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0279 MAPLE STREET - Health
279 MAPLE STREET,W. BARNSTABLE A= 132 047 � o 1 Commonwealth of Massachusetts l3a- 0 Title 5 Official Inspection Form 10 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �., 279 Maple Street Property Address Y Ernest&Jane Charette Owner Owners Name information is West Barnstable ✓ Ma. 02668 7/19/2018 ` required for every page. Cityrrown State Zip Code Date of Inspection Ci Pam... _. Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information fillingS/ /3a on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return key. Name of Inspector S.M.Jones Title V Septic Inspection Company Name 74 Beldan Lane Company Address Centerville Ma 02632 City(Town State Zip Code 774-248-4850 smjonestitle5@gmail.com S14522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/19/2018 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 has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc•rev.6/16 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form r, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 279 Maple Street West Barnstable is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 3 precast leaching chambers. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 N, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every west Barnstable Ma. 02668 7/19/2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street -� Property Address Ernest&Jane Charette Owner Owner's Name information is required for every west Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street L Property Address Ernest&Jane Charette Owner Owner's Name information is West Barnstable Ma. 02668 7/19/2018 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 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 ❑ E Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were an of the system components pumped out in the previous two weeks? Y Y P p P ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑, Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information.For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 335 gpd provided t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cit !Town Y State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d private well 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: currentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc•rev.6/16 Tide 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form ^ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments L 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: complete system installed 7-7-2016 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 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.): Joints ok, no leaks , vented through roof Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons Sludge depth: 4" t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 3' Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 6" 1011 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? opened covers and took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. Water level was even with outlet, tank was not leaking and was structurally sound. Covers are on risers. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 1^1Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owners Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was in good condition, no rot, water level was even with outlet invert. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every west Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: U500 gallons ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): s.a.s. consists of 3 precast leaching chambers with 2.5'stone surrounding. Leaching facility was found to have 1"standing water at time of inspection with no stain lines higher. Access cover is on riser 2' below grade. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately A 7AN�- _�— 2 r J31 ZSr AZ Z7 b i 0 13Z 2y r Z b 8-3 I z' C-3 3 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every. West Barnstable Ma. 02668 7/19/2018 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 6-7-2016 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: a) Design plan dated 6-7-16 states that no groundwater was encountered at 144" and system is designed to 5+' seperation between bottom of s.a.s. and adjusted high groundwater elevation. b) Property is elevated compared to surrounding area. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 279 Maple Street Property Address Ernest&Jane Charette Owner Owner's Name information is required for every West Barnstable Ma. 02668 7/19/2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information-Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-IIi1A009) Recipient: Order No.: G18108447 Ernest Charette Report Dated: 07/31/2018 279 Maple Street Submitter: Ernest Charette W Barnstable, MA 02668 Description: RE Kit-279 Maple St, Laboratory lQ#: `i$108447-01 Matrix: Water-Drinking Water Sample#: Sampled: 07120/2018 11:40 By; EGC Collection Address: 279 Maple Street W.Barnstable,MA Received: 07/20/2018 12:05 By: PalmerP Sample Location: Turn Around: Standard t I Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED TIME Nitrate as Nitrogen 1.2 mglL 0.10 10 EPA 300.0 LAP 07/20/2018 12:05 Copper ND Ong/L 0.10 1.3 SM 3111B LAP 07/25/2018 14:29 Iron ND mg/L 0.10 0.3 SM 3111B LAP 07/25/2018 14:29 pH 7.8 PH AT 25C NA 6.5-8.5 SM 4500-FI-B DCB 07/20/2018 14:58 Sodium 61 mg/L 2.5 20 SM 311113 LAP 07/25/2018 14:28 4. Total Coliform 0 1100ml 0 0 SM 9222B RG 07/20/2018 17:20 Conductance 260 umohs/cm 2.0 EPA 120.1 DCB 07/20/2018 14:58 i Sodium level is above the maxium contaminant level. Those on a low sodium diet may wish to consult a physician. Attached please find the laboratory certified parameter list. Approved By.• (Lab Director) r. i r r i ' f • t F F , E F t - - f } ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level i 3195 Main Street, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 1 of 1 i _ " ,Uf5�n2;y`r CERTIFICATE OF ANALYSIS v f l m Barnstable County Health Laboratory (M-MA009) Recipient: Order No.: G18108447 Ernest Charette Report Dated: 07/31/2018 279 Maple Street Submitter: Ernest Charette W Barnstable, MA 02668 Description:. RE Kit-279 Maple St. Laboratory ID#: 18108447-01 Matrix: Water-Drinking Water Sample#: Sampled: 07/20/2018 11:40 By: EGC Collection Addr: .279 Maple Street W. Barnstable, MA Received: 07/20/2018 12:05 By: PalmerP Sample Location: Turn Around: Standard Analyst: yn Method: EPA S24.2 Dilution: 1 Date Analyzed: 07/20/2018 @ 14:58 EPA 524,2 - Volatile Organks by GC/1195 Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L. ug/L Dichlorodifluoromethane ND 0.50 Chlbroethane ND 0.50 Chlaromethane ND 0.50 Chloroform 0.51 80 0.50 Vinyl chloride ND 2.0 0.50 ds-1,2-Dichloroethene ND 70 0.50 Bromomethane ND. 0.50 cis-1,3-Dichloropropene ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Dibromomethane ND 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Ethylbenzene ND 700 0.50 1,1,2-Trichloroethane ND 5.0 0.50 1-lerachlorobutadiene ND 0.50 1,1-Dichloroethane ND 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethene ND 7.0 0.50 - Methylene chloride ND 5.0 0.50 1,1-Dichloropropene ND 0.50 Methyl-tert-butyl ether ND 0.50 1,2,3-Trichlorobenzene ND 0.5o Naphthalene ND 0.50 1,2,3-Trichloropropane `! ND 0.50 n-Butylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 n-Propylbenzene ND 0.50 1,2,4-Trimethylbenzene ND 0.50 p-Isopropyltoluene - ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromoethane(EDB) ND 0.50 Styrene ND 100 0.50 1,2-Dichlorobenzene ND 600 0.50 tert-Butyl benzene ND 0.50 1,2-Dichloroethane ND 5.0 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloropropane ND 0.50 Toluene ND 1000 0.50 1,3,5-Tdmethylbenzene ND 0.50 Total xylenes ND 10000 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichloropropane ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichloroethene ND -5.0 0.50 2,2-Dichloropropane ND 0.50 Trichlorofluoromethane ND 0.50 2-Chlorotoluene ND 0.50 Compound %Recovered QC Limits(%) r 4-Chlorotoluene ND O.So 1,2-Dichlorobenzene-d4 85% 70 1 130 Benzene ND 5.0 0.50 p-Bromofluorobenzene 81% 70 130 j Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Attached please find the laboratory certified parameter list. Approved By:. (Lab Director) 0 �f '1 ND=.None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, (Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 t►+E Town of Barnstable Barnstable .� Board of Health • •AMSrABLF- v MASS. � 200 Main Street,Hyannis MA 02601 'a CFO NAAy a 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi June 28, 2016 Mr. Rich Capen Capewide Enterprises 152 Commercial Street Mashpee, MA 02649 RE: 279 Maple Street; West Barnstable, MA A - ;:132 047 Dear Mr. Capen, You are granted variances on behalf of your client, Ernest Cherette, to construct a replacement onsite sewage disposal system at 279 Maple Street, West BarnstableMassachusetts. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located ten (10) feet away from the foundation, in lieu of the twenty (20) feet minimum setback required. Section 360-1, Town of Barnstable Code: To construct a soil absorption system 89 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1, Town of Barnstable Code: To install a septic tank 75 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. The variances are granted with the following conditions: (1) The system shall be installed in strict accordance with the revised engineered plans dated June 9, 2016 Q:\WPFILES\279 Maple Street West Barnstable Variances.docx (2) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans dated June 9, 2016 These variances are granted because the physical constraints at the site restrict the location of a septic system due to the fact that there are cranberry bogs on the northerly and southerly sides of the lot and a stream on easterly side. Since ely yours., G ayne iller, M.D. Chairman Q:\WPFILES\279 Maple Street West Bamstable Variances.docx DATE. b 16 o� FEE: � + &mwsrABLE, * Q IJu MASS'� �°' REC. BY 16yA. ♦��0. n of Barnstable Tow SCHED. DATE: 411& Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION _ Property Address: Z-1 � � Assessor's Map and Parcel Number: 0 Size of Lot: 4' I Wetlands Within 300 Ft. Yes X' Business Name: No Subdivision Name: APPLICANT'S NAME: to Q61,k11QE T t.�f1�tI S Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: C A-PeS l &A Alae- -G Name: 42 P— � C-It c-11210 Address: � `7� Address: t- ]Vko Phone: .-'� Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only " " LVariance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paull ` `J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary �Zj6 /M91,9 T l�uV� Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC i s- tel.(508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cape engineering, inc land court civil engineers&land surveyors Daniel A.Ojala,P.E.,P.L.S. surveys Arne H.Ojala,P.E.,P.L.S. Andrew R.Garulay,R.L.A. structural design May 6,2016 Barnstable Board of Health site planning 200 Main Street Hyannis, MA 02601 sewage system Dear Board Members: designs Enclosed is a variance filing request for#279 Maple Street,West Barnstable. On behalf of inspections our client,we are requesting the following variances: Variances from 310 CMR 15.405 ("Maximum Feasible Compliance"): permits (1b) reduction in setback, leaching facility to full foundation (20'to 10') landscape architecture Under Town of Barnstable Health Regulations: Article I, Section 360-1: reduction in setback,leaching facility to wetland (100'to 89');septic tank to wetland (100'to 75'). The site consists of a 4.2 acre lot,improved with a 3 bedroom dwelling and gravel driveway; it is served by a private well. The dwelling is situated among working cranberry bogs and an intermittent stream which connects the bogs. The house and septic system are situated on a high point of land,well above groundwater. No construction work is planned. The project consists of the upgrading of an older 3 bedroom Title 5 septic system. The new leaching facility is situated as far from•the cranberry bogs and intermittent stream as possible,which requires a variance to the foundation (a liner is proposed). The leaching facility is designed with the base at 6.2'from the bottom of the test hole elevation,where no groundwater was encountered. The system meets the required setbacks to all known potable wells. We obtained approval for this upgrade through the Conservation Commission on March 8th We feel that by granting these setback variances the same degree of environmental protection can be attained without the need for strict adherence to the Title 5 and Town of Barnstable Regulations. 71 Daniel A.Ojala, PE, PLS Down Cape Engineering, Inc. cc:'R. Capen (Capewide Enterprises) f i I i 3 12 GET f ' i i i X -o- U Fl An Axle— I} 4 �7-7 r - _ down cape engineering, inc. SIEVE SOILS ANALYSIS 279 MAPLE ST W. BARNSTABLE, MA DATE OF REPORT: 6/9/16 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 279 Maple Street, West Barnstable LOCATION: DCE Test Hole SIEVE ANALYSIS Weight Sample(Grams): 112.3 SIZE :WEIGHT RETAINED % RETAINED % PASSED (sum ) -------------�- --------------------q--------------------_------------------ 1" 0.0: 0.0%: 100.0% ------------- ----------------------------------------- ----------- --------------------- --A--------------0%:---------100.0% --------------f 1/2" 0.0: 0.0%: 100.0% 3/8"---------P -------------OV ---------------0.0%r---------100.0% --------------%--- -----------------Y--------------------- ------------------ #4 0.0: 0.0%: 100.0% -------------- --------------------------b---------------------------------------- #10 6.1: 5.4%: 94.6% ------------- -------------------------- ---------------------� ----- ---------- #20 ---------------- - 27.3:............. 3%t-- 75.7% #40-------- 60.9: 54.2%: •------���-���f..........................Y-������������������-mil.................. '. #50 78.5; 69.9%; A #80 99.6: 88.7%: 11.3% #100• 104.1: 92.7%: 7.3% -------------- --------------------------A--------------------- ------------------ ` #200 110.2: 98.1%: 1.9% -------'-------------------------------------------------------------------------- PAN: 111.9: 100.0%: 0.0% SAMPLE: 112.3: NOTE:TEST ON PASSING#4 ONLY, 2.3% RETAINED ON#4<45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL AND SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK M #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION � >98%SAND s OF RESULTS: PERMEABLE MATERIAL-CLASS 1<2 MINJIN. MATERIAL NONCOMPACTED °� DANIELA yes SOIL DESCRIPTION: MEDIUM/FINE SAND &GRAVEL OJALA CIVIL N No.46502 �FG RHO ISTE �SSIONAL ENG\ Message Page 1 of 1 Stanton, David From: Stanton, David Sent: Wednesday, June 08, 2016 11:12 AM To: Daniel A. Ojala Subject: 279 Maple St. W. (Barnstable variance comments Hi Dan, We had our staff meeting this morning to review plans going to the Board of Health on June 14th. We had the following comments that you should try to resolve prior to the Board of Health meeting: Need to show the other lead- pit(to the East side of the septic tank) that will need to be abandoned and likely in or near the location of the proposed SAS. I have attached a copy of the asbuilt that is available online showing Jthe leach pit location for you. -Sieve results need to be submitted Need to clarify the strip out depth. C1 appears more restrictive than C2 and the sieve is shown as being done in the C2 layer. Need to either show a strip out down to the top of the C2 layer, or do a sieve analysis of the C1 layer if it is going to be used as part of the design Thanks, Dave e A61t l ss l w 6/14/2016 TRANSMITTAL DATE: 5/10/16 Down Cape Engineering, Inc. 939 Main Street. Yarmouth Port,IMA 508-362-4541 TO: Barnstable:Board of Health (for the June 14th public hearing) RE: Capewide Enterprises/Charette Request for Variances(upgrade only, no construction proposed) Enclosed: • one complete application package to include: application,variance request,floor layout, abutter notification letter, board of health abutter map, list of abutters, 7 page check list Also: • 4 copies of completed variance request form • 4 copies of engineered plan • 1 copy of 7 page check list _I��A -, 0 C� • 4 copies of dimensioned floor plans • signed permission letter from owner 4 Skr, i cc: File i AbutterReport Page 1 of 1 Board of Health Abutter List for Map & Parcel(s): '132047' Direct abutters(no set distance) and the properties located across the street. Total Count: 8 1 Close Map&Parcel Ownerl Owner2 Addressl Address 2 Mailing Country Deed CityStateZip 34 SHEEPMEADOW WEST 109021 LENTZ,SARAH S RD BARNSTABLE, 7063/164 MA 02668 ROSS, DAVID M& CAPE COD WEST 132001 DIANE F TRS CRANBERRY REALTY 60 WIDGEON LANE BARNSTABLE, 5109/73 TRUST MA 02668 WEST 132002 POLA, KIM E 289 MAPLE ST BARNSTABLE, 10634/246 MA 02668 PICKERING WEST 132003 MICHAEL G&JOAN P O BOX 103 BARNSTABLE, 6377/160 MA 02668 HARRIS JOANNE H 241 MAPLE STREET WEST 132004 TR REALTY TRUST 241 MAPLE STREET BARNSTABLE, 24657/143 MA 02668 WEST 132007 ROSS, DAVID M 60 WIDGEON LANE BARNSTABLE, 29180/125 MA 02668 NANCY A DIETZ WEST 132036002 DIETZ, NANCY A TR REVOCABLE TRUST 251 MAPLE STREET BARNSTABLE, 24296/192 MA 02668 CHARETTE, ERNEST WEST 132047 G&JANE A 279 MAPLE ST BARNSTABLE, 10435/129 MA 02668 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division-.o have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 2/2 212 0 1 6. http://maps.townofbamstable.us/arcims/appgeoapp/AbutterReport.aspx?type=BOH 2/22/2016 tel.(508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cape engineering, inc land court civil engineers&land surveyors Daniel A.Ojala,P.E.,P.L.S. surveys Arne H.Ojala,P.E.,P.L.S. Andrew R.Garulay,R.L.A. structural design May 6,2016 site planning Dear Abutter: sewage system designs A public hearing has been scheduled for the Barnstable Board of Health to take action on a request for variances from the Title 5 and Town of Barnstable Regulations for the subsurface disposal of sewage for the proposed Title 5 septic system at#279 Maple Street, inspections West Barnstable. The variances requested areas follows: Variances from 310 CMR 15.405 ("Maximum Feasible Compliance"): permits (1b) reduction in setback, leaching facility to foundation (20'to 10') Under 310 CMR 15-211(1)[4]: Breakout variance requested (40 mil liner proposed) landscape architecture Variances requested under Town of Barnstable Health Regulations:Article I,Section 360-1: reduction in setback, leaching facility to wetland (100'to 89'); septic tank to wetland (100' to 75'). Said hearing will be held in the Town Hall Hearing Room,South Street,Hyannis,June 14, 2016 at 3:00 pm. Plans and the application describing the proposed activity are on file at the Board of Health office, 200 Main Street, Hyannis. It is recommended to check with the Health Department to confirm date and time if you are interested in attending. 4 Sincerely, Daniel A.Ojala, PE, PLS Down Cape Engineering, Inc. cc:Abutters file Barnstable Board of Health I May 2,2016 Town of Barnstable Health Department 200 Main Street Hyannis,MA 02602 Dear Colleague, This letter authorizes Down Cape Engineering,Inc.of Yarmouthport,MA to represent my interests to your department as they relate to obtaining all the necessary-permits to install a new Title V septic system at 279 Maple Street,West Barnstable,MA. Sincerely, Ernest G.Charette 279 Maple Street West Barnstable,MA 02668 h Town of Barnstable Geographic Information System February 22, 2016 � o o 0 C ® I !{ 0 so Ova i O a e I O 0 1 1 i •'�[:�:.i,_�,I(iir:.;:•>)i..'.'oa;,�:,..y:;is�:`:':. .:iC.i�.�:'';�.ii�::}:�i::':;:idi.i�:•'J�.i:� . . 0 f DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:132 Parcel:047 Board of Health ! lyy boundary determination or regulatory interpretation. Enlargements beyond a scale of Abutter List Type-Direct abutters(no set distance)and the properties located Selected Parcel ° 1"=100'may not meet established map accuracy standards. The parcel lines on this map i� are only graphic representations of Assessor's tax parcels. They are not true property across the street. Abutters boundaries and do not represent accurate relationships to physical features on the map !��/f l such as building locations. Buffer /F AsBuilt Page 1 of 1 k TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE Q� ASSESSOR'S MAP & LOT Bl -a y 7 INSTALLER'S NAME &: PHONE NO. u_� SEPTIC TANK CAPACITY Ito o--�MQ LEACHING FACILITY:(type)_' (size) ovo �4j NO. OF BEDROOMS PRIVATE EL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED• VARIANCE GRANTED: Yes No f I i o— /1 \ http://issgl2/intranet/propdata/prebuilt.aspx?mappar=132047&seq=1 9/14/2015 ,,1l,,�� TOWN OF BARNSTABLE LOCATION 979 b-IAPLE 3T SEWAGE# o�215P�` oto7 VILLAGE WE5-t 6AAPS'To4R4,_ASSESSOR'S �MAP&PARCEL (3 ( -7 INSTALLER'S NAME&PHONE NO.CA?awi06C=�IT��sgtS �,G(, s6si-4"77-$97 j X SEPTIC TANK CAPACITY 15 oo G-C.L o ms LEACHING FACILITY. (type)(3)500 Fs4L U4A4e0G9 (size) NO.OF BEDROOMS OWNER L RV EST S 3A106 C HNRET—IE PERMIT DATE: COMPLIANCE DATE: 'I—?—Ao {2 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility N A Feet Private Water Supply Well and Leaching Facility(If any wells exist on i site or within 200 feet of leaching facility) (W Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 8q Feet FURNISHED BY (2A(P[-Wt�, 0 m r . �. A�S= 13 �` 13.Z --23.90 ti c-3 19, ° -� s ls�q, �CJ 17 No. Fee � ©�✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[pplitatlon for BispoBaf *pstim Co6tCULtion permit Application for a Permit to Construct( ) Repair IX) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2"A MAP4 S-r W.13, Owner's Name,Address,and Tel.No. GAQAJe57V,+?A4JG 414?10JET r€ Assessor's Map/Parcel ;Z 7 9 AAAPL.gr S r Installer's Name,Address,and Tel.No. 3'0?-q7'7-9?7 7 Designer's Name,Address,and Tel.No. CAk;-A6 E E1 a i L��Q( LAX- 00wty (2A?a ��I�JC7a°Lll�Jiq �i,1� S C.0 rust i -T At*W S T- r P® Type of Building: p Dwelling No.of Bedrooms Lot Size f C l 95� }sq.ft. Garbage Grinder( ) Other Type of Building f&L.. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330® gpd Design flow provided 33 gpd Plan Date —`a-aO t k Number of sheets Revision Date Title a.1 9 K Lr__ Size of Septic Tank 1- p0 GA C1 OWS Type of S.A.S.� � �y� C*44x.AJ 8a-S Description of Soil `73L`' 16&S P Nature of Repairs or Alterations(Answer when applicable) =tJ:5 g f. , &AJj� (5co GA4_L_r)b .S 4 1 c> T9N I:::, -ta i jeo 3) Saa OX) cLf I-r&E 9L,3 lr6,-r- or 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 o ` G��i ri f Date Application Approved by Date /6 Application Disapproved y Date for the following reasons Permit No. zlo* �y Date Issued ?•+a 6 g/ 4 Wit_ �X.mod: i ,.d1 V:..u5 5v..'' .•v;a ,' V. :i� 7 "1 �, No. (� C �� 41 a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS -Yes-: 4plication for Bisposal *1 t pnstCUctlon Virtu Application fora Permit to Construct( ) Repair O Upgrade( ) Abandon( ) ❑Complete SysteJm ❑Individual Components i Location Address or Lot No. 2"R ►"AP G SP W.I@)r Owner's Name,Address,and Tel. o: i Assessor's Map/Parcel a7 9 A4 APL9 S-r -r jt S?y1$ > Install is Name,Address,and Tel.No. TO?��(71—$$17 Designer's Name Address,and Tel.No.!I&O$—%A-*SyJ c � taE ��cP�C(ses LLc t3ou ! et�PG �[wca lisk :=L (S 1�we O.t [ ~rL' 93 r Ka.+E[[✓ S-T Po -- Type of Building: t Dwelling No.of Bedrooms Lot ze t 8�.�950t-sq.ft. Garbage Grinder( ) Other Type of Building C5(o a2m,4 N8,of Person( Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33o gpd Design flow provided 33 S gpd Plan Date /;t -aQ Number of sheets f Revision Date i Title CI1 9 M,I�t..tt -,"'T. Size of Septic Tank 1,500 �QO►,(S Type of S.A.S.T�� Soo � �b� � Description of Soil �� � �b 'S(z '70L"' 6eS j 4,90 Nature of Repairs or Alterations(Answer when applicable) Z'NSj7k e" ] t 5cx� W S 4"11rkc, fix/K+ -ta tielo C-3) &4",D)J C uvOK .0 w ir" oF- 4460 ax;m c ri 6AJa5 Aub 2.5 Eu5r oxi Sto Date last inspected: 0 ~ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in }u 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�f /� Date <0 Application Approved by Date /G Application Disapprove y Date for the following reasons Permit No. C t f(y 207 Date Issued --------------------------------------------------------------------------------------------------------------------------------- f 16E COMMONWEALTH OF MASSACHUSETTS S BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(k) Upgraded( ) Abandoned( )by C A PrE W D66 t l..r-r klS LLQ at Q79 MAPcIF S-rC-th--r .6 . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No�((, _ & dated 61-W XjvL Installer�CW I D c; L[JT- ieJSSK U.�, Designer �OLLI►.� � 11� o.1t [t��bYL[Xa,.. �-,#bedrooms Approved design flow R 30 gpd The issuance of this p rmit shall not be construed as a guarantee that the system wil fund'on s desi d. i Date�j"� r� Inspector ---------------------- --------------------------1----------------------------------------------------Fee----------o------- 016 No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) System located at 2779 Pl Pus .�T --T- ��S 6 �j�4P,ar,Js��44g cd 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. v Provided:Construction must be completed within three years of the date of this permit. ' Date ���p��/� Approved by rl!i9wr t of Barnstable Regulatory Services Thomas F.G eater,Director Public Health DiiAsion r ?k, hem"As McKean,Director nn0 Main e Office. 508-862,4644 Fax; 508-790-6304 IwtaUer DesrmLex Cerfi&zflon Form Date- 7 � b �ewa�e Pea�at## aOt(�°_�% Assessavx's I�aIS1lPa�reea / ]f9eaa�exd �IJ 4yJ1'�- 2ra� l�ex: 34 e W I Address: ��/ �— Address: 15 co iqf d a e S on_ (a CAmu'u06&— -rc�C UjS6Swaa issuedapermitto install a (date) (installer) septic system.at a � St based on a design draavn.by (address) Jdated / t a k (desi or) �I certify that the septic system iefaeuced above was installed substantially according to the design,which may include minor approved changes such as lateral relocation of the distribution box andloz 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 ox,any vertical relocation of any compoment of the septic system)but in accoxdauce with State&Local Regulations. Plat'revisioiL or ce6 ed as-built by designer to follow. (N OF Mgss oy . DANIELA. OJALA (Jnstaller's a gnature) U CIVIL M j No.46502 ky NAL (Designer's Signature) (Affix Desiguex's Stamp Isere) PLEAR MM..W TO BAD STABLE MLIO NAVY DIVISION. iERMOATE O1E? COMMTG't♦+ l•TM lR INSPER yND-1, BOOTH TM8 FOPM AND ALS-BUXT CARD .ABBE i. ,. c down cape engineering, inc. SIEVE SOILS ANALYSIS 279 MAPLE ST W. BARNSTABLE, MA DATE OF REPORT: 6/9/16 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 279 Maple Street West Barnstable LOCATION: DCE Test Hole SIEVE ANALYSIS Weight Sample(Grams): 112.3 SIZE ;WEIGHT RETAINED % RETAINED % PASSED ------------------- (sum ------------- --------------------r------------------ 1" 0.0: 0.0%: 100.0% - ------ ---------------- ------------- ---------------- -----�------------------- 3/4" ------------ - -A--------------0 0%:---------100.0% 1/2" 0.0: 0.0%; 1000% -------------=--------------------_ ---------=-------------;------------------ 0.0: -----------------------------------------Y--------------------- ------------------ #4 0.0: 0.0%: 100.0% -------------� -------------------- --a---------------------------------------- #10 6.1' 5.4%: 94.6% ---------------L...........................I---------------------------------------- #20 27.3j 24.3%.............75.7% ------------- -------------------- -------------------- #40 ......................... #50 78.5; 69.9%; 30.1 ------------- ---------------------- •---------------------------------------- #80 99.6: 88.7%: 11.3% ---=--------- ------------------------------------------------------------------- #100 -------------------104.1-%-------------92.7%1-------------7.3% #200 110.2; 98.1%: 1.9% _ --------------------------------------- PAN: 111.9: 100.0%: 0.0% •-----------•-,•--------------------------T---------------------- •--•-------------- SAMPLE: : 112.3: NOTE:TEST ON PASSING #4 ONLY, 2.3% RETAINED ON#4<45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL AND SAND)(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98% SAND 1 OF RESULTS: PERMEABLE MATERIAL- CLASS 1 <2 MINAN. MATERIA i NONCOMPACTED °� DANIELA SOIL DESCRIPTION: MEDIUM/FINE SAND &GRAVEL IViL No.46502 GISTSYL �o�sS ONAL NG\�� Town of Barnstable Department of Regulatory Services Public Health Division Date_ IV) MASS. ITTI x699• 200 Main Street,Hyannis MA 02601 7Q1 • rEp MA't A t.ax Date Scheduled ( 0 -�h-m Tune Fee Pd. !w� Soil Suitability ,Assessment for Sewage Disposal Performed By:. Din l C7��q �(/e Witnessed By:_ - 1. LOCATION& GENERAL INFORMATION Location Address +t`?9 M-4 PLC- S w Owner's Name A05V d Address Assessor's Map/Parcel: " ®4-7 Engineer's Name NEW CONSTRUCTION. REPAIR X_ Telephone � � %r 8T7S C.C.E. Land Use a lN✓/ Slopes(96) I v Surface Stones .. ol�'e Distances from: Open Water Body 7(00 7 BOG ] G� P y / ft Possible Wet Area ft Drinking Water Well ft Drainage Way l t Property Line y ft Other {t SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Pa rout material(geologic) Depth t4 Bedrock / P Depth to Groundwater. Standing Water in Hole: I�� Weeping from Pit Fna,/ Estimated Seasonal High Oroundwater Method Used: DE7[`E l.V ATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing In obs.hole: In. Deptli to Soil mottles: Depth to weeping from side of obs.hole: i►i' Index Well Q !n, Groundwater Adjustment ft•Reading Date: Index Well level_ Adj.thetor Adj.Groundwater Level Observation PERCOLATION TEST bate Hole N Time at h" — Depth of Perc Time at 6" Start Pre-soak Time Q Time(9"-6") '�^ End Pre-soak Rate Min./Inch . eve CZ . L2"',o1/T1,,(h Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN).A/ Original: Public Health Division Observation Hole Data To Be Completed on Back---------= ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\S EPTIC\PERCFORM.DOC DEEP.OBS]ERVATIONGOLE LOG Mole# Depth from Soil Horizon Soil Texture Sdil Color Soil Other Stuface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. onsistency,%t3rayell 0--36a ; l 3 -ya 90- 5� A /1, 0- 7z ,S_Y 1513 7Z- 14 Cz y ' ]DEEP OBSERVATION HOLE LOG Hole# ,Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. c onsis err % ra 32--3S S L IOti�R`�/z 3 X-S-1' 6 S L 0/0 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c O DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color gull Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consl to Flood insurance Rate Mau: 1 / Above 500 year flood boundary No— Yes Witldn 500 year boundary No J+ Yes, Within 100 year flood boundary NO Yes Depth of nturaHv Occurring Pervious Material Does at least four feet of naturally occurring porviop material exist in all areas observed throughout the area proposed for the soil absorption system? \/Lo If not,what is the depth of naturally occurring pervious material? —-- ,- Certification I certify that on� Z (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 10 CMR 15.017. Signature DMe/0A- �s Q:\SEPTICWERCPORM.DOC I - Nov 21 1146 BN'85 L-.s UES Po q '0' dam' y A/y � Q $oe o9e yow ♦ s ^ i vNsr 3So9 j Loc� MAP MAP 132 PCLS � JouN F. >; IJa11cY A. 7—NE. 2F Las' AAICUTOwI,- a.2 Ac. ♦ PLA`J of L&IJa '44q 2`o�` v' So .0, �- 8�121.ISTLI.BLE-�u/FST) �S♦ A Ji 4♦ Q cm• 2 l�ul Ll P 1'-1• £ 'BA.e76AV- P. GOULDI �� 3' Q Poe_ o� �� E^ ��� 5'yy g IT SCALG. 1`e6. tteY 2G Igg4 \ 3i�s�{ao^�w� �ryooa ;`' µ ,C38o2 q s°5.�23 6 R eaISTE2c=a LnNp Su2vsyrns �9`----' ` e$�/ ostt�a/ILLt. n.cAss. Tµe VIJDEfL51GNED 'BEING A 44AIO¢I'rY OF THE 'g—WAISLE R- WWI-L T3- c CE¢PFY /, •V1 `, Li ,✓.'4�.e1 1NAT T15 APVZWAL OF IWIS FL N µ QI G cH AS "^-IJ MODIFIED,AMEND2D / ♦` `p i'!c 02 ZaSCJ WT�D 11oR T11E R.nW C0114-D 6 4 sn�`� - _ �� S S6 Q•2s 8A¢IJSTA3l.E pl-ANh(IIJG '8oA20 01A. 09 ti 3 N I Ga¢n FY Tl1AT Won CE. OF PFVR vAt_ U � lii AOPQp�w> UNDGn ME SUW WISIorJ of TJIS P—'BY THE SAQOMIAB RANUIL4 �-y \�� P\✓ n_oa Ro IJAS EI.:EIJ RL.CIJV6-D—1. r�eC .— D GOl1TROL LAµ S )/� aT TH 25 OF1. AHD - , —YS WAS. p '♦/ QJ _ _...I. Da T6 APP RONEO.fY�•�l"/9P� Qt�G�.Vb'D II-1 Tile TNT Nry Ll'>`/5 4 V SS k'.Qyl'liT y DATG st6w.p / TD SI.CN Rwi>=I F'1' A D RGGo2�gJ � � $a2 NSTAC�E TauN CtE21L ?(���^'♦—"\//�� cl,._a� AyiH.:l.nxur!:nla,u;;cta:��,. �vVVV . V 1 C6RTIF`/ TIJ.AT nJIS PLA14 VLan !?'C:�: itlfv t9sNi1.. HAS Tdl?.t=AI PRC_PA2tn 11�1 d�011o' G OIJGO2MIT-/ W,TIJ T14612a- AND RE6Vl-ATIONS OF tNE IzrzcST-Erizs or'Dez-bs. OITE led , A-- 5/3/6s _0 Alael- ZsF'. BIG 229' Ft.81, Pv 2S1•'1 pG.41. 4 oT?/o S2264 -'-_ 9 7 TOWN OF BARNSTALLE ,LMN SEWAGE #_ � VILLAGE ASSESSOR'S MAP LOT ),3. _ Q V "? INSTALLER'S NAME PHONE NO. - a::r,® SEPTIC TANK CAPACITY aaPy LEACHING FACILITY:(type)�^ (size) ovo ^ NO. OF BEDROOMS _- PRIVATE EL OR PUBLIC WATER BUILDER OR OWNER ,, Qa _, DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �, en Illo ..�?�.. FF,.B ...$....2 a.Q.Q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------......`I'.O.Wn..................0 F.......Barn.s.t.ab-Le.................................................... Appliration for Dhipoii ai Works Tonstrurtion rrntit Application is hereby made for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at: ..........2.79 Map.] 8.ii. t...W1OZ t...Eax n t.ab 1 e .......-----•-------------------------------------------------------------------------•----------- Location-Address or Lot No. •---•-..--Barbara Goulding..---• .... - --------------------------------------------•------------------............----•---....•. Owner Address a .......... ...................................................... .................................................................................................. Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling X No. of Bedrooms.............3.............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ................................. .Q .._....... W Design Flow............................................gallons per person per day. Total daily flow..._........._............................._gallons. WSeptic Tank—Liquid capacity............gallons Length_............. Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date.-------------------------------------- Test Pit No. 1................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_-____-_-___-----_--_--. -------------------------------------------------------------------------------------------------•-.----•---------------------------------------------------- 0 Description of Soil..................................................................................................-------------------------------------------------------••--------.... x Sand V .............................................. •........................................................................................................................................................ ---------------------------...............................................................-----------------------------------------------------------------------------------------------------------•. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -----------------------------------•----------------------------------------------------•---•...................1.=.1eaah...P Lt.......................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IMZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. eY........... 715_/_.8.8 ........ Date Application Approved By............... ------.----------------------•--•........---------------....---•-- .. -- Date Application Disapproved for the following reasons:................................................................................................................ ---------------------------------•---------------------------...-•----......-----------------•------......__.....--••--......-----••-------•-------•-••--•------------._.....--•--•......._..------------ ^ /\l Date Permit No.--.. .S...l.......- ._. Issued----•------------------------------•----------------•-- --...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......tit;?.t''t t.z+ I I Appliratinn for Uhipnaaal Works Toustrnrtinn rrmft Application is hereby made for a Permit to Construct ( ) or Repair (y�X) an Individual Sewage Disposal System at: ...................................`...j.... .....:�� J i...� � ':C.3'.il .............................................. ....................................------. Location.Address or Lot No. ...........I'.'ta-r.3 r;3..CL".0 r1i_:1.g........................................... Owner Address ;T ? Na -----.--•.............................................. ........................••........................................................................ Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling X No. of Bedrooms.............3............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............... No. of ersons.........._......._......... Showers a YP g ------------- P ( ) — Cafeteria ( ) Otherfixtures ----................................................................................................................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date..------------------------------------. Test Pit No._J................minutes per inch Depth of Test Pit.................... Depth to ground water____--.._____-_-_______. 11 Test Pit.Vo. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._._-_____-_--_--_-____. ODescription'offS'oil........................................................................................................................................................................ �4 Sand V -•-•------•----•--•--------•---•-----------•--•--------•---•.....................................•-------------........-----------............................................................. ----- ---------------------- ---••••-•-------•---------•------------•---•--•--•....••-•••--•--------------••--•-••---•-......---•••......-•-••........................................................ U Nature of Repairs or Alterations—Answer when applicable._____________________________________________________________________•___-_-_---•__-_--.__-___. -------•-- ----------------•-----------------------•-------......------------------......------------------.....1_-..e ch---�1t•`---------------------------------•----•------•-------• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT$.,;• p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. 1 -' 7 -----•-----••- -Dat G Application Approved By.............. .:.� •------•....................................• � Date Application Disapproved for the following reasons:----•-------------------------------------------•------•------------------------------------------......-------- -----------------------------------•-----.............--------.......------------..............--•--•---••--•---------------••-................................................. ...................... c: ''- `l Date Permit No.._.... -----t!a --------------- Issued.--------•-•------------------------------•------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Bat:IZ.StaloI.e ..........................................OF..................................................................................... Tuertif irate of ToutpliFatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (' ) X be at.........Z73••_,4a.,le Street West Barnstable1e --------------••------•-•----------•----•••.....--•-•-------•-•----•-• .. ............... ----------------------------------------------•---------------- i has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code s be i in the s, application for Disposal Works Construction Permit No..___ .�.-..�...... :''... dated__....__._.. �__ __ TIME ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE----•--•----.... -= 7A.6...................................... Inspector...------.... .........=............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' rl'at'Jn BurrlStab�G' No.......... = �� .......OF............................................................................. ®.o® FEE........................ �i��rn��a� nrk� �nn��rnr�ilan rrnti# _� Permission is hereby granted................J_e_P.Macomber . ..-- to Construct ( ) or Repair (x4yan Individual Sewage Disposal System at No........... Mamie_..Stlteat...West---Barnstable Street L j�> ,' as shown on the application for Disposal Vl orks Construction Permit No..................... Dated.._.__ � --_-...•.•_.._.__. . .._.__....� /> ------------- ^DATE.......... L:s .............................................. Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS `i;ti"•., b 4 AsBuilt Page 1 of 1 TOWN OF BARNSTALLE LOCATION YW 121L_( _ ` �K� SEWAGE # VILLAGE ASSESSOR'S MAP & LOT 13:2 INSTALLER'S NAME S& PHONE NO.�_ � SEPTIC TANK CAPACITY pn LEACHING FACILITY:(type)____� (size) o00 NO..OF BEDROOMS��PRIVATE EL OR PUBLIC WATER r BUILDER OR OWNER �ic+in DATE PERMIT ISSUED; DATE COMPLIANCE ISSUED; -7 VARIANCE GRANTED; Yes No 1 1 1 i a i 01 � tz http://issgl2/intranet/propdata/prebuilt.aspx?mappar=132047&seq=1 9/14/2015 o -7 � - LO- CATION �. SEWAGE PERMIT NO. VILLAG 1 32-0ti 7 INSTA LLER'S NAME i ADDRESS P 3e �- d -r= mew. UILDE R OR OWNER aoo DATE PERMIT ISSUED G- � 7,f DATE COMPLIANCE ISSUED ,.._ ,� . - -�� it j '� M I� � �� �-:- � � �-_. ' ti "r _f 0 s f: No...............1.... 13�- >F�$ ........... THE COMMONWEALTH OF,MASSACHUSETTS "�7 BOARD � LTH t J�jf. .-..__. .._.[1....................OF...... �VVliration for Bi-spniiFal Works Tomitrnstinn Premit. Application is hereby made for a Permit to Construct (�) or Repair ) an Individual Sewage Disposal �^ Loc lion-Address ._...Vov� Z 4.... ......•---------- ..... . . --•- `• .. �1!t�lR .............. ..--••----Owne _.........-••-------------------Address a ...................lam.--. . . ----------- .._..---.._ .. ....-----•-•-- .......----- ...---------........--------------------... Installer Address Q Type of Building Size Lot............................Sq. felt Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons........................:... Showers — Cafeteria 04 Other fixtures -------------------------------- . . d ------------...--•-------------- Design Flow.................(X�r_.......... .gallons per person per day. Total daily flow--------- __..__ ....................gallons. WSeptic Tank L Liquid capacity/.__.gallons Length-------_------- Width................ Diameter................ Depth___--__-._--___. x Disposal Trench—No. .................... Width.................... Total Length........... _.._... Total leaching area....................sq. ft. Seepage Pit No........I.......... Diameter........ -..._ Depth below inlet.......�..._._. Total lea hing rea_3. q...sq. ft. Z Other Distribution box ( ) Dosing t nk ( , ) d , 04e"Z S' Percolation Test Results Performed by..... 4424.". ...!...................................... Date.. f4-:n.7& Test Pit No. 1....jr_"__minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 ........... - .............. ........ -•--•---- --------- O ... . - 2^I �` '".._.2.b..__.....y_. ..._...._. ✓ ,� ........ .�'... ."'/:�P.....15 !al.� x Description o Soil----_---- .___....�...... ........... - -�--� -.�--a--------------------------------------------------------------------------------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable...._........................................................................................... --------------------------------•-••-----------•---------------------------------------------------•-----•------------------------------•-------------•-•............................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi:Z; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. gned. ; ......................... ................................ / Date Application Approved BY f= Z.. �f - ...4j --/ — 7 - Date Application Disapproved for the following reasons----------------------------•--•----- -------------------•---•----------------•--------•----•-•---------..•---- 0 ....................•----------------•--............-----------------------------............---•----------••••-•--•---••-•------....---•---------•---------------------•-----------------------•------. Date PermitNo--------------------------------------------------------------- Issued.-- ..................... Date i' /1107'E /F E/ y-NER 7-q,E SEP7 rA.,VlK OR �O FT. M/N. i�ACfrr�G P/T ARE /10RE rHA,k✓ /2",8ZLOW /O FT. M/A/ ?4 **VIAMET.ER C0NC'M-=7-,C- COYER SJ�AGL BE /9ROUGHT To GRADE.�frN 6X7`RA r CONCRG7'E 'p"PVC P/PZ H,-=,4VY CA ST /RO/Y CO N7/N. P/7Cq /P /N ;DR/VENAY E'1_LFV. 1 02-1 COYER,S� Yg"PER Fr. e.•. s' p M/N. CD/VCR�TE ' - CrR.M1OB CU VER CL EA/V 'SAND A ! eA CA,'1 /LL- +. .:_�, _ L/QU/O LEVEL c r/ i 2"LA ER i � oOF /RON p I SC? O GAL. o •��, f • • • r • • + • o o4a WASHED STt7NE •o-4 MIN. P/TCH p/ST. ♦ • r • • + + n A • x.: . ._;.•'` V4"pern 1 r. SEPT/C TANK p oX 4 F n • • • • • ► .°p a d P • + + •EFFECT/VE ► • + 314 ' - I //2" �,: o D ° � , t • p,F�7J-/ • ♦ � +` • o o �S/�'ED STON E p:::..-4, o a • PRECAS T SEEPAG 1 4 -r r► a• e rat;• o • • ♦ • + p. �L E. 4-. �1 a ♦ p , + +t • • • . . + ♦ ' a a P/7 OR SOLI/V. lNverrr &LEVAT/oNs f __ . �_._ 40 6 IGT PIAM. /NYERT AT B!J/tQ/NG 9}Q FT. �"�"� /A/„/ �C(SEr T.�IBU-A7- I V44=7 SEP7-IC y"A/1/K q 3_,S F7 ►- - - . FT r- O/./TLET SEPTIC 7:ANK 9' 3.3 FT ' -- '- /N,LET O/STR/191JT/ON BOX Z r g`FT. SECT/ON OF" GRD�Np N�'�ITfR TABLE ouTLETD/sTR/Bar/oN Box`3 2-.7 FT SEI�t/AGE 015POSA L SYSTEM //1/LE7 LEACH/Na PIT FT. TABULATlL7/Y;. LEACH//VG F'/T "' DiMENS/ON AFT. DESf GIV Cft/TER/A 0,Ay r-N5/c n/ 8 f T DIMENSION C��..FT. M //.l. /VtlMBER OF BEDROOMS 3 so/L- L.DG G.ARQ,4GZ A/SPO.SAL UN/T 7- TUTAG EST/MA7"EO FLOW �O GAL.�D.4Y SOIL 7E57 #/ SOIL TESTP S �� T 07A ER OF LEACHING P/T.S_ �._ �^FCE�K IDO,O ELe 1!_.! 5�_ DATE OF Solt — $/L7F 1�°tACNl,vG PEft P/7 2Z SQ FT. r J4EStJL TS /�//THE SS BY gip._Qv''/'' CORM A LO R�l t� PtRCOLAT/ON x'�4.7E / Jam, M!N►//KCH ®OT"y'OM L6iACX/NG pG°R PI7' //3 SQ• FT S ci9 5 ty r L � S'b!3 S 0 r L TOTAL LEAGf/!Nti AREA 3�SoFT. _21 1 PERCOLATION RA 7-A!' ---+� ,$'AWD - 2 SstNA Rl 54FXVELEAC'IV//YGAREAS4. FT. wrTf•/ !-r/l h- 9NES GD UL C) Qr MA T1L,,55- 5 T - M�O, s�%vo MD. 5-4n/P A lZn/S7-A 6 ROBBERT � A_ SIVAtEs E sron/E� N/GST LLE ,8 SUNIKIS No.72tsz .a ; ELAREDGE ENGIIV.EERINCV CO.,INC. t 7/2 M,ArN Sr33 NG,M 3"'r• r$'` ,�,1''; Z EL, ' �3 �L_. SAS. HYANN/3, MR SS. SO. Y,gRMOC/TX►MAJ3 ENCOUNTEl�EO -__....�_..,..... .._ JOB NU. 78 0�3 SH=_4 �� -OF ?�... A v g n` 0 I r, Tr S �'ommonwealth of Massachusetts � i EP 1 �of,EnvironmentalAffairs l DER (}}I . �r Departm int of E'nvrionmenkal Protection SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION W2S � Property Address: Address of Owner: Q" NVY`4-1 (if different) °�'` �` -1 L\ Date of Inspection: �' r ' °2` C Name of Inspector: Michael DeDecko Company Name, Address and Telephone number: Atlantic Environmental P.o B ox 2384 - M ashpee M a 02649. Tel : (508)4771420 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 inspection . The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system -Y\ Passes --- Conditionally Passes ---- Needs further evaluation by the local Approving Authority ---- Fails Inspector 's S igna e: ate: 9 S The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. { SUBSURFACE SELVAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: a'C ' Owners : Cgss� + Date of Inspection : ct INSPECTION SUMMARY: Check A, B, C, or D A) SYSTEM PASSES: -- I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM R 15.303. Any failure criteria not evaluated are indicated below B) SYSTEM CONDITIONALLY PASSES: ---- One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determinate (Y,N, or ND). Describe basis of determination in all instances. If"not determinated",explain why not. ---- The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration ,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven . distribution box. The system will pass inspection if (with approval of the Board of Health). ----- broken pipe(s)are replaced ----- obstruction is removed -- distribution box is levelled or replaced ---- The system required pumping more than four 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 C SUBSURFACE SELVAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address : 3L71 11 Owner : Date of Inspection: C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---- Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system is failing to protect the public health , safety and the environ- ment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ---- Cesspool or privy is within 50 feet of a surface of water ---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. ---- The system has a septic tank and soil absorption system and is within 100 feet to a. surface water supply or tributary to a surface water supply. ---- The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. --- The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. ---- The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analy- sis 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 notrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: -- I have determined that the system violates one or more of the following failure criteria as defined in 310 CM 15.303. The basis for this determination is identiied below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: a1' � Owner: Date of Inspection : D) SYSTEM FAILS (continued) -- 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 over- loaded or clogged SAS or cesspool. --- Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. --- Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary to a surface water supply. ---Any portion of a cesspool or privy is within a Zone I of a public well. --- Any portion of a cesspool or privy is within 50 feet of a private water supply well --- Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality ana- lysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. L Y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Q,sSt At',► Date of Inspection : E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flow of system is 10,000 gpd or greater Large System and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist : --- the system is within 400 feet of a surface drinking water supply --- the system is within 200 feet of a tributary to a surface drinking water supply --- the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA)or a mapped Zone I I of a public water supply well The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CM 5.00 and 6.00. Please, consult the local regional office of the Department for further information. L SUBSURFACE SELVAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address a-) Owner: Date of Inspection: Check if the following have been done : -x Pumping information was requested of the owner ,occupant and Board of Health. --x None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N/A. --x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. --x All system components,excluding the Soil Absorption System,have been located on the site. -•-x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees,material of construc- tion, dimensions,depth of liquid, depth of sludge, depth of scum. ---x The size and location of the Soil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods ---x The facility owners and occupants if different from owner were provided' with information on the proper maintenance of Subsurface Disposal System. i f s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: RESIDENTIAL: Design flow : gallons Number of bedrooms : �} Number of current residents: 012-- Garbage grinder (yes or no) : r3 c�, Laundry connected to system(yes or no): Seasonal use (yes or no) : N-_�o Water meter readings, if available: ti A Last date of occupancy : COMMERCIALANDUSTRIAL : Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present(yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings, if available : Last date of occupancy : Other: (Describe) ............................................................................................................ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information ' ` System pumped as part of inspection (yes or no):....... '�.... if yes,volume pomped : .................... gallons Reasonfor pumping:............................................................................................................ I J1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of inspection: TYPE OF SYSTEM Septic tankldistribution box/soil absorption system --- Single cesspool --- Overflow cesspool --- Privy --- Shared system (yes or no)(if yes, attach previous inspection records,if any) --- 0 ther (explain). ......................................................................................... APPROXIMATE AGE of all components, date installed (if known) and source of information ............. lam ... `'�.?.. .��............................................................................................................................ ................................ Sewage odors detected when arriving at the site : (yes or no)��. SEPTIC TANK : . . (locate on site plan) Depth below grade: .......... Material of construction: ....... concrete ......... metal ........ FR P........ other (explain) ................................................................................................................................................ Dimensions: .................. Sludge depth:..C�......... Distance from top of sludge to bottom of outlet tee or baffle:.........�.`\............. Scum thickness:..cry............... Distance from top of scum to top of outlet tee or baffle: .............. ................................... Distance from bottom of scum to bottom of outlet tee or baffle :....�.y................ Comments : (recommendation for pumping , condition of inlet and outlet tees or baffles, depth of liquid level in rel ti to outlet invert,sttI ftwut egrity,yiden of leakage,etc.).... .... ............ ..... ... S ..,,.. .............. s�..�Z?1�CSi,,►�? `...�ruTr c��.\� ...... ... .. .... ............................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR T C SYSTEM INFORMATION (continued) Property Address: :;L 7 cl ttil► ��- �Q'; Owner. Date of inspection: GREASE TRAP: .......L44D. (locate on site plan) Depth below grade: ............... Material of construction: ........concrete.........metal........FRP........other(explain).... .......................................................................................................................................... Dimensions:............................... Scum thickness:........................ Distance from top of scum to top of outlet tee or baffle:....................................... Distance from bottom scum to bottom of outlet tee or baffle:............................... Comments: (Recommendation for pumping condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage, etc.)........................ ................................................................................................................................................ ................................................................................................................................................ TIGHT OR HOLDING TANKS:....���7. (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FR P..........other (explain).......... ................................................................................................................................................ Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches, etc.) ................................................................................................................................................ ................................................................................................................................................ 9 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: a-1`i Owner: Cc Vs t-PA) k Date of inspection: c ' DISTRIBUTION BOX:.s4--_S (locate on site plan) Depth of liquid level above outlet invert:.'?5.0 ...4 Comment: (note if level and di tribution equal eviden of ids carryover, evidence leakage into _ qf� or out of box, tc. x ...5� .. 6 k................. ........ .................................................................................................................................................. PUMP CHAMBER:J.-.\0... (locate on the site) Pumps in working order: (yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ................................................................................................................................................ SOILABSORPTION SYSTEM (SAS):... (locate on site plan, if possible; excavation not required, but may be approximated b non- intrusive methods) if not determined to be present, explain: ................................................................................................................................................ Type: .................................................. -........................................................................................ leaching pits, number: ..!.. .6k leaching chambers, number:........ leaching galleries,number:........... leaching trenches, number , length:..................... leaching fields, number,dimensions:................... overflow cesspool, number:.......... Comments: (note ondition of soil, signs of hydraulic failure, level of ppoding, conditipn pLmo9 etation, . .i.o .. ..c' �.. ... est- \ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property address: Owner: CO3SS%F.t Date of inspection: CESSPOOLS:... C . (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: ..................... Indicator of ground water: .................... inflow (cesspool must be pumped as part of inspection) ................................................................................................. .......................................................................................I......... Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ................................................................................................................................................ ................................................................................................................................................ PR IVY : ....K)S3.. (locate on the site) Material of construction: ................................... Dimensions: ...................... Depth of solids: ................ Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). . ................................................................................................................................................ ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : a1'i Owner: Date of inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100' DEPTH TO GROUNDWATER: Depth to groundwater: !.�..feet Method of determination or approximative: ... -- .: .`.� �,........................................................................................ ................................................................................................................................................ f � �� l =-_.. piINC T The Town of Barnstable Health Department { " MIL9 ° 367 Main Street, Hyannis, MA 02601 1639. ■MD Office 508-790-6265 (f Thomas A. McKean FAX 508-775-3344 3 Director of Public Health June 24, 1993 Philip & Barbara Goulding 279 Maple Street West Barnstable, MA 02668 RE: Underground Fuel Storage System located at 279 Maple Street, W. Barnstable and listed as Assessor's Map 132, Parcel 047 Dear Mr. and Mrs. Goulding: Our records indicate that you have a #2 fuel oil underground storage tank that is presently unregistered with the Health Department. You are required by the "Health Regulation Regarding Fuel and Chemical Storage Systems" published in the December 17, 1987 issue of the Barnstable Patriot, to register your underground tank(s) with the Board of Health. Please complete the enclosed Registration card(s) . Include any evidence of the date of purchase and installation, a copy of the permit from the Fire Chief, and a sketch map showing the location of such tank(s) on the property. Upon entire completetion of the Registration card(s) , you will be issued a brass valve tag(s) by the Board of Health. These valve tags shall be picked up by you or your representative at the Health Department located in the Barnstable Town Hall. The tag(s) shall then be attached to the filler pipe/cap of the underground tank(s) . Please return completed Registration card(s) to: Town of Barnstable Health Department, P.O. Box 534, Hyannis, MA 02601, as soon as possible. You are required to comply with this regulation by July 2, 1993. If you have any questions, please telephone (508) 790-6265 for Donna Miorandi or myself during office hours. Office hours are Monday through Friday from 8:30 - 9:30 a.m. and 1:00 - 2:00 p.m. PER ORDER OF THE BO D OF HEALTH . McKean Director of Public Health a y J i t ' l T I PAR Real Estate System - C,r�nE-eral. Frcaperty IngUIry F-eIU) F,arcel Id- 1.32 047- - Account 1'4a, '71.424 Parent Locati.can= 279 MAPLE ST' W BARNS Neighbc.*jncocc!- ia`!At: Fire Dist'. WD Devel Lot' I Lot Size. 40 o Acres t:'Urrent Own." GOULI:IING, P1_IILIP H State Classg 1 01 BARBARO P Gtr..1UI...D3:NG No. Bldgs= 1 Area." "7:9 !`1r`'-PI....E_ S'T Year Aciciecla JanU ary 1.stu G(Mi__'L;aING, !='h• ILIP H Deec-I 111"li:)M 0000 Deed Ref 2517/6, Values" Lando 80'80(_) Buildings. 81. 100 F ::tra Featuresn 200 Road System: 257XX Incle::::a ' 67 (MAl'='!._E STREET i Farntq-' 20 Inde::,:u t Fr•,nt:g« Control Info.' Last Auto EJpd.- 09:L'?5-rl-' Status.-, C Last TACS UI di.-ate; 1 031.8ED Lai--id Reviewed By". Date. 0000 B l dg s Reviewed By ! Date' . 000�:; I-ax *Title.' Account' Taken Account Status. Hold Status- t:'anceI F='r-•ess XPIT for more data I\le::.::t screen PAR Ac t•:.ioi Owners Name SME:Ad KEEPING YOU ORGANIZED No.10334 2453L IV1,49E IN USA GET ORGAfUM AT SMEAD.COM * � 1 J � 1 h j AZ 4, 1 \ TESoz ' \ 0 e '.• f � v 4 � s ' ' 'S. �� /Sop rlML r% 12 ' Z'P C i t 4 r.✓ J i o r W i , r � I i ! i ry s T 0014 R jy,C T"Zo ' ^4A SS s . DRAWN 8Y A rl !�' DA7.�ff M� /. c` /9 .SN Of yA O?/ j.OBERTi i t SC�)L.G- / ie✓. � •ICJ �'7; �r �. ��``� _ LJh 1 �c'T� E'n/G/R✓fie "R/�•'Ca- e.13.� INC , 9• wz - .j3 n/o. �a r� in/is /�' r)5.5• S -AA?A4 0(J7N, i ALL SYSTE SYSTEM PROFILE MARKED WITHC MAGNETIC TTAPEALL OR BE COMPARABLE MEANS FOR FUTURE LOCATION. 4 PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) o Ode ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 0� \ TOP FOUND. EL 41.9' FILTER FABRIC OVER STONE 6q spa 41.0' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 3E NOTE: 2" MIN. WALL PRECAST H-10 THICKNESS REQUIRED BLOCKS OR RISERS (TYPJ PRECAST RISERS 1_- SCw_"0pVC 2'0 4"OSCH40 PVC MORTAR ALL H-10 PROP. TEE PIPES LEVEL 1ST 2' COMPONENTS (TYP-) INV'S EL. 34 2 0 HENDS SIDES 35.0' � a� _7 ep 0 o CD *38.9' 10" 1500 CAL H-10 TEE -O®®� 38.25' TEE 38.0' °°°°°°°° SEPTIC TANK " o 0 0 0 0 "oc MIN. 12* INT. DIM ����������� ���®®®�®��� ° °o°o° 0 0 0 0 0 0 o c O o o °o°o o o 4' UO. LEVEL GAS anFFLE . o 605000000000 0c 6" MIN SUMP N i00000000 ®®®®®�®��0® a®ono®®o®®a o°o°000° ACME OR EQUAL ° �o_o°o°o°o°o o° i°o°o°o°o ®®a®®o®a®oo ®�®oo®®oo®a :ooa00000 , 34.67' 34.5' °°°°° °°o°°°°° 32.2 ill °°°° ° ° ° ° ° ° and o_h CLI �: •. .._... . : ... - : i Mill et �60 o°°°°°o°o°o°o°o°o°o°o°ocH-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. Stleet s{re 4 O O O o O O O o O O O c3/4"-1-1/2" W H T N 4' MIN. F W DOUBLE WASHED STONE E F FLOW DEPTH 0 O O O-O^O^O O�O�O�O-O,O, (3) UNITS REQUIRED le TEE SIZES: � � � ALL AROUND PRECAST STRUCTURES MoP 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30.00' X 9.83' rx� INLET DEPTH = 10" COMPACTION. (15.221 [2]) N OUTLET DEPTH = 14" MIN. pp ( 2+ % SLOPE) ( 1 % SLOPE) ( 1 % SLOPE) 26.0' BOTTOM TH-1 FOUNDATION- 14' SEPTIC TANK 33' D' BOX 13' LEACHING NO GROUNDWATER FOUNDFACIL LOCUS MAP *THE INSTALLER SHALL VERIFY THE NOT TO SCALE LOCATIONS OF ALL UTILITIES AND ALL BUILDING SEWER OUTLETS AND ASSESSORS MAP 132 PARCEL 47 ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM NOTE: BUILDING SEWER PROPOSED TO BE RAISED TO EXIT AT VARIANCES REQUESTED UNDER MAX. FEASIBLE COMPLIANCE 15.405; ELEVATION SHOWN (PROVIDE MIN. 2% PITCH TO PROPOSED SEPTIC TANK) (1b): REDUCTION IN SETBACK, SAS TO FOUNDATION (20' TO 10') SYSTEM DESIGN; UNDER PROPOSED) (4): BREAKOUT VARIANCE REQUESTED (40 MIL TEST HOLE LOGS SEPTIC DESIGN: (GARBAGE DISPOSER IS- NOT Al I OWED ) VARIANCES REQUESTED UNDER TOWN OF BARNSTABLE HEALTH REGULATIONS: DANIEL E. GONSALVES, SE #13587 DESIGN FLOW: _3 BEDROOMS ( 110 GPD) = 330 GPD ARTICLE'I, SECTION 360-1: REDUCTION IN SETBACK, SAS TO WETLAND ENGINEER: - USE A 330 GPD DESIGN FLOW (100' TO 89') AND SEPTIC TANK TO WETLAND (100' TO 75') WITNESS: DAVID STANTON, IRS SEPTIC TANK: 330 GPD ( 2 ) = 660 DATE: 6/20/15 NOTE: VARIANCE REQUEST FOR SAS TO FOUNDATION AND SEPTIC TANK TO PERC RATE _ < 2 MIN/INCH USE A 15.Q.0- GALLON SEPTIC TANK WETLAND ARE APPROVABLE IN-HOUSE UNDER LEACHING: "PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED CLASS I SOILS P# 13729 2(30 + 9.83) 2 (.74) = 117 BY THE I BOARD OF HEALTH REVISED DURING A PUBLIC SIDES: HEARING HELD' ON DECEMBER 10, 2013 BOTTOM: 30 x 9.83 (.74) = 218 ELEV. ELEV. TOTAL: 452 S.F. 335 GPD O" `V 38.0' 0" V 38.0' USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) WITH 2.5' AT SIDES AND 2.3' AT ENDS 36" FILL 32" FILL NOTES A A 1. DATUM IS NAVD 88 /SL /SL 2. MUNICIPAL WATER IS NOT AVAILABLE 40" 1OYR 4/2 38" IOYR 4/2 APPROVED DATE BOARD OF HEALTH MA 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. B B 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS / / TO BE AASHO H-M /SL �SL 5. PIPE JOINTS TO BE MADE WATERTIGHT. 10YR 6/6 1 OYR 6/6 6. CONSTRUCTION DETAILS TO BE 'IN ACCORDANCE WITH 54" 33.5' 51" 3.75' 310 CMR 15.000 (TITLE 5.) USED', 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO /Ci1 /C 1 PURPOSE.FOR LOT LINE STAKING OR ANY OTHER SL W/SILT SL W/SILT UNSUITABLE i / / / / SOIL 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 10YR 7/4/ 32 0' 68„ 2.5Y 5/3 32 3' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED 72" WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. C2 C2 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING SIEVE DIGSAFE (1-888-344-7233) AND VERIFYING THE M/FS M/FS \ \ LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. » 2.5Y 7/4 2.5Y 7/4 \ \ 144 26.0 1 44 26.0 „\ 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE �� � \ LEACHING FACILITY. AND AROUND THE PROPOSED NO GROUNDWATER ENCOUNTERED / 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND / REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. \ EXISTING WELL I \ 6Z7.34 \ 0 CRANBERRY BOG 2 6 23 0 (S 3.95 / / / \ C114 •� � / // SHED � �4.17 / / 7 34.63 • • 35.12 35.01 • 0 (o i 26.74 • / 28 I 100, z 30 x 35.69 26.66 SHED c1 • 2 x�.-77 9.39 I O OH UTILS DECK /. . 1 /C, 40 �•• Z. x 31.42 7 _ .• �x SY. 9 x.29.7 EXIST. x 6. 9 DWELL. 4.5 LOT AREA: 4.2 ACRES x 31.46 �. TOP \ 1 x 0 PROVIDE APPROX. 110' �. �� 40. 3 j OF 40 MIL LINER AT 5' • ... ' - ...__.(LP �I � FNDN. EL. � � "`b 1 0.81 OFF, SURROUNDING � 26.86 • �\ 41.9 42 o SAS. TOP,AT EL 35.0', BOTTOM AT EL. 31.0'f l 9.80 x3@ 14 .�30:1Z_... .30.24 x 41.27 0 EXISTING 5' RE VAL OF UNSUITABLE SOIL REQUIRED I \ 30.14 SEPTIC TANK 40 x AROUND ERIMETER OF LEACHING FACILITY, TO SUITABLE SOIL LAYER. REPLACE I ` TO BE 1.9 WITH qN MED. SAND, TO MEET REMOVED �.� SPECIFICATIONS OF 310 CMR 15.255(3) x 41.53 0 1 i 0 KS x 30.81 *27.24 •'•• O ` a 4 1\ "' \ p 8 9 BENCHMARK: USE COR. p.\30.41 PRO K - ' CONC. BULKHEAD AT LINE 0 ST ED SP CE ` EL. 41.9' - SILT F NC E (T ) 1 " PROP. 1500 GAL. AK 30 5 SEPTIC TANK (N E: 26.74 • BUILDING SEWE TO v PROP. WORK LIMIT LINE\' BE RAISED; P OVID 9• SILT FOENCEAKED /*7.55 \ -o MIN. 2% ITCH F x\.96 �d �P �Q' 131 00' • 30.53 ��� • • • 27. \\�E • / '•� PROPER • CRANBERRY BOG •�.30.72 p,PPROX •� OPER Y UNE /:' x 7.84 x42 APPR�X•C N 76.0 �l2 .08 • • �S x 31.24 0.34 6 • 29.92 TITLE 5 SITE PLAN OF 279 MAPLE STREET WEST BARNSTABLE PREPARED FOR OF M CAPEWIDE ENTERPRISES/CHARETTE k�f�L M SH OF 41,18 ZM OF Mq N ASS off 508-362-4541y 4ssgc ��Lsgc ss�c ti o DANIEL I �' y o % o DANIEL s •■ fax 508-362-9880 �o DANIEL A. Gs DANIELA. r A. �, i JANUARY 12, 2016 downcape.com © o OJALA `� OJALA c A. • CIVIL a CIVIL OJALA OJALA JUNE 9, 2016 (LP, TH) No.46502 46502 No. q No.4.0980 , down cope engineering, Inc. r C%V%% engineers °�Fo, R�G�``� �0 S STAR �a�� ��ss aESS�°� ~ Scale: 1"= 20' rs S STE F S y S RVE 9 S� NAL 4)supl land surveyors a 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. 0 10 20 30 40 50 FEET YARMOUTHPORT MA 02675 15-287 CAPEWIDE A.dwg >5-287 a ALL SYSTEM PROFILE MARK SY DSTSHALL WITHCMAGNETIOMPONECTTA E OR BE COMPARABLE MEANS FOR FUTURE LOCATION. 9h S3 PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE o �c 2" PEASTONE OR GEOTEXTILE TOP FOUND. EL 41.9' FILTER FABRIC OVER STONE 69 eoao \ 41.0' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 38.0' NOTE: 2" MIN. WALL BLOCKS OR PRECAST H-10 THICKNESS REQUIRED RISERS (M.) 4'0SCH40 PVC MORTAR ALL PRECAST RISERS .. 4'SCH40 PVC 2'� COMPONENTS H-10 PROP. TEE PIPES LEVEL 1ST 2' (Np) INV'S EL. 34.2' ao� F- E HEio, SIDES 35.0 14• v000 ®®®® ®®®® ®®®®38.25' 50o GAL H-10 TEE 38.0 EPTIC TANK o 0 0 0 0 0° MIN. 12• INT. DI ° ®® 5r00 0 o O ° ®®®®®®®®®® ®®®®®®®®®®®4' UQ. LEVEL GAS BAFFLE.. o o°o°O°o°o°o° °e 6• MIN SUMP o° �o�o�o.°.o�o�o o.. >°oo oo ,ACME OR EQUAL , ° 00000000 0 034.67 34.5 0 32.2 and ,� t cus Will et 10�6 0 0 0 0 0 0• 0 �o 0 0 o c H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL flee 5tre DEPTH OF FLOW = 4' o°o°o°o°o°o°o°o°o°oo0,Ic 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (3) UNITS REQUIRED �oPle 5 ^ ^ ALL AROUND PRECAST STRUCTURES TEE SIZES: 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30.00, X 9.83' INLET DEPTH = 10" COMPACTION. (15.221 [21) OUTLET DEPTH = 14" J �o MIN. ( 2+% SLOPE) ( 10 % SLOPE) ( 1 % SLOPE) 26.0' BOTTOM TH-1 > LEACHING NO GROUNDWATER FOUND FOUNDATION- 14 SEPTIC TANK 33 D BOX 13 FACILITY LOCUS MAP *THE INSTALLER SHALL VERIFY THE NOT TO SCALE LOCATIONS OF ALL UTILITIES AND ALL BUILDING SEWER OUTLETS AND ASSESSORS MAP 132 PARCEL 47 ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM VARIANCES REQUESTED UNDER MAX. FEASIBLE COMPLIANCE 15.405; NOTE: BUILDING SEWER PROPOSED TO BE RAISED TO EXIT AT (1b): REDUCTION IN SETBACK, SAS TO FOUNDATION (20' TO 10') ELEVATION SHOWN (PROVIDE MIN. 2% PITCH TO PROPOSED SEPTIC TANK) UNDER 15.211 (1) (4): BREAKOUT VARIANCE REQUESTED (40 MIL SYSTEM DESIGN. LINER PROPOSED) TEST HOLE LOGS SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT Al I OWFD ) VARIANCES REQUESTED UNDER TOWN OF BARNSTABLE HEALTH REGULATIONS: DANIEL E. GONSALVES, SE #13587 DESIGN FLOW: _3 BEDROOMS ( 110 GPD) = 330 GPD ARTICLE I, SECTION 360-1: REDUCTION IN SETBACK, SAS TO WETLAND ENGINEER: USE A 330 GPD DESIGN FLOW (100' TO 89') AND SEPTIC TANK TO WETLAND (100' TO 75') i WITNESS: DAVID STANTON, RS SEPTIC TANK: 330 GPD (2) = 660 6/20/15 NOTE: VARIANCE REQUEST FOR SAS TO FOUNDATION AND SEPTIC TANK TO DATE: I DATE RATE _ < 2 MIN/INCH USE A .15.0D_ GALLON SEPTIC TANK WETLAND ARE APPROVABLE IN-HOUSE UNDER LEACHING: "PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED CLASS I SOILS P# 13729 2(30 + 9.83) 2 (.74) _ -, u HEARIiNGBOARD ON DECEMBER REVISED 10, 013 RING A PUBLIC SIDES: - _ BOTTOM. 30 x 9.83 (.74) = 218 � ELEV. ELEV. TOTAL: 452 S.F. 3_GPD 0" `V 38,0' 0 38.0' USE 3 500 GAL. LEACHING CHAMBERS ACME OR EQUAL) WITH 2.5' AT SIDES AND 2.3' AT ENDS NOTES 36" FILL 32" FILL A A 1. DATUM IS NAVD 88 /SL /SL 2. MUNICIPAL WATER IS NOT AVAILABLE 1OYR 4/2 1OYR 4/2 MA 40„ 38„ APPROVED DATE BOARD OF HEALTH 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS B B TO BE AASHO H-Q F1OYRL /SL5. PIPE JOINTS TO BE MADE WATERTIGHT. 6/6 10YR 6/6 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH .75' 310 CMR 15.000 (TITLE 5.) 54" 33.5' rj1" 3 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO /C 1 /C 1 BEUSEPURPOSE.FOR LOT LINE STAKING OR ANY OTHER SL W/SILT SL W/SILT UNSUITABLE i i i i � SOIL 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. i i i 72" 10YR 7/4 32.0' 68.p 2.5Y 5/3 32.3' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. C2 C2 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING SIEVE M/FS M/FS DIGSAFE (1-888-344-7233) AND VERIFYING THE \ LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES • � PRIOR TO COMMENCEMENT OF WORK. 144" 2.5Y 7/4 26 0' 144" 2.5Y 7/4 26 0, \� \ 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE `\ REMOVED 5' BENEATH AND AROUND THE PROPOSED ` LEACHING FACILITY. NO GROUNDWATER ENCOUNTERED // \� 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND / \ REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. / / \ • \ EXISTING WELL I \ \ �7.34 \ O \ . A CRANBERRY BOG 2 16 \ \ 0 '59, A�0 � F 23 0 rSc 23.95 SHED Y 4.17 / / 7 • 34.63 35.12 / • %/ i 35.01 i i 26.74 28 0 // � is ��• / I 100, / 50 x 35.69 26.66 OH . / SHED CD/ x 39:77 UTILS 9.39 O DECK ••\ � � � gS � ! x 8.25 • 40 Q 9 x 29. \ �1 X 6. ' �- / � \ ••`` � •• EXIST. a�•. � 9 / 1 DWELL. x 04•S PROVIDE APPROX. 110' [LOT AREA: 4.2 ACRES • x 31.46 �. �.• TOP 40. 3 OF 40 MIL LINER AT 5' • P�1 `\ FNDN. EL. ^�� 9 0.81 OFF, SURROUNDING' 42 26.86 • 41.9 o SAS. TOP AT EL. 35.0', -�� L BOTTOM AT EL. 31.0'f 1 9.80 I x..�g•.I•gr___-...-N-30:a.3-•-...-yc.3 0.24 I x 41.27 0 EXISTING \ 5' RE VAL OF UNSUITABLE SOIL REQUIRED 40 \• SEPTIC TANK AROUND ERIMETER OF LEACHING FACILITY, i �30.14 TO BE 1.9 x TO SUITABLE SOIL LAYER. REPLACE WITH N MED. SAND, TO MEET REMOVED SPECIFICATIONS OF 310 CMR 15.255(3) i \ ♦` Q,... 0 KS x 30.81 x 41.53 (0L1 V� 27.24 ••,. OO ``` x x i • •• �\ P 8 9 BENCHMARK: USE COR. •p1\30.41 PRO K SP CE 4 CONC. BULKHEAD AT LINE 0 ST ED ♦ EL. 41.9' SILT F NCE (T ) PROP. 1500 GAL. ' AK o 5. �26.74 " SEPTIC TANK (N E: BUILDING SEWE TOLINE PROP. WORK LIMIT / • BE RAISED; P OVID '9• SILT FOENCEAKED 7.55` MIN. 2% ITCH F �P� x 30.96 mod, ) I\eA 30.53 • 27. OPER • CRANBERRY BOG PPROX P� R Y UNE : X 7.84 `'•. PROPS / APPROX• [31.24 .0' �l2 .08 �42 SCA • ' 0.34 \ 6' �lU� ` \•x 78 OOO, • • 29.92 J TITLE 5 SITE PLAN OF 279 MAPLE STREET WEST BARNSTABLE / PREPARED FOR CAPEWIDE ENTERPRISES/CHARETTE �N OF Mgss off 508-362-4541 cP��H of Mgss �� 9 N°F Mgs c s,`��.js-� ASH°F Mgss �� q�y o`' DANIELA. yGs C` DANIEL Any JANUARY 12, 2016 I fox 508-362-9880 0 � DANIEL OJALA A , -DANIEL s downcape.com © o OJALA �, A. ( ) U o CIVIL OJALA o ) JUNE 9, 2016 LP, TH CIVIL LJA\ down cope engineeri!!B, MC. No.46502 46502 �No.409 OJ 0980„ PO �F �� ��� 0'c S T E¢ �a ( F�S S a OAP » > civil engineers �F S�'/STE NG,� F� s� you Scale: 1 = 20 land surveyors S (°NAL -I6 uR 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. 0 10 20 30 40 50 FEET YARMOUTHPORT MA 02675 15-287 CAPEWIDE A.dwg i li L I II