-,v ck. C. SANP., MA.
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78.0 — A/c HZo doHzo l L 77-0 _
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EL. 1 oa0 -� �o f, .FQ'
c No.25575
1of' of VJAtL --- F/A/ G2 EL 93.5
G Tp X x
,--,u Far` . r►u. : Grp. 9Z.fl
Pvc
t L . SI,o 1)000
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Nor � ,,_ o �e r>✓v.�90 I � i � � k�' (?C_ co,vc_
15 Po SA 1.TA X Y I? W/-L-,
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• - - of� . : - .. �
A
September• 6 .9
ti -
..i j`"a.y. r �' a • .. .. Y -
.� A -
n
Mr. H, Earl Lantery
TM Lantery
'AssQci.at�s
P. Oa'Box 99.
East ,SandwI chi. �• {)253'7
Ike Lot 92, Crocker Road;;yt�Jest Barnstable
4 Dear' 1'r Lantery t.
�
r .
You :are granted a variance to install a leaching pit 125' f®et `
from `a well at' Lot• •92�` Cracker; Rpadt West'"'Barnstable, `'in lion F
of the'required 1504 feet:with _.the ,follow ng condjti6nsll
a
Prior to issuance;,:o£ a: sewage disiposal works
construction permit, we- milat'.receive two. copies
of an,'onwsite' sewage system plsn than meets the: `
4 ` requirements .o£ .Title. 5; of the ,State Environ
`�mental Code : ..-
A (2) Tha well must bey ins talled •and the"water,tested. ' �" h
for td issuance of 'a sewage
permit: .: j
This variance'�expi,res October;`ld, 198Q k
Very' 1 yours
r .Rob rt L, C ds,` chairman Y'
Mandelstam; me Do.
_
Ann. Jane E aug
BwO�ARD OF HEALTH
^' YY OF YA��F.1ST
.y r ^c},t;to .. _�-�, .. + • F _ l• r.
I � .
LANTERY ASSOCIATES
P. O' BOX 99
E. SANDWICH, MA. 02537
H. E. Lantery, Jr. , P. E. (617) 8884029
August 23, 1979
Mr. J. A. Williams, Chaitman
Board of Appeals
Town of Barnstable
Town Hall
Hyannis, Mass.
Re. : Lot #92/CDocker Rd. , Trailview, West Barnstable, Mass.
Dear Mr. Williams;
I am writing on behalf of my client, Mr. Rich Linstedt, for a
variance of the required distance of 150 feet from the well to`,
the disposal pit. In the design of the disposal system for Lot #92,
I was forced to locate the disposal pit as shown on the attached
plan because of a slope on the back, righthand corner of the lot.
The distance to the slope from the pit is in accordance with Title 5
and, therefore the need to locate the well and pit closer than your
min. distance, The location of the well was dictated by the location
of the disposal system on the lot next door, which is already in place.
I therefore, respectfully request that you grant a variance to Mr.
Linstedt on the distance of approximately 125 feet. It is my opinion
that the health and wellbeing of the area will not be lessened by this
action. And the hardship of my client will be removed.
If I can be of further assistance to you in this matter, please feel
free to contact me at your convenience. Thanking you for your
consideration in this matter, I remain. . . . . . " .
N OF 414s�9
Since
ARL
No.2 5 4
H. Ear
ONAL
a
ENGINEERING CONSULTANT
O/ ,5P oSAL S ,,15TE-m Ikx/A
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✓�. __ L . Q. f3AtSoAJ
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No.25975 i;
CRoc
If 51(Tn1
S/A/G05 0 W c L l../N(r \-I 13np ms � n)o G-A(LSAbt JO )SPD3A L
SrPTIC. 7AN1C VoL , 11V-9'10�
33o G .P. O . k I s 9 OT GALS.
o /1 o 0 o Cr H l. . TA ry f: o
O , sad sad` PIT Des IGry S •a
y
-� LiSLs (II of A . X �0 LA,- 62-1 A53ot.
I. SAXiOl MA-
D ti 37 -7 G�Zc17�
1-0 1 A --
oIf H' (*29&41 Wayside Lane Wells located NOTE: No known wells within 100'of proposed leach GENERAL NOTES:
greater than 150'from Leach Facility.) p p
facility. Well locations derived from field survey.
W.Meeting�e Oed Str Minimum 100'setback required per Town of 1. VERTICAL DATUM: Assumed
Rd �sd \� �� e�,t�o�a Barnstable policy with no increase in design flow and 2. MUNICIPAL WATER IS NOT AVAILABLE.
ay Syr o` repair ofjexisting septic only. 3. SCHEDULE 40 PVC PIPE TO BE USED THROUGHOUT SYSTEM
3 �e� Undeveloped Parcel
v Capes `o Failed Leach Pit to be � UNLESS OTHERWISE NOTED.
Map 110 Parcel 25-014
Tra/� oo Abandoned per Title 5 4. ALL PRECAST& PLASTIC UNITS TO CONFORM TO
Specification
o`o Route.6 °oo 8823 + AASHTO: H-10 &20
a, Service R ad NOTE: Prior to installation of Reserve Area,
m ap\e �ry'� -90 x 90.40 contractor to consult with Design Sanitarian. 5• PIPE PITCH-1/4" PER FOOT UNLESS OTHERWISE NOTED.
i? �o.o��90- 'g2 Removal of unsuitable soils may be required 6. ALL CONSTRUCTION DETAILS TO BE IN CONFORMANCE WITH MA
LOCUS - --yA due to existing grade changes. ENVIR. CODE (TITLE 5)AND LOCAL REGULATIONS.
9Z - gG .( %9 0 7. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR TO
x 9 ,os I 20 S6, CONSTRUCTION.
LOCUS MAP N.T.S. �� �94.43 /
x 92,94 4 x 94._48-� / 98 °9 �o LEGEND:
ASSESSOR'S MAP: 109 9 _ _ 9 - 1 F
PARCEL: gg 94.as x -98 _ _ _ 9s is (99 x 99,1 PROPOSED CONTOUR
REFERENCE: PL. BK. 301 PG. 99 96- - �l 001"0 �/ 2'-OAK--Re_use_Existing � �foo
95.89 e? / 1000 gal.Tank- ter. ' \ Map 110 Parcel 16 gg PROPOSED SPOT GRADE
FLOOD ZONE: C Town of Barnstable %' rx 101,40 - - - 1o4,�i �x�\� rq@.75 \ 10 80 Crocker Road '- 40 EXISTING CONTOUR
1 x � e 01 \-a'V102.90 4 \
#2500010011 C /8 19 4� g- � Edg / p \ - 30.23-- EXISTING SPOT GRADE
\ / / 9 - 100,15 7' Q2;6 i- 1Q4.22 \
101.9 TEST PIT
104,05 \ \
Undeveloped Parcel '1 0 l0 1 ® EXISTING WATER SERVICE
o �' - �SS "�q� �/e`' 106 Garage 1 4.z3 \ \ 97,73
Map 110 Parcel 25-014 ,R° , - �� 104 V/ 04, wE L/ABUT
106.53 TH-1 / 3 / 1 6 4 �� WELL SETBACK 100'
2' s 103.87 1 \
a uP.
Z38.91
91.
108. \% 105.50 106. 6 7°z c to oj �98.00 �`� flF Nx
Cr) x 109.79 4' - #60 Paved 1o2.7s -� �Q �y
=De T Dive TERRY G�00 106.� TOF=109 31..'lo7.sa ( o
°J° Benchmark set: 'moo- ?ios.76 (Assumed) 101,0o I �� I]F M,q g ANN
a on Sonotube Paint ff o WARNER
/ 110.17
EL.=105.61(Assumed) 102 s6 6. o AMY L. No, 38721
16-7-,69 Base Floor ; / t g VON HONEC/ � p
EI.=106.07• / LJI
x 109.30 / No. 1068
100.02
NOTE: Install 40 ml Polyvinyl Liner along ITA �A
northwesterly edge of Leach Field for H vily Vegetated Hillside \ / , < 100.71 "-9 100,00
\
breakout(min. 2'off units). Top EL. 102.3, 100'1 MAG/SET` / Q
°
Bottom EL. 99.3. At
O o
\ ho° Q`O NOTE: This plan is to be used for septic oo
ti� 19 II \ ti oti .o� system purposes only and is not to be
0
C° 3.Q considered a property line survey.
NOTE: Equipment access for septic 103.21
installation is severely restricted due to Lot b2
existing contours onsite. All disturbed \ 36,14 t S.F. wEL�acus3 :l �i`o4 � 60 CROCKER ROAD, W. BARNSTABLE, MA
areas to be re-established to pre-existing 0.831 AC. �Q �OV H
conditions upon consultation with owners. Ma 1b9 0
p t fV PREPARED FOR:
Parcel88 \ T �a associates I Robert & Anne Sennott, Jr.
� 105,94 SEPTIC SYSTEM DESIGNS
320 Cotuit Road 14-B Southpoint Drive
0 1 1 Sandwich,MA.0041 Sandwich, MA 02563
f (o)508.833.0041
_.� (c)508,274.0074
I
I 108.78 i NOTE:Contractor to Surveying by:
Map 109 Parcel 87
REBAR/FND provide minimum 48 hours Terry A. Warner. P.L.S.
I
42 Crocker Road notice for final inspections. H Long
h
108,52 Harwic
h, MA 02645 DATE REVISED SCALE SHEET NO.
✓110 25 (508) 432-8309 04/19/13 1" = 30' 1 of 2
WELL/ABUT
1.
Provide Riser over D-box ' NOTE:All components to be marked with NOTE:To prevent breakout, install 40 ml polyvinyl liner
T.O.F.(Split Level with Walkout) along northwesterly edge of units(min.2'off units). Top
EL. 109.31 (C within 6 of final grade magnetic tape or similar prior to final cover. EL. 102.3, Bottom EL.99.3. Final grade over leach facility
(Cover to be watertight) to be no greater than 3'maximum.
F.G. EL:
: 0 .4-107.7t F.G. EL: 106.75t F.G. EL: 106.Ot Maintain Min.2/o slope over leach facility to prevent pondin g
° p ty g F.G. EL: 103.0-105.25t
Install risers w/covers over inlet and Clean Fill per Title 5 Specifications Inspection Ports within 3"to grade
Slab Floor outlet to within 6"of final grade
EL. 106.07 :: L=11' (Access Covers min.20"diam.per Code) �` I Top EL. 102.3
4"SCH 40 PVC _ . . ... .
L-8 L=10' Naturally Occurring Suitable Sand o^Peru It Re eat Len
Top of Unit/Breakout EL 102.26
6" " 4"SCH 40 PVC c
/ @S=(2%MIN) s .4 SCH 40 PVC
Existing Main Line 1 ' @S=14%(1%MIN) s° @S=10%(0.5%MIN) 0.89' Eff. Depth E
Below Slab Floor - r
EL. 104.4t Install Gas Baffle EL. 104.15 EL. 103.0 -- EL. 102.83 :i : :
EL. 101.82 ) Bot. EL.99.3
PROPOSED DB-5 with Baffle Use 25(3 Rows of 6 units, 1 Row of 7 units
H-10 DISTRIBUTION BOX Biodiffuser Arc 36HC H-20 with End Caps 7 88'
Install PVC Inlet&Outlet Tees Watertest for levelness if SEPTIC SYSTEM PROFILE without Stone a Field Configuration
( ) (30.5'x 2.87'x 0.89'for 3 Rows)
EXISTING 1000 GALLON more than one outlet
H-10 SEPTIC TANK (35.5'x 2.87'x 0.89'for 1 Row) EL.93.05
N.T.S. Top of C2 in TH-1
PRECAST CONCRETE ADDITIONAL NOTES
(Per Septic Inspection Report dated 03/23/2013) DESIGN CRITERIA �
SOIL LOG 1. Contractor to confim soil suitability prior to installation. Contact BOH and Design
Sanitarian in the event of varying soils from original soil test. Number of Bedrooms: Existing 4 Bedrooms
SOIL EVALUATOR: AMY VON HONE, R.S. S.E.#2517 2. Failed leach pit to be abandoned per Title 5 specifications.
INSPECTOR: DON DESMARAIS,R.S. , BOH Soil Type: Class I
DATE: APRIL 19,2013 10:00 AM Design Percolation Rate: <2 min/Inch in C1 Horizon
PERCOLATION RATE: <2 MIN/INCH IN C1 3. Water line to be sleeved at any sewerline crossings and within 10' of any septic
PERMIT#: 13928 components, as needed, per Water Department requirements. Daily Flow: 110 G.P.D./ Bedroom x 4=440 G.P.D.
TH - 1 TH - 2
4. Distribution box to be placed on 6" crushed stone or compacted, level base. Design Flow: 440 G.P.D. (Min. Required)
EL.103.88 EL. 105.82 Garbage Grinder: Not Allowed
A
Sandy Loam Fill Leaching Area Required: (440)/0.74 = 594.59 S.F.
5„ 10YR3/2 103.46 28" 103.49 FLOOR PLAN'
Septic Tank Required: 440 G.P.D.x 200%= 880 G.P.D
LoamBsand Sandy Loam N.T.S. Minimum 1000 Gallon (Existing)
10YR4/2
14" 10YR 5/6 102.71 36" 102.82 Use 25 Biodiffuser Arc 36HC Units (H-20) in a Field Configuration:
B Slide 1 Row of 7 Units Each with End Caps,Stoneless
Perc Loamy Sand 3 Rows Of 6 Units,
@ C1 Bath a� Unfinished
54"Bo . 48" 10YR5/6 101.82 �� Storage Garage Effective Leaching Area:
Coarse Sand C1
2.5Y6/4 Coarse sand 4.8 SF/LF x 5.0'/Unit = 24.0 SF/Unit (Per DEP General Approval Letter)
2.5Y6/4 Family Room 445.94 SF/24.0 SF/Unit= 24.7 Units. Use 25 x 24.0 SF/Unit= 600.0 SF
130" 93.05 Bedroom 4 Design Flow Provided: 600.0 SF(0.74) = 444.0 GPD
...............
t?'''fri.............................................
ilt Loam....:......... Lower r
2.5Y5/4;?:•,••;: ::>?;, Level 60 CROCKER ROAD, W. BARNSTABLE, MA
*Unsuitable .;' .;.?: 132" 94.82V H
133" ';r;;::::::::::::::•:.:::::::::::•:::::::::::•::::::.92.8
C3 C2 PREPARED FOR:
Medium Sand Medium-Fine Sand aSSOCIatBS Robert & Anne Sen nott, J r.
135" 2.5Y6/4 92.63 150" 2.5Y7/4 93.32 Dining Bath Bath SEPTIC SYSTEM DESIGNS
Kitchen 14-B Southpoint Drive
No Groundwater Observed No Groundwater Observed Room � iBedroom 320 cocuit Road
PERC RATE:<2 MIN/IN.(Cl Horizon) 1 Sandwich,MA Sandwich, MA 02563
(o)508.833.0041
24 Gallons in 9:22 minutes (c)508.274.0074
I,Amy L.von Hone, R.S., herebycertify that I am current) a Living Room Bedroom IBedroom fy y pproved by the DEP pursuant toSurveying by:
310 CMR 15.017 to conduct soil evaluations and that the above analysis has been 3 } 2 Terry A. Warner.P.L.S.
performed by me consistent with the requirements of 310 CMR 15.017. 1 further certify that Harwich,Long
Road
o284s DATE REVISED SCALE SHEET NO.
I have successful) passed the Soil Evaluator's Exam on November,1994. Upper Level
y (508) 432-8309 04/19/13 1,�� = 30' 2 of 2
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