HomeMy WebLinkAbout2173 SERVICE ROAD - Health 2173 Service Road
West Barnstable
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TOWN OF B 1STABLE f
LOCATION
SEWAGE ` —7
VILLAGEh2b SSESSOR'S & OTZ �J
INSTALLER'S NAME& HONE NO
SEPTIC TANKISO - CAPACITY d go ("7j;;�EQLL 42zo
4K,--6
LEACHING FACIL typee�� 6 s
NO. OF BEDROOMS
BUILDER OR OWjNER �-MFVfftkd—a—,
PERMTTDATE:]S "�I' COMPLIANCE DATE: 'K �IJ�Z?
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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DECK
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of HbLt5e
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A ,I
—ail'q'l C, y - I b' 3`'
I-,IS'S" 5_ 0
3—Sb'.3'°
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No. � • Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftpliLation for Misposal *pstrm Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade QQ Abandon,( ) ❑Complete System ❑Individual Components
Location Address or L t No.21-?S Se riviLe ^ Owner's Name,Address,and Tel.No.
W: arnS 02 Ven} ra.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No.50 21 `$-63 Designer's Name,Address,and Tel.No.5 og,36Z-4fS41
R J, T3e;v 1 I Cl<- Lko-Cv n-S, Trq t4 i U r\ t�e s n 6--Pe �ni'le\eer;n9
p Dow
PO BOX 62-1 - FYire� d .M A a ,4 L4 S4- �: a
•lope of Building:
Dwelling No.of Bedrooms 9 Lot Size too 1 927 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) L4140 gpd Design flow provided �� gpd
Plan Date — (1 — r Number of sheets Revision Date
Size of Septic Tank 1,o o b Type of S.A.k3 Sj_O�n l dffio6 r-s
Description of Soil 5e& wn
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: Qro Z,; Q 6 P la n ,
Agreement:
The undersigned agrees to ensure the construction and mai?nd
ance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Cod not to pla a system in operation until a Certificate of
Compliance has been issued by this Rogd of Health.
,,,-Signed / Date "
Application Approve %�i Date /
Application Disapprove Date
for the following r ons
Permit No. Date Issued
_--------- ,�- -_---_-,--
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
'ftplitation for 34isposal bpstem Construction permit
t .
Application for a Permit to Construct Repair,( ),'Vpg'ade b<) Abandon( ElComplete System El Individual Components
Location Address oqqt No.2.1-7 S Se.fad fLt*' 0 Owner's Name,Addiess,and Tel.No.
W,Zctr n' ibU-
Assessor's Map/Parcel 2-1 2-9 t"N ty.
Per+
'A t,
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.5 0 364,Lf 5 4
R_T, T2x-_v i I oc_qU&Co e) e4j o r-,, 6o Doyvr, C_--pe �r%q'ie-,eeri Y)9
PO 80A to7A - r-yre4daa MA OZ.(,,L4 L4 1-.A 4 NoLim 11AAfspoc-L MA 020q
Type of Building: Re-.,1 C6,n-h a4
Dwelling No.of Bedrooms Li Lot Size too
1 2-7 , sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers Cafeteria
Other Fixtures
Design Flow(min.required) LIL4 gpd. Design flow provided L455 gpd
Plan Date- -1 - I - �--I -Number of sheets Revision Date
Title?i +_,.R. S
Size of Septic Tank I,C)06 Type of S.A.
Description of Soil5c�e P,k C,r�
a re of Repairs orAlteratio�ns(Answer when applicable
In
(Answer when
t'n Of)t a watl Of-)
3) 1.vi ))+E t4nrv_
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 Co 1'10000"
1
.'and not to place,the system in operation until a Certificate of
Compliance has been issued by this Boat;4 of Health.
i ��ge n ed
Date /J(77- 7
Application Approvqe6_y Date _e,&�Ienl
1001- r
Application Disapprovedo5y Date
for the following r a'ssons
Permit No. Zwq Date Issued
-------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(eff tifirate of Compliante
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired(-.00) Upgraded
Abandoned( )by A--N- A
at cg-/ 73 vev has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.7 D17-2& dated 9L7,#/;k17
Installer Designer
#bedrooms Approved design flow gpd
be construed as a guarantee that the system Gillfunc
The issuance of this t shalltioZasSdesigned.
t Date 7)� Inspector
No ------Fee--------------
2,3rj Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
bisposal 6pstem Construrtion-3permit -
Pemission is hereby granted to Construct( ) Repair( ) Upgrade(�7) Abandon
System located at ce-; tz� ts—Ipi
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Cqnstruption must be completed within three years of the date of this permi
Date Approvetrb
Town of Barnstable
_Regulatory Services
s � $ Richard V.Scali,'Interim Director
Public Health Division
Thomas;McKean,Director
200 Abin Street,Hyannis,MA 02601
Office: 508-862-4644
Fax: 508-790-6304
< J Q J Installer&Design er Certification Form
Date: 1 � Sewage_Permit# V 17" OVAssessor'.s Map\Parce1 ' ~z l
Designer: V rViiistAller.
Address: J Address:P
Y �1r�14
On
(date) tnsta r was issued a permit to install a
septic system at : j �/')({' based on a design drawn by
(address
1�
sign
ated
r) `
I certify that the septic system referenced above was installed substantially
the desl y according o
f gn, which may include minor approved;changes such as lateral relocation of the
distribution box and/or septic tank. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e. J
greater than 10' lateral relocation of the SAS or any vertical relocation.of any component:
of the septic system)but in accordance with.State&Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
w/ce
tisfactory.
Ihe system referenced above was constructed in compliance.with the terms.
oroval letters(if applicable)
� YN OFM,1SSq
sta er's 'ignature) ��� DANIELA. �yGN
o .OJALA
CIVIL N
�No:466Q2 �
(Designer's St gnature) I" (Affix s
s ere)
PLEASE,RETURN TO BARNSTABLE PUBLIC"HEALTH S10MAL EN
OF COMPLIANCE TILL NOT BE ISSUED UNTIL BOTH`THIS FpRMT.NIDA
BUILT`CARD ARE RECEIVED BY T
,THANK YOU. BARNSTABLE UBLIC HEALTH DIVISION.
WSepwoesippr-Certl6cation Form Rev 8-14-13.6c
1
r � 5
I _
��
} V� I
��
V
Town of Barnstable
01111 Regulatory Services
3AMSTABLK s Richard V.'Scali,Interim Director
9 MAM
g a63Q. ,e� Publie'Health Division
rfD"AO�A Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
1
Office: 508462-4644
€ Fax: 508-79076A4
Installer&Designer Certification Form
Dater Sewage.Permit#, Assessor's Map\Parcel,
i Desgner:
E l Installer:R
Address: Address:
lq
l On 2 ..
date _ was issued a permit to install a
I ( ) costa r
septic system at J[! y
based on a design drawn by
(address
signer) ated
_X I.certify that the septic system referenced above was installed substantial
to
the design, which may include minor approved changes such as lateral relocation of he
distribution box and/or septic tank. Strip out (if required)wa`s inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes,(.e,
greater than 10' lateral relocation of the'SAS or.any vertical relocation of any component
ofthe septic system)but in.ac0 dance with State&Local Regulations, 'Flan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
w/ce
tsfactory,
Ihe system referenced above was.constructed,in compliance with the terms
oroval letters(if applicable)
� N Of rygSS9�
staller's Signature) ° DANIELA.
1 OJAL44 a r
O " CIVIL C
�No.46502
(Designer's Signature) (Affix, i s ere
S�ONAL e
PLEASE-RETURN TO BARNSTABLE PUBLIC HEALTH �`�
OF COMPI;IANCE CERTIFICATE
WILL NOT BE.ISSUED .UNTIL-BOTH 'THIS FORM AND:A.AS-`
BUILT CARD ARERECEIVED BY THE'BARNSTABLE PUBLIC THANK YUU. HEALTH-DIVISION.
Q:\Sdptic.\Desigiier:,Certification Form Rev 8-14-13.doo
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3
• ,�y�'l�,`' :fin:;
;I
m A Public Heahh,Dlylslou Date
N,.
2001vi419 SLrmt,Hyanale MA 02601
Data Sollr~dulad F0e Aid l](J
gage Disposa
a'erFoamed By: tNP.. y` +; dot y" Witnessed Y. t �s'
FLacaaoin Address Owner's Wime
*A4 Address +\ '
IA
Assossor's 1�?(ap/Parcel: ��{ d� . >3nginacr's lYamc i,l��j�,�J y�
NEW CONSTRUCTM.ThI REPAIR.
Land Use: P r
t{� a rJ 5lnpes(`Jb) Surface SkouDs
Distances Flom: Open WaterBody l 00 ft Possibi:WetAraa . ' d•t DrinldngWAter WciZ , _ •` rt
Drainage Way ft Property'Line -A Other
� #t
SIC 0" ''clag(Sknetllame,dimensions of lot,cxaet locations of test holes&pnrc tests;locates wetlands�n pxoxioniLy to holes)
0.
Parent material(geologic)
PEAS�tK•' r,�2�"•.
Dnpth'to�3muudwatez: uLandingWaterin ldolo: � �- Weapingi'i'otxl Pltktgp4• �+ .
Estimated Seasonal Sigh Groundwater
DgTE
AEON FOR SEAS ON-AL BJJGJJ W411
Mothod Used: ,A t^
Depth Observed standing in obs.hale: lq, :Dap11zgttl..5Q119"PRIa6f_ it1,
Depth to wecpingfrorn side of obs,hole: In, t3t'aundwutaridJUetttLankC.
Index Well�# Rcading Date: Indox 17s�eil lieygl m Ar ,$BMW Adj.:9ro4lldwutarLavml _
PERCOLATION TEST
OUservatlon .
Sole#k 'alxnp•at.S�"
Depth of pert. 7g ` Ti mr.At fi'.
StaxtPxe-soap lima @a
• Sndk're-soalc low.,
u
RatH MIA:111A0i1 C.,� �gQ a ' .• J�,�
Sit�SultabillLy,P,sacssznent: Sita�'Assctl SitpFallad:� AddfdonaI'l'astingMceded('X7I+i) tom, .
Origlnat: Public Health Dlylsinn Obso6atlou Hole Data To Be Completed ou Bach----�-�-_-
t i
pert x2t o' n test Is to be e'oAducted witWmL 100' of weftud,you must-Arst-.otlfy the.
BaZaStRW® +Coaasei Vafaoza Division at least one(1)week prior to JbegixMing.
�:13E1''7:'IC1PE,[I.C.PQl2lYl',DOC �
DREPIOIBBYIRV'.IT.IlroXI)�ao L,r LOG Dole
Depth-rom SoilHorizon Soil Texture MI.Color Soil.. of tr
Surface(in.) , '0'b:k) (Murwrll) Mottling' (Structure, Stoner;Bouldrm,
Iz
Dopthfrom s❑llHorizou SelfTexturc Sell color Soil Other
Surface(iu.) (USDA) (Mansell) Mottling (5iructure,Stones,l3oulders.
onsis rave
-------------
DrpthTrord 8011.90rizon Soil' Eawrn Sail Color Soil Dlhar'
Surface(hr.) (USDA) (Munsall) Ivlottling (Stmtgm,Stones,)3oulders.
Co i fe o e
Depth front Sail Horizon soilToxturc soil Color SAII C�t6cr
Surface(ire.) (USDA) (Munsell) MattlIng (Sixactate,Stones"moulders,
• Co si Eett 6 i
Y Ion d InStrxaxr>'rafRatif Ma,.
Above500•year' ioadbaundarq 1�0_ es.. �
't iffiln 500 year'boundary. X13 m 'Yes
Within 100yesr flood houndary Pyb•� "Xt;.
• �eY1$yY.P51��L'"tYY�'��!(!Q�CCYYY;"B.':.0.Y1�•�s3�'VXitYY5����P1•��
Does at Ieast four feat of naturally ocott=ing pet v oug„,M-i:erial OX15t in all a1'm nbse'r,ved throughnut th6
area proposed fox tho soil abmtptiou systeml
If not,what 15 the depth of haturally occurring porvious mal�rlal�
C "r cation. , ve r
x certify that ou , `l (date)I have passed tine soil evalua�ox a9taminafidsn nppro ved hy the
Departmoiit e.fBn'viro�mental Frotoot on and thartho above analysis was.pe oxx rd by ma conslstant With .
the ragaifed training,exportig .and rxperienoo described in�.10 Cln l5,OZ7.
signat — a
um . `'
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' Q:1�,�,1''7'7Ctr�l�.Cl,C1TY.1�noc
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Er Certified Mail Fee
117 $
Extra Services&Fees(check box,add fee as appropriate) pn N
El Return Receipt(hardcopy) $ ��j r M n _)
r3 ❑Return Receipt(electronic) $ �� Postmark J�
0 ❑Certified Mail Restricted Delivery $ Here Al
C:3 []Adult Signature Required $ �O
[]Adult Signature Restricted Delivery$
O Postage
m $
I%-rl Total Postage and Fees >
a VENTURA, SCOTT & VIOLETTE,�DOREIN J
2173 SERVICE RD
C WEST BARNSTABLE, MA 02668 ,
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international mail. and provides delivery to the addressee specified
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with Certified Mail service.However,the purchase (not available at retail).
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insurance coverage automatically included with accepted as legal proof of mailing,it should bear a 7
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You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electmhicversion.For a hardcopy return receipt, L
complete PS Form 3811,Domestic Return
Receipt-attach PS Form 3811 to your mailpiece; IMPOITrANE Save this receipt for your records.
PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047
• THIS SECTION • •
e Complete 2,and 3. A. Si nature
le Print yotir-na ❑Agent
rand address on the reverse X
so that we can-#eturn the card to you. ❑Addre•
e Attach this card to the back of the maiipiece, Bby/�rinfo�,d,ame) C:.Da e of t :r,
or-on the front if space permits.
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
If.YES.enter delivery address below: Q No
VENTU A,, SCOTT& VIOLETTE, DOREIN J
2173 SERVICE RD
VAST BARNSTABLE, MA 02668
3.II I IIII�I I II ICI I III 11191 I I I I III II I III I II III o Adult Signaturice e ❑RegisteredPriori its press®
❑Adult Signature Restricted Delivery ❑Registered Mail Restricted
rtified Mail® Ddlivery
9590 9402 2480 6306 7765 44 ❑Certified Mail Restricted Delivery tYhieturn Receipt for
❑Collect on Delivery T Merchandise
�krtit.ie Ni,rriber ffransfec fiom'service labeD
❑Collect on Delivery Restricted Delivery p Signature ConfirmationTm
r: •a •: � _ ,, ❑Signature Confirmation
7025 17 3 0 f,0 0 01 f 4 9 9'0 15 5 OY 'i)il Restricted Delivery Restricted Delivery
PS Form 3811.,.July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
WSPS TRACKING# .
�•• ::yY•` ci. �,. :erayn,µ+a��N �Mm1l,.V,I,a.70NVt'Gll�:i?`
� �may-•.'°��+hm+�'
9590 9402 2480 6306 7765 44
United Sta#es •Sender:Please print your name;address,and ZIP+4®in this box•
Postal Service
Town of Barnstable i
U*D6, Health Division
200 Main Street
Hyannis,MA 02601
M ' I
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Pi►11111NHI 111111111ij1,itili,,POli1`!!it111'11111I11.1!!j
THE Town of Barnstable Barnstable
Regulatory Services Department AMmaicaChy
o BAMSCABLE
y Mass g
A39. ,0 Public Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7015 1730 0001 4990 1550
May_9, 2017
VENTURA, SCOTT & VIOLETTE, DOREIN J
2173 SERVICE RD
WEST BARNSTABLE, MA 02668
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 2173 Service Road, West Barnstable,MA was inspected
on 04/21/2017 by Paul Martin, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Static liquid.level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system within one (1)year from the date
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BO OF HEALTH -
WL
Thomas McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\2173 Service Road West
Barnstable.doc
f
THE r, '
Town of Barnstable
KUM
' ; IA�f'lSTA1IE,
Regulatory Services Department
Public Health Division
200 Main Street, Hyannis MA-02601
Office: 508-862-4644 Richard Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6, 2007
Rev. 5111116
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §36044 and Title V: 310 CMR 15.000) _
An"X"marked in the ❑is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA
❑ Discharge or ponding of effluent to the surface of the ground
❑ Pumping more than 4 times during the last year not due to clogged or obstructed
pipe.
❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool
ONE (11 YEAR D );DLINE CRI Ei,RIA
.Static liquid level in the distribu ' ove outlet invert due to an overloaded or
0
❑Any portion of the SAS, cesspool, or privy below high groundwater elevation
❑ Any portion :)f the cesspool within a Zone 1 to a public well
❑Any portion of a cesspool within 50 feet of a private water supply well with no
acceptable water quality analysis. (This system passes if the water analysis
indicates the well is free from pollution).
TWO (2)YEAR DEADLINE CRITERIA
q Single Cesspool
❑Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation
of a driveway due to H-10 components, etc)
❑Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code
§360-9.1)
o Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OTHER
Repair deadline:
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc
0,,-2-q
Commonwealth of Massachusefts
TitleC r M
Subsurface Sewage Disposal System.Form, -Not for Voluntary Assessments 0
Ut
2173 Service Rd. �
Property Address
Scott Ventura
Owner Owner's Plante
r37
informationairedfor
is
r every required West Barnstable t MA 02668 4121/2017
�
page, CityfTown State Zip Coae: _ 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 A General Information
filling out forms S/ a �-
on.the computer,
use only the tab 1, Inspector
key to move your
cursor-,donot Paul
Martin
use the return
.....
Dame of
.key. Inspector
Cape Cod Se tic Services
Company Name 4
350 Main St.
Company Address
�d W.Yarmouth MA 02673
CityfTown State Zip Code
508-775-2825 S15016
Telephone Nymber License.Plumber
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. l am a DEP approved system inspector pursuant to Section 15.340 of
'title's 4310 CMR 45.000).The system:
M Passes Ea Conditionally Passes Faits
Needs•Further Evaluation by the Local Approving Authority
w
1' �
4/25/2017
1RSpeCtOC`$Signatuce _ .._._.._....,�
Date „
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has,a design flow of 10 OQO gpd'or greater,the inspector and the systern owner shell submit the
report to the appropriate regional office of the DER The original should be sent to the system owner
y 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 fatale tinder
_ the same or different conditions of use.
15ins•W13 Tiff 5 0,`f rill]nspedan Form.-stibsuftw sewage Dispow system'-page to,-,7
40J19a. S
.W: _ .__ _: __. s _ ..
Commonwealth of Massachusetts
Title 5 Official Inspection Form
--i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173'Service Rd.
Property Address
Scott Ventura
................... .....__._-__.__
Owner Owners Name
informrequired
ie West Barnstable MA � 02668 412112017
required for every- .�-�. _
pager Cityrrown State Zip Code Date of Inspection_
B. Certification (cone:)
Inspection Summary:;Check A,B;C,D or E t always complete all of Section D
A) System:Passes:
Q :1 have not found any information which indicates that any of the failure criteria described.
in 310 CMR 15.303 or in:310 CMR 16.304 exist.Any failure criteria not evaluated are
indicated below.
Comments:
S) System Conditionally Passes:
F] 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 thatank is less than 20 years old is available:
Fl Y ❑ N ❑ [).(Explain below),;
_________ _.._.___.._._..e.-..........._
o
t5 ns 31t3 Tipe 5 OffidW Inspecdo Fornlubsurfew Soxase Disposal System•Page 2:of 17
Commonwealth of Massachusetts
a Title 5 Official In p do For
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd.
PropertyAddress
Scott Ventura
_
Omer _..__ .._...._.__
Uwnees flame
informal ie West Barnstable MA 02668 4f2112017
;requirtrj for every �.�_,__.........._
page. City/Towni State Zip Code. Date of Inspection:
B. Certification (cone.)
Q Pump Chamber pumpslafarms not_operational.System will pass with Board.of Health approval if
pumpslalarms 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 dueto a broken, settled or uneven distribution box.Systemwill
pass inspection if(with approval of Board of Health):
F� broken pipe(s)are replaced E] Y ❑, N D ND'(Explain below):
obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
distribution box is leveled or replaced [I Y n 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 Heaith):
Q broken pipe(s)are replaced ❑ Y El. N ❑ ND(Explain below):
obstruction is removed [ Y ❑ N ❑ Na(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:
El 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•3/l3 Tithe 5 official Inspection Form:Subsurface,Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Pitts 5 Official Inspection Form
Subsurface Sewage Disposal System form-Not for Voluntary Assessments
�- 2173 Service Rd.
Property Address
Scott Ventura
Owner
Owner's Name
information Ar dfd is West Barnstable. _ MA 02668 4/21/2017
required for every
page, 04/Town State Zip Gode Date of.Inspection
B. Certification (cone.)
2 System will fail unless the Board of Health.{and.Pu.blic Water Supplier,if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
El 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..
Q 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 DFP certified laboratory,for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or'less than ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to thisform,
3 Other:
pp
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
2 ® 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
Q than %day flow
t5hs-3113 Title 5 Offiasl Inspection Form:Subwfface'Sewage Disposal$pstem•Page 4 of 17
Commonwealth.of Massachulseft
- � m Title 5 Official 1 e dtion Form
= Subsurface Sewage Disposal System,Form-Not for Voluntary Assessments
. 2173 Service Rd. _
Property Address
Scott Ventura
Owner --------._.:._ _
Owner's Name
information is required for every West Barnstable MA 02668 4/21.12011
page, City/Town Skate Zip Code Date of Inspection
B. Certificat!on: (coat.)
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 asurface 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.
Anyportion 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.,
z The system fails.I have determined that one or more of the above failure
criteria exist as described in 310 CMR 1&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 15,101Wgpd.
For large systems;.you must indicate either"yes"or"no"to each of the following,in addition to the
questionsin Section D.
Yes :No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ El. 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—:1WPA)or a mapped Zone:ll of a public water supply well
If you have answered"yes"to any question in:Section E the system is considered a significantthreat
ar 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 1;5.304. The system owner should contact the appropriate.
regional office of the Department.
Mr's.3113 Tift 5 Waal lnspwicn Form:Subsurface Sewage Disposal System z Page S at 17
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface'Sewage Disposal System Form=Not for Voluntary Assessments
2173 Service Rd.
Property Address
Scott Ventura
owner -Owner's Name
required fo ie West Barnstable MA. . 02668 4/21/2017
tequired forevery — _ �._ _�___
page, Cttyl own 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
0 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 NIA)
1 ❑ Was the facility or dwelling,inspected for signs of sewage-back up?
M E] Was the site.inspected for Signs of break out?
z n 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): 3 - Number of bedrooms(actual): 3
110x3=
.DESIGN flow based on 310 CMR 15♦203(for example: 110 gpd x#.of bedrooms): 330gpt1
t5ins• 13': Me 5 Of dW.tnspedon F&n.Subsurfam Sewage pisposa3 System•Page 6 af17
Commonwealth of Massachusetts
r Title 5 affoc" l Ins, ct on for
51 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd.
Property Address
Scott.Ventura,
Owner _..._. _ ,._�..._.m� _
Owner's Name
requir required for
s West Barnstable � MA 02668 4/21/2017
required for every. _.— —.---
page. GttyfLawn 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 Yes No
information in this report.)
Laundry system inspected? Yes ❑ No
Seasonal use? [] Yes [D No
Water meter readings, if available(last 2 years usage:(gpd)): NIA Well
Detail:
Sump pump? ❑ Yes 0 No
Current
Last:date of occupancy: 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'presernt? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
-...
Mns-3113 Title 5:Official lnspeclion Form:Subsudaw Sewage Disposal System•Page 7 W 17
`Commonwealth ofMassachusetts.
z Title 5 Official 'InsDection Form
w
Subsurface Sewage Disposal System form-Not.for Voluntary Assessments
2173 Service Rd. _
Property Address_
Scott Ventura
Owner
Owner's Name
information is West Bamstable MA_ 02668 4/2112017
required for.every —
page.. City/Town State Zip Code Date'of Inspection
D. System information (cent.)
Last date of occupancyluse: Date
Other(describe below);
General information
Pu,mping Records:
Source of information: No Records
Was system pumped as part of tie inspection? ❑ Yes Z No
If yes,volume pumped; _......__ ........ _. _ _. . ....._ ,_ .........
gallons.
How was quantity pumped determined?
:Reason:for:pumping:.
Type of Systen%:
Septic tank,distribution box;soi4 absorption system
Single cesspool
El Overflow cesspool
Privy
El Shared system (yes or (if yes,attach previous inspections 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 UA system by system operator under contract
" [] Tight tank.Attach a copy of the'D,EP approval.
Other(describe)::
t5ins-,W13 Title 5 Official hsyewm Form:Sutsudece
Sex+ags mspo4 System•Page 8 cif,17
Commonwealth of Massachusetts
Title 5 Official Inp °ction o
. Subsurface Sewage Disposal System Form Not for Voluntary Assessments
2173 Service Rd.
Property Address
.Scott Ventura
Owner
Owner's Name
information is West Barnstable MA � 0266$ 4121I2017
rewired-for every _W.._._ _ _ _ �.._
page: Cayfrown State Zip Code Date of Inspection
D. System information (cant.)
Approximate age of all components, date installed(if known)and source of information:
2001 Per'BOH records
Were sewage odors detected.when arriving at the site? ❑ Yes Z No
Building Sewer(locate on site plan),:
Depth below grade 3' --
feet
'Material ofconstruction:
El cast iron Z 40 PVC ❑other(explain): _._........................................................................
Distance from private water supply well or suction line: +10'
feet
Comments(on condition of joints,venting,evidence of leakage,.etc.):
Line checked with sewer camera.i=oundwsettling and improper itch on i No si+n of root intrusion.
' _
Septic Tank(locate on site plait):
27`
Depth below grade: ._a__:_
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) 0 Yes Q No'` -.
Dimensions.. 1500Gal
.. - '.8"
Sludge depth:
t5ins ;3153 Tift 6 offidaf tnrspedior.Farm Subswiace t system!,Page 9 0,v
Sewage Di5jXs8a. ySf +
Commonwealth of Massachusetts
Y Title 5 Of ici l Inspection .Fore
Subsurface Sewage Disposal System Form=Not for Voluntary Assessments.
T ..
2173 Service Rd.
Property Address.
Scott Ventura
'ovine:• �
Owner's.Name
required on is _ 02668 4/2i{2017
:required for every West.Barnstable MA
:page. City/Town State Zip Code Date of inspection
D. Systern Information (cunt:)
Septic Tank(cont;j
Distance from top of sludge to bottom-of outlet tee or baffle -. - -........
—---
Scum thickness 9=3
'Distance from top of scum to trip of outlet tee or baffle -
Distance from bottom of:scurn to bottom of outlet tee or baffle --
;How were dimensions determined? Estimated _
Comments(on pumping;recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
150QGal H-10 tank in good structural condition. PVC tees'in place. Tank at normal operating level:
Covers 24"below grade.
...
Grease Trap(locate on site,plan):
Depth;below grade: _._. —.
feet
Material of construction`
[1`concrete [Q metal F fiberglass Q polyethylene other(explain):
Dimensions: . j
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.:
t6ins•2/1 3 TiNe S t fficoal:Insaedmn Fo m:'Subswface Sewags Disposal system•pa"10 o€17
Commonwealth of Massachusetts
.� Title 5 Official Inspection ForM
_ Subsurface Sewage Disposal System Form-.Not for Voluntary Assessments
_._ 2173 Service Rd.
Property Address
Scott Ventura .
Owner _ - ____----
Owner's%Name
information is
required for every West Barnstable _ MA 02668 4/21/2017
- T_.........._............
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 belowgrade:
Material of construction,
❑concrete M 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.):
e _ y
" s 'Attacfi co... of current. um in contract(,require . I`s co. attachetl?
pY P p g ( ) cop ❑ Yes ❑ No
r
t5 nit•M 3 T&5 Ofiioal Inspection Form:.Subsuriace$swage Disposal Systam•Pa&11_of 17.
Commonwealth of Massachusetts
Title 5 Official ins ection form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd.
Property Address __..
Scott Ventura
Owner Owner's Name
information is West Barnstable MA 02668 4/21/2017
required.for every _ - _......._
page, CityRown State Zip Code Date of Inspection
D. System Information (cunt.)
Distribution Box(if present,must be opened)(locate on site plan)
1"
Depth.'of liquid:level above outlet invert _ . T. :__ :......
Comments(note if box is level and distribution to outlets equal; any evidence of solids carryover;any
evidence of leakage into or out of box, etc.):.
H-10 DB-3:with 1 line in and 2 dines out in fair condition..Box is heavily loaded with solid waste. Box
currently.full above.outlet_nverts due to full SAS Cover 14"_below grade_
Rump Chamber.(locate on site plan):
Pumps in.working order: ❑ `Yes T-1 .No*
Alarms in working order. El Yes ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances,etc):
*if pumps or alarms are not in working order; system is a conditional pass.
Soil AbsorptionSystem(SAS) (locate on'site plan, excavation not require):,
If'SAS.not located, explain why:
c; s �iys 'nnes;ofosi lnsFeeScn Foam:$utxs;rrlace Setivaga Dispose System•Page,2 pr,17
Commonwealth-of Massachusetts.
Title 5 Official Inspection Form
- Subsurface Sewage:Disposal.System Form-Not for Voluntary Assessments
2173 Service Rd.
Property Address
Scott Ventura
Owner
Owner's Name
requiratifore West Barnstable MA 02668 4/21/2017
required for every --- -- --
page. Cityfrown State Zip Code Date of Inspection
D. System. Information (cant.)
Type:
leaching pits number:
2-�aaGal
-leaching chambers number: _---
0 teaching galleries number:
[} leaching trenches number, length;
leaching fields number, dimensions:
�] overflow cesspool dumber:
El 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..):
2-50OG81 leach chambers with4 of stone. Both chambers completely:full. SAS in failure.Covers 32"
below grade:
'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
m Dimensions ofc+ sspool
_ Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
15ing 3/13 T de.5 official liispeKiors Form;subsurface sewage Disposal S.%am r Page 13 of 17
_ ..-.
Commonwealth of Massachusetts
Tittle 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd.
Property Address
Scott Ventura
Owner
:Owner's Name
information is West Barnstable NA � {}26fi8 _,_ :_: 4121/2017.requited forsvery ,.
pegs. Cityrrow n State Zip Code Date of.inspection
D. System Information (cant.)
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.):
t5ir s ~3t73. Title 6'Off€cim Inspedon Form:Subsurface Sewage.Ossposw System•Page,14 of 17
Commonwealth of Massachusetts
_ - Title 5 Official Inspection For
= — Subsurface Sewage Disposal System Form-Not for Vo#untary Assessments
2173 Service Rd.
PropertyAddress --- --__.�...._..�,_ �..._..�.._... v........m.. ..�.�.....�.w_....._____._,._._
Scott Ventura
Owner
Owner's Name
inforrequired
is West Barnstable MA 02668 4/21/2017
required for every
page. City/Town State Zip Code Date of Inspection
D. System information {cone:)
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
I drawing attached separately
i
i
i5i 1s '3/?3 Title 5 Official Inspection Forn.Substdace Sewage Disposal system•Page 15 of 1,7
Commonwealth of Massachusetts
Title 5 OfficiaII inspection Form
AS
._ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd
Property Address
Scott Ventura
owner
Owner's Name
information is West Barnstable MA 02668 4/21/2017
required for every _____.._
pays, City/Town State Zip Code Date of Inspection
D. System Information (cunt)
Site Exam:
Check Slope
Surface water
Z Check cellar
Shallow wells
Estimated depth to high ground water +10'
-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: 2002
Date
Observed site(abutting property/observation hole within 150 feet of SAS)
0 Checked with local Board of Health explain;
Checked with local excavators, installers`-(attach documentation)
[ Accessed USES database-explain:
You must describe how you established the high ground water elevation:
Test hole data per plan on file at BON
_.... ...................... �_.._, .�._ .....__
Before filing this Inspection Report,please see;Report Completeness Checklist on next page.
Mns•W* TWO 6 Offta€b+speaon Form Subsurface Sewage Disposal System-Peke 16 of 11
Commonwealth of Massachusetts
Title 5 Official In section Forms
Q; Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
2173 Service Rd.
Property Address
Scott Ventura
Owne
Owner's Name
informationaired#or every is
required West Barnstable MA 02668 4/2112017
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
;inspection Summary:A, B, C, D,or E checked
inspection Summary:D(System Failure Criteria Applicable to All Systems)completed
System information.-Estimated depth:to high groundwater
Sketch,of Sewage Disposal System either drawn on page 15 or attached in separate file
•t5irm•VI Tdle 5 Offidel'InspecUm Forn.subsurface sewage Wposal.System•Page 17 of It
Mj. Jt:xwnA&An!Woundown loom Ow Bmmmul LuaAgNOU1
14vatr I'awr NqQ, wt-I! anz t Ixaciimg Who (H my wQG cWt
on mw m %"hm NY) M4 Icadunp W"D
Njjc of weda,And Lcwhyng Imuhy M any wcdmWN eks-,
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IT n"Awd by,
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2-7
25
BARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND THE ENVIRONMENT
SUPERIOR COURT HOUSE
POST OFFICE BOX 427
BARNSTABLE, MASSACHUSETTS 02630
(508) 375-6605
August 13, 2002
Mr. Jacques Morin
Bayberry Building Co.
1597 Falmouth Road
Centerville, MA 02632
Dear Mr. Morin,
This letter is in reference to two water samples taken from new wells at 2173 Service Road and 1
Service Road, West Barnstable, MA. Both samples had low levels of Chloroform and Toluene
(see enclosed report). The chloroform is ubiquitous to the Cape's groundwater and is thought to
be a by-product of chlorination of groundwater wells. The levels of chloroform found range
from approximately 4.0 ug/L to less than 0.5 ug/L. The toluene is not indicative of Cape
groundwater however we have commonly seen it at these low levels when new wells have been
sampled. The toluene dissipates after a short period of time as the well is purged.
If I can be of any further assistance please call me.
Sincerely,
Thomas F. Bourne,
Laboratory Director
'01 CERTIFICATE OF ANALYSIS Page.
0 Barnstable County Health Laboratory
.AH1)
Report Prepared For: Report Dated: 06/26/2002
Bayberry Building Co Order Number: G0215173
Jaques Morin
3,00 Bearses Way
Hyannis, MA 02601
Laboratory ID#: 0215173-01 Description: Water-Drinking Water
Sample#: 15173 Sampling Location: 2173 Service Road W Barnstable MA Collected: 06/18/2002
ollected by: E Meehan Received: 06/19/2002
Test Parameters
ITEM RESULT UNITS MDL MCL Method# Tested
LAB: Microbiology
Total Coliform Absent CFu/loomL 0 0 P/A 06/19/2002
Note: Water sample meets the recommended limits for drinking water of all above tested parameters.
i
Approved By:
(Lab Director)
61200Z
r
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
r
s�.
M
CERTIFICATE OF ANALYSIS Page: 1
''��s�nc Barnstable County Health Laboratory
Report Prepared For: Report Dated: 06/27/2002
Bayberry Building Co Order Number: G0214945
Jaques Morin
300 Bearses Way
'Hyannis, MA 02601
Laboratory ID#: 0214945-01 Description: Water-Drinking Water
Sample#: 14945-01 Samnline Location: 2173 Service Rd.,West Barnstable Collected 06/11/2002
Collected by: Edward Mee Received 06/11/2002
Routine
ITEM RESULT UNITS MDL MCL Method# Tested
LAB: IC Lab
Nitrates <0.1 mg/L 0.1 10 EPA 300.0 06/11/2002
LAB: Metals
Copper <0.1 mg/L 0.1 1.3 SM 311113 06/13/2002
Iron 3.4 mg/L 0.1 0.3 SM 311113 06/13/2002
Sodium 9 mg/L 1.0 20 SM 3111B 06/13/2002
LAB: ]Microbiology
Total Coliform Present P/A 0 Absent P/A 06/11/2002
LAB: Physical Chemistry
Conductance 151 umohs/cm 1 EPA 120.1 06/11/2002
pH 7.2 pH-units 0 EPA 150.1 06/11/2002
Note: Maximum contamination level exceeded due to presence of Coliform Bacteria. Retesting is recommended.Based on the results
of the parameters tested,the water is suitable for drinking but may present aesthetic problems(taste,odor,staining)due to
Iron.
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
s7Mt Page: 2
CERTIFICATE OF ANALYSIS
Barnstable County Health Laboratory
ys9Aotn�sv'
Report Prepared For: Report Dated: 06/27/2002
Bayberry Building Co Order Number: G0214945
Jaques Morin
300 Bearses Way
Hyannis, MA 02601
Laboratory ID#: 0214945-02 Description: Water-Drinking Water
Sample#: 2173 Service Sawline Location: 2173 Service Rd.,West Barnstable Collected 06/11/2002
-ollected by: Edward Mee Received 06/11/2002
EPA 502.2- Volatile Organics by PID/ECLD
ITEM RESULT UNITS MDL MCL Method# Tested
LAB: GC LAB
1,1,1,,2-Tetrachloroethane BRL ug/L 0.5 EPA 502.2 06/24/2002
1,1,1-Trichloroethane BRL ug/L 0.5- 200 EPA 502.2 06/24/2002
1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 502.2 06/24/2002
1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
1,1-Dichloroethane BRL ug/L, 0.5 EPA 502.2 06/24/2002
1,1-D-ichloroethene BRL ug/L 0.5 7.0 EPA 502.2 06/24/2002
1,1-D.ichloropropene BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2,3-Trichloropropane BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 502.2 06/24/2002
1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2-Dibromo-3-chloropropa BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 502.2 06/24/2002
1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 502.2 06/24/2002
1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
1,2-Dichloropropane BRL ug/L 0.5 EPA 502.2 06/24/2002
1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
1,3-Dichlorobenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
1,3-Dichloropropane BRL ug/L 0.5 EPA 502.2 06/24/2002
1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
2,2-Dichloropropane BRL ug/L 0.5 EPA 502.2 06/24/2002
2-Chlorotoluene BRL ug/L 0.5 EPA 502.2 06/24/2002
4-Chlorotoluene BRL ug/L 0.5 EPA 502.2 06/24/2002
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
y
'pF Iiq'-
y'4'�
Page: 3
CERTIFICATE OF ANALYSIS
: "ss� ssti '. Barnstable County Health Laboratory
Report Prepared For: Report Dated: 06/27/2002
Bayberry Building Co Order Number: G0214945
Jaques Morin
300 Bearses Way
Hyannis, MA 02601
Laboratory ID#: 0214945-02 Description: Water-Drinking Water
Sample#: 2173 Service Sampling Location: 2173 Service Rd.,West Barnstable Collected 06/11/2002
:ollected by: Edward Mee Received 06/11/2002
Benzene BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
Bromobenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
Bromochloromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Bromodichloromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Bromoform BRL ug/L 0.5 EPA 502.2 06/24/2002
Bromomethane BRL ug/L, 0.5 EPA 502.2 06/24/2002
Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
Chlorobenzene BRL ug/L 0.5 100 EPA 502.2 06/24/2002
Chloroethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Chloroform 1.4 ug/L 0.5 EPA 502.2 06/24/2002
Chloromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
cis4,2-Dichloroethene BRL ug/L 0.5 70 EPA 502.2 06/24/2002
cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 502.2 06/24/2002
Dibromochloromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Dibromomethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Dichlorodifluoromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Ethylbenzene BRL ug/L 0.5 700 EPA 502.2 06/24/2002
Hexachlorobutadiene BRL ug/L 0.5 EPA 502.2 06/24/2002
Isopropylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
Methyl-'tent-butyl ether BRL ug/L 2.0 EPA 502.2 06/24/2002
Methylene chloride BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
n-Buty.lbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
n-Propylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
Naphthalene BRL ug/L 1.0 EPA 502.2 06/24/2002
p-Isopropyltoluene BRL ug/L 0.5 EPA 502.2 06/24/2002
sec-Butylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
Styrene BRL ug/L 0.5 100 EPA 502.2 06/24/2002
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
CERTIFICATE OF ANALYSIS Page: 4
9ssy' Barnstable County Health Laboratory
Report Prepared For: Report Dated: 06/27/2002
Bayberry Building Co Order Number: G0214945
Jaques Morin
300 Bearses Way
Hyannis, MA 02601
Laboratory ID#: 0214945-02 Description: Water-Drinking Water
Sample#: 2173 Service Sampling Location: 2173 Service Rd.,West Barnstable Collected 06/11/2002
Collected by: Edward Mee Received 06/11/2002
tert-Butylbenzene BRL ug/L 0.5 EPA 502.2 06/24/2002
Tetrachloroethene BRL ug/L 0.5 5.0 EPA 502.2 06/24/2002
Toluene 1.4 ug/L 0.5 1000 EPA 502.2. 06/24/2002
Total xylenes BRL ug/L 0.5 10000 EPA 502.2 06/24/2002
trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 502.2 06/24/2002
trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 502.2 06/24/2002
Trichloroethene BRL ug/L, 0.5 5.0 EPA 502.2 06/24/2002
Trichlorofluoromethane BRL ug/L 0.5 EPA 502.2 06/24/2002
Vinyl chloride BRL ug/L 0.5 2.0 EPA 502.2 06/24/2002
Note:
Approved By:
(Lab Director)
lZ 7/Zaa-L
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
z Jul 22 02 04:44p Bayberry Building Company 5087712116 p. 2
g CERTIFICATE IFICATE OF ANALYSIS Page_ 1
Barnstable County Health Laboratory
Report Prepared For: Report Dated: 06/26/2002
Bayberry Building Co Order Number: G0215173
Jaques Morin
300 Bearses Way
Hyannis, MA 02601
Laboratory ID#: 0215173-01 Description: Water-Drinking Water
Sample#: 15173 Sampling Location: 2173 Service Road W Barnstable MA Collected: 06/18/2002
ollectcd by: C Meehan Received: 06/19/2002
Test Parameters
ITEM RESULT UNITS A DL MCL Metbod# Tested
,LAB:Microbiology
Total Coliform Absent CFu/lo0mi. 0 0 PIA 06/19/2002
Note: Water sample mats the recommended limits for drinking water of all above tested parameters.
i
Approved By:
(Lab Director)
Superior Court House, PO.Boa 421, Barnstable, MA 02630 Ph:508-375.6605
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certificate ®f (Compliance
THIS IS TO CERTIFY That the Individual Well Constructed (,*I, Altered ( ), or Repaired ( )
. taller
at—_eC D has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well P otecti
ton
Regulation as described in the application for Well Construction Permit No. Qc��-331)ated— —bZ
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---- — Inspector-------------- -------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Ivey[ Con!9truct ion Permit
Fee
Permission is hereby grantedto Construct (i'j, Alter ( ), or Repair ( ) an Individ al Well at:
No. ,� f �? s� U�CG .�/X /5> .9F'�'it/—
Street
as shown on the application for a Well Construction Permit f
No. - � C�b2- �� ___ Dated
S DATE �. � Board of Health
I
Fee-----�6--
BOARD OF HEALTH
TOWN OF BARNSTABLE
Application for lVell Cootruct ion Permit
A plicatioq is hereby made for a permit to Construct (0), Alter ( ), or Repair ( )an individual Well at:
Location — Addres Assessors Map and Parcel
ef P �. -BEN •�� �/, --- —
Owner -
Address
- ------------- -------- ------------ ------------------------
Installer — Driller Address
Type of ing
No. of Persons-- ---
Type of Well--L-v _--_— Capacity ----�_�_--_
Purpose of Well
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 C ertificate .of ompliance has been issued by the Board of Health.
Signed
Q,� c to
Application Approved By �- —_— %Q'61-�-
date --
Application Disapproved for the following reasons:
/ date
l
Permit No. `-����a � Issued -- `_ `�`02 ---____^_
_date
a i
No. -'--C---- _ Fee-----��-----
BOARD OF HEALTH
TOWN OF BARNSTABLE
Application,forlVell CongtructionPermit
A plication is hereby made for a permit to Construct (/f, Alter ( ), or Repair ( )an individual Well at:
Location — Add res Assessors Map and Parcel
Owner Address _
Installer'— Driller Address
Type of B illding i'
DDwxelling� --- --------
r Other - Type of Building--_ -______ No. of Persons----------------_
Type of Well-�v� ��� �------ Capacity-------------_�_--__.
Purpose of Well----- --
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 of ompliance has been issued by the Board of Health.
Signed r - - - - -a--
Application Approved By �Q'(�2 1
date
4 Application Disapproved for the following reasons: ------------- - k--- -
date'
a� l
Permit No. �-�a � - — Issued
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certifitate ®f Coinpliance
THIS IS TO CERTIFY That the Individual Well Constructed (,.p, Altered ( ), or Repaired
TO ( )
/ I taller��,�'
has,been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. Dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
. SYSTEM WILL FUNCTION SATISFACTORY.
�rDATE -- Inspector------------ --- -----
BOARD OF HEALTH
TOWN OF BARNSTABLE
�r
Vell construct ion Permit
No. - -- Fee -'
Permission is hereby granted
to Construct ./), Alter ( ), or Repair ( ) an Individual Well at: /
Street
as shown on the application for a Well Construction Permit J
No.- C�(j�c - 3� Dated--- ----`t
1`4�
Board of Health
DATE
(- I-� a BATH M.HEDROOM
L'J 2-tea P.T.GIRT I`�-—-—--I " ' 1 F
L L_J TYPICAL LMD[IOR WALL CON6TRUCTIQ4
WC.eHIHGL.Ea 5 I/2'f EXPOSURE/'TYFAR'OR TYPICAL 3/4'OSp TX:
ll 12'• 4^.I5*EE ON EQUAL HOUSE34R.AP/1/2'058 NBt.lAT10N
O Z4SO4Yri'FTC. ' SHEATIING/2x4 STUDS AT K'O.C./5 V2' (RII) GLUED f NAILED TO JOISTS
• 2r N'O.C. 2.8 I K'O.C.
f: T _ pry'ApOVE
c
V2'GTP BD
o PLUSH Bry.
ABOVE
o I:O STRAPS 1 IL•O.C. I
I
n
I F LIVING RM. COL.
-------------------------- 7:::
BEYOND
I
1 r-I „---- ------------ -----
-_----J_------------ �iIIii II
.. TY PICAL S4055 T•G
SUBFLOOR
GLUED t NAMED TO JOISTS
?xp 1 1 O.C. jo
CR15 V2 -1)
FIDERGT LA
a S
ie
INUATION MUll.
•BASEMENT
COL.
p�O"D BA5EMENj 2_2m S'CONCRETEATON LOW20'x10 CONTFOpT
ND
PKT.
r r1(TYr) CONCRETE SLAB8-2XG e-2X?2,G1RT It 4
L L J - - - '- c�Ncro�
r a+D '
1.@ �.
I
2
-2`e I !Alf"DIA CONE FILLED r SECTION TNRU LIVING RM. t M.BEDROOM
I II I �I DEEP-.12'COW FTG N o 1 i 3 SCALE: I/4' 1'-p'
II III I 5A5F7rlFNT v I
I j II hII III CLEAN COMP RED SAND j I ON CONTINUOUS RIDGE VENT
OF KALLIP TOP II L- -----------------�----�-_-----1 r 1 i I
OF wALL le• I STRUCTURAL RIDGE
- -�'---'
------
DOhi>'1�• �O�R VTILITIEH I I L -1 I TOPICAL ROOF CONSTRVCf10N�
F
I I 12'DC DROP TOP I I I .. - ABRV/LL.T ROOF 6HINGLF9/I4• ELT PAP"....I I a WALL 1S I . I I _ . .. .. . '.i3� ...
I I I 1 e• x�'-X)' I 5/e•Gee /]x O.
THK • .
WALL ON I I RAFTERS AT K'O.C.
-- I CONY K'xI& CoNC. I :
--------- e:-- I FOOTING
12
W.g DOWELS• I
.. K�fN6ECONC. I I I I 2x 4 K
I�e i�Litlse�T UNa iDO L---------------J I ! O.C. --- (Reo)rmocGLApa INwL. (TAT)
------------------ 62'GYP BD ON
he STRAPS•N•O.C.
BEDROOM CL, BEDROOM
' TYPICAL EXTERIOR WALL CONSTRUCTION.
. W.C.SHINGLES 5.1/2•f EXPOSURE/'TYPAR'OR IU 1.3/4'068 T•G
EQUAL IIO)SEWRA.F/1/2•OSB .
SHEATIING/214 STUDS AT IL'O.C.A V2' (RII) LUED•HAJL.ID TO JOLSTB
.. 2:8•1 f'O.C.' 2r0 0 N'O.C.
FOUNDATION PLAN bM�K•O.C. °
SCALE: 1/4'
•
Y KITCHEN DINING RP1,
PROVIDE DArjPROOFING
TO PERIMETER OF NEW FDN. WALLS TO
HEIGHT OF NEW FINISHED GRADE.
TYPICAL.S/4' OSS T•G
SUMFLOOR
I�/7) OWED a NAILED TO JOISTS .. .
2.5 0 l2' O.C.
D-2,12 DROPPED 5-2:12 DROPPED
NOTE wU III 2■&F.T.SILL GIRT GIRT Um
OR �
1.PRI TO CONSTRUCTION, CONTRACTOR \/� ,I / ^ o " C(A. COL.
SHOULD VERIFY ALL DIMENSIONS AND/OR ( lY/ ( // Q ocr BA5EMENT BEYOND e•CONY
EXISTING CONDITIOI{S OR ApeUMF,THE �7 \•mil ) E
KLsro L51BLLrly FOR ANT DISCREPANCIES / T- FOUNDATIOL WALL, TY•P.
ZO'xW' CONY. FCOTNG
OR INCGN616T1
9" EB NOT BROUGHT TO THE
' ATTENTION a TWL DCeIGNER.
4'CONCRETE SLAB
' 2.ALIGN DOUBLE Jd6T
UNDER All PARALLEL _ _ — ,_._ .—.
PAJtTrrION WALLSABOVE
CLLAIT COH►t�CTLD
5, eue-QVNTRACrOR TO NOTE LOCATION OF C21SECTION THRU DINING RM. $ BEDROOM
VTILITY BLOCK-OUT IN FOUNDATION
SCALE 1/4' I'-O°
CO7IRIN4TE..✓GENERAL CONTRACTOR
911
INTBATH
BED
' 2 (It.) Q4.)
�T
' A3 �
0 4.
ON ATTIC _
►VLL-DOWN
M.BEDRROOM STAIR
BEDROOMBE�ROprl/LOB E•
DECK I HALL WALL
ITi410,-O' CONTRA[-TOR TO Lveptiry
OCATION
-
KfTCHEN M XX4CA.B LCGTAN
u✓KITOIEN CABINET Pt.VI WALK-IN i
CLOSET
% IBELOWTO[ x
I
- LAV, Q
VP KITCHEN •
1 �
� riIVING RMRM.
HEADER TO BE
i OIZID m•OTHERS BF40"
n FWSN Bn.MOVE
n GA, — CL — FL—"B` °"—°O E—— SECOND FLOOR PLAN
FII[EPLACE -____ SCALE- 114' I'-O'
DN.
BP40"
4.L
FLUSH Bn.ABOVE POST
---DINING
R---� R---A II
1/ ♦I I/ ♦1
I �IOR TO CONSTRUCTION, CZNTR,4 Trm
S.Y7ULD VERIFY ALL DIHEN910NSAND/OR
0.
1J . THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,MASSACHUSETTS
L
Ofpplication for ]Diopogaf *pgtem Construction 3permit
Application is hereby made for a Permit to Construct(X or Repair( )an On-site Sewage Disposal System at:
Location Ad r� o. �qR,N� Owner's Name,Address and Tel.No.
p, L o r Srr�..�1 c � �-'P .u,I j c Q CAMS KO X I A)
Instalt ;s a�,�A dress,and Tel. o. �-y1 Designer's Name,Address and Tel.No.
PL
9`PEPE'N J. DOYLE & ASSOC.
42 rry.} ._bury Lance)
.e
--arm- Alt.b Telephone: 508/540-�534
peo
Dwelli No.of Bedrooms �J Garbage Grinder( )
er Type of Building No.of Persons Showers( Cafeteria( )
Other Fixtures
Design Flow 1 7 0 gallons per day. Calculated daily flow. -5 r(o gallons.
Plan Date of•'L G'' 01 Number of sheets Revision Date
Title s►tt~ 171-M tk 13J'R.1,1sYP+;s.UC tra'SL, i�1�3 1 'T>rtm . 4e
Description of Soil Str A7L 15'9\L. S
Nature of:Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the prov. . ns of Title 5 m of.the Environmgntal Code and not to place the syste ' ration until a Certifi-
cate of Compliance has been 'ss ed by.this Boa[d of �
Signed -air,
f o v
Application Approved by
Application Disapproved fo the following reasons
Permit No. 1 I q R Date Issued _3 j I41 d
-------- _--.--— — ,___——_-----.---.,._-- --- _�. --.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- 0ARNSTA8LE,MASSACHOSETT%, .
Certificate of,ctComfiattce
THIS IS TO CERTIFY,.thaf the On-sit0 ewag�Disposal System installed( ).or repaired/replaced( )on
by `- for' -
as^ L.0 7 .. ?, '.Z/�, �X yr t �t 1] �' /A&A has been constructed in.accorda.ce .
with the provisions of Title 5 and the for Disposal System Construction Permit No. b�" dated_
Use of this syste is conditioned:ph. ompliance with the NoVisionsyset forth Belo
-
()�i_ ,.. /
Nd.•� Fee
THE.COMMONWEALTH OF MASSACHUSETTS .
PUBLIC HEALTH-DIVIBiON - BARNSTAB.L.E. MASSACHUSETTS
a gpozaf *patent cotYgtruction Permit
-Permission is hereby.granted to
to construct( . )repair( )an On-site Sewage System located at, o 0 3 If 4 a
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.
All construction must be completed within two years of.the date below.
Date: j 1 I l 9 I U I Approved by
01ppiication for Yell Cootruct ion J)ermit
A plication is hereby made for a permit to Construct (�, Alter ( ), or Repair ( )an individual Well at:
Location — Add res Assessors Map and Parcel
Owner17 -—
' Address
Installer — Driller `^_ Address —
Type of ing
Dwelling
Other - Type of Building No. of Persons---------------_
Type of Well�_ /a /� Capacity— _
Purpose of Well
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 ertificate of ompliance has been issued by the Board of Health
1101,
SignedApplite
cation Approved Approved By `��-� 3Oh�
date _—
Application Disapproved for the following reasons:----------,
date —
Permit No. [_1 — Issued
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compriance
THIS IS TO CERTIFY That the Individual Well Co si�ructed (,*I, Altered ( ), or Repaired ( )
taller -- —'
at
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well P otect'on
Regulation as described in the application.for Well Construction Permit No.(A
Regulation
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE
Inspector—__--- -- ------ -------
BOARD OF HEALTH
TOWN OF BARNSTABLE
]Dell Con5tructionpermit
` Fee y
Permission is hereby granted
to Construct �, Alter ( ), or Repair ( ) an-Individual Well at:
Street —
as shown on the application for a Well Construction Permit
J
No.- b�- 3� DatedQ.
DATE 'a- Board of Health
TOWN rOF BARNST LE
MCATION V1 SEWAGE #20101
s4P_TOF x1 62
V LLAGE AS E9'rS a & LOLL
INSTALLER'S NAME NO. J+ ro
SEP ITC TANK CAPAITY
P-
MC
LEACHING FACILITY: (type) ize)
NO. OF BEDROOMS U
BUILDER OR OWNER \u) k , Ak\r\(\ On
PERMI'TDATECo OMPLIAN DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) - Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
G �
1 -
II_ o�•� A c-,
a— 33'6„ D - 13'
s 19 1/7 R
„4 � i Sul
C)"lk
_ J
No. I `7 • Fee O /
THE COMMONWEALTH OWMASSACHUSETTS r
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pprication for Migooar *p6tem Congtructiou permit X
Application is hereby made for a Permit to Construct( or Repair( )an On-site Sewage Disposal System at:
�1 Location Address or Lot No. &. W AA-Al Owner's Name,Address and Tel.No.
L a ' - -L "-Vz' rc � �-'i? �`'`�i-c q vas o
Installe 's ame,A dress,and Tel. o. Designer's Name,Address and Tel.No.
2 •LyV/ l U/a (�0 STEl:'1IEN J. DOYLE & AS aOC e
42 Can`,4�rbury Lane
., 9
peo arQLQ�1�1 �� 'telephone: 508/540-2534
Dwelli No.of Bedrooms 3 Garbage Grinder( )
er Type_of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 33 O gallons per day. Calculated daily flow -sr(, gallons.
Plan Date o'L- ZG- 6 1 Number of sheets Revision Date
Title 51 r- (.�a
Description of Soil 'S-V 1,L �.O W S
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the prov' ' ns of Title 5 of the Environmental Code and not to place the system ' ration until a Certifi-
cate of Compliance has been 'ss ed by this Bo d of e t Signed '2 UQ'
• ®2-
Application Approved by
Application Disapproved for the following reasons
Permit No. r M)—I q RS Date Issued 3PLe d '
y���ti3""z^W'i°r"'+• :•..,,,,ll w`a%.x" t}_:c.r.d•F�;r, _ . `�:, ';.'Tv'.. =. ,. •' ,s.• �,,•:,t,��w.�^f ....'.,. �,- = ;"'r�si'.'�a
i 1
-i •wNo.. - i {� y g, ...,�F }' y FCC�
THE COMMONWEAM OF'MASMACHUS'ETTS
P16BLIC HEALTH DIVISION - TOWN OF BARNSTABLE. MASSACHUSETTS-,-
"WA cation for MigPogaY*p!5tem Con5truction Permit
Application is hereby made for a Permit to Construct( V)or Repair( )an On-site Sewage Disposal System at:
/ Location Address or Lot No. A Owner's Name,Address and Tel.No.
oy� P o L a �-.,, Q M p IN
Installe 's ame,•A dress,and Tel. o. Designer's Name,Address and Tel.No.
2 �/� 906&U L.0 STE?"_-FTT J. DOYLE & ASSOC. .
42 '�a::l_-.,arbury Lane
� r�r\L/&/_1 V� Zas-` imouth, MA 02 36
S ^'e-ohone: 508/540-2534
fiyp'eofBWg: DrcSQ`tll`""` d
Dwelli No.of Bedrooms 3 Garbage Grinder( )
Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 33 D gallons per day. Calculated daily flow 3 r(, gallons.
Plan Date of- Z(1- O 1 Number of sheets Revision Date
Title 5 t T t-= Qk.14 N t is \la • "�)��2►.15 k A'5 LC 131*13�tt-R�-%L-T> . C�
Description of Soil s'=r ��ds ,S0\1... ,. S p 1J, �i
t
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: a
� n
Agreement: E
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the pro' ns of Title 5 of the Environmental Code and not to place the system ration until a Certifi-
a cate of Compliance has been ss ed by this Bo d of
6— {
a Signed . l
Application Approved by
)Application.Disapproved fo the following reasons
Permit No. Date Issued Il4 lU
• a
-----_—_____-_____________ —_==
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTSP
Certificate of (Compliance
THIS IS TO CERTIFY,thath On-sfte e w a g Dis osal System installed or repaired./replaced
g P Y ( ) ( )on
by for
as L47- 2 2/7 .Sg77viC ,e2 i 4ri, /�r9�P/1/ has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a by1-1119 dated
Use of this system is conditioned n compliance with the�r•.ovisionsj et forth belo :
7 _l�r Cf Ir
Y
No. a Utz l !' (-I Fee jC0
l
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
]X5pozar *p5tem Congtruction Permit
Permission is hereby granted to C V
to construct( )repair( )an On-site Sewage System located at L_ay T R y/e
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.
All construction must be completed within two years of the date below.
Date: I Lo U I Approved by
d
TOWN OF BARN T LE �L
LOCATION SEWAGE #
VII.LAGE stlAS�ESS MAPSOR' & LO!_ a�L
INSTALLER' N NO. i
SEPT C TANK�C��PA��
LEACHING FACILITY: (type) ize) 5
NO. OF BEDROOMS V t
BUILDER OR OWNER AA
PERMITDATE6 I Q (T� OMPLlAN DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
I
'PEAK
� 2
i A FRONT
G D
n-39'�" A C 1q'
Fee AF0
` THE COMMONWEALTH OF MASSACHUSETTS rLt/
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTI
2pplication for Mioogaf bp!gtem Construction 3permit
Application is hereby made for a Permit to Construct(V)or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. �I �ARN Owner's Name,Address and Tel.No.
Installlef's aj ne� dress,and Tel o. ,� lyo Designer's Name,Address and Tel.No.
•Ly dQ " ,( (�Jo ' STEPHEN J. DOYLE & a.990C'.
Nl ll��v�l �� 42 �;:�xbury LanI2
)�ok' —orn-Walt,Ra-,b Telephone: 508/540-2534
DPer
No.of Bedrooms �✓ Garbage Grinder( ')
Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 31 O gallons per day. Calculated daily flow gallons.
Plan Date OIL. L(,'' B 1 Nuer of sheets t Revision Date
Title S►'4 T` Fc.PU 1K�A •mbr1er,,' ,,-,,w_ .15crA„ -T;t�jxk" ' uno , C.u
Description of Soil �.o %
Nature of.Repairs or Alterations(Answer when applicable)
Date last inspected: ".
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the prod • ns of Title 5 of.the Environmjntal Code and not to place the system' ration until a Certifi-
cate of Compliance has been 'ss ed by this Bo d of --•��
Signed •G-� O�
Application Approved by
Application Disapproved fo the following reasons
Permit No. Date Issued 3�P 0 6 '
THE COMMONWEALTH OF MASSACHUSETTS ,
PUBLIC HEALTH DIVISION,- BARNSTABLE., MASSACHUSETTS,'
C-ertificate of Compliance
THIS IS TO CERTIFY,.that tfi On- ge w agb Disposal System installed( ),or repaired/teplaced( )on
by for
as 4) /.3rIX11/ has been constructed in accorda ce
with the provisions of Title 5 and the for Disposal System Construction Permit No. i2_001"118 dated
Use of this syste , mpliance with the ovsio t forth Bel o
y • .
Nd. Gb Fee
THE COMMONWEALTH OF MASSACHUSETTS .
PUBLIC HEALTH-DIVISION .- BARNSTABLE. MASSACHUSETTS
�Ditpo!gar &pgtem Cow9tructiou Permit
Permission is hereby granted to N27 C /91D X
o construct( }repair( )an On-site Sewage System located at, a r Z. 7 3
/2 GcJ. B44 ill .
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.
All construction must be completed within two years of.the date below.
Date: a h lP I U I Approved by
o .
INT r
.,_r--=-- L '34' Z-r�p.X., C.--ra�,l1�� C�:aV'�.1•'... S" s"C"��`Eve <._.t7MP��i.1R:�"i`S. ..�....... _._.. ..._.,..._ S „ -
1 _..
TOP FOUND. EL. q`z.o0 2 of 1/8 Peastone
- 1/,Z" -��
0
QD
-
\ � - Do
�� pro,
ti fit= Y�AIF.R IL;HT COVER
Y s d- - �, ---z' 1 EVEL - - Total Trench Length _Z_
7f ench �d th 1 ?
FLOW LINE - � I 314" - 1-1/2" 11'ashed Crushed Stone 3/4» -- 1-1/2" ,Washed Crushed Stone 6
INV. EL 8A•o �,
_ OVA
PROPOSED S. R s ,o• uw. 111 , INV. EL. 'Yq•1 -=- ;, r ': o�° A. S. TRENCH SECTION oc�s
'� �itiuli�s' ��°
I. INV. EI_. I SUMS' �'l8•�1 og`oo•.' o :.o 0 0 o •�" o m o gERNG
10' MIN. 'A 118 LIQUID DEPTH — INV. EL. Ins! El. '1$,tti o cc
o WATER
o F-
oVTOWER
'• 8 EI. 'l�.•o SHOOT FLYING HILL RD.
INV. EL -IA•A ' _ - b
- No. f Trenches �_ I
-L
No. of 500 Gallon Precast Chambers 5 wEQuAQUET
LAKE
PRECAST REINFORCED C01,1CRETE 3/4" - 1-1/2" Washed Crushed Stone--/
1500 GALLON PRECAST REINFORCED CONCRETE SEPTIC TANK DISTRIBUTION BOX LOCUS MAP SCALE: 1"' = 2000'
E'1 �I1 ,�
MINIMUM CONSTRUCTION MATERIALS PER 310CMR 15.226(2) INSTni_I. ON n LEVEL BASE
MINIMUM WAIL THICKNESS - 2"
TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND MIDJIbtI ih.4 I?1SiDf; I?IP.1Eh1SI0N - 12"
SHALL EXTEND A MINIMUM OF 6" ABOVE THE FLOW LINE
OF THE SEPTIC TANK- AND BE ON THE CENTERLINE OF THE
SEPTIC TANK LOCATED DIRECTLY UNDER THE CLEAN-OUT OUTLET INVEP i-S SHALL BE EQUAL i.. I nCH
MANHOLE. OTHER AND AT 2 MINIMUM BELOW Itii_ET INVERT.
THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR THE DISTFOU TION LINES FROM THI-- t_�ISTRIBUTIOtl t:30x
MORE THAN 3" ABOVE THE INVERT ELEVATION OF THE SHALL ALL HAVE EQUAL INVERTS n,1 DETERMINED D I-R E1.00JING T�
OUTLET PIPE. THE DI 7R113UTN� BOX TO THE I-IF_�IGHT OF THE D15�i�I1�U710td �
UNL" liIV1 RT Al=11-R ALL LINES HAVE 13EEN SEALED IN PLACE.
INVERT ADJUS11iENTS SHALL PE It.,IADE BY FILL-ING WITH DURABLE
SEPTIC TANK SHALL BE INSTALLED LEVEL AND TRUE TO GRADE AND NON-DEFORM ABLE MATERIAL PERMANENTLY FASTEND TO THE
ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY LINE OR RECONSTRUCTING THE LINES UNTIL ALL INVERS ARE OF P¢aPOSCp �1� yL.
COMPACTED AND ON To WHICH SIX INCHES OF CRUSHED STONE EQUAL ELEVATION.
HAS BEEN PLACED TO ENSURE STABILITY AND TO PREVENT Access & Utility Easement - edge of aVe edge of ave
$ETTtJNG. ------------- --------------�-----= _ -__ __ `_ _--. _--_-_ ..................
_--------------- -------- -_- -----
p CB E1. 122.35 - - -_- _ _ 11 _ _ _ _ _ _ _ \ - _ _ edge of pave_ - _
AVE A MINIMUM COVER OF 9". BM. To - 116"_ - - - 8— - - - - - _ 2 - __ - - - - - - - _ - - - ------ _ - - -
TANK SHALL H � _ 1 _ _ _ `11® 1��'\.� jam¢ \ - / - - -
SEPTIC Datum: NGVD _ - - - - - - _ � \ \ \ 1,z�? _ _ =13p- , / //// ' l - - IZ -----
150.00 _ / _ _
THREE 20" MANHOLES WITH READILY REMOVABLE IMPERMEABLE �1�' _ - - - - -�_ _ _ _ _ _ _ - - - - -
�� 86 - _ - - - _ � ..s 15000 ��
COVERS OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS ` - �S \
PORTS BEING PLACED AT THE CENTER AND OVER THE INLET AND 00 / _ - - �08 - � \ _ - - - -
\ O�•s eJ 124 150 00 / IISt
OUTLET TEES. (�1 �' '� �. 1�6' ��,p \ \ \ , �1 1c�2 - - - - - / //// I Jh2 , 1 - -THE OUTLET TEE SHALL BE EQUIPPED WITH GAS BAFFLE. ^ _ ' >- -- -
0'� _ 8 1
4 4 .
• q, or
/ _ __ . _
+
77
71 _
98 I- -100
- — — — — — — — — — — — — — .10
-" i
GENERAL CONSTRUCTION NOTES _ - - - - - - - - - - - ��' ,re _ roe _ _ - -
a �4,qa _ 9 - - - - - - q - - `98
// /i / — — — — — — — — — — — — — — — — —� \ �� �� •��'.1 'w'` •,o �` + ` lO4• ' i _ _ _ _ _ IvtS 9V - 94
D.E.P. ITLE 5 REPLACE SOILS NOTE. �' �r �`' - - - - - - - - - -- - - - co _
SHALL CONFORM TO � / j - - - - - -8e 90 \\ . \ �So'�eZ�e • 1p2 -1 - - _ _ _
1. ALL WORKMANSHIP AND MATERIALS0 i f '"�� . - - - - - - dJ :,d ��,`59s�16•? '98� _ - - - _ _ _ -Dr /f :` 86' +
i _ \ J " '9p
AND THE TOWN OF _____________ RULES AND REGULATIONS FOR REMOVE UNSUITABLE SOILS FIVE FEET LAIE'RALY 0� 4 „r j
SURFACE DISPOSAL OF SEWAGE. IN ALL DIRECTIONS BEYOND THE OUTER PERIMETER '� ' 2�1 - - - - - - - _ _ __ — - ` - - _ -
.THE SUB .>rS' - - - - - - _ - ,•� _ _ 90
50RBTION SYSTEM TO THE DEPTH OF r/ / rr / ' _ _ - _ - - - - - -
OF THE SOIL AB � / r r r 1r ✓ \ 9
2. AT LEAST ONE ACCESS PORT OVER TANK TEES SHALL BE ACCESSIBLE NATURALLY OCCURING PERVIOUS MATERIAL AS REQUIRED � r _ _ _ _ _ _ _ � �� \ - _ - _ � _ - _ _ _ 88
r r i r r
BY 310CMR 15.240 AND RELACE WITH CLEAN GRANULAR 2� l / r r :ill r rr / / - _ - _ _ � P \ ``4 0� `
WHITHIN SIX INCHES OF FINISH GRADE WITH ANY REMAINING ACCESS - - - - - - - - - - - "� � _
+ 86,
PORTS BROUGHT TO WITHIN TWELVE INCHES OF FINISH GRADE. SAlIrD, FREE FROM ORGANIC MATTER AfVD DELETERIOUS / - - - - - - - - - - - - - _ - _ - - - _
SUBSTANCES.' �r l / � l ?4 � ` . � _ 6 _ .......
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF D� 100 / l l l l l
WITHIN 10' l l l l 1 I zo
- •�D
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR i r / / / / /
DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER OR WITHIN `� 4 9 6'O 68 _ o
OF ....�"` ,gyp 8. \ rr �i r 'I / I l \ �8.28 S f � � ,,,c� , _ •��A � � � , _ fj�.AoseQ,
10' OF DRIVES OR PARKING UNLESS NOTED. ► I 9r
`D `; � l ; l I �
SHALL VERIFY THE LOCATION OF ALL ° `s \ P pose D 11n
4. THE EXCAVATOR/CONTRACTOR 98� r i/ ,/ \ I I I I I 0 0l1
E UTILITIES PRIOR TO ANY EXCAVATION. - - _ - 6'
SITE 00 ,y4ids � I � I I r �t�
r r s o 9 ' I 2 0 4. - ` ` Tehk - titi -�¢ - Zoning District: RF
5. SEWER PIPES SHALL BE 4 SCHEDULE 40 PVC LAID AT 0.02 SLOPE. '� Og2 I I I 16 - pro 6 ° - ' \
prop .,may ! i I I I I I I I I�OPoseQ, �0 �T2 s011 1
RE;place
q,� 92, / prl {� I I I I I I i I 168 �° Gal. �' ` 3- - �0, �ti / Overlay District: GP
6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE Note: Should soils be encountered during installation of sewage system the are
/ Q,e L I V I � 1 I I � \ � r \ - ��
MORTARED IN PLACE. consistent with soil logs, contact the designer and/or your local Health Department �' \ \ 6' / o
o� .90 ` \ t I I I I I I I I ;O 4 _ - s6 / `� Building Setbacks.•
not consl $ ,,w ;� t'o 1 I \ - / / /
7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FEET PER FOOT. before pro l l Ros: �t F1'OI1t--3j,
fj Aos I I I 6� \ \ A
88 ,ti \ Qs roffl o / I I I I \ ?2 \ L j'oAo \ ► / /
• �`� I •\ \ � � 'S'oo' S 1 +, 6'¢ / / .Af, ` � ; �'S Slde-15',
Wiz` 74 �zor sz s l , l memos , 9�• / Rear-15
3� ° 8yt 1
I � � � , , , � . Assessors Da ta.� z�A- x�
' _ -8� 80 \ \
8111 , b - \\ \' �z `�o \ \\ \ \ r rl l FEMA Data: Zone "C"
_ _
- _ _ _ 9.14
Soil _ - S•� \\ rS6578�,�0» l 19
�8 Rep_ _ ` 1�':�• ' ' Prep sed S• 1 - ` " N657840 E 175.3 / r /
SOIL 08SERVATION- DATA: 6' . - �_� _ _ -
DESIGN DATA: _`113 0-- -30 00 l_0'� Z U.WCou (-r►t�Te
'4 ` , _ •.� -_ � _ _ , _ 8 0 -¢o!ti - �,l•!►ow►'1w� 'QGccc. LTG �. •zM�1Z•
STRUCTURE 3
TEST DATE -L- \$-qq ?%'1yEL�.tts. — _ - - r �O - -----
TYPE NO. BEDROOMS GARBAGE DISPOSAL ��I ------------------------- ----------- `I .o\.0 }~1.';3•S
s . ------------ - 40 tit �� s, s� 1Q�r1z �: �-ji�U.�u
SOIL EVALUATOR DESIGN FLOW 3X \10 = -5'3 l7 _ , 161'' G 11 fk --
56578 w _. -
B.O.H. AGENT orl a \**4v S�(. _�a �� ��(o...._Z A 1
Easement z
Cape & Vlneyard Ele C,
SITE PLAN OF LAND IN
PERC/RATE c. t_ M�la. �iiyk� - u C't
-- SEPTIC TANK t o 1F�NiK WE,S T BARNS TABLE
Prepared For.
O U LEACHING FACILITY u 5 E �>�ww► r�z. �c',��- u�, I" OF mf��+� I �3z" "" �.,: .a �o '01A-rzq BA YBERR Y BUILDING COMPANY
A �� I n `I, C,1r��µ of M�� co p Depicting
13•Z�,� �i. `Zti L -7 rc-Fr- y V-V►T!4 STEPHEN •r �\ ��\ 4A'r 9'\
L 1 u Yt1 � ; J. l V' o! �.
y 3Ip� A0T �. o 'Tyl- = 3�t, Cf_7 > ` ��.► �,.�I Do�LE ,��. GRAPHIC, SCALE �,-�' -�
`3C� .. rrq WILLIAM ��
s L z,S`t '(f Z N0. 373 o LIEBERMAN 40 0 20 40 e0 160
'(J 1l1. x.S� ZAou �1' �,� •P��%$�'7� ! I v ��u. ZJ9� f^I• -
'` ,` ;,t;u �M•;'' �'\ w0 Scale: As Shown Date: 02126101
CrsTEF'
�+r _ -& 9 z,ti- 1/3 �cslnnnl�1 c% ( IN IEET') Prepared By
Stephen J. Doyle and Associates
i inch = 40 tt. 42 Canterbury Lane, east Falmouth, MA 02536
- \ Telephone. 5061540-2534
IZIN: '>-L-M19-ot Aop 71t `1'123
i
_ - F
i
p p
�0 SYSTEM I- ROFILE ALL SYSTEM COMPONENTS SHALL BE
E G E N D I MATE MARKED WITH MAGNETIC TAPE OR VENT
Cope Cod
ELL PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. Community
--- gg - EXISTING CONTOUR I ACCESS COVERS TO WITHIN 6" OF FIN. GRADE H-20 CAST IRON COVER TO GRADE G[Ytrett College
2" PEASTIONE OR GEOTEXTILE Pond
X 9-9-1 EXIST. SPOT ELEV. \ TOP FOUND, EL. 87.4' FILTER FABRIC OVER STONE
-[99]- PROPOSED CONTOUR I 86.0 MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM
NOTE: 2" MIN. WALL
PRECAST H-10 BLOCKS OR
198.4] PROPOSED SPOT EL. RISERS (TYP.) THICKNESS REQUIRED PRECAST RISERS
TH 1 - - PIPES LEVEL 1ST 2' 4' COMPONENTS �' Exit
2'0 4"OSCH40 PVC MORTAR ALL H 0 Locus
- « 6" MIN. SUMP
TEST HOLE 12" MIN. INT. DIM. I£ND5 (TYP.) INV'S EL. 75.0' �SIDES6
76.0'
.. 10" 14" 'ooc000Qoo°. - °•,. rr .. `o=°a^o°°o°° d .
2� SLOPE OF GROUND 1 TEE
TEE *83.0 000� 0��� ®��� ���� R
::EXISTING o0000
00000°00 0°o°o°o� I0M0� Ser�IGe / \
UTILITY POLE I o 0 0 0 ° o WATERTEHT D'BOX o ° ° ° °
SEPTIC TANK GAS BAFFLE :• +°o�o,°o°o°o° nj o0 000000
FOR LEVELNESS °
77.67' 77.50' �o�o�o�o oa000000 73.0' /
FIRE HYDRANT
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING I H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL.
0 3/4"-1-1/2" DOUBLE WJASHED STONE 4' MIN. (3) UNITS REQUIRED
\ 6" CRUSHED STONE OR MECHANICAL ALL AROUND PRECAST SITRUCTURES OVERALL DIMENSIONS TO OUTSIDE OF STONE: 33.50' X 12.83' It
Wequaquet
^� COMPACTION. (15.221 [2]) 1 Lake
O
LOCUS MAP
\ ( 7.4% SLOPE) ( 25% SLOPE)) NOG 0 NDWATER FOUND SCALE 1 2000't
"INSTALLER TO CONFIRM
EXIST. LEACHING NO GROUNDWATER DON ASSESSORS MAP 214 PARCEL 29
FOUNDATION SEPTIC TANK 72' D' BOX 12' FACILITY TO EL. 67.0. NO GROUND
WATER EXPECTED SITE IS LOCATED WITHIN A ZONE it
PER BARNSTABLE TOWN ORDINANCE 330 GPD/AC MAX.
*THE INSTALLER SHALL VERIFY THE **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK 60,827 (330/43,560) = 460 GPD MAX.
LOCATIONS OF ALL UTILITIES AND ALL SIZE AT 1000 GALLONS AND ITS SUITABILITY FOR
BUILDING SEWER OUTLETS AND RE-USE. REPLACE WITH 1500 GALLON H-10 NOTES
ELEVATIONS PRIOR TO INSTALLING ,ANY SEPTIC TANK IF NOT SUITABLE VARIANCE REQUESTED UNDER MAX. FEASIBLE COMPLIANCE
PORTION OF SEPTIC SYSTEM 1. DATUM IS NAVD 88 ,
15.405 1b: SAS TO BE > 3 BUT < 6 BELOW FINISH
2. MUNICIPAL WATER IS EXISTING GRADE (VENT AND H-20 PROVIDED)
C 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
SYSTEM DESIGN:
4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS
GARBAGE DISPOSER IS NOT ALLOWED TO BE AASHO H-2_Q
5. PIPE JOINTS TO BE MADE WATERTIGHT.
� 6. CONSTRUCTION(DETAILS TO BE IN ACCORDANCE WITH TEST HOLE LOGS
DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440 GPD 310 CMR 15.000 TITLE 5.)
>o T � _ USE A 440 GPD DESIGN FLOW 7. THIS PLAN IS BE USED OR LOTOLNEROPOSED STAKING ORRAN�NLY OTHERD NOT TO CRAIG J. FERRARI SE 13871
60, 27 S.F. - - PURPOSE. ENGINEER. #
1 . AC. SEPTIC TANK: 440 GPD (2) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.= 880 WITNESS: DONALD DESMARAIS RS
9S �
**USE EXISTING 1000 GAL. SEPTIC TANK 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED DATE: 7/7/2017
WITHOUT INSPECTION BY BOARD OF HEALTH AND PERC•. RATE _ < 2 MIN/INCH
LEACHING: PERMISSION OBTAINED FROM BOARD OF HEALTH.
SIDES: 2(33.5 + 12.83) 2 (.74) = 137 GPD 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING CLASS I SOILS P# 15395
BOTTOM 33.5 X 12.83 (.74) = 318 GPD DIGSAFE (1-888-344-7233) AND VERIFYING THE
�} LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES
N PRIOR TO COMMENCEMENT OF WORK.
N �Z TOTAL: 615 S.F. 455 GPD 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE 1 ELEV. z ELEV.
USE 3 500 GAL. LEACHING CHAMBERS ACME OR EQUAL REMOVED BENEATH AND 5' AROUND THE PROPOSED 0" 80' O" 79'
( ) (,. ) LEACHING FACILITY.
WITH 4' STONE ALL AROUND r ` EXISTING12. CILITY SHALL BE PUMPED AND
31" FILL FILL
0� G G REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. A 24PA
DRI E 36" 1 QYR 4/2 LS/
� '
�
1OYR 4/2
2 8
MA
�LS g
APPROVED DATE BOARD OF HEALTH 54„ /10YR 6/8/ 75 5' �S
/ I \ C 1 48" /1 OYR 6/8
PORICH 75,
/
/ GRAVEL / / ,
� CS ,
DRI E
EXISTING 72„ 10YR 7/6 74.0'
/ DWELLING \ 8o OP. VEN WIT CH AL FILTER UNSUITABLE C
TOF = 87.4 / `� \ AND GSC EEN AL PL CEM T SOIL C2
PERC� Y CON AC WITH OM WNER FS
C ULTA ON)
L�6 I� \` FS� ` 10YR 73 TEST HOLE LOGS /
BENCHMARK:
�`��� ''' / ( 132" 1 OYR 7/3 69' 120" 69'
COR. BULKHEAD 2. ENGINEER: S. DOYLE
j = 87.4' NAVD88 0 i9 DONNA MIORANDI RS NO GROUNDWATER ENCOUNTERED
86 / �I WITNESS:
1
S� SA,, ORES TH1 0 DATE: 2-184 1999
78 1 PERC. RATE _ < 2 MIN/INICH
1� I P 9372 TITLE 5 SITE PLAN
TH 15 CLASS _ SOILS #
OF
of,
lA 0„ 2A 17 SERVICE
A AN S T A tr_31 L ffE' M A
/ SL SL 7
2 / 10YR 2/1 10YR 2/1 6» 6„ PREPARED FOR
B1 B1
FURA
70 / S L S L
z:s tw u .i T V E N
/ 1 OYR 6/8 1OYR 6/8
/ 36" 36" DATE: JULY 17, 2017
66 / 62 B2 REV: AUGUST 17, 2017 (H-20, WATER LINE)
6
/ 62 60 58 SL SL
40„ 10YR 7/i 401) 1 OYR 7/2 Scale: 1"= 20'
�-�
'- 0 10 20 30 40 50 FEET
"�IOFS �jN OF Mq QS`ZN OF_,
� 0rM� �� sq vat s90 o=� DANIEL cti� off 508-362-4541
FS FS a 9y o ti� o`' DANIEL ti�
/ 56 0� DANIELA �� :� OJALA �A '. O ALA I fax 508-362-9880
r DANlELA.
A. downcope.com
132" 2.5Y 7/3 132" 2.5Y 7/3 QJIVi� NCIVIL
4 bo2 Noo 40 80 �No.40980� down cape en ineerin //!C.
(� A No.46502 p o r o" o� �l
/ O °���G�sTE� ,� ° s c �R��`�� s` ��NF o�0 `q"�SURVEy�� civil engineers
21 NO GROUNDWATER ENCOUNTERED .Fss1pNAL �N� s oNAA �. s RVE land surveyors
���� 939 Main Street ( Rte 6A)
n DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
DCE # 17- 173
17-173
)B No. =30671 E0301
i