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HomeMy WebLinkAbout0051 KERRY DRIVE - Health 51 KERRY DRIVE, M..MILLS - - A=060-025 I TOWN OF BARNSTABLE LOB C-ATION I& SEWAGE# - VILLAGE Pip a7i ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) rg1g�pGM— (size) �-S Jr 1�-•��NO.OF BEDROOMS `S '-• OWNER ©t�0 PERMIT DATE: �r�sr 1:7 COMPLIANCE DATE: Separation Distance Between the: _ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) t4 114C Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)�1 Feet FURNISHED BY f '23 r9' , O yq .ati, No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippliCation for Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(k� Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No..S'1 �r, M�txra Owner's Name,Address,and Tel.No.629-369 90 9� Assessor's Map/Parcel 60 .2$` fwws hnas Installer's Name,Address,and Tel.No.,6vj -Y)f 93917 D�si�per' Name,Address,and Tel.No. MA 02VK Type of Building: Dwelling No.of Bedrooms Lot Size �35 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ! gpd Plan Date ''tfty 1,_J&17 Number of sheets / Revision Date Title i� 1"n/6Yi 61 6-1�"��2/��LtP &/s" t/1 X Size of Septic Tank exjgy'hp / yecx Type of S.A.S. - per ,(p �j� j �,t ASX d a-83 Description of Soil 6�u :50, 42�g Nature of Repairs or Alterations(Answer when applicable) i 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 Enviro ode a not to place the system in operation until a Certificate of . Compliance has been issued by this Board of th. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued 1 /f t No. ! ...�- � � .._.-..+-�-----4 Fee THE COMMONWEALs.- ",�'.,MSSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF bjRNSTABLE, MASSACHUSETTS Yes 01pplication for Disposal 6p�t�m Construction 3pErmit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. $fi r ( . Owner's Nam-ee Ad/dress,and Tel.No. j9•,3(",9-r/o 9 9 dtt r �1S !—fi7Gt/C1V j OCf'C1tr J✓ Assessor's Map/Parcel fop .2$` fr�'15 /4 U Installer's Name,Address,and Tel.No.S-ol; 5399 Designer's Name,Address,and Tel.No. .�X 3Ga S� Char-fir,lOtL C_bos--rtx-kf'ort ys'?=►-c(t..4 ry/2-j' ji•aeerii�y.�i-� 9�9�ifa��Sod 4jar+G /U A oae,qg Type of Building: Dwelling No.of Bedrooms 3 Lot Size .33315* sq:ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided .3 gpd Plan Date `11htj 1,_JVD17 Number of sheets / Revision Date J , _. X11115,, A1/4 Title ��}-�� S i"1CCY�l.F� .�� rlo✓/Z/.[��LrF' /��l�S�n/x t Size of Septic Tank exisS ,rX /(XXJyzc r Type of S.A.S. - t, � (p�����j•a,� �n �S+X /�l Description of Soil as Sri �ir�S 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 Environrrgental-Code�to place the system in operation until a Certificate of Compliance has been issued by this Board doof .ealth. Signed /� --"""� `. Date Application Approved by Date n, 5 / Application Disapproved by Date for the following reasons Permit No. Date Issued 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 �XS r���'/,I�( r�,j,�;TfrC NG�3 "►�C at ! ��PfYU �e'• /l ld(!5(r�3t�,f!!i/1�5 has been constructed in accordance / ��• with the provisions of Title 5 and the for Disposal System Construction Permit Na'—� Dated 51� Installer Designer #bedrooms *j Approved design flow gpd The issuance of this permit sh 11 npt be st-•ed as a guarantee that the system wil function des' ed. �I Date /[l./� -�'� Inspector ---- ----------------- )---------------�------------------------------------------------------------------------------------------------ / Fee �CJtJ I YTHE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstte.Construction permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at � i/ � r- -u f`r r Y 100 V-S.t"A S �A A 1 S `J 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 c o mpleted ithin three years of the date of this p�rmit. Date 5 � Approved by\ JUN-07-2017 22:14 From: To:15097906304 Pa9e:1,11 0- Town Town of Barnstable Regulatory Services 1 8 Tho is F.C eiler,Director NAM Public Health Division. Thomas McKean,Director 200 Main Street,Ylyajonls,MA.02601 Office: 508-862.4644 Fax: 508-790-6304 Installer&Desianer Certification Farm Date: 6 //7 Saw2ge Permit# d17--141 Assessor's Maplparcel �A ,\ Designer Z�t."�AJInstaller: rUaA o Address: !3 P Address: I • 060_X �a ! �''rrlu-lk >�t rr a„�'�i9io /L t Oa was issued a permit to install a in r), septic system at lP.►r (�✓?Ve based otr a deli drawn by (address) a n Id ti ,gl( 1 V dated Lf i � (de . V I certify that tk}e septic system referenced above was installed substamtially &word' to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with ma or changes (i.e. greater tban 10' lateral relocation.of the SAS or any vertical relocation of any component of the septic )but in accordance with State&Local Regulations, Plan revision or eertifie -bui p desipeir to follow. 141 ` (ItasWer's Signature) No.465C�! z I„C (Designers Signature) J (AfU Designers Stamp Here) PLEASE REnMN TO BARN9'I'AB]<.E ang HEALTH DWISION, CERM.GKM OF QDMP'LIANCE WILY. NOT BE 1§§UED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECRI'' JD BY THE DARNSTABIX pC7IiUK HEALTH DIVISION. jg&W YOU. Q:H*nt WScPdQ uigaer CetOrAdan)For+n 3-26r04.eoe 4 ------ .------- ....__.._.._.__. Q ,_f a r�/%ad, Town of Barnstable Pit Department of Health,Safety,and Environmental Services V* Public Health Division Date d �7 5(, 367 Main Street,Hyannis MA 02601 S HAaaerearx, , rE t,Ntt� Date Scheduled � Time Fee Pd. Soil Suitability Assessment for SeFage Disposal Performed By: 6011�al Ue,� Witnessed By: 25 ..................:...::. :::::::....:...:.::.::, . .:::.:.::.:...::.:...:.:.. ...... ... �k2i17 :. : :.:: ...... ......................... ?v:::::K:.�::i:::.:�:::::;:C:viii::v:6:4i::iiiiiiiii:'hiiii::•Y:i:'::v�iii:•:;i:i}:vY::;i:•i+:i::�iJiiSi:Ji::�ii:�ii:•i:•ii:{v�`:ii"vi:::ii::::i:::::��{i;; Location Address f \ i, Owner's Name /� /�'1 • M i Address Y Assessor's MaplParcel: t/p hpZs Engineer's Name._.�_O..w.� rl-e� r NEW CONSTRUCTION REPAIR Telephone# S 0 Land Use La wK7 t" Slopes(%) 0-5 Surface Stones /V Distances from: Open Water Body to��6 It Possible Wet Area > 0� R Drinking Water Well > 7 `w R ' Drainage Way �00 ft Property Line � ft Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) V,J2. 'L N A'k 2 I S'7 Parent material(geologic) 6 kl a 0 u-�WCc Depth to Bedrock Z00 Depth to Groundwater: Standing Water in Hole: Weeping from Pit Pace Estimated Seasonal High Groundwater NSA- . .. 1�11'��ATY.O:...�t:.�'CJlR, .�A�U� ..::: . . . :..; . «.::•.:.. :. :<:»»;::;.;::.>:.:.;:.::;:.:;<. Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping froin side.cf obs:::cle:- - in. -Groundwater Adjustment _ _ft. Index Well#___•_,_ -Reading Date:_. Index Well level.--,Adj.-factor Adj.Groundwater Level :.:;;:i:>;•5:::;t:;.`•:;t::::�::::t;;:;:::::::;;;::::rr�:;5:;::iii;:::;:::;:::;S:a:%:i.'•:::ti:;:%:.::::;:.:.:;<:..;:::.:.i::;:.,;•::::::;::.::.;.:;•...:.:.:::::..::::::%;`:Disc;ii; sF:$�;rFiS >,:� f ::3i•>;;::�::::;::�::<:::::.:.i:;:-:••;- / ..,.; .:..:.:.:.::..::::::::.::::.:::::.:::.:::::.:................:.::::::::::::::,.::::::::::::::::::::::::..........::...::...:::::::::::::::::::::::::.::....:.:............. . Observation Hole# / Time at 9" Depth of Perc UI Time at 6" Start Pre-soak Time© Time(9"-6") End Pre-soak /� Rate Min./inch d'I•�/-V I)C�7 Site Suitability Assessment: Site Passed Site.Failed: Additional Testing Needed(Y/N) N Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant o • ........................__............... ........---...._._..._................. .................... .__._........._.......... . ._.. _......._ ..._....._ . ..._.. ..... .......... .._.._..._.. _ _................... .:..:....:.....:::..:,..::...::.:.:.::::i:;':::::::.:::..;..:.;,,....;:.;:.,...•: 's'r' ::ii '!r ;:...,.,,,•,y,,,;..::1: ;:::;}.'•:: ::'f:f:i;i;i: i::ii ;:" ::.::..<:. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muusell) Mottling (Structure,Stones,Boulderes. % O-S- S /0YA '?/,2 '�--, I g S In 10W-11k q-140 C 5 y-/y yO-13g, Z,Sy 7/ i;i 'i°Yi' iii:iiai!ii t• � Hole: ..::.. ..: ...::..:...:.: ::.:>.;:<::::;::;>•:::: L..LO . ..#......_.�:........................................ ....... .... ... :. . ;;:•:;:�i..Te...11fe•::>> oilolor;.:;;•;.. ::::•::Sol l:.::;:::. ....�—.Other :;.;:.;.... ........... Depth from ..... Soil Horizon .... •..•..So I xt S C :.:.:::::::.:::.. Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Gravel)Consistency.% 0-�0 S L IDYL 3/z - � P -3g Depth from Soil Horizon Soil Texture Soil or Soil Other Surface(in.) (USDA) (Nhinsell) Mottling (Structure,Stones,Boulderes. Consisteriev.%Gravel) ::>> �::::DLEr..OBSER....A'�'ION.H.+C�LL..L .G..................... ls..#................................................... l H rizon :Soil'Iexliire Soil Colo Depth from r Soil;:<;..... Other •• Sol[ o Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No— Yes L� Within 500 year boundary No v Yes Within 100 year flood boundary No L Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �f's If not,what is the depth of naturally occurring pervious material? Certification I certify that on S //� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature /`' ` Date-S///o Town of Barnstable Health Inspector Office Hours FZHE Tgy�o Regulatory Services 8:30-9:30 ■ * Thomas F.Geiler,Director 1:00—2:00 * BAMSfABIX • "9. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 - - Fax: 508 790 6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: �C_�6 Address: El ke p" 2MAP 5q0 `S Ma Parcel p Name: ✓`'�"/}LLtS0"J -r0'.L)08.0FF- Phone# So 0 qa-t-0sa.3 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? /' If yes, how many? / 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 2d. Please include a copy of the floor plans for the entire property- showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. �l�eq�� r�f� ��� o� F 3. Is the dwelling connected to public sewer? YES or NO 4. Location of dwelling is INSIDEw� or OUTSIDE a Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to UBLIC WATER'? 6. Is a disposal works construction permit on file? ',:)TS ; or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES-- or C O 8. Is there an engineered septic system plan on file at the Health Division? Y;E,S/ or NO .. 9. Has the septic system been inspected by a DEP certified inspector within the last two years? di) or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: - Date: Q;/health/wpftles/amnestyapp TOWN OF BAMSTABLE LOCATION 51 kere, V C fide SEWAGE # VILLAGE ASSESSOR'S MAP& LOT 'Oo INSTALLER'S NAME&PHONE NO. - I Cd &4zk 77,9 SEPTIC TANK CAPACITY LEACHING FACELITY: (type) �c+�1 FUti (size) �_�X�b , �` NO.OF BEDROOMS 3 BUILDER OR OWNE PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 0 v4 6AC c� � e11► Q 2 a a yy 0 0 3 0 r r a 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, hereby certify that the application for disposal works construction permit signed by me dated -(. Jc�� , concerning the property located at 6- 1 kf'-�W f 6wte. V r `41 l J meets all of the following criteria: v • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling.. (� The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed ,/• There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor Ymethod when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation � �+the MAX.High G.W. Adjustment. _ C� DIFFERENCE BETWEEN A and B q f� SIGNED : DATE: [Sketch proposed pl f system on back]. q:health folder:cen r * ""-_ C9 TOWN OF BARNSTABLE LR64--ATION . J I 1(erry Afidea SEWAGE # 4�1 ,TILLAGE MaC546^55 �ilLs' ASSESSOR'S MAP & LOT 'OG INSTALLER'S NAME&PHONE NO. I� 77f3-062� � SEPTIC TANK CAPACITY I("d Uc,Sc i LEACHING FACILITY: (type) 43QCil"1 jS'(size) NO.OF BEDROOMS 3 BUILDER OR OWNE PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist . within 300 feet of leaching facility) Feet Furnished by di. ®f 17�eli� A 3� A+)3+ -49, , NO. ! ` ,00;7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppYication for Migaal *pztem Construction 3dermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System X.ndividual Components Location Address or Lot No. �� yy Owner's Name,Address and Tel.No. Assessor's Map/Parcel a l(,4 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: {� Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7-3 0 gallons per day. Calculated daily flow �Lfi gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank tS`3 -A--- 1000 Type of S.A.S. C c Description of Soil Nature of Repairs or Alterations(Answer wh n applicable) ��� G ' AF�'4"-1 L/ f '1,�� cif r/lt�,-Lt-f�, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b thi ealth. Signed Date Application Approved by Date �r Application Disapproved for the following reasons Permit No. 21y, Date Issued c/"—'111114 n .r y +� No. 1 Fee \� x THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipprication for Wgpogaf 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System Aindividual Components Location Address or Lot No. /r 4EIf Owner's Name,Address and Tel.No. Assessor's Map/Parcel da&o Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other,Fixtures c,� g �`'.. ���Design Flow.. gallons per day. Calculated daily flow �'�r( gallons. . Plan Dated Number of sheets Revision Date Title _ Size of Septic Tank q,�,� 1 - f 00U Type of S.A.S. C ' r Description of Soil Nature of Repairs or Alterations(Answer w n applicable) �w.� 6 VIZ <fq ec % .:�7 /Li L( 1w/'D f0_S Gt--y I S�G�2_ - /�� l/lt�a �,��f h Date last inspected: 1 Agreement: f The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss ed b thi ealth. Signed Date 3 0-71 ' ' Application Approved by Date Application Disapproved for the following reasons M• t l Permit No. ZZ4k, Date Issued -------=------------------------------- 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 = has been constructed in accordance with the provisions of Title 5 and the f Disposal System Construction Permit No �"�� '` dated�7 Installer Designer The issuance of this Re it s 11 n be construed as a guarantee that the s s will function desi$�d! 0 s Date Inspector V�A No. 's ! ,/� --------------------------Fee P THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 30i5po5al *pgtem Congtruction Permit Permission is hereby granted to Construct f )Repair( )Upgrade((/,Abandon( ) System located at V v � t and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co pleted within three years of the date of th*8pJ.9 Date: Approved b3'`� � �� � �'`'Y "�/J f ,/ Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld C'o~rnof Trudy Cox* Argeo Paul Colluccl S«nury U.ckwwrx f David B. Struhs Commnworrr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A Ke cc CERTIFICATION Property Address; K ✓.i Dv: s U;tj S Address of Owner. / C Date of Inspection: [oZ/!$�9 G A A different) ` _ Name of Inspector. j,��„•� Jd�`� _ Q. �Ok (o$ Company Name,Address and Telephone Number. Jai—s =�L, (1 as A'-.4 - S�. �' I z � . 'M4 A Ma• CERTIFICATION STATEMENT 3 3 9 I certify that I have personally inspected the sewage disposal system at this address and that the information reported ste 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 Symms. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Q�,� Date: [q [ / /c- The System Inspector shall submit a copy of this inspection report to the Approving Authority 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. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 C Any failure criteria not evaluated are indicated below. MR 15.303. B] SYSTEM CONDITIONALLY PASSES: O or moresystem components need to be replaced or repaired system, upon completion of the replacement or The syst repair, paaseS inspection. 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, 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 Conformi by the Board of Health. ng septic tank as approved (revised 11/03/95) I One Winter Street a Boston,Massachusetts 02108 a FAX(617) 556.1049 a Telephone(617)M.Sb00 A �, Pnnted on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: �� l�c ✓✓.� D1' Owner. M C . Date of Inspection: Fh G B)SYSTEM CONDITIONALLY PASSES (continued) — 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 peas 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 faur 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 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 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — The system has a septic tank and soil absorption system and 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 is within a Zone I of a public water supply well. — The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. — The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for ooliform 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 Isy than 5.ppm. 9) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 5`/ 1C -r 1 O'. Owner. C"J(A`C Date of Inspection: DI SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined 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. 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 1/2 day flow. Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipeisi. 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 I 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. El LARGE SYSTEM FAILS: 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: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _, the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: S 1 K�✓'/�/ /. Owner. Date of Inspection: Check if the following have been done: Pumping information was requested of the owner, occupant, and 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. X The facility or dwelling was inspected for signs of sewage back-up. 4 The system does not receive non-sanitary or industrial waste flow YThe 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 condition 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 or approximated'by non-intrusive methods. The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. _V0 f f�c_t�`��` ✓tip,^.�,�k Z ��r,W rA- r (revised 11/03/95) 4 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner. Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design flow: O allons 3 Number of bedrooms: Number of current residents:Q Garbage grinder(yes or no):_,V(7 Laundry connected to system(yes or no):45 Seasonal use(yes or no): 4 0 Water meter readings, if available.: Last date of occupancy: COMMERCIAL/I ND US TRIAL: Type of establishment: Design fl0w:-----P1lons/day 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: System pumped as part of inspection: (yes or no)_ If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM _ Septic tank/distribution boy/soil absorption system Single oesspool Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed(if known)and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: J / K,,if y DJ- Owner. r,4,(. C. Date of Inspection:/./` SEPTIC TANK - - - (locate on site plan) Depth below grade:-3 Material of construction:,-concrete_metal_FRP—other(explain) Dimensions: AAo rax I x S x Sludge depth: ., Distance from top of sludge to bottom of outlet tee or baffle: AC Scum thickness: 10_ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle:— Comments: (recommendation for pumping, condition of inlet and outlet tees or baffl , depth of liquid level in relation to outlet invert, structural into ern ence of 1 linty. eakage, etc.) ✓cL/a L �f- S c,vn c % _ i..G G✓bf,ft.� � �AN R h OV..✓Ld GREASE TRAP:_ (locate on site plan) De-jth below grade: Material of construction:_concrete_metal_FRP_other(e:plain) 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: 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 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: �- 1 lam✓i y. Owner. Date of Inspection: C. TIGHT OR HOLDING TANK (locate on site plan) Depth below grade: Material of construction:_concrete_metal_FRP_other(ezplain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX' (locate on site plan) 11 Depth of liquid level above outlet invert: V Comments: (note if level and distribution is equal, evide of solids over, evidence of leakage into or out of box, etc.) PUMP CHAMBER_ (locate on site plan) Pumps in working order:(yes or no) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C //�� SYSTEM INFORMATION (oontinued) Property Address: -5-1 V-� / Owner. E, C Date of Inspection: ✓v Al' ' 'SOIL ABSORPTION SYSTEM (SAS): (locate on Mite plan, if possible;excavation not required, but may be approximated by aon-intrusive methods) if not determined to be present, explain: Type: leaching pits, number._^'(I <_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Co to: (note condition of }l, a of hydra 'c fail le v i of ponding, condition of vegetation etc.) i) CESSPOOLS:_ (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:_ (locate on site plan) Materials of constriction: . Depth of solids: Dimensions: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) (revised 11/03/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner. Date of Inspection: SINPCII OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' S.T DEPTH TO GROUNDWATER Depth to Vcvadwater.- 4- feet method of determination or approsim&Uon: ��q c (,�; �• t �v (revised 1143/95) 9 CO CATION � SEWAGE PERMIT NO. Lod a:j rSr- f3� VILLAGE y4-135- INSTA LL'ER'S NAME i ADDR S2kd�!Ar /2 - a,,� el. !, 0 U I L E R OR OWNER 0& / DATE PERMIT ISSUED zcuzz DATE COMPLIANCE ISSUED �3 � 3� ' 3�` �� ' CIS ' C J No..-•-•-•----...._... Fps..... ....................... THE CGMMONWEALTH p.F,MAsSACHUSE` 7iS BOAR® OF HEALTH ...................0 F........... - ------------------------------- ApplirFation for Disposal Works Tonstrnrtion rumit Application is ereby made for a Permit to Construct (K) or Repair ( ) an Individual Sewage Disposal System at: �IX4_51 .. __........ ..... •-••• ti.......... .... ..... -• ......._. Location- dress or Lot No. .^............................I 2'$• C... ---...............................---.............-----••--------•--. Owner ddress� �si.!::------.n- . ....---.mac U� k ._.. ?..c �..:.... Installer Address Type of Building Size Lot.33!.] 4......Sq. feet U Dwelling—No. of Bedrooms._.._....T Q.......................Expansion Attic (✓f Garbage Grinder ( ) per, Other—Type of Building ...( A_J>9�.......... No. of persons........ -............... Showers ( 1 ) — Cafeteria ( ) a' Other fixtures ......................................... W Design Flow..........J`r`-2...........................gallons per person per day. Total daily flow___._..._..3-3•0---•---_--.___..__.gallons. WSeptic Tank—Liquid capacity.l�D..gallons Length$`__b....... Width..4 .1�._.. Diameter________________ Depth5.'_.'B 4... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--____I_____________ Diameter......1........... Depth below inlet.......a. ....... Total leaching area.2,6.�o__...sq. ft. Z Other Distribution box (N) Dosing tank ( ) 4 —550 84 Percolation Test Results Performed by._....�!}4ob...���!...... _.__ - --•-- Date ----------------- ,`�a Test Pit-No. 1.. .Z......minutes per inch Depth of Test Pit...1_? '__._..... Depth to ground water.._.!O�---_...... Gr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ � •--------------------------•-•---•---.....-----•----------------------------------_-••. --•----••-•------•-•-••.....-----•----- ................... O Description of Soil....0 1... ....... L----- `'� I U ��.............................:..............:........................................................................................-............................................. . W x ...........................-........................................................................•.................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•----------------------------------------------------------------------•------•---------------------------••---------------- ........................-•-............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I IL LE 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. f /Sig ---------------�---•------------7....------•••...------...._--••-- .513-0 !4... t� D Application Approved By-------------------------•--•--- `_..�—_.. _ ._-°_.._..._.._. ....._.. '` ---------- ate Application Disapproved for the following reasons:.............................................................................................................. -•--------------•---......••-•--.....----.....--•-••-•-•-------•-•--......--------•••.....----••--------•---•-------•-------•--------------•---•---.................................................... Date PermitNo..................•-------------------------------------. . Issued_....................................................... Date .................. �T}-1F-COMMONWEALTH OF MASSACHUSETTS BOARD OF - HEALTH ram.............OF...... .....6�, ",�:� ..S �.�r � � ..................... Appliration for Uhip sal Works Tonstrur#ion anvil ` Application is hereby made for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal System at ..!.a..... ....� .....h, _.t ,:.n......ci-r-L.L.•5 . .........1_:. 1 :..'�+1.i.7 �=?......--(�/� `` -- Location- ddress or Lot No. .. Owner Address Installer Address Type of Building Size ......Sq. feet I—I Dwelling—No. of Bedrooms..........�4,,xQ........................Expansion Attic ( , Garbage Grinder ( ) Other a —Type of Building ^�.-g __ __._�• .._.._...._ No. of persons....... ................. Showers ( l ) — Cafeteria ( ) Other fixtures .................. w Design Flow..........5.!...........................gallons per person per day. Total daily flow........... _ ._...__...._._.__..g�Gllons. WSeptic Tank—Liquid capacity.�s .O gallons Length '._l '!._.. WidthW..19,L.... Diameter________________ Depth5y ._j �.... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No-------!------------- Diameter.•....a00........ Depth below inlet...... ........ Total leaching area.�;,fa(......sq. ft. Z Other Distribution box (x) Dosing tank '-' Percolation Test Results Performed by.....:,►.; r :.. .1�3.1 .c _ , Date. Test Pit No. LA._&......minutes per inch Depth of Test Pit.J.?.............. Depth to ground water....t4/A.......... rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -••••-•-•-••---• ----•-••••••-•-••-••-•---••••••••••-•••---•-•-•...----•-......••....... ......•--................................................_...... . D Description of Soil--0.:- =. ....... ........ c., w UNature of Repairs or Alterations—Answer when applicable.....................................•____......._................._...._..............____.... ----------------------•-----•-•------------•-------------------•---•--------•-----------.....---------------...------------------------------------------------------------------------....-•-•..••-•--. Agreement: The undersigned agrees to install the aforedescribed In Sewage Disposal System in accordance with the provisions of TITLE 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. k Signs •---• - .Z.0 �j_4�.... � Dat Application Approved By --••-- ••• ... Application Disapproved for the following reasons------------------- •----------•------------------------------------------------.._._...._ .................•---------------...----•----•-----------•--•-------------•------•--------...-----.•......_......-•---------------•---------------------------------------•-------••--...-•••-••-•---••-- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH :.t .t ..........OF................12 .��; ............... (9rdifirate of Tompliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �er Repaired ( ) by.....R o6ee c:-------Ow-c-------- SJ.. r.C.e---•----------------------------------------------------------------------------------------- Installer L f 4 at o- �, ------....r '�f--• � c t',-.tom, ------ C t 5 t�k�t .................................... has been installed in accordance with'the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...... ,,_. .��_�` dated----_........................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BCOWSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... ?: s. __..I t .� Inspector.....�..............-•-------•---•.............•--•---•--•----•-----•......•. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OW.C\.................OF........... �15 . ..r? :b1'��..,,...........-----..... No.. ...... 5 FEE.... .y- ----------- 10orkii 'Tonotrudialt Errant Permission is hereby granted.... ....... .......C_Q.._ to Construct (>c ) or\Repair ( ) an Individual Sewage Disposal Sy tem at No.....I., ........ ...........nC q 5 Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... DATE_ G-- Board of Health .... / FORM 1255 A. M. SULKIN, INC., BOSTON Massachusetts Water Resources Commission/Division of Water Resources WATER WELL COMPLETION REPORT VVEL LOCATIO Address �� Al IRQ-r-y-%I 11�1- City/Town M$Iwr2 KS-a t,-, ���rJ �7 G.S.Quadrangle Map \ -~ Grid Location 5 Owner 14C�C lam,Q.-, Address 1 Ll tSE MA-fLS ��1 l ti i1 ik.t Jt 1 WELL USE CONSOLIDATED WELL Domestic Public❑ Industrial ❑ 'Type of Water-bearing Rock Other Water-bearing Zones METHOD DRILLED 1) From To Rotary(type) Q,1r Cable ❑ 2) From To Other 3) From Tgt 4) From To ,,!��, CASING Depth to Bedrock Lengthy Diameter o� � Type 10 y '- UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface Sand: fine❑ medium❑ coarsebie Date measured Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL Slot* I14 'length'-%3 from�5eg to� Yes ❑ No Split Screen(or 2nd screen) WATER QUALITY TESTS MADE Slotxf ` length from to Chemical Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To A D t . LIFFO W LL D LLIN C G o . Firm � - Address 6.5u@ Rock Road City -South Yarmouth Mass. 02664 Registration No 01 p44 0 rator s Signature Please print irm y IOM-8/81.164843 , p Log Number: , 4104 Bottle # 929 Date: 911.7184 04 BARS s� BARNSTASLE-.BOUNTY HEALTH DEPARTMENT ,, �. SUPERIOR COURT-HOUSE O BARNSTABLE, MASSACHUSETTS 02630 nSa DRINKING WATER LABORATORY ANALYSIS PH 2-2s„ EXT. 331 Client: Jack McKeon Collector:. Fred Clifford Mailing Address: 145 Great Marsh Rd. , Affiliation:. -- Clifford Well .Drilling Centerville, MA 02632 -Time & Date of, Collection: -9111:84,_4*00 n_m_ Telephone: Type of Supply: Well water Sample Location: Lot 27 Kerry Dr. Well Depth: .55' Marstons Mills Date of Analysis: PARAMETER SAMPLE -RESULT RECOMMENDED LIMITS Total Coliform Bacteria/100 ml ` . 0 H 5-4 Conductivity (micromhos/cm) 500.0 Iron m) � 0.3._ _ Nitrate-Nitrogen ( m 10.0 Sodium ( m) 20.0 ' 0 I , xx Water sample meets the recommended limits for drinking of all above tested parameters. II . Based only on results of the parameters tested for this sample, the water is suitable for drinking but may present the problems checked below: A. Water sample has higher than average levels of Nitrate.' Future monitoring is recommended (2-3 times per year) to'establish' any upward trends. B. The low pH of the water may shorten the useful life of the house's plumbing. C. Water may present aesthetic problems (taste, odor, staining) due to D. Water sample has high level's 'of sodium. Persons on low sodium diets should . consult their doctor. ` III. Due to one or more of the reasons checked below, this water- sample is unfit for human consumption: A. High Bacteria B. High Nitrates REMARKS: " CC: Barnstable Board of Health CC. Clifford Well Drilling Laboratory Dir ctor 7/17/84 Ex satJan of Test`Results Tot rrn. Bacteria .- z. Coliform bacteria are an indicator of the sanitary quality of_.a water"supply. Water supplies may become contaminated from,nialfunctioning septic systems,cesspools and surface runoff. A total coliform count of zero indicates that'your water supply is safe and.approved for human consumption. A total coliform count of greater than zero is most_ofte'n the result of accidental contamination of the sample bottle through improper sampling methods. For this reason, it would be advisable to retest any well water that is not approved. pH pH is the measure of acidity or alkalinity of the water. On the pH scale, the number 7 is neutral, less than 7 is acidic.and more than 7 is alkaline.-The pRof water on_Cape Cod tends to.be acidic in the range of 5.0to 6.5 Conductivity Conductivity is a measure of the.dissolved salts in solution. Amounts in excess of 500 micromhos'-m are generally considered unacceptable and may.have a laxative effect upon users: Iron The presence of iron.in water in concentration of .3 ppm or greater may: give the water a bittersweet astringent taste, cause an.unpleasant odor, often gives t}ie water a brownish color and cause staining of laundry. . and porcelain.;The average conceniration of iron in Cape Cod's water is ,2 - .6 ppm. Although the presence of. iron in water may..cause-the problems listed above. it. is.not considered deleterious to:health. Iron may be removed by. useof.an iron;.remov.al system Nitrate-intro en , The'Massarhusetts Drirkmg`:WatertFt IatieIis have set a maximum,,contaminant level for nitratesat.l0, ,. ppm:Excessive concentrations may causenethemoglobinemia (an infant disease),and have been suggested to form potentially carcinogenic nit rosamines Contamination:sources include fertilizers,fertilizers, cesspools and industrial wastes. Copper Due to the acidic.nature-of the water on.Cape Cod, copper tends to leach from,pipes. This normally.does not present a health hazard,• however;concentrations in excess of 1.0 ppm may cause a metallic taste and/or a bluish green stain.on porcelain fixtures. Sodium A concentration of soditurn over 20 ppm is only:of concern to people who are on a low sodium diet. If the water supply has more than 20 ppm sodium, it up to the people who are on such a diet to find another source of drinking water or contact their doctor to determine if consuming the water is advisable. Concentrations exceeding 50 ppm indicate that there may.be ocean water or road salt.runoff,water Petting into the well. Lor 7 LbT /3 t X�- Fa v ggio a q 196 'JAW 74,7f3 t-ca . 11 h: s \ IIACY ex T^ ; .U '�-'•,�, 1. Lo T- N. IV fV t t r� r 4 Y 'Z7 OFM4ss 33 3S4-S, !a-V °10 ALB44 F,R�A J i b S K ;Q No.10951 p Q Z.O c9,D i kW E,:f,1 , �i0Fl LD 5 NAl. G—s �7�Nr.�� c s SSOC„ /N C ` ✓✓car LEGEND ". EftITINP.' SPOT 'ELEVATION ®x0 EI, TIWS- 1CONTO.UR --__ ® ___ CERTIFIED PLOT PLAN tPN : HEO ,:SPOT ELEVATION - LoT P lE® CONTQUR ® M�4 r�STyn/s /i'l i��s location of any' existing underground sewerage, -- 4` `wells,,or;other utilities shown on this plan is approx- IN � ra mate;`onl as determined from records and/or verbal r a I IA0 ��j 7 ,% ormatiort The_ contractor is responsible for the kc-v. sir£ verification of `the existing locations 'in the field. SCALE, �'(= 40 DATE 8 3/ /,?-¢ GE`ENGINEERING CO. INC) C1.IM.,-------- I CERTIFY THAT, THE PROPOSED E6I$TERE REalSTE�E® JpB N0� �'¢ BUILDING SHOWN ON THIS PLAN •� � `CIVIL LAND CONFORMS TO THE ZONING LAWS ER RV OR: Y OF BARNSTABLE , MASS 712 MAIN STREET CH,BY� HYANN I S MASS �. �� ` SWEET-L OF DATE REG. LAND SURVEYO77 /Y07F /F E/TNER_THE SEPTIC TANK OR Y 20 FT. M/N /EfiCNlnlG P/T ARE MORE THAN IZ"SEL0�1f /D FT. M/AI GRROE, 24 1?/AMET.ER CoNG'R�T� COliER .SWALL B.E BROUGHT 7'0 4MA DE C4NCRE7`E '�"PYC' PIPE /�►eAVY CAST IRON Co✓�R Sf/ALL DE USED M./N. P/TCN IF/N DR/VE kVA Y G'OIiERS �B�i�FR FT. O i G .4DE COVER CLEAN, SANG l � -►. . . . BAGXR/LL z LAYER MJN.o/TcN DjST. o WASHED S7nNE %4 PON err ' SEPTIC TANK ' o a ! ♦ • • • • • t • s•a .+ . BOX • ! � o • • • • r a �• Qo r ir 1 , .. ! • •�f-ECT7VE e • o •� 4 - I I2 • o r ♦ • DEPTH • • r + v • WASNEO STONE `: .15/ X Z,� .57 7 C�a y G•a r c�� o • a • ! s o • • • • • �h._..'" s • ' PRECAST SE,EF346z" / 3 X /..0 / / 3 • m• e • • • s • • • • • p •a p , o ► • • • 0 • • • • w o PI7 OR ZVVI V. lN!/L®RT �LEY�T/G/VS /YY-r j�`��7y 490. �R�-/v.�� P O o /" INVERT AT Bl//L®/NG. / FT.. -� 3 C�SEg 77+A1/LAT1 oN> /NLET. .SFPT/C :TANK ®U7LET✓EPT/C 7"ANK ..:/ot ? FT. IMLE'®JSTRl�U?/ON BOX o`' t P SECT/O/S/ OF GR®uNo ic�4TER TALE OIITLeTD/STAR/L3lJT/ON.SAX /o c.Spr //vt�r tF.aca/�►+G /a/T / SEh/�C� OI.S'®OS�3 L SY.�T°�M Tie l.AT!®� L EACf I"a Z Z. 7T. SCAL-E DJl+9EN.'�tCtlV D��'lGJY Ct�t T°E�/�1 ip-- -�• A/UJ49EBR QF�EAi�oO/+9S 3 G.4R45AGED/5POs-4t vN/T wvNE S►OIL.. LOG S®IL 7-05r Ta�.gL E riNf.�cTE® �[o*v 33 O G.ac./®Ay SOIL TEST )P/ SOIL 7—,=S7 r NUA18E�P QF 40ACMIMCc P/75 / f`FLEK /OrJ./ /+-EL�Y. DATE OF S®/L TEST !`3 y S/®E LEACH/NG PER P/T / S/ .SY•t P7: r sr ftESL/LT.r I'+/JT/b/ESSED BY /?I3C — //3 a - 5.5. PERCOLAT/®N I�AT� / L- MINsI/NCH 60,E 7''OM L 1 CH/NG P� P/T so. FT e. G_O A.M . �i J l TOTi4L LEACH/NG aRE�4 2.6 1- SQ, =7 �-` G�.6�� PEe�C®LAT/�/�Ro4�"E 2 TZ IV'°yJAI�ING�I I RESERb�E LEs4l`MING fBRE/8 2-C9 cx SCJfL T"6557- Ir->— F,� Nico �t/A Lo 7- z7 KE2Y D2r�E '• ` �` . /? q rti1� spy E Cl MORE, w° RO$ERT G� o No.i0951 4 BRVCE 0L.IWEAM91 J �M l C. 0 9 C,�/!i� ELDRED 7f2 /vjA!'N Ste: f/YANAI MASS. qo FG r s T EF` \� s'' ti LL + .l s • FFSSIONAk F-�� /YA 'ITOU/YI� N�i4TL1 �NCOC!/VTL�R'Lr0 �E NT Mcl�c DA/._ D.tTE•$ �/ �¢. Teo ` c3t►w :�traT�R : r: � �. :Jd 8 s�r "_'u�l z .+ - T .......... 12- L-T-1 -114j,--I --- ---------- I F I -��I.. L_ I _ I 'i.-.. i i ..i I i I� ...i _ I ...i , i i � . I ..i_ .I i T i � i L� I ....! . ! �I .� __..I I I ._ I . I.._I I I_ .I . I . ! - .I ! _L....�. _I ­ 3 J I J I J go _-J All 'TUTLIA I - A I R __.I 1 ot .1-IT-1 I- I. 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I --- .. i .i I I � I i i I I - ,_.._ , I � I ' I I I I _ __ ____�_.._. __._I _ ; _. __ ... _.__� _. � I � � � 11 I __ I . ,. _ _ ' I �. I I ...na , � y -- _ I , .. .. . � ,. - IILv SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR i SHALL NOTE) (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE 1. DATUM IS dAVD 88 2" PEASTONE OR GEOTEXTILE TOP\ FOUND. EL. 84.8 FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING omesteod Olde 83.6' MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 82.5' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. R okeb WATERTEST D'BOX FOR LEVELNESS BLOCKS OR PRECAST H-10 MIN. 2 WALL THICKNESS PRECAST RISERS RISERS (TYP.) 4. DESIGN LOADING FOR ALL PROPOSED PRECAST poo 4"OSCH40 PVC MORTAR ALL UNITS TO BE AASHO H-LQ torus o 82.6 PIPES LEVEL 1ST 2' COMPONENTS INVERT IN 79.0 ,.. -.'.. ENDS p 3' SI . PIP JOINTS E MAD N W (1"P.) ES � hgd Y 79.8 5 E JOIN TO B E WATERTIGHT o atefs 10" EXISTING 14" ®®®� 0®®® ®®�® o®O� >°°g°g°o° 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE + TEE SEPTIC TANK** TEE 81.2t'* o,a;o;000000 6" MIN. SUMP agooa000 ®®®®®®®�®®® ®�®®®®®®®0� ;0000000o WITH12 o e o 0 0 0 ®®®®®®O�®®® ®®®®®®®®®�� 310 CMR 15.000 (TITLE 5.) p� g o a 12" MIN. INT. DIM. o°og0000 ° ° ° ° >00000000 ®®®®®®�®®®® ®®®®®®®®®oa a0000000 , OAP- q GAS BAFFLE::: ° ° ° ° °°°°°°°° 79.37' 79.20' ° ° ° ° ° ° ° ° 77.0 0� aA 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND •, . . ....,,.; .••, , : . •..: } NOT TO BE.USED FOR LOT LINES TAKING R ANY moo 1` `. H-10 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL. a 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED OTHER PURPOSE. / �a ALL AROUND PRECAST STRUCTURES 6" CRUSHED STONE OR MECHANICAL - OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00, X 12.83' " PVC. _ 8: PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 COMPACTION. (15.221 [2]) T TO BE BACKFILLED OR' / R 28 (6% SLOPE) ( 2 % SLOPE) � 9. COMPONENTS NO �5�f utie CONCEALED WITHOUT INSPECTION BY BOARD OF LEACHING HEALTH AND PERMISSION OBTAINED FROM BOARD "FOUNDATION EXIST. SEPTIC TANK 30' D' BOX 12' FACILITY OF HEALTH. *THE INSTALLER SHALL VERIFY THE **INSTALLER SHALL CONFIRM MINIMUM 10. CONTRACTOR SHALL BE RESPONSIBLE FOR 72.0' BOTTOM TH-2 - CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP LOCATIONS OF ALL. UTILITIES AND ALL SEPTIC TANK SIZE AT 1000 GALLONS NO GROUNDWATER FOUND VERIFYING THE LOCATION OF ALL UNDERGROUND & BUILDING SEWER OUTLETS AND AND ITS SUITABILITY FOR RE-USE. o OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000'f ELEVATIONS PRIOR TO INSTALLING ANY REPLACE WITH 1500 GALLON SEPTIC - WORK. PORTION OF SEPTIC SYSTEM TANK APPROPRIATE TO SITE ASSESSORS MAP 60 PARCEL 25 CONDITIONS IF NOT SUITABLE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL �?a � G BE REMOVED BENEATH AND 5' AROUND THE SITE IS LOCATED WITHIN A ZONE II R� PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED ' AND REMOVED OR PUMPED AND FILLED WITH CLEAN ,I 8 ° SAND. ' o L $p•Op L E G E N D R \\ SYSTEM DESIGN: 99 - EXISTING CONTOUR 55 GARBAGE DISPOSER IS NOT ALLOWED 22 X 99.1 EXIST. SPOT ELEV. - DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD PROPOSED coNrouR USE A 330 GPD DESIGN FLOW 198.4] PROPOSED SPOT EL. �� *�o TH1 SEPTIC TANK: 330 GPD (2) = 660 QD rEsr HOLE SHELL N **RE-USE EXISTING 1060 GAL. SEPTIC TANK SLOPE OF GROUND DRIVE 2�' LEACHING: UTILITY POLE SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD UNSUITABLE _ a (1 BEDROOM) r FIRE' HYDRANT SOIL m BOTTOM 2G x 12.83 (.74) = 237 GPD GARAGE NOTE: NOT ALL SYMBOLS MAY APPEAR IN DMWItLG_j DE K TOTAL: 472 S.F. 349 GPD (2 BEDROOM) USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) TEST HOLE LOGS EXISTING WITH 4' STONE ALL AROUND DWELLING TOP OF FNDN �� f ENGINEER:DANIEL E. GONSALVES, SE #13587 EL. 84.8 Q; 86 DECK QQ� WITNESS: DON DESMARAIS, RS Ca x DATE: 5/1/17 �y MA PERC. RATE _ < 2 MIN/INCH f APPROVED DATE BOARD OF HEALTH PATIO \� CLASS I SOILS P# 15335 x a SHED ELEV. ELEV. LOT f TITLE 5 SITE PLAN 0 . 0 Q 825 „ Q 82.5 33,354 S.F. OF A A 0.76 Al f 51 KERRY DRIVE SL � x /� \/ X/SL / o ; TH2 MARSTONS MILLS, MA /10YR 3 2 10YR 3 2 5„ 6„ N N AUTION PRIVATE X \ PREPARED FOR B B ELECTRI LINE �S� isL THIS AR 81 BORTOLOTTI CONSTRUCTION/ got10YR 4/6 81 .8' 12» 1OYR 4/6 / 81 .5' a� TODOROFF / BENCHMARK: - C� C1 SURVEY SPIKE_ y DATE: MAY 1, 2017 /SiL /SiL 84.1' NAVD88 '� REV..: MAY 25, 2017 (BOH) 40„ 2.5Y 5/4 79.2' 38» 2.5Y 5/4 79.3' Scale: 1"= 20' o1 °yG lj��l �(N MASSAc 0 10 20 30 40 50 FEET o G C2 2 SWING N � DANIELA. J, � DANIEL �r CIVIL off 508-362-4541 -1 PERC SET AREA OJALA N o A. �fi\' CS M M CS I / / h � No.46502 " OJALA fax 508-362-9880 a"' No.40980 � /I 2.5Y 7/3 2.5Y 7/3 Og °�FFo�sreR�\a� pop o�� / /� W/� w . downcap/�e.com/�/© 2 $ SS/ONAL ENG {gNOSURVEIO� 001,W irQ a e��ifteefifif, iI/fr� �- civil en ineers 138" 72.0' 138" 72.0' 1 �� E landsurveyors �� f NO GROUNDWATER ENCOUNTERED / ' 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 LICE # 17-090 17-090 BORTO-TODOROFF.DWG Ali 'i