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Home My WebLink About1756 OST.-W.BARN. RD - Health 1756 Osterville W/Barn. Rd W. Barnstable F/R. - A = 128 035 a _ TOWN OF BARNS AIlLt r LOCATION I� IAI �s� SEWAGE 'G�/y vm. AGE Ly ASSE OR'S MAP & LOT U3, INSTALLER'S NAME&PHONE NO. <D 6 SEPTIC TANK CAPACITY !E; ZY l LEACHING FACILITY: (ty ) � ��.. L"y�-/LE��'�( ,�(size) NO.OF BEDROOMS BUILDER OR OWNER A, PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �`�r ` !' /q— �:��. �� ` �` y � �_ . d ,. �- 1U �� No�. � ' * FEE y COMMONWEALTH OF MASSACHUSETTS Board of Health ��,MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair5� Upgrade( ) Abandon( - ❑Complete System Xndividual Components Location IqSl,, Owner's Name r Map/Parcel# Address E Lot# . } Telephone# Installer's Name -ce Designer's Name Address `� �S ykqmwvhi Address 20, Telephone# Telephone# c7*9 Type of Building �.S C�e.21Q� Lot Size T 3 6403 sq.ft. Dwelling-No.of Bedrooms r\ry-ep- CS-) _ Garbage grinder(44 Other-Type of Building �s?�CC',.C�P C� I�SQ No.of persons !!51 Showers (V,Cafeteria ([� c �Other Fixtures LAUl4�iD2Y. A , ' Slf l k-, Zee )n :ICt - Design Flow(min.required) gpd Calculated design flow Design flow provided 5�) o gpd Plan: Date o2)20 f b 4 Number of sheets 1 Revision Date Title 2b*Q6-0—d Description of Soils) Soil Evaluator Form No. A Name of Soil Evaluator Z 1Al2(3PIJAC' Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS aLl The unders' ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agre to no to place tem in operation until a Certificate o Comp'ance has been issued by the Board of Health. Sign d Dat 4) Inspections 'iw �'4" r-A.4��v.- � .••yf • �'W O. T' ...� R+� 4. Fy` iY V�r'.�..•.. ...-. �1��, "} * f �'�.,�.-.++1..+,.rti.-1� �n_....��,�+r.;�.�*'� . �.. ,;.^,�Nd4"��1•-"�'�'1r`..�s-.r�r^ -.'` '� *.'• ` ,� `i r'"-L• . No. 7v / FEE -� Board.,of Health, \,k�t`�'S�CC��2- MA. i - II APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - ❑Complete System�ndividual Components Location , �l i �.-( �� Owner's Name e, \Q Map/Parcel# !�.?J� 1 +"+'� Address Lot# } ( Telephone# Installer's Name - Designer's Name g �� nit s�nFa� SvC_ � ,•ri_.. Address � Address a h �O, "-A Telephone# Telepe#J s1,4 8-o-:01, aa5 (o Type of Building Lot Size LI 5 1+S sq.ft. Dwelling-No.of Bedrooms Garbage grinder,,(1y4 Other-Type of Building 'CCU' (Ga C -�<Q No.of persons Showers V•,Cafeteria (Ly � LL f7 CIM_Other Fixture ; Design Flow(min.required) 3) gpd Calculated design flow Design flow provided 33 gpd Plan: Date r21 20 10 4 Number of sheets , Revision Date Title OC a�2C� SJ SU(- Cf' 5eV.X_—QQ I1SC�C ., `ALAS- Description of Soil(s) �Cj� r Soil Evaluator Form No. fa Name of Soil Evaluator •K• t A,IQ( rWk' Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS rIP-P cz A \Cfl` r i The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and h further agreesto.not to place a system in operation until a Certificate of Compliance/has been issued by the Board of Health. Signed /yam}'// � � l� _ Dated a� _- 4-f \ Inspections No. L11 6-70 COMMONWEALTH OF MASSACHUSETTS FEE Board of Health,,,,13 ,12 5/zi_ MA. CERTIFICATE OF COMPLIANCE Description of Work: 4Individual Component(s) ❑Complete System IV The undP797 ed hereby certify that the Sewage Disposal System; Constructed ( ),Repaired'(,Upgraded ( ),Abandoned ( ) by: e b-1 c. Si ) /, �.� E 1 at o _q e h 1/i! 1 S has been installed in accordance with the p ovismns of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application N-o. X0 D H- o() dated a. �3 W- Approved Design Flow (gpd) t Installer Designer: Inspector: a. f1.1 J- Date: 0 The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. C?`G 0 V 70 ,,) COM��( �T��T EALT14 OF ,('� �T FEE SETTS Board of Health,m' y Lf (g=, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( Upgrade( ) Abandon( ) an individual sewage disposal system / at ) '7�k� %/� �I�' I (ter �/�I Y J as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the dat o t irmi . All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date!C�3kV Board of Health TOWN OF BARNS ABLE LOCATION -3 -SL SEWAGE VII LADE IAJ � '��`'�� ASSE OR'S MAP,&LOT U3� INSTALLER'S NAME&PHONE NO*.-I" SEPTIC TANK CAPACITY— LEACHING FACILITY: (ty ) LE r� (size) NO.OF BEDROOMS BUILDER OR OWNER PERMI'ILDATE: ® a3 d� COMPLIANCE DATE: aS b 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 Feet within 300 feet of leaching facility) Furnished by If �oil( - , d - i Town of Barnstable OptHE ram, Regulatory Services Thomas F. Geiler,Director * BARNSTABLE, 9�A MASS: Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Designer: &UtfW�\ Installer: C)6Q S Address: `� -1' �� Address: �C�.�mr�J�i, . 1� �- 6�:5� �"i4-�r►o��t1, !r�-f�1- On 8 �S was issued a permit to install a (date) (instal er septic system at l��le �S ui�,�o - w,TDgcDE�A based on a design drawn by (address) -i�4 &UVKM,, � dated `� a designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Ice"- (Installers Signature) o�o`� CARMEN SHAY N ;� r�yt No. 1181 (Designer's Signature) (Affix �, ssre) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH1&��rZOCERTIFICATE OF COMPLIANCE WILL NOT BE .ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form w SIN 20-01 13 : 62 BARNSTABLE HEALTH DEPT 5087906304 S25Oi NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST At\M SOIL EVALUATION EXEMPTION FORM to • t� SAPH hereby certify that the engineered ian signed by Me o Y Y � P o u�;ecJ'aC)j concerning the property located at la—s v Q ��\\2 — c rJ meets all of the fcl!owmg c^terra • This failed system•is connected to a residential dwelling only. "There are no :ommt!rzia! or business uses associated with the dwelling, • The soil is cidss: ed as CI.ASS I and the percolation rate is less than or equai to 5 -n:nutes per inch. The applicant may use histoncal data to conclude this fsc: or may. :onduct ?re!tmt,:ar% tests at the site without a health agent present • Ther: :s no increase to now and/or change in use proposed • There are ;to vanances requested or needed. • The bottom of the proposed leaching facility will not be located less than Fourteen l-1 iee; aoove the maximum adjusted groundwater table elevation, fAdius( the --nundwa;cr table using the Fdmptor method when applicable) Please complete the rollowing: Ground Surface Elevation (using GIS information) _ 0 S G.W' Elevacon, n— adlustnent For nigh G.W. _ •.g = __. ` FR,H(NCF EETWEEN and B A S.GVED DATE: NOTICE 3asec j;•ort t.nt ab•ove ir•formatlon, a repair perrm will be issued for aedr^ores ,,ddiuonai bedrooms are authorized to t` e future wiaiout en;tneerec :opt+c s_�aer-t plans. --- — ° �ctun!c:act Prim mC z, Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: t) Lot No. _ Owner: AeAk -) z-�no ,V\1\ Address: Cjgt�n Contractor: t5k�nit A RQQ l(M�rW4ddress: Notes: STEP i Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date 916 1401 Mon /day/Aar STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OAppropriate index well.................................................... 53 (� Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... mo th/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ...... ....................................... -T► STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ......... ...................................... I; Figure 13.--Reproducible computation form. . 15 f COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION FAILED INSPECTION MAP '�- PARCEL ; 3 LOT TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1756 Osterville-W. Barnstable Rd. Os w, t�1►2,��-,off �Z.� 3® Owner's Name: National City Mortgage Corp. Owner's Address: Date of Inspection: November 24, 2003 -CEIV LEM Name of Inspector: (Please Print) James M. Ford D E C 10 2003 Company Name: James M. Ford Mailing Address: P.O. Box 49 Osterville,MA 02655-0049 TOWN OF BARNSTABLE Telephone Number: (508) 862-9400 HEALTH DEPT. 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: Passes Conditionally Passes Needs urther Evaluation by the Local Approving Authority ✓ Fails Inspector's Signature: Date: November 30, 2003 The system inspector shall submi copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 r Page 2 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined", please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or 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: 2 r Page 3 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 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 I of a public water supply. The system has aseptic 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"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 '/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped— ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply.or tributary to a surface water supply. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] Yes (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 System: 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 tI 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. 4 Page 5 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 Check if the following have been done: You must indicate`yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period ? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up ? ✓ _ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions, depth of liquid, depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ 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(3)(b)). 5 1 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City MortQa,¢e Corp. Date of Inspection: November 24, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 0 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): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): pd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable 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 ✓ 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: Nov. 15194-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK: ✓' (locate on site plan) Depth below grade: 30" Material of construction: ✓ 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: 1000 gal. Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness: 10" Distance from top of sum to top of outlet tee or baffle: 4" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Solids were above the tees. There appeared to be signs of backing up from the leach pit. The cover was to grade. GREASE TRAP: None (locate on site plan) 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.): 7 Page 8 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 TIGHT or HOLDING TANK: None (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: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. Solids were present. A camera was used to perform the inspection. PUMP CHAMBER: None (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.): 8 Page 9 of 11 OFFICIAL INSPECT ION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 - 6'x 6'(1000 gal.) H-20 leaching chambers,number: 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.): The leach pit had 2'ofwater on the bottom. The scum line was up to the top of the cover. There appeared to be signs offailure. The cover was 8"below grade The leach pit is in the driveway. CESSPOOLS: None (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: None (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.): 9 • Page 10 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, AM Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 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. A 13 j3 c 3 19 So y9 i96 �a SI a �' y p ' � 3 p cc� O O io Page 1 I of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1756 Osterville-W. Barnstable Rd. Osterville, MA Owner: National City Mortgage Corp. Date of Inspection: November 24, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 50 +/- 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: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with:local Board of Health-explain: Topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map the maps were showing approximately 50'+/-to ground water at this site This report has been prepared and the system inspected and failed of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 TOWN OF BARNSTABLE LOCATION tart' Autl�� e� 18.¢mg )ff)4La SEWAGE # VILLAGE i+� ST �A 2r�S t'A�(� ASSESSOR'S MAP & LOTl� f '� INSTALLER'S NAME & PHONE NO. �; � �iss� _ �I�� a�St�fS/ SEPTIC TANK CAPACITY JoaoST' LEA HING FACILITY:(type)_ALog (size) p NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER wa;(L BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No L✓ Ems, � T. r r � 1 J ...... Fizic ........ THE COMMONWEALTH OF MASSACHUSETTS 3(6, BOARD OF HEALTH �L 9 TOWN OF BARNSTABLE Appliration for Biti-poi3ttl Works Tonmtrnrtion rrrntit Application is hereby made for a Permit to Construct (V/,)' or Repair ( ) an Individual Sewage Disposal System at: :_1�✓.:134�!?. . ... ... off- Location-i\ddress �r -------------------o-r-----o-t--�--I-o----�------------------•------ 2 AOLK O 12a -- ------------------------------------- .................... .....................................................( Owner f Ad ess a ---.13._.c�,a"'.._.. :.551�.�--------------------------•---------------..._....._ ...7_'�...�61�J___.��aQ�'--- --..._._�t1�s ._.�.�4�w.�a.�tY.��. Installer Address Type of Building Size Lot.._�'.3,l..'563....Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-_--__.__.--____------------ Showers ( ) — Cafeteria ( ) a' Other fixtures W Design Flow........11D-_GcV� .'6......g..a..l.l.o..n...s---p e.r. person -er day. Total daily flow... J-�0.........................gallons. WSeptic Tank—Liquid capacitvlQ.4.9_-gal Ions Length$_- Width.5'.-':!!?... Diameter_S---.7.--- Depth....f-....... Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------1------------ Diameter-S.._ f._. Depth below inlet.....(........... Total leaching area..;;?:o(_d.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~" Percolation Test Results Performed by.__�4_wn._ c,� .....C—q-, _ /� _______________ Date_____1..^�t{'` S_..._.._ Test Pit No. 1.y-.!'!>>hzminutes per inch Depth of Test Pit.... Depth to ground water.) —W.4 ..... (T Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ j-. ....... ---•-•- Descripti9n of Soil l�- 3 1 ..-e... uG�4l� �-�� I_�->-- .!^�--- --G. .------ �4/l rn ...qh.<A- - ore ° -✓� '-✓�s P✓��h . W ---------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable............................__._.....___....____....____._..._...............................__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the b rd of health. Signed ------rgAAAA.r.) - ----------------------- ---------------- - ------------------ Dace Application Approved By --------- � ate... `. --------------------------- '...... ......---------------------- ----- -^-�� J ------------------------------------------------------------ Application Disapproved for the following reasons: ........................................................... ... ......... .... ............................ . .............. . ........................... .................. . . ---------------------------------------- PermitNo. ...... " ........................... Issued ------------------------------------------------------------------ Dare 1P el t `1 No... �Ly Q.l-• Fxs..... ,�.. ........ THE COMMONWEALTH OF MASSACHUSETTS �r8(K BOARD OF HEALTH C? 9 __!) TOWN OF BARNSTABLE " Appliratiou for Dio oottl Works Tonotrnrtton Prrutit Application is hereby made for a Permit to Construct ( or Repair ( �) an Individual Sewage Disposal System at: 17,...-� � Location-Address � or Lot No. l.. 1�C7:�'`'Y '. of l�l �q c o - ----•--•-----------------------•--•-------•' owner q/� .-�•• /} Address q / � .". ._ .l._ '......'.'.-...'..-'-'----...-....'.....' .................................. 1 P ,La"J')___A7�rr v�tf... ?......'•.. ..1 -$1....v .01Mf-�_.l?._..t.. a ------•---•---••--•---- --------'-- ------'-----' J Installer Address _ Type of Building 3 Size Lot... ....Sq. feet t-, Dwelling—No. of,\Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther —Type oft Building -------------------- ------ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------- ---------------------------------------------------- --------------------------------------------------••--------- W Design Flow......... _.gallons per person per day. Total daily flow.._....2.3'_`0...........................gallons. WSeptic Tank—Liquid capacityLq�_gallons LengthR 'F ... Width. -ln.".. Diameter s.'. f... Depth... - ....... x Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------- Total leaching area--------------:.....sq. ft. Seepage Pit No--------I............ Diameter.j�... Depth below inlet.....6.._......... Total leaching area..;�:!?!A.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.... ?.::n.. rf?&-_.. h, .�_lnl:.:............. Date.-.-.�...........�SS........,. a Test Pit No. 1.`t.L''2=h_�minutes per inch Depth of Test Pit-----1.1........... Depth to ground water. .. 44 Test Pit No. 2..:.............minutes per inch Depth of Test Pit.................... Depth to ground water........................ x Description of Soil n�- 1.. 'rt.bs ....�...... - o..................................il'c� 171 _.._ .� OU ...............I Sal Y_ Oct _ ?cr ry s ,!t/o • !ca�r+?fe ...X V.q 5 �nr�J�h elrC �_ �tr----••---- W x '-----------------------------------------------'--------'-'-------'--..........--------------"------.........---------'-'-----------------'-------------------------------'•-----'--'-----------...... U Nature of Repairs or Alterations—Answer when applicable_ ........................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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. Signed -------,E`;'> :t_.Cl._� ,!\ i�''� v` ..'.----------------------- --------------------------------- ApPlication Approved By ------------ --- .. .. ----- � Dace Application Disapproved for the following rearons- ------------------------------------------------------------------------------------------------------------------------------------- ............. ..--.....--........... . --- . ...--...--.............--... ....................................--....--.... . ... . -- -.....--......-----.-..----------------- Dare PermitNo. ------ _1/....... D-l------------------- ----- Issued ......................................................... Dare I - —..-------_._—•_—,--..-- .— ------------.---------- —. ——_ —_—._. -------_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE l t v�Eltifi ate of Q-1O iplianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Y __ Q Incr,uer at _........4,07..-(I ......._�- ........ . -e --- ------------------1., ------ ...... -------------------.--------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..It/..... ...A..... dated ......_.................-....---_--_--....-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO ATISFACTORY. DATE--..../6.._./. - . ..... -....---- Inspec�..... ...... --------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH qq� �� TOWN OF BARNSTABLE No...1.. .'.. ._.... FEE ................... Ropmat Vorkn Tonotrttrtion "nutit Permission is hereby granted............ 't---------- ----------------------------------------------------------------•-••---•------------ to Construct or Repair ( ) an Individual Sewage Disposal System atNo.------. -.... -V--rt.......................................................... .....---•--------------------. ------------.. Street as shown on the application for Disposal Works Construction Permit No..� .501? Dated.--. ......... DATE------- ------•---'-----------•-- Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS 4 F• ;AUG-25-94 THU 14 :06 ENVIROTECH LABS 5g18 998 6446 . P. 01 'I' Cfi LABORA.TORIESt INC. Eg�, . 449 R te. 130 . Sandwich,MA 02563 (508)M-6460 • I.W-330-8460 l FAX(508)888-6446 F A X M E S S AGE S a s,7r7 7 7S —3 3 T0: U�`� .- �GL.S S CC1 N �S arl k FROM: I7 UI i-n 4,f r !� p � DATE NUMBER OF PAGES INCLUDING COVER PAGE: ADDITIONAL COMMENTS: ANY QUESTIONS PLEASE CALL: (508) 888-6460 AUG-25-94 THU 14 :07 ENVIROTECH LABS 508 888 6446 P. 02 ENVIROTEC-I LABORATORIES, INC. MA Ccn.No.: M-MA 063 449 Otte, 130 • Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508)888.6446 CLIENT: Russ Carlson LOCATION: 1756 Osterville West ADDRESS: Centerville, MA Barnstable Rd. W. Barnstable, MA SAMPLE DATE: 8-23-94 COLLECTED BY: L. Wile & Son DATE RECEIVED: 8-23-94 TIME: 4:2,5PM SAMPLE ID: 71 JOB TYPE: New well WELL DEPTH: 120' 4" PVC FLAW: 25 G.P.M. RESULTS OF ANALYSIS: Parameters Units Recommended Result Limit Coliform bacteria/104m1 (MF Method) 0 0 pH PH units 6.0-8.5 6.13 Conductance umhos/tm 500 153 Sodium mg/L 28.0 14.9 Nitrate-N mg/L 10.0 0.64 Iron mg/L 0.3 0:10 Manganese mg/L 0.05 0.006 Hardness mg/L as CaCO3 500 25.6 Sulfate mg/L 250 6.0 Potassium mg/L 20.0 2.5 Alkalinity mg/L 200 9.8 Chloride mg/L 250 31.7 Turbidity NTU 5.0 5.6 Color APC units 15.0 LT 1.0 Volatile Organic Compounds EPA Method(601/602)* COMMENTS: *See attached report. Yes No WATER IS SUITABLE FOR DRINKING PURPOSES 0 PARAMETERS TES XXX Date on ld J. S ri LT = Less Than Laboratory virector No. '_-_1----- BOARD OF HEALTH bOTOWN OF BARNSTABLE # 11 0(pplicat ion ArVe[C Con0ructionpermit Ap)icat'on is her ade for a perm't to Construct ( , Alter ( ), or R )awn individual Well at: Location — Address Assessors Map and Parcel -1-9(1550lL--C_--.� --------------------------------- --------1.1--2-F3�-ac�5----------------------------- Owner Address t Installer Driller Address Type of Building Dwelling------- ------ ---------------------------- Other - Type of Building -------- No. of Persons--------------------------------------_------- _ Type of Well - - Capacity-- f/(`! -- Purpose of Well-------- Q ��`'------ - --- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until erti .o lian has been ' sued by the Board of Health. Signed /A - -- - ___-`---- ---7 a /date LI Application Approved By— � - ----------r �= L -- date Application Disapproved for the following reasons:----------------------------------------------------------------------_--____—________-_ ------------------------------------ --------------------------------------------------------------------------- date Permit No. ---�/—�-7-= -- -- -- Issued --- -- - - - -- --- — ------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (>.C), Altered ( ), or RepairedAd A ( ) by---------- - -��-- ---------t4/_ ----------------- - - - - ---—Instalict at- -- L'��-� ��` --�- - -�.L1__-i---��--------------------------- has been installed in accordance with the provisions of the To of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. - '"y --Dated'------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------—-— -- —-- — ---- Inspector---------------------------------------------------------------------- W �,� r� ,'nl..��`4�x,:+�'.,},�.`1�1 `'w�, v.. '� � a �, ' a,,,zz�'=,✓ a � ..n ,�„�fi,�.,.sr*`1 `G -' .� - '. prh.- �•.:, i ' " "�+rtF Tti I, .�. ..y, `� ".� ''✓"i"�G • iai7..`F3r+Y7� , . . Fee----- ,. BOAR.D.OF HEALTH t - ' TOWN OF �B'ARNSTABLE �t., 1 ► Cicati0nore11 Congtructionermit App icat'on is hereb de for a perm't to Construct (}�, Alter ( ), or Repair ( . )an individual Well at: �''� ------�---��-----�� fat_ �-5----------------------- ? Location — Address Assessors Map and Parcel tX,vs ,�1sa90 --_ - -------- - _ �� 5---------------------------- t i Owner Address ------- --- te a F ®-- —J—� ��"f Installer — Driller Y Address 7 Type of'Building Dwelling - -- Other - Type of Building-* - No. of Persons--------------------------------------------- -- -�-0 1_(1 - - -— ----Type of Well-----------�--� .�----�--r----- ----_ _ Capacity------=-----,- --�----- Purpose of Well - ® '�f- ''�"-- --------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The`undersigned furtfieragr,Tes not to place the well in operation until a Cerfi'fiearte .o/ to lian has been sued by the Board of-Health. t --- �a Signed ------ -- ------------ --- --- ---------- . -- — date �6 Application Approved By----� -- -- , - - -4-/--__ ----— date Application Disapproved for.thelollowing reasons-:--_---=-----=--------= ------------------------------------------------------------ TY ---_-_-------_--___-_—_--_—_—____—_---_ date Permit No. -- - = --— --- - Issued--- -- - date -- --- — ---------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance r THIS IS TO CERTIFY, That the Individual Well Constructed (ye), Altered ( ), or Repaired ( ) by----------- ---- ---- ----------Installer--------------------------------------- - - --- --- --- ' at---------ze®I1- -�. ----_ I Li -- - -- ------------------------------- has been installed in accordance with the provisions of the Tou of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. V-9&Y-3--Dated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- --- --- — —------ Inspector------------------------------------------— - - ------------ BOARD OF HEALTH TOWN OF BARNSTABLE Iver[ Con5truct ion Permit No. �V`t°GI___1_ Fee---`-=-`-��-�----- Permission is hereby granted -- -------—------- -- ---- ------------------ toIAV Construct (�), Alter ( ), or Repair ( ) an Individual Well aat,: No. - -�� 1--— — -P'tom - Street as shown on the application for a Well Construction Permit No.------W V_-=---14-�----------- -- - - Dated--- '" -^ - ---.............. --------------- -------------------- ----------------------------------- . .... - oard of Health _,PATE, -- =; -- --_— -- 3z'-o" - iry jz'- 6n ' O 15 IT I !3 !0 2 CAR 9 i rz?ARAGjE p , g 6 I a a!P_ \ 5 g .3 z. 1 AS-3" 1l-6" SCALEU14" — !tl-ON APPROVED BY: DRAWN BY DATE: 3/13 /04 SU51 ROE 1756 05TERV I LLE -VUE5-rZA- HSrABLE"IZOAr7 WEST Z^RNSTABLE , MA , 02668 DRAWING NUMBER FIRST �LOOZ-PLAIN ;►tee scb.�-; �A-S. r it I � v ` I I I I o LOFT' L sD is I ' H .44 13 z 4'-0'' - ,� I p IC) I i i I i . r s 4 3� ii � --_- ------t �---__ ---=-! i i sl-611 ol 13-d 9- 6 SCALE: 1/4II ■ 11I-0A APPROVED BY: DRAWN BY DATE: 3 113 1�4 SUSS ARACaE 5756 0EMERVILL6 -WEST13ARNSTAISLE -ROA9 WES?' $AR}►�1-ABLE � MA � 02668 DRAWING NUMBER SECOND TLOOV,'PLAN A5 +1ALT Sf11N:CL:ES ex l2'l Rt. GE 1/2" Cpx?Lywoo Z,►X SO RA"ER5 --- - 2_ X 6_ .COLAR.TI ES.. VENTS EAC+i51�e 17,30 \X/j VENT. 3ATFLE:S 3 X_IZ UI.Rr 12 �,. pMN 3 y z P ETE T I LLF-D 'N 2Xlo (%-.L ' O.C. e x 4" G,10 O.C. f 01 Pr e x 6" W 51L1. SEAL a. Aa chop, ZOLT5 0 C%RA p S I I L-- --1 4'►cONc.�t X 91Yz" Tii K ( 2-O X 2-O x 14'T♦I K CONCRETE TOL)RpAnON WALL : c0VAcKETE COLL)M m TOOTING S/4n_ 1,►-0►► APPROVED BY: doll SCALE: DRAWN BY z4P—On DATE: C�ARAyE 5756 05TEFtVI LLE - WFSTBARN5TABLE RDAD I WEST 3AKH67rASLE , M A ,O Z66 8 DRAWING NUMBER SEC-1"I O H A.1 .3Z - 0 hl I I i I�z coHercEtE cAu)tr►wsltl.E9 "T}►IGK CONGRE�_.Cta!UMII�I�OTII�tC� b C;ARAc�E 'i All c01!mlm TLm.K e 5LOVEtj TO poor- 1 N SCALE:1/40 n S"-Q" APPROVED BY: DRAWN BY DATE: 31 3 04 SUSI GARACiE 1'7 56 05,rERV 1 LLE -W ESTBARN5TABLE ltOAl WEST BARNSTABLE , M A , 02 6613 DRAWING NUMBER :'OUNPATION PLAN A- g 2" x le .JOISTS 50LID SLOCKINy t 3 -Z" x ul, CRI _B.L_.SOISTS V A PLT IT1.O_K -5COLID 3LOCKI NG4 r SCALE: 1/4 s i -o" APPROVED BY: DRAWN BY DATE: .3 ' 13'O/T SU$1 I T r OSTEXV I LLE -VU -5TSARNST�$LE vo" WEST $ARNSTABL+E I MA � OZ668 DRAWING NUMBER 1 Z"x -R►��7E SCALE:i/J" 11-0/' APPROVED BY: DRAWN BY DATE: 3I 13I0� SUSI GIARAG-IE 1756 05TERVILLE -WE6TBAIW5TASLE F0A1f' Vu£ST SARNSTABL.E , M A, OZ668 DRAWING NUMBER -ROOF RAM 1 NCj A-iO J ---------- .---------- - __ - --------,- -------------- ------------ - - -I � 11�� ,�t,� — , _ �_ ' _��,� - ,"", - , , ", " �, , , - , , , "- � �,,-I , ' ' �. ,, " ,z,T,�r , ;,r�-'' 514 1 1�111� , �: ", '.ze - - — , ,%�� , �P Z ?""',�' — '�N , ", ' " �� '� " -, - _ ;101 __ --,----- __ , � . _. - , i - �', ,", �� '�,!,`�w4_n�"', ""� -'�, " - ` '7:71, -O�-., "r". �,_ ", �T ,1 ,_� - 7t�_�`__;_, x_11"I"11-1-11 - '.�` :�" , , , I, '_ Iln't-�"I ., � �� , . -��, _". .� 1� - , - -. 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ACCESS MANHOLES SECTION A -A 6. _Yq4 PROFILE VIEW OF ADDITION TO LEACHING SYSTEM ' 10' min. from . ,. .. .. Xrchw!!`j-.w • � :, NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. o• .' ;••;,r:• . ".� e Existing Foundation [house t0 septic tank VENT PIPE (O Least 24 inches toll A�'' .��'--'y'L-=t=•'i��'3..=v- ,,•kK� .x;--^ "+.�-.,y '•S�-_ Septic: tank covers must be Schedule 40 PVC w/Charcod Odor Fllter 'r• TOF ELEV = 100.00 within 6 In. of finished gradeI' ; ` Grade over Septic Tank - 98.75 �Orode over D-Box - 98.50 va de error SAS - 98.50 3• of 1/8" - 1/2" Washed Peoston THE ACCESS COVERS FOR THE SEPTIC TANK, 3/4" to 1 1/2 Washed Crushed Sterne INLET - ) ' -" GRADE SHDiSTRIBUTIAM BE RAISED OBOX AND HING WITHNOMPIENT v r \ / \ OU SET DEEPER THAN 6 INCHES BELOW FINISHED S - 0.02 3 HOLE H-10 Top load-El",-M60 ` ` 11 't L S-0.10 GIST. BOX J Maximum Cs+w "•i FlNISHED GRADE. i p 7 w a ,5' EXIST. OR GREATER 3' Maximum Co er EXIST, PIPE r; 1,000 GAL. A `' INSTALL TUF-TITS GAS BAFFLES OR EQUALS 1 " r '` � 0.010• 0`EfTsetM Depth �4.,s.�,�T�, �,'•�; p FROM FOIMDATIDN rn 62' er foot ..,a .. ';'z,;c'T..-::,5'•";'�ti,T'+�.;,'`.w... � s SEPTIC TANK Pvc TEE C�1 0 20 • ^r r m n H-10 aa'left REQUIRED � � 0.83 (10 inches) 5 hits E 6.25, � 30' STEEL REINFORCED PRECAST CONCRETE ��sb WATER VELOCITY s 3' PLAN VIEW = ' -�, - '" CONCRETE FULL FOUNDATIO m TO REDUCE pr O, r•'^^•--�•�- - -�ypa rn' X LO / / d y 1 as 3725 3-24• REMOVABLE COVERS rs rust rwno•a sao C eaaf.a cor sac sf SYSTEM PROFILE 6 In.of 3 4•-, , 2• "'°-BOX compacted stone -y u 4' 4' p Not to Scale '� 2 Eff•ctivs Length 4' GENERAL NOTES Effectivs Vldih •.,;,.•y I . ,y 3 min. clearance 8 In.of 3/a'-t t/2' Bottom o+rest Here, o.v.-6e.o0 m SOIL ABSORPTION SYSTEM (SAS) utLET 6 min. 2• min. Inlet to outlet 6.m� " sntr 1. Contractor is responsible for Digsafe notification NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE compacted stone o No Groundwater Obswvsd 0 156" OUTLET INFILTATROR HIGH CAPACITY fH-10 LOADING)/ GEORGE O'BRIEN _ ,O.mti + �euldTvel-� and protection of all underground utilities and pipes. (OR EQUIVALENT) Not to Scale 5' -7' a ;� .'5' -7" 2. The septic tank and distri L{tion box _shall be set level on 6 of 3/4'-1 1/2 stone. NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10• E J 'v I �• 4'-0" r ln. 3. Backfill should be clean sand or gravel with no J o oa.ems. I uvula depth stones over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. +'''+'': , 4'-10' " 5. The contractor shall install this system in accordance with Title V of the Massachusetts state code, the approved plan CROSS SECTION END-SECTION and Local Regulations. I FOUNDATION• o' SEPTIC TANK -----ax' D-BOX •-- eo' �LEACHING FACILITY 6. If, during installation the contractor encounters any soil conditions or site conditions'that are different USE EXISTING 1000 GALLON H- 10 SEPTIC TANK from those shown on the soil log or in our design installation must halt & immediate notification be NOT TO SCALE made to Carmen E. Shay - Environmental Services, Inc. 7. No vehicle or heavy machinery shall drive over the septic system unless noted as H-20 septic components. y PERCOLATION TEST 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. �j 9. All Distribution Lines shall be 4" diameter Sch, 40 NSF PVC '':> pipes. /-' Date of Percolation Test: ,_- 10. All solid piping, tees & fittings shall be 4 diameter �/ Test Performed By. RICHARD FAIRBAINKS, P.E.., C.S.E. Schedule 40 NSF PVC � f Results Witnessed By. J. CONLON I( Barnstable B.O.H.) pipes with water tight joints. O FVA' OF Excavator: UNKNOWN 11. MUNICIPAL WATER NOT AVAILABLE AT SITE and Surrounding Properties FO Percolation Rate: 4 min./inch 0 36"" BELOW GRADE. EXISTING WELLS WITHIN 150 FEET OF SAS AS SHOWN ON PLAN. o o Test Hole No. 1 �1.4TE DEPTH SOILS ELLEV. THE PROPERTY LINES ARE APPROXIMATE AND c d 08'; 17-- - _ _ _-, 0 981.00 DOWNCOMP CADPEROM THE SURVEY PLAN GENERATEDENGINEERING OF YARMOUTH, MA, DATED 5/13/94 N 74 - Loamy SandENTITLED " PLOT PLAN OF LOT #35 OSTERVILLE-W. BARNSTABLE ROAD" - W. BARNSTABLE, MA" AND IS NOT INTENDED TO BE A SURVEY PLOT ' 0"-6" Ap 9T'.50 PLAN, IT SHOULD BE USED FOR NO PURPOSE OTHER THAN 0 ' Loamy Son THE SEPTIC SYSTEM INSTALLATION. 98, ; 9 6"- 36" 95.i.00 45 Loamy Q I i Med. Sand THERE ARE NO WETLANDS LOCATED WITHIN A 200' RADIUS OF THE SAS. w 'rrace Silt ' ''i i' ,' i � } 36"-156• C, 85.i:00 I i ! 9ttr NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE FROM THE EXISTING SEPTIC SYSTEM TO BE DISPOSED Sly' OF AS PER BOARD OF HEALTH SPECIFICATIONS. EXISTING LEACH PIT TO BE PUMPED DRY & ---96 LOT #10 FILLED IN PLACE OR REMOVED IF NECESSARY. UNDEVELOPED LOT ------------ -�_ 8 ASSESSORS MAP - 128 LOT 035 9 PROJECT BENCH ION # # ZQNING RESIDENTIAL TOP OF FOUNDATION - Per.- 1 ® Test Hole 2 1 '\ ELEV. ea 100.00 (ASSUMED) Depth to Pere: 36" do 54" FLOOD ZONE C LOT #19 1 1 1 11 1 Perc Rate= 4 min./inich _I 1 s _ - _ Groundwater N'�.. . . of Observed -- -- - -- --- T C ,01r1:`0 -TEST I H„L,E E,ati. THERE ARE NO`WETI�NDS'IOCATED WITHIN DECK ADJUSTED H2O Elev. = No Adjustment Required. OF THE PROPOSED SAS. f DECK LEGEND FROM sReua+� � EXISTING - SET LEVEE..FOR AT LEAST 2 FT. -,r k� 2 CRETE COVER - 3 BEDROOM ,• _ 1 �; � 3 5. OUTLET ' .v •4'• HOUSE { KNOCKOUTS 8X0 DENOTES PROPOSED S.5 «,TLE1 WT SPOT GRADE e DENOTES EXISTING - - .' #f 756 r---" '-_9s ;:.... .. • X 104.46 EwSr.Tax 9d. I %' 15.5•_1 Swk tss 4• - SCH. 40 Te 1,75• SPOT GRADE PLAN SECTION CROSS-SECTION PL �\ o /^ ��• PROPERTY LINE _ 92 3 HOLE DISTRIBUTION BOX - H-20 LOADING ---�7�-- PROPOSED CONTOUR TEk HOLE #1 4 ' EXISTING ` � NOT TO SCALE 97---------97 EXISTING CONTOUR LEv>�= 98.00 ` GARAGE __-- �6'• _ Design Calculations ® DEEP TEST HOLE & LOT #> 1 LOT #2 PERCOLATION TEST LOCATION 43,562 S. F. +/- V I,` 1`� \� �\ '`�_ ; i `•� \ Number of Bedrooms: 3 Equivalent to 330 Gmol./bay (330 Gal./Day Mina per Title V) FENCE PRIVATE WELL IS Garbage Grinder: No - ` ` LOCATED OVER Failed i Leaching Capacity Proposed: 330 Gal./Day Mimlmum (Min. Per Title V) ll. a'Leach 'Pit \ 150' FROM SITE Septic Tank - 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL. Septic Tank. � PRIVATE DRINKING WATER WELL " ` 1 ` ` SOIL ABSORPTION AREA: Using ,' '�� `` \\� c 1 - Bottom Area: 0.74 gal/sq filer x 370 sqa efit f Q 273.81gallons i i `\ �`. \' " ----____"'-',' `•`�� `\`��- 90 0.74 gal./sq. ft. x 78 sq., ft. ee 58 gallons REVISIONS \ --- _ Sidewall Area: -A1l_ •a`- --WENT PIPE�� , ------------ 192 Proviiding: _ 331.80 gallons N0. DATE: DEFINITION - ' i �\ `,\ - ----- --, `9Sr Use: (5) INFILTRATOR HIGH CAPACITY H-10 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, O ` `96' TO BE USED WITH 4.0' OF WASHED STONE ON 'THE SIDES, AND 3.5' OF WASHED STONE ON THE ENDS. NO STONE UNDER. ' I � W 1 \ \ I I ' O , 1 1 W PROPOSED ` tc� I'llPREPARED FOR : 11 `�� SUBSURFACE SEWAGE DISPOSAL Y � __-----goo SYSTEM I y , OF MS . HELEN SNOV�JHILL >00 1756 OSTERVILLE-W. BARNS,TABLE ROAD --------106 C/O NATIONAL CITY MORTGAGE CO. W. BARNSTABLE, MA ° 3232 NEWMARK LDRIVE ' �' � � LOT #1 �` � � ,1 PREPARED BY: CA.RM.�'N E. SHE Y LOT #1z MIAMISBURG , 0HI0 45342 %��° �. ,. c �'`", • 110 �a 5' :? ENVIRONMENTAL SERVICES, INC. PRIVATE WELL IS _ ------- 4 � c 0. Ir 34 THATC HERS CHERS LANE 4; LOCATED OVER �Fc � EAST FALMOUTH MA 02536 150' FROM SITE 15TE SCALE: 1"=30' TEL/FAX 508-548-0796 SCALE: 1 "=30' DRAWN BY: CES DATE: FEB. 20, 2004 PROJECT#SD--526 FILENAME: SD526PP.DWG SHEET 1 OF 1