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Home My WebLink About0732 OAK STREET (CENT./W.BARN) - Health 132 OW Street W. Barnstable A = 215 001001 f / J Commonwealth of Massachusetts 4 v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , M 732 Oak Street y Property Address h Kevin Howard t-- Owner Owner's Name "d information is required for every West Barnstable Ma. 02668 10-18-2017 � page. City/Town State Zip Code Date of Inspection " Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information S/* a ---7-1� on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere use the return Name of Inspector key. Cape Septic Inspections Company Name 624 Old Barnstable Road Company Address Mashpee Ma. 02649 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-20-2017 _ In ector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 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: This 4 bedroom home has a H-10 1500 gallon septic tank and a D-Box feeding two leaching trenches. At the time of the inspection the leaching was dry and there were no visible signs of past hydraulic failure. 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): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is West Barnstable Ma. 02668 10-18-2017 required for every page. Cityrrown State Zip Code Date 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 ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i °-fey 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/z day flow t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 L Commonwealth of Massachusetts W Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 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 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 Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Citylrown 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? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): <440 GPD t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage Well water 9 ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Cityrrown 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: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract to be obtained from system owner c f( y ) and a copy o 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•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 L_ r Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is West Barnstable Ma. 02668 10-18-2017 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 01-14-2013 Were e e sewage odors detected when arriving at the site? El Yes ® No Building Sewer(locate on site plan): Depth below grade: 48"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.): Septic Tank(locate on site plan): Depth below grade: 36"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Standard H-10 1500 gallon septic Dimensions: tank 1r Sludge depth: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 r Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) j Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 36" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 5„ Distance from bottom of scum to bottom of outlet tee or baffle 12" How w Sludge Judge r � 9 9 were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the tank on a maint. plan with a local septic pumping co.The Barnstable Health Dept. has a list of local septic pumping co. Note the inlet cover is raised for pumping. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions:. Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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 ❑ No t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 l Commonwealth of Massachusetts u - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 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.): The D-Box had no visible signs of leakage or evidence of past hydraulic failure. 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: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 l_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is West Barnstable Ma. 02668 10-18-2017 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: Two ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the leaching was dry and there were no visible signs of past hydraulic failure. 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 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 r Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is West Barnstable Ma. 02668 10-18-2017 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts w - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 2 D o� CIA <� J &Vj Sr t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10 plus feet 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: 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: I augered a hole at a lower elevation and shot it with a transit to show four plus feet of seperation Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 732 Oak Street Property Address Kevin Howard Owner Owner's Name information is required for every West Barnstable Ma. 02668 10-18-2017 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file �( e � v �u`I'farn d�' S>A S N o H, t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABBL LOCATION � SEWAGE# VILLAGE I1S ASSESSOR'S MAP.&PARCE INSTALLER'S NAME&PHONE NO. [ SEPTIC TANK CAPACITY s LEACHING FACILITY:(type) 1 (size) TvZ�eAck- '. NO.OF BEDROOMS OWNER 1 PERMIT DATE: 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 ow site or within 200 feet of leaching facility) X Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY i 3r 83 13 x� 1� V 0�. Fee No. / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4pliLation for Disposal 6pstem Construction VErmit Application for a Permit to Construct( ) Repair( ) Upgrac?e( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 73 Z �— Owner's Name,Address,and Tel.No. Assessor's Map/Parcel alb—po/ /�• Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ?071 6z Type of ilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building A/p 011.0 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) !�/S/�J gpd Design flow provided ��/ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 60 0 Type of S.A.S. lb tf-2-0 ftV Description of Soil Nature of Repairs or Alterations(Answer when applicable) sG 5- 1<po ay. Tyr.k Pao 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. Signed Date Application Approved by Date �� 13 Application Disapproved by Date for the following reasons Permit No. odd f 3 — .0 10 Date Issued J /d" 1 3 No. g Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: h/ PUBLIC HEALTH-DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipphration for Misposal *pstpm Construction Permit f Application for a Permit to Construct( ) Repair( ) Upgrade- an ( ) Complete System ❑Individual Components Location Address or Lot No. 73 2 - E Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 915-po/ 6fy? Q OS I a f Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of riding: Dwelling No.of Bedrooms Lot Size #. sq.ft. Garbage Grinder( ) Other Type of Building /n No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow'(min.required) gpd Design flow provided �/(,/ gpd Plan Date Number of sheets Revision Date Title t Size of Septic Tank s 600 Type of S.A.S. >~ 1- :�v 1 ftDS j C Description of Soil .f 1 Nature of Repairs or Alterations(Answer when applica(e) se 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. Signed �'f L.--_-'`. Date / /S Application Approved by Date (.- to_ 13 Application Disapproved by Date for the following reasons Permit No. d d l 3 — O 10 Date Issued I �d^ 13 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Cprtifirate of Compliance G THIS IS TO CERTIFY,that the O -site Sewage Disposal system Constructed( ) Repaired(__J Upgraded(�) Abandoned( )by S at� !�AAff U1, !� O C k- has been constructed in accordance / with the provisions of Title 5 d the for Disposal System Construction Permit No.;C)13 G�� dated 'I - II Installer Designer #bedrooms U Approved design flow /�/ gpd The issuance of this permit shall not be c nstrued as a guarantee that the system will nction signed:. Date L1 � Inspector No. �d 13 o r Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS '4 Misposal 6pste Construction Prrmit -- Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 7 n A 52: 414 x�e and as described in the above Application for Disposal3S,ystem Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. G Provided:Construction must be completed within three years of the date of this permit. Date — y J Approved b PP Y i � 6 ' Town of Barnstable �. Regulatory Services q, Thomas F.Geiler,Director , ABM Public Health Division 39. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: I'VV o 13 Sewage Permit# ' 015- V 1O Assessor's Map/Parcel 2 f-001-00 1 Installer&Designer Certification Form Designer: kQAA C° D�rr�yr �,�t/inJ �s. Installer: C1-t V �C�.5ll e Address: I L J_,Jc. (Zo) Address: � ng i ig 5� / 4 0A,►-1+0"Jlt4%`ff 1%4 Ao-. On was issued a permit to install.a (date) i(installer) septic system at 7 3 Z 06 k S+ W. gaw-W U04,19 based on a design drawn by (address) 6'U E ht6LV--Ek5 0 , ��S. dated t qZ 6Il Z rev (/6//,� (designer) � I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with,major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic s stem)but in accordance with State&Local Regulations. Plan revision or certified as- ilt by designer to follow. Stripout(if required ted and the soils were foun is actory. �,taOF (711 lip I�r ERIC ( stal 's ignature) HARRINGTON �. No.1070 esigner's Sign tore) (Affix llesi ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification forndoc No QQ i � �1Jpi j ,n . ,.41 do 1 . 07 Town of]Barnstable P Departitnent of Regulatory Services f Public Health Division DateMABM c /� 0.1 200 Main Street,Hyannis MA 02601 - Date Scheduled / Tirane/ Fee Pd. / �-'`� Soil Suitability Assessment fog- Sewa e Disposal Performed By: Q�I� L `��+P�!"tQ 7�1��S' Witnessed By- Location LOCATION&GENERAL INFORMATION Lro�cation Address 11 Owner's Name ` Address -I za Asse sor's ap Q ce1: Engineer's Name , G_ Iet� NwRl�iny�r, NEW CON �i /TRU ION REPAIR V Telephone# So Land Use: e-4,4 I'., Slopes(`). 3 " 3— Surface Stones Distances from: Open Water Body ft Possible Wet Area=1L ft Drinking Water Well A 0 ft Y Drainage Way �' �?�° g � ft Property Line ft Other ft SKEi TCII:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) CD P Cy ++ -n ti 00 . eta r... Parent material(geologic) WgrAll"e-L Depth to Bedrock 7 'roo Depth to Groundwater. Standing Water in Hole: /v,K Weeping from Pit Fnce ? fy Estimated Seasonal High Groundwater ,� • DETF NATION FOR SEASONAL HIGH WATER TABU �Q ir- Method Used: -- t Depth Observed standing in obs.hole: Iu. Depth to soil mottles: Depth to weeping from side of obs.hole: In, Groundwater Adjustment f. Index Well# Reading Date: Index Well level___-_-,_-__ Acj,&ckor- AdJ,Groundwater Leval, PERCOLATION TEST bacp l z " t „� fvi o Observation _ Hole# Time at 9" eft, _ Depth of Perc 4 T-1A Time At 6" �-7!4 t Start Pre-soak Time @ C9 Time(9"-0) End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/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:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones;Boulders. ConsistenCy,%'Qravel) �0y,�Y 3 �� -t.-C? DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsis en %Crave DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co i tee c Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling _ g (Structure,Stones;Boulders. Consistency: 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 r Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? XA!!� .^, ' If not,what is the depth of naturally occurring pervious material? �_____�_�" Certification I certify that on (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 'ni exppeer�ti d erience deso 'bed in 10 CMR 15.017. Signat �-f ". Datb QAS.EPTiC\PERCFORM.DOC r , LOCATION SEWAGE PERMIT 10. VILLAGE A & B CESSPOOL SERVICE A ®� ®w, 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER �0 DATE PERMIT PERMIT ISSUED DATE COMPLIANCE ISSUED ..� �,; /J� .� /�-`- %.- - _ �,�� .,��-.� . �_-- �, �_ _ - So)� FIm$.......� _ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH IVIAP Z 215 DF .-"--"""..Tawn......................OF........Barnstable--."-""""-"............................."...---....P./_rRtCS( 1 3 r' Appliration for Disposal Works Tonstriir#inn rrmit--A_ ,� �-- Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 732 Oak Street, W.Barnstable ----....... _......... •-•--•-•----•----•........................-----.....-------------- .................................................................................................. Location-Address t Robert Rossignol 732 Oak Street, f.ifarnNo. stable, MA ---•- Owner------- --- ----------•--•••--•--------•--•--•-- •---.-.-•---•-------------.---.-- .- .._._.... Ad. ---dres.s........................................... dres aA•& B. Cesspool-Service-•----•-••-••--_•-•-,_-_----_•--•.--__--_- 128--B is hops-Terrace,_._H_rannis, MA 02601 Installer Address UType of Building Size Lot-------- ----------------Sq. feet ,.� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a p., Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures -----••-------••---------"------ . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total.leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ----------•--------------------------•----••----....---•-------•----........--------•........................................................................ 0 Description of Soil........................................................................................................................................................................ W U ...............................................................•----------•-••-•-••------•-----•----•------------•--•--.._..-----•--•---••----...--•---•-•------------•------------•-•---------•-------. W UNature of Repairs or Alterations—Answer when applicable_....1,00.. gallon.stone packed overflow ------------------------------------------------•----------•---......------•--•-------------------••---•----....----------------------------•--•-------------•---•--•--•-------............---......---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL IT 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 the b r h ga Signed....Z .... .-. ... ......_.. `^ ----••--•---..---• ....��' Date Application Approved By................ ............6®ZS------�? Date Application Disapproved for the f ll wing reasons-------------•------------------------------------------------------------------•------------------•---•-••-••••- ........................................................... ...................................................... Date PermitNo... s.. ----------------- Issued....................................................... Date L%AW6&&Ad6& No,,:........:i.......... �6� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... .....OF........ .. jVjiratiaan for 14sposal Works Tonstrnr#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ... ------------------------------------------•- �•( Ic Y1E*e•l; L ct 04:grdt'2f��T1-e--•--•-------------•----- or Lot No. ,, Ro�rert r sstgzro2 03 �a�c S ree �+1r �r +stsablaT--T4A------------------ Owner Address A & 8 Cesspiiol""Se 1 ---------------------------------- ...12ff-Tishops Type of Building 1. Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) PLO Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures -----------------•------------------•-•--•-••----------•-••------•--•----•-----•--•------•••---•••••••-•••......--••••-•-----•--...........---------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-----•---------------------------------•----------•----.....---------....--•-•--••--------••--....•........................................................ ODescription of Soil.........................................................................................................................-.............................................. x U -•----•-------------------------------------------------------------------------------------•-•._...-•---------•----...•.._...---------------•------------.•...--•----------••---••---••-•---------- W ---------------------------------------------------- -----------------------------------------------------------------------------------------....................................................... U Nature of Repairs or Alterations—Answer when applicable_ I_j_000__gallon..stow.-parked...averflaw-------. ----------------------------•-------------------•-------•------------•-••-----•-----•-••--••----------------....----------------------------•-------------------------------------------.._........•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned furthgr agrees not to place the system in operation until a Certificate of Compliance has been issued y the board lth. G Signed .._. ..:................. ....................... ••-•-•--....................... Date ApplicationApproved By--•-•--•-•--•-•---•----••--••••-----•-••.....................••-•--•-••-•-•-•-.........•...••-•-- ........................................ Date Application Disapproved for the following reasons------------------•---------•-----••-----------------------•--------------------•---••----•----••-•.....-•-.._... ......................................•••..........-•-•--•-•--••-•••-•••••---- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............l.own...................OF................BarnstAble.......................................... C9rdifiratr of TI-Im lianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by---*--&-.B...fleas-pool--&rv4oe-----12,8.41 ish4"--Terrace,...Hyannis,..yA.....0260. .......................................... !� `I�nsttaller ry at----- J2---Ga ---s-twPet--••-l-rBaimstarbI49p-MA--•--02668---�M--adbext.--.Ros ��Ql 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 BE CON RIDE® AS A=GUARANTEHE SYSTEM WILL FU CTIO SATISFACTORY. DATE..... S- .. -.._..------•------•----•-------- Inspector.-•----•---• ...... THE COMMONWEALTH OF MASSACH ETTS BOARD OF HEALTH ......... OWa...................OF............................Barns ttable............................... No......................... FEE........................ Disposal Workii Tonstrnrtion amit Permission is hereby granted.....A..&_p...C"spool... arvJ Ge,...128..iahops..Te -....Hyannis t T_`A _OQ 601 to Construct ( ) or,Repair ( ) an Individual Sewage Disposal System at No........... .. ..S-txs�et�...�T�:T:a tasbhQ+ F=�....W_68. Robert_•Ross.gnol---------•--. •---......... Street as shown on the application for Disposal Works Construction Permit No.. ................. Dated..__._. ._._....__.__.................... ! ----------------- / rd t DATE..------....t .•. S - FORM 1255 A. SULKI , INC., BOSTON LOCATION yy ` SEWAGE PERMIT NO. N' VILLAGE A & B CESSPOOL SERVICE A I S �®I C313 128 BISHOPS� TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER L7 DATE ,PERMIT- ISSUED 57� DATE COMPLIANCE ISSUED fit;; _.. •',r _ • i MOCO RD. N PERK TEST & SOIL EVALUATION F Date of Perc. Test & Soil Evol.: DECEMBER 11,2012 }- CMFR SIT E Evaluation Performed By. Glen E. Harrington, R.S. hr 16 Excavator: Mike Leary N �C Witness: DON DESMARAIS, R.S., BOH AGENT : NIVER ENS CAP Percolation Rate:< 5 mpi • 34.5` END SECTION ARC 36 HC 6 Stamped H-20 Test Hole Test Hole ROUTE Q- No. 1 No. 2 DEPTH sal t Imo. DEPTHSOILS ELEV. PERK TEST P 13 814 o DIS�FRI��ION BOX$HALL 8�E # _ 0, `iE'f LEVEL FEX� AT LEAST 2 ET. 12' CONCRETE COVER " 0 o DEPTH: 48-66 ,�( A BEGINI SOAK: 0:00 V�po� � ?75 `• :`' b" 3 S" Oi)TiFTf » aM. '. .^ 2 ,oany,a,A 4 OAIt S rt ray FTs 9• ,oYn4/s Flu END SOAK: 15:00/00:00 �<v als-0 TRE�' . :». ,, A f ew 9,.- 6:15/00:00 W o2 �s` c�� 't 92"^»13l T µ leant.sae c«.vjacent 6"= 77:45 ell Water ° y....r 48. ,"5A °� P� ,�. �l F• e• I • Y C1 TIME: 2 MIN. 35 SEC. PER INCH 0 �•:� ".» , , ::: .. ..2� lawny ° USE <5 MPI FOR DESIGN e9.90' X „ LOT A 33399, PLAN--SECTION I ,Rt SS ECTI N yen . eam sow Zsn4 F^ » _.» » - • LOGOS 3__'_H 0 L E H--2 0 D I S,I,,,,R I B U�3 I 0 N BOX NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED AREA- 43 ,578 ± SQ. FT. hEt3T To SCALE NO SCALE Soil Evaluation Certification 9 1 certify that on October, 1995, 1 have passed the soil evaluator MAL examination approved by the P and thot the nalysis was performed by GEN NOTES Me, x �� me consistent with the requi ing, p e d e rience escri ed 100, in 310 CMR 15.017. 7 c7 _ 1 ..,ADDRESS: #732 OAK STREET, WEST BARNSTABLE Gle Harting n, s. D e 2. ASSESSORS NUMBER: MAP 215 `PARCEL 001 -001 �q 3. DEVELOPER'S LOT: LOT A '� 4. TOPOGRAPHIC INFORMATION WAS COMPILED FROM AN ON THE GROUND INSTRUMENT SURVEY.' 2 . X 99�,' 5. WELL WATER IS PROVIDED` TO SITE & `SURROUNDING PROPERTIES. pot radius from 6. REFERENCE PLAN: PLAN BOOK `342, PAGE 15 potable well at 95 #26 Elmers Way ::, REFERENCE >PLAN: "PLAN OF LAND IN BARNSTABLE, MASS., PROPOSED SAS D.P. ._ " " ;•.::•::•:. ::>:.::•::: PREPARED FOR ROBERT & JANE ROSSIGNOL SCALE: 1 "=30' 2 40 OL X 2 10"W/ X 11.0D ��.��I. :: : :::::::•: : ::: ::.: :. , 1eachln tre - VENT Gj. IbM1 nches using 8 H 20 94, ® �. I . ::::: :;::::.;:•:: :::::.:::::::. ::::::. T 6 987 BY YA g �,I . . . . . . . ; DATED MARCH 2 , 1 , NKEE SURVEY CONSULTANTS. ADS ARC 36 HC '�- w I s :: :::::;:;::•: :::::::;..:.:.:.:.. ... chambers w s7 _ 1 :.. •..•::.:.:.:.:.:.:.:.:. 6 7. NO WETLANDS ARE LOCATED ,WITHIN 150 FEET OF SAS. without stone. d . OII ..... . . . . . . . . . . :;��.• - . NO POTABLE ELLS ARE LOCATED ` WITHIN 0 TH • • •�•'• • • •�•�•°••••�•�� '�• 8 P E W 15 FEET OF SAS. . . . . S PLAN I BE USED F ' , ..........:.....:.... ....:.. . 9. THIS DESIGN OR .SEPTIC . INSTALLATION ONLY AND �l 974 a :...:............... .......... .•. . . . . ..,.. .. NOT ' FOR :NY OTHER PURPOSE. s . . . . . . E <1 S T 10. THE SITE NO LOCATED WITHIN A TOWN OR EP DESIGNATED ZONE IM. 99d�,( o D 0 V 0 26' •:.:..�:,.dirt ,...;:•.:.:.:.:..:..:.:..:..:...:.: ..:..:.:.:... '. do house100.61, o ::•::: :. :•:•.:•. ::..::.: c Design �alculatlons t? d B:M. 9919' ..,..•;,;•.,:.;.;;.:.;..:......:• ':':••'• ::::::•:�..:::::::.... .. .. . Number of Bedrooms: 4 EXISTING I .� Garbage Grinder: N0 GRINDER NOT ALLOWED WITH THIS DESIGN Septic 'Tank Capacity , �' :.. ::.:: ..;..•' A'h°� ,:;:.;.•:' •::~: .•:.:::.:.' P P tY Required: 440 d X 200% = 880 d. 1,500—GAL MIN. REQ D. '. ___--- o' 'o, q gP 9P Septic Tank" Provided: NEW 1500 GAL H-10 SEPTIC TANK. . F o s LeachingCapacity Required:. 440 Gal. Da o 'p s• .. o �` ;:;`:`•:?.:'•:. ;:;;? LeachingArea Required: 440 Gal. 0.74 Gal. S .Ft. =595 S .Ft. Leaching Areo Required. 595 S .Ft. 7.79 -SF PER LF OF ARC 36 HC CHAMBERS=76:38 LIN. FEET Proposed Leaching Area Provided. - 2 -ROWS OF 40 —0 TRENCH 80 LIN FT. X 302.90' •::�:�:99.tl23 , Total Leaching Capacity Provided: 461 _gpd > 440 gpd. req d. , 101.e1 :.:.... COIySTI ��, IICII'V NOTES - 1. Contractor is responsible for DI safe notification X 102.69' , -. � ' and protection of all underground utilities and pipes, t � 2. Te septic t' nk n ' :; •::.:;::•. � h " U a �1, distribution box shall be set 1d y Ci - level on 6, of 3 4_-11 2 stone. :; .•:•: 3 24 DIAM. ACCESS MANHOLES • �� :•::::::•:�::•. 3. `Backfill should be clean sand or gravel with no - 150 radius from .:.:::•::•.::.:.;, � ,. . oa stones over 3 in size. t ble well at •••�:�••�• 1o4s1' P712 oak street 10' _6" 4. This system is subject to inspection duringinstallation j X 104.95 b Glen E. Harrington, R.S. :. .. � Y 9 ,,;.;.: ::•: :_ •.,• ,i. 5. The contractor shall install this system ` h y tem in accordance with Title V of the Massachusetts Environmental Code and the Regulations of the Town of BARNSTABLE. 15 sa.96' •, ,n S P LAN 0 THE ACCESS COVERS iFOR THE SEPTIC TANK, 6. ' Provide a Wi in Precast H-10 1500 al se tic tank - - - ITE 99 9 P , H 20 DB 3 D Box . and 16 H-20 ADS INLET OUTLET DISTRIBUTION BOX AND LEACHING COMPONENT " ARC 36 HC chambers or equal Chambers must be stamped H 20. SHALL BE WITHIN 6 OF FINISHED GRADE. �� o .; 7. No vehicle or heavy machinery shall drive over the — `r INSTALL TUF—TITE GAS BAFFLES OR EQUALS — 10s.2e' . � ••, septic system unless noted as H-20 septic components. SCALE . 1 20 ON ALL OUTLET TEE ENDS 8. Install as baffle or equal on se tic tank outlet tee end. . 9 q P • 'r:-.: '.- : •,; �` :. existing ,inverts and site conditions shall be verified b contractor. CONTOUR INTERVAL 2 All g y STEEL REINFORCED PRECAST CONCRETE 10. The ADS ARC36HC's shall be installed according to the DEP General Use Approval letter PLAN VIEW and the ARC Installation Guidelines. B.M.= 100.00 ASSUMED ON CORNER 103.46' ' O F BRICK STOOP. 3-24" REMOVABLE COVERS i 3" min. clearance INLET "T" " " 8 min. 2 mir. inlet to outlet '"LET s mrn. OUTLET LOCAL BOARD OF HEALTH VARIANCE REQUESTED: Liquid level Q to min. i4- la• a •: 360-1: :A VARIANCE IS REQUESTED TO ALLOW THE PROPOSED SAS 5 _q , 5 -7 To BE CONSTRUCTED APPROXIMATELY 1 2 FEE F M c ** 1 T FROM THE EXISTING ON SITE POTABLE WELL f E :' " ,, IN LIEU OF THE REQUIRED 150 FEET. NO OTHER VARIANCES TO ABUTTING WELLS ARE REQUESTED. I .: � .. .,. 4 0 min. Q s Gas same • , Liquid depth mot'o •.. i LOCAL UPGRADE APPROVAL VARIANCE REQUESTED: *NOTE: ..S » T _ " SCHEDULE 40 P.V.C. _ " ' _ " 310 CMR 405 (1)(b): A VARIANCE IS REQUESTED TO ALLOW THE (PROPOSED SAS NO I"�.. ALL PIPES L.� ARE TO BE 4 ,UGH 10-0 5 8 TO BE CONSTRUCTED APPROXIMATELY SIX FEET FROM GRADE IN LIEU OF THE �' T S BAFFLE OR EQUAL OI't•I ALL SEPTI;•., TANK OUTLET TEE ENDS. END—SECTION REQUIRED THREE FEET. H-20 SAS COMPONENTS AND A VENT WITH CARBON FILTER ARE PROPOSED. *NOTE. INSTALL TUF— SITE GAS BA LE 0 CROSS—SECTION „ is TYPICAL 1500 GALLON H - 10 SEPTIC TANK • • Provnde 4 doa. SCH 40 PVC Distribution Box REVISED: 1 6 13 BOH COMMENTS �,,,x vent with ;carbon filter Cover to be NOT TO SCALE . LEGEND . • I Finished Existing Dwelling ng Below I in€ r . d SEPTIC SYSTEM REPAIR Se tic tank covers must be x . .3 p Grade. .� F,I;LC EXISTING CESSPOOLS PREPARED FOR µ ' 6 below finished grode lev.::: 100,02 First Flour CW H�-20 " O TO BE PUMPED AND REMOVED i DI`T. BOX Provide 4 SCH ,40 PVC et` observation port 3 below grade RTC MICHAEL LEARY • , o 0 o NEW 1500 GAL = Finished grade over (stern=2% slope away ExistingGrade Elev.=95-97' OVER SAS � H-10 SEPTIC TANK � AT CRA'�fl.„ SPA Existing Grade--97 � 9 0 I :,b � ,�y " 0 732 OAK STREET L 38 72 max X 104.46 DENOTES EXISTING . R Y L 3 ram. ' F _ SPOT GRADE ' IS'C h . .��».:. L. ,1 0 W-8 �» , =,02 s=-ni FT,. L Elev.-s1.o t yETA t BARNSTABLE (WEST BARNSTABLE), MA ! PROPOSED Level S=0.01 /ft. ».m 95 EXISTING CONTOUR OWNER: JANE ROSSIGNOL 1,500 GAL _ x Invert Elev.=90.59 Ex. Inv. eiev.-- 92.38' H-10 . . . . . . . . . . . . . . . . . . . DEEP TEST HOLE El.W, SEPTIC TANK � ��+ ;v, ��„ PREPARED BY: GAS BAFFLE �P Approx. location OR EQUAL ll h GLEN E. HARRINGTON R.S. 40 Facility Elev.=s9.s7' existing water line lai' 7.4' rovidedf 5' Min. required) 9 LEDA ROSE LANE . . ... .. � » . . _..__ � ( a ) Approx. lacatlon ExistingInv. elev.::= 93.14 6" OF 3/4"--11/2„ STONE � existing as service MARSTONS MILLS, MA 02648 (typical) ' LEACHING TRENCH Bottom of T.H. #2 elev.=82.30 , g g °0 Observation Port TEL: 508-428-3862 6" OF 3/4"' 11/2" STONE FAX: 508-428-3862 Potable Well i SYSTEM _-PROFILE SCALE: 1 "=20' DRAWN BY: GEH DEC. 26, 2012 Not to Scale DATUM: ASSUMED FILE: LearyRossignol SHEET 1 OF 1 i ___