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HomeMy WebLinkAbout0126 PLUM STREET - Health 126 PLUM ST ' ,=195-024 ;� o Commonwealth of Massachusetts ip Title 5 Official Inspection Form. a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ., 126 Plum St. 'g Property Address , Amy.and William Hallett " Owner Owner's Name } information is W. Barnstable MA 02668 11/29/2019 required for every page. Cityrrown State Zip Code Date of Inspection 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. Inspector Information filling out forms on the computer, Christopher use only the tab Maki key to move your Name of Inspector cursor-do not Cape Cod Septic Services use the return Company Name key. 350 Main St. Company Address West Yarmouth MA 02673 City/Town State Zip Code �++an 508-775-2825 SI-14423 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete'as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 12/16/2019 _ Inspector's fgnature 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 form should be,sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 7 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA .02668 11/29/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 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: System in working condition. 2) 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): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of.Massachusetts P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 ❑l 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): 3) 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. a. 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: t51nsp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts - Title 5 Official- Inspection Form F Subsurface Sewage Disposal System Form-Not for Voluntary Assessments •�� 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name . information is required for every W. Barnstable MA 02668 11/29/2019 page. cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 aseptic 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. c. Other: 4) 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 j ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18. Commonwealth of Massachusetts P Title 5 Official Inspection Form F a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 126 Plum St. Property Address Amy and William Hallett Owner Owners Name information is required for every W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 water supply well. ❑ Z 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 t5insp.doc-rev.7/26/201.8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage'Disposal-System Form -Not for Voluntary Assessments 126 Plum St. V Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cant.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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: ® ❑ 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip Code Date ofInspection D. System Information Y , 1. Residential Flow Conditions: Number of bedrooms(design). 4 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for rexample:0110 gpd x#of bedrooms): 110x4= 440gpd Description: Number of current residents: 1 II Does residence have a garbage grinder? ❑ Yes ® No Does,residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d N/A Well 9 ( Y g (gp )): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date t5insp.doc•rev,7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 I f Commonwealth of Massachusetts Title 5 Official Inspection Form Io Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 126 Plum St. Property Address . Amy and William Hallett Owner Owner's Name information is'required for every W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges'to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/user Date Other(describe below): . 3. Pumping Records: Source of information: No Records Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: — ---- ----- t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip.Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age.of all components, date installed (if known) and source of information: 1998 Per BOH Records Were sewage odors detected when arriving at.the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 1811 Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC []-other(explain): -------- Distance from private water supply well or suction line: +10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Line checked with sewer.camera and was found to be clean, properly pitched with no sign of root intrusion. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts a - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. Cityrrcwn. State Zip Code Date of Inspection D. System Information (cont.). 6. Septic Tank(locate on site plan): 10" Depth below grade: 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: 1500Gal Sludge depth: 2-4' Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 1-2 11 Distance from.top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estimated Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1500Gal tank in good condition. PVC tees in place and clean. Tank at normal operating level. Covers 10" below grade. t5insp.doc•rev.7/2612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official, Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owners Name information is required for every W. Barnstable MA 02668 11/29/2019 a e. City/Town State P Zip p Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal [].fiberglass, ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 I Commonwealth of Massachusetts ,9 Title 5 Official Inspection Form Subsurface Sewage Disposal g p System Form Not for Voluntary Assessments �V 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. Cityrrown State Zip Code Date of Inspection M System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(If present must be opened) (locate on site plan): Depth of liquid.level above outlet invert Oil 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.): H-10 DB-3 with 1 line in and 2 lines out in good condition. Box is clean and level. No sign of overloading or hydraulic failure. Cover 12" below grade. t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. City?own State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 5-Cultex ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc): 5-Cultex 330's with stone. in a I Vx42'Trench. No standing effluent in chambers during inspection. No evident stain. No sign of overloading or hydraulic failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer. Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W. Barnstable MA 02668 11/29/2019 . page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for every W Barnstable MA 02668 11/29/2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information is required for.every W. Barnstable MA 02668 11/29/2019 .page. CityiTown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar , ® Shallow wells 'Estimated depth to high ground water: +10'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: 1998 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: Test hole data on file. No-water at 10'. Max bottom of leaching is 5'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � 126 Plum St. Property Address Amy and William Hallett Owner Owner's Name information,every is required for W. Barnstable MA 02668 11/29/2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification:Signed & Dated and 1,2, 3, or 4 checked C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF BARNSTABI,F QQ ' LOCATION tITaqM'R SEWAGE# V VRIAGE-1w. II ASSESSOR'S MAP&LOT 193- INSTALLER'S NAME&PHONE NO. (�rORdeh} IJUmraL7S y�.9•SL4d N . SEPTIC TANK CAPACITY f 1500 "I. rLEACHINO FACILITY:(type) �o��Y R io'S (size)�� Iva . NO.OF BEDROOMS_// _ BUILDER OR OWNER C h rt R I£S HUPT PERMTTDATE: -$ COMPLIANCE DATE: .1/..{o-4! 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 2W feet of leaching facility) a50 f Feet Edge of Wetland and Leaching Facility(If any wctlands exist within 300 feet of leaching facility) Feet Furnished by 1 - 0 ' J•!AN �ry� � g 37 � o� sa ywc 6d' Cu(r&x CIDI . n ComPLETE T14IS SECTION • • ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Aqant ■ Print your name and address on the reverse X lmk k I QAddressee so that we can return the card to you. B. Recelvedl Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, ��E� or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Wilhi n: :ia Ilets 126 Flunn S1tTe:1 3. Service Type West.Barn stahlc, 14'1A 026h<i � CCertified Mail ❑Express Mail � ------ '❑Registeredturn Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7008 32,10..3 ,0,092 5177. 919 0, (Transfer from service label '•`` PS Form 3811,February 2004, Domestic Return Receipt 102595-02-M-1540 I UNITED-STATE Z C I i ..;m F :�� "*» r_S ' s'YC I1 yq Ik f 2u E I i � aid -t.o h ;3 ;". : s .- ' • m • Sender: Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public health Division mo A.LIin Sn+cet Hyannis, MP. 02601 I I I � I i Certified Mail: 7008 3230 0002 5177 9190 _ Town of Barnstable Regulatory Services (� I Thomas F. Geiler, Director . BAFtVS're1QF @, 't` l MASS. oQ t � Public Health Division J`�� Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 S( ) , r Fax: 508-7901-6304 William Hallett `e � June 30, 2010 126 Plum Street West Barnstable, MA 02668 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE CODE i The property owned by you, located at 126 Plum Street was inspected on June 30, 2010 by Timothy B. O'Connell, R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violation of the Town of Barnstable Board Code was observed: § 353-1 Responsibilities of Owners: Rubbish was observed on your property in the form of scrap wood which was accumulated during the construction of a garage on you > property. A 9 0- 0y" 1 � You are directed to remove the rubbish from your property and dispose of it A, >Lt properly within (30) thirty days of your receipt of this notice. Your second option is ZSS to move the pile of scrap wood to a more secluded section of your property and store it in a more orderly manner so that it is less offensive to abutting neighbors. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Please be advised that failure to comply with an order will result in .a fine of $100.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF T BOARD OF HEALTH Thomas McKean,'CHO, RS Director of Public Health Town of Barnstable Q:\Order IettersiRefuse,126 plum street.doc � t f Citizen Web Request Page 1 of 3 cl Request Information r e £3£ 3 ... .-...._. ....... .......... -. .-_................ .............. ....__. ................ _.............. ......... ...... .......... - ... ._........._. .............. ...........:.. i Request ID: 31366 Created: 6/25/2010 12:34:37 PM _ ____. __._.._._ _. ..__.._.._ __.____ .................. ............................._.... . ............... ......_.. ... ....___. I Status: Assigned To Staff Assigned To: O'Connell,TimothyHealth Office ------------ Anonymous: No Request Category: General Routine work: No Estimate: No Date scheduled: _ ......-._.._ ._. ...___ ......._........ .. ............. .._.._-_...__ Estimated 7/12/2010 Change Estimated Jun July 2010 Aug Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 '1 2 3 4 5 6 7 8 9 10 11 z.::'_ 13 14 15 16 17 i - 18 19 20 21 22 23 24 r 25 26 27 28 29 30 31 1 2 3 4 5 6 7 _._._._. ._.... ......... ._._..._......................... ___ ----- ------- __............ Created By: Wadlington, Ellen Priority: Medium Health Office Citation Numbers: Requestor Information 1 Requestor Beatrice Matton Request DETAILS: 103 MOCO ROAD LOCATION: 126 PLUM STREET West West Barnstable, Ma 02668 Barnstable Ma 02668 '( iRequest Parcel Number ,Map: 1195 Block: 24 ; Lot: 01 j States'neighbor behind her has equipment--dozers, old tractors, back j. hoes--he operates during the day and Parcel_Lookup some times into the night fumes and noise comes into house. Lots of cars, http://issgl2/IntemalWRS/WRequest.aspx?ID=31366 6/25/2010 Hzalth Master Detail Page I of 1 ,. Vti .�.a: Z. Parcel _ e t c Wt�-e l r ,e!.I n F... Parcel: 19-5-024 Location: 126 j-ILO Sli).E3ET, WES' R,,�STABLE Owner: H'A E', a, VVi.UHAM C &AM Business name: Business phone: _w Rental property: l.. Deed restricted Number of bedrooms : 0'? Contaminant released: Fuel storage tank permit: ,:. Save Parcel Changes Return to Lookup arcel Info Parcel ID: 1.99-�'24 Developer lot: UN Location: 1.26 !'L ,l `,>1t3,EE..l. Primary frontage:280 Secondary road: Secondary frontage: Village:WE`a'_ P,AR v5`del"LE Fire district:W BARNS!ABLE Sewer acct: Road index: 7,284 r7n Asbuilt Septic Scan: 95024 1 Interactive map � Town zone of contribution:A (,xa.qu,fe'r Protection OverlayDistrict) State zone of contribution:OUT Clvvrie,Y Info Owner: H/;t_t...-1 WILL_1AM C kk AMY E Co-Owner: Streetl: 126 (I_t - ,' 1" Street2: City:;,', Ei",R NS i.ABLE State: MA Zip: 02668 Cc Deed'cate: 1f0/20/1,39.7 Deed reference: 1.1012/180 Lalld info Acres: 2A,5 Use: Single Fang DL-01 Zoning:R Neighborhood: n Topography: '.._e'vel Road: Unpaved Utilities: ,'tr'+ cll,se-)tic Location: Rear ;..ocatior` 1 1998' 14024 1344' 12 Bedrooms Full Buildings value: .? ' ,2'J,t:'C} Extra features: 02,900,0? Land value: Q—!2,400.;1J http://Issgl/Intranet/healthMaster.'HealthMasterDetail.aspx?ID=195024 6/25/2010 t Citizen Web Request Page 2 of 3 etc. States can't get the neighbors attention to stop that. Can't sit out back or have windows open. Please _ .......... _............ I see e-mail from council person. Email: Edit._Requ..estor Ir�format©_n I I ._.......... . ............. .... ............. ............ ........ ..._.................. __....._. __.. .... .. .......... .......... _._.._._...............__.____ ............ _--.._._- _ ..___.._ - . _... . _......._ Track Request Progress ' Request Work History. —Internal Note History: System entry on 6/25/2010 12:34:37 PM Assigned to O'Connell, Timothy .Enter work progress: Enter internal note: (Viewed by e evybody) (Viewed ed internally only) i j' F SARI Check ,.Spell Check �__-... .....__......._-._. Add document or image link: :Browse... € Yc,iJ c n also ty pt, I. ;.t.. ,. 3 s[a 4'i � s_ _.. F Y t t.i a .h I J Jer Current Links: F . ............... .............. ......... ................. ................... ........._...... Time worked on request 10 Response tttime: {0 's sw ;� ,�< C,�:� ;,. is Lr F�;�t'7arpk� s aja tiro _ „F ..::::.tY �.'..�, `•. V,1'`.3 .3., .�. ,E..3F �,.t. I R 1f Jt 4,--_. brneE . �,ci:�(_lred from tlhL cr do n i -��to yo I7 �?irst saw ons on t hc� . j ID'o nio include n g -fts d��l �=4t�.,, ar, � i.:`•t3 r rk"g,ponse �.:d'le for mosI £�..� Y{,- Check to notify town employee below http://issgl2/IntemalWRS/WRequest.aspx?ID=31366 6/25/2010 I Message Page I of 2 O'Connell, Timothy From: Wadlington, Ellen Sent: Friday, June 25, 2010 12:35 PM To: O'Connell, Timothy Subject: FW: 126 Plum Street Ellen Wadlington -----Original Message----- From: McKean, Thomas Sent: Friday, June 25, 2010 10:36 AM To: Wadlington, Ellen Subject: Re: 126 Plum Street Please have the health inspector provide me a written report adressing garbage, vehicles, etc The complainant wrote. "Mr. Hallett continues to run the back hoe incessantly and she has not heard back from anyone from Health." - From: McKean, Thomas To: Wadlington, Ellen ' Sent: Fri Jun 25 09:32:29 2010 Subject: Fw: 126 Plum Street i el 4,7t, Please log in complaint From: Geiler, Tom To: Gatewood, Rob; McKean,Thomas; Perry, Tom < Sent: Fri Jun 25 07:47:58 2010 Subject: Fw: 126 Plum Street Please review this complaint and respond to me in writing with your findings and actions, no later than June 30. From: Klimm, John To: Geiler,Tom Sent: Fri Jun 25 07:40:19 2010 Subject: Fw: 126 Plum Street -------------------------- r Sent from my BlackBerry Wireless Device From: acanedy@comcast.net <acanedy@comcast.net> To: Klimm, John w Sent: Fri Jun 25 07:32:45 2010 Subject: 126 Plum Street John: I am writing about a constituent complaint I received earlier this week. I have would have forwarded this to you earlier but my computer has not been able to send out emails. The constituent is Marjorie Madden, 103 Moco Road in West Barnstable, She is having 6/25/2010 Message Palle 2 of 2 b problems with her rear abutting neighbor Charles ? Hallett 126 Plum Street.p g g ( ) S eet. Mr. Hallett apparently has been running a back hoe constantly for several years as he grades and regrades his property all day sometimes not quitting under after 9 pm. Mrs Madden says that the odor is so noxious and the noise so loud that they have to keep their doors and windows closed all spring and summer and can not enjoy the outdoors. The odor is a strong diesel smell. This is particularly bothersome to Mrs. Madden's elderly parents. The Hallett property is also up-gradient of the Madden's well and of a pond located on Moco Road and Mrs. Madden is concerned with run off. Mrs. Madden says that in addition, Hallett has stripped his lot of all trees and there is no buffer between his property and hers, He apparently has just completed a garage which is separate from his own residence and abuts the Madden property, but continues to grade and regrade. She says the lot is littered with unregistered autos and other vehicles. She believes he may be working out of this garage. Mrs. Madden has apparently contacted the Town's Health Department (last week) and they said they would take care of the problem. However, Mr. Hallett continues to run the:back hoe incessantly and she has not heard back from anyone from Health. If Mrs. Madden's account is correct, and I have no reason to doubt it, I would think there could be a numberof potential violations: 1. Conservation: Clear cutting of trees up-gradient of well and pond 2. Health: Odor, trash,"possible building permit violation (if garage is used for other.than , vehicle storage) 3. Regulatory services: unregistered vehicles 4. Violation of 240-10-noxious odor 5. OKH violation if construction of garage required landscape plan Could you direct this complaint to the proper Town departments for assessment with`some indication when these issues could be addressed and how they will be addressed? Thank you. Ann B. Canedy Town Council - Precinct 1 Box 23 Cummaquid, MA. 02637 6/25/2010 240,10 Prohibited uses. The following uses are prohibited in all zoning districts: A. Any use which is injurious, noxious or offensive by reason of the emission of odor, fumes, dust, smoke, vibration, noise, lighting or other cause. B. A tent maintained or occupied for living or business purposes, except as permitted in § 240-9D above. [Amended 2-22-1996 by Order No. 95-194] C. A trailer parked, stored or occupied for living or business purposes, except as specifically provided for in §240-9 herein. D. Hotels and motels in Precincts 1, 2, 4, 6, and 7 as existing on November 9, 1983, except in the IND Limited and IND Industrial Districts. LQ -zz - b b4 i do 6; e ................... Message Page 1 of 2 O'Connell, Timothy From: McKean, Thomas Sent: Tuesday, August 03, 2010 10:01 AM To: O'Connell, Timothy Subject: Fw: Moco Road From: Geiler,Tom To: McKean,Thomas Sent: Tue Aug 03 09:58:05 2010 Subject: FW: Moco Road Tom, do you know if Tim had spoken at all to the complainant Ms Matton? -----Original Message----- From: Klimm, John Sent: Monday, August 02, 2010 1:18 PM To: Geiler, Tom Subject: Fw: Moco Road -------------------------- Sent from my BlackBerry Wireless Device From: acanedy@comcast.net <acanedy@comcast.net> To: Klimm, John Sent: Mon Aug 02 12:41:48 2010 } Subject: Moco Road ... John: Hope you are enjoying this glorious weather!! Several weeks ago, I forwarded to you a complaint a Mrs. Madden on Moco Road made about a neighbor-Hallet-on Plum Street. You had Tom Geiler, Darcy Karle and Tom Perry look into it and I appreciate that very much. No violations were found. Mrs. Madden is still contacting me. This is a very real annoyance for her and another Moco Road neighbor who has contacted me. In one of the emails, I noted that Tom Geiler said he would try to speak with Mrs. Madden. I don't think he has done that, but it would be great if he could. It was also indicated that staff would periodically check on the progress of construction. I have given Mrs. Madden the information gathered by staff. She says he (Hallett) works on other people's cars which I guess he denies, plays a radio until 1 am, leaves the compressor on and is generally harrassing her at this point. One question she asked me that I did not have an answer for is : does a building permit expire? I believe it might if construction has not commenced, but once construction has started, does construction have to be completed within a certain time frame? Mrs Madden can be contacted at 508-364-8075. 103 Moco Road. 8/3/2010 IMessage Page 2 of 2 Ann B. Canedy Town Council - Precinct 1 Box 23 Cummaquid, MA. 02637 8/3/2010 TOWN OF BARNSTABLE LOCATION D Pktj m SEWAGE # I V — - 1 VILLAGE W S A ASSESSOR'S MAP & LOT /9S—� INSTALLER'S NAME&PHONE NO. CoRdaN m!RUS y2.$s(,,tid SEPTIC TANK CAPACITY /500 Q_aI_ LEACHING FACILITY: (type) 3 3 o's (size) Id X ZYa NO.OF BEDROOMS /I BUILDER OR OWNER C h A R I F-S H A I IF_11 PERMTTDATE: Lf $ -!� COMPLIANCE DATE:�_I (e� 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) a50 t Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by - o 3y i fj a Sal a �d� Gu 1 � No. �O lO G/ A4 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS Yes 01pphration for Migpogal Opgtem Congtruction Vermtt Application for a Permit to Construct Pe)Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No.��� ��v� z �� �,® Ownr's Name,Address and Teel.No. f� //l Assessor's Map/Parceli9�� Installer's Name,Address,,and Tel.No. Designer's Name,Address and Tel.No. O'S Z;,&vI 1 . �css ya8���la Type of Building: Dwelling No.of Bedrooms_ Lot SizeJ11668 sq.ft. Garbage Grinder( ) Other Type of Building No.of Pers ns Showers( ) Cafeteria( ) Other Fixtures Design Flow "• � gallons per day. Calculated daily flow Ljqn gallons. Plan Date hk Number of sheets_ Revision Date Title Size of Septic Tank �a o 0 Type of S.A.S. 9-CV1916 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi Board of Heal ,Signed Date Ayplcatio.-,Approved Gu by_ Date 4 Application Disapproved for the following reasons Permit No. & Dare„Issued r�.9....r+�.---•. now. .t�� „ .-. 'kv._.- _ :r.m+cT-a�i + .. __ No. ��/ 4 .AL! ti �_ _ Fee THE.COMMONWEALTH'OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS V 01pprication for.)Diopogaf bpfinem Construction Permit Application for a Permit to Construct(/ti)Repair( )Upgrade( )Abandon( ) 3/Complete System ❑Individual Components L"on Address or Lot No.A;G �/vj�-Z j f�Z,f,_,.' Owner's Name,Address and Tel.No. Assessor's Map/Parcel I�nst,aller's Name Address,and Tel.Now Designer's Name,Address and Tel.No. 0.3� :�U i l is � as-6< '� s "Type of Building: Dwelling No.of Bedrooms_ _, Lot Size 6618sq.ft. Garbage Grinder( ) Other Type of Building No. f Pers ns "' Showers( ) Cafeteria( ) ' _ Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Jl i Number of she '. Revision Date z J Title Size of Septic Tank_�Q3 cl TYpe of S.A.S. Description of Soil t -* - t A ' Nature of Repairs or Alterations(Answer when applicable) h ' Date last inspected: f ' Agreement: ;d 4' 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 Certif- cafe of Compliance has been issued by thi Board of Heal ' Signed Date d.....: , APplicati:.n .Yproved bye r Jt. �, Date. _,�� Application Disapproved for the following reasons h r Permit No. O Z/�o t Date Issued �'"� ' --------------------;---- ————— ) -----� THE COMMONWEALTH OF MASSACHUSETTS c 4 BARNSTABLE, MASSACHUSETTS C ertificate of Compliance ,k THIS IS TO CE TIFY, at the O site wage Disposal System Constructed(X)Repaired ( )Upgraded( ) Abandoned )b 9,& FV Z V, at it 44Q has been constructed in accordance k with the provisions of Title 5 wAthe for Disposal System Construction Permit No. 7'Z//- dated Installer *1%A eta Designer The issuance of this permit shall not lieconstrued as a guarantee that the system will function as designed. Date" 1, 1 O _Inspector -----------------— — — ——— -- ------- 4 4 No. v Z/ 4�. Fee r'�— k THE COMMONWEALTH OF MASSACHUSETTS { w. PUBLIC HEALTH DIVISION`- BARNSTABLE., MASSACHUSETTS E lnigpogar *pgtem Congtruction Permit Permission is hereby granted to Ystruct Repair )Upgrad bandon( ) - System located at i+L / a m` t/� 5 r6 s � and as described in the above Application for 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 thi t. Date: G� Approved b 'K - r 1 TOWN OF BARNSTABLE (�Q LOCATION s R V ►'�� SEWAGE # VILLAGEo S A nn ^ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. lrokdd hl fJ��mr,� C ya.$• �y d �`/`� SEPTIC TANK CAPACITY 1500 Q,aI. LEACHING FACILITY: (type) &C fftuy 3 3 0'S (size) /O'.Y Spa ' NO.OF BEDROOMS / BUILDER OR OWNER C h A R I P-5 H I I 1--� 1 PERMTTDATE: COMPLIANCE DATE:_ i 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) a50 t Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 0 A � 7' A 8 3yi 3yb�"�1 13aX ya't � i CU 17Ex o, 41 56 1 � ti -7 O -------------- I , i 1?` C. 2`f 79 ZSX v� c\ N � W CJ �- N 3 `7S-,7 Z k 1�X32 J �' Po � r TO THE BEST OF MY INFORMATION, AS- BUILT" PLOT PLAN KNOWLEDGE, AND BELIEF THE BARNSTABLE, MASS. -/fJ�-2 �.n�.✓ SHOW S PLAN HAS BEEN LOCATE Y j GROUND AS INDICATED DATE /V14Y iy, 199U SCALE . mCox JOB /Y 86-aa CLIENT No.33" ,S`WEETSER ENGINEERING q d oP 235 GREAT WESTERN ROAD I /� P.O. BOX 713 ATE PROFESSIONAL LAND YOR SOUTH DENNIS, MASS. 398-3922 02660 FAX 398-3063 106 TOWN OF BARNSTABLE LOCATIONS ) d kU Yr SEWAGE # / 8 VILLAGE W �?ARS A ASSESSOR'S MAP & LOT /9S—02 INSTALLER'S NAME&PHONE NO. 0"OkddN 1�U m!Z2US y,11gsC46 I SEPTIC TANK CAPACITY _/500 ��LEACHING FACILITY: (type) 5•C�l��.0 3 3 0's (size) /O'Xd,9 NO.OF BEDROOMS BUILDER OR OWNER C h A R I LS H A I JZF/ 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 :a on site or within 200 feet of leaching facility) a150 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ca s P No.- ---- - Fee------- BOARDOF HEALTH TOWN OF BARNSTABLE Application for lVell Con0ruttionPermit Application is hereby made for a permit to Construct (Alter ( ), or Repair ( )an individual Well at: Lo —r ------------P------------ --- - -- - Location — Address Assessors Ma and Parcel k_C.il-Q i-1_-- AALIE- ----L07t Owner 3�$ ®cS�� 14,&s= oa(.0357 Installer — Driller Address Type of Building Dwelling---------------------------------------------------------------- Other - Type of Building------------------------- --------------------------------------- o. o Persons i Typeof Well- ---- ';- -- =------------------------------- Capacity-------------------------------------------------------- ----- Purpose of Well - -1� --------------------- 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 un4to,,a Certificate .of Com liance has been issued by the Board of Health. pp Sign d -= - - -�Q date 6 Application Approved By-- tzl -� -'�------------— -- -_ L__j__�_'_---- date Application Disapproved for the following reasons:------------------------------------------------------------------------------------------ ------- ----------------------------- date Permit No. --- - ----—------------- Issued------------ ----------------- ---—---------— —---------- -------------- date BOARD OF HEALTH TOWN OF BARNSTABLIE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (v), Altered ( ), or Repaired ( ) by---- ------------------ -------------------------- -------- - Installer at- -� b-- �i-__—_ - - Ar 11_� �� --------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ------Dated----------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- --- -------—--------- --- -- Inspector------------------------------------------—- - -- - - �_��_" _ _ . ',,,,�:.: Fee- No. ---- -� 1 BOARD OF HEALTH 1 TOWN -OF, BARNSTABLE �-- 2pplication-for Veil CootructionVermit Application is hereby made for a permit to Construct ( ►�, Alter ( ), or Repair ( )an individual Well at: Lo-r � -�i�1`'� - = --- car n s-> b12. ----------------------------=---------------------------- -- -- - Location - Address Assessors Map and Parcel - t Owner -s 3s RaM J-rf. 1 SC fires= L�GS � oa(D 3 5 -D---- r�_�-M�Q eft— ---D r; 2,n Se._�r Q ` c_1�. (` - ------ ------ Installer - Driller Address Type of Building Dwelling-------------------------------------------------------------- Other - Type of Building ------------------- No. of Persons----------------------------------------------______ e) " Typeof Well- ----- ;- - ------------------------------- Capacity-------------------------------------------------------------------------- Purpose of Well-------- L - ---------------------- 1 a 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 u a Certificate .of Compliance has been issued by the Board'of Health. f c Signed -_---_ - - - ---- - _ ---_-I_CD-------- date Application Approved By- date Application Disapproved for the following reasons:-------------------------------------------------------------------------------------- r ------------------------------------- --------------------------------- - - ----------- date Permit No. --- �-� ------- -- - Issued---------------- -------------------------------------------------------- date +�.•....:��,wn.•.._.-- --._...v.�__r>._ice�_��.,�_�._�,� �_��._,o� ._.. ,._ .- _.�+r_a�r-.,..Y.►^_.:�_.�_.4�.__`_ _. BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f ComPhance THIS IS TO CERTIFY, That the Individual Well Constructed (Altered''C ), or Repaired ( ) I LL ---------------------------------------------------- nstaller at ----- — ---—s- - ------ ------ ------ -- 4 has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. _W_�K J-------Dated-------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. J DATE------------ -------—------------------ Inspector---------------------------------------------------------------------------- +xa4-..wt.r - <. BOARD OF HEALTH TOWN OF BARNSTABLE Vell Construct ion Permit No. -- -� --- Fee----- '�- Permission is hereby granted---------------------------------------------------------------------------------------------------------------- to Construct ( ), Alter ( ), or Repair ( ) an Individual Well at: No. - -y -- - ------------------------------- Street as shown on the application for a Well Construction Permit - —-- --- - ------------- --------- ~----- No 1- - . - Dated -— = --- ------------------------) Board of Health DATE -=---— - -- ---- ------ Bottle Number: . 712501 _ Date: 0V27/98 Y 4 1 BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT 0 SUPERIOR COURT HOUSE ! V BARNSTABLE,MASSACHUSETTS 02630 �lA g 5 PHONE:362-2511 LAB 337 Client : HALLETT, AMY Collector: CHARLOTTE STIEFEL Mailing 20 MICHELLE AVENUE Affiliation: COUNTY STAFFER Address : COTUIT, MA 02635 Tvpe of Supply: W Telephone: Well Depth: 70 FT Sample Location: 24 PLUM STREET Date of Collection: 02/23/98 Town: WEST BARNSTABLE Date of Analysis : 02/23/98 PARAMETER SAMPLE RESULT RECOMMENDED LIMITS Total. Coliform Bacteria PRESENT 0 pH 5.4 Conductivity_ (micromhos/cm) 180 500 Iron (ppm) < 0 . 1 0 . 3 Nitrate-Nitrogen (ppm) < 0 . 1 10 . 0 Sodium (ppm) 9 20.0 Copper (ppm) < 0 . 1 l .•3 BASED ON THE ANALYSES PERFORMED, THE FOLLOWING, ADVISORIES ARE GIVEN: * This water sample exceeds the recommended maximum contamination level for drinking water clue to the presence of Col-iform Bacteria. I Thomas F. Bourne , Laboratory Diiector I I it Bottle Number: 716801. Date: 03/04/98 BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT Ut - SUPERIOR COURT HOUSE BARNSTABLE,MASSACHUSETTS 02630 �lq S 5 PHONE:362-2511 Client : HALLETT, AMY Collector: LAB337 Mailing 20 MICHELLE AVE Affiliation: Address : COTUIT MA 02635 Type of Supply: Telephone : Well Depth : Sample Location: 24 PLUMB ST Date of Collection : 03/02/98 Town: WEST BARNSTABLE Date of Analysis : 03/02/98 PARAMETER SAMPLE RESULT RECOMMENDED LIMITS Total Coliform Bacteria ABSENT 0 pH Conductivity (micromhos/cm) 500 Iron (ppm) 0. 3 Nitrate-Nitrocten (ppm) 10 .0 Sodium (ppm) 20. 0 Copper (ppm) 1 . 3 BASED ON THE ANALYSES PERFORMED, THE FOLLOWING ADVISORIES ARE GIVEN: This is a Retest * Water sample meets the recommended limits for drinhinq water of all above tested parameters . Thomas F. Bourne, Laboratory Director I Barnstable County Health and Environmental Laboratory Superior ,Court House, Route 6A P.O. Box 427 ' Barnstable, MA 02630 (508) 362-2511 ext. 337 Volatile Organic Analysis Analytical Method: 502.2 Collection Date: 02/23/98 Date Received: 02/23/98 Analysis Date: 03/06/98 Client: AMY HALLETT Mailing AMY HALLETT Sample Location: 24 Address: 20 MICHELLE -AVENUE PLUM STREET COTUIT MA 02635 WEST BARNSTABLE Sample ID: 712602 Laboratory ID: 712602 Sample Description: PRIVATE WELL Compound Amount MCL Reporting Detected (ug/L) (ug/L) Limit (ug/L) Benzene BRL 5. 0 0.5 Bromobenzene BRL 0.5 Bromochloromethane BRL 0.5 Bromodichloromethane BRL 0.5 Bromof orm BRL 0.5 Bromomethane BRL 0.5 n-Butylbenzene BRL 0.5 sec-Butylbenzene BRL 0.5 tart=Butylbenzene BRL. _ 0.5 - Carbon tetrachloride BRL 5. 0 0.5 Chlorobenzene BRL 100 0.5 Chloroethane -; y BRL " f 0.5 Chlorof orm 2 .8 0.5 Chloromethane BRL 0.5 2-Chlorotoluene . BRL 0. 5 4-Chlorotoluene BRL 0. 5 Dibromochloromethane BRL 0.5 1,2-Dibromo-3-chloropropane BRL 0. 5 1,2-Dibromoethane BRL 0.5 Dibromomethane BRL 0. 5 1,2-Dichlorobenzene BRL 600 0.5 1,3-Dichlorobenzene BRL 0.5 1,4-Dichlorobenzene BRL 5.0 0.5 Dichlorodifluoromethane BRL 0.5 1, 1-Dichloroethane BRL 0.5 1,2-Dichloroethane BRL 5. 0 0.5 1, 1-Dichloroethene BRL 7. 0 0. 5 cis-1,2-Dichloroethene BRL 70 0. 5 trans-1,2-Dichloroethene BRL 100 0. 5 1,2-Dichloropropane BRL 5. 0 0.5 1,3-Dichloropropane BRL 0.5 2,2-Dichloropropane BRL 0.5 1, 1-Dichloropropene BRL 0.5 cis-1,.3-Dichloropropene BRL 0.5 trans-ii-3-Dichloropropene BRL 0.5 Ethylbenzene�; BRL 700 0.5 Hexachlorobutadiene.- BRL 0.5 BRL: -Below Reporting Limit MCL: Maximum Contaminant Level f r * page 2 Sample ID: 712602 Laboratory ID: .712602 Compound Amount MCL Reporting Detected (ug/L) (ug/L) Limit (ug/L) Isopropylbenzene BRL 0.5 4-Isopropyltoluene BRL 0.5 Methylene chloride BRL 5.0 0.5 Naphthalene BRL 0.5 Propylbenzene BRL 0.5 Styrene BRL 100 0.5 1, 1, 1,2-Tetrachloroethane BRL 0.5 1, 1,2,2-Tetrachloroethane BRL 0.5 Tetrachloroethene BRL 5.0 0.5 Toluene BRL 1000 0.5 1,2, 3-Trichlorobenzene BRL 0.5 1,2,4-Trichlorobenzene BRL 70 0.5 1, 1, 1-Trichloroethane BRL 200 0.5 1, 1,2-Trichloroethane BRL 5.0 0.5 Trichloroethene BRL 5. 0 0.5 Trichlorofluoromethane BRL 0.5 1,2, 3-Trichloropropane BRL 0.5 1,2,4-Trimethylbenzene BRL 0.5 1,3 , 5-Trimethylbenzene BRL 0.5 Vinyl chloride BRL 2 .0 0.5 Total Xylenes BRL 10000 0.5 BRL: Below Reporting Limit MCL: Maximum Contaminant Level Thomas F. Bourne, Laboratory Director Department of Health,Safety,and Environmental Services IM Public Health Division Date— 367 Main Street,I lyannis MA 02601 ! aAr MnABM rE ► Date Scheduled �E C 7/ /9 7 Time ID �� Fee I'll. /9 7 Soil Suitability Assessinent for Sewage Disposal Performed By: -rA �JU/77A5I �,5_f C.S.E . Witnessed By: G V (2,pLOCATION & GENERAL INFORMATION Location Address Owner's Name Lo r z d' f L,um S- . W. 309RY,5'MZl L.E- C//4,az5 AW 11-rTT Address ��m/Cf1E//E RVF, Coruir, ^1, ozeo Assessor's Map/Parcel: /9-s �z`/" Engineer's Nan rF-I ZDUmAS NFW CONSTRUCTION REPAIR 'relephone ff 3 BS-z4z5' Land Use gesl wow Slopes(%) 24—30 /,a Surface Stones "r Distances from: Open Water Body / R Possible Wet Area / R Drinking Wntcr Well 4/-TD it Drainage Way i Il Property Line �" /D fl Other R SKETCH: (Street name,dimensions of lot,exact locations of lest holes&perc tests,locate wetlands in proximity to holes) 4,6T z 4- N Ta J A- Alo WIE/Is o 1�1�l�rcAa� IJ/TH 1Y1 USV a 69 PRO 14*5 Parent malcrial(geologic) TBMAjj_9A'1 AE, Depth to Bedrock Depth to(iroundwaler Standing Water in I lole: Weeping from Pit Face Istimated Seasonal I ligh Groundwater IA DETERMINATION FOR SEASONAL HIGH NVA'I'ER TABLE Method Used: Dcplh I)hscrved slanding in ohs.hole: _ in. Depth to Soil tnolllcc o 0cp1h to weeping from side of obs.hole: in. Ciroundwalcr Adjuslnuwl l IlydCx Well N Reading Date: Index Well level_ Adj.factor Adj,t i mindr%:w i I (- rcl PE,RC'OLATION TEST Dale Iliar ------ Observation Itole N Time at 9" ------------ Dcplh of Pere Tintc at G" Start I'rc-soak I inrc(ii) Time(9--6-) find Pre-soak Rate olio./Inch •N/ / 910 a /3z Site Suitahiliiy Assessment: Site Passed Site Failed: Additional I coinit Nccdcd thiginai Puhlic I lcallh Division Observation Hole Data To lie Colliplcictl on lincic-------� Copy: Applicanl r UEXP OBSERVATION ]TOLL LOG II()lc # _:Z7 � Delrlh (foil) Soil I lorizon Soil•Texture Soil Color Sail OIhcr Surface(in.) (USDA) (Munscll) Mottling (Slnlcunc.Slones, Ilouldcres. 30— sa C r S r aT 4o,aM �� --------.._.------- 10 - 13R C ,z rr J 32-19.Z e 3 I.OpM y SAfI� N 0 G cry E DELI' OBSERVATION IIOLE LOG IIole ## ::&C- Dcpth lion) Soil Ilorizon —Soil'Icxture Soil Color ` ' `Soil Olhcr Surface(in.) (USDA) (Munscll) Molding (Slnicturc.Slimes. llooldcres. C:l is i,Ivl r;tLcl.) 36- 94'' Rlo" JS� -- Cz lI1EDIFINEJlgN� — I�JD 6�vE DEEP OBSERVATION HOLE LOG IMe ## Depth from Soil I lorizon Soil Texture Soil Color Soil ()Ihcr Surfacc(in.) (USDA) (Munscll) Molding (Slruclure,Sloncs. Itouldcres. DEEP OBSERVATION MOLL LOG Ilole ## _ Depth from Soil I lorizon Soil Tcxlurc Soil Color Soil ( thcr Surface(in.) (USDA) (Munscll) Molding (Suuclurc,Slone;, Iloiildcrcs. _(�Sllitiis.tcilcy..'i� c,iravcl) •i_I1Vu I lice Rafe MND: Ahovc 5O0 year flood boundary No_—/ Yes ✓ Wilhin 500 Year boundary No V Yes Wilhin 100 year flood boundary No Yes Vcalli Qf J_V_ bl--;ll.ly_Occurring Pervious Material Does`M least four f'ect of naturally occurring pervious material exist in all areas ohscl c d I III oI1 ,11mIl III(., area propnce(I for the soil absorption system? _ *_5 f not, what is the cloth of naturally occurring pervious material? cAtirie;(ti()n certify•th5t on //�¢ _(Mate) I have passed the soil evaluator exalninalirrn ;II,Inuvctl I,�� IIIL! Department oI I:nvironmenlal Protection an(I that the above analysis was perfln'IIICd I)y me cnn�i dent ,'ills !hc require(1 Im ill ing, expertise 111d experience described in 310 CMR 15.017. signature T -.— D a t c 1 ..�? 97 1 . y "Z-'.I. �I:,,l 1�; . , .,... -i _ .. s ..-. ar .. - 3 _.. ... _. c. ...��-.�t��"",I'�._.:,�,�._.�t.��-Ik1�'".-h'':,".,;._-1.r."1..I.I I.!,����;'.,.-�,.�t":"",,;-*.'"�I-�,.-.,--�m,-,�-',"'-,,,-,-.�,.�._.,':,I..�_0I�­-WII­1,I.A-.�.1z.?I,-­I'.,-,'�i- I"I.�I;I, -,�. .-".,���:.1.�., .'I�1�I4 I,.;:I,I­-�. I.�.I-I 11 1I.1-�.-% , ♦ -, .... "1--I'�.i. ,. 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C�`IERS: LW W ANO SEED 4• sdlEDULE 4o Pvc PEE ,_ OBSERVATION HOLE 1 ELEv.- ELEy,-,:. .� OBSERVATION HOLE' 2 1�1 �'�; al . , s PERCOLATION RATE ,e S" MML/INCH AT 132 INCHES PERCOLATION RATE _ M*L AT. 4d N�Iq�IES ,- . ..S I. L,,�I NIEI N - IMAM PITCH 1/8' PER FT. :. ., ,.,, ._� ' :� . M ".. OF - V TO 1/�• THE RE COLOR MOTr. 07M DEPTH IIOR12 '(EXTURE O • .. _ . - A�,y��� li • .,.. _ - i,•M ♦C7�T 0 QI/� f4NDr 7�/f/ QOf-K.5: O.- 81 610 11 kRJ"too m I . /EGG - ,24, 4 CAST IRON PIPE 9 7' 1 NOT REQUIRED _ ,_i, ., MUM -, a . . (OR EQUAL MINI 8 30 8 > . , M 4 P FT.. _ 5� S,�TLo�n -44 �� r PITCH 1� • . 1 CU. FT. OF 3c (' r C � 1. - . , . . . - T ': . "� CONCRETE ♦ .. _ { pW 4. I a ANCHOR z ,.t FL LINE. . f 9 10. f31- G C�}.1 $RNt so - uP III�1.I.-.1.­.I L.,..LI.I._I IL,I�I�I�.�._ILI,.tI...I I iI.1I lL I...:.I I-�,,���I-:,.��4.I1�.�q!,-Z,I.3�I1 I.L,_I�X�I II.,-1.I-:ELEV - -2--- -_,11-%1.�-I._1 L,I.1.,I.,�"._I I��_1I.;"L­-,:,.-I-')'.,..!�-,.ILI,1 L-:'__�.�.j­,.,,IL..I,.'_I­,�,.�.F.I-�L.-�.�,:,,­1��­.I�I.,I�`I:IL­I.II�.:,_-,L,.�'...L.'a��l.II.....�I..I..1...��-.�.'..,"L.,,_.-.,-1 L,1 11�II I I-.%I,I:­�....,��.�­.­.�-,I I.II I LI'I L­�I�­I�,-I,I,,I,,_�I-.-I�I1��4—1 L,:.`-�I.,,,L.-,I�1.,:+,11.�­.L.�,,­L.I;�,:�.I L,."L�11_1I:1'1.�:I:1 1I,I1�_.2IL'�L�-_:.1 I7,-�-I�-LI�.I.�I'��,�i�''1IA,-�:�­�-,.­'-�L I,.I.1,I,.'A-�:,LI-I,�.I-:�1 11...,.r.....�......�,.�,,,l.....­,I I--�.�-._L �I ­I-,,&I-.I­�?L 1',�1 I:-" 111 w. s . , . : _ _ - i. , ; ':4,G r ELEV. � ELEV. - . G ft �41 o a ELEV. 3, , E1F1/.. _ . , LTC /� ^- BAF _ 30,.S ,..C� _�._3 ,�,t :3. E ISTRIBUTION , 'a I. , ..s >. RD1G'To EL A8.8 jo�aN ,. El E1/. s evF (+n f39 Q BOX : , 93.6 . (TO BE PLACED ON FIRM BASE) ; - i - . _ TO 8E WATER TESTED c a x -+z' -,TRENCH FoWATi0N 3 1 O ON " tF MORE.THAN ONE.ouTLET tb' . 5 O� GALL � _ -_ (TO BE PLACED ON FIRM RASE)_ - WELL -N O WATER ENCOUNTERED AT 192 ELEV. ' ��., Nb M►ATER ENCOUNTERED A7 alSro" . may,- m 83•'8_ SOIL ABSORPTION � -----: ----- SEPTIC TANK t„ ZONE . 31e To 1 1/2" ' INDEX - . SYSTEM (SAS) ,- WASHED STONE - , . - : AD ST . LEGEND: ,t DESIGN CALCULATIONS BOTTOM OF TEST HOLE ELEV. - b_�. $ . NUMBER OF BEDROOMs '+' - - EXISTING SPOT ELEVATION 00,�0: : .SEWAGE DISPOSAL SYSTEM .PROFILE . . OBSERVED WATER TABLE (- / ,' ) ELEV. - N , E>aSTiNG CONTOUR -00 GARBAGE DISPOSAL uN(T NOT TO SCALE FINAL SPOT ELEVATION TOTAL ESTIMATED FLOW . ,, ! ,.., . FINAL CONTOUR (I I O GAL/�t./DAY ) 4' BR.) CAL/bAY -. .. ,, , „ , , SOIL TEST LOCATION _` REQWtRED SEPTfC TANK CAPACITY: GAL. b:: <: - - . _,: .._- , UT} ACTUAL`=.OF SEPTIC TANK 6AL ,,._ LITY POLE -0- . . :` .. ,...- .:. . :. - t :. . _ -_ Tp ,_ .� _ SOS. cLA! 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MINIMUM , ,. . -, r -. ... „901L.ZEST DONE 9Y•:._J.�.. . 4 >- CLEAN. AND `- . CDVERS LOAM AND SEED - a _ ., OBSERVATION HOLE : 1 ELEV.- 9 �, - ,F IfII II -: . 4 SCHEDULE 40 PVC PIPE .. OBSERVATION HOLE. 2 ; - :. ,`MIN. ATE ..`S MIK/INCH AT 13 x INCHES PERCOLATION RAZE _..: MIN./U�CFi AT _ INCHES 1 . . . . lJ1 PITCH 1/8' PER FT PERCOLATION R , - OF . ., ., 1/Z' DEPTH COL MOTT. OTHER DEPTH COLOR MOTT. OTHER WASHED STONE 01 A S.N Jaq..r Roc'cS_ :. o 8' of A ' 7� VENT ;I,4 4' CAST'IRON PIPE , . . •. NOT REQUIRED 8--30 •8 g--a(o 3 . (OR EQUAL MINIMUM , . w tcao m- , � Sr�T La4P" �I. C 8ELT PITCH 1/4 PER FT. . - . 1 . _ - 1 CU. FT. OF . - C, + - - u,J 4- ! AN ORS -�a�. b. G C'z nalF,we FLOW IJNE 1 a CH l9, IN. • • :: • 19' . ., i.:. :-... . ::.- . , to ��, / • - . 44 3 ° � /. , G4.G Q. . . 'Z ELEV. ELEV. .. cAs ELEV: � i4,O 9 8 -. - . - _ _ :s , ,� r . BAft'LE <, Guy.._.G.., 3d 3 . I U 0 D STR B T1 N To`EL. 68.e` A :. ELEV. • S ovERD/G (►�/as Nj, Q . BOX (TO BE PLACED OK FiR1A SASE) TO 8E WATER TESTED �+ .- /c x -+Z' -•TRENCH FORMATION 1500 GALLON` . IF MORE.THAN ONE OUTLET _. J ��., WELL N o WATER ENCOUNTERED AT 9z E1FV. 7��p %/d WATER ENCOUNTERED AT ELEV. 8 3.8 SEPTIC TANK (To BE PACED ON FlRM eASEy SOIL ABSORPTION - . . VIC TO 1 1/r ., SYSTEM (SAS INDEX P WASHED STONE ` ADJUST LEGEND: DESIGN CALCULATIONS f , BOTTOM OF:.TEST HOLE EIEV. .. 6=j. �� `�' EXISTING SPOT ELEVATION 00,�0 NUMBER OF BEDROOMS . } SSE WA GE DISPOSAL SYSTEM PROFILE : ,.. :; jj:j : vm WATER TABLE ( / / ) ELEv s - DOS7ING coNTnuR 00--- GARBAGE asPosAl. 0 : . . NOT TO SCALE - FINAL SPOT ELEVATION TOTAL ESTIMATED-FLOW .` . . : . FINAL CONTOUR �QURED =�ANIt X`-;�' BR.) GAL/bAY _ . SOIL lES T LOCATION CAPACRY GAL UTILJTY POLE -�- AM&U 51 ,OF.SEPTIC TMIK ,- . '1.�iSt� GAL . - _ , ,^ . ,., > .. ...r - SOE.:ir.ASStFiCATiON < TOWN WATER. . W . , - - . : CATCH BAST' DESIGN"°PERCOt.ATiON Ra1YE M;IN. . . •1 GAS UK G EFFLUENT:LOADING RATE>: GAL/bAY/S.F : t N ;,.I, • LEACH�IQ.AREA SQ•;FT . f I . _ t �� - - �i .3 cA . s✓'".. - .i: - I ACI fY X:RA GAL" AY . . ( /b . - _. ._ , i C , ,, _ > ,,, A, to .! +2o� -, ..: ,� E . , - 4 ,4 � , 7z A S < k. , L o . �.�'', , LEACHMIC-,�APACtIY . 1: _ } 4 4{�.4.'y l,SD 8S r :. :. ��¢ . 4 , t . _ ., . oA :. . . ct . ._ . , ,, , . ,- .. .. . ,/ n - _ _Z . . _ :.r _: N TE S.fi.___ , r . - s+ _ .. .: ♦ - ...M.. f! yr. . . ; . ' ', `i. ALL TNORIOdANSH� ANI� #�UIIERIALS SHALL.00I�CFtf�t-Ib.:D :.:. x.. y- tM1_ - t ..: .. r : ;',='iTRE'3:ANO•T�;�'i�OWN OF` >-RtA.ES AND ;�. . , , , . - fOR.•ME°DACE.DISPOSAL: OF.SEWAGE.-_ . ,: , .. , _ _ _ ,REQULATIONS '. - - .- ,: ,, . ,- .. _ _. :.. ... .::. ;... 2 ALL CI�V£RS.,1+O SANITARY'11ti175 SNIILI.,6E BItOt1GHT PO _ .. , -..._:... -. _- .. _ y. .. -..._. -...- ij° .-Tad': . _ - . , <S.ALL 00iJPONENiS:OF;'f HE;SANITARY SYsI'SHALL.'BE CAPABLE OF ::.: . - . . . I -�'x:WITiiSTAN�iNG fi-10'10ADINC UNLESS THY ARE t1NDER OR:WITHIN_ , \ �G i , . .10 20 Lp ADIN t ' �1 USED .UNDER OR Wtlt�ri 1A c_ DRIVES OR ARKMIG AREAS. . ;\ 4. ANY MASONARY: USED''TO DRING CQVERS TO`GRADE:SHJ1ti.' ,. . . l7 - o� '� I ! . • _ _,. __ _l ., .. - _, BE MMARED * PLACE _, _ . ,, r ..: .:• , _. . , . M � _ w , , ( , _ 3.!!0 DEIERMMATION:HAS BEEN ADE AS'(0 COMPLIANCE WiIK , s . : _ a DEEDED OR ZOMt+Ni: lEt�tJtfATIONE 01IMETt" APPLIGINT 1S_IC , - : -:: . \ OBTAIN SUCH DEt>Rt�1A110N FROM APPROPRIATE`AUTHORITY 1 „ ` 1 Y ., � / •r, 1 6.U'i1U'ilEs S"iiC�tkAi Ai2r_ 'PPitOXIMr',714 EX&Y. EXCAVATION GONTRAC'init �p . `` a3r ; r> # \ t iS TO CALL"'WG-SAFE' AT i-a00-322-4844•AT LEAST 72 HOURS , J m , ,.\.a¢' I . R `, I �� �:.:< PRIOR TO Vr01tIC ON SITE. . , 1<a ;1 r 7. CONTRACTOR IS :TO VERIFY GRADES AND ELEVATIONS AS WELL AS' - rY 1 t _ SITE'.00NDIIIONS PRIOR TO COMMENCING WORK ON SITE ' r` i-- _# 8. PARCEL IS iN FLOOD ZONE �' ' `;I I ' a - 4. LOT_IS'9HON4 ASSESSORS - ,;. P . -t I - r' - RE _-�,�1-���,-II .1.,�1�--II�I��1II,-�.-j­.AI��I�FIL�,�I:I t.'-��-.I.I.�.L,.,I)_1.I1L.,P L,.I-I,m�­_L-*,��.L�'I,..I-I-.'LI.,1�;*F�­,�..,-.I..,.,."­1L t2.I�I-.1 I.,.,I.-,..;,/,,'�.II".�..LII.�..I:-.'01I 1,,,.L'e�'.,­.1.:-.L.+-�L,fL tI,�,.IL.1-.�1-II..I,t��.­-?.,�-II�,I,+.�,,­._� . Y' `'TI qn. { , r SAS 4, 1o,-1JaI~lt�ls aeWj7LAwDs A�er t�•►7Cn k:rr,,.;� 0s .I..��.0�t,+-.',..L*�.*-j L�.,I�p�..��.-I..:., i --- . _ 1 � 7 ,T - , , }�e . r -�"�-- :, } •, ��•-- :- j i: , .4, ` . .- / f ` ,h, _., ; Pcu"or invn IN BAt,v5rAHr_F. Pr+p,' rcrE LNR`�7c►'hr"i' .'' kUHr1 r r AK 1 I� BY Dcv.'NCa� E• i ist �`. 6. rNG.Sr.wtE /'c . 1, ,- v U r ', - P (f f 1 r ,r : \ , 4 y� n !f 4 - .-L - �, \ -e - , rh:,, t T �_ APPROVED: BOARD OF HEALTH 'A,' 1.-- i f- L, - .- - � \ t r -f y f i 1- / \ J f \ - G -- - � - , :' , ` PROPOSED . SEPTIC DESIGN 991� -- _- , r �- -- _ _ - � - err► ,. - .. V. FOR \ , , -, - ,. ;�, . W CHARLES -AND AMY HALLET T . ,- : 3`!w ._ - ,/ :. ., i. - v . x , . . - �� y; -; - PRO,LECT:LOCATKaN - \� t--� % , . . , ;. ' , - _ -. - - L .` Lt?T.: 24 f?LUM STREET �l .�� 3 W. 6ARNSTAOU _ - ` ( _* ,. , s L r. . <� 4 m ! f""�., �� TADCONVIROI��EI�ITAL CONSULTANT'S \ ��% kiss �, � . \ ` �, • �` �a �' .,� / P.O.:BOX 615.' EAST-DENNIS, .MA_02641 _ >: O°� �, ' 385-2425 . - � T. A. DUMAS ., I,.,'-.1'-.1��,..Iv I.r.,­1�1.,..,­.-',.;:,/­-���,,...­�,-�,L-I�,TI�1,,I.;:,L,I�.­I I.1i,,I-��/�I1�..,-jL---."�,;-­,,..I-.�II I.�,,I-L.�I.L,1,I.I�'_.I 1 L.��I I1-�.,­.-...-..,,-,,,,.�1.I�.�1 i-�,,�..L"�II��L1,_-_%'-..7,.II 1..-I­..',.LI:�.,1.'.L-.,'-:�-I­�L/,IVi%,-'�,t.l.mI1 1�.1 W�,L­,L.1,1;1-�-,I. �:---­1L,-II I-1/1I,-1---I 1 I,I.1,-.1 I,w.V-�-1L-..I.r.III I-=I.:�2 \�v II I.:.-..L�I II`L,,�.­.I�'q'/I 1,1I-,.".1LILII 1T.,-��L'.I I1/.L�L.��L��.11�\ ILI,"-�­4­..LL 1I. III.I.�-III II I I"I.,.- IL _.. . t a. _ _ DATE j SCALE . �, �...L�I-.,2-I.I.I.'-I&��I.-0-10.II.-�::.I-''..,nn'I-+.,-..­IiL,L�-.I,I..I'­..,,'",,I L.I..I..I.-.1,L,..I-f 61 . 2 49197 30 �, I _ x _ 4G. . - • 1 - -- Y. .-. _ -..-.. r. _ a w i , is t _ _. .. . ;� R :. - JOB NO.:. A ^ REIASED : -.. :. .. .- .. ..,.,, .. - .4,:. - - a - -: .__ ti . I 3 f,, ,_. .r.-:Y 4. , .. - - , .. :-. -c b, - , •,�y��,<�� c- , r •.�A��•� <•: ' Yam.s. .. .. - _ - - - fir' t' <.- . o , . , a . y _, _ _ ON A SHEET. F�� - - _. �r _ .� _ LOCAL _ M I I - _- _ . T °�: ., .,,. Y: . �. ... ., : . h �. :. 4,.. .5. A.Y n..... .,.:,.<.:l. ,Y' . s:r•, a ,.,� ... ... • ». i .s., .._ 'x+>.aA' r.. .. h.. .,. , X of :a.. r. ,¢ �. ..... .. M1 ::- .-:v. , ., J...`x.. s:t �:.. .t.....5..,. ,.xax. .it.•J". ri. a ,. -...1..... .. .. .. i.,. s n .. n... 1, ,•.: _ .. .. _ _ ._ _ .. .. , s. .,..: .. .. a e .. .", .. K a.. e. - € .,. :. : v .._ .. .. .. . ._ ..,s -. .t. .. ... .. >•, - '._'. a.:. ,. ..._ -.._ , _. x. � .. .." r _ ... 1._. - '- _ 1 .y _ , __ �--1 __ - - - ---- ------ -_.-.._.. -_ -- ------ _ ----- ____ i1 I L _ I i i w t _ 20 FT. MINIMUM , FROM CELLAR SOIL , TEST r, tr � o DATE 7,C? 1 FT. MINIMUM ,FROM SLAB OR CRAWL SPACE TE OF SOIL TEST ELEV. a 10 FT.''.MINIMUM ., SOIL TEST ON Y • A. DUM CLEAN SAND TE DONE 8 I�.__ rr c>gam_ r v _ + CONCRETE - WITNESSED BY COVERS LOAM AND � ,. SEEP U V �4 ,SCHEDULE 40 PVC PIP ELEV . E OBSERVATION HOLE , 1 OBSERVATION HOLE 2 ELEV. �._ MIN. ' _ PITCH 1 8 PER E FT - � �. 3,r. - I 4 : PERCOLATION RATE MIN. NCH'AT 1 u/1 INCHES `PERCOLATION-RATE � MIN./iNCH AT INCHES 2 LAYER OF _ 1 TO DEPTH HORi_ /$ 1/22 TEXTURE COLOR MOTT.: .OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER W , •< ASHED STONE r. s AM- 4 r a_ � S _ o �; 01 �� • .., ti 4 ...CAST IRON 'PIPE VENT S I' kmv � ,•.c»c. . REQUIRED _ . OR Etx7AL NOT EQUIR MINIMUM:: .. .. :.. • :f'. PITCH 4 PER FT :1 P f 0 ,_ Z 7 Los; �w 3� .. r 3.. � S tc. Tc '. .. ,.. .� . _..:. - : • ♦ ram..... CONCRE TE FLOW NE ANCHOR LI fir. � a 10 i$7 C ELEV. .., M IN. p p- ppp ELEV. 19 a 7 r e - , 0 , r / / LEVEL p ELEV. GAS 4.0 6 SU s .�. ELEV• � ELEV. BAFFLE Gu.. : r F , o 1 D STRIBU TI ON . ELEV. �VFRb G. r Eg,B � t+y sa,v TO BE PLACED `ON RM HAS BO/\ .� _ � Fl E) WATER TO ._ BE TESTED l c. X �? 2. : TRENCH FORMATION IF MORE THAN ONE-OUTLET OUTLET 1500 . .GALLON TO BE PLACED ON FIRM..BASE WELL N o WATER:ENCOUNTERED AT _ ELEV. 7 t7 : WATER'ENCOUNTERED AT '� SOIL ABSORPTION N ELEV. :. SEPTIC ,TA �, N K ZONE 34 TD11 2 � INDEX WASHEDSYSTE M,STONE \ -`r E `ADJUST LEGEND, DESIGN CALCULATIONS BOTTOM OF TEST HOLE 0�R1 JCBLE ELEV.'= EXISTING SPOT ELEVATION 00 0 NUMBER OF BEDROOMS SEWAGE 'DISPOSAL` SYSTEM_ PROFILE x - OBSERVED WATER TABLE ( / ,/ ) ELEV. _ ' EXiST1NG CONTOUR ----00----- `GARBAGE'DISPOSAL UNIT NOT. TO SCALE `:.FIN SPOT TOTAL ESTIMATED FLOW ;<AL OT ELEVATION 4 FINAL CONTOUR 0 a GAL AY GAL.'' R. u ;+ SOIL TEST`LOCATION REQUIRED SEPTIC TANK CAPACITY .GAL UTILITY POLE -4- AC TUAL�`SiZE Of SEPTIC TANK o o GAL. • TOWN WATER WSW SOiL CLASSIFICATION _. CATCH BASIN ® DESIGN PERCOLATION .RATE MIN. N. GAS LINE G EFFLUENT LOADING RATE : _ 7 GAL/DAY/S.F.LEACHING AREA SQ. FT. IF --~ _ LE CAPACITY (AREA X RATE) -�, GAL. AY "�- , .4. a �}: ao x,2 1~G "RESERVE LEACHING CAPACITY 4 • Al NOTES. . . 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM v / T'0 D.E.P. ti TITLE S PRNS7'f.^C L-AND THE TOWN OF RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE 2 ALL COVERS TO SANITARY-UNITS SHALL BE:BROUGHT TO WITHIN 6. OF FINISHED_ � GRADE. ,, 3. COMPONENTS ALL NE OF THE SANITARY. SYSTEM SHALL'BE CAPABLE`OF --, WITHSTANDING H--10 LOADING U 4 NLJ=SS THEY ARE .UNDER OR WITHIN r• FT. ,Of 10 : DRIVES OR PARKING AREAS. H 20 LOADING SHALL BE "� USED UNDER OR WITHIN 10 FT. OF DRIVES 0� - fi� ,�..� � VES R PARKING AREAS, ♦ 1 4. N M „ r y ANY ASONARY 11NiTS USED TO BRING 'COVERS TO GRADE SHALL MORTAR i I BE MORTARED N PLACE, t 5 NO,DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 1 t a DEEDED OR ZONING REGULATIONS. OWNER APPLICANT 1S TO r f hr APPROPRIATE AUTHORITY. 1 _ .. ,�: r 6. UTILITIES 'SHOWN F OBTAIN SUCH DETERMINATION FROM ARE APPROXIMATE ONLY APPROP IA EXCAVATION CONTRACTOR , IS TO CALL DIG SAFE. A $ - T � 00--322 4$44 AT LEAST 72 HOURS - ri PRIOR T0'COMMENCiNG'WORK ON P, , ... n 4 ,:,. SITE.:. 1 �.... .�. 7.'CONTRACTOR IS`TI? VERIFY GRADES AND ELEVATIONS S�- f t � A WELL AS SITE CONDITION RI S PRIOR TO COMMENCING WORK ON SITE, 8 PARCEL IS IN-FLOOD ZONE _ 4 c- �, 9. LOT IS SHOWN ON ASSESSORS MAP .- AS PARCEL r 1 ff, � t r. - t E / *. ' P r / ! h Q GF t , 1' r'• s- , r' Ile ., , � ��. APPROVED: BOARD O F HEALTH f� _ E LTH A DATE ' AGENT PROPOSED SEPT IC DESIGN ! ' `�.. FOR 4 T• .. � W CHARGES AND Ar�IY HALLETT PROJECT LOCATION 1 �: r , �� LOT _24 PLUM STR EET W. ST t "I� ,; . BARN ABLE I 1 a lr , 1 r s �. r ..� � 4 TADCq ENVIRONMENTAL 'CONSULTANTS ti P.O. 'B X 6 0 15 EAST DENNIS MA 02641 :. +t ..� 385 T.�. t�il�1lAS 2425 w .. w 7' At, ow 619 SCALE � l2 J19 /97 -30 is r � REVISED to _JOB NO. 1 5 :3 REVISED LOCATIO N . MAP - . _ S. H EET OF 1 01995 T. A. DUMAS ; > .t u. , .,