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HomeMy WebLinkAbout2177 SERVICE ROAD - Health Road West Barnstable 016, ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■®■■■■■■■■■EE■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ No MEN ■■■■■■■■■■■■■■■■■■E■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■®■sMEE■M■■■M■■■SEEM■■■■■■M■■sE■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■E■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ - ■■■■■■■■■■■■■■■■■MESS ri 10 ■■■■E■■■E■■ME■■■■SM■■■■■■■■ ,rep ■■SEMM■M■■■■M■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■M■EM■■■■■Mee■■ MEN NO MEN mmmMmmmMMMMMMMMMmmmMM MEN ME 0 MmMMMMMMMMMmMMmmmMM ME mom MENEM mom No NEI NMI 0 NMI No OMNI MMMmMmMmM SEMI MOMI NONNI iiii s���� � � / ' `- OMNI MOMMEMEMMEMM mom MmMMMMMMMMmmMMI mom .... .............................. ...■......■.....■...■.�........■■. ................................... ................................... �■■■■E■■N ■NE■■MEN ����■■■■■■■me Commonwealth of Massachusetts T Title 5 Official Inspection Form ®Q� Subsurface Sewage DisposalySystem Form -Not for Voluntary Assessments cn 2177 Service Road, West Barnstable Property Address Joseph Demby ; Owner Owner's Name required for is every West Barnstable MA 02668 August 26 2106 required for eve , page. City/Town State Zip Code Date of Inspection Cal r%2 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 on the computer, use only the tab 1. Inspector: key to move your cursor-do not David B. Mason use the return Name of Inspector key. David B. Mason AJ Company Name 4 Glacier Path Company Address East Sandwich MA 02537 City/Town State Zip Code 508-367-1617 S1287 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 August 31, 2016 Inspector's SignatuN 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 10,000 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. i ****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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 V� / v1d Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g 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: ® I 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: Inspection identifies the condition of the system on August 26, 2016 at Noon and represents the condition only for that date and time and does not represent the continued operation of the system in the future. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demb Owner Owner's Name information is West Barnstable MA 02668 August 26 2106 required for every g , page. City/Town 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 breakout 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is required for every West Barnstable MA 02668 August 26, 2106 page. CityrTown 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 '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 III Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26 2106 required for every g , page. Cityrrown 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•3/13 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 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g page. Cityrrown 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): 3 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts u Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable required for every MA 02668 August 26, 2106 page. Citylfown 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 ® No Water meter readings, if available last 2 ears usage Yes 9 ( y 9 (gPd))� Detail: 2014; 87,000 gallons and 2015; 94,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flo w ow(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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•P g p y age 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form m io Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Au ust 26, 2106 required for every � page. Citylrown 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: Board of Health 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every 9 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: Installed 6/24/2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 150 feet Comments (on condition of joints, venting, evidence of leakage, etc.): Observable conponents appear in adequate condition Septic Tank(locate on site plan): Depth below grade: 34"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) No risers to grade on the tank. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Typical 1500 gallon Sludge depth: 2" l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 42 Scum thickness 3 Distance from top of scum to top of outlet tee or baffle 2" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Scour Stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Effluent level with outlet invert. Obwervable portions of the tank appear in adequate condition. Replaced existing outlet tee filter with new tee filter. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g page. City/Town 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g page. Cityrrown 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 Level with outlet invert 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.): No evidence of solid carryover. Dbox is 48 inches below grade. Riser is 32 inches below grade. 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable _MA 02668 August 26, 2106 required for every g page. Cityrrown State Zip Code Date of Inspection D. System Information (cost.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 2-500 gallon chambers with out signs of hydraulic failure at time of inspection. No damp soil. Units are 72 inches below grade. Risers are 41 inches below grade. Effluent is 16 inches below the inlet invert. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26 2106 required for every g , page. City/Town 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form as Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owners Name information is West Barnstable required for every MA 02668 August 26, 2106 page. Cityrrown 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owners Name information is West Barnstable required for every MA 02668 August 26, 2106 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: 20 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: March 16, 2001 Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Ground water contour map ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Existing soil logs on file with Board of Health Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I <�1 -7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 August 26, 2106 required for every g 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 hi Y p h groundwater 9 ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION 1 Li 97 S6t'�/'icB Q• SEWAGE# VILLAGE In�e$f "S+Xgf, ASSESSOR'S MAP&LOT Z! -072 INSTALLER'S NAME&PHONE NO. - " 3 152V i( _Cq fillA SEPTIC TANK CAPACITY !S'oo 4AI LEACHING FACILITY:(type)C2 (size) 2-5 NO.OF BEDROOMS 3 BUILDER OR OWNER rAG 4 VZ5 In PERMIIDATE: I o f COMPLIANCE DATE: Z D 3 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 LF 3 I t http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=214072&seq=1 8/25/2016 a I 1'6":d ��•5::� . '?T 113 e:0 c::a 4 4 I Doc_= 1 g 244 F:S36 a v 29 BARNSTABLE LAND COURT REGISTRY DEED RESTRICTION Whereas, Joseph Demby of 2177 Service Road, West Barnstable, MA is the owner of 2177 Service.Road, West Barnstable, MA 02668, being shown as Lot 3B on a plan entitled "Subdivision Plan of Land in West Barnstable, Massachusetts", duly recorded in the Barnstable County Registry of Deeds in Plan Book 551, Page 81. and being shown as Lot 28 on Land Court Plan No. 22556-F. Whereas, Joseph Demby as the owner of said lots has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on,said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; Whereas the Town of Barnstable Board of health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 .CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary e p ary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property is requiring that the agreement for the restriction on the number of bedrooms in any .house constructed on the lots be put on record with the Barnstable County registry of deeds by recording the document, t , Now, therefore, Joseph Demby does hereby place the following restriction on his above referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: r ' 2177 Service Road, West Barnstable, MA may have constructed upon_ the lot a house containing no more than 3 bedrooms. Joseph Demby agrees that this shall be permanent deed restriction affecting the house located on 2177 Service Road, West Barnstable, MA and being shown on the plan recorded in Plan Book 551, Page 81 and on Land Court Plan 22556-F. For title see deed recorded in Book 23701, Page 344 and Land Court Certificate of title No. 188542. Executed as a sealed instrument this—Asiday of May, 2014 Joseph Demby COMMONWEALTH OF MASSACHUSETTS County: )3ar Y1ln� On this Sfi day of � , 2014, before me, the undersigned Notary Public, personally appeared the above named Joseph Dem y, proved to me through satisfactory evidence of identification which was r ' to be the persons whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily, for its stated purpose and as his free act and deed. 4AFTAUECO NTY'DS i (AURA A. GUfNDON I ST , blIC Public COMM NWEALNoloT O MASSACHUSETTS My Commitslon Expires t� �HN F-�A1bi�f�" D*O* mbstr t 8. 4020 BARNSTABLE REGISTRY OF DEEDS I Cfl R l0 j s osrr r � i.b 50olvis JKQP OOS6 1 s �e� r47s•� n• � t Ito (� �� `s:� �`pra�` wry`' -�i_^. ..iy�♦ •r �- ._•-- �• - ^� ,�,sq or rya '7 .�, oosN �cyz)IDIOUA ode z ay .s9 s �+ 82 SSG .co 1.81- J �. .+ _ �lB• M1 r+ 99 v ,Or r1�81 - 7 gr-fL£ tt•�L l , o �/ ��,� co ui ! 41 cn a o Nh h '� `� ham• lob * cl pet. a N fLYLI _• 99;16 v - e 3 .or •a ,.IL N 11;7 7 .AD40 •OiC .9L N 1�., �1 O~ O� fi'� i Aw ti70 cet 0. u m �� .fOsotr,� �wuns ye /�r♦, ( 'it 00 i a fA / � < MY1y • ; ��l � > m vOOAV7 JyytQl �^ odor or" �� Wr. VV1 APPUCant'.. per y L . -Prvper-ty: earmtabie r Pro posed 4e'Ces5'r utaly Erse aj4-*per pt" 2B�97' deck, 211i? \ (,0t 3C t stovy shed lab ref o T 05 c- - f �a PAuL � ftmb cerufj lfwt mortgRge ins tioa was.prvp�-�r eR. A ter u *f eY dt-a1 awk a mEER � tees, AlAn She dWUt'ru1 shown hapm does Mt cfaL im ar spevi od TEMA flood fta=vU =Gc with am e*ctive date o f S-19-65 and. rdie locac bon. op "a su ft dwelling d d-s conform rrn*he local pn ng bylaws im at-theti rw aFcmutruaiom wilt mpeatu horizonud drone st'ona� scale: iR setback or is o m Vwlatlron ¢rt rternenx-' Date: g-2G- &tLom u n err Alass. Gcmrd.Laws Chiapttr4o A-UctLon. 7. File No. cg_w5 - PLEASE NOTE: The structures ae shown on this plot plan are ipproximate only. An actual .rurvey is neeesbary for a precise determirnation of the building location and encroachments. if any exist. either way across property linex, Thiv plan must not be used for recording purpose,~ oc for use in preparing deed descriptions and must tot be used for variance or building plan purposes. This plan must not he uccd to locate property lines. Verification of building locations. property line dimensions, fenc" or lot cordliguradon can only he aaomplished by an accurate instrument survey which may reflect different information than What Is sbown hereon. Picase note that thin iy 'NOT A BOUNDARY SURVEY* and is -FOR MORTGAGE PURPOSES ONLY'. COLONIAL LAND SURVEYING COMPANY , INC. W 269 Hanover Street • Hmover, Mass. 02339 phone: 781-826-7186 - Fax: 781-8264823 c o 34' 8' ie Bedroom 12' Bath Bedroom ti moo, Suring l0' Sitting �r ° 14' Yf- Y1 24' Ati Deck 7 0 \ \ 20.0' v \` C Laund �s ~ 1/2 Dining Kitchen Bath Living Room b ,a v M Bedroom e�a Bath 0 Garage Foyer eO b 24.0' v 10.0' Sketch W Apo MWm" Comments: AREA CALCULATIONS SUMMARY . `;` . '.+ LIVINd AREA`BREAKDOWN Code Oeseription ";. Net Size''` '_Net Totals':? ; ,Breakdown Subtotals., OLSi First Floor 1S31.5 1431.5 First Floor._ GLa2 second Floor 1570.0 1470.0 0.5 s 1.0 a 1.0 O.S. 0.3 a 13.0' a 13.0 04ti 0.3 x 1.0 x 1.0 0:,' 3.0 a l9.0 117.0 0.5 s 2.0 a 2.0 2.0 0 s 5 4328.0 1147 4.0 4.00 6.0 x34.0 2 .0 7 2.0 14 0.5 a 8.0 a 6.0 24.0 4.0 a 10.0 40.0 0.5 x 2.0 a 2.0 2.0 Second Floor 24.0 a !.0 120.0 0:3 a 3.0 a 2.1 3.1 a 1.0 a 4.0 8.0 1.0 a 20.3 20.3 S.0 x 16.8 84.2 4.0 x 52.1, 208.3 6.0 s 42.0 2'2.0 8.0 x 34.0 432.0 60.0 x 3.0 180.0 9 item Not Listed 262.0 Net LIVABLE Area (rounded) 3102 30 Items (rounded) 3102 Commonwealth of Massachusetts ®Q� Title 5 Official For Inspection p m Subsurface Sewage Disposal System Form -Not for Voluntary Assessment 5 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owners Name information is April West Barnstable MA 02668 A 18 2014 required for every p � , page. Cityfrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any wa y. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: J J key to move your cursor-do not David B. Mason use the return key. Name of Inspector David B. Mason ICI Company Name 4 Glacier Path �I Company Address East Sandwich MA 02537 City/Town State Zip Code 508-367-1617 S1287 Telephone Number License Number B. Certification _ w I certify that I have personally inspected the sewage disposal system at this address and that thed 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 y Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority Aril 18, 2014 Inspector'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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the 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. LA t5ins-3/13 Title 5 Official Inspection F surface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 .Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Aril 18, 2014 required for every p page. City/Town 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: ® I 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: Inspection identifies the condition of the system on April 18, 2014 at Noon and represents the condition only for that date and time and does not represent the continued operation of the system in the future. 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 com plying.septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. -❑ Y ❑ N ❑ ND (Explain below): i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form r,. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 required for every p �il , 2014 page. CityrT'own 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 i ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 I Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2M Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 2014 required for every � City/Town frown page. Y 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 . p a nitrogen and nitrate nitrogen is equal 9 9 q to or less than 5 ppm, provided that no other failure criteria are triggered. A copy Y 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 town overloaded or clogged SAS or cesspool i ❑ ❑ Static liquid level in the distribution box above outlet Invert due to an overloaded orblogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r Commonwealth of Massachusetts :. Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18, 2014 required for every p page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ E 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. ❑ Z 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. Ey 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•3/13 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 ,•''v 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 required for every p �il , 2014 page. Cityrrown 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 ® E Pumping information was provided b the owner, occupant, or Board of Health Y ,P ❑ ® Were any of the system components pumped out in the previous two weeks? - P P P ® ❑ 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): 3 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is April West Barnstable MA 02668 A 18 2014 required for every p � , page. Cityrrown 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 ® No Water meter readings, if available last 2 ears usage Yes 9 ( Y 9 (gpd))� Detail: i 2013; 87,000 gallons and 2012; 94,000 gallons Sum pump?p p p El Yes ® No Last date of occupancy: current 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 :Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for-Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 required for every p �il , 2014 page. City/Town 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: Board of Health 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 El Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 5 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Aril 18, 2014 required for every p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: March 16, 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 150 feet Comments (on condition of joints, venting, evidence of leakage, etc.): Obwervable conponents appear in adequate condition .Septic Tank(locate on site plan): Depth below grade: 2'-10" feet Material of construction: ® concrete metal fiberglass' ❑ ❑ g ass El polyethylene El other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Typical 1500 gallon Sludge depth: 211 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Aril 18, 2014 required for every p page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 42" Scum thickness 3„ Distance from top of scum to top of outlet tee or baffle 2° Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Scour Stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Effluent level with outlet invert. Obwervable portions of the tank appear in adequate condition 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 2177 Service Road, West Barnstable Property opert Address Joseph Demb P y Owner Owner's Name information is West Barnstable MA 02668 A 18 required April for every p � , 2014 page. City/Town 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 g g a k(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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Aril 18, 2014 required for every p page. Cityrrown 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 Level with outlet invert 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.): No evidence of solid carryover. 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s) Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is April West Barnstable MA 02668 A 18 2014 required for every p � , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ICI ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ 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.): 2-500 gallon chambers with out signs of hydraulic failure at time of inspection No damp soil 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 .Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 Aril 18, 2014 required for every p 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts M Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 required for every p �il , 2014 page. Cityrrown 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 April 18 2014 required for every p � , page. Cityrrown 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: 20 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: March 16, 2001 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Ground water contour map ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Existing soil logs on file with Board of Health Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 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 °M 2177 Service Road, West Barnstable Property Address Joseph Demby Owner Owner's Name information is West Barnstable MA 02668 A 18 required for every April p � ,.2014 page. Cityrrown 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 y pp y ) o pleted ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION, r L19 7 9&-V 1 cg r it• SEWAGE# ZOO �52 VILLAGE ASSESSOR'S MAP&LLOT 21 — 2. INSTALLER'S NAME&PHONE NO. 3 RP V'i &1-g bt0L C&ISk SEPTIC TANK CAPACITY l gw LEACHING FACILITY:(type)_(2) sz4yt_eA,-krS (siu) 25'"1.3.2-'x Z' NO.OF BEDROOMS 3 BUILDER OR OWNER G f ue-S !n PERMrrDATE: I Ol COMPLIANCE DATE; &I Z D 3 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 LF 3 r � t 2,31 ,10� y.;V'6 `��J'L, http://town.bamstable.ma.us/Assessing/HMdisplay.asp?mappar=214072&seq=1 4/15/2014 :�S" • ■ ■ �0< � 0 � � i '�i ■ ► a ,, / ,a � � / � . � � / ■ . ��� • J-11 �' M.BEDROOPI L'1 2-2-10 P.T.GIRT 2 j L L`J TYPICAL EXTERIOR WALL CONSTRUCTION, U,. W.C.SWIHGLES 6 1/2'S EXPOSURE rTYrAR'OR 'TYPICAL B/4.OBD T. p i u ta•I SONIOTUee ON EOIAI WOIUSwRArn/1'aBe �� P�ERaLAw E/Bt.LAT1oN O a4SO4'kn'FTG. SWEATHING/2,A STUDS AT K'O.c./s 1/2' (an) GLUED I NAILED To Jotwm • .. 2:6 0 W O.C. 216• Ii'O.C. DM.ABOVE . _ FLUBW DM. C L/Y GYP DD ON ABOVE I'm STRAPS O 16,O.C. A o TI LIVING RM. e�Ero1ID -------------------------------------------- TYPICAL 3/4'ceD TIG GLUED It NAILED TO JOISTS ' II II I 1 I ee iu1st am 0 la•O.C. 1J-II (Ri9)'PIDERGJ.SS TION ID'o • _ J�I 1 l=AI BBASD'IENT TYPICAL I� • 1° 'i 4 I BEYOND l CM�T PNq�I 1 = 0 1 1 � .:b ; BASEMENT • I " 2-2m W CONCRETE -J n I tI om I 1 FOUNDATION'WALL, . 1 I 20'x10' tail.FOOTING rTYP) 1 - y -' i •'--+------ �6-2X GIRT t raxn1GIRT �. --- j 4•cO1+cRErE GLAD — .—.—. L J L J L J J L J I _ cL.EAN CON'IPACTED SNND I 1 ---; I a-a:e SECTION TNRU LIVING, RM. t M.BEDROOM O 111/2'DIA CONC.FILLED I II _ I I� ALALL I0e7 Wt-I xCON ON y i SCALE: 1/4" I m • a 24I DEEP CONK.FTG. Z I I�i�g11 III I BASEMENT Joel 1 DROP TOP 1 I�l II M1II Ip. 4' GONG SLA_ ON 1 ; CONTINUOUS RIDGE VENT -------GLEAN COMPACTED SAND I OF WALL I6• 1 " r 1 I STRUCTURAL RIDGE �-N1g-pR-T-�---------------- 1 I FOR IITILITF9 I I L TYPICAL ROOF C0NSTRL)CTkX4 J i 1 la ASPHALT ROOF INGLMOSI'FELT F'AP6R . I I I12 ooC �S DROP TOP I I I sl� 6/e•OSD /s x 10 II OF WALL b j I S'TWK k T'- 1 1 - RAPTERS AT I&'O.C. 1 I L------ ------- ------ I .. WALL ON10' I 1 I -- -- I CONT ILSIIO' CONC.-1 1 ---- 1 FOOTING I tl --------- ----------------- 1 I ON •'a' 1.DOWELS• I 1 I �Is - GQIT CONC. I I J I 2t0• C. -- (RW)FUMML DS INSUL. (Ty?) VL L- -W ---IClµ1l T UNB ----------- I GYP ON ----------------- - % 6.be 6 51'RAPs a li'O.C. o BEDROOM CL. BEDROOM I F TYPICAL EXTERIOR WALL CONSTRUCTION, W.C.SHINGLES 6 1/21t EXPOSURE rTYPAR'OR Ir kL 5/4'OBB TIC EQUAL WOUSEN"PnrJ•om SUDPLOOR SWEATNING2c4 STUDS AT li'O.C./3 I/Y(MI) WED I NAILED TO JOISTS (I 2.60 1 DM. PLUSH 1/2'GYP_DD OJ DM. FOUNDATION PLAN bM STRA"0 N' SCALE. 1/4" • 1'-0' w 'P KITCHEN DINING RM. • PROVIDE DAMPROOFING t` TO PERIMETER OF NEW FDN, WALLS TO HEIGHT OF NEW FINISHED GRADE. TYPICAL 5/4,OBB Tw suarLOOR GLUED I NAILED TO JOISTS aae 0 Ia•D.C. I —6 saa aRaPPED a-ula DROPPED NOTE l �A a%i P.T.BILL GIRT - el 1 GIRT COL' COL. 1. BA —BEYOND FYnF7EcIOD BEYOND_ EXISTING CONDITIONS OR ASUME THE e yp •T•��+"^" RESPONSIBILRY FOR ANY DISCREPANCJES OR INCONGI6TENGES NOT BROVGtT TO THE I ATTENTION OF THE DESIGNER. t y 4'caNrnErE SLAB . a.ALIGN DOUBLE JOIST UNDER ALL PARALLEL `' —.—.—.— —. L ABOVE PARTITION WALLS 1 CCdA ta"IPACTED S.SUS-CONTRACTOR TO NOTE LOCATION OF 2 SECTION TH R U DINING R M. t BEDROOM UTILITY BLOCK-OUT IN FODUIDATIONI o 3 SCAJ.E. 1/4' . 1'-0' COORINATE u✓GENERAL CONTRACTOR ' -------------- 0'-O' IN 044WR' BATH b n''477 BEDROOM ED ...... EoO cL. LW \/ I CL. - - ATTIC . ON. STAIRPVLL- WN IJ' BEDROOM STAIR EDR ' HALF WALL — CONTRACTOR TO VERIFY I \ TTi':10'-O• KRCHEN WINDOW LOCATION WALK-IN I �_ u✓KITdON CABINET PLAN Cl09ET I F, �T /1 s, !, -___ __ I ♦ / I OPEN TOI \ / I • ...................................... J _ IL AV. Q - - UP• KITCHEN • LIVING RM, NeAnER Tc BE DFAO6D ' SECOND FLOOR PLAN I BRED OY on+eRs SCALE. 1/4' 1'-O• O II FLUBN eH.ALOVE_ _ _ rweH- _— ABOVE II W CL. rIREPLA= ------- } CL. DN. 9W40" rLusN 6H.ABovE POST DINING _— ---'1�_ — x a• 1 _V l'_ _Y . NOTE: I I 1.PRIOR TO CONSTRUCTK7N, CONTRACTOR SHOULD VERIFY ALL DIHEN910NB AND/OR pCIST1/K+CONDITWNG OR ASSU1'1E THE RESPpJ$IBILRY FOR ANY DeBGREPANCIES I. . i . Commonwealth of Massachusetts Title 5 Official .Inspection Form ' P Subsurface Sewage Disposal System Form Not for Voluntary Assessments 2177 Service Road' Property Address Washington Mutual Owner Owner's Name informatiom is Centerville MA required 02632 September 9, 2008 eve 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. Importafrt: A. General Information When filling out forms.on the computer,use 1. Inspector: only the tab key to move your Darren M. Meyer cursor-do not Name of Inspector use the return key. nla v��I Company Name- P.O. Box 981 Alf Company Address East Sandwich MA 02537 City/Town State. Zip Code 508-362-2922 SI 3920 Telephone Number License Number _41 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 Leo, - ag In ors Signature Date The system inspector shall submit a co 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 10,000 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. 2177 Senate Road,Centerville-TILE V INSP•08106 Me 6 Official lnspecton Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information is required for Centervillep MA 02632 September 9, 2008 every page. Cltyfrown State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I 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: 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. Answer yes, no or not determined (Y, N, ND)in the❑.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 exf1tration 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 K a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or breakout.or high static water level in the distribution box due to broken or obstructed pipe(s)or to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 2177 SeMce Road,Centerde-Trn.E V INSP-08106 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System Page 2 of 15 �Q Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address 'Washington Mutual Owner owner's Name information is Centerville MA 02632 September 9, 2008 required for State Zip Code. Date of Inspection every page. cityfrown B. Certification (cunt.) B). System Conditionally Passes(cunt.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Expl ain: 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 15.343(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 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. 2177 Sen ice Road,Centenolle-TnTLE V INSP•08/06, We 5 Offiaai lrepection r-onn:Subsurface Sewage Disposal System-Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information is Centerville MA 02632 September 9; 2008 required for every page. Cityfrow n State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health(cant.): ❑ 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 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 inllowing for all inspections: Yes No ❑ E 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 s than Y2 day ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Z 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. 2177 Service Road.Centerville-TITLE V INSP•08/06 Title 5 Otficlel Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information is Centerville MA 02632 September 9, 2008 required for every page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ® 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 CHAR 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 E] ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—lWPA)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. 2177 Service Road,Centerville-TITLE V INSP•O&W TiBe.5 Official Inspection Form:Subsurface Savage asposel System•Page 5 of 15 Commonwealth of Massachusetts Title 5 official inspection Form Subsurface Sewage Disposal System Foam-Not for Voluntary Assessments 217.7 Service Road Property Address Washington Mutual Owner Owner's Narne information is required for CentervilleP MA 02632 September 9, 2006 every page. Cfty/rown 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 E ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 2] 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. ® El approximation 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)] 2177 Service Rood,CenteNlle-THE V INSP•08108 Title 5 Offidal hspecdon Fenn:Subsurface Sewage olspasal System•Page 6015 Commonwealth of Massachusetts Title. 5 Official Inspection Form .1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information is required for Centervillep MA 02632 September 2008 -- every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15,203(for example: 110 gpd x#of bedrooms) 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ED No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, If available(last 2 years usage(gpd)): private well Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based'on 310 CMR 15.203): Gallons per day(gpd) Basis of design flown(seatstpersonsfsq.ft.,,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste_holding.tank present? ❑ Yes. ❑ No. Non-sanitary waste discharged to the Tile 5 system? ❑ Yes ❑ No Water meter readings; if available: Last date of occupancyluse: Date Other(describe): 2177 Service Road,CenterNlle-TITLE V INSP•08/06 Title 5 Official Inspection Form:Subsurface Sewage Olsposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property.Address Washington Mutual Owner oww'.5 Name - information required fo ed for Centerville MA 02632 September 9, 2008 requir —_ every page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) General Information Pumping Records: Source of information: Owner Was system pumped as part of the inspection? 0 Yes [ No If yes, volume pumped: gallons How vvasquantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool Privy -❑ Shared-systerry(yes-or no)-(if-yes, attach prev4ous inspection records,if any) ❑ Innovative/Alternative technology..Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed(if known)and source of information: system installed in June 2003' Were sewage odors detected when arriving at the site? ❑ Yes No 2177 Service Road,CzHerville-TITLE V INSP-08/06 Ttle 5Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form MWJW Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name is required for Information required for CentervilleP MA 02632 September 9, 2008 every page. CItyfrown State Zip Code Date of Inspection D. System Information(cont.) Building Sewer(locate on site plan): Depth below grade: 14 inches 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.): No issues, no signs of leakage Septic Tank(locate on site plan): Depth below grade: Winches 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. ---------------------------------------------------------------------------- --- Dimensions: typical 1,500 gallon tank Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 10" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? tapes/rods 2177 SeNce Road.CedeMlle-TME V INSP•08106 Title 6 Officlal Inspection Forth Subsurface Sewage Deposal System•Pep 9 pf�§ f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forrn-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's.Name information is p required for Centerville MA 02632 September 9, 2008 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cunt.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Tank appears in good.condition,PVC tees are intact, liquid levels are even with outlet pipe, no signs of leakage. 18"x 24"riser to within 6"of grade. Recommend pumping every 2 years. 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.oflast pumping: Date 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): 2977 Service Road.CemeNlle-TM-E V INSP•08M Tifle 5 Official inspection Farm:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information Is Centerville MA 02632 September 9, 2008 every page. city/rown State Zip Code Date of Inspection D. System Information (cunt.) Tight or Holding Tank(cunt.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in worldng order. ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy ol"current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert n/a Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was level,flow.is not equal, no signs of solids carryover, no signs of leakage,.Riser cover 30" below grade, box 46" below grade. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working.order: ❑ Yes ❑ No W7 Service Road,CenteMlle-TITLE V INSP-08/06 Me 5 Offtdal trapec8on Form:Subsurface Sewage DispGSal'System Page 11 of 15 Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name information Is required for Centervillep MA 02532 September 9, 2008 every page_ citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate.on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 2.Precast 500 gallon chambers ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: 4 ❑ 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 chambers with stone 25'Lx13'Wx2'D,.no signs of hydraulic failure, no ponding; soild normal, vegetation normal, riser 42" below grade, MT o; , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name Information is required for Centervillep MA 02632 September 9, 2008 every page. City/Town State Zip Code Date of Inspection-,- D. System Information (cont.) 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i 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.): 21775eNce Road,Canteroille-TITLE V INSP•08106 Title 5"Official Inspection Form:Subsurface Sewage oisposal System•Page:13 of 15. 7. Commonwealth of Massachusetts Title 5 official Inspection Form t Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r< 2177 Service Road Property Address Washington Mutual Owner Owner's Name require for information � Centerville MA 02632 September 9,.2008 every page. CIty/Town State Z!p Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties f'r. to at least two permanent reference.landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. FROM CAO l TIES ES A = 25 ' R- 1 - 2i 4. A- 2- - 59 ' g' 2 17 ,q r 13 - 3 : 2S- 6 2177 Service Road,Centenrlle-TITLE V INSP•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposer System•Page 14 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2177 Service Road Property Address Washington Mutual Owner Owner's Name Information is required for Centerville MA. 02632 September 9, 2008 every page. Cityfrown State Zip Code Date of InspWion D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: 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: Dace ® 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: Dug test hole to 14 feet below grade. Bottom of system is 7 feet below.grade. Due to site evaluation and lack of groundwater 14 feet below grade, it was determined that system is not within any groundwater. 2177 SerVce Road,Centerville-TITLE V INSP•08106 Title 6 Official Inspedon Form:Subsurface Sewage Disposal System Page 15 of16 Fee---� '_--- BOARD OF HEALTH TOWN OF BARNSTABLE Application-for Vell Congtruct ion Permit Application is hereby made for a permit to Co struct ( , Alter ( ), or Repair ( )an individual Well at: Location — Address s Assessors Map and Parcel Owner f Address Installer — Driller _ Address Type o wilding � Dwellin ---------------_------- O:her - Type of Building—=— --_ No. of Persons _-----_—_—____ Type of Well— ___ 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 Ce tificate of Compliance has been issued by the Board of Health. Signed —_— _ -- n ^ ,- ate Z Application Approved By [yvy!(/ 't/- —_—___— U date Application Disapproved for the following reasons: ---------- --__---- —_ _-------------_----___-- date Permit No.. a �✓—- — Issued date BOARD OF HEALTH TOWN OF BARNSTABLE Qt ertif irate ®f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed', Altered ( ), or Repaired ( ) by--- — --- ------------------------- nn Installer —^ at--,%7 7 �Qcv,G Qhas 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—D ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector------------ -- --------_--_ a No.------------------ Fee--­- '- BdARD OF HEALTH TOWN OF BARNSTABLE Applicatlow_*rVerr Con5tructlonpermit Application is h re made for a permit to�;o struct ( ^)', Alter ( ), or Repair ( )an individual Well at: Location — Address , Assessors Map and Parcel Owner , Address -------- Installer -_��i_9,c°r�/Si9 _ - -------------- r — Driller — — — Address _ Type °uilding D�elj --- -- ---- Other - Type of Building-- —_____ No. of Persons---------____—__—_—____:_ Type of Well—�v"�'� ------- Capacity ---------------- f Purpose of Well---- ---- --_ — Y Agreement: The .indersigned agrees to install%,Ithe 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 Certi 'cateof Compliance has been issued by the Board of Health.. Signed --- --- - lv ,, ate Application Approved By k/W /V " �7 date f Application Disapproved for the following reasons:--------------- ---------------------- r _ J date W � nd2 "SS /� ;Permit No. - — Issued �-7--- -/0-2— --- ----------- date ti BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed, Altered ( ), or Repaired ( ) by---- --____—_—____------- -----_--------------------------- -/� l Installer at----017 7 r✓ c e r�i' b 13 _ V j gP t n --- --has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Pro ection 1 4 Regulation as described in the application for Well Construction Permit No. w�-� -=� 5 Dated, �'2---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. i ` DATE - - Inspector------- t -- - - ----- - BOARD OF HEALTH TOWN OF BARNSTABLE Ivetf Congtruct ion Permit No. Fee 0J� Fee Permission is hereby granted — ------------ to Construct .), Alter ( ), or air ( ) an Individu I Well at- No. 17 �Q� Re ). Street as as shown on the application for a Well Construction Permit No._ I/N�-00 Z'S.Sr Dated— 7 U z —� ---- - — ------------- DATE V702 Board of Health ____ Page: 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-01 Description: Water Drinlang Water Sam le#• 1804101 Sampling Location SecjRd W Barnstable MA p � . Collected: i i/04/2002 ollected by: E Meehan Received: 11/05/2002 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB:IC Lab Nitrates <0.1 m9/1. 0.1 10 EPA 300.0 11/06/2002 LAB.Metals Copper <0.1 mg/L 0.1 1.3 SM 3111B 11/12/2002 Iron <0.1 mg/L 0.1 0.3 SM 3111B 11/12/2002 Sodium 12 mg/L 1.0 20 SM 311113 11/12/2002 LAB:Microbiology Total Coliform Absent P/A 0 Absent 307 11/05/2002 LAB:Physical Chemistry Conductance 89 umohs/cm 1 EPA 120.1 11/05/2002 pH 6.5 pH-units 0.1 EPA 150.1 11/05/2002 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 Page: 2 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Prepared For: Report Dated: t i/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-02 Description: Water-Drinldng Water Sample#: M148149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GC/MS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 11/15/2002 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 1,1-Dichlor.oethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 11/15/2002 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 5241 11/15/2002 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 5241 11/15/2002 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 5241 11/15/2002 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 5241 11/15/2002 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3-Dichloropropane BRL ug/L 0.5 EPA 5241 11/15/2002 1,4-Dichlorobenzene BRL ugiL, 0.5 5.0 EPA 524.2 11/15/2002 2,2-Dichloropropane BRL ug/L 0.5 EPA 5241 11/15/2002 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 Page: 3 s Y= CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory C Report Prepared For: Report Dated: 11/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-02 Description: Water-Drinking Water Sample#: M148149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 Benzene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Bromobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromochloromethane BRL ug/L 0.5 EPA 5241 11/15/2002 Bromodichloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromoform BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromomethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 Chloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Chloroform 7.7 ug/L. 0.5 EPA 5241 11/15/2002 Chloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 t cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 11/15/2002 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Dibromomethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 11/15/2002 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 11/15/2002 Isopropylbenzene BRL ug/L 0.5 EPA 5241 11/15/2002 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 11/15/2002 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Naphthalene BRL ug/L 0.5 EPA 524.2 11/15/2002 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Styrene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 f Or ERTIFICATE OF ANALYSIS r Page: 4 C y. Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centen, le, MA 02632 Laboratory )D#: 0218041-02 Description: Water-Drinldng Water Sample#: M148149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Toluene BRL ug/L 0.5 1000 EPA 524.2 11/15/2002 Total xylenes BRL ng/L 0.5 10000 EPA 524.2 11/15/2002 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 11/15/2002 Note: Approved By: u.�•--�— (Lab Director) c!/zo�io�Z Superior Court House, PO.Boa 427, Barnstable, MA 02630 Ph:508-375-6605 r'o CERTIFICATE OF ANALYSIS Page. 1 U: j n Barnstable County Health Laboratory .ACHtl Report Report Dated: 11/19/2002 p Prepared For: Bayberry Building Co.Inc. G021 4 y y g Order Number: 80 1 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 �p0► Laboratory ID#: 0218041-01 Description: Water-Drinking Water Sample 4: 1804101 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB:IC Lab Nitrates <0.1 mg/L 0.1 10 EPA 300.0 11/06/2002 LAB:Metals Copper <0.1 mg/L 0.1 1.3 SM 3111E 11/12/2002 Iron <0.1 mg/L 0.1 0.3 SM 3111E 11/12/2002 Sodium 12 mg/L 1.0 20 SM 3111E 11/12/2002 LAB: Microbiology Total Coliform Absent P/A 0 Absent 307 11/05/2002 LAB: Physical Chemistry Conductance 89 umohs/cm 1 EPA 120.1 11/05/2002 pH 6.5 pH-units 0.1 EPA 150.1 11/05/2002 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. RECEIVE® NOV 2 7 200Z TOWN OF BARNS f H HEALTH DEPT��L� Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 0 F`HA �y CERTIFICATE OF ANALYSIS Page: 2 Vic: fi ` q Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-02 Description: Water-Drinking Water Sample#: M148 149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GC/MS 1,1,1,2-Tetrachloroetharie BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 11/15/2002 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 11/15/2002 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 11/15/2002 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 11/15/2002 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 11/15/2002 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 11/15/2002 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 11/15/2002 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 U CERTIFICATE OF ANALYSIS Page. 3 Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/19/2002 - Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-02 Description: Water-Drinking Water Sample#: M148 149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 Benzene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Bromobenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 J Bromochloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromodichloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromoform BRL ug/L 0.5 EPA 524.2 11/15/2002 Bromomethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 Chloroethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Chloroform 7.7 ug/L 0.5 EPA 524.2 11/15/2002 Chloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 1 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 11/15/2002 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Dibromomethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 11/15/2002 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 11/15/2002 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 11/15/2002 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Naphthalene BRL ug/L 0.5 EPA 524.2 11/15/2002 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 11/15/2002 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Styrene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 i Page: 4 CERTIFICATE OF ANALYSIS l' Barnstable County Health Laboratory Report Prepared For: Report Dated: 11/19/2002 Bayberry Building Co.Inc. Order Number: G0218041 Jaques Morin 1597 Falmouth Rd. Suite 4 Centerville, MA 02632 Laboratory ID#: 0218041-02 Description: Water-Drinking Water Sample 4: M148 149 Sampling Location: 2177 Service Rd W Barnstable MA Collected: 11/04/2002 ollected by: E Meehan Received: 11/05/2002 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 11/15/2002 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Toluene BRL ug/L 0.5 1000 EPA 524.2 11/15/2002 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 11/15/2002 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 11/15/2002 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 11/15/2002 Trichloroethe:ne BRL ug/L 0.5 5.0 EPA 524.2 11/15/2002 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 11/15/2002 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 11/15/2002 Note: Approved By: u�• (Lab Director) /a191Z00 7— Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 AsBuilt Page 1 of 1 TOWN OF BARNSTABLL LOCATION i 97 SlrAe fit.• SEWAGE# ZOO 1 VILLAGE WOLAYWASWit ASSESSOR'S MAP&LOT 21 "07 2 INSTALLER'S NAME&PHONE NO. P'� P�2� (Ac9"OL ( 5}^ SEPTIC TANK CAPACITY 15 0o go,l LEACHING FACIL=: (type)�2 ek-,.be S (size) LS"x 13.2 ,x 2- NO.OF BEDROOMS 3 BUILDER OR OWNER G VX-5 MLD4A PERMrrDATE: I OI COMPLIANCE DATE: 2 O 3 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 '�-- 3 � bey 4 :U 6 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=214072&seq=1 4/29/2014 TOWN OF BARNSTABLE LOCATION i T 7 J �/i c� �0( � SEWAGE # 2-CO 1 s l�Z VILLAGE Wts+ &,tr►L54w1L ASSESSOR'S MAP& /LO1OT 2ty s ©72 --INSTALLER'S NAME&PHONE NO. S SEPTIC TANK CAPACITY 115500 403 'n LEACHING FACILITY: (type) �2� 5-004a/. c`4,mher5 (size) Z� x 13.2�x ZP . NO.OF BEDROOMS 3 BUILDER OR OWNER AG VZ�S PERMIT DATE: 1 U 0 l COMPLIANCE DATE: J?q10 3 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 C�l JU, 16Lk G L I5Z_ No. Fee ' •' � � V THE COMMONWEALTF rP� KASSACHUSF TTS Entered in computer: _ `1a Yes PUBLIC HEALTH DIVISION -TOW14 OF BARNSTABL�3 MASSACHUSETTS Zipprication for &goof *pgtem Con!trurtion Permit Application for a Permit to Construct(VRepair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I—v'C 3"g Owner's Name,Address and Tel.No. 2-111 Assessor's Map/Parcel 0 F 2IL - 0 skc a.c. A4 n ^'gr a. rye+ In st lets Name,Address,and Tel.No. 0 �/� Designer's NaVd;lAddr"essandTTel. �+ u f. / 4?,. ��tiS 62V .QR. Telephone: 508/5410-22 4*AA Type of 9B 'ding: Pb felS welli No.of Bedrooms S Lot Size �{L sq.ft. Garbage Grinder( ) er Type of Building No.of Persons% Showers( ) Cafeteria( ) Other Fixtures Design Flow 33 O gallons per day. Calculated daily flow 3 gallons. Plan Date '0Z-ZG- ® Nu ber of sheets Revision Date Title S\T rZ 1710aU two I Foci -5-9-0- Ce t Size of Septic Tank 15100 CAt'til.Le" Type of S.A.S. �CgA44yiS'n.. '-C-"_%_WA Description of Soil Sfl✓ ��'i'CC� ���, �9\l. �.-uGtS Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to enjbs construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions o of the Environmental Code and not to place the system in operation until a e - cate of Compliance has been issued Board of Healt t k 1j,� �14 �y� Signed Dat (r�:� Application Approved b Date Application Disapproved for the Knowing reasons 3 Permit No. Date Issued ASZ7 _ `" .,7,`.y.- r.., y.-T ,:.r`^ -�r ^- �,y:—�y:, •_ a; �. ,�;_ �4; ,��,,,.E�. f:. �•..,e•�; ._�++^r.+»t..�,i::,�yt.�.,,,,�\g.5,L.,-(wld.i 1'.y.rn.ww�•.� --K"":��^e--^^ - = No" Al a .� — —� i �E � :w+: ...►' $ Fee THE OMMONWE&L-TF, N!ASSACHUSETTS --Entered in co�puter: Yes PUBLIC HEALTH DIV SIO.N - TOWN`OF BARNSTABLE MA tAC'H' USETTS ipterrY Construction Permit Application for a Permit to Construct( \Repair( )Upgrade( )Abandon( r',)`.❑Complete System Y❑Individual Components Location Address or Lot.No. L u= 3'6 _ /,V Owner'i Name,Address and Tel.No. d2 I`f 7 '`.05 c_lZ,v�Lr \�.b• l ,.w,_: .> , Assessor's Map/Parcel _ Inst er's Name,Address,and Tel.No. �� 5 �s `Designer's NaAdtrfe"s�an�tjI;el.�OYLE F .%°�i jOC �, �aa 42 --;.bury La r. 62v�1� 6 yZ ' ;:south, M7. 0; ;6 5b� � 2544 Type of Building: F[9�2°S wee lli No.of Bedrooms 3 Lot Size6_ 1 L sq.ft. Garbage Grinder( ) ') (Tther Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 33 O gallons per day. Calculated daily flow 3 gallons. Plan Date nZ- -z(.- 0 1 Nu ber of sheets Revision Date Title 0-"51-#rA_n q�:_ FOR :T&, 51�tULL Size of Septic Tank 10 �t't.u.o��_S Type of S.A.S. C1�At�'���ctL `��.+=u(-k� ;o i Description of Soil Sf c=_ S� _ � y S5\>` Nature of Repairs or Alterations(Answer when applicable) 4 1 �s Date last inspected: Agreement: The undersigned agrees to ensItenstruction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of the Environmental Code and not to place the system in operation until a e • I- cate of Compliance has been issued ard of Healt •�,&,Ui la 4Signed - Dat /I J, Application Approved b h S�� Date • -, �, -' Application Disapproved for the ollowing reasons 0 Permit No. 104 �° ° Date Issued r'"�, 0 d THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE�I _ ,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by <)a e -v-e I • N)o�Zz - `� r-- ` _ � at 1 J �1�3"�b, 1 o a_c �1 C \, q C U has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N4ZdOZ,,14Z dated "'• Q'�3 Installer Designer � The issuance of thi ermi shal g y of be construed as a uarantee that the system , 11 Date 7-y Inspector No. rX.P�7� 1� I,SZ --- r•----Fee (��-�. y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS �Dizpogal *paem Construction Permit Permission is hereby granted to Construct( )Repair-( )Uppade( )A k andon( ) System located at b7( 3_. ) Cs— `y 0 0Lc( U-J-0 Si- Q-r,"q 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. Provided: Construction must be completed within three years of the date of this permit. Date: �1 LP Approved by TOW OF BARNSTABLE LOCATION �� 7 Jtr`/'3 ce- SEWAGE # 2-C'D e VU.LAGE__ I�es� -�s-I-� ,2 ASSESSOR'S MAP& LOT 21gl . 0r12- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY IS-oo 4o.I LEACHING FACILITY: (type) La)_�ka. (size) LS,', 13•2-Px 2� NO. OF BEDROOMS 3 BUILDER OR OWNER kC U-eS I PERMITDATE: I U [0 17-qlo l COMPLIANCE DATE: 3 Separation Distance.Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet v Pn ate Water Supply Well and Leaching Facility (If any wells east 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 . A. I Town of Barnstable P# Department of Health,Safety,and Environmental Services el tt+E rod Public Health Division Date 367 Main Street,Hyannis MA 02601 enruvsTABM aU4iOlEp Date Scheduled � A� D / Time Fee Pd.J 00 Soil Suitability Assessment for Sewgge Disposal Performed B y: �e'�l 1� Witnessed By _....."'....LOCATION: :::GENERAL:;INFORMATt©N L:cation Address yr}i�,�/+� PD o Owner'si✓1'+-� id 'moo O �G1�4 S Ohl p r IGC,i�" BA� &E Address WLJ! �/ STEPHEN J. DOYLE & SaOC. Assessor's Map/Parcel: -2141 o. Engineer's Name 42 Canterbury Lane NEW CONSTRUCTION V1�11 REPAIR Telephone# East Falmouth, ILIA 0 536 m I Land Use VI Lo.11_ QDO\`D Slopes(%) Surface Stones r i Distances from: Open Water Body 00 It Possible Wet Area �-,COO ft Drinking Water Well Sl7 /ft Drainage Way D�ft Property Line > 0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) �A��LV \lam ? r�� ,�'oi \4Z ,� N -5 c vU�a 19 o t 1qc Parent material(geologic) QSv n — k►��I✓�0'4.P1ty\[, Depth to Bedrock NLI x Depth to Groundwater: Standing Water in Hole: ;/+/* Weeping from Pit Face !KJA Estimated Seasonal High Groundwater(`OXTa t= 3C DETE ATION FOR SEASONAL HIGH WATER TABLE Method Used: i�rG — t te a Depth Observed standing in obs.hole: in. Depth to soil mottles: _in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# __. _._. Reading Date:.___.__ Index Well level Adj.factor___ Adj.Groundwater Level FERCtJLATTON TES')~ natc.$. �`� Time tot Za Observation Hole# i Z Time at 9" 1 o'.A0 N tt it Depth of Pere A3 � Time at 6" to` �, 11'.tD Start Pre-soak Time @ ID=Z3 18;lk Time(9"-6") End Pre-soak \ �7a h1e0 Rate Min./Inch L Z L'L Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant DEEP OBSERVATION TIOLE LOG HoleCD Depth from Soil Horizon Soil Texture Soil Color Soil Other 11 Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel `5L 1Q�(L 3'Z �� Loe'Srz—I vJ 5-L1 iIN 5" Nr ZA, 11 t'l�� S+aN,� z`y—\f -t 3 �0 Gj aaav mL DEEP OBSERATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil I er Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. onsistency,%Gravel) 'bil_zjlt` 'LS 10 `{v- \14/STD�y I k3Z.It DEEP OBSERVATION HALE LAG HQIe# :; . . ... . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel) I DEEP OBSERVATION HOLE LAG Hole##' _ .:..... ....... :... ... a Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Graven Flood Insurance Rate Man: Above 500 year flood boundary No Yes y Within 500 year boundary No Yes Within 100 year flood boundary No .\,/ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? PQV S\Tf` If not,what is the depth of naturally occurring pervious material? Certification I certify that on 1cl%w 5"� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature V ),Y Date oz-- 5-—tiff 4AV �5 � TOWN OF BARNS TABLE .a i. c \ � . i 91 a O ... . . .A.-. <•--<�,.;,:_�.,.<...,. t?',r?�i��s�,;gT3•Ss R rem - - , 5 Sep -4-�� --- " le Idox r / ---------�------�----�- \ \ \ \\ �� SECO►.PD FLOOY. PL[�.1 a ' '�CA. ` o. r S_�, lye 6'.9• 4 _ . i - f 1 - 3 a , sT vnli ' I a'O`wo.r-w ngE \ 4vo- z.::a tj f . THK CONC.SLAB j se 9 I >01 oilI O so iL I -\ o ' ' p Q � r ' r TW WALLS ON 1-4'X P- - rHK-KEYED FM L PLY. O„ F'CIUF�yD4T10l1 F�,D1�1 �'a'-r-a� • _ � ��j t' rY.X WADS ON ►HX- .KEYED FfQ. � ism ,... - +>titti�. parts an a-3Gn — -- — ' i Mc' Q z:s • ,a ! 4'+T C ONC. 747 IN - _ — -� to �- � Q F1l C[i�tht/ti.CT' L - `4 / r•. r TM WALLS ON 1-4'X U � — TWIC KEYED FT3L C Q i 10:0' 1 24.0. I'Tf K.YYALI.:QN 1-4-X f' " rHK.KEYED Fro 1 PrsN�nitssrY plan and A Nts by i _.. I i 7 T F�e C� ,�:._.......�. - _.- 3 Gc'I PI\�sx. C..opt�tt,,:.- L��I C,Q. 5`•t s'i�'N� GcsMyo't��•t�''C S .-�--�-•---•--------� - ,G of 1 B i 1 ,2 P C e TOP FOUND. EL. �l. O / ttstone __, •+ .��•, -.""�.,��"""�.•cw2r�•.,..,•.•*�.,+tptew,.,.... .,�.,,�.�•„�i ...�.�„� +t-,� o __ aZ 4 �.� Inc_c t s rti .• ,. _ wAIVP ncr1l cow_r1 fA x 1�I. - - Total Trench 'Length Z S� -i•'! Trench ;�dth- 1-1 2" lYa.shed Crus ed Sirly. EL. 'i :�' "° ! 3/4" 1-1/2 n'eshed Crushed Starve ( 3 4" / tone -- Fl..OW LINE _ _._^�.__� __ To'MIN. 1 ..-,. _._ --- + INV. EL. —s � PROF SCIO , A. S, _,INCH SFC,'7ION a i ! INV. tl_. �rl. _.'_._ J w .L pog 00 J � c=-� o �� r� o c� o �,� SE --10 MIN. 11� UQM DEPTH j __.._... INV. fa_. r ' rTO.Q �$vo j as WATER n' rrnj. �.1. _ a ° c� c a c� o cam_ o o FI 4$.4 TOWER o SHOOT FLYING HILL RD, EL e - a INV. Z1,0 N F a o fi Trenches +0 o N f ' WEQUAQUET No. of ,500 Gallon Precast Chambers �_ 8 ' LAKE. � PRECAST RE-;?•ii=ORCED CONCRETE 3114" - 1--1/,2" Mashed Crushed Stone---' i50© GALLON PRECAST REINFORCED CONCRETE SEPTIC TANK u;STRIBUTION BO'/, LOCUS MAP SCALE: 1" = 2000' I PER 310CMR 15.226 2 INSTALL ON A LEVEL BASE MINIMUM CONSTRUCTION MATERIALS O MINIMUM WALL THICKNESS 2" TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND " E FLOW LINE i _ SHA LL E3CTT-�D A tr+liNlMUi�A• E,?f' 6. ABOVE 7N MIN+1v�t.In i,rSlf�L DIMENSION - S2 F ' E SEPTIC TANK- AND BE ON ,TME CENTERLINE OF THE I O UNDER THE CLEAN—OUT• SEPTLC TANK LOCATED DIRECTLYoU P ET fiNVtRTS SHALL Bc. EQUAL •CU EACH i MANHOLE. OTHER AND AT 2 MINIMUM BELOW 0-11-ET INVER F. PIPE ELEVATION.S14ALL BE NO LESS TT'iAN 2" NOR 7i-IF DiSTPi13I 7,Q,"1 LINES FROM THE DISTRIBUTION Sri THE.INLET SHALL ALL HAVE FauAL INVERTS AS DF-TERMINED .Bl'. FLOODING_-kIt?RE TITAN 3" ABOVE `ME INVERT ELE1tATION OF THE OUTLET PIPE; TI-IF 0,1STRIBUT ON BOX TO THE HEIGHT OF THE DISTRIPUTIO`J -->' - LINE :ITV I3? hr FR ALL LINES !1A`.�I BEEN SEALED IN.PLACE. } TRUE T GRADE INVERT :4DJUST7;`;EIdT5 SHALT. BI MADE C3Y FItt.ING 'MTH DURABLE SEPTIC TANK SHALL BE IN STALLED LEVEE AND E Q AND NON-DEFORMASLE MATERIAL PERMANENTLY FA aTEND TO THE I ON A I EVEL•STABLE. BASE THAT HAS $I EN MECHANiCALi.Y LINE OR RE=is RUcnNG THC LINE, UNTIL ALL INVE T S ARC OF COMPACTM AND ON TO VMItH SIX. 1NC`HES OF 'CRUSHED. STONE c C EQUAL ELEVATiOr�, 13AS HETI' PLACED TO ENSURE STABILITY AND TO #PREVENT __ ---------- ... ---------- Av Access Utili ty Easement edoe of va ve _ edge Ve _____ SET1t3NG. r- ==- - __ ___ ________ _ _ _ _ of `aa - ________------ ------- egkT' _ of a G'BEl. `12235 _ -Lr _ -- _ - _ _ _ - 1z� � � - _- - -- - - , `---- COVER BM,• Top 116 _ _ 6_ -.1 0 1�¢ �. -- _ OF 9 - - --- 51;PliC TANK SHALL HAVE A MINIMUM _ - - _ _ _ - - - - - - _ - — - - - - - - ---- Da tum' 'NGVD - - - `- _ lIg � \ � � - _.. r / i 150.00 - _ / / , - _ _ _ _ - - - - 7M READILY-REY.OVABLE. IMPERMEABLE rj� ._ _ - _ __ THREE 20 Matoi, s w1 s - _ - - - _ - - - - - -DURABLE MATERIAL.-SHALL BE PROVIDED WITH ACCES ✓ X 1VgB 1 ` sue \ 15Q 00 — — _ / f/ 116 116 PORTS BEING PLACED AT THE C£PiT R AN OVER THE INLET AND O JD _ �O '". �. `- -- _ _ — _ _ � . ��. Bj . \ . I�'4 150,00 / _ 114 V OUTLET Tls. 1 , _ — - '' �. �,•.. , , 22 _ _ _ _ , , 1 _ �--� WITH GAS BAFFLE. — TEE SMALL BE EQUIPPED �t _ _ _ - - TriE OUTLET _ _ — 1 y r - _ _ - - / V �.:.. _ 4. IB j ✓ .1 _ . _ _ — — . .;o � Irk, _+ — 0 104 �' ✓ - - - - - - - - - - - -10 I12 ►�'� i D �. z' _ _ .. - ✓ _ _ _ _ — - - - - - - - - - - — — - � , M o B �! A` 0ONSTRUC 110N ,'COTES � _ .916 r y ` _ r _ 6 REPLACE SOILS NOTE _ — -- ,jyr (/ -•� .;. .— to -' 1© " " WORKMANSHIP AND- MATERIALS SHALL CONFORM TO D.E.P:._ TITLE 5 9�'/ ✓;, ✓ ✓/ t - - -- - -- -.-- -`•u'8 ,9p `` o to 1. ALL. ,'VORi�MANSHI _ _ — � — '2 O _ _ T. RULES AND REGIJ !IONS FOR , ' }� ' ✓ r _ 6' \----,�- _ _ - _ _ AND �THE TOWN OF yrr s RE 1.01 UNSUITABI,.�.' ,S01I.S 17TV FEET .C, T RACY 04 10 , ✓ ✓ slxr- g _ F WAGE. THE DUTE'R I'E'RIhfETER S ✓ ✓, / , ,c�`ar - - - - -- - - - __ - 84 �� t-- - --= ��oy4 6� _ THE SUBSURFACE DISPOSAL 0 SE IN ALL DIRECTIONS REYO.r'VD _ _ - - - _ _ _ _ _ _ _ _ _ - _ - 90 OF T1IE SOIL ABSORBTION SYS1EW TO THE DEPTH OI' - �, S `�H ALL 13t ACCESSIBLE Lt. , �-•------ _ _ .,� - - ?_. AT LEAST ONL ACCESS PORT OVER TANK TEE NATU a.y OCCURING PERV OUS ALATFRIAL AS RE'QUIRI,D � Qr� //^ re FINISH GRADE WITH ANY REMAINING ACCESS V h'F,.1,rICF,` Tf7TL CL�.'�i1�r.GRANULAR � _ _ _ _ \ - _ - r�IIITHI;v SIX INCHES OF $Y 310CIv& 15.240 AND f / r TWtLVE INCHES O 'FINISH GRADE. r ', {' r l E t FR OUS d ✓ f / :� / / i / / - - - - - - - - - - - - (916 r-ORrS BROUGHT TO WITHINSA.RD, FRLI.' IRO�tiI OI�C I, IC �f�i7TER AND I,iE'LF,T� I 1 , v / , / / \ _ _ SU.3STAlV CFS- _ BE CAPABLE OF / 7ALL r^ f TS OF THE SANITARY SYSTEM SHALT_ - I00 i l I i l l _ - - - - _ - I SS !f-I,E Y ARE UNDER OR WITHIN 10' � ✓ / ! / Z077 ?0 . ,/ -�v►� ...o 1Vill-ISTANDING H 10 LOADING .1NLE ^.-� - �I R OR WI N ✓ / / 1 / / ! r _ 84 �> ,aat,_ OF DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER Q4 '98, � ✓ / l ` 60,g� � � 66 • � � � - Alo � � r _ - 6 � 9� �, a 1, 60 10' OF DRIVES OR PARKING ONLESS NOTED.' ti ✓ / // I ` sQ;f a - d,� _,� I� o`s�'a• `8C' '. `�° _ �9 ✓ \ t I I / O , � moo � ` ^— _ \ 1,I✓ -�80 r , .P710 4. T NTRACTOR SHALL VERIFY THE LOCATION OF ALL �} �6', � - l I � •�'J — � � � � � r. HE EXCAVATOR/CO , \ / ✓ �� I I I I I �.0 S0*f _ _ *� ', U ,q ?g 150�osed SITS_ UTILITIES PRIOR TO ANY EXCAVATION. o • / I I I 1 I I I r lam- ctl •,, ..,, `: _41 - - !Od ` � / -. f✓ �Bd-�' ` I 1 � I t I 66 0� � ' l 9 �. -' ° ... ;,;. '� "?• �' � � 6 h- _ -- 'y�" 74 5. SEWER PIPES SH ALL BE 4" SCHEDULE 40 PVC LAID AT 0.02 SLOPE. _. _.._ ... os t t I I I �. Alp 6 1',� o - - Zoning District: RF / prop ';9 Y . \ a I I I t t I I I ✓ rOOAo eQ, �. . �� �? e soil I 35 a G$I ✓ - _ _ > %O. ,� -- - . HALL BE � I I I I , � $rl �1 sue_ r 0 erlay District, GP 0. ANY MASONRY UNITS USED TO BRING COVERS TO GRADES ofsewa e system the are D • I t \ Nate: Should soils be encountered during installationg y , N PLACE.C`, 0 0 i. �' t t r ` 6'sr f - ? o, � MORTARED contact the desl er andlor our local Health De rtmcnt t of consistent with sail lv s. � y Pa ti ..� t I I I I TO � ✓ 66• � g ti BuildingSetbacks PER FOP be fore proceeding.g. .� � sr I>A� s� ` � p r Res > :� 7. ` FINISH GRADE $HALL HAVE A MINIMUM SLOPE O 0.02 FEE i ES� - _ e8� � s � �. I � � � 1 ` I r / �� Front.—�0 }- r o s Side-15 /r/ K 22 6yr r A I .. � o _ -- , - �� , 4 \ _T s.2 �:S r r ��• Rear-15 6�1 � r 84 Assessors Da to %A - <91 J l 8D �° FEMA Data: Zone C - _ lane Soil- _ \\ _ - 5 _ - - -,� / I \I \� �� B� // /5651 199.14 , 175.34 roP°Sad- S•tL _ 1V851B 40 E SOIL OBSERVATION DATA: '�'� `1Z� 6 - - - - - - - - DESIGN DATA. _ - - ,EST DATE g .Z{v"al°1 STRUCTURE Z7w1 �•t r �i _ 1^D- _---- ---- ----- TYPE NO. BEDROOMS GARBAGE DISPOSAL �� - -------------- -- - SOIL EVALUATOR s _ _-`_-- ________-___� 181.81 _ DESIGN FLOW s� wo �>?- , _ __ S6518'4O„W B.O.H. AGENT 'Nl Cape & vineyard Ele Easement -� SITE PLAN OF LAND IN P�"RC/RATE G "Z" ����, tr.�4�a. SEPTIC TANK y L btu 4- t,L12&t rt�CLr�S�" i 4 V - T'irE-S' 7 BARNS TABLE - t Prepared. For.' 1 ' are _. Ott LEACHING FACILITY tirtH OF w A sIr �o ��z I..- �'' '''s.� _ BA YBF,RR Y BUILDING CC�IIIPAIV \, t + , �, p�OSSTTER `rJ� .STErn�I� Chip` - ti ass, Depicting J -t h . -�� c GRAPH ��n ,� wlll►nM. �t IC SCALE + I 7 ti ...... . : .__ � LIEBEaMAN r f� C'7f'.' u enr► 40 0 20 40 80 160 - 0- Z3 ,, .;�1 '�o a�aTea ��wNMI Scale: As Shown Date: 02 26 01 {I I . . I �� ..._• ti`,;;�,,,,'•-„, " ( ti+t �,>;"1'') Prepared By: t, Stephen J. Doyle and Associates 1 inch = 40 ft. }} ( r4,2 CanterburyLane, east Falmouth, MA 02536 _ Telephone:. 508/540--2534 .. F 0 0 Tc i 2" of 118" - 1/2" Peastone--� } � TOP MUND. EL 8 5 r - 3� ��AY_ C.avr_n Z�erez S�s•r t� Goy--�?cs�at�eiTS a e r , Trench tiridtb kn-! as - - )fasberd Cr ed Stone WATER TIGHT COVER 3 j¢q 1-1�2J. • 7cta1 7`ie1�c1� %ength zS SECTION z• I.�L TRENCH �.E' r • : S.A. S. TR PROPOSED - � � .�5 � I ,1,�� -- j---1•�,2 �Yashed Crushed Stone -� - INV. FLOW LINE tl 4?Jo.o o 14" INV. EL. so'-10 Mitt. 6' / o p � c� �+ ' o p c= c� r� c� : "1't,y O UWD Owl t INV. EL. ,ao--i:o JEF:Z INV. EL .o a No. of Trenches t f 1 INV. 1=1. 60 1 V .L `iZ SRO - • No. .of 500 Gallon Precast Chermbers � , - / i A.Z3 , K. u< .Z , ��TU►trD� \ , X t ZM 3 4 - 1-1 2 Ireahed Crux tea Stone PRECAST REINFORCED CONCRETE - \ I o� DISTRIBUTION BOX ed88- \ •:: "�}, 1500 GALLON PRECAST REINFORCED CONCRETE SEPTIC TANK INSTALL ON A LEVEL BASE REPLACE SOILS NOTE i - WMN CONS1RUClN NAIEAtS PER 310CMt 15.228(2) MINIMUM WALL THICKNESS 2 REMOVE SU ITABL ESO IS FIE FEET LA IN ALL DIRECTIONS' BEYOND YTff OUTER PERIL=R �e�t \/' 110 1mr $HA• Of SCHEDULE 40 PVC �D MINIMUM INSIDE DIMENSION — 12 + $ . OF. THE SOIL ABSORB770N SYSTEM TO THE DEPTH OF --- "- Ut#�t� use `� ~�'•�••• ; \\. '� 108 tt� SHAi t. EX'l�trD A httNNrt OF �" A80VE THE Flow t.M1E NATURALLY OCCURING PEKVIOLTS 1[AT TER AS REQUIRED d \ , i OR THE OEM TAW AND K CN THE CENIENLINE OF 'ME OUTLET INVERTS SHALL BE EQUAL TO EACH ale r ss an ,55 ::• x:,'• 1 � � RD SIP11C TANK LOCAWD DIRECTLY UNDER THE CLEAN--OUT OTHER AND AT 2 MINIMUM BELOW INLET INVERT. BY 310CMR 13/240 AND REL.4C�L' A7TH CLEAN GI�4IYULAR p--'' cce 87 �. aANHOL SAND, FREE MJ1 ORGANIC "MR AND DE,t.E'TERIOUS °i sea A 2 �' THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX dI� prbPo ; lo, d 1�jaQ 106 wAT'R '1W "Er PIPE UVATIION SMALL. K NO LESS THAN 2- NOR SUBSTANCES -'`' -' se TOW SHOIDT FLYING mu RD. SHALL ALL HAVE EQUAL INVERTS AS DETERMINED BY FLOODING j08 -,,.- ..r -�, �•O� ��� c'` � I+IOAE THAN 3" A9011 TMt: MlVERT ELEVATION OF THE _ THE DISTRIBUTION BOX TO THE HEIGHT OF THE DISTRIBUTION ,-• /' _ GB O� DU1tET t'IPE. LINE INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE. ,✓�'-toB \\ -- INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH DURABLE .•-' "�;•• \ ;:.•• ' l AND NON—DEFORMABLE MATERIAL PERMANENTLY FASTEND TO THE - 100- .�.;... -,�- _ _ 1O4 \ as WEQUAQUET - T TRUE T GRAD R CO STRUCTING THE LINES UNTIL All INVERTS ARE OF ;M ` ,. � l9E IWS"1' t.EVEL AND 0 E N OR E N U ........ _S1EPIfG TAW U E 00 -X:: SHALL ALl4ED - a - U1Kt: 5 0 :w _ 02 ON 5Y BASE THAT HAS ti�lANtCAt.LY EQUAL ELEVATION. _ A LE1�t. ABLE E - _ -Y- O f COMr_AIC'tED AND ON To tirFW MX M CM OF CMJM STONE ek e, 120 114 ' ' �'� - - _ - - 8i8�-- -- - - - HAS OW Pt.At;ft-v aftiRE STAR Y AND TO PREVENT ,� j16 . � ' %� - ; -;: " - - - - - L0 LDCM MAP SCAM 1" � t000l T5 sET1tJNG ,� ,� .. .- _ g8 _ _ - ge 5 Sq. _ _ 118 r � ' Joe i ' -i ./. •:::...•... --ram SV.ter TANK .SHALL HAVE A I�INrtllb COVER OF 9w � '_ ~ - / 08 g8�,-',98 � � Note: / 110 . 1 102 + ' 4 ,' " B8 . \ i / 1 that are / 9 in installation � Tt•IRFE 40' INS M, - Health li i1 YlEA[3LE Should soils be encountered during sewage syste 112. _ MATtH ACCt not consistent with soil log,contact the designer and/or your local ,,-' l 00 �� �i �' ' , 104� S P011T5 �I 1P JID ) 11 P1roP° '��'1800_ Department before proceeding. r / e2OUTt.Ef TE -' i� r , i / , �. y ,' , 104 , 92 71on = t b 1 \ 1W oun" TEE SHALL 91E E "'M GAS RAFt:'t.E. � ' � . ' r � , � 85 r r 90 , ` , I , 1 / -- — Unde 0o .1 ^80 .� \ r r r r i / \ . cbw 2 d r / 98 1 / J � J i r P 9`f�1 3--30-00 124 122 15D0.'�'��'r ' 8 •'�\ \ - �, , J<rJ •82- ° F � 150 ° \ pop / 1 _ _ e OII r i -. L 1 ✓Cs r r r 8 f , BJe s General Canstruchon Notes try - z�tN, .__.. - � \ \ r1. 8 a• . ,; , • '. .,, . 18 i — — +-�-- — i i 8 ! \ 6 1 � off"" , 1 worlananslu and materials shall conform to D.E.P. Tine S and the Town of o _ • , f / r 1. All the p - � � . r � � 9 - •� . �• --9'0 - / 1 _ t 114' � � � A.S 1 /1\ L. N L i ... t — Barnstable roles and lations,for the subs�faae disposal of tt. �► o^ti� 5 `! 'sht ,� J 1►elj _ _ 1 / / 50 g4 / 1 i — / •J , t7,.77� t.S _ 08 8z .. 8e / $ ;. LIP -� 1 s - _ � hal i e withm 6 niches of finish D �; / / � •oa' / ✓ _ At least one axes oven tank toes s l be access•bl �,.� >;� 1 � y �f 4 d 4 - 80 With remaimn access its brought to widiin 12 inches of finish e. 10 1 , _ - _g4 / - _ _ _ _ e4 09 ,t L $04 r v 96 / 3. . All components of the sanitary system shell be capable of withstanding H-10 loading � ! ► � - _ - - _ 80 8 � ✓ •r"_.. , � .s: unless are under or within 10 feet of drives or n H-20 loadm shall be used c q z Ct " - 7 _ _ _ J. swv ` ' / 5, under or within 110 feet of driven or parking unless noted. tZo r , J , -- - - - r - - _ ' , 88 i ..74 BB 84 4. The excavator/contactor shall verify the location of all site utilities prior to any �o 14Z" Ta „'� �'Z 0 � •\ Proposed excavation. V.�/�Tt=q.► 'f 1 _ _ -- — — `—may.! - • ose , / 1 5. Sewer pipes shall be 4-inch Schedule 40 PVC laid at 0.02 slope. Denotes prop 6. Arry masonry units used to bring covets to grade shall be in place. of Breakout > . _78 ' ���' - - - /� tf- S t �j porn - - Q DenotB8,• Lot:) -78 � f, / � 898 $ ,tt. 7. Finish grade shall have a minimum slope of 0.02 feet per foot. _ _ _ _ -741T 3BE/� .�Ol2iIXg DistriC> ', RF 82 LO •-70• I ggat• .gl.(,. nx,sY �P�•»�. q 60,1 Overlay' Di9trict.• GP _ - 68 aj ' ' r 88 _ t t �. ,40'E BUUding Setbacks• Fron Side 15 64 �� i Rear 15' DESIGN DATA: 1 tl t I 14 9 SOIL OBSERVA71CW DATA: /,y i� 3 r v t I t I i9 °pt �a o FEMA Da to: Zone "C" I� sTRucTu .._._3�yt•\i� I t ► I . GARBAGE DISPOSAL88y�, TYPE N0. BEDROOMS 1 1 16LSIF�fp " 1 t t40*� ' tG STEPMEAI DESIGN FLOW 3x.\, e .. •mac s Z,7�C- I l �� t . tX�YLE TEST DATE t3-Zti"q°� CA 1 I S� , I • ' NO.3?5+gq SZ t e PI a . X2 ; SOIL EVALUATOR s• 31 Lr I I 'C?i I t , •,,No 2e+ � � ;e Premed , B.O.H. AGENT `N�a'i',, I 0 St! : . SEPTIC TANK �er�i.tT- �r BA BERRY. UILD.LNG •V 01�P1N ' ' s �z. o� IIIu PERG/RATE G Z Nt\p. »a�l�► LEACHING FACILITY West Barnstable, a ss ehuset -. � • 11rtt�N1111 sG NO 0' oilIto �97t DAMOM LOT �. St. Vt tt s o.'14 - h � h sL �o R � f .{ Scale: .1 = 40' Date: hme J2B, 2002 SL ZA�t '$ SL loy ti. (. i zg �'V Prepared �" W S hen J. Do a And �osie tes to P YI M�o No te. 'Y"` ae E Palmou JG! O G (., `4.1t� 42 Canterbury La This plan is a revision to the Telephone: 506/540-2W4 o•.>'+Q z.s•� `t�3 s,,,,�t, z•,-�S' 'r�3 ',Site Plan of .band bn 11'est .� vets i o rz $1 o - _ cep._cq• �•z`' ,��.-��,,` r Barber Barnstable, Prepared snot o �+► ct, �-� \4�AA W-` Depicting Lot 3$ - Da ted 02/26/01 Revised--05116102 a,ve -� =Cicr_W , NO. DATE DESCRIPTION BY Asasessors Data: Z-1A-w i i ,.._ n '.'Y .. . ..lr ..m..., ... r. _ r. .f.� , a. 4. .•. ♦5 �* n... ,e � , ..s• -,:r: .. .. _... � _..... .,...._rf ,.,.-:-�.- .»-- ad.-.. a , ..:�'" r:,•: �a �.. ,- My.rift ,..<-! <'- �;:.', Y. , s i b, t .v „ t � , r ' J� p -�� � -. `✓ r _ ( ._ �' _tcf_) _ f _ +dr>✓ r.�1f/� � rj 7- ADO t MID FOUND. EL g� , � ,—__....._._.-...._._..___..___ •Sr� �AaB-'!.. c,.,..,�s.�r��-' c?�<.ct'��x_ �"�`�5�t•� t;.....:ot-'���'G-?aC`ct-�'i,! --_ _ ___»_______._,; a �' � ,�m11be, � ZZ t Y wATER 11(34T WI.,tRf 31 s4 r _ --1/12" )Y'eshed Cr ed Stone ' r FLOW LINE �{•- -- "` aria.,_ 1C �M►. _.—.__yy,M�—�� 334V. EL, $Cs,""4o ,r'�� � . 8" � `—`_�...__..._._.____._�.,�,�,�,.� J.,, ..�.,_. � ' -.._.,--_--�-^1'--•--�- , ,_.,_�_._„�....-.,_�.. ;; �f"` ,-s�_..-...-_._,._:€ ,,.:...��.1�:,,�� J'�-.-•r�,^,l'4` �am� A•. / TAip 1'6 C _-'_ /!I _.-_.. L > d,t j�, +:�1. _,.e,:.�<-a � �'t r S".- �.rx,"•°1. d 'f x n•n..Mw ` «l L +r"++"- f •4 6,t � , i i�JV. r.�.• 'cam--Lt? r � ;-1Gt1h3� INS EL 80 > oof 't .t} 1 Nro < PRE CAST ./•r•�� td `_fit' 1500 GALLON PRECAST! REINFORCED CONCRETE SFPT)C T"AN�' x ter} �J}s� REP rPl'Af✓•L'i SOILS N 1. „t iNSTA�€L A LE l,• BASE - .� -•'"`•-� /� .�'- w SOILS -Y 1 f 7 .T. .':.r wry~�'. i•.� 1. �' w I MV*" MAT�"� t� ,� 11,226(2) st�at+�UM WALL ,141 ,i�I IESS � r" REMOTE UN,S''L��',�IBY �`��,IL r�� ' �'� 7' .� 'E'��?,4. ,_ ��. ?E.S ' l .t. , N 110 MINIMUM It+t'S{a'3,E i�WENq-5 0�' E OF TAW 809,SHOU +A OF tr � liter FLOW t E: INVERTS EQUAL O A NAn � Y Cc't='�,, i PgmouS' .a.�.�, r��' 1��� ,• t .. � ,, �� � � C TIC E t�l1 ti= GUTLETv Arc T Eve .. - 012tl . :. 0T14ER AT � MINIMUM M-OW itk r F•RT. R 31O 1AR4 ND .PSLA , CLEAN - ' �°�� � � 9Wft TAM( LOCAM bl!WC"Et Y 7 CLEAN—OUT � - - - A �. THE etsTRIBU'll(V LINES FIM T 01STT ft1 TION BOX �SAND, edge..,- �, : pro ,' cl, I�Qo 106 t� WAT>rR 'SHALL ALL f�1 lE EQUAL 9 lE1?TS _A D s" P#N F�! SCt3t# C " �: 'I�St ":�C ,'' j®6 ,� _ ,� �p}oft) e r �. R .,..._ + SHOOT FlUrIN' WILL RD , ?lam,. OUT PIPE S K 140 LESS �r�, � ,� 11 tin MOW M DIS?Rf�3tJTi(d+3 BtIX r� TF#E !�tGHT" OF THE D6STRIBUTIOA « � T ! 3* TM lletT nEVAIM OF Tl'tE 1 aUrlt~T l E. LINE �1t�dERT AF'� ALL LINES HAVE BEEN Sc.,ALM IN PLACE. .�- ��G �'"° s 1 INVERT r�Z}.tl{S1� T5 SIiR#.L � kiA� 8Y PAC T� DURA " � -_ ANC? P�fiON--DIE. A -�»ATE�At �'�n�A EkJ�F:Y F�STEA 3 TQ THE _ r ... - ' ,�'"'^.:. 4 ✓ 'tPE{3UA{�t1Ei SEPTtC TAW $13JA}A 'Si'11R.Et9 TR 3E TO GRAM Llht£ t7Ft ficECOhSTRUIn C THE LINES UNI'M ALA, s�d`�,Ftf8 A€�E t)F �'- 0 -�`` � _ ._ _ E -µ QN A tM1i t. 8h9 1�fAT NdeS r EQUAL ELEVATION. `- � 1 _ _ of - 10� 120 M Ttl ,f8 - ,,E ,- .�'- : ;' `= _ 9 T Wals M" SCALE`: l - MO y �. SETUA& SEPVC •C W S1iAU. HAW A � COVER O S" - � Note: --' lid . i MA Y miM o . S3 c uid soils enemptered during swage system installation that are � - � Wit:; ,got consistent with s+�jl log, Writ t the designer and/Or your local ..-- {`�.t�t3  ; , 1 :� �r 104 ll o�e� - f�'-`'.� � AT 1� Aat3 .- z , i rprop t l'R:@i Health Department before pro e lirtg 100 THE auvw sm&L GAS SA T G. . - C j '� .< r:�/ r �,r r r.. ...,g•""'y .^ , '.✓ .i ,' /' ;s• j - .,,'' ✓ .. +� ..,. w "'.•. 9 b-+e �� .fir +�'. J.M1a � \ • -�--•-'••�--,.-•,.•_,..,_..n..--'"� - f f„ _ f r r ./:, i4a.:;,Mt -. .- s f,, � rr _ � f _. ' .r. '_° k"V`�ts@',x'-�•°..:,�a _._ ',... ''"` .,.+ c.«rkF:`4it'a� +'" '�'�^ f ./" .+' -- ,�'•Y`I,J , ' r a,.. rs .t J .._..L - ...__.G,�._.,.,. y ' - ,- - i R , lion _ - t R 1l@� l , r `�¢r ��arar�g F� .r'}+ ra F,f - (/as :. General Construction Notes ` °a� 2 I r�6f 1�1I„e-. $ :r' r se ,r �, :'- ,•`r ,F,,.r.,,,,, -�� ! � !, � � .. .-. _.- �1'". __'^ ._. .e. � � - E3 - - - rr f �f ,A� - r,A,. t � ,F r,,,�y 3ws" �}-�'" ."`a4 "+ ,' •+' / ,i �.,,. ,- * � ,: .,.<.,r.-.:-..-,. r�ir],�sa�t -/. `�'�, •�'�� , _ .� ._ •_ _. '4..7'.... _ f,,c-.Lf� qa ��..'. r� V -i r WkI TM"1 g Y {F � � �� „"" I, �, a_ w,,, / y✓ � .Fe� d3 �rR f ,` -._. ..._ _.. ,_ .. t. All the workmanship and materials shall conform to D.E.P. Title 5 and the Town of ..� � � _ � � �,� �� V -- -"ifl9 � �..,,,,. t ,','4". j s�. , •.+ - - r ""- ! / !' �r//.. /r �:...e&..Y J ,? SGq r! F ! ~ �•< �' ,-• / #!r` ,,:• f ,,r f .1 n Barnstable rules and regulations for the subsurface disposal of sewage. . A �% • 1� �. � '�. -..� � � pfs31 � � - _ 9® - -- _ _ _ y+ �- '* " ^Z-fils i,6s ,�^ t ...: 1 0$ r/iT r (IG, ,r 4 "� 't yg �. " ! 1 _ ��Q �/f / ✓/r j t` W66 2. At least one access port over tank tees shall be accessible within 6 inches of finish grade, ,, ., 1 -- (' 1 �. , .£ 1 !' -- f with any remaining access ports brought to within 12 inches of finish grade. 98 1p 10 r �'I +r ' ' N - ga 310 - _ - 3. All components of the sanitary system shall be capable of withstanding H-10 loading _ _ - -- //++ s ! „ ` k , , 76 unless they are under or within 10 feet of drives or parking. H-20 loading shall be Lmd :14 � ; �' t 166 �..►� l a,�;� .t` � _ � 'r! i' ; � � �� � y � - _ _ _ - -- -- - � _� �, .- 70 under or within 10 feet of drives or parking unless noted. - - , _ _ ,7 CA 4. The excavator/contractor shall verify the location of all site utilities prior to any �`~- t -►�o� �� v .�r��. --�-`� '" �� ,' ` tz°mod�` excavation. ^...-,�• .,' �^' "` � ' � ' _...' P _. __ ,•. -{ .. _ ( �r'` -. � , 5. Sewer pipes shall be 4-inch Schedule 40 PVC Laid at 0.02 sloe. , .oate' ` ° j ` `� -' , <cl 60 5. Any masonry units used to bring covers to grade shall be rtsred in phwe. re `.,gut 1"' 7g ' �° ' '• > 7�1 f o t o P f F r- 7. Finish i am of 0.02 feet r foot. °f" V- _ -_ t 4 grade shall have a mm m slope lye ` ' ry k .-' , J Y �� � t g ryf f /! r yg ddd r "? 4 r r -' G�.7�ZZ :" �" IF- _..- f�� '� /.µ{ � yp�y i � � +� �a. G'�``rYi'", �..�.3'a!'�'�G� P"'69�k�+8�'$�. �•�tJ+ � �. � � e� iii 4��r«.....///�::� A ,�AP�i'��� � {�r•� f; � , (� s"'`�p� Omrldy District: l 66 N," Building Setbacks: 30 } e 15' } i m+� ° DES04 DATA: l SOL OBSERVATION DATA: � � � S'tR'4?�TlRE �, �4 „ :�.- _. �.� " � � � �� ��r�'"� �� KMA Data: _ . ._ `��ZQ►, T GARBAGE DISPOSAL 7 s� .,•s q OCS104 FLOW TEST DATE h, SOIL EVALUATOR _.. �_ - t B.O.H. AGENTSEP 71 -T ♦s® x „ 'r.+!'Al.1RA_., ."�a•-' ` ' ! '�'""''^7. `a� .J $ I F I"_�...,� "" A i' a ,...._+n.a•.•...._ -=,.,_,.w.+�+ -'� lei°°ti`n'� �. ti w n!'+a.. J' 1 �. A _.^,�_p-{�_'�.^i..'.." �j'f:jf� {j�'`♦ ] d i/fT . rL J,Y.L ✓n y PrRC /RATE G i Z 1Yl%r,► . \1JL�,1F ,. 1"n b Jos {, t'� r�r - r �'.r�,;�� .,i.� �f .tom /d. S 1. tt 3 Al •i ♦•r e Stop Z Do #,.. 42 n tel-bur�� Vie- APiRi raou t i� P1 i p This plan is � re f�1�1ox� to he . `„ Tele -:bone. 50t�. -40 Site .Flan of Land I e t Barnstable, J.�LI`S �,Z �'�a+t'eC� 9,Jf" Bapberr7 Building Comma � Depicting Lot f r Dated—0 ,,1126 01 Re seC :__ 5114 6, 0e Da�'�3'.,',