Loading...
HomeMy WebLinkAbout0037 HAMBLIN'S HAYWAY - Health 37 Hamblins Ha ay Marstons Mills l A = 03 a - a � - - --- -- - - - TOWN OF BARNSTABLE LOCATION 2 b V��1 lJ� 11 `o-Oa-l ,3 r , 5' G�G1rL1 SEWAGE# VILLAGE t l . ASSESSOR'S MAP.&PARCEL 0yC DO INSTALLER'S NAME&PHONE SEPTIC TANK CAPACITY LEACHING FACILITY:(type) Z RL�c (size) NO.OF BED40OMS OWNER '00r l PERMIT DATE: Z COMPLIANCE DATE: o l 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 Leachin cility(If any wetlands exist within 300 feet of ac faci i Feet FURNISHED BY � z L� o a` 7 Wo • No. Zoo Fee 9/ed c� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF.BARNSTABLE, MASSACHUSETTS ftpYiration for Misposar 6pstem Construction Permit Application for a Permit to Construct( ) Repair v6nuade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.%4;1 KAM13(i A/S (4A-Ye0*Y O� era's Nam�A ress,and T Assessor's Map/Parcel 1 Installer's Name Address,and Tel.No. �iy Zf P ''3 Designer's Name,Address,and fel.No. G ros`i ice 14S� ` -ts 2[ c7 e 'er Type of Building:. Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building JJAV 5 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date —X2 5-�.1� / Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) A-11b/J Gh iseyk5 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 thi o d of Signed P Date Application Approved b Date a a Application Disapproved Date for the following reasons Permit No. Date Issued 11F�kV " No. i �.; 1 r f 3 f` Fee k THE COMMONWEALTH''OF MASSACHUSETTS Entered in computer: Yes PUBLIC'HEALTH DIVISION - TOWN OF'BARNSTABLE, MASSACHUSETTS roa pyyolicatlon for BIsposal *pstem Construction 3PPrmit Application for a Permit to,Construct(') Repair(1/ U�rade{ ) Abandon( ) El Complete System El Individual Components z, Location Address or Lot No.q•_ RP-h1R(1M5 !- 0YW A-Y O neJN Address,and Teel.No. Assessor's Map/Parcel Installer's Name Address,and Tel.No. �4y*"ON 0 PV)V)tS Designer's Name,Address,and Tel.No. G61J7�"l�Jtyt Ice M14 5Z*"'5—oct--a T 1 a Type of Building: Dwelling No.of Bedrooms" Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Qy'f .- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 3"1,2 5—,). 0 Number of sheets Revision Date r Title p r.. Size of Septic Tank Type of S.A.S. f F _ Description of Soil x V. Nature of Repairs or Alterations(Answer when applicable) tJP�,�f,-c.�. S-`�3 0 4-11"1 a Date last inspected: f 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 Bold of Health. ��/ ., Signed.I/ ,.. --h« a Date ' c/� Application Approved by ..,__. Date Application Disapproved�1y� �, Date for the following reasons Permit No. CYO Date Issued ���)T r -.. - - >-.�.--_-.-__--__.- -- -- - __•---------- --------__•- ._.--_•-_-•------.---------- THE COMMONWEALTH OF MASSACHUSETTS' (� BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(Upgraded( ) Abandoned( )by at kta 1•.4M R 14, 14-A_y 0A•• y has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. i-313 dated c7 � X Installer i �1t411l�f7� 1�UN1?}—C_, Designer #bedrooms r r Approved design flow (o gpd The issuance of this permit shall, not be construed as a guarantee that the system will functias-designed.n E ' Date I % r [ Inspector / Z ------------------------------------- No. . f? .� �� Fee's/00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-'BARNSTABLE,MASSACHUSETTS Bisposai*pstem Construction Permit S` Permission is hereby granted to Construct( ) Repair(u,< Upgrade(_ ) J: Abandon( ) System loocated at R f t/V / A7rW fF}� t 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:Corfsrttruction must be completed within three years of the date of this permit. Date { ? l ( Approved by r. Town of Barnstable Regulatory Services Richard V.Scali,Interim Director ' DAIUMMIM g Public Health Division i0'EnMa+" Thomas McKean,Director 200 Main Street,Hyannis,CIA 02601, Office: 508-8624644 Fax: 508-790-6344 Installer&.Designer Certification Form Date: � , Z sewage Permit## Assessor's MaplParcel �S Designer: t)ttutA o. 6eh5fa,. LrS Installer: .. Address: 1 .5 S fi = Ry ee A Address; Ono was issued a permit to install a (date) (installer) septic-system.at 42 Oq lnbli'y5 An w4�4 based on a design drawn by (address) ' D-%A 0- o. ow` >t s dated Y 25 , 0 2 . (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 mound satisfactory. I certify that the system referenced above was construe with the terms o the AA approval letters(:if applicable) DAVID D. COUGHAN©WR (In leCs_ Signal re) fior e �� sr R (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 BARNSTA.BLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptickDesigner Certification Fonn Rev 8-I4-13.doc I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIR�S� 1 � DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617)29Z5500 � =d o FO l 09 TRUDY-COXE `�000 Smr Lary ARGEO PAUL CELLUCCI DAVID&,STRUHS Commissioner Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM A PART A CERTIFICATION Property Address: 37Hamblins Hayway, Marstons Mills, MA Name of Owner: Hugh White Address of Owner: 175 West Main Street Date of Inspection: August 3, 2000 Hyannis, MA 02601 Name of Inspector: (Please Print) James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: James M. Ford Mailing Address: P.O. Box 49, Osterville, MA 02655-0049 Map: 030 Telephone Number: (508)862-9400 Parcel. 033 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ✓ Passes Conditionally Passes Needs Further Evaluat' By the Local Approving Authority 'Is Inspector's Signature: Date: August 6, 2000 The System Inspector shall submit py of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page 1of11 Primed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37 Hamblin Hayway, Marston Mills,MA Owner: % ti - Hugh White Date of Inspection: August 3, 2000 ' A INSPECTION SUMMARY: Check A, B, C, or D.- A. SYSTEM PASSES: ✓ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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. Indicate yes, no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, is cracked, structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or,breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system.will pass inspection if(with approval of the Board of Health) broken pipe(s)are replaced _ obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2of11 I w SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37Hamblins Hayway, Marston Mills,1MA Owner: Hugh White Date of Inspection: August 3, 2000 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 the public health,safety and 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 THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system(SAS)and the SAS is within;100 feet to a surface water supply or tributary to a surface water supply. ' The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 37Hamblins Hayway, Marston Mills,MA Owner: Hugh White Date of Inspection: August 3, 2000 D. SYST EM FAILS: You must indicate either"Yes"or"No"as to each of the following: _ I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 '/z day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 H of a public water supply well The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 37 Hamblin Hayway, Marston Mills, MA Owner: Hugh White ; Date of Inspection: August 3, 2000 Check if the following have been done: You must indicate either"Yes"or"No"as to each of the following: Yes No ✓ _ Pumping information was provided by the owner,occupant,or Board of Health. ✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ _ As built plans have been obtained and examined. Note if they are not available with N/A. ✓ The facility or dwelling was inspected for signs of sewage back-up. ✓ _ The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. ✓ _ All system components,excluding the Soil Absorption System,have been located on the site. ✓ _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for conditions of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.. The size and location of the Soil Absorption System on the site has been determined based on: ✓ _ Existing information. For example,Plan at B.O.H. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)]. ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 37 Hamblin Hayway, Marston Mills, MA P Y Owner: Hugh White Date of Inspection: August 3, 2000 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom. Number of bedrooms(design): n/a Number of bedrooms(actual): 4 Total DESIGN flow n/a Number of current residents: 9 Garbage grinder(yes or no): No Laundry(separate system)(yes or no): No; If yes, separate inspection required Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last two year's usage(gpd): 1999-232,000 gals.;1998-199,000 gals. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gpd(Based on 15.203) Basis of design flow Grease trap present: (yes or no) _ Industrial Waste Holding Tank present: (yes or no) Non-sanitary waste discharged to the Title 5 system: (yes or no) _ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pumped on Aug 20199 and Oct. 21193-per treatment plant. System pumped as part of inspection(yes or no): No If yes,volume pumped: gallons 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components;date installed(if known)and source of information: -Aug 2190•-per as built'cdrd. Sewage odors detected when arriving at the site: (yes or no) No revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 37 Hamblin Hayway, Marston Mills, MA Owner: Hugh White Date of Inspection: August 3, 2000 BUILDING SEWER: _ (Locate on site plan) Depth below grade: Material of construction: _cast iron 40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting,evidence of leakage,etc.) SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 24" Material of construction: ✓concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 1000 gal. Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: 29" Scum thickness: 12" Distance from top of scum to top of outlef tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: S" How dimensions were determined: Measuring stick Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) The baffle and tees were present The outlet pipe going to one pit(#2)is lower than the other one and is receiving all of the flow. Recommend Dumping GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 37Hamblins Hayway, Marstons Mills, MA Owner: Hugh White Date of Inspection: August 3, 2000 TIGHT OR HOLDING TANK: None (Tank must be pumped prior to,or at time, of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present: Alarm level: Alarm in working order: Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: None a, . (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER: None (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order: (Yes or No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 37 Hamblin Haywc , Marston Mills, MA'. Owner: Hugh White a Date of Inspection: August 3, 2000 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) If not located,explain: Type: leaching pits,number: 2-6'x 6' leaching chambers,number: leaching galleries, number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Alternative system: . Name of Technology: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) One pit (!l2)is receiving all of the flow, because the outlet pipe in the tank is lower than the other pit. The pit had S'of water on the bottom. The bottom to grade was approximately 9' The other pit 03)was dry, and the bottom to grade was 11'. CESSPOOLS: None (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(cesspool must be pumped as part of inspection). Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 37 Hamblin Hayway, Marston Mills, MA r Owner: Hugh White Date of Inspection: August 3, 2000 Map: 630 ' Parcel: 033 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) i C 3 revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 37Hamblins Hayway, Marston Mills, MA Owner: Hugh White Date of Inspection: August 3, 2000 NRCS Report name Soil Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 50 +/- Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions ✓ Checked with local Board.of Health Checked FEMA Maps Checked pumping records Check local excavators, installers ✓ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) The bottom of the pit to grade was approximately 11'. Using the Barnstable topographic map and water contours map, the maps were showing approximately 50' +/- to groundwater at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty the stem will ion properly in the ure. There have been no warranties or guarantees, either expressed, or guarantee that system fund p p y fur S written or implied, relating to the system, the inspection and/or this report. I revised 9/2/98 Page 11of11 ' 1 TOWN OF BARNSTABLE H �A LOCATION A^1Uv%S N O.-#6 AV SEWAGE # q 0- 3y VILLAGE AlArS 1 o-%j YVt►I1 S ASSESSOR'S MAP & LOT O30 033 INSTALLER'S NAME&PHONE NO. H�(aL t-i COAST SEPTIC TANK CAPACITY LEACHING FACILITY: (type) TS (size) a- G X NO. OF BEDROOMS q BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE tnsp ion 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 aAuk.. AI as, ai- s5 0 3a 8a- 8a JI A3- a3- b a TOWN OF BARNS TIL ABLE LOCATION f)"7 hl) SEWAGE # 9-0 " V/ VILLAGrE �fzS?6A)S �. ASSESSOR'S MAP & LOT III INSTALLER'S NAME f PHONE NO. 9 l (160Sti' U, o� SEPTIC TANK CAPACITY /4 00 0 LEACHING FACILITY::t7pe)7 NO. OF BEDROOMS- PRIVATE WE ISL OR PUBLIC WATE"R� BUILDER R OWNER DATE PERMIT ISSUED: o DATE CObt 71, IANCE ISSUED_ 7. VARIANCE GRANTED: Yes No { 4��i1 � f - Fimic............._....._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tomitrnrtinn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair } an Individual Sewage Disposal System at: Locati -Address ,9�F I yat Owner Address -P- 0� b •• � 6.... C C•!i s vi Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.....Y.................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria 04 Other fixtures ............................ W Design Flow.....................................I..___..gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .........:.......... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ •-------•--------------------•-----•------------------------------------•-----------•-•••----------•......................................................... O Description of Soil------. - ................3...~--------•..y--------•-�..thN------•-�..-Q---------•S .$ x V .---------------•------••------------------•-----------------•-------•--••-•-••-•••-------•---......-------------------------------------•-----•------------------------..........-•••-•----------....... ----------- - ------- - • -- ---•--------....•----------•••-••------•------------------......---•--------------------------------------------•---.................----••------. VNature of Repairs or Alterations—Answer when aRZlicable..___J! ......._ ' _'r..........�`000-_---..��L�:O�''� ----• ..cl--------------`--'......--------`ems------------.... ---.....---....f-...-.....----.....-•--------...--------------------------..................._.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n issued by t)he board of health. Signedd,:_7_ .--- �'^--------- ---- ------------------- ApplicationApproved By -------------- .............................................................-------- ---- Date Application Disapproved for the following reasons- -----------------------------------------------..........................................----------------------------------------- -- ------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------- ----------- ------------............................ Permit No. ------7G...... 3...!Y---l......................... Issued ----------.......---------------------------....----..mate---... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ;HEALTH TOWN OF BARNSTABLE Appliration for Diapniial lVorks Tunstrnr#uan ramit �. Application is hereby made for a Permit to Construct ( ) or Repair/<) an Individual Sewage Disposal System at.:,_ 1...._ 4r9`•► --------- .............•---- -- ----------------------------- ---- Location-Address or Lot jvo. Owner Address !At`�------�'--4�:__. w--------------------•-- e--Q-1•---..W......7.:3:4..............n e,�"''r�dJ4.t.lf� a Installer Address, UType of Building' t [ Size Lot............................Sq. feet I•—I Dwelling—No. of Bedrooms--.----. .................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -------------------------------- • W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. `. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench—No........... ..... Width-................. Total Length.................... Total leaching area.._............_..._sq. ft. Seepage Pit No-­------------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test'Results Performed bY------------••--------••----•--------------------•--••......•------------- Date........................................ Test",Pit No. 1................minutes per inch- Depth of Test Pit-------------------- Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... W ----••----•-•----•---•---------•---------------•-----•-••••----------------•••......----•-............................................................... � �ODescription of Soil--------0 I 5Ui --------------- ... ---------- LCAv------..rs.-•---•---•-1 8 ------------------------------------------- •--- •--- •--------------- •----------------------------------------------------------------------------------------------------- •-- --------------------- -------------------------------------------------------------------------------- .. V Nature of Repairs or Alterations—Answer when applicable...._).k S�q--------- ........... r-0.0o_-_-_- ..... ; ....�f'_C`c......---•Q T--•----------�---•----------------)l r S i.-«'-......------. S..=......--_.....-------------------........................................ - Agreement: 11 . The undersigned agrees to install the aforedescribed Individual,Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. r Sipned �-••�- j - --- ------------------------------------- Aplication Approved BY ............... ..e��.•-•-- -�....--..... = :, Date Application Disapproved for the following reasons- --------------------------- ------------------------------------ ------------ --- ------ ---------------------------- ------------------------------------------------------------------....------------------------------....----.....-- --- ---- ---- ---- ------------------------ ------------------ --------- -------------------ate PermitNo. .- s Y/------------------------- Issued ---------------------------------------------------------Date------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C Croft a e of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired,QO) by----'- VWIZ' 4........0C�aS'Q---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at3`1 t r•1-Li W�-----------t 11 fir..,►-P`-`------------------------------tM `,-----------1-------- ------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 p The State Environmental Cod Was described in the application for Disposal Works Construction Permit No. -----, -'---------y --.. dated ----- ................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �'� DATE �?s�. / --- Inspector --CON.. _....--...:� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No. FEE..�,�..................... r -- �i��rrr,��l nrk� �nn,��.rnnr�uorn .erxni� Permission is hereby granted.....��C�C n...-- ( WI Q' �) I. V-------------------•-•-•----------....-•------...----•-•--- to ) or Repair Individual at No.Construct_(....f't Ark l lni:-,JII>) an f A�i �✓.a Sewage---Disposal System r . /� ........................... /`�,�t rya is il/ t r �1 � Street ??G _.� as shown on the application for Disposal Works Construction Permit No. ��..-J_ .. Dated.............................. ....:: ................... .......... . DATE--------------- ! _ �� Health \ -• - �•-' Board of -d .--- h------------...------------ V FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS TOWN OF BARNS T ABLE LOCATION al SEW AGE # lZ, VILLAGE '07A<,. 7&4j /l ASSESSOWS. MAP LOT INSTALLER'S NAM � E PHONE NO. fT i���C�" r'Sq" 0-0 SEPTIC TANK CAPACITY 1 00 LEACHING FACILITY:(type) 10,71S. -- �a 1 NO.OF BEDROOMS . PRIMATE WE OR PUBLIC WAT OWNE BUILD p DATE PERMIT ISSUED: DATE CO P,I:IANCE ISSUED: 7; VARIANCE GRANTED: .Yes No i i i ''a'S 1' 8�' .: MARSTONS MILLS, MA mom. 416 p 105 THIS IS A n COLOR , r :� � SQ,gLE cIs o�rly�js ut ��®Y�l s T",P` ¢'�> ms¢ Sire t �,<0ELEVATION �- LANAsa'Meigs �'706.41 _ USE COLOR P ANONLY r �oad �,* 4FOR INSTALLATIONFULL DETAIL IS BEST 93 {t / VIEWED IN 223._ 1 FULL COLOR o_oQ O LOT 19 I � •L .b� ��a,p u t p , a 00A. k..... 105 _ l2 in PLAN RBOOK 206 PAGE+135 R�f® lam l�1/ S •"MA P ' PINE C ASSR MAP 45 PCL 4 ° - rDPISTRIBUTION END OH — MPONENTS G G Ci G a �i' w dw 1 L / C��.C§SS 9NNG � r',, i K BEDROOM PROPOSED SOIL _ \ 3 ABSORPTION N XISTING \ DV�1 WELL§NG SYSTEM �' EACH PIT/ 0 ESSPOOL TOP OF FNDN 1 6 � -SEE DETAILON BOX® EL 9/000j,49/�.o q ON BACK '- — s , 7 \ 1 I Q� lzu oAK \ GRADING 1 EXISTING LEACH PIT MINIMAL �� PROPOSED \ TO BE PUMPED AND , FILLED 'OR REMOVED ga r �E *106 inWATER LINE AVWAY a AK \ 1 Z'+, 6rt 16 in 1 GATE x^ -�':, � OAK WATER O p. � A LINE — -- w M IN , �, , \ OVERHEAD WIR OH� �xp�. ,_: ° `IO6/ 6 UTILITY ' '.r• i 1 OAK 105 POLE e � ,.�• w ; � ��� 198.62 ft e i FIL A Y V a � � SCALE: t in = 20 f t 105 �P`�H 9FMgss9� �N OF�Ilgssgr,\ 0 20- - 40 Jop SEWAGE DISPOSAL DAVID yes off' DAVID % o Io 20 SYSTEM PLAN D. D. Sao -TO SERVE EXISTING DWELLING v COUGHANOWR n v COUGHANOWR n PRINT ON 11 X 17 in No. 1093 No. 461 1 PAPER FOR PROPER SCALE PATRICK AND LORI GEILER �FGISTE gPPRO�� OWNERIS) OF RECORD qN s° ALV -- =° 42 HAMBLINS HAYWAY THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM 155 Geo Ryder Rd S MARST ADD MILLS, MA y DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING PROPERTY ADDRESS PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS, OWNER Chatham, MA 02633 - - SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. DOVidcouOHotmaii.Com DATE: MAY 25. 2021 508 364-0894 PG. 1/2 woe# ETE-4564 necoe SOIL TEST LOo ' . o 0 DEMON c�adc�Muda4DoaS 1000 c�Ac�c�O�r SEPTIC ��ANK SOIL Ac�so�pTaow SOIL EVALUATOR: DAVID D. COUGHANOWR. ASE #461 - - - -DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD EXISTING UNIT — DIMENSIONS &. DETAIL S YS TEM CONSTRUCTION .DETAIL WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. TANK TO BE PUMPED DRY..AT TIME OF INSTALLATION SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONSNO GROUNDWATER ENCOUNTERED AND EXAMINED FOR STRUCTURAL INTEGRITY. INSTALL USE SHOREY PRECAST 500 GALLON LEACHING DRYWELL TEST PIT PERC AT 68 In - 2 MIN/INCH IN C SOILS USE EXISTING 1000 GALLON SEPTIC TANK IF IN NEW PVC OUTLET TEE EQUIPPED WITH A GAS BAFFLE. DRYWELL ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOUND STRUCTURAL CONDITION, IF NOT, INSTALL REPLACE WITH A NEW UNIT 24.0 ft 105.95 INCHES HORIZON TEXTURE (MUNSELLI MOTTLES NEW 1500 GALLON SEPTIC TANK. 1500 GALLON TANK cr) 0-6 Ap LOAM 10 YR 2/2 NONE FRIABLE DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 1• in IF CRACKED. ROTTED OD oil 6-30 Bw LOAMY SAND 10 YR 4/6 NONE FRIABLE TAPER +1 SOIL ABSORBTION SYSTEM: y OR OTHERWISE_ +' w 30-48 Cl LOAMY FINE SAND 10 YR 6/2 NONE FRIABLE '� COMPROMISED. % MIN - 101.95 THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE c) tfD 48-138 C2 MEDIUM SAND 10 YR 5/4 NONE LOOSE SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES c v4_ nj 94.45 PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. 0 N NO GROUNDWATER ENCOUNTERED THE 24 ft x 12.5 ft x 2 ft LEACHING GALLERY f °o (( I ±3.57f TEST PIT 2 ,a ,_ � �; ,. .. r � .,. M- 2 MIN/INCH IN C SOILS DEPICTED BELOW CAN LEACH: NOT STONEDEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHEfl "'_� f `ELEVATION BOTTOM AREA = (24 x 12.5) = 300 s f6 � „� TO 3.5 ft 8.5 ft 8.5 ftt INCHES HORIZON TEXTURE (MUNSELLI MOTTLES q• t• !�-% Lo 105.20 SIDEWALL AREA = (24+24+12.5+12.5)x2 =146 so. ft. T SCALE 0-6 Ap LOAM 10 YR 2/2 NONE FRIABLE ,m, �(� 6-28 Bw LOAMY SAND 10 YR 4/6 NONE FRIABLE TOTAL AREA = 446 sq. ft. 5�� GALLON DRYWELL 28-46 Cl LOAMY RNE SAND 10 YR 6/2 NONE FRIABLE FLOW CAPACITY = 0.74 x 446 = 330.04 gal/day 8 ft_ r�r' 101.36 6 in A DIMENSIONS & DETAIL INSTALL ONE INSPECTION 46-138 C2 MEDIUM SAND 10 YR 5/4 NONE LOOSE INSTALL A 24 ft x 12.5 ft x 2 ft GALLERY AS CONFIGURED RISER TO WITHIN THREE 93.70 BELOW. FLOW CAPACITY = 330.04 gal/day WHICH EXCEEDS INCHES OF FINAL GRADE - - I THE 330 gal/day REQUIRED FOR A THREE BEDROOM DESIGN. INLET OUTLET USE & INDICATE LOCATION - COVER COVER H-10 ON CA BUILT UNI T =INDROP Pd -INSTALLER TO OBTAIN DISPOSAL WORKS A/ FLOW LINE _ '0% 33 PERMIT BEFORE STARTING WORK. FROM p p �p M _` 'oD� in -ALL COMPONENTS INSTALLED SHALL MEET DISTRIBUTION �Ol/O pB-3HHO20y- BUILDING 1O �n �� TO THE MINIMUM REQUIREMENTS OF DIMENSIONS PIPES EXITING D=BOX ro `RUN.aLEVEL 48 in D-BOX �dP MASSACHUSETTS TITLE 5 SEPTIC ! AND DETAIL,', �,FORn2,,F,EET BEFORE .PITCHING DOWN` w LI�JUID GAS O CODE (310 CMR 15). -INSTALLER TO VERIFY LOCATIONS OF ALL - LEVEL BAFFLE 1�2 in UNDERGROUND UTILITIES BEFORE m EXCAVATING FOR SYSTEM. MINn =V b in STONE BASE IF NEW CROSS SEEW CTION /APPROVED GEOTEXTILE -ECO-TECH RAPID RESPONSE RECOMMENDS —► FABRIC OVER STONE THE INSTALLATION OF LOW FLOW FROM = S SEPARATION BETWEEN INLET & OUTLET fE FIXTURES & APPLIANCES. AND PERIODIC N TANK ,� �, To K TEES NO LESS THAN LIQUID DEPTH PUMPING OF THE SEPTIC TANK. O ° ^ SAS e CROSS SECTION VIEW o 314 in TO 24 in a 3%4 In TO -SYSTEM IS NOT DESIGNED TO WITHSTAND �= o�ood� 28 in GRAVEL ,r+ EFFECTI VEa 1-112 in GRAVELY.: VEHICULAR LOADING. DO NOT PARK OR �� bin STONE BASE in r e DEPTH e rr DRIVE VEHICLES OVER SEPTIC SYSTEM. 21 !n 2� CROSS SECTION VIEWIL L 46-in 58 in 46 in 150 in TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE 4 in SCH. 40 ?VC EL = 106.41 +— 6 in OF FINAL GRADE AND TO PITCH AT 1/8 in/ft MIN +i V i \7� + j j 105.0 USE H-20 M A X EXMTT NG 102.0 EXISTING 10000 GALLON o°°o°aooaooa n ��pp °p° goao°o PRECAST �000�000°000 ������ ��I1V� 103.5 a°� o°° DRYWELL oo°o�°oar° D00 ° Oo 0 0 o Op0 101.38 w6 °polo °oo°oaa° EXISTING REFER TO DETAIL BOX STONEinSOL A°- o SOG�RPTT ON + 101.55 BASE 101.25 EXISTING 6 in STONE BASE IF NEW SYSTEM -REFER TO � 62 ft 5-12 ft DETAIL BOX 99.25 NO GROUNDWATER In BELOW MOTTLING OBSERVED _ 93.70 SEWAGE DISPOSAL SYSTEM PLAN 42 HAMBLINS HAYWAY MARSTONS MILLS, MA MAY 25, 2021 ETE-4564 PG 2/2