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0056 KERRY DRIVE - Health
Marstons Mills",- � A= o60=624'!. - - - i �v 27 2016 21:56 Jim The Inspector Man 5085349919 page 1 ■ ■: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22-16 required for every page. Cily/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the and of the form. . Important:When A. General Information /a�j 3� filling out forms �� \�������ttt'OF1ArrU,�i�,, on the computer, S'f�i���� use only the tab 1. Inspector cyG, key to move your cursor-do not James D.Sears JAMES use the return Name of Inspector ? = B key. - Capewide Enterprises, LLC s =.oe. �o Com an Name �'�i�( � ,i�.) 2$ rsh P Y �� a ..., p `� 153 Commercial Street 'o"x, 5,INSI?t ,\\ rnunfl►►i --- Company Address Mashpee MA 02649 Cityrrown State Zip Code 508-477-8877 S 1623 Telephone Number License Number l I B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to—Section 15.340 of Title 5(310 CMR 16.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 11-23-16 Jn2p%e=torsgnature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP; The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority.' ""*This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc•rev.6116 TAIe 5 Officia'Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 2 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22-16 required for every page. Cityrrown State Zip Code Date of inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D. A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist..Any failure criteria not evaluated are indicated below. Comments: The system is a 1000 Gal Tank D Box and two chambers. Note: Outlt has a zable filter. l I B) System Conditionally Passes: ® One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old" or the septic tank(whether metal or not) Is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): i l5ins.doc•rev.6f16 Title 5 Official Inspection Form:Subsurlace.Sewage Disposal System-Page 2 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y' 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-16. page. CityrTown State Zip Code Dale of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND•(Explain below): ❑ obstruction is removed 4 ❑ Y ❑' N ❑ ND(Explain below): y C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect pubilc health, safety and the environment: i ❑ 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 15ins.doc- ev.6116 Title 5 Official Inspection Form:Subsurface•Sewage Disposal System•Page 3 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 4 Commonwealth of Massachusetts u Title ,5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 56 Kerry Drive Property Address l Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22'-16 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2.. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the.SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone,1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "This system passes if the well water analysis,.performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool; ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in is less than 6" below invert or available volume is less El ® than %day flow I- £ACAv t5ins.doc-rev.6116 TI11e 5 of dal.nspection Form:Subsirface Sewage Disposal System-Page 4 of 17 I ' i Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Kerry Drive 1 Property Address Polly Goddard Owner Owner's Name- information is MA 02648 11-22-16 required for every Marstons Mills page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design.flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a,nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well ti If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System-Page 5 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 6 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 0264E 11-22-16 page. City/town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? I - ® El available as built plans of the system obtained and examined? (If they were not available note as NIA) y ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with ❑ ® information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CM 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 15ins.doc•rev.6/16 Title 5 Official Inspection Forrn:Subsurface Sewage Disposal System•Page 6 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments N 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22-16 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal Tank D Box and two chambers. 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2014-25,000GaIs g y 9 (gP )) 2015-25,000Gal's Detail Sump pump? ❑ Yes ® No Present Last date of occupancy: Date Commerciallindustrial Flow Conditions: I Type of Establishment: Design flow(based on 310 CMR 15203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: l5ins.doc•rev.6/16 Title 5 Official Inspection Farm:Subsurface.Sewage Disposal System•Page 7 of 17 Nov 27 2016 21:56 Jim The Inspector Man 5085349919 page 8 Commonwealth of Massachusetts kipTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' . 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-16 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) - Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 11/10115 Was system pumped as part of the inspection? 0 Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract, • ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): _ t5ins.doc-ray.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22-16 required for every page. City/T'own State Zip Code Date of Inspection D. System Information (cost.) Approximate age of all components, date installed (if known)and source of information: Tank 1983 Permit # 83-912 /Box &Chambers 2007 -Permit#2007 $41 - Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 32 p 9 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40. Septic Tank(locate on site plan): 1 ' 20" Depth below grade: feet Material of construction: ❑ concrete ❑ metal El fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Ga). Precast H-10 2„ Sludge depth: t51ns.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 — Ncv 27 2016 .21:57 Jim The Inspector Man 5085349919 page 10 Commonwealth of Massachusetts i Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is Marstons Mills MA 02648 11-22A6 re wired for ever y 4 Zip Code Date of Ins ection i ITown State p p page. C ty D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" 1" Scum thickness 8 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 17 How were dimensions determined? Asbuilt-Plan-Tape h Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, y liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank at 20" below grade w/both cover's at 8". Inlet tee, outlet tee w/zable filter. No sign of leakage or over loading Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.00c•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 0117 1 Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M y 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-16 - page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach.copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ Nto t5ins.doc•rev.6116 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 11 of 17 i Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 12 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is regilired for every Marstons Mills MA 02648 11-22=16 page. City/Town State .Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x 16"-2' below grade. Box is clean and solid wltwo lines out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ .Yes ❑ No* comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): ` If pumps or alarms are not in working order, system is a conditional pass. - Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: i i t5ins.coc•rev.6/16 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 12 of 17 'i Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 13 Commonwealth of Massachusetts Title 5. Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 56 Kerry Drive Property Address g Polly Goddard Owner Owners Name information is Marstons Mills MA 02648 11-22-16 required for every LL4" page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Typelname of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is two 500 Gal. dry well chamber's (12'x25')w/inspection port. Chamber's are 4' below grade w/cover at 1'. 4"water in channi wall's are clean like new. No sign of over loading or solid carry over. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top,of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15irss.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 or 17 f ' Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 14 Commonwealth of Massachusetts :.. T ale 5 Official Insp ection n Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4M 56 Kerry Drive Property Address Polly Goddard Owner Owne,'s Name information is MA 02648 11-22-16 required for every Marstons Mills page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)-. Privy,(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): I6insAx-rev.6r16 Tille 5 Official Inspection Form:Subsurface sewage Disposal System•Page 14 or 17 Nov 27 2016 21:57 Jim The Inspector Man 5085349919 page 15 I - Commonwealth of Massachusetts .. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-15 page. CitylTown State Zip-Code Date of Inspection D. System Information (cant.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i A - .= 9- 8.37 p IJ- -L r � C o 5= 3 °/ 03" C . ,_ :33� t5ins.doc rev.6116 Title 5 Official Irspedion Form:Subsurface Sewage Disposal System•Page 15 of 17 Nov 27 2016 21:58 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts _ l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 56 Kerry Drive Property Address Polly Goddard _ Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-16 _ page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑' Surface water ❑ Check cellar ❑ Shallow wells wu Estimated depth to high ground water: 1 + feet Please indicate all methods used to determine the high ground water elevation:' ❑ Obtained from system design plans on record If checked, date of design plan reviewed: 11-28-07 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health- explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: T.H. on Design plan 11-28-07 114 no G.W.. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins doc-rev.6116 Title 5 Official Inspection Form:SuosuMace Sewage Disposal System•Page 16 of 17 Nov 27 2016 21:58 Jim The Inspector Man 5085349919 page 17 j Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a: 56 Kerry Drive e Property Address Polly Goddard Owner Owner's Name information is required for every Marstons Mills MA 02648 11-22-16 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, 8, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in.separate file I - t5ins.doc•rev.6116 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System-Page 17 of 17 / 0 Town of Barnstable P# Department of Regulatory Services Public Health Division Mug, Date O t63y �� 200 Main Street,Hyannis MA 02601 A ,¢ FD AAKt I r Date Scheduled I l Time Fee Pd. Soil Suitability Assessment for S -, age Disposal Performed By: u c0 i erl�� t 1 T G S , , Witnessed By. LOCATION& GENERAL INFORMATION Location Address S76 K-fRi2y Dri VF Owner's Name -Dq h�Se Dev[,-n I't 4�sra�s are II S Address StaKerey Assessor's Map/Parcel: O 60/a 21( Engineer's Name 3•C .Ens,,e�i,'H ci NEW CONSTRUCTION REPAIR Telephone# So T- Z o3 7 7 . Land Use �h5(� F "(Y / ceuaen�(G Slopes(�O) I" 2. Surface Stones Distances from: Open Water Body 160 ft Possible Wet Area 2 106 ft Drinking Water Well NIA ft Drainage Way ft Property Line > (0 ft Other _ ft j SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) I See elm doh No,e.-A,"r 2R, 2007 by SC Ev) i�neec�vl5 Parent material(geologic) Depth to Bedrock 7 (32 109 S Depth to Groundwater. Standing Water in Hole: 7 132 . S Weeping from Pit Face 7 032 Estimated Seasonal High Groundwater 7 (32' >15 DETERMINATION FOR SEASONAL HIGH WATER TABLE 'd Method Used: perer-� 00secucc,;n Depth Observed standing in obs.hole: 7 l 2- In, Depth to soil mottles: 7 i 3 2 In. Depth to weeping from side of obs.hole: 7 13 2- in. Groundwater Adjustment Index Well# Reading Date: - Index Well level ter• Adj.factor��._ Adj.Groundwater Laval,,;_ 1 PERCOLATION TEST Date il-29-67 Time.lAn Observation Hole# ( r Time at 4" Depth of Perc (° Time at V Start Pre-soak Time @ 11`.US A Time(911•611) - End Pre-soak 4 Rate MinJlnch 2- 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---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTI0PERCFORM.DOC t DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) O- a • F 1, 145 I.A. 66-1 32 G-2 fit-C S lay se 5% 5sove DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv. td-32 CS SL I0Y,- s/8 32-.6� �-I S4 2•'i 6/e 6�3-i32 C-Z µ-es 7— S "(6 — loose 5Srr6ue.1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. tConsistencv. { DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. on ' e Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes_ -✓ - Within 500 year boundary No Yes Within 100 year flood boundary No✓ 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? :y If not,what,is the depth of naturally occurring pervious material? Certification I certify that on )b-27-9 (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,expertis and experience described in 310 CMR 15.017. Signature /W", Date 0-28<7 Q:ISEP n0PERCFORM.DOC I r! TOWN OF BARTN8TABLE f,CATION SEWAGE# 0-7 VILLAGEM* S ASSESSOR'S MAP&PARCEL (go INSTALLERS NAME&PHONE NO. 4C)1 j '�P'g /O,olS SEPTIC TANK CAPACITY VDU 0 o LEACHING FACILITY:(type) O a (size) / Z x a S� NO.OF BEDROOMS OWNER 1 Q 0 PERMIT DATE: ii1301-Lto-7 COMPLIANCE DATE: 04 Z0d"-I Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility . wU 6@10 '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 �� "� � D✓) S�S t: 4 3 �a � • OL r 33 a9•- J3y 33. co 3t� L41 eLl 3a. �. CS 3a - 'j,f � • '4 No. > Fee I d U / ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for �Diopont 6p!5tem Con0truction Permit Application for a Permit to Construct( ) Repair(/ Upgrade( ) Abandon( ) ❑.Complete System Vndividual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. bzftjs( ►��flSice►s ;��S 51o,Lerry �f :C\QC Assessor's Map/Parcel C,0 •Z fV40-5 Installer's Name,Address,and Tel.No. CAP4E J"'J e E_✓!— Qf i Sel Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size �0�.Z�7 + sq. ft. Garbage Grinder ( ) Other Type of Building S. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow A(m1 in.required) 33� gpd Design flow provided gpd Plan Date ( u• Number of sheets 1 Revision Date Title 5(0 lde6,-!, bt,l,.� Size of Septic Tank I pon Type of S.A.S. t o .C, l —� L L( Description of Soil �� ,.016, �L =Q Z Nature of Repairs or Alterations(Answer when applicable) "_LZ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date 1 l 717— Zoo? Application Approved by Date "' 2Z—z Application Disapproved by: Date for the following reasons Permit No.�( ?"'S Date Issued f 30 No. `+4�n. 1" Fee Ent--red computer: �Oy V $ « Ed i TMM.QNWEALTH OF'MASSACHUSETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS - Application. for �Dtgo!gat *pgtem Congtructton Permit Application for a Permit to Construct( ) Repair a Upgrade( ) Abandon( ) El-Complete System individual Components Location Address or Lot No. 156 Kemi-b-,v e Owner's Name,Address,and Tel.No. yl j se �C' C� %,py) M"WOAs � %%S 5to►Leer y p (00 /�.y MA(Srw-S "0 s:.,v. Assessor's Ma /Parcel -�^ t Installer's Name,Address,and-Tel.No. Cp pew,6U fr✓4aPt $e-� Designer's Name,Address and Tel.No. J• �A.k t4 f. a n 5 o� zss�� G. „l6,w�14wy Type of Building: Dwelling No.of Bedrooms Lot Size 20; -4$'7 ± sq.ft. Garbage Grinder ( ) : : .,. Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3-2 gpd Design flow provided 3�SI gpd Al Plan Date K6• Zct"r 2,0 o') Number of sheets Revision Date A Title 5.l, keg(,, Size of Septic Tank 1 DOD 5,A 1 Type of S.A.S. Description of Soil n 1 go" Nature of Repairs or Alterations(Answer when applicable) l: l s h `4-y !\QA.Z I�-•fix a') Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ?.• Signet I r Date r f—2,5 . Zoo-7 Application Approved by I zz Date I/— �— �-� Application Disapproved by: Date for the following reasons r Permit No.� 1z� _s�/ Date Issued /t— 30 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewa a Disposal System Constructed ( ) Repaired ( V) Upgraded ( ) Abandoned( )by � p a,J i Cja - . f 1 } LL L at 5 p k(�"r rr t X yt'a_ vVY-VS kA(0-(t( has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. . d4 -7 ��� dated /) '3u-c"? Installer.,)t, [_.Q -e4 Designer .c. #bedrooms Approved design flow d _ gpd The issuance of 2h*S e t s: not.be construed as a guarantee that the system w I unction as des ned. C Date p > g Inspector f ------------------------ ------------------- } No. 0--? // Fee o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 'Wi0 po5al 6p.5tem Coon5tructton Permit Permission is hereby granted to Construct ( ) Repair (V ) Upgrade ( ) Abandon ( ) System located at �(a ���,(�., ��,.o�"��� o ri h,0o and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and.the following local provisions or special conditions. Provided: Construction"must be"completed within three years of the date i is perm• . Date 1 1 13 u/d 7 Approved by (`J LETTER OF TRANSMITTAL mti .. Eft .... -- ,- ',yea , .... .sN� �,'�i`�!' ...: V•��.r�5..r�� ,n:..• a�,S�it $rs tt Ott x� JC Engineering Inc. Civil&Environmental Services 2854 Cranberry Highway Telephone: 508-273-0377 E.Wareham,MA 02538 Facsimile: 508-273-0367 TO: (Town of Bamsta3le DAT:: 12/06/07 JOB NO. 1339 Board of Health RE: Septic System Asbuilt Plan 200 Main Street 56 Kerry Road Hyannis,MA 02501 Marstons Mills,MA WE ARE SENDING YOU: X Enclosed _ Under separate cover via X the following: Report Prints Brochures Shop Drawings Sl)ecifications Copy of Letter Change Order Forms � z Please find enclosed a septic system asbuilt plan for your records. Cz ~ a r C- Est Ell P THESE ARE TRANSMITTED as checked below: X For Approval _Resubmit Copies for Approval For Your Use _Approved as Noted Copies for Distribution As Requested Returned Approved as Submitted Returned For Review and Comment For Your Information REMARKS S:-iould you have any questions,please feel free to contact our office. i COPY TO: File(1),Client(1) SIGNED: Michael Piment E.I.T. - - OCAT ION 10 SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i DDRESS - w BUILDER OR OWNED DATE PERMIT ISSUED DATE COMPLIANCE ISSUED /� i ,t 76 r No................ i Fxs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t1® ......................................O F.......................................................................................... Appliration for Utipoial Works Tutuitrnr#inn umit Application is hereby made for a Permit to Construct W) or Repair ( ) an Individual Sewage Disposal.. System at: ...��-•-•....e.-r` - a Q:......................................... ..............-----•...............--•------........-•------•-•----.........--•--.............---- yTation adress or t No. Owner Address Installer Address Q Type of Building Size Lot._2�_._ 1.... feet U Dwelling—No. of Bedrooms.......... .............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria G4 Other fixtures ------------------------•--------.........•......-•••-.......... W Design Flow.................... .............gallons per person per day. Total daily flow........3.3-.6......................gallons. WSeptic Tank—Liquid capacity._ .0010.gallons Length-__ Width.�L.'td.. Diameter................ Depth.5.:.25.." 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 ( ) 8-1 Percolation Test Results Performed by.....WAwAp.!u.4...�L7N5 C�......................... Date.....m`.`_. .J�...,.�°.1 aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground wate ....................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...................................................................................•-•-•--------.............-•---•---..._......------........._......_.............................................................. 0 Description of Soil................................................................................................................................................._...................... x V ---- •---------------- ------------------------------- ------------- ••-••........ ------------- ••--•------ •-------------------------------------- -........ -------------------------------------- W ---............................................................--------._._........-•------._......-------•----....--•-•-•-----------...-------•---------------•-•-••---.............--•-•--•---------- VNature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------------------------=-•----•---•------------------.................-----........-•--••--...------•.•-••---•-------•------------•-••••---•••--•-•-------•----...--•-_.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compli e e .ss the board. ealt f . ........... .. ....................... r ...:S..........�� ApplicationApproved BY--- ;' . --. ............. ....................................................... Application Disapproved th llowing re ons:-----•------•-••----•-•---------------------------------------•-----------------•------- •-•-----•........ .................................................... .................. -••••-•---•--...-•••-------.....................-•----••---•-•-•-•-•-••••-------------....---------...-•---•• ................. Date PermitNo.................................. Issued....................................................... Date No. FIs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH yb ........................O F..........................---...........------•--.........--------..................-----• ApplirFatiun for DiivuuFal Workii Tontitruriion ramit Application is hereby made for a Permit to Construct (V ) or Repair ( ) an Individual Sewage Disposal System at: rr� D(IL)e . l.3........• .................................................................. ...........................................••------.........------........----................-•-- L `} cation• jadress or t No. n e., I- �� r ..1 .. .. .................. Y .:._._.. ............._............................................................ caner Address .. .= .................. .................................................................................................. Installer Address Q Type of Building Size Lot...2G...19Q.:.Sq. feet U Dwelling— No. of Bedrooms__...__................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No. of ersons____________________________ Showers 0.1 YP g -------------•-•----------•• P ( ) — Cafeteria ( ) W Other fixtures ............... ....••---•_.__. - Desi nFlow____________________ gallons per person er day. Total dail flow_._._...z __�.____.__ Ions. W g !1{�-•-------- -g P P o, Y• t Y -_.....---- � i� WSeptic Tank—Liquid capacity_.1,T).Q_gallons Length--- . Width__:..:•Ld:'_ Diameter________________ Depth_.5_:..6._.. 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.._-_ ,e:�� z�1.r!...CC?.l :......................... Date......C_na!,k.1�__,_ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water__....................... Gz, Test Pit No. 2..................minutes per inch Depth of Test Pit____________________ Depth to ground water........................ •----•-••-••-------------••.....•----•--•---------•--•-......_.......-----------•-------•------_............................................................. 0 Description of Soil........................................................................................................................................................................ x U ------...•••-•---•---------...••---------•----•-----------------•---------------•--••.......---•••-•---------•-••---------...-----------------._....-•----------•-----...._•---••------..._.._.._...---- w --------------- •-------------•-------•---•--------•-•--•---...-----------------------•---•-•-••••----•-----•-•-----------------•••----•------------._._._._._.._..----....._..-•-------•....---•-••-- UNature 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 TIT!i, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compli e e • s the board ealt . g - ... _. ... ....----.---- ----------- -- --------••---.....-••- Application Approved By...... `---....... ....................................................... Date Application Disapproved r th ollowing re ons.--- -------- •-------------------------•••-••••--••---•--••----------------•-•--••••---•-. ...-------__-----� ...................... _...........- Date PermitNo......................................................._ Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF......................................I.............................................. Trr#if iratr.of Totnplittnrr IT. S IS 0 C .��k That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.. !� i ... -•----------•---•--•--•-------------------------------------------------------------------- •----------- ........... ------- -----------..._ _._.. ��--� Installer at.....�. ......_Y� i ----= r •----------------•-------------------•--•----has been inst accordance with the rovisions of TI F r.of The State Sanitar Code s d ribed in the P , / Yapplication foosal Works Construction Permit �o_________________________................ dated_. ,._ ..... ...._��_ .,,,�_.___...__.__.._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST AS A GUARANTEE THAT THE SYSTEM WILL SATISFACTORY. DATE..... ��:. 1._...-------•-•••--••-------••-•.................... Inspector.--- -- ......................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -� Z..- ...........................................OF..................................................................................... �/0 No.:--•--...._..._:�..._. FEE....................... iuott k$ Tn� u ttr#ion rrmif Permission is y granted_c:.CCC ...... at to Construct �� or Repair an Individual Sewage Disposal System atNo........... �C --- -- ------------------- Street ' as shown on the app• tion for Disposal Works Construction Permit No......._ ..... Dated. ...__....................... ............................. -•--- .... -_YQQ��jj.!�........................................... Board of Health DATE----------- - ;. FORM 1255 A. M. SULKIN, INC., BOSTON DEC,-05-2007 12 :02 PM JdENGINEERING 508 273 0367 P. 02 'l'own of j3arnstple ! Regulatory Service's Thomas F. Geller,Director f _ MAW Public Health Division Thomas McKean,Director 200'Main Street,Hyannis,l'►IA,02601 . Office: 508-862.4644 Fax: 508-790.630e Jngtaller & Designer Certification Form Date: i Designer.: L , '� ; �vl c Installer: �aw�cie �n +5e 5 Address: `6 rW Lroberz kivJq Address: ( . r7b . on cn,w3�- was issued a permit to install a (o K r;y�D_c•V_ h osslu�n s k�tt�_.__based on a design drawn by septic system at _ (address) 6 eef dated tl•2l-ar (rca, it so•c7) _ I certify that the Sept c system referenced above was installed substantially according to j �+ the design, which'rnay include minor approved changes•such as lateral!relocation of the distribution box and/or septic tank. Acertify that the Septic' system referenced above was installed with M 'ors changes (i.e. � greater than 10' lateral relocation of the SAS or any vertical relocation 6f any component of the septic syst")but in accordance with State & Local Regulations Plan revision or certified as-built by designer to follow. C`•;vi n Steller s 1 ure} r i ; Wgn , _er (Affix signer's ' P Here) P ASE TU TO ARN 'T E'PUBLIC AL H DIV SI C TI A j OF CO LI CE ILL NO E SUE UN L B I O AND ) BUILT ARE R +CE�'�ED BY T BA] ST�1BL L T D� It j THANK YQU. I Q. Health/Septic/Designer Certification Form \ � h " 1 n H11V3H 30�- OHV00 As O1SS3NIIH i'.�.'iG z • 31VH 393d Slid 9NIH3 SIMS1H 1S11 0113d _ 9L ' til , SL 1NOlS Z 3NO1S O3H SVfj - LL - OL 6 t ' L Z '0N 0 L 0 901 110S p, � _ `�/.—=moo•,, L i � �f mac- = J � G3 .3� • � i w�� J SEWAGE PLA SITE A . . a . ^ .3 BEDROOM SINGLE FAMILY DWELLING ,•, o DATE .•; ii ,., t� ,ice,/ �/= t� %�iJ" -_i { D 010E `�' p SS OCIATES FAlI�OUTH , AS, ti- ..�-��,� :� Z�.4;;�4 :. GE SYSTEM REGULATIONS AND SCALE 1/4"= 1' 0 t �y R E LEVEL 3�GAL/DAY WIo�,T GARBAGE DISPOSAL GALIDAY APPH.OVEO BY : BOARD OF HEALTH DATE : �•� 1,� c R „O , l Mti/l • 31n3S ONd SNOIi vm 9 SAS E�� \ L •n 10,�� 009 00 ° n Sild 9NIH3n31 iStiO3Hd a aOo 9 c d o oa o , Hid30 '113, °°o 09 'Q 9- v 0 v o o p o 3NOiS 03HSVM Z/l l WEa aQa a � o a� � �z » NI 71 3NOiS. 03HS M S/£ B/L H3n00 Z I , PROFILE OE PROPOSED SEWAGE SYSTEM DESIGNED BY THE TOWN OF REGULAT STATE TITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE . t . N . R . 1. ALL PIPES SHALL BE SCHEDULE 40 P-.V-.C. SEINER PIPE 2. ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FOR THE FIRST . 2 FEET OUT OF ' THE' D /B WHICH SHALL BE LEVEL 3. DESIGN FLOW BEDROOMS AT 110 GALDAY PER BR. GAIL SEPTIC TANK SIZE X GAL. USE B AL. GARBAGE DISPOSAL LEACHING SYSTEM: USE EFFECTIVE AREA : SIDE BOTTOM TOTAL FLOC TOTAL REQ'D FLOW S X = - W/= RESERVE FLOW GAL/DAY _ REFERENCE PLANS PROPERTY OWNER : TI , ; �- I E PLAN 0` TOP OF FOUNDATION EL.: 00 0 6 e 0 V _ e p • e se; IN.EL. D•e 0 • .• i rr s, IN.EL. IN,EL. = a L IN.EI. 1 0 4- LIQUID LEVEL ' D/B W/ 6"/SUMP ,D16 PRECAST SEPTIC TANK WITH CAST IN PLACE INLET AND OUTLET T "S PER TITLE SC SIZE PROFILE OF PROPOSED SEWAGE � SYSTEM DESIGNED BY THE TOWN OF REGULATION; STATE TITLE Y FOR SUBSURFACE DISPOSAL OF SEWAGE . SCA N . B . 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE 2. ALL PIPES SHALL BE SLOPED 1/4 PER FOOT EXCEPT FOR THE FIRST 2 FEET OUT OF THE D /B WHICH SHALL BE _ LEVEL 3. DESIGN FLOW BEDROOMS AT 110 GALDAY PER R. 5-DGAL/DA SEPTIC TANK SIZE GAL . �. �. .._ =5-�---_---- BOARD OF HEALTH TOWN OF BARNSTABLE Z(pprication,forlVerf Con0ructionPermit Application is hereby made for a permit t9 Construct ( ), Alter ( ), or Re air Xan individual Well at: Location — Address Assessors Map and Parcel -- -------- - s6 1(c>`X -QL_, mg/sTo-ems n� ;1�G�c y Owner ------ � ----- --/---- / Address �+.—__ =SOX c�__o_ �1f J -- -- -- Installer — Driller Address —�— Type of Building ' Dwelling �au5 C Other - Type of Building------------------ No. of Persons-- Type of Well----- ---- -- ------- -- - Capacity— - ---- Purpose of Well--.QP__MCSZi wU_ c't---------------__-__ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not.to place the well in operation until a Certificate f Com 1' nce has been issued by the Board of Health. Signed ��� aSo7 y_AZ5'L date q, Application Approved By-- � ''' -- - -ems- 1— _r/--- ____ _____ date Application Disapproved for the following reasons:--- ----------------- date Permit No. Issued —_--_- - - ----- date — — BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaire by---- �—- � :____--- ---- ------------------------------ -------------—_— — - _------- Installer at-— - -_�_--- - ---- T -- - ---_--- ---has been installed in accord with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.1U-y4( a-L---Dated-THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------ Inspector----------- -- 'Fee---= = -------- BOARD OF HEALTH bar� TOWN OF BARNSTABLE - 0[ppritation-*rVefr Con5truct ion permit Application is hereby made for permit to Construct ( ), Alter ( ), or Repair (s�n individual Well at: PP Y P P "fl, v r • �a,, >�i -'-fit .1J CSC >� 7 __________________________ —___ r Location — Address .,._.--- Assessors Ma and Parcel 'a -------------------- -!-5:C A--- nT /c_t__�- Owner Address ox0 ` C h f- -- -__rD �_G•_-_S-_- G !� l/ � = Driller JIns � r Address Type of Building I Dwelling ---- Other - Type of Building ----- No. of Persons--------- - ----------r-----' :YeT Type of Well-') - - -� ----------- Capacity- ____ ____- ------------------ Purpose of Well � 1_4P 7�L....L='A_f2t:l-.........-.......--- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance ith the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersi ned further agrees not to place the well in operation until a Certificate of Com fiance has been issued by the Boa d of Health. �Sa - -` --' -- - ,� Signed ��--���------- �c --------------- ` date Application Approved BY--- � - --------------------- - i date Application Disapproved for the following reasons:---------------------------------------------------------------------------------y---------__-_-- ------------------- --� --- ----- - n date 11 Permit Nc^-- -- = - /----------- --------------- Issued---------------------------------------------------- - c , \ date i — — o,. 17 BOARD,OF HEALTH TOWN OF BARN`t ABLE Certificate Of Compliance THIS'IS TO CERTIFY, That the Individual Well Constructed( ), Altered ( ), or Repaired( ), - -� ---— -- - - f---------- - Installer 0 —at- -- -- -- I - - - ---f,- - �^j -—' - - -T44--;- ---------------------------------------------t--------------------- has been installed in accordance_w.ith_the-provisio.ns_of-the Town-of-Barnstable-Board-of-Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -,------ --- ( - Dated------------------------ t -�(� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT ON�St UEH AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE —- - - -------------------------------- - - Inspector- =--------------------------------------------- t BOARD OF HEALTH TOWN OF BARNSTABLE Ivell congtruct ion Permit No.---------------------- Fee Permission is hereby granted - - n2-- --------------------------------------------T - to Construct ( ), Alter ( ), or Repair ) an Individual Well at: 1 fir A_ ��r^'' 1 'f ------------------------------------------------------------------------ ' . . - - - NO. — — v — V-- v Street as shown on the application for a Well Construction Permit // No-------------------------------------------------------------------------------- Dated - ---_ram---=1 - f - - -----------------------\-� ----------------------------------------- I -- Board of Health DATE-------------------------- -------------------------------------------------------- �O LA i r _ v y e I v� w c« Y o , I I ff f PROVIDE PRECAST CONCRETE FINISH GRADE OVER D-BOX= 83.4'± FINISH GRADE OVER CHAMBERS= 83.83' - 83.11GENERAL A 1®TC TOP OF FOUNDATION EXTENSION RISER WITH CONCRETE " 3/4"TO 1-1/2"DOUBLE WASHED NOTES E � REMOVABLE CONCRETE COVER ELEV= 85.7 + COVER TO WITHIN 6"OF FINISH GRADE TO WITHIN 6 OF FINISHED GRADE OVER INLET AND OUTLET COVERS. 4"SCHEDULE 40 PVC MIN SLOPE 1% STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE 5"DIA. OUTLET(S) INSPECTION PORT 2"OF 1/8"TO 1/2" DOUBLE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE @ FND. EL.= VARIES FINISHED GRADE OVER TANK EL. = 84,5± SLOPE @ 2% MIN. OVER SYSTEM (SEE NOTE#21) WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. f 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD 20" MIN-ACCESS COVER PLACE RISERS ON ALL OF HEALTH AND THE DESIGN ENGINEER. [ I (TYPICAL FOR 3) PROPOSED 4" TOP OF SAS= 79.33 PVC SEWER PIPE 36"MAX. 9"MIN. CHAMBERS TO 6"OF 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL \ 9"MIN. 78�50_ 36"MAX. BREAKOUT EL = 79.00' (80'29 FINISHED GRADE BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. (7 9.46') 79.96' 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" 3" DROP MAX ELEVATION =79.96' FOR A DISTANCE OF 15'AROUNDTHE PERIMETER OF THE SAS. UNLESS � 2"DROP MIN 3 9 - _ PROVIDE WATERTIGHT o 0 0 A 40 MIL GEOMEMBRANE LINER IS PLACED AT LEAST FIVE FEET FROM S.A.S.AND THE TOP s 10" JOINTS(TYP-) OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14" +8 .7'+ 8 .83' 4 PVC IN FROM 0 O 0 0 ,o o O 0 ( ) SEPTIC TANK 4" PVC OUT TO o 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. APPROXIMATED O LEACHING FACILITY oo 0 0 0 0 100 0 0 0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. ( ) oo iO o 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO CONTRACTOR CONTRACTOR SHALL 2, SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 81.00' 12 QT 0 0 0 0 0 °° 0 0 oop BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR Mw. 80.83 (79.98 AND CONDITION OF EXISTING TEES n - °° o 0 0o INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING 22 ZA13 EL FILTER $0. $' o D O D O 0 0 o 0 0 0 0 E o EXISTING SEPTIC AND REPLACE AS -" ( ) 6"CRUSHED STONE o _ APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. MODEL#A1801-4x22 TANK NECESSARY OVER MECHANICALLY 4.0' I 4.0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L DATUM OF 85.00' COMPACTED BASE 8.5' (TYP.) �- 3.55' 4 9' 3.55' ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. 5 OUTLET DISTRIBUTION BOX 25.0' I (TYP•) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION TO BE INSTALLED ON A LEVEL STABLE 43,0'± * 12.0' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE BASE. FIRST TWO FEET OF OUTLET 76.5Q' GROUND WATER ELEv.= AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY EXISTING OOO GALLON CONCR'IETE SEPTIC TANK PIPES TO BE LAID LEVEL. DISCREPANCIES TO THE DESIGN ENGINEER. 77.46 _ 2 500 GAL. CHAMBERS 5 MIN. CHAMBER END VIEW 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE CROSS SECTION VIEW TYPICAL CHAMBER PROFILE i STRUCTURES SHALL BE MADE WATERTIGHT. *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL CHAMBER D�TAI LS *AS SHOWN ON TOWN OF BARNSTABLE'S 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT- NOT TO SCALE NOT TO SCALE NOT TO SCALE: 1992 GROUNDWATER CONTOUR MAP ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE IL NOTE: �+ DETERMINATION FROM APPROPRIATE AUTHORITY. M ° * TEST PIT DATA 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS 1.) MAGNETIC,MARKING TAPE SHALL BE _x° PLACED ALONG THE TOP EDGE OF EACH LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE �� PERC. NO.: 12042 THEY SHALL WITHSTAND H-20 LOADING. .. xx SEPTIC SYSTEM COMPONENT. INSPECTOR: Donald Desmarais 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND SOIL EVALUATOR: Michael Pimentel, E.I.T. FINES. :r I November 28, 2007 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND � , _• - � DATE: ,x UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF :> TEST PIT#: 1 LEACHING FACILITY REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN \I - 5: ELEV TOP- 83.20' COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ,. - /� ACCORDANCE WITH 310 CMR 15.255(3). 4 _ . ELEV WATER= <72.20' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE_ <2 MIN/IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. i co MAP 60 � ': xra I " 16. PROPOSED PROJECT IS LOCATED WITHIN: :�. s. MAP 43 , �-` e4` o , x *► DEPTH OF PERC= 68 -86 to criPARCEL 20. �} ?: ASSESSORS MAP 60 PARCEL 24 PARCEL 26 ( TEXTURAL CLASS:', 1 N a F t w OWNER OF RECORD: DENISE J. GEOFFRION a, 1' 0" 83.20' Fill ADDRESS: 56 KERRY DRIVE N87"10-34"E _ _ 8" 2 53' , 8 S MILLS, MA 02648 MARSTON _ 2 Q0' -- \ ,:: r •" B Sandy Loam FEMA FLOOD ZONE C X ( C-X-X-X-?X X-X X 19. TP 1 \ j � 10Yr 5/8 AS SHOWN ON COMMUNITY PANEL# 250001 0015 C 83.20' 32" 80.53' 17. PLAN REFERENCE: I � � "AS-BUILT"2-500 GALLON `� � 'I �s ' • 'r � L.C. PLAN 35186-B �I O R LEACHING CHAMBERS 4 . q�. �y .Sandy Loam 2 C} \ . "AS-BUILT" INSPECTION PORT = _ P 2 �' ,,� s "�, w C-1 2.5Y 6/6 18. DEED REFERENCE: 83.40' \ "AS-BUILT" DISTRIBUTION BOX L.C.C.#123013 III i I 7C r+' - � a� � ....?' •' � - � /mot'.; , REMOVE& REPLACE UNSUITABLE MATERIAL -="" fr' ;�: �' 1 68" Y,,,y 77.53 19. ALL DISTURBER AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. TO C-2 SOIL WITH CLEAN COARSE SAND ` Perc 20. PROPERTY LINE INFORMATION IS APPROXIMATE ONLY. THIS PLAN IS TO BE USED ONLY �..:. � �>� p� � ; � ;>�; rLL,;.. � )14.. ,:,• ; w 76.03 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY \ _ EXISTING-LEACHING PIT TO BE .R.,,=, -- - . ZONE I I,: _ a, .,. - INTENDED P P 8 LP ,, ?,, - Med.to Coarse Sand FOR USES OF THIS PLAN OTHER THAN ITS IN E DED UR OSE. 1 PUII�PED, FILLED WITH CLEAN, ' f�f s, �-, �W .. \ \ 6/ BRICK COARSE SAND, &ABANDONED - 2.5Y0 6 21. A 4" PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A 1 PATIO � \ . � �,�-`� � , .,� yx ,,, (Loose<5/o Gravel) „ C-2 X " V ,: DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF I FINISH GRADE. A x \ REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. �. ------EXISTING 1000 GALLON SEPTIC TANK TO BE UTILIZED 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,ITHE FOLLOWING LOCAL UPGRADE p \ AS PART OF THIS DESIGN LOCUS PLAN 132" 72.20' APPROVAL IS REQUESTED FROM 310 CMR 15r.221(7): \ *(1.) A 1.5'VARIANCE (3.0-4.5')FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY.. p1 No Standing,Weeping,or *VARIANCE NOT NEEDED DUE TO THE REMOVING AND REPLACING OF UNSUITABLE X J \ SCALE: 1"= 1000' Mottling Observed \ Benchmark MATERIAL TO C-2 SOIL AND RAISING SAS TO ACHIEVE MAX COVER OF ONLY 3 FEET. "AS-BUILT WING TIES Nail set in Tree ,s DECK \ El,ev. =85.00' TEST PIT DATA SCALE: 1 = 10 \ LEGEND Approx. M.S.L. DESCRIPTION HC 1 HC 2 #56 \ PERC. NO.: 12042 EXISTING \ DESIGN DATA INSPECTOR: Donald Desmarais 100 EXISTING CONTOURS CHAMBER COVER(1) 31.3' 35.1' , \ 3-BEDROOM \ DWELLING w SOIL EVALUATOR: Michael Pimentel, E.I.T. / November 28, 2007 102 PROPOSED CONTOURS CHAMBER COVER(2) 31.7' 39.0' \ TOF=85.T± \ DATE: NUMBER OF BEDROOMS 3 TEST PIT#: 2 102 PROPOSED SPOT GRADE DISTRIBUTION BOX(3) 25.4 29.5 \ MAP 60 a INSPECTION PORT(4) 32.6' 41.5' DESIGN FLOW 110 GAUDAY/BEDROOM ELEV TOP= 83.40' SHED PARCEL 23 -X-X-X-X-X-X- EXISTING FENCE LINE _ ttr TOTAL DESIGN FLOW 330 GAUDAY �8 ELEV WATER= <72.40' Z 4� Q DESIGN FLOW X 200 % = 660 GAUDAY ❑/H/W EXISTING OVER-HEAD UTILITIES ,, PERC RATE_ USE EXISTING 1000-GALLON SEPTIC TANK �\ rn `Ja', DEPTH OF PERC- GAS EXISTING GAS LINE I � W W EXISTING WATER LINE. / rn MAP 43 3 w TEXTURAL CLASS:. 1 PARCEL 30 \3 c�/ TEST PIT LOCATION INSTALL 2 500 GALLON CHAMBERS WATER LINE Q 0" 83.40' 2 (approx. loc.) Fill Q O I EXISTING 1000 GALLON SEPTIC TANK ( _ / SIDEWALL CAPACITY 8" 82.73' t4) 3 MAP 60 / g Sandy Loam "AS-BUILT"4"SOLID SCHEDULE 40 PVC PIPE ~ : ~ (LENGTH +WIDTH)(2)(2' HIGH) (0.74 GPD/S-F.) = GAUDAY 10Yr 5/8 4 / B DISTRIBUTION BO PARCEL 2 �'�� (LEN ❑ "AS-BUILT" DIS X - 82-__ / (25.0'+12.0') (2)(2') (0.74 GPD/S.F.)= 109.5 GAUDAY 32" 80.73' / 20,287 S.F.+ i "AS-BUILT"500 GALLON LEACHING CHAMBER r BOTTOM CAPACITY C-1 Sandy 6/6m (96.87') , ACTUAL ELEVATION AS-BUILT' (LENGTH x WIDTH ) (.74 GPD/S.F.) = GAL/DAY 68" 77.73' p (25.0'x 12.0') (.74 GPD/S.F.) = 222.0 GAUDAY REV. DATE BY APP'D. DESCRIPTION (3) r $�/ 25 0 0 ------ ❑/H/W o/H/W "AS-BUILT" SEPTIC SYSTEM \ / R_3 p-0� - _ --- ❑/H/W Med.to Coarse Sand I TOTALS: C_2 2.5Y 6/6 PREPARED FOR: t, H/W O/H/W ❑/H/W (Loosed<5°�oGravel) CAPEWIDE ENTERPRISES ❑/H/W ❑/H/W U.P.#1403-4 TOTAL NUMBER OF CHAMBERS: 2 EDGE OF PAVEMENT LOCATED AT KERRY DR'vE TOTAL LEACHING AREA: 448.0 SQ..FT. KER TOTAL LEACHING CAPACITY: 331.5 GAL-/DAY 132" 72.40' 56 KERRY DRIVE 40'WIDE LAYOUT) ( No Standing,Weeping,or MARSTONS MILL S MA 02648 HC 1 Mottling Observed RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 20 FT. DATE: DECEMBER 5,2007 0 10 20 40 80 FEET I V .. 4'ximxA rt.� EXISTING "AS-BUILT 0 a CukWF,ra+. PREPARED BY: DWELLING `, JC ENGINEERING, INC. 416 7 PLAN vT 2854 CRANBERRY HIGHWAY HC 2 �` EAST WAREHAM, MA 02538 SITE PLAN 508.273.0377 SCALE: 1"=20' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.1339 �� T PROVIDE PRECAST CONCRETE FINISH GRADE OVER D-BOX= 83.4'± FINISH GRADE OVER CHAMBERS= 83.83' - 83.11' PROPOSED VENT WITH CHARCOAL GENERAL NOTES TOP OF FOUNDATION EXTENSION RISER WITH CONCRETE FILTER TO ABOVE GRADE REMOVABLE CONCRETE COVER 3/4"TO 1-1/2"DOUBLE WASHED ELEV= 85.7 COVER TO WITHIN 6"OF FINISH GRADE TO WITHIN 6"OF FINISHED GRADE " 0 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION OVER INLET AND OUTLET COVERS. 4 SCHEDULE 40 PVC MIN SLOPE 1 /° STONE TO CROWN OF PIPE FINISH GRADE 5"DIA. OUTLETS) INSPECTION PORT 2"OF 1/8"TO 1/2"DOUBLE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE @ FND. EL.= VARIES FINISHED GRADE OVER TANK EL. = 84.5± SLOPE @ 2%MIN. OVER SYSTEM (SEE NOTE#21) WASHED STONE - ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD 20" MIN.ACCESS COVER ' PLACE RISERS ON ALL OF HEALTH AND THE DESIGN ENGINEER. (TYPICAL FOR 3) PROPOSED 4" TOP OF SAS= 79.33 PVC SEWER PIPE 36"MAX. , 9"MIN. CHAMBERS TO 6"OF 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL - 9"MIN. 78.50 36"MAX. BREAKOUT EL = 79.00' FINISHED GRADE BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" 3" DROP MAX ELEVATION =79.00'FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS 2"DROP MIN 3 9 -_ i PROVIDE WATERTIGHT o 0 0 A 40 MIL GEOMEMBRANE LINER IS PLACED AT LEAST FIVE FEET FROM S.A.S.AND THE TOP 10" _ „ JOINTS (TYP.) OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14" *8 ' 4 PVC IN FROM " 0. 0 0 0 0 0 0 40 0 0 0 0 0 0 ° SEPTIC TANK 4 PVC OUT TO o0 00 5. SLOPE ALL SOLID PIPE AT 1.0 /o MINIMUM. (A(APPROXIMATED) LEACHING FACILITY oo 0 0 0 0 0 0 1O° 0 0 0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. � 0 0 400 12" 2' 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO CONTRACTOR CONTRACTOR SHALL ..� � 0 � � � 0 � 0 o 0 0 � 0 81 .00' MIN. 80.8 SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 3' "` '` o 0 0 � � o BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR __, o o o INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING AND CONDITION OF EXISTING TEES 22"ZABEL FILTER o _ 0 . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 EXISTING SEPTIC AND REPLACE AS MODEL#A1801-4x22 - s"CRUSHED STONE _ o _ APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. TANK NECESSARY OVER MECHANICALLY 4.0' �4.0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L DATUM OF 85.00' COMPACTED BASE 8.5' (TYP.) 3.55- 4 9' 3.55' ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. 5 OUTLET DISTRIBUTION BOX - 25.0' (TYP•) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION TO BE INSTALLED ON A LEVEL STABLE _ 43.0'± * 12.0' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE BASE. FIRST TWO FEET OF OUTLET 76.50' GROUND WATER ELEV.- AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY EXISTING 1 000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. DISCREPANCIES TO THE DESIGN ENGINEER. 2 - 500 GAL. H-20 CHAMBERS 5'MIN- CHAMBER END VIEW 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE �/ TYPICAL CHAMBER PROFILE LI_Z HAM p Epp DETAILS L�7 STRUCTURES SHALL BE MADE WATERTIGHT. p CROSS SECTION VIEW f-1 L7 (� *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL ® � AS SHOWN ON TOWN OF BARNSTABLE S 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE T NOT TO SCALE NOT TO SCALE: 1992 GROUNDWATER CONTOUR MAP ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH I. i ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE IL NOTE: DETERMINATION FROM APPROPRIATE AUTHORITY. 1.)'MAGNETIC MARKING'.TAPE SHALL BE TEST PIT DATA 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS PLACED ALONG THE'TOP EDGE OF EACH LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE �° � � *f, «: F •• 12042 THEY SHALL WITHSTAND H-20 LOADING. � SEPTIC SYSTEM COMPONENT. . INSPECT - PERC NO' Donald Desmarais OR 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND 1 ' r SOIL EVALUATOR: Michael Pimentel, E.I.T. FINES. DATE: November 28, 2007 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND f UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT ON ALL SIDES OF f ' N TEST PIT#: 1 LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN a �! ELEV TOP= 83.20' COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ELEV WATER= <72.20' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PER RATE_ <2 MIN/IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. C CID MAP 60 �� ;, A � u=� � ,� _ 16. , PROPOSED PROJECT IS LOCATED WITHIN: CID E o OF PE - 68"-86" ko MAP 43 PARCEL 20 S` I M p ASSESSORS MAP PARCEL 24 �► DEPTH RC ,} SS co 60 PARCEL 26 I ' TEXTURAL CLASS: 1 „ OW RECORD. OWNER OF DENISE J. GEOFFRION N 1, , 0 83.20 �:� - � ��« = � `' Fill ADDRESS. I N87°10'34"E _ g" 82.53' MILLS, MA 02648 Is • 56 KERRY DRIVE MARSTONS 2 0' -a- - \ PROPOSED VENT, EXACT LOCATION Q g Sandy Loam FEMA FLOOD ZONE C X X-X ;X X-X-XX ( c V� TO BE DETERMINED BY OWNER 1a , � 250001 0015 C }, .. - OYr 518 AS SHOWN ON COMMUNITY PANEL#1 7c 'Q �.. 32" 80.53' 17. PLAN REFERENCE: PROPOSED 2-500 GALLON sn t � ���- � � L.C. PLAN 35186-B \ H-20 LEACHING CHAMBERS ; . Sandy Loam C-1 2.5Y 6/6 18. DEED REFERENCE: PROPOSED DISTRIBUTION BOX L.C.C. REMOVE& REPLACE UNSUITABLE MATERIAL 68 •.;: 53 19 ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. © , . 1 �' ` ,s„ ✓ TO C-2 SOIL WITH CLEAN COARSE SAND Per( _ 20. � �.,ve.,. .,; ;;.., . ,; ; �,�, _ :.;, ,, ,;, � !► ,,,� � PROPERTY LINE INFORMATION IS APPROXIMATE, ONLY.. THIS PLAN IS TO BE USED ONLY g4 , \ � _ )It a> FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY \ EXISTING LEACHING PIT TO BE ;,,p4 I . : ,._ ZONE II_ �. ��. r� ��,} �. . ,�, .,;�.� Y_ � ----- -� ., , •� - - .� . ,-< .:- - > ; : FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE_ _ cp LP - Med.to Coarse Sand PI✓fMPED FILLED WITH CLEAN - I BRICK o S ' t : C 2 COARSE SAND, &ABANDONED w; ,� � , � • 21. A 4 PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A N \ * Loose;<5%Gravel X PATIO ,. ( ) DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A ' \ \ REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. x� --EXISTING 10010 GALLON \ �$ O � SEPTIC TANK,TO BE UTILIZED 132" 72.20' 22. IN APPROVAL NCE ISREQUIESTED FROM 3 0 CMR 15 2��E FOLLOWING LOCAL UPGRADE � 4, o �- AS PART OF HIS DEIGN LOCUS PLAN ( ) (1.) A 1.5'VARIANCE(3.0-4.5')FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. X \ No Standing,Weeping,or \ I t SCALE: 1"- 1000' X \ - Mottling Observed � SWING TIES \ Benchmark Neil set in Tree "- x DECK \ Etev. =85.00' TEST PIT DATA LEGEND SCALE: 1 = 10 Approx. M.S.L. DESCRIPTION HC 1 HC 2 \ ` #56 \ PERC. NO.: 12042 EXISTING / \ DESIGN DATA LEACHING CORNER(1) 26.2' 25.5' 3-BEDROOM \ INSPECTOR: Donald Desmarais 100 EXISTING CONTOURS \ DWELLING �� SOIL EVALUATOR: Michael Pimentel, E.I.T. LEACHING CORNER(2) 37.2' 34.0' TOF=85.7'± November 28, 2007 102 PROPOSED CONTOURS DATE: \ \ NUMBER OF BEDROOMS 3 TEST PIT#: 2 102 PROPOSED SPOT GRADE LEACHING CORNER(3) 49.7 53.0 f \ MAP 60 LEACHING CORNER(4) 41.6' 48.0' SHED \ PARCEL 23 DESIGN FLOW 110 GAUDAY/BEDROOM ELEV TOP- 83.40' EXISTING FENCE LINE , \ TOTAL DESIGN FLOW 330 GAUDAY -X-X-X-X-X-X- ELEV WATER= <72.40' DESIGN FLOW X 200 % = 660 GAUIDAY _ 0/H/W EXISTING OVER-HEAD UTILITIES (3 PERC RATE_ ¢ N USE EXISTING 1000-GALLON SEPTIC TANK � / GAS EXISTING GAS LINE DEPTH OF PERC _ \ / �6, W W EXISTING WATER LINE MAP 43 \ 183 TEXTURAL CLASS:' 1 (4) PARCEL 30 3 Co INSTALL 2 - 500 GALLON H-20 CHAMBERS TEST PIT LOCATION WATER LINE-�� ¢ r 0" Fill 83.40' O o EXISTING 1000 GALLON SEPTIC TANK (approx. loc.) 2 SIDEWALL CAPACITY 8" 82.73' _:.. `� _ / `MAP 60 g Sandy Loam PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE (LENGTH +WIDTH)(2)(THIGH) (0.74 GPD/S.F.) = GAUDAY 10Yr 5/8 / Q-82--_ PARCEL 24 �,Q,'� / / (25.0'+12.0') (2)(2') (0.74 GPD/S.F.)= 109.5 GAUDAY 32" 80.73' ❑ PROPOSED DISTRIBUTION BOX 0 _ - 20,287 S.F.t _ i' 0 PROPOSED 500 GALLON H-20 LEACHING CHAMBER / Sandy Loam (2) / i �, i BOTTOM CAPACITY C-1 2.5Y s/s (LENGTH x WIDTH ) (.74 GPD/S.F.) = GAUDAY 68�� 77•73' 1 11-30-07 MCP JLC RAISED SAS cj (25.0'x 12.0') (-74 GPD/S.F.) 222.01 GAUDAY REV. DATE BY APP'D. DESCRIPTION i H1W --- ❑/H/w -- ❑/"/w PROPOSED SEPTIC SYSTEM UPGRADE j 01 TOTALS: C-2 Med.to Coarse Sand PREPARED FOR: 5Y 6/6 ❑/H1W ❑/Hiw: ❑/H/w ❑/H/W (Loose;<5% Graveq CAPEWIDE ENTERPRISES U.P.#1403-4 TOTAL NUMBER OF CHAMBERS: 2 EDGE OF PAVEMENT LOCATED AT Y DR'vE TOTAL LEACHING AREA: 448.0 SQ.'.FT.` � KERB 132" ' 72.40' 56 KERRY DRIVE TOTAL LEACHING CAPACITY: 331.5 GALL./DAY 40'WIDE LAYOUT) HC 1 ( No Standing,weeping, or MARSTONS MILLS, MA 02648 Mottling Observed RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 20 FT. DATE: NOVEMBER 29, 2007 0 10 20 40 80 FEET 1H of Mq,p„cy ! J'OHN L. `gym PREPARED BY: CNUR%,FiiLL JC ENGINEERING, INC. 1418 2854 CRANBERRY HIGHWAY a�� EAST WAREHAM, MA 02538 HC2 SITE PLAN 508.273.0377 SCALE: 1"=20' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.1339 I I