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0157 POINT HILL ROAD - Health
157 Point Hill Road West Barnstable a: A= 136-023 1 f No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(%4 Upgrade( ) Abandon( ) ❑Complete System XYIndividual Components Location Address or Lot No. 15-7 f0T n T'A,*I( -I&a 4 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /3 toZ 3 V11. cM ��TGh tl� (r�4m�� ; Installer's Name,Address,and Tel.No. So$-k-1-1- leZ-7-1 Designer's Name,Address,and Tel.No. Zo�vlw Ov" co, fie. 3(03 ally"-fEs e<+rL, DIaui.i Type of Building: J Dwelling No.of Bedrooms 3 Lot Size 3 512co 0} sq.ft. Garbage Grinder( ) Other Type of Building 5 i ndk -vt' ,,ty No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided -3 j gpd Plan Date l 0 " IT — 202Z Number of sheets Revision Date Title 157 Pd eAZT ACY _ Z Size of Septic Tank / O o® Type of S.A.S. t A vixj. S177L.p �x 3Qj Description of Soil p a-vi Nature of Repairs or Alterations(Answer when applicable) *o Ot( Date last inspected: U r1 V_t10 W%1 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe t Date 1� Z0 Zb Application Approved by Date Application Disapproved by ( Date for the following reasons Permit No. c3 rd, � Date Issued ^ � �Y No. o <' Fee,. THE-COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTSYes � ZippYitation f Or bispos4 6psten ConstrUttion 30 rmit Ln Application for asPermit to Construct( 1 Repair(4 Upgrade( ) Abandon( ) ❑Complete System 'Individual Components Location Address or Lot No. i f 7 p0;h r a,'1( IZ o A � Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /3 to`Z 3 r ws Installer's Name,Address,and Tel.No. 5-CiT_q-7.1 Ij I'7 7 Designer's Name,Address,and Tel.No. Type of Building: Dwelling .No.of Bedrooms - Lot Size S 5,20 o t sq.;ft. Garbage Grinder( ) Other Type of Building Si ic,4A 'Aa -," No.of Persons Showers( ) Cafeteria(, ) Other Fixtures j r ' Design Flow(min.required) " gpd Design flow provided y , gpd Plan Date 10 - Q - 610 Number of sheets i{ Revision Date Title Po"h T" 1/ 1,J Size of Septic Tank Q�'�{� c Type of S.A.S. 1 a Description of Soil n #ZVI Nature of Repairs or Alterations /y(Answer when applicable) "_rKVV0_ T 6 (VO-A-.3 �--,�©V o _ r [*, Date last inspected: U r11~fit Q L,J vA Agreement: It t The undersigned agrees to ensure the construction and maintenance of the afore describedFon-site sewage disposal system in accordance with the provisions of Title 5 of the.Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this B-o-arr-d�of Health. SigneC,. 1�C •*•. Date !I-f Zd "Application Approved by toC ( - ' Date Application Disapproved by 'Date for the following reasons Permit No. �� Date Issued ( " 7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compfianre ' THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(, ) Upgraded( ) Abandoned( )by fRo 61flj fB - 44 0 or C o . L a "., r , 1 ti�?` at 151 p+�`t r1 Via,1 a 8 �'..£��� :`;onst u n"aacco d a o• a has�been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. &�� V dated ` d Installer 1 ,Cjkae/Vr 1�, t�Jf Co '94n e- Des gner _0 o";n. C :e 6-nc,-�,e�o- #bedrooms Y}Approved esi�n�flodw gpd The issuance of this permit shall not be construed as a guarantee that the system will funcbion as designed. 2 Date Inspector ,- - No. -C)d-(� 3 f � Fee "'✓ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION��BARN::STABLE MASSACHUSETTS Misoosal 6pstem ConstrUrtion permit Permission is hereby granted to Construct( ) Repair V_) Upgrade( ) Abandon( ) System located at 1517 b t h ✓ i,P fG-Id 1, U)-e1, _�,neA%it A 61-e'_ and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. r� w e. Provided:Construction must be completed within three years of the date of this permit. .r✓'""" (� ��v���'`� �j Date Approved b .J ./ rr Y 1 Town of Barnstable `"Erao Inspectional Services , i i Public Health Division 1 v M" Thomas McKean,Director i i6?9. yo �� .. 200 Main Street,Hyannis,MA 02601 K Office: 508-862-4644 Fax: 508-790-6304 h Installer & Designer Certification Form Date: I 1 d Z0 Sewage Permit# W ZO—35L Assessor's Map\Parcel %J��2_3 Designer: Down Cape Engineering, Inc. Installer: -Qf5j�gf IF), DU(Z CO. Address: 939 Route 6A Address: Yarmouth Port, MA 02675 On (I S I 20 � T"7,r�4. was issued a permit to install a (late) (installer) septic system at 115 7 r0lNJ- HILT. F (BEST gfk2N5T$F_LF, based on a design drawn by (address) Daniel A. 0jala, PE, PLS dated D Z (2-0 (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. Strip out (if required) was inspected and the soils were found satisfactory. 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. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in nce with the to rms of the RA approval letters (if applicable) I OF rtr',4S. DANIELA. ,p ij OJALA CIVIL (In ller's Signa re) No.46502 TNAL (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. UtoaldeplslHEALTBSEWERconnect4SEPTIC1DesignerCertifiication Form Rev 8.14-13.DOC TOWN OF BARNSTABLE LOCATION I5`i P©I.Jl /LL P-D. SEWAGE# ?.o?.o - 351 VILLAGE W. 6AWS08LL--ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO, U669,1- 3.OjAe SEPTIC TANK CAPACITY I DDo LEACHING FACILITY:(type) &CF N16 I.J Sro.Jr (size) ct %d NO.OF BEDROOMS 3 OWNER D* A-JA M t-mmELL PERMIT DATE: I I l 5 ZD COMPLIANCE DATE: t I I Separation Distance Between the: Maximum Adjusted Groundwater Table to.the Bottom of Leaching Facility 5' Feet Private Water Supply Well and Leaching Facility(If any wells exist on site.or within 20.0 feet of leaching facility) J`-� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ? /+ 3.$ Feet FURNISHED BY t-0. A -4r17 pots F Il 1W a P3, z 3 �95 (*43 9 qq �4.3 No. Woo 14 — 0 17 Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2ppricatiou jFor Vert Cougtructiou Permit Application is hereby made for a permit to Construct( Alter( ), or Repair( ) an individual well at: j 5�l Pa�n� Nib\ N o23 Location-Address Assessors Map and Parcel 15 Owner Address Uz5vy\" a OfAIMInt.- P.0-B oX 2-1 h3 rOa9wc UN Oz653 Installer-Driller Address Type of Building Dwelling " Other-Type of Building No. of Persons �I Type of Well SCt{"D p�pc Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 a Certif&cate of Compliange has been issued by the Board of Health. Signed Date ' r Application Approved By':1 4 Date Application Disapproved for the following reasons: Date Permit No. V- Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( Altered( ), or Repaired( ) by )6�51 Installer at All, Zc-- 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. � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEIE AT THE ELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector t.� No. Wc�01'7 �`-y— Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYication jfor Yell Construction 3permit Application is hereby made for a permit to Construct(J), Alter( ), or Repair( ) an individual well at: 13L/ o23 Location-Address Assessors Map and Parcel owner Address Installer-Driller r Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well r 5���'a pJL Capacity 1 d�. �Vw- Purpose of Well ?Oya,D Agreement: The undersigned agrees to install the afore described 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 a Certificate of Compharwe has been issued by the Board of Health. Signed �. Date Application Approved By-::j V1 Date Application Disapproved for the following reasons: Date Permit No. (n� oc (y ' I Issued / f— Date BOARD OF HEALTH TOWN OF BARNSTABLE r Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(L< Altered( ), or Repaired( by Z)6-5�y 61 2 Jc,c i,"J 6 -i� Installer at /�7 !�"e �,i / ic c & A) . .Ze 2 r2S L c 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 SATISFACTORILY. • 3 i Date Inspector BOARD OF HEALTH F�! 3 TOWN OF BARNSTABLE �A Yell Construction 3permit No. Vyp)D )q — V 4— Fee Permission is hereby granted to b d, i Installer to Construct(�), Alter or Repair( ) an individual well at: No. I �J1 QO�n'� �l\� QC�1 \� �OQ(Y,S+a)W L, Street as shown on the application for a Well Construction Permit No. d Dated U Date Approved By .rY�t � Gt;�,d", cr`�'(� 1 ' � EST, 1NBLLS 701(v- SUN Pelt $1 SFf OE r CUT ELLTOP 7.f 15.7 GARAGE OK Et..- 1&V 62 cr S I 4, 7.82 ' AILS6 STOI `� ♦� '� ca 100, 47 -15.27 463 I AsBuilt Page 1 of 1 ' P 1�-? l0 TION SEWAGE PERMIT NO. '� � h'/ ,� � O�d�• 2 a2, —moo VILLA.CE wes� �aY�, ' INSTALLER'S NAME i ADDRESS rc h co n s T BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -3(o /a Liq Ac http://issgl2/intranet/propdata/prebuilt.aspx?mappar=136023&seq=1 5/16/2014 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: New Well Street Number: Street Name: Q 157 POINT HILL ROAD Please specify well type: Building Lot#: Assessor's Map#: tJ' Domestic —� Assessor's Lot#: ZIP Code: Number Of Wells: 02668 City/Town: Well Location BARNSTABLE In public right-of-way: GPS G Yes G No North: West: 41.73086 70.39001 Subdivision/Property/Description: Mailing Address: r click here if same as well location addres Property Owner: Street Number: Street Name: DANA MITCHELL 157 POINT HILL ROAD CitylTown: State: Engineering Firm: ABINGTON MASSACHUSETTS ZIP Code: �C7 0 �. Board of health permit obtained: .ter p zE 'Yes G Not Required C Permit Number: Date Issued: r W2014 014 5/16/2014 � e r' 3 I . 4o c1 Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock ,Auger (--Choose Bedrock WELL LOG OVERBURDEN LITHOLOGY From Drop in drill Extra fast or slow Loss or addition of To(ft) Code Color Comment (ft) stem drill rate fluid 0 20 IMedium Sand 113rown r YES 0 NO 0 Fast r Slow 0 Loss C3 Addition 20 25 Medium Sand ;Brown 10 YES 0 NO r Fast 0 Slow r Loss Q Addition 25 30 ISilty Sand Brown GO YES r NO Fast r Slow r Loss r Addition 30 35 IFine To Coarse Sand Brown Ct YES NO GJ Fast r Slow r Loss 0 Addition WELL LOG BEDROCK LITHOLOGY From Drop in drill Extra fast or slow Loss or addition of Visible Extra To(ft) Code Comment Rust Large (ft) stem drill rate fluid Staining, Chips Choose Code f —1 G YES 0 NO I r Fast r Slow r Loss 0 Addition Fr Ye Ye ADDITIONAL WELL INFORMATION ............................................... Developed r Yes G No Disinfected R)Yes No Total Well Depth 35 Depth to Bedrock Fracture Surface Seal Type None Enhancement Ca Yes r No CASING r Is Casing above ground. From: 1 To: 0 From To Type Thickness Diameter Driveshoe 0 - 32 Polyvinyl Chloride Schedule 40 4 r Ye SCREEN r No Scree From To Type Slot Size Diameter 32 35 Stainless Steel Well Point 0.010 4 WATER-BEARING ZONES I I DRY WEL From To Yield(gpm) 24 35 12 PERMANENT PUMP(IF AVAILABLE) Pump Description --Choose Pump Horsepower [Horsepower Choose Description--- --- Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) Pump Intake Depth(ft) Nominal Pump Capacity(gpm) ANNULAR SEAL/FILTER PACK Ll From To Material 1 Weight Material 2 Weight WaterBatches Method Of Placement (gal) Choose Material lChoose Material --Choose One WELL TEST DATA Time Pumping Time To Recovery (ft Date Method Yield(gpm) Pumped Level (ft Recover (HH:MM) BGS) (HH:MM) BGS) 5/22/2014 lConstant Rate Pump 12 1:30 27 0:01 24 WATER LEVEL Date Measured Static Depth BGS (ft) Flowing Rate(gpm) 5/22/2014 24 12 COMMENTS WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete and accurate to the best of my knowledge. WILLIAM Supervising Driller DESMON Driller URQUHART Registration# 299 Monitoring[M] Signature THOMAS, DESMOND WELL Firm DRILLING,INC. Rig Permit# 024 Date Job Complete 5/22/2014 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. .a °F""' CERTIFICATE OF ANALYSIS Page: 1 of 1" 3 Barnstable County Health Laboratory (M-MA009) 3 " � Report Prepared For: Report Dated: 5/27/2014 Sally Desmond Desmond Well Drilling Order No.: G1480006 P O Box 2783 Orleans, MA 02653 Laboratory ID#: 1480006-01 Description: Water-Drinking Water Sample#: Sample Location: 157 Point Hill Rd., W. Barnstable Collected: 05/22/2014 Collected by: Customer Received: 05/22/2014 Routine M ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen 2.1 mg/L 0.10 10 EPA 300.0 LAP 5/22/2014 Iron ND mg/L 0.10 0.3 EPA 200.8 LAP 5/27/2014 Manganese 0.040 mg/L 0.025 EPA 200.8 LAP 5/27/2014 pH 6.0 PH AT 25C NA 6.5-8.5 SM 4500-H-B DCB 5/22/2014 Sodium 11 mg/L 2.5 20 EPA 200.8 LAP 5/27/2014 Total Coliform Absent P/A 0 0 SM 9222E RG 5/22/2014 Conductance 120 umohs/cm 2.0 SM 2510B DCB 5/22/2014 Water sample meets the recommended limits for drinking water of all the above tested parameters. Attached please find the laboratory certified parameter list. Approved By: (Lab Manager) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 IrvCERTIFICATE OF ANALYSIS . Barnstable County Health Laboratory (M-MA009) Recipient: Sally Desmond Matrix: Water-Drinking Water ! Desmond Well Drilling Sampled: 05/22/2014 13:30 1 P O Box 2783 Received: 05/22/2014 13:59 Orleans, MA 02653 Collection Address: 157 Point Hill Rd.,W. Barnstable 1 Order#: G1480006 Sample Location: Lab ID• 1480006-01 Description: Routine less Cu plus Mn Sample#: Date Analyzed: 5/28/2014 @ 13:57 Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Water sample meets the recommended limits for drinking water of all the above tested parameters. ! I EPA 524.2- Volatile Organics by GC/MS ' Parameter - Result j MCL � j Result ug/Lug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND j ! 0.50__ Chloroform - ND L 80 ( 0.50 I ,Chloromethane ND j ___-_, o•� ; as-1,2-Dichloroethene ND 70 oso ' Vinyl chloride ND 2.0 I 1 0.50 cis-1,3-Dichloropropene I ND , 0.50 i �Bromomethane _ ND I 0.50 I�Dibrom_ochloromethane ND �'-0,50 11,1,1,2-Tetrachloroethane l ND 0.50 ND 0.50 j Dibromomethane i i 1,1,1 Trichloroethane ND ; 200 0.50Ethyl ND 700 0.50-- 1,1,2,2 Tetrachloroethane ! ND ; _j 0.50 Hexachlorobutadiene _ ND + 0.50 ND Isprpylbenzene 0.5o2 Trichlorcetfiane i1J-Dichloroethane ND 0.50 Methylene chloride ND 5.0 o.so '---_- -- _.._ 1,1-Dichloroethene - ! ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 I - � - 1,1-Dichlo - roProPene -._..__._.._-i-_ ND o.50 ( Naphthalene ND j 0.50 1,2,3-Trichlorobenzene I ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane _ I ND ` 0.50 (In-Propylbenzene ND - 0.50 1,2,4-Trichlorobenzene I ND 70 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Tdmethyibenzene I ND I _ ! 0.50 --_f sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chioropro ane ( - ---� ! _p ND I 0.50 j Styrene _ND � 100 ^0.50 1,2-Dibromoethane(EDB) ND ' ---'� 0.50 tart-Butylbenzene -ND_ j 0.50 1,2 Dichlorobenzene ND 600 ± 0.50 Tetrac hloroethene - ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 _ _ 1,2 Dichbropropane _..._ I ND 0.50 Total xylenes - __.Np i0000 j 0.50 1,3,5-Trimethylbenzene ( ND ! 0.50 trans-l2-Dichloroethene ND 100 0.50 r- 1,3-Dichlorobenzene ; ND I o.5o trans-1,3-Dichloropropene ND o.so _. 0 1,3-Dichioropropane ND j 0.50 Trichloroethene ND ! 5.0 C 0.50 I 1,4-Dichlorobenzene i ND _ 5.0 j 0.50 Trichlorofluoromethane ND I - 0.50 { ----.. 12i 2-Dichloropropane ND ' 0.50 - - . I Surrogates _ _ %Recovery QC omits(�k) 12-Chlorotoluene ND ; j 0.50 p-Bromofluorobenzene 81% 70 130 A-Chlorotoluene ND I 0.50 - - -- -- --- -I 11,2-Dichlorobenzene-d4 84% I 70 130 + 'Benzene ND i 5.0 I 0.50 _-_..-- JBromobenzene - - ND 1 0.50 _ 113romochloromethane ND < I 0.50 Bromodichloromethane ND I i 0.50 jBromoform ND i 0.50 l Carbon tetrachloride ND 5.0 0.50 i IChlorobenzene ND �j 100 I 0.50 Chloroethane ND I 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 608-376-6605 Page 1 of 1 i s SNE Town of Barnstable Barnstable OF Tp� � Regulatory Services Department M"a�1 i BARMASS.LE,o! public Health Division m MASS. 0 �A 163q. �0 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #701 1 0470 0001 4525 6713 April 17, 2012 Ms. Mildred E. Fuller 157 Point Hill Road West Barnstable, MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5. • The septic system located at 157 Point Hill, Road, West Barnstable, MA, was last inspected on 4/4/2012 by Troy Williams, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails"under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in Hydraulic Failure r You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system with in the deadline period will result in future enforcement action. em;R.S. CHO THE B ARD OF HEALTH Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\TOB Itr Parcel Detail http://issgl2/intranet/propdata/ParcelDetaii.aspx?ID=8521 c. Logged In As: Parcel Detail Wednesday,April 11 2012 Parcel Lookup Parcel info Parcel ID 136-023 I Developer LOT 8 Lo Location 157 POINT HILL ROAD I Pri Frontage 160 Sec Road I Sec Frontage Village WEST BARNSTABLE I Fire District W BARNSTABLE Town sewer exists at this address No ( Road Index 1287 Asbuilt Septic Scan: Interactive�i, 136023_1 Map - Owner Info owner FULLER, MILDRED E I Co-owner Streets 157 POINT HILL ROAD I Street2 City W BARNSTABLE I State MA Zip 02668 Country v Land Info Acres 0.80 use Single Fam MDL-01 I Zoning RF Nghbd 0114 Topography Level ( Road utilities Gas,Well,Septic I Location Water View Construction Info Building 1 of 1 Year 1980 I Roof Gable/Hip I Ext Clapboard Built Struct Wall Living 2376 I Roof Ash/F GIs;Cm I AC None I 72 DK 20 p p Area Cover Type UAT 12 Style Saltbox Wall nt Drywall Rooms Be 3 Bedrooms I 4 GAR ? 1510 Int Bath 22 14 FEP 1010 t0 Model Residential Floor Hardwood Rooms 2 Full+ 1 H I oP 3 15 B/MM�51TT, 10 8•d4• �- Grade Average Plus I Heat Hot Water Total 6 Rooms I 44 Type Rooms FUS. Heat Found ,BAS. - Stories 1.5 Fuel Oil ( atio Typical I eMT,, 44: Gross 5478 ' Area Permit History http://issg12/intranet/propdata/ParcelDetail.aspx?ID=8521 4/11/2012 ����� �'�/��e � � � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owners Name information is required for every 157 Point Hill Road,West Barnstable MA 02668 April 4, 2012 page. City/Town 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 filling out forms A. General Information on the computer, OPY use only the tab 1. Inspector: R key to move your cursor-do not Troy Williams use the return Name of Inspector key. Troy Williams Septic Inspections Company Name 19 Hummel Drive Company Address South Dennis MA 02660 City/Town State Zip Code (508) 385- 1300 S1682 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and makdenance ofdn sit8 sewage disposal systems. I am a DEP approved system inspector pursuant to Se tion 15:aO of.* Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails :pc- 13 ❑ Needs Further Evaluation by the Local Approving Authority ry April 4, 2012 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. ****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. L% t5ins•11110 Title 5 Official Inspection Form:SfturfSewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M-348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road,West Barnstable MA 02668 April 4 2012 required for every P page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): N/A 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 a 1 Commonwealth of Massachusetts ugTitle 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M -348 P-34 L-28 ` Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road, West Barnstable MA 02668 Aril 4, 2012 required for every p page. Cityrrown• State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with,approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ 'Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): N/A ❑ 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): N/A C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further,evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of,a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 M �r '157 Point Hill Road, West Barnstable M-348, P-34 L-28 Property Address John Fuller Owner Owner's Name informrequired is, 157 Point Hill Road West Barnstable MA 02668 April 4 2012 required for every , P , page. Cityrrown State Zip Code Date of Inspection" B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The,system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a'private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: N/A D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® , Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow I t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M-348 P 34 L-28 Property Address John Fuller Owner Owner's Name information is ' 157 Point Hill Road, West Barnstable MA 02668 April 4 2012 required for every P page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official. Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M r 157 Point Hill Road, West Barnstable M-348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road, West Barnstable MA 02668 Aril 4 2012 required for every P page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ' ` ® 0 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? ® El information the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of,distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):, 330 gpd x A 4. . t5ins•11110 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is April 157 Point Hill Road, West Barnstable MA 02668 A 4 2012 required for every p � , page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): private well Detail: exact well location unkown. Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A Grease trap present? _ ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N/A t5ins:11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road,West Barnstable M-348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is required for every 157 Point Hill Road, West Barnstable MA 02668 April 4, 2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): General Information Pumping Records: Source of information: Last pumped in 2007 per owner. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M-348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road West Barnstable MA 02668 April 4, 2012 required for every , page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Tank, d-box and leaching were installed on 10/31/80 per compliance Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18" feet Material of construction: ®cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints, venting, evidence of leakage, etc.): Lines were found clear at the time of inspection Septic Tank(locate on site plan): Depth below grade: 18"riser to 6" feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene El 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: 5.5'X1 0.5'X6' 1500 gallon Sludge depth: 4" t5ins•11110 Title 5 Official Inspection forth:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts = ti Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yy. 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is required for every 157 Point Hill Road, West Barnstable MA 02668 April 4, 2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 2 8 Scum thickness Thin layer Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? probe/measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): N/A Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/A N/A Dimensions: N/A Scum thickness Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A N/A Date of last pumping: Date t5ins•11/10 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �e 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road West Barnstable MA 02668 Aril 4, 2012 required for every � p page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): N/A Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/A Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): N/A "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments .�" 157 Point Hill Road, West Barnstable M-348 P- 34 L-28 Property Address John Fuller Owner Owner's Name information is required for every 157 Point Hill Road, West Barnstable MA 02668 April 4, 2012 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was found level and in working order. 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.): N/A - Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M _ - 348 P- 34 L 28 Property Address John Fuller Owner Owner's Name information is required for every 157 Point Hill Road, West Barnstable MA 02668 April 4, 2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type. ® 1 -6'X6' leach pit leaching pits number: with 2' of stone. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovativelalternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit was found with water level 6" below inlet on inspection with walls found stained above inlet line and up riser. This is evidence of leaching being full and in hydraulic failure at times in the past. Leaching does not have a minimum 1/2 day flow available at this time Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 a Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Officia'I Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M-348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road, West Barnstable MA 02668 Aril 4 2012 required for every p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A , Privy(locate on site plan): Materials of construction: _ N/A Dimensions N/A Depth of solids N/A Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A ' r t5ins•11110 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is required for every 157 Point Hill Road, West Barnstable MA 02668. April 4, 2012 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately I I GwNwr. lob' fj,✓J" f O 3 , ILl O 2 L,Df 3 ``I `5 13 . 3 �.. S 3- O t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 157 Point Hill Road,West Barnstable M-348 P-34 L-28 Property Address John Fuller , Owner Owner's Name information is 157 Point Hill Road,West Barnstable MA 02668 April 4, 2012 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ' ❑ Surface water , ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 13.0'+feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record 10/24/79 If checked, date of design plan reviewed: 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: SDW 252 Zone A 47.0' 1.1' adjustment You must describe how you established the high ground water elevation: Test hole showed no groundwater found at a depth of 13.0'. Groundwater adjustment at the time of inspection was 1.1'. Bottom of leaching at 9.0'was found not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins«11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 157 Point Hill Road, West Barnstable M -348 P-34 L-28 Property Address John Fuller Owner Owner's Name information is 157 Point Hill Road, West Barnstable MA 02668 April 4, 2012 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 FROM :down cape engineering' inc - FAX NO. :1508361-Y May. 17 2012 09:14AM P2 down cape engineering, inc. SIEVE SOILS ANALYSIS 157 POINT HILL RD W. BARNSTABLE, MA DATE OF REPORT: 5/17/12 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 157 POINT HILL ROAD, WEST BARNSTABLE LOCATION: DCE TEST HOLE #1 SIEVE ANALYSIS Weight Sarnpie(Grams): 235.0 SIZE ;WEIGHT RETAINED ; % RETAINED ; %PASSED 1„----------- -----sum -----------0'0 ------------676 ......... ... 100.09�° 0.0: 0.0%% 100.0°/ /4----------------------------------------------4__-_..-._--A-------------- 1%2" 0.0: 0.0%: 100.0% -------_-___ ;..........................+--------------------->•----------------- 0.0� 0.0%; 100.0'Y - --------�__-- - ---------------------r--------- ___-- ------ 0.0: 0.0A: 100.0°/ 10 8.6: 3.7%: ---..........-......---................A------..............%.................. 0 26_B: 11.3%: 88.7% -------------------- -1-------- 0 74.1: ---31-50/ -- - ..,$8.5% 0 176.2: 75.0%: 25.0% '100'-------;- - -- - --- -200.3:-------,_. -85 2%............14.8% 00_ 225.4: 95.7 ,' 4.3/0 ------- -------------------- , .f--------------------Y---------------- PAN: 233.2: 100.0%; 0.00/ SAMPLE: ; 235.0; NOTE:TEST ON PASSING#4 ONLY, 0.0% RETAINED ON#4<45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3(FINE SAND)(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OIL #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION s98%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1 as MINAN.MATER 10°F WAIS.q� NONCOMPACTED SOIL DESCRIPTION: FINE SAND 1..1/]`IwtGi; Slur [JANIELA.WALA "a CIVIL No.4_502 U FROM :down cape engineering inc FAX NO. :15083629880 May. 30 2012 11:02AM PI 71 Fr. cv-ic-es K. olm)5 r's 110, z NY) Moin Street, Hyzguiil""1.WA 0.'2601 Clf&,P: S09-962-464,1 I'HA: AR--'790-6304 ltkshm -�nfiva Yom] DI t 3 L ew a Pr'e r A) P-A Z11, Oil was is's-un'd 7 pe-i-mi I:to ins[ii-E a (date) hh el-) 'gertic,systi'm at —60 1 r)f /t ' l I. .'DaSCIJ 01L,1-df-gi F,'.13.di.',awn by AE 16 0111fuld. I ccofify t11LL1'th(, S('Ptje system.rt-Fei,P-n(xd above, vas jL1stafled :,'LlbsLautlally acnording to Lc (-*1vsi[,,u., -M-iich ia,'jy iarbmle mijam, approved uhiu-igus svicLl as kl-fual re'loca[lou of the di^"hibuliuu box,9JAIDT Sel'['U LMR, that the -x-ptit'-, system. rf,fe-ye-m-ed 3h0-Ve WLUs iiistallpd. with mi;jor uhai.i.gc:s (I.e. grifatur than 1.0, lawTal rc1uv;4tj.o.a of or aily verLic.al je-,Iocatio�i.of any uompoij.(:mt of the x-p-tic.: system) but in WAL st-'W' Local RtVLlhiliOILS, Plall DC VU ()-n 01- u-stifi(.-H '99-I)II11L by dc-'sle-w-'r to follow. I�A OF 4- DANIELA. OJALA Yt 1-1) CIVIL No,46502 PoF GIs N (Alt z 1) it .07TTUI TO .0A W T,�,,TABLE PUBLIC AEALUH Q091'.1111CA77, 011' a alit—kr :ROT] VOIRM AN'l) AS.?,TJ1LT CARD Allf WC TILU�QKYQU 3RF,(,'EfVFP BY T.4411-BARMSTABLE, 1'Ya3T,R )D.M—ST,4 F TOWN OF BARNSTABLE f , LOCATION SEWAGE# 20101 • /S8 VILLAGE �, a►CnS ,rl��ASSESSOR'S MAP&PARCEL J3L - P 3 INSTALLER'S NAME&PHONE NO. (3; C3 EXcQva►-)i oN SEPTIC TANK CAPACITY /DOO qc I LEACHING FACILITY:(type) =nJ'J-1rQ4pf S (09)(size) /JJL zy NO.OF BEDROOMS OWNER fTJ )fired F011er PERMIT DATE: COMPLIANCE DATE: 3•07 9• /Z. 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 AI- gl• 15 ' 0 Az• Bz• 2.1 ' A3• 13 ' 33• G 3' A4. 8G'(v a F-RflMT day• 5� ' 1 3 020 1 2-- 15 V OZ� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 4plitation for Misposal *pstPm Construction 3permit Application for a Permit to Construct( ) Repair(1�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5-7 t n+ t I ZO Owners N�IA�ddress,and Tel.No. Assessor's Map/Parcel .� 13(p �i arG'1 `23 Jo hn +v((ce 6N-6 49 — gg3,z Installer's N e,Address,and Tel.No. Designer's Na Address, nd Tel.No. -Br6 LXCQ ac -ion 509—)417-b&53 1Jovjn �-P.e 609,362- 641 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) n gpd Design flow provided 3 k2 gpd Plan Date ;d �I( L Number of sheets Revision Date Title l i 41P �5 cp ae-,P a n Size of Septic Tank Type of S.A.S. 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 Certificate of Compliance has been issued by this Board of alth. Signed Date 5 Application Approved by Date S f-7 ^ r�— Application Disapproved by Date for the following reasons Permit No. a 0 i1' 15 Date Issued S f� a Q 1.,1- Fee No. �� / THE COMMONWEALTH OF MASSACHaUSETT� Entered in computer: Yes PUBLIC HEALTH DIVISION - �MA TOWN OF BARNSTABLE,, SSACHUSETTS application for-IDIsposal *pstem Coustr Oon Permit Application for a Permit to Construct( ) Repair( � Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 157-PD I�h r+ H l I t IC 0 Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel -,.,L4 ao 136 To 23 fohnTjl(c.,te. 509-649 " qCi32, Installer's Name,Address,and Tel.'No. Designer's Name,Address,and Tel.No. B-t6 Excclvcjlon 509-)ALTO&53 1-)ovvn C ye, en 50V-362- Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3y gpd Design flow provided 3 3.h gpd Plan Date IL4117 -Number of sheets Revision Date r Title i Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) j Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in $ accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of ealth. ff Signed p h Date Application Approved by Date $- 7 - '�-- Application Disapproved by Date i for the following reasons f Permit No. a a �l ` 5 Date Issued 5- f 7- _ ------------------------------------------------ ----------- ------_ ----------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ,4' Upgraded( ) Abandoned( )_by l at 5 has been constructed in accordance with the pjpXisions of Title 5 and the for Disposal System!Construction Permit No.00��- 150 dated Installer v� 1 Designeron r no L )o 1rl 1 v #bedrooms s3 Approved design flow �l gpd i The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 5 f2o b, Inspector (`, # I ,r ^4 Jv &,(AJ i a f f ---- No. Fee --�UI�----'- -�- -f------------ --- ` - ----- - .. -,------3 ------- _---.--------------- ----- ----- --- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(' Upgrade( ) Abandon( ) System located at 01 F, 1- and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. 5 l� lr Date Approved by a' Town of Barnstable - Departi- ex'It of regulatory Services • � >���rAe�, 4 Public He0th DAvAsAm 1" 200 Main Street,Hyanuis MA 02601 Tate Scheduled_ � o'_ Time F L e Pd. `oil Suitability Assessm1entfor Se'wa .e Disposal Perfomcd By: �2�E y�`�A�-� + 'rYitnessed By; — --- LO CA7[ION & G EN NE ][Il FORIVIA`A ION Location Address �0 Owner's Name (le--- Address C //'',�, ��,,p ✓ Assessor's Map/Parcel: '� 3 6/L3 Engineer's Name i�0 W✓'\ lam(/l NEW CONSTRUCTION REPAIR Telephone It hd Land Use � S���T�tTt<64 Slopes(90) `� Surface Stunes r� t Distance's from: Open 4Vater Body, rl Possible Wel.Areq 100' fl Drinking Water Well I�ft O O t Draihe.ge Way 7, rt Properly Line r[ Oilier ft S KETCJH, (SLTeel came,dimensions of lot,exact locat ns f lest hales Ec pert tests,locale we[lands'jn prorinuly to holes) ( Z �N ^ ,,► � ,� r Parent material(geologtc)_VICC'L C^J �— Depth to I3vdroels Depth to Groundwater: Standing Water In 1-101e: II Weepllig I'I'ohl Pit paf a Estimated Seasonal High Groundwa[er � DE,T ERNUINTA7CION FOR SEASONA L HIGH WATER TABLE Mclhod Used: _ wi"-#Tz..W—„ Depth Observed standing in obs. hole: � _In. Deptll to s411 Ikloltk Depth to weeping from side of obs.hole: ill, Crouadwuler Adjus(hlent lndcx Well✓# 3.5'1� Reading Datc::Ab4dje Index Well IeVnl AdLI,fllctoP 1 tl� AtJ,Croundwuter Uve.l Observation Holc# Time lit 9" Depth of rc Tin1p at 6" _ Statt Pre-soak Time @ _ Time(9"-6") End Pic-soak Rate Min./Inch Silt Sui�labilily Assessment: Site Passed_ Silq'-Failed: Additional Testing Needed(YIN) Original: Public Hedlth Division Observation IIole Data To Be Completed on Back----- ***If percolation test is to be conducted witiiiaa 100' of wetia nd, yoea niuxst first uotiiy tine. Barnstable Conservation Division at least olle (1) Week Prior to begiiiining. Q:\S EPTfC\PERCFORM.DOC ID1IE ]�][�gT7C][OlOT lF]f®lC + LOG — Depth tram Soil Horizon ]I$®le # Surrace(in.) Soil Texture(USDA). Soil Soil Color _ . l (Mansell) Mottling N g (Stru Other cture,Stones'; Boulders, L Can ista c ravel 41 s z qf- , D]E]CI[D LOG OBSERVATION ff�®g.,7C Depth from Sail horizon Surrace(in.) Soil Texture Soil Color (USDA) Soil rr _ ) (Mansell) ^,^cltlirer 9 (Rructurr,IStones, Boulders. C sis e c %Gravel .„ — n DlE]EP OBSER�?�4TION De th Prom Soil Horizon So Hole Surrace On.,). il Texhira Soil Color. -�— (USDA) Soil (MunsGll) Mottling (Structure.Stones,Boulders, Co si to cy, 4a p( veil Q�]3�'I RVAA7CION� OLE, Depth fiorn ' Sail Horizon � ��` Hole Sr+rraoe(in.) Soil Tcxture Soil Color ' ., Soil --Other (USDA) (Mansell) Mottling (Structure,Stones; Boulders, Consistenc__ v 9y Oraveil I lfIVaod Insasn•arnce][take Mnp. Abovc 500 year Rood boundnry No Ycs A Within 500 year boundary No ' i+ Yes. %V11111n 100 year flood boundary No Yes De flu of Lyt¢nlrally C_iccu Prim)E ga vic)us Material Does at least four fe©t of naturally occurring pervious material exist in all areas obsery d throughout the area proposed for the soil absorptidn system. S )(l not, 1�'112t is the depth of naturally occurring pervio s maPal'ial? Ce> if-- carGlon 1 ' f certify that on � (date)I have passed the soil evaluator examination approved by the Dennrfm Ant cf En��+ -r,nme:otP.jii.�:: a N,... .t,.,. t,.,.._ +. - �. `.� a roams u+ut iuG Fiuuvc fi,Ti&r :;i� 1�✓a� �erfOr(r(cu' . I by me eunsrstent with IPae segtiired irai ing, expert' e and experience described in 10 CMIZ 15.017. Signature Datb q i Q:\SP-PTfCTERCrORM.DOC FROM :down cape engineering inc FAX NO. :15083629880 May. 30 2012 11:26AM Pi P-- 1 � � cz V,--u-nioxwu L IM- io u OM.r,c: 508-V2-^644 .Kfiqu L7-A- Date.: 1� -,i-! c �--rujit# J Lf 4een Insiallu.: Dc-d"Vilf.cy d d 7 wa.21 j.Gqj-jed Cj pemi.IL to instmid a 0 sc�t I A L IG SlYST-CM based on a dnsiffn.drawn 1) -Y T xltif�- Ichat the sc-P-hr, IiY'ti,`am rCeTf-rUd above was iastallu.d M,hsLM1iiU-7 IcCurcli-119 10 the,dcs.IP IQ I)TO 9(Id c,b,,,nKL.s snich as n afed ,D., 'AILdCh M4, , Clude, Millof FFIP distribution 1-.()y_ tank, be se.T.A.In 7Ptt:,mTt:fhrei1ccd abc,-�,e -WLU, jj)jqtIljJ.ULj 'Nif.h. ITegUC (",hElngUS 01-6. a:turLjj re.l.ocution of fb.e- ")'AS ur ALly veytj(-,ffl.I-cjonaTtop, of any C0Tr-p0ILc33IL r r L c jS. Ic iml SC','PtC HySt�,111) bUt ia a.GCO L C,,U 1 v s by c.'jr,,-,jt-,jjuj to fojIn-W. DANIGI-A, yr Y 0i CIVIL" No.46502 Pow P CD—.:�, COP/ Is MP IT 17F J-1 ID1 V is . TEIEI U I WY112i TWI, fIICYRm' WILL T-40..' U�L�2`1- CA:91; AL-L 07-23-13;09:28 ;From:BN Fiel To: 150879063C4 :7744137476 # 3/ 4 • ...... ... ...... .. .....:�:.......................ME D2Pc�ONE ........................................... .. , A.LTH OF MA,SSACRUSETTS - ----------- ........... BARNSTABL,E,MA,SSA.ciauSETTS Cerftf'fimte of OmmlivWre THIS LS TO that ulC Ott-site SeWago Disposal systeth t'ottstruCtad Abando1r ( { } Ropaircd{ v Upgraded( at 11 with the sions of Tine 5. �. hos baca constructed in aeCordance for Disposal System Constmetion,Parmit .o.o0C?a.—1�g dated bededotns The issuance o£this permit sha t not be construed as a Approved design flow SPd Date i �, guarantae that the system will fwtCticrt as designed. InSpector c a I 07-23-13;09:28 ;From:BgB Fiel To: 150879063C4 :7744137476 # 4/ 4 ` No. o•vtd ......-.......................... - . ]P THE COMMONVVEALTIJ OF MASSACEWSETTS Fee`I-OZ'—LX REALTY DMMON-BARN9TABLE, ASSACH>pSETTS ?cMaWion is horeby i= sttuct( �ertmit } �} SY loaatcd a# 1 r 5 c) t ) AbUidon{ ) and as tioscribed is the above A plic 4tion for Disposal System Construction�-omnit, The Applleant reoognixod his/bur duty to comply with. Tide 5 and he foilgwW9 local revisions or special coma ions. Provided:C=t Lion ust be m�letcd within thTcc etas of the data of this Date � Y lrt Approved by r 07-23-13;09:28 ;From:BoB Fiel To; 150879063C4 ;7744137476 # ?/ 4 EXIST. WELLS 120 r ,x EMST1N WELL PER SITE LAN SOT g o� 35,200 SFf �o. _ 17.91 18.p3 •.hh�� CA r DECK EXlST1NG INVERT DWELLING OUT EL. 25,13 TOP F►�DN, 15.7' 7.9G GARAGE EL.- 18.6' 181fi2 +1 7 15 1� 18.55 1 1 . S 7.61 18 1 17.82 `' i �Q 84 tir 17. QP 1 w`;• DRIVE CEDAR 4 94.98 a 6. 3 (TYYp -15.0 � �15.27 -4.65 I SEWAGE PERMIT NO. o VILLAGE INSTA LLER'S NAME i ADDRESS V�rc h Co n s I U I L D E R OR OWNER v .e �-- DATE PERMIT ISSUED DATE C01A,PLIANCE ISSUED 1d 21-d� .` .__ `3� _ r� � , . �9 �h 13 .�.� � � �� . . � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........t'e .. . . ........ We�;..................................................... Application is hereby made for a Permit to Construct (Pl�or Repair an Individual Sewage Disposal System at: Location-Address Z or Lot No. 2A114 A '..-IJ -Y wn Address In)Aller Address Type of Building Size Lot.-!tM20ja......Sq. feet ............ Diameter..... Depth below inlet 4�_ Total leaching area..A.4.4/1—sq. ft. Other Distribution box Dosing tank The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TII THE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. \ / Application Approved By..... g��--- � Date Application Disapproved �rthe reasons:-'--.----------'�--------..-----.._--------------------- ................................................................................................................................................................—.................................... Date Permit Date No ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH :. _...OF........ �---------- ............................... App iration for Dispug�a irks Tonstrurtion ramit Application is hereby ade for a Permit to Construct ( ).,.;,or Repair ( ) an Individual Sewage Disposal W s..y51's•.t t _ ., �: o r or,Lt ` .............. . .7.- ........ Owne o -•----•- • F i- In aller Jr Address dTyped Building » Size Lot............................Sq. feet Dwelling—No. of Bedrooms........I. ....i-----•---------------Expansion Attic VWh- Garbage Grinder (,/J p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( j 0.1 Other fixture . ...... . ----------t.....•'----•--•-----•-•--•--••-••-••---"---••-•----------•.......................................•--- W Design Flow........................ .... - gallons per person per day. Total daily flow........... .................gallons. WSeptic Tank—Liquid-*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench— o. .................... Width.................... Total Length.............. Total leaching area....................sq. ft.. Seepage Pif,No................._- Diameter.... Depth below inlet ..._. ........ Total;leaching area..;.,-,, -...sq. ft. z Other Distribution box ( ) Dosing tank aPercolation Test'•Result,f` Performed bY----•-••--•------------------------------••---•------•••---•---------..... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2- ..........minutes per inch. Depth of Test Pit :_ ._........'Depth to ground water........................ Pd ...-••---•---•------•......•.•.•.-•-•-------•.................................................. ......................................................... D Description of Soil . . 1 ".4- "� .. w ! /3 UNature of epairs orllterations—Answer when appl' , . ----------1- . •.....'�.................. /=Agreement: Th undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the prove 'ons of TITLE; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation u til a Certificate of Compliance has been issued by the board of health. t • i _ `Date Application Approved By _.._ .asr w y:vu ✓T/I / / to 7 ABplication Disapproved for the.following reasons:-------•------- --------•------------------------------------------•--............ r Date PermitNo......................................................... Issued....................................................... Date ,ta THE COMMONWEALTH OF MASSACHUSETTS BOARD �OF HEALTH ..... ✓di.........O F.......... .......................... rr#ifiratr n untp ianrr T49 IS 70 RTIFY, T t•t hidividual Sewage Disposal System constructed 4;�_ Repair ( ) by---• --- -- - -• - - - ------------------------•--- -- ................................................. ----......._.._..... Ins Her 1M air.j. --- .......... ...F..... .. .. ... k...... - J6 ha been inst,' led in accordance with the provisions o >df The State"sanitary o e as escr the application for Disposal Works Construction Permit N _. ......_.s/__X_ ............ dated_.. ,._...�tt__.. __�. V----•------_--••. THE ISSUANCE OF THIS CERTIFICATE SH NOT BE CONSTRUED AS A UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 33 DATE.......l _x �J.,.....e ....•••------------- Inspector_. ------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o... . .........OF... '�' FEFa,0.*--A:.•-•-• �i �rrn rkii Tono , n rrntit Permissio i ereby granted 3 .----••----•---•---•....................•------.0...................... b Co struct , or air ( I divid ewag is o stem at V ~ � '".... . �y / y t e of sr........ ............... as shown on the application for Disposal'Works Construction Pit Dated _._... J/ .__ ....._ _ __ .____----...................... DATE.--_.,- -----------•-----------------------•-•--..............-•---------..------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �..�-...., ..: W.1',- --sti+'1• �.i rYM if''_ rac�.•i r.+r r-rs�t r `T. r....;. ,�, ,r.,�.�- - •.. _ �r•��q���- tt.� � ,•� a�PKttLTI NEs �f'�t N - JT.�t"�i or, .4-t-r--Bcgo *ov• t�Z?v3- 0;40r -AwWl IcN• ,W�+CrS• H.'-. Nr —c�rLy a ow s 3 ►c l ld n Sao 6,4 FI P. 6H,4• - US,=— r cx>O davV-. TPt*<. tr�_ IN6 P^-�r - G. 5+cr1� �v= ?Sea ��• - usa ro' K-7'r � Plr + 7-I s-raNOL `s �1�•' r-+�1'Glrtf �i Ib �t 2./.+�-�- � K �j2 I r0) = Jp 6ou- . hh4D 1N kco W1 T40 ¢ -n nz- 5 _ wr p �I fl — W 7- p` � Q LA �� t � � SU �' ,III I �� '�%�e. ��y,,� �..- �''� q• t11 too re � x -114 Pull. F411-• G`. i I t Fri t-f INS• INV / 9 tNY• '.r;, � ( �4o.4P TO 9+•14,y g4-.,7 +--' 'remit-t = 1 I 0 _ 7 Z rP"f 4 tt�IE-/elf+� �L• �7,�tc�R � PCB+ E,1►1r• P.a.CLt�RS� 4 ,TN-1K !o �'71 Prr n' mF 31�,'' TO i'h w�E� _ . . _ !StrHrl� AZL-AwaAHV •+-2"GF 1 O 1 Fw hY• ! Cope Cod Boy L E G E N D SYSTEM DESIGN: SYSTEM PROFILE MARK CORNERS of NOTES LEACHING FIELD W/ o� PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) REBAR SET 4" BELOW 1. DATUM IS NAVD 88 tl�t 99 - EXISTING CONTOUR ACCESS COVERS TO WITHIN 6" OF FIN. GRADE INSPECTION PORT (SEE DETAIL) et GARBAGE DISPOSER IS NOT ALLOWED GRADE �e X TOP FOUND. EL. 17.8' 1 2% SLOPE 2. MUNICIPAL WATER IS NOT AVAILABLE Gt° EXIST. SPOT ELEV. DESIGN FLOW: 3 BEDROOMS © 110 GPD = 330 GPD , \ FILTER FABRIC -[99]- PROPOSED CONTOUR USE A 330 GPD DESIGN FLOW MINIMUM .75' OF COVER OVER PRECAST TOP 13.03 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 15.0-16.0 FINISHED GRADE- 4" LOAM & SEED PRECAST H-10 MIN. 2" WALL THICKNESS 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS [98.41 PROPOSED' SPOT EL. RISERS (TYP.) �` I`A TO BE AASHO H-LQ 2'� 4"� �; d. J TH1 SEPTIC TANK: 330 GPD (2) = 660 15.3' SCH40 PVC CLEAN FILL PIPES LEVEL 1ST 2' / / 5. PIPE JOINTS TO BE MADE WATERTIGHT. e° °l d Naywoy TEST HOLE **RE-USE EXISTING 1000 GAL. SEPTIC TANK 4" PERFORATED PVC 5. O.C. S=0.005 - ° 10" EXISTING 14" 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 2� SLOPE OF GROUND LEACHING: TEE SEPTIC TANK** TEE 13.9t'* 3/4"-1-1/2" DOUBLE WASHED o 310 CMR..15.000 (TITLE 5.) Locus 0 0000000000 \ 9" STONE LEACHING FIELD 6"DEPTH MIN. BELOW NV. ` UTILITY POLE 330 GPD (.74) = 446 SF REQUIRED GAS BAFFLE::` °00000°000° 12 7' ° 2 rj' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO / LEVEL BOTTOM o BE USED FOR LOT LINE STAKING OR ANY OTHER FIRE HYDRANT 15' X 39' = 585 SF OK 12.91 12.74 /.�/i,ii.�i i i / / / i i,i _ !•� +' 6" MIN. SUMP :\/\/.\/.\/.\/.\/.�/�/\/\, PURPOSE` - NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING 585 SF X .74 433 GPD OK 12" MIN. INT. DIM. �� 39•0' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. USE A 15' X 39' PIPE AND STONE LEACHING FIELD 6" CRUSHED STONE OR MECHANICAL 12.0' COMPACTION. (15.221 [2]) 9. COMPONENTS,NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND ( 2 % SLOPE) ( 1 % SLOPE) 5 O' y PERMISSION OBTAINED FROM BOARD OF HEALTH. FOUNDATION- EXIST. SEPTIC TANK 49' D' BOX 6' LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING FACILITY ADJUSTED GROUNDWATER DIGSAFE (1-888-344-7233) AND VERIFYING THE MA *THE INSTALLER SHALL VERIFY THE ** EL. 7.0 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT PRIOR TO COMMENCEMENT OF WORK. LOCUS MAP APPROVED DATE BOARD OF HEALTH LOCATIONS OF ALL UTILITIES AND ALL 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACESCALE 1"=2000't BUILDING SEWER OUTLETS AND WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ELEVATIONS PRIOR TO INSTALLING ANY CONDITIONS IF NOT SUITABLE REMOVED BENEATH AND 5' AROUND THE PROPOSED ASSESSORS MAP 136 PARCEL 23 PORTION OF SEPTIC SYSTEM LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND LOCUS IS WITHIN FEMA FLOOD ZONE AE EL. REMOVED 13 & ZONE X (AREA OF MINIMAL FLOOD HAZARD) AS SHOWN ON COMMUNITY PANEL #25001CO532J DATED 7/16/2014 IST. LL we � SRO 35 TEST HOLE LOGS p 33 34 32 ENGINEER: ARNE H. OJALA, PE, SE WITNESS: DON DESMARAIS, IRS 37 DATE: 5/14/12 30 PERC. RATE _ < 2 MIN INCH PER SITE WELL 29 CLASS I SOILS P# 13639 28 ELEV. ELEV. 27 0" 15.3' 0" 4 15.3' 26 2 24 25 0, A A 0 T 8 24 LS LS 22 5,200 S 23 10YR 4/2 10YR 4/2 S 12" 12" ^� 22 B B 21 FS FS 20 2.5Y 6/'4 2.5Y 6/4 20 48" 48" 19 � V C V TV 4X4 EXIST. WELL C 1 C 1 cA V eox ELEC PA a SILT LOAM SILT LOAM 18 DECK /"�cq� � 150.0 17 CA Tv---CATV 72" 2.5Y 6/3 9.3' 72" 2.5Y 6/3 9.3' 17 g SIEVE C2 C2 �EXISTING / WELL ADJUSTMENT DATA: MS MS DWELLING / WELL: SDW 252 114" OBS WATER 5.8' 114" OBS WATER 5.8' TOP FNDN. I 15 GARAGE a EL.= 17.8' 111 \ ZONE: A - 1 / ADJUSTMENT: 1 .2 (APRIL) � ' 6 132" 1 OYR 7/4 4.3' 132" 1 OYR 7/4 4.3' 17 \✓n x / / STONE 16 / �\ // 4 1 �\ / Qw 15 �y DRIVE CEDA (TY 2 / 5' OVAL OF UNSUITABLE SOIL REQUIRED AROUND PERIMETER OF LEACHING FACILITY, N ` r / / O DOWN WITH TO SUITABLE SASOIL LAYER.ND, TO MEET REPLACE TI ILE 5 SITE PLAN SPECIFICATIONS OF 310 CMR 15.255(3) 14 2 Vv o 157 POINT HILL ROAD a 22�0 . 3 WEST BARNSTABLE x �0 12 S NE DRIVE O PREPARED FOR g a � o ROBERT B. OUR CO. o ,J OCTOBER 29, 2020 � 10' � ,2 BENCHMARK � 0 Scale: 1"= 20' fi 0 CONCRETE BOUND p , , `� sq�y` ��_ di;: OF iygs y; EL - 12.2 F SS'�y . o� r Y:A 1 �r DAN1_i_A. 0 10 20 30 40 50 FEET r " DANIF_L L in OJALA �,,M o P ' OIVIL cn ry,,. _ A. y� No.46502 F off 508 362 4541 No.40380 c/01� J Ft G�;a fax 508-362-9880 downcope.com down ca e evihee i r . q, inc. civil engineers land surveyors ` 939 Main Street ( Rte 5A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 BI CE ##20-265 20-265 R.B.OUR.DWG SYSTEM DESIGN: Cape Cod Boy µ_ GARBAGE DISPOSER IS NOT ALLOWED SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES LEGEND MARKED WITH MAGNETIC TAPE OR PROVIDE WATERTIGHT MIN. 20" DIAM. (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. APPROX. NGVD '1. DATUM IS tt`l 99- EXISTING CONTOUR DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORTS TO F I - WITHIN 3" OF FINISH GRADE 2. MUNICIPAL WATER IS NOT AVAILABLE 0 X 99•1 EXIST. SPOT ELEV. USE A 330 GPD DESIGN FLOW \ TOP FOUND. EL 18s' 2% SLOPE REQUIRED OVER SYSTEM 16.0' - 16.9' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 99 PROPOSED CONTOUR MINIMUM .75' OF COVER OVER PRECAST ' SEPTIC TANK: 330 GPD (2) = 660 4. DESIGN LOADING FOR ALL PROPOSED UNITS TO BE [98•4] PROPOSED SPOT EL. RE-USE EXISTING SEPTIC TANK** AASHO H-1,Q ° 4"SCH40 PVC 4"�SCH47 PVC d' of o Way TH1 4 PIPES LEVEL 1ST 2' 5. PIPE JOINTS TO BE MADE WATERTIGHT. ec �. Hay TEST HOLE LEACHING: :'" 13.87 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH o� °H YYY 22; SLOPE OF GROUND 4.73 SF/LF x 4' LENGTH = 18.92 SF PER STD. *15.7' 10" '4- .' 310 CMR 000 (TITLE cocas ;. .. 15 (T 5.) QUICK 4 UNIT TEE SSEEIPnnc TANK TEE 14.5f*' 13.54' 330 GPD/0.74 GPD/SF = 446 SF LEACHING ° °°°°°°°°°° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO C UTILITY POLE GAS eAFFLE o 000000000000 0� 0.6T BE USED FOR LOT LINE STAKING OR ANY OTHER FIRE HYDRANT REQ D .. 13.75' 13.58 PURPOSE. ' 12.87' 0 7 24 QUICK4 STD. INFILTRATORS 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING 446 SF/18.92 SF/UNIT = 23.6 UNITS 6" MIN. SUMP 24' x 11.3' O.A. DIMS. 12" MIN INT. DIM. (NO STONE PROPOSED) 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED THEREFORE, USE GRAVELLESS SYSTEM OF (24) 6" CRUSHED STONE OR MECHANICAL WITHOUT'INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. STANDARD QUICK4 UNITS IN FIELD CONFIGURATION COMPACTION. (15.221 [21) o *THE INSTALLER SHALL VERIFY THE OF 4 ROWS OF 6 UNITS L' r 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCUS MAP LOCATIONS OF ALL UTILITIES AND ALL DIGSAFE (1-888-344-7233) AND VERIFYING THE BUILDING SEWER OUTLETS AND 24 UNITS x 18.92 SF/UNIT = 454 SF> 446 SF LOCATION OF ALL uNDERCRouND & OVERHEAD UTILITIES NOT TO SCALE PRIOR TO COMMENCEMENT OF WORK. ELEVATIONS PRIOR TO INSTALLING ANY 454 SF (0.74 GPD/SF) = 336 GPD (OK) (1.5 % SLOPE) ( 1 % SLOPE) ADJUSTED WATER ELEV. 7.7' PORTION OF SEPTIC SYSTEM 11.°ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 136 PARCEL 23 LEACHING BOTTOM TH 1 & 2 EL 5.0' REMOVED 5' BENEATH AND AROUND THE PROPOSED FOUNDATION EXIST SEPTIC TANK 49' D' BOX 6' LEACHING FACILITY. FACILITY MA 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND APPROVED DATE BOARD OF HEALTH REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE OW WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE EXIST. WELLS CONDITIONS IF NOT SUITABLE TEST HOLE LOGS ENGINEER: ARNE H. OJALA, PE, SE EXISTIN WELL PER SITE LAN WITNESS: DON DESMARAIS, RS DATE: 5/14/12 PERC. RATE _ < 2 MIN/INCH 220 CLASS I SOILS P# 13639 LOT 8 ELEV. r�I ELEV. 35,200 SFt ©o O" 4 16.0' 0» 4 16.0' A A LS LS 10 - 17.91 12" 12" CATV BOX 4X4 EXIST. WELLL B B 5 /I fLEC PAD �-20.48 FS FS CAT 98 ��-20.01 18.28 17.71 C , 20 / 1 2.5Y 6/4 2.5Y 6/4 DECK CATV ,� -/ 17.23 48" 489' +�6� .29 f{/ C1 C1 19 3 d SILT LOAM SILT LOAM INVERT DWELLINGX OUT EL. 7.96 1 //� 2.5Y 6/3 r 2.5Y 6/3 , 25.13 TOP FNDN. 18162 +1 '3 15.7' . `` 2 / 72rr 10.0 72" 10.0 GARAGE 23. EL.= 18.6' 11 +1, . 7 18 6 / 3315 1 6 �// WELL ADJUSTMENT DATA: SIEVE C2 C2 18.55 15.94 6•(,l / \ p / r ZONE: A WELL: SDW 252 21.6 / 1\ \�� 17.49 \ 2 / BENCHMARK: USE MAG NAIL MS MS \ 1782 � IN PAVEMENT AT EL. 15.6 �7.61 \ 18.0 1 84 `� % �� \\\ g //-�is.66 ADJUSTMENT: 1.2 (APRIL) 114" OBS WATER 6.5, 114" OBS WATER 6.5' 7.101 " 10YR 7 4 " 1OYR 7 4 r 132 / 5.0 132 / 5.0 /-16.66 STONE \ 1P / 16.60 \ / DRIVE 1 .•�. f // CEDAR 1 / o / 1 1 ( _ / / 3 TYP 7 V 6 5' REMOVAL OF UNSUITABLE SOIL REQUIRED 14.98 15.70 \ +1�"LILAC �-14.52 Q AROUND PERIMETER OF LEACHING FACILITY, \ 4-\.81 DOWN TO SUITABLE SOIL LAYER. REPLACE \\ / -k15.63 \-�5. , •\ LPIT ? O // O WITH CLEAN MED. SAND, TO MEET fff COVER Q5 1� I \ 5.47 \ 15 27 0p' // `C SPECIFICATIONS OF 310 CMR 15.255(3) i \ 4.65 5 T I T L E %om"A T E L A N _zz 14.25 r /4 // .� O F 22QO�, \\\ \• 3.10 12.58 13.10 i /`STONE 12.4 '13.06 157 POINT HILL ROAD � �-1.2 53_ .�\ f _i .72 DRIVE 12.51 55 WEST BARNSTABLE �7--L2,.48 57 / PREPARED FOR 12.23 B&B EXCAVATION/FULLER .43 .,12.09 12.39 MAY 14, 2012 + e1 .47 01 + Scale: 1 = 20 7.49 747 0 10 20 30 40 50 FEET 12.96 I ' � I I "* (HOFhf q off 508-362-4541 ASSgO fax 508-362-9880 DANIEL yG downcape.com DANIELA. (P I OJALAA. OJALA N down cope eaghneer/ng, inc. Na 46502 No.40980 �o,,� °^ S es \0 civil engineers _ land surveyors 5'0� �N 939 Main Street ( Rto 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 >2- > >8