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0056 JENKINS LANE - Health
56 Jenkins Lane W. Barnstable P 128 004008 _ TOWN OF BARNSTABLE LOCATION 5G_et V_JKS LAA 1JE SEWAGE# VILLAGE WK%, gAgkI I� SOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 47- ESCAV{Irr t OM V'cg'SZq'SsoI SEPTIC TANK CAPACITY LEACHING FACILITY. (type) 2, ��Clr3- InA(L (size) .S$a NO.OF BEDROOMS OWNER AL�x At J b W Ar V CES O PERMIT DATE: COMPLIANCE DATE: T Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility Feet FURNISHED B A l - 41'5 ER 3 �1 3 TOWN OF BARNSTABLE `` LOCATION , �'e '�''5 �'► h`e SEWAGE # VI?;LAGE w'eSt 43"2 rk) S ASSESSOR'S MAP & LOT ba INSTALLER'S NAME&PHONE NO. l �I Sh-P CCL I" SEPTIC TANK CAPACITY I= I I' �0-5 C—C- ,LEACHING FACIL=: (type) (size) 140.OF BEDROOMS BUELDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by se Ow 105 \ y, NA001, L as 9L 6 37' w • u4�gq to f No. / Fee r 5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippItratton for Mfgponl *paem Cow5tructton Verna Application for a Permit to Construct( ) Repair( ) Upgrade fi Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. LAO& Owner's Name,Address,and Tel.No. AL&Mwo0A-` j (OF_S' — J&Jg1 J&T- A-6tgt_ AAA OZ&W S-ro YEmW BLS LAiJF_ Assessor's Map/Parcel 1,Z$ 00%+ OOS 5Q' 6 -(o� g5N( � b Installer's ame,Address,and Tel.No. Designer's Name,Address and T I.No. GI+Q-t_S Cos;PA_Z4. -44 GM4.t S Type of Building: **�� n Dwelling No.of Bedrooms J Lot Size 49 10S4 sq.ft. Garbage Grinder ( ) Other Type of Building 1 —o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.require 0 gpd Design flow provided y� gpd Plan Date (rl Number of sheets Revision Date Title Size of Septic Tank �. ,�� Type of S.A.S. /�nO Description of Soil 2 �(' ��� �,i`.. fi l)/S fTcJ E_ 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 by this Board of Health. r115K, Signe Date _,0_/102 A0-7 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. �� �`� ^ Oc Date Issued No. .... ^ / L Feezo �c J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE, MASSACHUSETTSs 2pplication for ;Bcgpoal 6p!gtem Cowaruction Permit t Application for a Permit to Construct Repair Un, rade Abandon pp pg( ) p ( ) ) ( ) ❑ Complete System ❑Individual Components A " ae Location Address or Lot No 5G 7C.13V4� LAY,) � Owner's Name,Address,and Tel.No.AwTAWfl) A- 6 . �D tOF—Sr GAQ JSYA&(so, ► AA- (OZ6630 S76 -TEOVj A-N& - Assessor'sMap/Parcel 17-6 004 006 _� � IM 50g-G8S+ 511/� � 'Tl� Installer's Name,Address,and Tel.No. Designee's Name,Address and Tel.No. er 1 3 h+ _S CcST,4), Tbc . fit- .S Type of Building: �� v� - Dwelling No.of Bedrooms / Lot Size q9 .64 sq. ft. Garbage Grinder ( ) Other Type of No.of Persons r -Showers( ) Cafeteria j ) Other Fixtures " Design Flow(min.required) IL1 Q gpd Design flow provided y gpd Plan Date t l ��(� t7(� Number of sheets Revision Date Title Size of Septic Tank l Type of S.A.S. 3t x Description of Soil 2-43 y �� 211,. Ir <(,► � � Nature of Repairs or Alterations(Answer when applicable) oVl�.sC� To ouI0E ��1�� 4 tVL 401- fTcc�,� T 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 Health. rie~� g��<' Si ne Date 0 (,a c,J 7 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ocu Date Issued ———————————— —=— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of (Compliance Iy THIS IS TO CERTIFY,that the On-si a Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned//( b^ at X k, }erg has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 7 S) ' I dated //b- l Installer ;—P—u f Designer C A,,R aw, #bedrooms Approved desi -1 ow 3 d gpd The issuance of this permit shall no,peecoi1strued as a guarantee that the syste will functt n esi ned. Date / 17 Inspector No. Fee J, . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Migpogal 6p!5tem Construction J)ermit Permission is hereby gra t//ed tonstruct ( ) Repair ( ) Upgrade Abandon Abandon ( ) System located atf: and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construc/tionr�11!must be completed within three years of the datefof this p rrr Date /%` rit Approved by.... COMPLETECOMPLETE ' '7ELIVE7�� ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑'gent ■ Print your name and address on the reverse X • � Addressee so that we can return the card to you. B eceived by(Pn ted�Name) C. D_at of Delivery ■ Attach this card to the back of the mailpiece, f or on the front if space permits t e t� , D 5 L9 1) D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Mr.'Ai Belo D1Censo 56 fenkins Lane West Barnstable, lVLA 02672 3. Service Type ❑Certified Mail ❑Express Mail M ❑Registered ❑Return Receipt for Merchandise - ❑Insured Mail ❑C.O.D. 31w, 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number Ty` (rmsfer 6om service label) 7 0 0 5 116 0 0 0 0 `0190 8901 PS Form 3811,February 2004 Domestic Return Receipt., .'y` ' 102595-02-M-1540 • t.:`'M4:2twe;$�.'. 'ar,�.�y'�s;<'t.r.:Aif�s'�•:::x::}'s:«a. .�.. .a - «.;.�•" "'��,pw-twnaa.q ' ""�i --,r. UNITED STATES POSTAL SERVICE x ,cv ,.. �`::v.'.�..i.�•. ..w�.:�'�rj: �:'4F.1.: ::,�. s..,. _h�•Y;.S. ..�OS��g �$e$i„�` •Sender. Please print your name, address, and ZIP+4 in this°box • I I I I i PUBLIC HEALTH DEPARTMENT j TOWN OF BARNS'TABLE 200 MAIN STREET HYANNIS, MA 02601 II I S��3aiis�t�l�ylti��titirttE�t�ie��l��tilslttS�t�i�t�Cf�tttslf�l{ E3 a Y co TO .: FFICIAL USE Y Postage $ • 3 9 E3 certified Fee / ffs FiYq�/�i iC3 Retum Receipt Fee s S (Endorsement Required) Q 9�diere ` Restricted Delivery Fee f —0 (Endorsement Required) p Total Postage&Fees C3 Sent To tr 4n�c�o �e�so , _ Street,Apt No.; or PO BoxNo '6C/1k/n5 � Clry,State,ZI Certified Mail Provides:o A mailing receipt asjanay)ZOOZ aunf'OoBE wood Sd o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important(reminders: n Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. e NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ® For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is,not available on mail addressed to APOs and FPOs. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that tie On-sit Sawage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )b `/'Q/ / at 5� , ,,),-7A &..1 C)J has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 10 ^� 1 dated Installer "7jW �� S/C i Designer_ �C-�r� i �.�►�" #bedrooms U Approved des' ow d _ gP The issuance of this permit shall not l co n Arued as a guarantee that the system ill funct� si ed. Date Inspector YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years)._A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1' FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) °,~ DATE: t�lnl In-7 . � Fill in please: APPLICANT'S YOUR NAME: Af GaL� O . ��. . BUSINESS YOUR HOME ADDRESS:rh6-S!iAU�a ivS t A1,3S, So$-4 Z-e—doo"7Co ��" A> MA O 2ford' TELEPHONE # Home Telephone Number g293 --c)0-2G NAIyIE:OF NEW BUSINESS Apc i3�3tt "� STYPE OF BUSINESS .r=� stf Ctit c ' IS THIS A HOME OCCUPAT,ION� 5c3 i Have.you been given,approu I from the`tbuilding division? NO ��lF ADDRESS OF BUSINESS'_ � .. tA fe IHs e MAP/PARCEL;NUM IER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMI NER'S OFFICE _ This individual h:s Mepn i f ed any permit require at pertain to this type of business.MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO Authorized ature** COMPLY MAY RESULT IN FINES. COMMENTS: .. 2. DOARD OF HEALTH This individual h en infor e of t e p r it-requi ents that pertain to this type of business. Authorized Si a ure* COMMENTS: MOUTOWMATERKS �LYWIiN/ll l 3. CONSUMER AFFAIRS (LICENSING AUTHOR52 This individual h en infor ed of the ' ' re irements that pertain to this type of business. Authorized Signature* COMMENTS: Town of Barnstable �pF THE Tp� yP ti� Regulatory Services * BARNs1ABLE, Thomas F. Geiler, Director MASS. A tb,9. Public Health Division plFD MA'S a Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 April 30, 2007 Mr. Angelo DiCenso 56 Jenkins Lane West Barnstable, MA 02672 The Health Department received your letter on April 20th 2007; again we are not able to accommodate you in your request for the following reasons: According to the Town Ordinance (refer to Town Ordinance 232-5) you are in an area of contribution which contains both private and public supply wells. The ordinance prohibits discharges of more than 330 gallons (equivalent to 3 bedrooms) per acre per day(e.g. a minimum of 1.34 or 1.33 acres of land are needed for 4 bedrooms). BARNSTABLE HEALTH DEPARTMENT <02mas A. McKe , R.S., C.H.O. Agent of the Board of Health I 04/11/2007 To: Tomas McKean Re: 56 Jenkins Lane 4 bedroom My name is Angelo DiCenso.Me and my two daughters live on 56 Jenkins Lane, parcel # 128004008. The lot size is 1.13 acres. As time goes by it seems that my father needs more and more attention and the best solution is for him to live with us. As it is, our home only has 3 bedrooms witch one of them is very small, and it will be impossible to accommodate my dad. After discussing the matter of adding a bedroom with the health department I was told that if I had 1.34 or 1.33 acres then the town will not have any problems. I talked to the abutters and my neighbor that is willing to sell me land only has 1.1 Acres, To keep her status she has to have 1.00 acres leaving only the .10 to sell that brings my total to 1.23 still .10 acres short. I am pleading with the town board members to grant me the possibility to add another bedroom so that I can take care of my family's needs. Uj Yours truly; Angelo DiCenso ..........:.:. . ...::... . . .. . ............. . From:Angelo DiGenso Fax:508-428-0086 To:Christopher Costa Fax +1 MB)WONO Page 2 of 2 12ik616 io-m Ur toarus table W F" (wRvj, J7 Public Health WAS)[" 110mas McKfaq jM"qqp,- 200 (MM :`0586146)4 fo Ar'I a t.e: k4" Sewage jornM4 `VLfp/Ta reel........... Designer: aflec WDI)� Address V, ........... ....................-.............. Address: .. ......... .................. ............... beed on a deip &awn by (adc(Yess) Y `�,JMced above War WHAMS! subsWndaRy monhug jo may hwhWt mlor hpp'n---1 4 011. Sic i"pclut (if cerdly Val, this septic sysim, Ahnnau'di. of acccMaicc, mWed Mai ft !,.o GAW. Suipou'! C. "oi1s .......... OF Mq qcy ........ z CHRISTOPHER DIA11"SIDN'. 4 as.%5�.V, '31. P!31-AS E MW I NNflry I Nit 7 p f,2N S 111 k--B J, 7%7 su i Y V COMMONWEALTH OF MASSACHUSETTS .y EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ,A/�p .. 1 2$ . "ARCEL. . QOq'OO TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 56 Jenkin Lane,West Barnstable,MA Owner's Name:Jill Bouton and Dan R. Kaufman Owner's Address:56 Jenkin Lane,West Barnstable,MA Date of Inspection: 8/30/2M RECEIVED Name of Inspector: REID C.ELLIS Company Name: ELLIS BROTHERS CONST.CO. Mailing Address: 23 ENTERPRISE ROAD, S E P 2 4 2004 P.O.BOX 59,YARMOUTH PORT,MA 02675 Telephone Number: 508-362-6237 TOWN OF BARNSTABLE HEALTH DEFT. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 n 15-W of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: LY=J L Date:01 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. Notes and Comments { ****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. I Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 56 Jenkin Lane,West Barnstable,MA Owner:All Bouton and Dan IL Kaufman Date of Inspection:8/M2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I QA A1 have not found any information which indicates that any of the failure criteria described in 310 CMR 1 .303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: IA- One or more system components as described in th "Conditional Pass"section need to be replaced or repaired The system,upon completion of the replacement r repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the fo r the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or d a septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or k failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as al proved by the Board of Health. *A metal septic tank will pass inspection if it is structuraII3 sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is availabic. ND explain: Observation of sewage backup or break out or high tic water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven disi ribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are rep aced obstruction is remove( distribution box is levi led or replaced ND explain: The system. required pumping more than 4 times a ear due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are repl obstruction is removed ND explain: 2 Page 3 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:56 Jenkin Lane,West Barnstable,MA Owner:Till Bouton and Dan R.Kaufman Date of Inspection:WMn.004 C. Further Evaluation is Required by the Board of H Ith: Conditions exist which require further evaluation b r the Board of Health in order to determine if the system is failing to protect public health,safety or the environmen. 1. System will pass unless Board of Health determi 2es 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 surfs water _ Cesspool or privy is within 50 feet of a border ng vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and rublic Water Supplier,if any)determines that the system is functioning in a manner that protects the 1 ublic health,safety and environment: _ The system has a septic tank and soil absorpti4 n 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 I of a public water supply. t _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to detem ine distance "This system passes if the well water analysis,pei formed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates I iat the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrol en 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:56 Jenkin Lane,West Barnstabel,MA Owner:Till Boston and Dan R.Boston Date of Inspection:8/30/2004 D. System Failure Criteria applicable to all systems: You most indicate"yes"or"no"to each of the following for all inspections: Yes N� _ Ny�,,,lll 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 r 1 spool rquid depth in cesspool is less than 6"below invert or available volume is less dean%z day flow uired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number times pumped _ y portion of the SAS,cesspool or privy is below high ground water elevation. y portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface iyterply. sup portion of a cesspool or privy is within a Zone 1 of a public well. 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.) (Yes/No)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: -41114 To be considered a large system the system mm t serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or`5ro"to each of I ie following: (The following criteria apply to large systems in dition to the criteria above) yes no the system is within 400 feet of a surfact drinking water supply the system is within 200 feet of a tributa y to a surface drinking water supply the system is located in a nitrogen sensit ve area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Sec ion E the system is considered a significant threat,or answered "yes"in Section D above the large system has failo d.The owner or operator of any large system considered a significant threat under Section E or failed under 4ection D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appr priate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:56 Jenkin Lane,West Barnstable,MA Owner:Till Boston and Dan R Kaufman Date of Inspection:$/30/2M Check if the following have been done.You mast indicate"yes"or"no"as to each of the following: Y No Pumping information was provided by the owner,occupant,or Board of Health 7Were 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,ooKcluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition _07of th Mes 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: /Yz no Existing information.For example,a plan at the Board of Health. V _ m in Detenmed the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] S Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:56 Jenkin Lane,West Barnstabel,MA Owner:Jill bouton and Dan R.Kaufman Date of Inspection:8/30/2004 FLOW CONDITIONS RESIDENTIAL Numb of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents:_1 Does residence have a garbage grinder(yes or no):A!!�p Is laundry on a separate sewage system(ye or no),, )if yes separate inspection required] Laundry system inspected(yes or no):tj/- Seasonal use:(yes or no): 4#17 Water meter readings,if available(last 2 years usage(gpd)):<D tL1 V 41:j-, WcIA- Sump pump(yes or no): ND Last date of occupancy:_(�st�Lta- COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): d Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system— or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): j¢ GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):jai _- / If yes,volume pumped: QP� llons--How was q ti pun determined? 1� 0A /Ul(_ Reason for pumping: ��►„� •� C �l�/, YIE 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): Appr imate a of all com;when to' lied(if known) d sourcerof" ormation� fo Were se od77 ors detecte arriving at the site(yes or 6 Page 7 of 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:56 Jenkin Lane, West Barnstable,MA Owner:Jilt Boaton and Dan R.Kaufman Date of Inspection:S 30l2004 BUILDING SEWER(locate on site plan) Depth below grade:-;3;r-/ Materials of construction: cast iron 40 PVC`other(explain): Distance from private water supply well or suction Iine: F Commepts(on condition ofU'pi�nts,venting,evidence of leakage,etc.): Ve-At CA- SEPTIC TANK: (locate on site plan) 0i� ` av Depth below grade: Material of construction: concrete metal fiberglass , polyethylene other(explain) — #)/kiifiank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 9k -;6 y Y Sludge depth: 6 W N Distance from top of sludge to bottom of outlet tee or bathe: Scum thickness: ;;L- � Distance from top of scum to top of outlet tee or baffle: !y Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: I44" V--- Comments(on pumping recommenddtions,mlet and oust tee or baffle ndition,structural integrity,liquid levels as related to outlet invert, vidence of ka e,etc.): < 8n a GREASE �f TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete metal Tfiberg _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 me: Date of last pumping: Comments(on pumping recommendations,inlet and outlei tee or baffle condition,structural integrity,liquid levels as related to outlet,invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 56 Jenkin Lane,West Barnstable,MA Owner:Jill Bouton and Dan R.Kaufman Date of Inspection:8/30/2004 ,f/1A TIGHT or HOLDING TANK: (tank must be pum at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fl glass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no : Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: AP 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.): )PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition o pumps and appurtenances,etc.): i 8 Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 56 Jenldn Lane,West Barnstable,Ma Owner: Jill Boston and Dan r.Kaufman Date of Inspection:8/30/,2004 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: -�Aleaching pits,number: j coo �A` / /''�- &�' ''��" �-c.�►s�" leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Typetname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): �c..s �vo Ca a� ClQ-,o�✓ A4- 007%0' IDO" T*,w AV';-e- Avf- w//n 7-#t ,14~00 fA A d' � All CESSPOOLS: (cesspool must be pumped as f in ecti lo�e on site plan) `r/ ( P� P P � sP x p ) �iMBc Number and configuration: nf 7��o 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 or no): Comments(note condition of soil,signs of hydraulic fai lure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) f" Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic Hure,level ofponding,condition of vegetation,etc.): 9 Page 10 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) S Property Address:56 Jenidn Lane,West Barnstable,MA Owner:JiII Boston and Dan ILKaufman Date of Inspection:8/30/2m /V SKETCH OF SEWAGE DLSPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two t re benchmarks.Locate all wells within l00 feet,Locate where public water supply enter the anen u Icing landmarks or k fey r z �N D by ,y,,,, �! wy AXIwo W*fP016-, C� z o oZ� 6 13 37 , Q , 10 r Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 56 Jenldin Lane,West Barnstable,MA Owner:JIB Bontun and Dan R.Kauftan Date of Inspection:S/30/2004 SITE EXAM Slope Irl 8Ac%- Y.4,t.4 $' , 7A A Ado �/Lo�Surface water �ONe wj Check cellar Shallow welts s Estimated depth to ground water l//Off Please indicate(check)all methods used to determine the high ground water elevation. Obtained from system design plans on record-If checked,date of design plan reviewed; Observed site(abutting property/observation hole within 150 feet of SAS) ecked with local Board offlealth-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: / ,,v G/m)41 You n4=t descn'be how you established the high ground water elevation: �(0 ell 8 100 ll f CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory �`ss�cFNsg Report Dated: 09/14/2004 Regort Preaared For: Reid Ellis Order No.: G0427801 Ellis Brothers Construction 23 Enterprise Rd. Yarmouth Port, MA 02675 Laboratory ID M, 0427801-01 Description: Water-Drinking Water - Sample ifs-2780l--_. """ --sampling Location`-56 Jenkins Ln WeTBarnstable MA Collected: 08/30/2a Collected by: R C Ellis Received: 08/31/2004 Routine ITEM RESULT, UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen 6.6 mg/L 0.1 10 EPA 300.0 09/01/2004 LAB: Metals Copper BRL mg/L 0.1 1.3 SM 3111B 09/02/2004 Iron BRL mg/L 0.1 0.3 SM 311113 09/02/2004 Sodium 16 mg/L 1.0 20 SM 3111B 09/02/2004 LAB: Microbiology Total Coliforin Absent P/A 0 Absent P/A 08/31/2004 LAB: Physical Chemistry Conductance 200 umohs/cm 1 EPA 120.1 08/31/2004 PH 7.1 pH-units 0 EPA 150.1 08/31/2004 Sample has higher than average levels of Nitrates. Monitoring is recommended(2-3 times per year)to establish any upward treads. Approved By:_ ( Director) RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 TOWN OF BARNSTABLE 00+ 00 LOCATION L n) L J J, SEWAGE # g(-i 34, VILLAGE '�,�,�j-ya Q ASSESSOR'S MAP & LOT _ i'ItSTAI.LER'S NAME 6i PHONE NO. -oil II--e-(d2 '.S)~PTI.0 TANK CAPACITY Do 6=�L.L__ LEACHING FACILITY:(tyPe) c ca-4 + (size %Opp c t� NO. OF BEDROOMS PRIVATE WEL1. OR PUBLIC WATER BUILDER OR OWNER -„_���N -;,ff L NmR�.� DATE PERMIT ISSUED: DATE COtiPLIANCE ISSUED: VARIANCE GRANTED: Yes No .4 S t L U4 G i. No...... F.Rz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH IoW,tj...................OF....... ...................................................... Appliration for Uhipaaal Workg Tanotrurtion frrutit Application is hereby made for a Permit to Construct (X ) or Repair an -Individual Sewage Disposal System- at ....�Tcfq ..................................... ..........40.rn6......................................................................... Location-Address or Lot No. ......... ..... ................................ ......... ........................................................ wner Address .;... ..........................................I[ ........ ...................................................... I staller Address Type of Building Size Lot....Acfj.0��.....Sq. feet Dwelling—No. of Bedrooms....Z.06KC:..........................Expansion Attic Garbage Grinder (4/0) Other—Type of Building ............................ No. of persons....................._.._._. Showers Cafeteria Otherfixtures .................................................................................................................................................. Design Flow..................................� _.gallons per person per day. Total daily flow.......................-aAJP........gallons. 1:4 Septic Tank—Liquid capacity/ gallons Length.5. WidthA'.-.(Q" Diameter.............. Depth.':9,. Disposal Trench—No. .................... Width..............__.... Total Length.._....._.. ._..... Total leaching area....................sq. f t. Seepage Pit No-----(,-Wle------- Diameter......M--------- Depth below inlet................ Total leaching area..rZ.6p.7....sq. ft. Z Other Distribution box K )" Dosing tank ( ) Percolation Test Results Performed CIAJ11111,5e................ Date._.. . ..... ..... ............... Test Pit No. 1......Z......minutesperinch Depth of Test Pit...... ....... Depth to ground water._ . rX4 Test Pit No. 2................ni utes per inch Depth of Test Pit.................... Depth to ground water OF ................................................................................................................................ . ................. 9 STEPHEN 0 Description of Soil... ..................................................... 7--------AUYN'---- ..................... .....W ----•-•--•----•---•--•-•---•----------•-••---•------•----------•--........ Aq+L sjlCV.Sr 7S0N____ ........ -------------------------------------------------------------------------------------------------------------------------------------**--------------------------- %Na-30.21.6 U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------ - .................................................................................................................................................................I......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with( the provisions of TITLE LE 5 of the State Sanitary Code— The undersigned further wrees not to place the system in operation until a Certificate of Compliance ha: issued by board of fie, Signed..... .............. .................... Date Application Approved By.......QN4,_3.. --- .... .... ;1 Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo............ ............... Issued............................................... ------ Date 'l No.... .A Fmc............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �Q.w.rl...................O F.......13.o b/c.:. ..... K ApplirFa#iun for Disposal Works Tonotrur#iun Prrutit Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: .....................••-.............. ..-- •---•--•..........---•••.............. .......... 6.................................................................... .. /� Location-Address or Lot No. �.1.....car.,p................................. .........7g fr&j?ZP..4anc...........*----•------- ---------.-----------. ----- Owner Address W ........ Sri frlf....ddre•-------------------------------•-------... � Installer Address U Type of Building Size Lot..._� j 053.___Sq. felt Dwelling—No. of Bedrooms----T&nCc:.........................Expansion Attic (4) Garbage Grinder (�� Other—T e of Building a Other—Type g ____________________________ No, of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------......••. --•••--•---•-•-••---•--•-••-•-••----..---••-••-•-•---•----•••-••. ----•-----•---•-•-••-•-.....•--...-----•......-•--••--•............ W Design Flow..................................Ss..gallons per person per day. Total daily flow............._........_33 .. .. WSeptic Tank—Liquid capacity/4?Q_gallons Length.8.'-Gz�.... Width-4 c-.1_Q* Diameter................ Depth 5._=-." x Disposal Trench—No..................... Width.................... Total Length............(.__.... Total leaching area....................sq. ft. Seepage Pit No......�r►2..__,.. Diameter......1_0........ Depth below inlet................ Total leaching area..e?a46...sq. ft. Z Other Distribution box (X ) Dosing tank ( ) aPercolation Test Results Performed by...Ajq_��!._f-/c� c ,•£_/✓r f� r_______________ Date.....7�Z"i` g� Test Pit No. I.._....Z......minutes per inch Depth of Test Pit......,1.!f....... Depth to ground water_._ _ fs. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wat O Description of Soil....IrcT!k.... .:J3.629......Q.-�.�.7b p E S�6roi j---------••- �� STEPHEfs' �� --- -- ---------•.------•-----. (> �..._� -}1'19c�Q.:.. sn--. --�� -•- !1'lFd.__... WiL--Se-N----- ........................................ ...........................••-•----....._. to�� U Nature of Repairs or Alterations—Answer when applicable.................................................................. JA Agreement: OV/� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a cordance with 1 z/Zr/`f the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agr es not to place the system in operation until a Certificate of Compliance has issued by t oard of healt a Signed ._.. ` -z�6"` - Date Application Approved By----•-•ow»- -- - ........................................... ..... Date Application Disapproved for the following reasons:-----•--------•---------•---•--•-------••-----------------------------------•---------------•-•------.....--•-•- ...-••-•...................................•-•-•---...-•---•--•--.....---•-----••-••-----••------••-•---•--...............•---------•-----•............................................................ Date PermitNo............. Q.-.. -------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trrtif iratr of Tuntpfinurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY••-----•---••-------•--------------•----•-•-----------------------------------.--.------- ---•- ---•-------.----.--.-..------------------------.-.---------------•-----•-•--------•------------ Installer at................................................................................. ••------------------ has been installed in accordance with the provisions of TITLES of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........... ...0....... ..... dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FU CTION ATISFACTORY. DATE.......... 1�. ... � -------------•-•--...--•---. Inspecto L•��/. 'vim .. ••---•• THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... /uitrl ................OF........1A... '!/.6....................................... / �•- No..... { / FEE ........ to u 1 Vorks Tun ttr#iutt antic Permission is hereby granted �._4/ ..-- ...... to Construct k) or Repair ( ) an Individual Sewage Disposal System at No Street as shown on the application for Disposal Works Construction Permit -Dated.......................................... ----•------••----••-•....-•-••- �s�-------- DATE_ ..-..-----•---•--------•-----•-•--•.................... hoard of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ice' .. .... ITsue. .-. '"4:.. ♦ 't , b 1 .i. ", �..:hE r5^ t.';:., :1`'F r �¢ t �• . FIRST FLOOR PLAN ., t za # . udders 1118, aozx"; v wvl.t 4, x ° LV Q J N R 73-0111 ' cc 12'-2 3/16" 36'-31/4" m J -0 3/8" 5'_71/8" 3'-1 11/1 -9 3/8 5'-71/8" 5'-10 5/8';: 5'-71/8" 4'-4 1/4" 5'-71/8" 5'-5 5/&' : y lu C H 5749 5749T 5749 5749 to r.f DECK ®I'l_ 433 sq R + DINING -IMF 237 sq ft cV ' KITCHEN LIVING ROOM 17-11 5/6" m 327 sq a 1022 sq ft 4 3/1 3/ ;-8 3 to j . 11'-7" co um 2050 205D - 6'-01/2" -v � ~ OP cr) C7 6 f1 Co aw I IF 0 _ P 6� -2" 8'-11 1/2" im BD INDOOR DECK O 234 sq E 0) Office/Storage j 134 sq ft ��� ENTRY C Q� _1 1 � �..� M c�9 - O Co 3-2' k 13'-6 1/4" `1 C N! N E N 2244. 2244 � 4445 4445 4445 O o q Q v v Z ' m '46 CID cc 2349 2666 2349 - "O T-5" '-2 7 '-2 6'-013/16„1'- 1 _ '- 1 ,-01; '13'- 10'-10 5/16" 4'-4 11 / '-41/4" '-10 5/1 3! "4'-4 1/4" 6'-2 1/4" a 211/16' a 11'-T' 3'-2" 9'-4 5/16" 11'-91/2" � 23'-11 5/16" 12'-11 1/4" 73'-011/16' n ' N In O W C T Q SECOND FLOOD PLAN 3 70'-3 511 G W 'Q '-3 7/8" '-9 5/16" 1'-10 7 8" _j 5'-0" 15'-4 1/2" '-1 1/4' F-8 3/4" 7'-11" 12'-10 7/8" — C 2' 15/ P V. 5/ '���' 101 8" r, '-9 1/16" 3'-611/1 �w -2 10'-8 9/16' �\ 1� -6 5-7 1/8 m y S .? z44 co 0 �I + ' m r + 7M a BATH tU N BEDROOM 3 "°s"" 275 sq ft rn a co co ti v 4 0� o� O eee CLOSET C� N 25 sq ft 'U1 10'-2 7/8" r- cc _ 95 $ Z MASTER BEDROOM 1 z �y o c) D BATH 2 55 sq ft to _ ° ? s 6M 868 F, C11.Z cc i_ul FFI O G O C BEDROOM 2 °3sgf W J 234 sq ft CO Cc CO .... O rn + zo44 444s ILI ... O w� L 6'-11 1/8" 11'-31/16" -8 9/16' 4'-4 1/4" 3'-8 3/8 4'-51/4"14'-4 1/4" 4'-3 3/16" a 3'-10 15/16" 20'-2 9/19' 11'-9 3/1&' 3' 9'-0 1/2" 13'-011/16" 1 r-6r 10'-6 7/1Er'- 7 0'-3 5/1,61p C � d NOTE: The area used in this floor (New Section) will be under or equal p to 66% of the floor below 0 c SCHEDULE OF ELEVATIONS SEWAGE SYSTEM PROFILE 8c DETAILS GENERAL NOTES NOTE: NOT TO SCALE 1 FIRST FLOOR = 1 119.5 1. RISERS AND COVERS TO 1. ALL CONSTRUCTION AND MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL 2 TOP OF FOUNDATION = 2 118.5 FINISH GRADE 1 119.5 OBSERVATION PORTS CODE (310 CMR 15.00,TITLE 5), .AND THE LOCAL BOARD OF HEALTH. =4 +w 2. H-20 COMPONENTS AND t 3 PIPE INV. AT FOUNDATION 3 107.59 SCHEDULE 40 PVC PIPE THROUGHOUT 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN 4 INV. OF PIPE AT SEPTIC TANK INLET = 4 106.94 S=2% MINIMUM PERMISSION OF THE LOCAL BOARD OF HEALTH. ' 5 INV. OF PIPE AT SEPTIC TANK OUTLET = 5 106.69 2 118.5 i 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL 6 INV. OF PIPE AT D-BOX INLET = 6 106.59 BE BROUGHT TO THE ATTENTION OF THE ENGINEER PRIOR TO PERFORMING THE 7 INV. OF PIPE AT D-BOX OUTLET = 7 106.42 11 1109.5 RELATED WORK. 14 110.4 4 106.94 131110.08 INV. OF PIPE AT START OF LEACHING FIELD = 8 105.92 r` � 12 109.8 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND 5 106.69 9 BOTTOM OF LEACHING FIELD = 9 103.92 16 TBD �' IS NOT TO BE USED TO ESTABLISH PROPERTY LINES OR BUILDING SETBACKS. 'i MIN. BREAKOUT PROPERTY LINES - 10 106.5 PROPERTY LINES AND BUILDING LOCATIONS ARE GRAPHIC ONLY, F STONE 10 106.5 <7. {a, •(. .: �. t, ;, r i 10 TOP 0 :;�:., -., �� ,_ , � ��! _ .;s. .. 'r,_,t-_ t•._, ,.".. ._ ...�'h_.,t",. ..E.�!.,'� Y'�",x7i, cq' _ ,..1... -'1,__-�.._• ;...,,,:.:,• _ .../ .._'.,_. ,.,.-,'. .._ .. .. ,. • -.,.:., .I .,_ fk+6.., . r >-. ..' ,_..,k , ,Frr .s.t; d . ,<1••,r-i_1. ,.,.,$., ;r �.... T.*... ..(. .,,,,.q.:.:.,.•..:• s,..:,-..;.t sw .....,_ _,,._, _,,.. t CERTIFICATION AS TO THE ..,._. t...,., 15 VERIFIED. NO REPRESENTATION OR CERT C :. ,.. _. .',•.. 3 .. ._��M,.,�_ aa ... .,,. ((.,�,;...,,.,� ,.,-,.y .s _ r ,.t .. � ,t_ k3 jj NOT HAVING BEEN E Y. ^ .•'. ..,,1 .v�,, ....•t.,,. 3.t -7teSi'.._�. l t.t< ., f rtc- , .. 1 .. , .F rt L4.-.ie-r ^SI.,r e._,r. i.-, k ...,3r:..r t i LEACHING 1 1 9 5 .. ...q.•-..a � „ .c > a 3r7. -. c.._4,..-. J.f .Gr. .,. x...rn �,�+r.j w...., .� .s ,.,,,..., '-t`._. -..Y'.'. _ - 1 FINISHED GRADE OVER EAC G 1 0 ... • .>.• ,....,..,,:,.,1 ..,. . _.4;,<..,: •. ..,_, ..... .� ,:._.,,,,w Ru ._ .:w,. ,.a .-E . ,i.,,r. .,t, :,.{r ... .,,^ _. ic_ ��t r , � #... , U.r: !! F Ia. ,..' {''..�z,..7 -..,. ,..7. 1�...,. t...1•}»{. ....r _ ...t, „1 ��..:l• 9., .zinit q } .,_ -... .. .'.;. , �' :'.,:. . :�'1 .t ... e..� 1 , t 1 <, ... { [ , .. ,. .v/,,.,•4. s._. ..�.... .. ...'� F l u i T .{ /t.•-f.,..,. .. , , 12 109.8 ._.., r>a�. .a�. _ #.�.a, z ,. ,,,z>_ ,._ . a < , �. 4.,._�.{. tea. ,. ._� _. _ , ACCURACY OF .THOSE SHOWN IS IMPLIED OR INTENDED. 12 .... _ ,._,kr... ..,.>_. ..x .. ..... ... ... .....h. .. .,.. ,.. rb_..<ir'<, �.k 2i tc{..:v .,� ir_,P.. , •_ � =4. .,:• �.. ,: t.. .. ,. .. . >r,1. ,w...,, ,..., ,�. kl�--x _ ., .. . .. u_,Y�'tc,C ._»,._t.l., .._. ..v .4. > .3Y"n:.f !. � d. ,r a g .. r..- r , �, .,, .�, ....� ...k i' � r , 5:.. ! {{ FINISHED GRADE OVER D BOX € . . .. a� fir, . .: .. ...-. ,.. r, ..� ... n•. lw •rtl.,,-,-.,r~. , if nl,t9,.,1:...r_. ,.. X-..w,�...r. 5. k .7 _. .i ar 6 OUTLET =.,._u ., .. „. •t,. ... .. ,P..�-.,.. r' , _E,:..., » " ,,r < 1�. AL DISTURBED AREAS . ARE TO BE LOANED SEEDED AND MAINTAINED _., .. "_�', ..• tr• _ty >. BACK FILL WITH 5• L 13 110.0 13 FINISH GRADE OVER SEPTIC TANK .-,--.�,;_ D Box � S t t a._.rv�.� li,l;,� -. .,. ., d. ts;, _. �.• s LEAN ILL. S� ' r � , .,._- ., S 0.02 L=32 c {, TO PREVENT EROSION. 14 FINISH GRADE AT FOUNDATION = 14 110.4 •6 r •, ,%,tsr3..- r,� ._- 5=0.02 L=S :„ i t LOCUS MAP NOT TO SCALE 15 BOTTOM OF SEPTIC TANK = 15 102.36 i. y ; S=0.02 6. FOR PROPER PERFORMANCE, SEPTIC TANK SHOULD BE INSPECTED AT LEAST ---- 4P L sqx t al .: 3r ' ONCE A YEAR AND WHEN THE TOTAL DEPTH OF SCUM AND SOLIDS EXCEEDS 16 TOP OF CELLAR FLOOR = VARIABLE 16 TBD ` !i o SCHD. 40 PVC TEES f i�a:" ,�j`�n ' ' t., `r 4? 0 C2 r tY : ® C2 C3 ®® ;r N 113 THE LIQUID DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED. 3 107.59 ^ I~ t l 4- t 1(:G„r'.7; 'ls�. {�:t �tr,rn"., t L k'°!•, . �s,'r .,y..l.. r {{ :, k 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED � ' fz `fr)� 00 €roc k,t ,f GAS BAFFLE ,>' !c:j s 6 106.59 7 106.42 z ,.;; r3 F .. f1!. ,s`: : i-• ~"f rcr 4'FoF NATURALLY BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH; AND �, 1 ,G CODE. , w L CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. SANITARY CO E 8 105.92 PERVIouS MATERIAL { rr7 � s 7 « 'x '�4 ' ' �'' f5 fi r, r y; ' 1 " rj . GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. !n ktt.t 7a er � },c a:n7! ;:•1i s ..i` k ,a,'.i. NO '.'• ;;, uk ,x tit .•a z t t{ g: F rs rr„ , ti ,r ;' 8. TEST HOLE INFORMATION SHOWN HEREON IS LIMITED TO SOIL CONDITIONS FOUND ° Sg7 1500 GALLON SEPTIC TANKr {ia r ; 9 103.92 H-20 PRODUCT ACMEr,'' ` " ,¢ ,c AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN PRECAST MODEL OR EQUAL 's,,rt�� 1 USE (3) H-20 LOAD RATED GALLEYS IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF ,{€ , K, � ^z x'^.'ah :.$�;vq.-p.. ..S 1` rs^T s rr ',,••l.��r.lhFi f WITH: SUCH TEST HOLES. 48 STONE ALONG SIDES; 6" MIN. CRUSHED STONE BASE 9. ALL ORGANIC AND UNSUITABLE MATERIAL MUST BE REMOVED FROM THE AREA l 15 BETWEEN; DIRECTLY UNDER AND 5 FEET BEYOND THE PROPOSED LEACHING FACILITY. THIS 15 102.36 P 48" ENDS. AREA MUST BE BACK FILLED TO THE ELEVATIONS INDICATED ON THESE PLANS WITH SELECT ON-SITE OR IMPORTED SOIL MATERIAL, CONSISTING OF CLEAN GRANULAR SAND OR OTHER GRANULAR MATERIAL, FREE FROM ORGANIC MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS SHALL NOT BE USED. THE FILL MATERIAL SHALL CONFORM TO MA STATE DESIGN DATA HEALTH CODE TITLE 5 - 310 CMR SECTION 15.225(3) AND SHALL HAVE PERCOLATION RATE OF BETWEEN TWO AND FIVE MIN. PER INCH, BEFORE AND AFTER PLACEMENT. 1. BUILDING TYPE: 4 BEDROOM HOUSE 10. ALL STONE MUST BE DOUBLE WASHED AND FREE FROM FINES AND ANY 2. DESIGN FLOW: 110 GPD PER BEDROOW 110 x 4 = 440 GPD ORGANIC MATERIAL AND MUST HAVE LESS THAN 0.2 PERCENT MATERIAL : 3. DESIGN PERCOLATION RATE: 5 min/imch FINER THAN A NUMBER 200 SIEVE. 4. GARBAGE DISPOSAL: NO 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCT OR SUPERVISE THE CONSTRUCTION OF THE SYSTEM. THE CONTRACTOR IS ,- f'" 5. SEPTIC TANK DESIGN o REQUIREMENT: 200% DESIGN FLOW RESPONSIBLE FOR MAKING ARRANGEMENTS FOR INSPECTION OF INSTALLATION S38'13'517TI �.. �- -� �' �- f , j `;� o ,.} 440 X 2 = 880 GAL. (USE 1,500 GAkL. MIN. PER TITLE 5) OF THE SYSTEM WITH THE LOCAL BOARD OF HEALTH. �_• o 6. TOTAL LEACH AREA REQUIRED: ` . ` � -�, � � � ., .,__ -_ ._. �� r-Cl�r,....._. .w_ -� �..� M`^ � -� � �� , t ) o,•J n �,�, 12 THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND »_ `•.� i ~� -J I '�I TITLE 5: 440 GPD / (0.74 GPD/SQ).FT.) = 595 SQ.FT. (CLASS I SOIL) VERTICAL CONTROL OF ALL SYSTEM COMPONENTS. _ a �, ( off' 7. TOTAL AREA PROVIDED: 13. TIGHT JOINT `PIPING TO CONSIST OF POLYVINYL CHLORIDE (P.V.C.) • / _ .._ .,,� .,_ EXISTING .WALL-�I'4-f�EMAIN 1 � J SCHEDULE 40, UNLESS OTHERWISE NOTED. �- -� 13 X''36 LEACHING TRENCH SEE DETAIL) - -1p -�.. I I ( ) R FOR CONSTRUCTION 0-. 14. THE SHALL NOTIFY THE DESIGN ENGINEER `•, \ `� \, y ry 7 ---. ---- �' EFFECTIVE DEPTH 2.0'; LENGTH - "36'; WIDTH - 13' �,��.� � _ � _ o _ INSPECTION AFTER EXCAVATION FOR THE LEACHING BED (PRIOR TO THE -- - w PLACEMENT OF STONE) AND ALSO AFTER PLACEMENT OF PIPE & STONE � �, 1 ' f -.. .._.. � -� .. , , • _ SIDEWALL AREA 2x36 2 144 SQ.FT.` � 1 �. ;_ .. • _ . .. - _-, ( )O t._ PRIOR .TO BACKFILLING•; 1 - = t ti - - ,a� , . �'. � �, � BOTTOM AREA 13x36 468 SQ.FC. CONSTRUCTION OF SYSTEM AND MATERIALS�, � , �, �, � l 1 I .__: _� �.. �_ __..._.-• ,�. .-' ,:- , `-o-- , _1 . 15. DESIGN ENGINEER SHALL CERTIFY CONS < o \ ° = 2x13 2 = 52 S .FT. C� ? o o END WALL AREA ( )O Q INS7ALLE©. THE CONTRACTOR SHALL PROVIDE A SIEVE ANALYSIS OF THE FILL _ SUBMITTED TO THE LOCAL MATERIAL REQUIRED. AN AS BUILT PLAN SHALL BE SUB IT f� l 1 # AREA :.PROVIDED - 144 + 4683 + 52 664 SQ.FT. M ER L EQ i � TOTAL , . N COMPLETION. , ., BOARD OF HEALTH UPON . .._ .:� T GPD _ 4E91 GPD 4 - 1 o, _ _ 664 'SQ.FT. x 0.74 SQ.F ./ MACHINERY SHALL DRIVE OVER THE PROPOSED � I 1 / .o ' . o �1 ,� 16. NO RUBBER TIRE CONSTRUCTION C t BENCHMiAR } l I f o ^ - SEPTIC BED EXCAVATION DURING CONSTRUCTION. TOP 'CEN 'OF TOTAL FLOWPROVIDED 491 GPD "� SAFE' AND ALL OTHER NECESSARY AUTHORITIES SHALL BE NOTIFIED FOR '•. •, �'. ` �, � 1 ', 1. � � l g CATCH BA IN - 17. DIG PRIOR TO ANY EXCAVATION. EL=100.31 THE PROPER LOCATION OF EXISTING UTILITIES k �� \ o• � � NOTE: SYSTEM IS NOT DESIGNED FOR A GAfRBAGE GRINDER. LOT 6 EXISTING SEPTIC ' h ,moo .-� �. d l TO BE DISCONNECTED -" I ,�� oo ,w �� , l ; 1 l AND REMOVED y `� SOIL EVALUATORS LOG 49 054 S. F. _ , ` , I I � ' �. 11 ^ ry ti ry II II -'�� O ice'` �'` \ J D' °�, Depth from Soil Soil Soil Soil .Other I ,.. . .: Surface Hor. Texture Color Mott. Relative X , '._ \` Inches USDA (MunselI) Factors Z ` v 1 4 ^�` - ROPOSED LANDSPAPE WALL",-,. �' Ao DEEP OBSERVATION) HOLE 1 r - { 1 f I 1 ; e it , / ,•- '. :_- ^ 7.4 � { � � � � 1 ! ; , � • \ � � �' ^ �O o -132" C L/S 2 5Y7/3 REVISION DATE DESCRIPTION APPR 'D� I y .mot ^° J APPLICANT: j i `� ( DEEP OBSERVATION) HOLE #2 o, ALEXANDRIA DICENSO ' M . z Z ` 0"-3" B L S 1OYR 5 5i i j l E r 1 I RES w �� ` �. _ `� / / 56 JENKINS LANE RVE r / �' ' ' 3"-132" C L S 2.5Y 7/3 SMALL STONES in R OSED N j ^,� I / WEST BARNSTABLE, MA. 02668 GA AGE X .� / � .•' r , w o �.'�: �� DEEP OBSERVATION! .HOLE 3 0 �, , ( ,. , .. SL B I 1 ;� ;. . .' �.' }k� oX E 67 ^) ) PROJECT: 0 -3 B L S 1OYR 5 5i COBBLES tt : ;;a ,v . . . * _. ' 3"-,32" c L S 2.5Y 7/3 COBBLES SEWAGE DISPOSAL SYSTEM UPGRADE DESIGN ` / ,lt � l t y5_ in 10° E 188.5 ! fi i �` t° ` �`t ,, (� o; { , �' DEEP OBSERVATION HOLE 5fi JENKINS LANE'' p� �' J '' �' ° ' ° Imo a911 `' w'� /1. . / .% � � fr/.E� � , r � .. ,� ,�o°j� , •. o `,` 4,.W ;� ,` +� i � `�4 0�. 0"-132" C L/S 2.5Y 7 3 STONES W/ / IN � N�36 54 28 W o 98 5� , WEST BARNSTABLE, M. ASSACHUSETTS PERCOLATION RATE - < 5 MIN• INCH EXISTING SHED ,��•o' t �° ,✓ �^o DEPTH TO GROUNDWATER N A SHEET NO.: 1 OF 1 DATE: 11 08 06 TO BE RELOCATE EXISTING DECK OBSERVATIONS BY: DCON DESMARIS TO BE REMOVED O DATE TESTED: 10/23,/06 SCALE: As Noted PRG FILE: JENKINS-56-DICENSO o°' DESIGN BY: DAVID FRENCH CHECKED BY: CHRISTOPHER COSTA, PLS LEGEND Q, O ^ N 0 TES PREPARED BY. yA �`� ? Boa• EXISTING PROPOSED oti�9s, } Q� Associates, �C 1 AS SHOWN SONOFIRM FLOOD INSURANCE ZRA E MAP. Christopher Costa & Associa es, Inc . - - .. � r•..r CONTOUR ELEVATION T S ' 2. WATER SERVICE LINE SHALL BE LOCATED AND MARKED CIVIL ENGINEERING • LAND SURVEYING ENVIRONMENTAL CONSULTING 50.5 50x5 SPOT GRADE PRIOR TO ANY EXCAVATING AND 110' MIN. SETBACK TP TEST PIT (TP) �P�ZW FMgss ,r DISTANCE FROM SAID SERVICE TO, THE SEPTIC SYSTEM P.O. Box 128 / 465 East Falmouth Hwy. 508.548.0350 FAX LAYOUT PLAN ��Pti�H OF l�gss9c ��N.DouGLAs9cy� 3. ALL SHALL A ER LINES MAINTAINED.SHALL BE SLEE':VED WITHIN 4" PVC East Falmouth, MA 02536 508.548.6424 PHONE � ❑ 0 CONCRETE BOUND (CB) o� ♦ SCHNEIDER SCH 40 PIPE FOR 10' ON EACH SIDE OF SOIL ABSORPTION SYSTEM. � CHRISTOP'HER �n ♦ ' sy � � -.� DRAWING TITLE: SPIKE (sPK) GRAPHIC SCALE cosTm ► �� 0 CIVIL o -i CHRISTUPHER No.38540 4. GROUND ELEVATIONS ARE BASED ON AN ON THE 'GROUND zo o �0 20 40 N0.313(Dso COSTA m ♦A S`. INSTRUMENT SURVEY. UTILITY POLE (UP) 9NO.313� y ��,cFS GJ 5. LOT COVERAGE: SEPTIC UPGRADE DESIGN PLAN LIGHT� FOiSTERc� TOTAL EXISTING & PROPOSED COWERAGE 1,478 S.F. ( 3.0% )WATER GATE WG ( IN FEET ) a SURd'E SUR' yoP � �N ( ) i inch = 20 ft. `j ASSESSORS INFORMATION: MAP 128 SECTION 004 PARCEL 008 ° 0° WATER SERVICE (WS) I