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HomeMy WebLinkAbout0060 MEADOW LANE - Health j601Vleadow � 3 -�L - �wks v II l� e o a ------------- Z UPC 12034 H4TWG&UN } 0 /� 60 Meadow Lane"W. Barnstable • a I I p 0 1 a �s i oz CERTIFICATE OF ANALYSIS Page: 1 y TOWN �1� Barnstable 6untPffialffiELEboratory _ W te��5/1 /�03: ' Report Prepared For: J Order No.: G0530082 Susan A.Aalto 253 Nottingham Drive 51V1S N .Centerville, MA 02632 Laboratory ID#: 0530082-01 Description: Water-Drinking Water Sample#: 30082 Sampling Location 60 Meadow Lane,W.Barnstable,MA Collected: 5/9/2005 Collected by: S.Aalto Received: 5/9/2005 Routine ITEM RESULT _ UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen BRL mg/L 0.10 10 EPA 300.0 5/9/2005 LAB: Metals Copper BRL mg/L 0.10 1.3 SM 3111B 5/12/2005 Iron 0.30 mg/L 0.10 0.3 SM 3111B 5/12/2005 Sodium 25 mg/L 1.0 20 SM 3111B 5/12/2005 "LAB:' Microbiology Total Coliform Absent P/A 0 0 307 5/9/2005 LAB: Physical Chemistry Conductance 110 umohs/cm 1.0 EPA 120.1 5/9/2005 pH 7.4 pH-units 0 EPA 150.1 5/9/2005 Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a physician. The m water may present aesthetic problems(taste,odor,staining)due to Iron. -� Approved By: Director) RL = Reporting Limit. . MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r 5 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION F ti Q sy° David B.Mason,RS,Certified Title V Inspector,508-833-2177 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:60 Meadow Lane West Barnstable,MA Owner's Name:Edward Clough Owner's Address:60 Meadow Lane West Barnstable,MA Date of Inspection:August 19,2001 Name of Inspector. (please print)David B.Mason Company Name: Mailing Address:4 Glacier Path East Sandwich,MA 02537 Telephone Number:508-833-2177 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signatu • Date: g �' The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments System in good condition Maintenance pumping should be performed every years. This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not addresg:how.the system will perform in the future under the same or different conditions of use. Page 2 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 60 Meadow Lane West Barnstable,MA Owner:Edward Clough Date of Inspection:August 19,2001 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _ inX_ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If`not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:60 Meadow Lane West Barnstable,MA Owner: Edward Clough Date of Inspection:Aupst 19,2001 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: i Page 4 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . Property Address:60 Meadow Lane West Barnstable,MA Owner.Edward Clough Date of Inspection:August 19,2001 D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: Yes No _X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _na_ Liquid depth in cesspool is less than 6"below invert or available volume is less than''/z day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _pa Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _na Any portion of a cesspool or privy is within a Zone 1 of a public well. _pa Any portion of a cesspool or privy is within 50 feet of a private water supply well. _pa Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] NO (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. Page 5 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT_S SUBSURFACE SEWAGE IDISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:60 Meadow Lane West Barnstable,MA Owner:Edward Clough Date of Inspection:August 19,2001 Check if the following have been done..You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant;or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS,located on site? X _ 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? X_ _ 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: Yes no X _ Existing information. For example,a plan at the Board of Health. X_ 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(3)(b)] f Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 60 Meadow Lane West Barnstable,MA Owner: Edward Clough Date of Inspection:August 19,2001 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4_ Number of bedrooms(actual):4(Information on file with BOH) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):440 Number of current residents: Does residence have a garbage grinder(yes or no):NO Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] Laundry system inspected(yes or no):NA Seasonal use: (yes or no):NO Water meter readings,if available(last 2 years usage(gpd)):Private Well/Information not available Sump pump(yes or no):yes Last date of occupancy: Current COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/s(ftetc.): 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/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:Yarmouth Board of Health Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) —Tight tank _Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information:Approx. 3 Years per BOH as-built Were sewage odors detected when arriving at the site(yes or no):NO r Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:60 Meadow Lane West Barnstable,MA Owner: Edward Clough Date of Inspection:August 19,2001 BUILDING SEWER(locate on site plan) Depth below grade:Approx. 39 inches Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: 120' Comments(on condition of joints,venting,evidence of leakage,etc.):Appear in good condition,sewer line into tank is at minimal pitch. SEPTIC TANK: X (locate on site plan) Depth below grade:_28" Material of construction:_X_concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions:Typical 1000gal. Sludge depth:Approx.6 inches Distance from top of sludge to bottom of outlet tee or baffle:Approx.28" Scum thickness:Approx.2 inches Distance from top of scum to top of outlet tee or baffle:Approx. 8 inches Distance from bottom of scum to bottom of outlet tee or baffle:Approx. 10 inches How were dimensions determined:Actual measurement Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Components of tank appear in good condition Inlet tee in place is PVC. Outlet tee is precast. Liquid level is level with outlet pipe invert Recommend pumping every 2 4 years. Recommended pumping. GREASE TRAP: N.A. Depth below grade:— 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:60 Meadow Lane West Barstable,MA Owner:Edward Clough Date of Inspection: August 19,2001 TIGHT or HOLDING TANK:—N.A.—(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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:Level with outlet inverts Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-Box depth was difficult to excavate Owner may consider bringing such to within 12"of grade. PUMP CHAMBER:—N.A. (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE IDISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 60 Meadow Lane !Nest Barnstable,MA Owner: Edward Clough Date of Inspection:August 19,2001 SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,ezcavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: X leaching galleries,number: 6 Infiltrators with 3'stone around and 13"under per attached letter 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.): No indication of hydraulic failure ponding damp soil or excessive vegetation growth Probed field without any indication of saturated soil. CESSPOOLS: N.A._(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 or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: N.A._(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.): Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 60 Meadow Lane .West Barnstable,Ma Owner:Edward Clough Date of Inspection:August 19,2001 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. 1 3y kG)6- 1 lITTT!'�T♦T T+4'11r9AT AT/OT TOlT9 197/9T TTIATT A"%)r ♦L�CVTICICIXffVIATTCI Page 11 of 11 s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:60 Meadow Lane West Barnstable,MA Owner: Edward Clough Date of Inspection: August 19,2001 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_7.83_feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: X Observed site(abutting property/observation hole within 150 feet of SAS) _X_Checked with local Board of Health-explain:Recent Test Holes,GIS Dept.,Existing engineer records with BOH Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: High ground water established by utilization of Barnstable GIS Department(see attached map);Grade over system is elevation 24 with ground water at approx.elevation 5 with a depth to ground water at 19 feet. Information prepared by Down Cape Engineering indicates that groundwater was found at 12',with the SAS installed at a depth of 6.5 feet to the bottom of the leaching,which is 5.5 feet above observed water. Ground water adjustment is 1.6 feet. This is based on the well readings for the month of July. The well is SDW252,Zone A, Index 47.5. W01 i IZ 4e*•5 vat , . �� O TO OF BARNSTABLE LOCATION r� J SEWAGE # 2- " 1 r VILLAGE �A r r @. ASSESSOR'S MAP & LOT 1 3 -U 2 L I 1 ;— INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY IV m LEACHING FACILITY: (type) `e ' (size) NO.OF BEDROOMS BUILDER OR OWNER411 PERMIT DATE: �-� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by rIS- f f ;^i-c2F.1 J' II 939 main street rt 6a yarmouth port �p mass 02675 �' s down cape enp"sfteefUll l civil engineers& land surveyors structural design Ame H.ojala P_E P Timothy H.Covell p land court July 31 1998 surveys ' David C.Thulm,P.E. Michael Leary site planning 791 Pitcher's Way =; Hyannis,MA 02601 sewage system designs Dear Mike: On July 30, 1998,1 inspected the soils at 60 Meadow Lane in West Barnstable. I inspections found fine sand from 9' to 13',with silt loam above this layer. Water was found at 12'. permits The existing septic system could be replaced with 6 High Capacity Infiltrators with 3' of stone all around and 13"stone underneath the system, assuming a 4 bedroom design. A 5' removal of the silt loam layer down to the fine sand layer will be required around the perimeter of the leach facility. The base of the septic system will need to be at least 5.5' above the groundwater level. Please do not hesitate to call with any questions. Very truly yours, Arne H. Ojala, PE, PLS Down Cape Engineering, Inc. j fi�a �3A Y p 4.2 a STANDARD LEGEND .7, 24 I, NOTE:not all symbols will appear on a map IT 1,9 2 9.4 10.1 i �,1� GOLF COURSE FAIRWAY 1.78 A( 26.4 EDGE OF DECIDUOUS TREES EDGE OF BRUSH 26.6/ --- / .., ORCHARD OR NURSERY 2 8.2 MAP 133 .......... >/2 V V EDGE OF CONIFEROUS TREES 2 3 Z. #94.. 1,1,1.78AC 11 MARSH AREA _MAPI33 EDGE OF WATER 14.8 6 _\<30.4 DIRT ROAD 53 0 20 AC, DRIVEWAY PARKING LOT 131 8.7Z PAVED ROAD MAP 133 2 2) DRAINAGE DITCH #78� 3 1 # .87'At /\ J PATH TRAIL I'D( 9 0�,Q O PARCEL LINE 36. --- ----- --- MAP im— MAP# 21 PARCEL NUMBER #1860 HOUSE NUMBER —MAP 1 8.1 370 21 # T CONT \ .5 2ffl AC60 OUR LINE .,' 117 2 FOO Ix MAP 15 10 FOOT CONTOUR LINE E 551,11- levation based on NGVD29 ..........-.......... #21 —------ MAR-1-31- 1.50 At 20 4.9 SPOT ELEVATION #46 2 _AC.22 STONE WALL 'e FENCE ,.. \\ �......U- RETAINING WALL 12.1 15 RAIL ROAD TRACK ­::D MAP133 STONE JETTY SWIMMING POOL P r 2 PWL /-/20.8;.x C1' x 04 0 A 2 PORCH/DECK BUILDING/STRUCTURE Ji feet X8 3 r — 16.4 � DOCK/PIER MARJ3 HYDRANT # GROUNDWATER CONTOUR ELEVATION ABOVE SEA LEVEL 1.01 AC Groundwater contours are based on 1992 Gahrety&Miller model and are uncorrected for year. (E) VALVE @ MANHOLE T 0 W N 0 POST 0" FLAG POLE 0 IF B A R N S T A 8 L E G E 0 G R A P H I C I N F 0 R M A T 1 0 N S Y S T E M S U N I T IN PRINTED SCALE:IN FEET 0 SIGN S STORM DRAIN *NOTE: Planimetrics,topography,and * NOTE:The parcel lines are only graphic representations D SOURCES- Planimetria(man-made factures)were interpreted from 1995..i.l photographs by The lames vegetation we aped to meet National of ptopettyboundories.They a a Topography and vegetation were interpreted from 1989 aerialphotographs by GEOD UTIUTY POLE m TOM W., sg re mapped are not true locations,and W.Sewall Company. 0 75 150 Mop Accuro(y Standards at a scale of do not represent actual relationships to physical objects Corporation. Plonimehics,topography,and vegetation were mapped to meetN tionol Mop Accuracy Standards S I INCH=ISO FEET on the map. at a scale of I I DO'.Parcel lines were digitized from 2000 Town of Barnstable 0 ELECTRIC BOX S ble Assessor's tax maps. UGHT POLE OF BARNSTABLE LOCATION SEWAGE # 2— VILLAGE ��C, ASSESSOR'S MAP & LOT-L3-3----Q;-),1 --t � L ea r INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:— g — flCOMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands nds exist Feet within 300 feet of leaching facility) Furnished by No. / (1 �(J d— t Fee s� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01 pplication for IDi.5poe ar *pgtem Con!6truction Permit Application for a Permit to Construct( )Repair( Upgrade(' )Abandon( ) El Complete System ❑Individual Components oq Location Address or Lot No. m o�v h Owner's am e A dress and 1.No. ecru 5'f&✓- Assessor's Map/Parcel j ? - /O :� Installer' Name,Address,and Tel.No. ! O Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size a Csq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) l"Gi/eae 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 ofAhe Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y this and th. cy Signed Date ^ L Application Approved by Date Application Disapproved for Vie fo owing reasons Permit No. — !J Date Issued No. Ur .�D c _ « ; +. �C Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _l_ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Miopargar *pgtem construction permit Application for a Permit to Construct( ).Rep(/t [Jpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No °'�y Owner's amee�dressand 1.No. �Assessor's Map/Parcel � � S/O Installer' Name,Address,and Tel.No. 7 O °1—�5� Designer's Name,Address and Tel.No. j{ _ L ece r 7 `7 / Pdak ers W Q l Type of Building: a c Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. c ` Description of Soil ,x 1 f Nature of Repairs or Alterations(Answer when applicable) r`G l eel; 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 e Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued this and th. Signed Date Application Approved by' Date Application Disapproved forte fol owing reasons Permit No. - J �_ Date Issued THE COMMONWEALTH OF MASSACHUSETTS s BARNSTABLE, MASSACHUSETTS (tertificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( 7Upgraded( ) Abandoned( )by at t,A has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer--- The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 4 14 _ Q.9 Inspector --------------------------------------- No. >C a Fee 22 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Migoaf *pztem Construction 3permit Permission is hereby granted to Construct( )Repair( }Upgrade( )Aband n( ) System located at r) Idn , :429 1A and as described in the above Application fo Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: Approved by tel.(508)362-4541 main 939 a street rt 6a yarmouth port fax(508)362-9880 mass 02675 down cape engineering structural design civil engineers& land surveyors Ame H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court July 31, 1998 David C.Thulin,P.E. surveys Michael Leary site planning 791 Pitcher's Way Hyannis,MA 02601 sewage system Dear Mike: designs On July 30, 1998; 1 inspected the soils at 60 Meadow Lane in West Barnstable. I inspections found fine sand from 9' to 13', with silt loam above this layer. Water was found at 12,. permits The existing septic system could be replaced with 6 High Capacity Infiltrators with 3' of stone all around and 1.3" stone underneath the system, assuming a 4 bedroom design. A 5' removal of the silt loam layer down to the fine sand layer will be required around the perimeter of the leach facility. The base of the septic system will need to be at least 5.5' above the groundwater level. Please do not hesitate to call with any questions. Very truly yours, r Arne H. Ojala,PE,PLS ' Down Cape Engineering, Inc. a I A '���t f ��� �S f�th e -. 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only: CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) r _ hereby certify that the application for disposal works construction permit signed by me dated r , concerning the property located at (9© i,"L q-ad o v J 6,a/'R 5 l�l'e,meets all of the following criteria: • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will.=be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert