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HomeMy WebLinkAbout0179 BOULDER ROAD - Health Barnstable A 038 No. ®(7 ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in compute Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitation for Mtopooal *pgtem Conotruction Perrot Application for a Permit to Construct( . )Repair( )Upgrade('Abandon( ) O Complete System O Individual Components Location Address or Lot No./7q Owner's Name,Address and Tel.No. Assessor's Map/Parcel `" Inscta�aA/er's Name,Add��drees�ss,and el. o. ,� / De'ssj� ignneer�r's��Name,Addd�ress and Tel.No. � 410 e of Building: TYP Dwelling No.of Bedrooms �3 Lot Size -A r ' sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow P gallons per day. Calcu ted daily flow 1336 gallons. Plan Date i Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is u Heal Signed Date Application Approved by Date J t ,4/07 ZDl r Application Disapproved r the f wing reasons Permit No.2�01q— v.,Q� Date Issued `f 30/ .x 2 /00 No. C�V I l Ql7 �, ° Fee ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-- TOWN OF-BARNSTABLE, MASSACHUSETTS __,_,Application for Mi!6po!6al *potem Con!5tructiou Permit APP hcation for a Permit to Construct( )Repair(( )Upgrade({/Abandon( ) El Complete System El Individual Components ,�� , Location Address or Lot No./?�,/�j��f Owner's Name,Address and Tel.No. Assessor's Map/Parcel 2� Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. Type of Building: {�� f"/ Dwelling No.of Bedrooms � Lot Size -1 `7K sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow . 1119 gallons per day. Calculated daily flow°-t gallons. Plan Date i _ a�I/ / Number of sheets Revision Date ` Title --" ,. Size of Septic Tank Type of S.A.S. Description of Soil .fit/I % t,/�f•��t ��'`�„ Nature of Repairs or Alterations(Answer when applicable) �f Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5j of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has-been is%eed,,Uy thi Board'of Health. Signed Date Application Approved by Date 3 q 1 Zal q Application Disapproved or the fo wing reasons Permit No.7�i�W--?JA' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,,thatrythe n-site Se a e Disposal System,C�jnstructed( )Repaired( )Upgraded(V) Abandoned )by G.�' J AY,,s.. at 1 q AVU_ G 02qv has been constructed}in accordance with the provisi ns�of/Title 5 aan)d the fo ristem CAon�s�ction Permit-No. 7©I q- /6( dated 31 u! �!r-( Installer/ ! ! k/ �AX,-Designer � r� The issuance of this e .' o be construed as a guarantee that the syst ill funcf�'o'n a des g�ed� Date r Inspector , WIT / _--/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mtgool *p$tem Congtruction PeClutt Permission is hereby grnyted�tp Construct(f �Re )Upgrade )Abandon( ) System located at (G and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of tris pe t Date: 3/y��/y Approved by f, — TOWN OF BARNNSSTABLE f LOCATION 179 60Uu &/W SEWAGE # %ll—o` Vrf,LAGE M ASSESSOR'S MAP&LOT ® INSTALLER'S NAME&PHONE NO.. SEPTIC TANK CAPACITY IDDDC� �2D5J � � �� LEACHING FACILITY: (type) Q� �aize) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 6n c'), CA 04 T� y FROM :down cape engineering inc FAX NO. :15083629880 Mar. 18 2214 O8:15AM P1 T.own of . armt-able, e, r y �f'i..n cp `���D�llt+Y3 �1�. �iS��l y .LL9'1L111Q�B�� a ELpniItSE9:dL�, +� . per ? blic�1Temith 6 Visio n uUms 1 �c�a��t,Hymm ,ice. Q:,Ti�r,}: 508-862-4644 Fmc: S09-790-6304 LaB,�Bi�Il�.Y'�c�D(�j 1C�1' A hfi.fl:�$b�i0.11F�Y�l DatLg'- f ! e Fe,yrmnt II er, ,�OOA p, ��• M r42 o k`�- ►� !�'l� �aa� �cn� �� wsS issued.a-per�rt to install a sr ptie ;ystefrn at ,! N• �"`" . . _bared oc.a dry€ip draWA by o�r,el A- 6al Lei datPrl !! /� I C' i&Ty that th['. ST—du system,relu-rc::aced ebov,- was installed 57zbgL tinily accozd ig to the ri.eSZgU,-W= i11�y iuC1i7,de rniuor? rp:Tnved. rfl il�Tes slI.el,. as lateral rciocation Of thn dis-hbl7tlon box andfOr SEFEe to L k I cCTO—Y thaL the septic sy.,'tenL n.fe�e�res_1 �Bove was :irnstLillod vviih Major ohwiges (7..e. greaie than.].0' Iatezal TCloraaon oftlle vL1ttcal,1C.R) Hon of any comp im-t of the�c'ptic syste)T1.)but in.ao(jor uCC with.State Lo(,al.X5galatinus. Plan,r.:vi.5).0n(1x cert:ided as-hunt by deSignR_ :fr:II vV, r ram/ E v, DAM LA c . - QJALA j ' (lT]Stuaces sI Fh.iF,') civil.. in " l _ y (1]e,1�,riei's S:I.EnL���1T,�'. fiv�I�t.g3.o�eT'S 1t TEP { ' ..._� t �,�s 1.1R t;_UTIFI � a� S OiWe�1,IaT�TGT s' i0x-,%�7u I� a�ED Cut ��aal� �� ��AtI� 7i�T CARDA���: Lt�B��I'a �lT19 T1 ,F. :E9"�F�.A.LTH SFIVVSI�DA TI�[AT����f. rrelfliflon Frain 3426-01�.di6G e - v Deck 11' 5.x16' 9. Cil ao ° Kitchen Dining Room x - 11 ftx 13'ft IIftx12 Garage (2 car) 21 ftx23 ft Bedroom Living.Room 11 $x12ft 12ftx15ft " up - 17f?vi4 t#r)ZoA,�, Tirst Ftoar Roof O Bedroom Bedroom 1 5 x 21' 6 (max) . do 1' 12'4.x 2 1'6.(max) . Roof Roof l74' Bau leer jzoac�, Secavii� 3�taor Town of Barnsiable P# Departi rent of Regulatory.Services >xnnrtarAer r Public Health Division Date rho ^� 200 Main Street,Hyannis MA 02601 cro Date Scheduled Time 1—r Fee Pd. Soil Suitability .Assessment for ,Sewage .Disposal Performed-By:10,h 690 /ul e S '. Witnessed By: LOCATION& GENE INFORMATION Location Address r-, 0 r Owner's Name ,C / l �Qa„-��e !f LI^-/�A I�� Address Assessor's Map/Parcel: i�/� Engineer's Namc . 0 W V\. e NEW CONSTRUCTION REPAIR Telephone# Land Use: d Slopes(%) G J Surface Stone'.. A10A Distances from: Open Water Body >IGi�l n possible We[Area lv IIJG /r' ft [ Drinking Water.Wcll ft Drainage Way ft Property Una '(O ft Other It SIM'TCH:(street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands•fn proximity to holes) �ouId-Ptl �aJJGt� Dwelt'h-O, s Dog b . Z11 ��TNZ Z(V%, !� Parent material(geologic) f�C Q G(A�wQ� Depth to Bedr, Depth to Groundwater. Standing Water in Hole: /v /+ Weeping from Pit Fgee �� Estimated Seasonal High Groundwater_ A DE TERMINATION FOR SEASONAL HIGH WATER'TABLE ,Method Used: —_V(2 VU/ U - Depth Observed standing in obs.hole: it,. Depth to soil mottles: In, Depth to weeping from side of obs.hole: In. Groundwater Adjustment . Index Well# Reading Date: Index Well 1001 Adj.factor �.�. Adj.Groundwater level „ Observation ]PERCOLA.TION'.rEST DANi/Y// Thnn10_', Hole# Thna at 9" Depth of Peru Time At 6" Start Pre-soak Time @ Time(9"-G") End Pre-soak Rate Miri./loch «h" 17IT,,ch Site Suitability Assessment; Site Passed Sitp Failed: Additional Testing Needed(Y/N) /V ((` Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you;must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\S EPTIC0311CFORM.DOC DEEROBSERVATION HOLr LOG Hole# L Depth from Soil Horizon Soil Texture .Still Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders, • o i ten�Y�°b'Gravell o - ro �- • •L.� 3/2 Z 9-0 DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. `t '�1 3/Z o sis en 90 Grave ow zy_�z c DEEP OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon Soil Texture Sol]Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co i to c G c DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Sfoues;boulders. • Cositn ' Flood Insurance Rate Map: I/ Above 500 year flood boundary No Yes 7 Within 500 yearboundary No r Yes Within 100 year flood boundary No. Y65 _ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in a]I areas observed throughout the area proposed for the soil absorption system? Y 5 If not,what is the depth of naturally occurring pervious matarlal l Certification I certify that on / (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the requited training,expertise and experience described in�10 CMR 15.017. Signature � �'' �'"��'z 'L� Date W/9 Q:\SEPTIaI'ERCPORM.DOC F Steve Bartlett 21 Pokonoket Ave. Sudbuy; MA 01776 January 9,2014 Mr.Thomas McKean Town of Barnstable, Public Health Division 200 Main Street Hyannis,MA 02601 J RE:Your Certified Main#7102 1010 0000 2851 1234, Dated January 6, 2014; Order to comply with State Environmental Code,Title 5 Dear Mr. McKean: 1'am writing on behalf of my mother,Sue Bartlett, for whom I have power of attorney. My mother owns and used to live in the house at 179 Boulder Road that is the subject of your order.' I commissioned Troy Williams to inspect the septic system because the house is for sale,and I was with him during the inspection so I am aware that it failed and the reason for it. I am arranging to have Down Cape Engineering designthe repairs required to bring the system into compliance with Title 5-. t expect that the pert test and system design will be underway in the next week or two, after which I.will put the design out for estimates,and will then choose who-will do the repair. l"will try ij&meet th-e March 7th deadtirre°orderod'n your letter, but at th-e moment I do not know if it will be possible to get everything done by then. Nobody is living in the house now and nobody will be living there until after it is sold.-Given that the house is not occupied,will it be necessary to adhere strictly to the 60 day order or will some leeway be possible? I hope to have the work completed by mid-April at the latestin order to get an early start on restoring the landscaping that will be destroyed by reconstruction of the septic system. —fi Sincerely; 1� Steve Bartlett Tel 508=895-1910, Email:steph'enbartiettl@juno.com F Barnstable oFzT Town of Barnstable AlARe ulato Services Department "'�'�ac'" g1 . BARNSrABc.E, - r""SS i639. Public Health Division ��� m prfDA"p� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Intrim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 1234 January 6, 2014 Mr. & Mrs. Stephen Bartlett, 21 Pokonoket Avenue Sudbury, MA 01776 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 179 Boulder Road, Barnstable,MA was last -inspected on December, 10, 2013, by Troy Williams, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T BOARD OF HEALTH r Thomas McKean, R.S., CHO Agent of the Board of Health • Q:\SEPTIC\ etters Septic.Inspection Failures or Future Eval\179 Boulder Rd Bam 2014.doc r . Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface,Sewage Disposal System Form-Not for Voluntary Assessments 179 Blugoulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue Sudbury MA 01776 December 10, 2013 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not use the return Troy Williams Name of Inspector key. _ Troy Williams Septic Inspections Company Name 19 Hummel Drive Company Address South Dennis - MA" 02660 Cityrrown State Zip Code (508)385- 1300 S1682" Telephone Number License Number B. Certification 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: D Passes ' Conditionally Passes ® 'Fails. ❑ Needs'Further Evaluation by the Local Approving Authority - , ,k C iLoz �, December 10, 2013 0 c� Inspector's Signatu Date The system inspector shall submit a copy of this inspection report to the Approving AuthoritylBoard of Health or DEP)within 30 days of completing this inspection. If the system is a Aared system or- has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit-tote report to the appropriate regional office of the DEP. The original should be sent to th rrl•e systeown% and copies sent to the buyer, if applicable, and the approving authority. 3 f: ****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 i the same or different conditions of use. t5ins•3/13 Title 5 Official InspectiVFourface Sewage Disposal System•Page 1 of 17 1 • r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .�" 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owners Name information is MA 01776 requiredevery for eve 21 Pokanoket Avenue, Sudbury December 10, 2013 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: 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 179 Boulder Road, Barnstable M -315 P-38 Property Address Stephen Bartlett , Owner Owner's Name information is required for every 21 Pokanoket Avenue Sudbury MA 01776 December 10, 2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of.Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont:): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ 'broken pipe(sj are replaced • ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed r ❑ -Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): A ❑ 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•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No El Z Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool I� 99 ❑ ® 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 Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary•Assessments 179 Boulder Road, Barnstable M -315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is 21 Pokanoket Avenue Sudbury MA. 01776 December 10 2013 required for every rY , page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No a ❑ ED Required pumping more than 4 times in the last.year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ 0 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. F 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 Foam: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 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any Y 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): 3 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 179 Boulder Road, Barnstable M -315 P -38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes"® No� Is laundry on a separate sewage'system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage 12=7,000 gals. 9 ( Y 9 (9Pd)) 11=9,000 gals. Detail: A Sump pump? ❑ Yes ® No Last date of occupancy: occasional use Date Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 31'0 CMR 15.203):. N/A- Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A:_ Grease trap present? _ x ❑ 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: N/A t5ins•3113 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 w ° 179 Boulder Road, Barnstable M -315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is 21 Pokanoket Avenue, , required for every Sudbury MA 01776 December 10 2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): NIA General Information Pumping Records: Source of information: Last pumped in 2009 per info from owner. 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 f Commonwealth of Massachusetts Title 5 Official Inspection Form_ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is 21 Pokanoket Avenue Sudbury MA 01176 ' December 10, 2013 required for every � rY 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: Tank, d-box and leaching were installed on 9/30/86 per compliance.` Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: fee" 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.): Lines were found clear at the time of inspection. Septic Tank(locate on,site plan): Depth below grade: 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: 5'X9'X6' 1000 gallon a 41' Sludge depth: - t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments rY 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 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 21811 Scum thickness none Distance from top of scum to top of outlet tee or baffle no scum Distance from bottom of scum to bottom of outlet tee or baffle no scum How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and concrete outlet tees were found present and in working order. No evidence of damage was found. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 M Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 .required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert evidence of leakage, etc.): : Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal , f ❑ fiberglass R ;: ❑ polyethylene ❑ other(explain): - Dimensions: - N/A Capacity: , : N/A,gallons gallons ` N/A Design Flow: gallons per day Alarm present: ❑ Yes ❑ No . Alarm level: ' N/A Alarm in working order: ❑ Yes ❑' No Date of last pumping: N/A 'Date Comments(condition of alarm and float switches, etc.): N/A "Attach copy of current pumping contract(requite d). Is copy attached? ❑ Yes ❑ No I l5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 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 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 found level and in working order. 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.): N/A *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 r - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information isequired or every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: : ® leaching pits number: 1 -4'X6' pit with T of stone ❑ leaching chambers number: ❑ 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.): Leach pit was found dry on inspection with walls found stained up to inlet line. This is evidence of leaching being full and in hydraulic failure when home was occupied. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth-top of liquid Ito inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 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 179 Boulder Road, Barnstable M -315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, SudburyMA 01776 December 10, 2013 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.): N/A Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yt 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 required for every _ page. CityrTown 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 -31 3 G. , t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 f /' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ti 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is requ red for every 21 Pokanoket Avenue, Sudbury MA 01776 December 10, 2013 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: 20.0+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: AIW 247 Zone C 24.3' 4.8'adjustment You must describe how you established the high ground water elevation: Hand augered 5' below bottom of leaching with no water found at a depth of 12.5'. Groundwater adjustment at the time of inspection was 4.8'. Bottom of leaching at 7.5'was found not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t;ins•3113 Title 5 Official Inspection forth: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 179 Boulder Road, Barnstable M-315 P-38 Property Address Stephen Bartlett Owner Owner's Name information is required for every 21 Pokanoket Avenue, Sudbury MA 01776 'December 10, 2013 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information-Estimated depth to high groundwater. ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 J ASSESSOR'S MAP N0. 1P PARCEL L>0 CAT ION Ler I Is EWAG PER IT No. �- .v L L ACE 0 . .. dl V- h C4 � /c I N S T A LLER'S NAME A ADDRESS c 1Myc.�,�Qo� S U I L D E R OR OWNER L __ u icy{v�S '����,�, • WA ® s , DATE PERMIT ISS ED DAT E COMPLIANCE ISSUED �� �1 a � . 1 I a _ � � � � �� p� �� � ��-� � � � � � � � � � � n � � �. _ � 9'ARCEL NO.: F:cs 'V190 THE COMMONWEALTH OF MASSACHUSETTS �.• BOARD OF HE���T� ...............Z� ......-.OF............... ... .................................................................... Appliratiun for Uiipusal Worko Tonstxn.r#iun ramit Application is hereby made for a Permit to Construct VY) or Repair ( ) an Individual Sewage Disposal System at• ----• - ���� G % - ..... ..........�LT../ ._ ........... -----••---.--.-----T=LocatioOn:n ddyess. ��f� ...�Ad�reNo. ...........� ....... ��� W J v ss ,.a ---------------------- �........_... r Installer Address �! Type of Building Size Lot.. .....Sq. feet U Dwelling—No. of Bedrooms........ Other Attic ( ) Garlfage Grinder a Other—Type of Building ............................ No. of persons............................ Showers ( ) = Cafeteria ( ) Q' Other fixtures .--•--------------•-•----•..... . d --•...-•..- ..----• W Design Flow............................................gallons per person per day. Total daily flow............... � ...................�-� gallons. WSeptic Tank—Liquid capacity.I.4.UT.O..gallons Length................ Width................ Diameter................ Depth................. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Ca� / j`�i/�'� // '~ Percolation Test Results Performed by.......___.�......C............................................... Date...______ _.. --------__ ,.a Test Pit No. 1... .....minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------•------------------------------------------------------••-•---------.._......------................................................................. 0 Description of Soil..........................-------•--.................... --- -----------------------------------�-- ----------------------•---------..................... x Q'��' c.� -------------------------------------------.---. ---------------------= .... t �-� W -----•-----•-------•----------------------------••--------•---•••------•-•--•--•--•• -------•-•-•-------------------------•----•--••--------•------------------------------•-......-------- VNature of Repairs or Alterations—Answer when applicable--____•-•...................................................................................... ----------------------------•--••---•------•-----•----------------------=-----------....----•-----•-----•---•---------------------------------------------------------..._.._....----•-•--•....._...---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dispo a System in accordance with the provisions of ITLL '5 of the State Sanitary Code—.The unde ned further a ree not to place the system in opera on until a Certifi to of Compliance has been issued by thelooard of he ` Signed--(7•'•- _.. ................................ ...... /'�� - / 7 'D a' Application Approved .. ...................... : . '1-. .... Date Application Disapproved for the°following reasons:............................................................................................................ ---•-•-•--•---------•--------------------------------------------•--------------•----•-----•--------...--------------..............•---------•---•----•--•------•-------------------•--•---------••---•- Date Permit No....:: - ...... Issued--------------- ��V ........................................ 1 THE COMMONWEALTH OF MASSACHUSETTS _-- BOARD OF HEALTH / ......... (/ o .......O F.............��..-.(!dI. � ........................ Apphration for 11isposal Works Tonstrurtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: NLOCatiOn-Ad ss or Lief-No. ... ..;•I -. ............. �r Owner { / Ad eas /J 14 .i C.� -!--s..•:... r _• t�' � ;r`........................... — Installer C �/� Address / �+ U Type of Building tt Size Lot.... j .-Sq. feet 1-1 Dwelling—No. of Bedrooms..........`. .....:....................Expansion Attic ( ) Garbage Grinder (� `4 Other—Type e of Building ....... No. of persons............................ Showers a YP g ..................... P ( ) — Cafeteria ( ) 04 Other fixtures -------------------------------------------•-- W ------------- Design Flow............................................gallons per person per day. Total daily flow................ rM%............gallons. W Septic Tank—Liquid capacity..! .gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ,( ) r Percolation Test Results`/ Performed by......_..... �. _._.......`"..... - Date......... ... ....... : .. a Test Pit No. 1....r::%.....minutes per inch Depth of Test Pit.................... Depth to ground water......................,... Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....--.................. a ............................................=••••-••••-••-•.............----•-......•........ --------------------------------------------------------- Description of Soil.. r �, � ?.....•......... ..............•----•--------...---•-•............••. ._.. ...........................•-------•----------------------------------------------....-•-•---•------------...-•----------------------......-----------••-•----------•---------...............----•-•••. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ••• •--•-•-•-----•--•-••.....................•-•-........._....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal-,System,in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operat on until a Certifi a of Compliance has been► issued by the board of hea �.� Signed- ==t 'j"'" :_._.. _:.:_.. ` / .......... ... ... . .�... ,_,...� pate] Application Approved By. -4,<a...0 -`/ _ _ (l f.... Date.............. Application Disapproved for the following reasons:..............................................................I------ ................---- --......-•....................•---------••------•----------•------..........-•----------..........------.... ••-•••••••••••-•-••.............--•••-------......-•••••-••-•-•---•-••-•--............- Date Permit No.-E;'.;;i� Issued_...........................................--------- -- .Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL.T Tntif uttie of f ampliana THIS IS TO CERTIFY, That the Individual ewe I- esal-System constructed ( or Repaired by................................... .......................... ........... . ............................)......... ........ -.-) has been installed in accordance with the provisions of TITJLP 5 of he St to Sanitary Code as d cr''Ted in the application for Disposal Works Construction Permit No..- ..."" . dated............. .f �s ......--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATI FACTORY. DATE........................... ... � .........- - Inspector._.. - .................. THE COMMONWEALTH OF MASSACHUSETTS -" j0 - - BOARD OF HEALTH Zc1 OF............. ��yy��`LGv� , ........................ .......-----•-----....... .......................... No................••-••W. Fn....�...... . Disposal`18jorks Tonotrurtion rr tt Permission is hereby granted..... = ... ........ .......... ......._--.. to Construct (x) or Repair'( ) an Individual Sewage Disposal,S St at No......... ems. ¢}(� t l • ...._:...._ .gar :.._. ... ' Street e0............. ........... as shown on the application for Disposal WorksaConstruction Permit No. .. Dated_.. ...... Board of Health DATE..... ..-- ... ..................... ................... FORM 1255 A. . SIILKI N, INC.. BOSTON �, t r } , 36 FEET T-o \ .-� • pf Ag - / 2� -43' 93� //Z `)/7/ x `v A U ' 104 / - 2 'I l �20p D 2 ivE -U-4P �� //4•S 3 _t_`►4 0 � / TD W WgTWR- 009 2 ' l ry to •N �'. t'�`' c\t �- \ — J/7 12) 12 _ _ _ . SETa-sctr O -� -- — — -- -- // ;40 'F4WAAi-. 40 OF A14 /7 � PAUL' y A. LEVY No.10050 4 /3 LEGEND k �- E ISYING SPOT ELEVATION Ox0 CE I IED' ., PLOT AN. E (STING.- CONTOUR ''IF NISHED SPOT ELEVATION LUT D Buv�oE2 �eoA FINISHED CONTOUR 0 �� Aos!<RT s I- APPROVED - BOARD OF HEALTH EDGE " IN No. t83s7 9AItI`1 S`fA MAIsS ? rDATE AGENT SCALES O" 4U ' DATES S12lo Ah6: �. ILEVY & ELDREDGE ASSOCIATES INC. /Vie/r���s CLIENT_. 1 CERTIFY THAT THE PROPOSED ENGINEERS-LANDSCAPEARCHRECTS JOB NO. J 5 O BUILDING SHOWN ON THIS PLAN rPLANNERs-LAND SURVEYORS DR.BY, CONFORMS TO THE ZONING LAWS' ' �'� OF BARNSTABL-E MASS. HYANN I S, MASS. / Z --- _ .`�— ___ SHEET— OF D TE EG. LAND SURVEYOR ®- Ai Y 2D,FT. MOnY. r n OTC �TNG•R THE SEPTIC TAN �C E . . .4•e:w�rvG-..P/, "�q-RE'_ `/70iPE._7""�y'AN ��"���. 4'AOE, 24'O/AMET.ER CONCRETE- COYEk _ SgALL BE BROUoSR7* 770.61rA EXTRA �_ Y =_ . /2 _S Q)NCRG'TE AWN. P/TCN I J -0E'4 V Y CA S 7- /4-OIV CO V4ffR S Al q L L DE USED COYERS ��APER FT i t IF/iV OR/VEPVAY • i 2". M/N. CD/VCRLrT.E A ; Get^oE GO VER CLEAN .SANG I ? BACAC,=/L.L. •�= - 4"PIA. _ ,Up�,'�o LEVEL .• _ - '• •. 4'. SCNEDVLi40 - r. 2+LAYER --1 or E/r�: SEP?/C : TANK /sT. . •'� • • . • • • • • • • • ; /4/ASNED 572�/yE ._ t.• BGX . _ � .. - •y p' • / •EFFECT/VG' • r • •• 3/Q' - � �2~ • • •.OEPTt/ • • • o lV.4SNED STaNE . v • • • • . • •11 �• 0 . . __ I/3 A, e. • • . • • • • • • a• a PRECAST SEF�GE • • • • • . • � ' a �o P/7 ,OR EQU/V. /Nf�GRT ELRY.4TIONS I'm,�iT. dw s /NY.ERT AT QU/LD//VG 121 FT, Gar o ac�. O.S a X 3 6 fT D/AM. /INLET SEPTIC Y.4N/C /2/- 3 FT, LL2' FT. O/AM. SEE T [/L�4TJOA/> OM7LE7'SEPTIC TANK AFT. ' //VLET o/STR/et7-,o.,! BOX /20-9 FT SECT/ON OF _ GROUND WATER TABLE O�ITLETD/STR/,9/lT'/ON BAX L�7� SEI�IAGE ' O/S/®OrS'A L SYSTEM //VCET LEACHING /�/T //�O T LEACH!/VG P/T T,q�ULATION SC.A L E : %�" _ /=o p DIMENS/O N A DES/G/V CRITERIA DIM,&V510 AI S—:AO FT. HUMMER OF BEDROQ/yS .3 D/MENS/ON CLJ F7; M/Rl- G4RQAGEO/SPOSAL UNIT��tU99' SO//- L..OG ' TOTAL ESTf,"A7 ez> FLoA, 330 6.4L.1DAY SOIL TEST #/ SOIL 7�ST#2 SOIL TEST i{(UMBER QF cEac/IrnrG PiTs_ � fE'tEK //70 PATE OF S014 TEST S/OE Lj'ACH/N T _-_G PER P/ �_;Z SQ, PT. l ' RESULTS iTNESSED SY F BOTTOM L64CN/NG PER P/T�i2 $q, PT. Z /��' rlv �/t- �//PERCOAAT/ON RATE At / M//V,/INCH•_ I TOTAL LEACH//YG AREA �SQ. FT. PEitCOLAT/ON E N NH RAT 1k2 s M/ .�/ C RESEMVE LEACHING AREA SQ. A l� or s�•H F 4 T�1> 7 �C%✓ � CS P A U,� G CiT 4f BovL b E/1 2✓i�d BUJ eA/S7, G po EL DREDGE h'AW1VASERNVG W.INC. siAL L84t�S ti Z NS��� 7/2 MAIN ST., NYANN/9, MA.5S. . /EMT:y1Ct V.4TE:' G] GMOUNO yvATE.Q A LEt/.T Q45 ". 1 i.i SYSTEM DESIGN: .,.. NOTES s °ate 6 GARBAGE DISPOSER IS NOT ALLOWED cCal SYSTEM PRO �LE ALL SYSTEM COMPONENTS SHALL BE 1. DATUM IS APPROX. NGVD EXISTING 3 BEDROOM DWELLING MARKED WITH MAGNETIC TAPE OR LEGEND PROVIDE MIN. 20". DIAMETER WATERTIGHT (NOT M SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. DESIGN FLOW: 3 BEDROOMS 0 110 GPD = 330 GPD CONCRETE COVERS TO WITHIN 3" GRADE ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2. MUNICIPAL WATER IS EXISTING 2" PEASTONE OR GEOTEXTILE 99 - EXISTING CONTOUR USE A 330 GPD DESIGN FLOW \ TOP FOUND. EL. 12ss' FILTER FABRIC OVER STONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. °c MINIMUM .75' OF COVER OVER PRECAST 1 2% SLOPE REQUIRED OVER SYSTEM 117-118' �c X 99 t EXIST. SPOT ELEV. BLOCKS OR 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO r Bf°9gs SEPTIC TANK: 330 GPD (2) = 660 PRECAST H-10 WATERTEST D BOX FOR LEVELNESS PRECAST RISERS 99 PROPOSED CONTOUR **RE-USE EXISTING 1000 GAL. SEPTIC TANK 230Rs (TYP.) 122.56' 4"0SCH40 PVC H- 10 *` TEE PIPES LEVEL 1ST 2' 4' COMPON NTS INVERT IN 114.17' BOULDER ROAD 98.4 PROPOSED SPOT EL ?'. ENDS (�P> 4' 5. PIPE JOINTS TO BE MADE WATERTIGHT. TH 1SIDES LEACHING: 1o" EXISTING 14" Pogo 1 ,QoU Locus 15.0 TEE SEPTIC TANK**TEE 121. 14f'* ° ° ®® ®f"I'19 ®® - 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITHTEST HOLE - 112 GP ,.,�,�,o,o, 6" MIN. SUMP 000000°° °°°°°°°SIDES: 2 (25 + 12.83) 2 (.74) D ® ®®® 2® ;°000 °o MASS. ENVIRONMENTAL CODE TITLE V. GAS BAFFLE +-'o 0 00,o',0? 12" MIN. INT. DIM. °000000 ® 2% SLOPE OF GROUND BOTTOM 25 x 12.83 (.74) = 237 GPD ° ° ® ' 114.54' 114.37' >�o�o�o�o ' °oogog°g 112.17' 7, THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO Common/cot/on >r: BE USED FOR LOT LINE,STAKING OR ANY OTHER PURPOSE. w°y-� C-O, UTILITY POLE TOTAL: 472 S.F. 349 GPD 3/4"-1-1J2" DOUBLE WASHED STONE 4' MIN. H-10 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL FIRE HYDRANT ALL AROUND PRECAST STRUCTURES (2) UNITS REQUIRED �� Independence USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' x 12.B3' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. ��/�e NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING WITH 4' STONE ALL AROUND COMPACTION. (15.221 [2]) 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED (17.4% SLOPE) (?% SLOPE) WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION LOCUS MAP FOUNDATION- EXIST. SEPTIC TANK 38' V LEACHING OBTAINED FROM BOARD OF HEALTH.D' BOX 12' FACILITY 1os.o' BorroM rH-1 NOT TO SCALE NO GROUNDWATER FOUND 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING MA **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL DIGSAFE 1 888-344-7233 AND VERIFYING THE LOCATION APPROVED DATE BOARD OF HEALTH ( - ) ASSESSORS MAP 315 PARCEL 38 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS OF ALL UNDERGROUND & •OVERHEAD UTILITIES PRIOR TO WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM COMMENCEMENT OF WORK. CONDITIONS IF NOT SUITABLE 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND - I REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE TEST HOLE LOGS I REMOVED 5' BENEATH AND AROUND THE PROPOSED I LEACHING FACILITY. DANIEL E. GONSALVES, SE 13587 ENGINEER: � I DRAIN. EASE. WITNESS: DONNA MIORANDI, RS r I DATE: 2/4/14 I PERC. RATE _ < 2 MIN/INCH I CLASS I SOILS P# 14294 L - ELEV. z ELEV. - _ opt4 117.0' 0„ 1 17.5' A A lb^ LS LS o• Q) 10YR 3/2 10YR 3/2 o 00• + 10" op t P4, B B LS LS 10YR 5/8 10YR 5/8 - 24" 115.0' 24" 115.5' C C PERC MS MS 2.5Y 6/6 2.5Y 6/6 00 132" 106.0' 132" 106.5' LOT 18 NO GROUNDWATER ENCOUNTERED 46,441 Sq. Ft. X 1 15.27 X 1 17.33 i 11 BENCH MARK - CORNER OF 11 CONIC. BULKHEAD. EL. = 126.1 118 T115.42 119 X119 0 120 121 X 1 X 12ITK \ Jam_ - 123 X 123. X 0.26 I ] I 124 cp X 1 16.83 - 125 O 1 1 .70 126 ----� x 24.2 �'� X 19.16 � X 1 15.i ' > > ' N N N '� PAVED DRIVE X 125.23 �� 1'I ' ITE PLAN 699 N P S O � TITLE 5, S0 121.89 4.42 TH1 21.3' j X 114.55 OF �^ X 1 1 3.95 126.8 \123.70 122.56 6 v C 1 .14 0 0 4N H 179 BOULDER ROAD m \124.59 EXISTING DWELLING X 1 17.36 OP EL./ X OF FNDN 1 4.39 26.8 N - 1\2.2 j 21.6' BARNSTABLE, MA cc) I\125. DECK 0 0)X 118.86 PREPARED FOR 121 6 O � ■ w � c X 1 16.06 STEPHEN BARTLETT 1co120 66 o \ DATE. FEBRUARY 11 , 2014 1 17.05 174.08 / G X 1 16.96 lI .Ma" 0 41 U 21t ��HC�MAS��ti S�Et1�JFMy�gya�H MgSs9 *� \(HOFyS'\� �\ fax 508-362-9880 o �cI , r. L�AIJIEL \ DAP�IEL \;� ' downcape.com OJALA 1 ' a i `,� o A. A. ,oCIVIL C) icOJA.� x do w� cap e e� iaeer�n iac 116.06 X 115.61 , No.4a502 GIVI� �` No.4C �8C No.400'0 / g gj * X 1 15.19 T�f,;' civil engineersSCaI�: 1 20 U land surveyors 0 1 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. 939 Main Street ( Rte 6A) YARMOU THPOR T MA 02675 DICE # 14-006 14-006 BARTLETT.DWG