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HomeMy WebLinkAbout0172 BRAGG'S LANE - Health 72 Bragg's Lane, 7'1 Q / 6V No. ( Oq Fee ( THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitation for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade�Z` Abandon( ) Complete System ❑Individual Components Location Address or Lot No. i-i Z $ra ls L 4 n Lr Owner's Name,Address,and Tel.No. 04",'v g ea ri fe(op 13 p,z115 T r�3�e to 3�,,,za levy. ,z._v A 3da-'C Assessor's Map/Parcel L�'9 p GC� Ii`P-7 5<,_� Installer's Name,Address,and Tel.No.C'46(fj,ite Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size '2 3. o? sq.ft. Garbage Grinder( ) Other Type of Building 5o c 12 •r a M 4 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided gpd Plan Date D ' I " )01 Number of sheets Revision Date Title 1-7 a<&5 q S Size of Septic Tank Type of S.A.S.��� (�� S6a 9. L. L., C. U --2 Description of Soil Nature of Repairs or Alterations(Answer when applicable) —Lp Sbo S.#,�Z —1PW4- Date last inspected: -2,b 19 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. e Date Application Approved by«` Date C, Application Disapproved b Date for the following reasons Permit No.�� 301 Date Issued �,. ` r No: ( - k Fee fit �.. THE.COMMONUIfEALTH.OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DVISION - TOWN OF BARNSTABLE MASSACHUSETTS Yes ftptication for Misposal *pstem Construction Permit t Application for a Permit to Construct O Repair(, ) Upgrade Or Abandon( ) ,Complete System ❑Individual Components Location Address or Lot No. 1-1F cl �.� ' Owner's Name,Address,and Tel.No. T3 e1%6 Y�r.,i s is 1L to 5"f,sdoo.l�°=2•`y,� Assessor's Map/Parcel Z9,9 /0 c".Ka Installer's Name,Address,and Tel.No.04j,:c w,c Designer's Name,Address,and Tel.No. ' f �" a � L'✓3� s'Y-+.2.`c, l e•.l �' �_,� Sd.. �°�i�.TE..�..r;r y#;' Type of Building: / Dwelling No.of Bedrooms Lot Size 1 3, '7`( " sq.ft. Garbage Grinder( ) Other Type of Building 5i- P f No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided egpd Plan Date l `� > Number of sheets Revision Date Title 1. s f P Size of Septic Tank Type of S.A.S. Spa ; ,- V 10 Description of Soil Nature of Repairs or Alterations(Answer when applicable) C?,,4,3 I -(p ( O e i= U ' Qom. Q �50 Date last inspected: 19 - Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of _ Compliance has been issued by this Board of Health. r 7gne Date Application Approved by,'_' — Date t7 �9�Z01 Application Disapproved by/ Date for the following reasons Permit No. ?,O 1q -foq Date Issued 6/1-/ t7/ r r -.k• THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( .) Upgraded'( ) Abandoned( )by e,4 r 4-,,t.E.x p >- (,> .)(L (,'o , Z444— at1 114. r Aft) 1La has been constructed in accordance. with the provisions of Title 5 and the for Disposal System Construction Permit No ill— 3A, dated Installer 0t,�q Cam. Z— Designer ~ Gt t i C.c.a i.c #bedrooms 3� ( Approved design 0 gpd The issuance of this permit shall,not be construe as aa-ryguarantee that the system will fu c'tion)aspdesigned. Date �J - - -' I C Inspector % U1 f ------- ----- ---------------------- ----------- -- ---------------------------------------------------------------------------- No. ,D t 309 Fee A THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposat *pstrm Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade O Abandon( ) System located at I` l_ f '. .f rC %P S rkey's t and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this perm* . Date Approved/7i0/� Approved by TOWN OF BARNSTABLE ' LOCATION t ate. r-" ►GC-C'5 [A NC SEWAGE# Ot VILLAGE 5&p_&ni7 ,3C, ASSESSOR'S MAP&PARCEL'dLe(lg d INSTALLER'S NAME&PHONE NO. Cr4PG WL 1DL RaA9 S&w— C;4'-gg-q SEPTIC TANK CAPACITY ,S®® & &)S LEACHING FACILITY. (type)121 500 GEC_ d[44p S(size) 12-FS K 9L NO.OF BEDROOMS OWNER ()AV(T) g' ALVC-,eLA PERMIT DATE: 'I9-al®(! COMPLIANCE DATE: 9-A-7'A® !9 e aration Distance Between the: ©NC imum Adjusted Groundwater Table to the Bottom of Leaching Facility 0P.6rCVC5 D Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) NIA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY c s� uv N W- J- C W. F v1. p 3 (p Town of Barnstable IME'O'�.° Regulatory Services Y Y Richard V. Scali,Interim Director RARABLE. 9 ;9. a6S9. Public Health Division �0 10 lFer,� e, Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: g-Zg- 9 Sewage Permit# ;ZU I CI 30 9 Assessor's Map\Parcel Designer: G EnS ioeei-61c) Installer: Cn�zw�d� LvrE�� +s Address: 2 925 N CC4.1\erc y t iLVt wn y Address: 1 3 C-6v nm ere i e J i5cisk Wor6A&m N 6i_3 HA 0 2 !o y i On EML e,►u?S was issued a permit to install a (date) (installer) septic system at 17Z 8(a S L a n t� based on a design drawn by address) SG &o!J 1ezt.l.Y1 S�1G, dated` (/9USf lS� 2619 . (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral.relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system):but in accordance with State & Local.Regulations. Plan revision or certified as-built by designer to follow. Stlip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was construc nce with the terms of the IAA approval letters(if applicable) ;,����jH A ssq CNUR ILL J�, VIL (I talle ' Sign ure .4171, �cs /ASE signer's Signat (Affix igne s St mp Here) PL RET TO BARNSTABLE PUBLIC HEA H D VIS N. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOT11 THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic0esigner Certification Form Rev 8-14-13.doc ,-Stanton, David From: Stanton, David Sent: Monday, July 01, 2019 9:15 AM To: 'Joe Martins' Cc: McKean, Thomas Subject: RE: 172 Braggs Lane Barnstable Attachment's: 2 1of1.jpg; 3_1of1.jpg; 1_1of1.jpg I. Hi Joe, Thank you very much for the update. I apologize on behalf of the Health Division, I am not sure who told you there was nothing in our file, that was incorrect. We do have a file, however, it has very little in it,just 3 pages, which are attached. I was unable to locate the original septic permit. We do not have an asbuilt card of the original septic system. I researched the building department file, but they do not have a record of the septic permit either on their building permits.The only information regarding the septic in the building department file was in reference to a permit signed off by Tom McKean with a note regarding the fax we had, which is attached. I have cc'd the Health Director,Tom McKean, on this e-mail with your response to the questions he was asked to pass out to Title V Inspectors from DEP. Thank you for your assistance, I will let you know once a determination is made to the status of the report. Thank you, David W. Stanton, RS Chief Health Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 Direct phone: (508) 862-4647 Health Dept.:phone: (508) 862-4644 Health Dept.;fax (508) 790-6304 From: Joe Martins [mailto:Joemartins@comcast.net] Sent: Monday, July 01, 2019 8:35 AM To: Stanton, David Subject: 172 Braggs Lane Barnstable Hi David, Please confirm to me what I was told that there was nothing in the file at the Health dept. regarding this system. To answer the questions: There is detail on page 4 and 14 of the report that I filed. So.yes, the home use is seasonally and is used intermittently by the family. 1 Y .r The sr'aining in the leach pit as described varies from heavier on the bottom to moderate just below the invert. There are voids in the stone in the leach pit openings. The coloration is not black. There are no other indications of failure. No Dbox was found as both the pit and septic tank were 7-8' below grade and the septic tank outlet cover was under a cinder block:stair foundation and inaccessible. This is not a cesspool system. It is a septic tank and leaching pit w stone. Part of the reason this is further evaluation is the depth that the H-10 components are 7-8' below grade and the leach pit is under the driveway partially, In some towns that I work in, this immediately triggers a further evaluation. There is also a broken pipe from the tank to the pit as the effluent is coming in thru the stone to the pit. There is also no access to the outlet cover of the septic tank. If you have any further questions please feel-free to contact me by email or phone. Joe Martins Accu Sepeheck Septic Inspection and Locating Services joemartins(cicom cast.net 508-776-3479 Visit our website, Like us on Facebook! CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know,the content is safe! f 2 ti VE Town- of Barnstable Barnstable A P Inspectional Services Department 1 Ica i + BARN'SMABLL "ass. i639' Public Health Division \� A'fD"u� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 9712 July 9, 2019 ABATE, DAVID T & ANGELA C 10 JERUSALEM ROAD COHASSET, MA 02025 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 172 Bragg's Lane, Barnstable, MA was inspected on 06/05/2019 by Joseph M Martins, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Needs Further Evaluation" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Septic system components constructed of light duty (H-10) loading, 7-8' deep, and partially below a driveway. The Board of Health requires corrective measures wherever an H-10 component is below a driveway. Also, at greater than three feet deep, the system is too deep for light duty loading components. Also there is a broken pipe. You are ordered to repair or replace the septic system within two (2) years,from the date you 'receive this notification. Failure to repair/replace the septic system.within the deadline period will result in future enforcement action. You may request a hearing if written petition requesting same is received by the Board of .Health within ten (10) days of your receipt of this notice. PER ORDER OF THI OARD OF HEALTH ...o...a a , S., CH Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\172 Braggs Lane Bamstable.doc tME Town of Barnstable 9� b Sa 9 ,�� Inspectional Services Department PrED MA'S� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS' (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe_ (per Town Code §360-20 h) OT ER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc -701 o , l M1 � Stanton, David From: Stanton, David Sent: Friday, June 28, 2019 4:02 PM To: Joe Martins Qoemartins@comcast.net) Subject: Title V Inspection report for 172 Braggs Lane, Barnstable Hi Joe, We have received your inspection report that needs further evaluation. The Health Director,Thomas McKean, wants me to have you fill out some answers to questions that he received from DEP to review the Title V inspection report and make a determination. The questions from the State are: Has the home been vacant for a while? What was the degree of staining? What was the extent of it? What was the coloration? Were there any other indications of failure? Did he/she notice any staining in the d-box? Is it a cesspool or a Title V system? Thank you, David W. Stanton, IRS Chief Health Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 Direct phone: (508) 862-4647 Health Dept.:phone: (508) 862-4644 Health Dept.:fax (508) 790-6304 1 .Stanton, David From: Joe Martins <Joemartins@comcast.net> Sent: Monday, July 01, 2019 8:35 AM To: Stanton, David Subject: 172 Braggs Lane Barnstable Hi David, Please confirm to me what I was told that there was nothing in the file at the Health dept. regarding this system. To answer the questions: There is detail on page 4 and 14 of the report that I filed. So yes,the home use is seasonally and is used intermittently by the family. The stainingin the leach pit as described varies from heavier on the bottom to moderate just below the invert. There are voids in the stone in the leach pit openings. The coloration is not black. There are no other indications of failure. No Dbox was found as both the pit and septic tank were 7-8' below grade and the septic tank outlet cover was under a cinder block stair foundation and inaccessible. This is not a:cesspool system. It is a septic tank and leaching pit w stone. Part of the reason this is further evaluation is the depth that the H-10 components are 7-8' below grade and the leach pit is under the driveway partially. In some towns that I work in,this immediately triggers a further evaluation. There is also a broken pipe from the tank to the pit as the effluent is coming in thru the stone to the pit. There is also no access to the outlet cover of the'septic tank. If you have any further questions please feel free to contact me by email or phone. Joe Martins Accu Sepcheck Septic Inspection and. Locating Services joemart nsrr'ucoincast.net 508-776-347.9 Visit our website, Like us on Facebook! CAUTION:This email originated from outside of the Town.of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email-address and know the content is safe! 1 Commonwealth of MassachusettsN 0& Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments c� 172 Bragg's Lane, Barnstable MA r� Property Address ~' fQ David Abate 10 Jerusalem Road > Owner Owner's Name K information is required for every Cohasset MA 02025 6/5/2019 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. Inspector Information S'j �39 pg on the computer, use only the tab Joseph M Martins key to move your Name of Inspector cursor-do not Accu Sepcheck use the return key. Company Name r� Northside Drive Company Address South Dennis MA 02660 City/Town State Zip Code I 508-385-5891 SI 147 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 16.340 of Title 5 (310 CMR 16.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ® Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 6/17/2019 Insp ors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: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. t5insp.doc•rev.7/2&2018 Title 5 official Inspection Form.Subsurface Sewage Disposal System-Page 1 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address ' David Abate 10 Jerusalem Road Owner Owner's Name information is Cohasset MA 02025 6/5/2019 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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 c ' ria not evaluated are indicated below. Comments: E 2) System Conditionally P sses: ❑ 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 noWs structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. Sy.4Wm will pass inspection if the existing tank is replaced with a complying septic tank as approv by the Board of Health. . , *A metal septic tank will pass inspection if it is structurally sound, not king and if a Certificate of Compliance indicating that the tank is less than 20 years old is ava' le ❑ Y ❑ .N ❑ ND(Explain below): zut .. t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high stati water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, se ed 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 pla ❑ Y ❑ N ❑ ND(Explain below): ❑ The system requir d pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass spection if(with approval of the Board of Health): ❑ ' t brok pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): o truction is removed ❑ Y ❑ N ❑ ND(Explain below): e } 3) 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. a. 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: t5insp.doc-rev.7/2612D18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system Is functioningin a manner that protects the public health, Y p 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. c. Other: BOTH SEPTIC SYSTEM COMPONENTS ARE H-10 CONSTRUCTION AND APPROXIMATELY 7-8' BELOW GRADE. FURTHER, THERE A PORTION, INCLUDING THE OUTLET COVER OF THE SEPTIC TANK THAT IS UNDER THE FOUNDATION CINDER BLOCK FOOTING FOR THE STAIRS. IN ADDITION APP.2.5'OF THE LEACH PIT IS UNDER THE DRIVEWAY. THERE IS ALSO A BROKEN ORANBEBURG PIPE LEADING TO THE LEACH PIT.THE EFFLUENT IS COMING IN THRU THE STONE FROM THE TANK TO THE PIT.THE LEACH PIT STAIN LINE VARIES AND IS MODERATE TO THE INLET INVERT OF THE LEACH PIT. 4) System failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No El ® 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pap 4 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cunt.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 El ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) Large Systems: To be considered a large system the system must se a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes"or"no""to each o following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 f a surface drinking water supply ❑ ❑ the system is withi 00 feet of a tributary to a surface drinking water supply ❑ ❑ the system is ated in a nitrogen sensitive area(Interim Wellhead Protection Area—IW )or a mapped Zone If of a public water supply well t5insp.doc•rev.7/26/2018 • Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 1S Commonwealth of Massachusetts Title 5 Official Inspection Form vz:�Vv 1i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every COhasset MA 02025 6/5/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department., 6. You must indicate"yes"or"no"for each of the following for all inspections: 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? 0 ® 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 1.5.302(5)] t5insp.doc•rev.7r2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 ' s r ' : Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): NA Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Description: 1000 G SEPTIC TANK,AND A 6'X6' LEACH PIT W STONE. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection . ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 43 9 ( Y 9 (gP ))� Detail: 2018: 17,000 G ; 2017: 14,000 G Sump pump? ❑ Yes ® No Last date of occupancy: INTERMITTENT Date t5insp.doc•rev.7l26=18 Title 5 OfBdal Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 f Commonwealth of Massachusetts UiTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day Y(9Pd) Basis of design flow(seats/persons/sq.ft, etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ "No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: PUMPED 5/12/2017, 11/2011 AND IN 2010 PER BARNSTABLE WASTEWATER TREATMENT PLANT Was system pumped as part of the inspection? ❑ Yes ® No If yes;volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 172 Bragg's Lane,'Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information(cont.) 4. 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/Altemative 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): Approximate age of all components, date installed(if known)and source of information: INSTALLED LATE 1970'S PER OWNER Were sewage odors detected when arriving at the site?: ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ®40 PVC IN FLOOR, 2 PIPES r ❑other(explain): Distance from private water supply well or suction line. N/A feet Comments(on condition of joints,venting, evidence of leakage, etc.): NO EVIDENCE OF LEAKS Mnip.cioc%rev.7P W018 " Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 9 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's(dame . information is required for every Cohasset MA 02025 6/5/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 7.3 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: APP 8.5 X6X5 1000G Sludge depth: 0 INCHES Distance from top of sludge to bottom of outlet tee or baffle 0 INCHES Scum thickness 0 INCHES Distance from top of scum to top of outlet tee or baffle 6"W MIRROR Distance from bottom of scum to bottom of outlet tee or baffle NOT MEASURED How were dimensions determined? CORETAKER FROM INLET END Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): HAS CONCRETE INLET TEE AND CRACKED CONCRETE OUTLET. H-10 TANK IS UNDER CINDER BLOCK STAIRS FOUNDATION. LIQUID LEVEL IS 48". SOLIDS MEASUREMENTS TAKEN FROM INLET END OF TANK. t5insp.doc-rev.7/M2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 c Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: N/A t feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ poly ylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or ffle Distance from bottom of scum to bottom of utlet tee or baffle Date of last pumping: Date Comments(on pumping recomm dations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet' vert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate o/sitean�): Depth below grade: N/A Material of construction: ❑concrete ❑ metal ❑fiberglass /ollyethylenie ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7r2WO18 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 f : Commonwealth of Massachusetts Title 5 Official Inspection Form Y Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: Z.): No Alarm level: g order: El Yes ❑ No Date of last pumping: Comments(condition of alarm and flo Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert NOT FOUND OR LOCATED 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.): a t5insp.doc-rev.MM2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 19 Bragg's Lane, Barnstable, MA'.--; Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: /andappurtenances, ❑ No* Alarms in working order. s ❑ No* Comments (note condition of pump chamber, condition of p etc.): *If pumps or alarms are/y: r, system is a conditional pass. 11. Soil Absorption Systemsite plan, excavation not required): If SAS not located, expla Type: ® leaching pits number: 6'X6'W 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: t5insp.doc•rev.7/2612018 Title 5 OftW Inspection Form:Subsurface Sewage Disposal System•Page U of 18 : Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is Cohasset MA 02025 6/5/2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS)(cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): LEACH PIT IS DRY. IT HAS VARYING STAIN LINES UP TO INLET PIPE. VIEWED STONE AND VOIDS IN LEACH PIT OPENINGS. 12. Cesspools(cesspool must be pumped as part of inspectio (lo ate 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 const ion Indication of oundwater inflow ❑ Yes_ ❑ No Comm s(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc. t5insp.doc•rev.7r2612018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plXn Materials of constructi Dimensions Depth of solids Comments(note condfailure, level of ponding, condition of vegetation, etc.): - t , t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 18 .` Commonwealth of Massachusetts Title 5 Official Inspection Form 11. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 172 Bragg's Lane;Barnstable, MA Property Address V David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14, Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i �eJ(i�• j l • rfee, �57 e yW t5insp.doc.rev.7/26/2018 Title 5 Official Inspection Form Subsurface Sewage Dispos&i:: .sm•Page 16 of 18 f I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 42 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: GOOGLE MAPS, CCC GROUNDWATER CONTOUR, FRIMPTER You must describe how you established the high ground water elevation: SITE IS 70'ASL . GROUNWATER CONTOUR IS 20'ASL W A MAX RISE OF 8'. GRADE TO SAS BOTTOM IS 12.3'. SEPARATION MATH: 70-(20+8+12.3")=29.7'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7f28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form iSubsurface Sewage Disposal System Form-Not for Voluntary Assessments 172 Bragg's Lane, Barnstable, MA Property Address David Abate 10 Jerusalem Road Owner Owner's Name information is required for every Cohasset MA 02025 6/5/2019 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 FROM FAX NO. : 5oe7590655 Jun. 06 2003 11:59AM P3 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PRODTHDEPT. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART ��c� CERTIFICATION j t; Property Address: � Z r i 5 L 3 7` Owner's Name: R A i r Owner's Address: Date of Inspection: 1'Z -O I -DD Name of Inspector: (please rint) Ci I- - r Company Name- Mailing Address: 16 ) L)1) f'S Sj Telephone Number: J r_ �-n 0140 CERTIFICATION STATEMENT 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-1 am a DEP approved system inspector pursuant to S lion 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Sianature: - Date: P ze 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 origginal should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ""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. Title 5 Inspection Form 6/152000 page 1 FROM FAX NO. : 5087590655 Jun. 06 2003 11:59AM P2 Page 10 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address- \ Owner: I(3 T Date of Inspection: 17--bl —GYM SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. J F 0 k 10 FINISH GRADE OVER D-BOX= 81 .0'± - , PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE T.O.F. EL.= 81 .5'± FINISH GRADE OVER CHAMBERS = $Q,Q, $2,Q G EN E RAL NOTES SLOPE @ 2/° MIN. OVER SYSTEM PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER 4' NE ' W O PIPE 1. UNLESS OTHERWISE NOTED ALL SYSTEM COMPONENTS AND CONSTRUCTION ED WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= STONE TO CROWN OF PIPE RISER TO WITHIN 6"OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL OUTLET TO WITHIN 6 OF F.G. 4 SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS BOX FINISHED GRADE � � ° 2"OF 1/8"TO 1/2" DOUBLE WASHED @ FOUNDATION = 80.7 ± 81'0 # _ 5" DIA. OUTLET(S) MIN SLOPE 1 /o TO F.G. (SEE GENERAL NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. -- STONE OR GEOTEXTILE FILTER FABRIC 24' MIN.ACCESS 9" MIN. --- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED, BY THE BOARD OF HEALTH AND THE } DESIGN ENGINEER. COVER(3 TYP.) � f TOP OF SAS- 76.00' (PLACE RISERS ON ALL 36" MAX. _ PROP. SCH. 40 PROP. SCH. 40 4. , 6.0' MAX. CHAMBERS WITH 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER PVC SEWER SEE NOTE 23 75.00 SEE NOTE 23 BREAKOUT EL= 75.50' INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. �--� FINISHED GRADE gl 3" 2" DROP MIN. 3 g„ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN.SLOPE @ 1% 3" DROP MAX. L=7± _j 1 4MINESLOPE 1% PROVIDE WATERTIGHT ELEVATION = 75.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 3" 4" PVC IN FROM JOINTS (TYP.) mow- 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF *77.50' 1411 .75' SEPTIC TANK 4" PVC OUT TO 0 O 0 0 0 0 0 0 0 O 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. • LEACHING FACILITY o0 00 S 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 77.00' INLET TEE 12" ,� oo 0 0 48" OUTLET TEE 75.40' MIN. 7rj.23' 2' o � � � � � � � � � o 0 0 � o 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK TEES TO BE CENTERED GAS BAFFLE 4" PVC TEE 6" CRUSHED STONE o 0 0 0 00 0 00 0o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS DIRECTLY UNDER RISERS OVER MECHANICALLY o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 16.3' OFFSET TO FND COMPACTED BASE AND DESIGN ENGINEER. . TYP - 5 4.0 85' ( ) 4.0 4.0' 4.83' 4.0' OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 80.00' 6"CRUSHED STONE TO BE INSTALLED ON A LEVEL STABLE 25.0' (NP'} ESTABLISHED ON NAIL SET IN 20"OAK TREE AS SHOWN ON PLAN. OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET 73 00, GROUND WATER ELEV.= < 62.00' TP 1 12 s3 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE C C C , PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 2 - 500 GALLON CHAMBERS 5' MIN.*CONTRACTOR TO REPLUMB SEWER LENGTH 10'-6" WIDTH 5'-8" DEPTH 51-8" (Dimensions per CROSS SECTION VIEW CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES PIPING INSIDE HOUSE TO EXIT SEPTIC TANK PRC)FIL��.: H-20 DISTRIBUTIUN BMX DETAIL TYPICAL CHAMBER PROFILE H-20 CHAMBER DETAILS TO THE DESIGN ENGINEER. ACME/Shorey) 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. HOUSE AT THIS ELEVATION AND NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING LOCATION AS SHOWN ON THE PLAN. _ - _ -- \� � • `.."`� , _ y TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 6 C� U t I APPROPRIATE AUTHORITY. 8� PERC NO. TPT-19-110 INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED APPROX. LOCATION OF EXIST. 1,000 • 2 11 I UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR _ . • EVALUATOR: Bradley Bertolo, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. � \ � GALLON SEPTIC TANK TO BE PUMPED, • (', ° � .-� • • - -70 - --- , • ' I C.S.E. APPROVAL DATE: July 29, 2003 \� BOTTOM RUPTURED, FILLED WITH � 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. o�b kS \ a ! ' . -� f3 �' llr.•• ;-' DATE: August 15,2019 ti �o CLEAN SAND &ABANDONED ° ' �__ w SOo 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE 2 • -tiy r I(c + TEST PIT#: 1 • r MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. 0 6 ' ��� �' ELEV TOP= 76.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, •' • r i, ~` v • ~ii FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). \ O'cp �• N ELEV WATER = <62.00 LOCUS ' _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN \ ,(2, PERC RATE SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. �ti F g �.. • DEPTH OF PERC - 16. PROPOSED PROJECT IS LOCATED WITHIN: APPROX. LOCATION OF EXIST. IT � ASSESSORS MAP 298 LOT 68 \ �Q TEXTURAL CLASS/ , J : 1 OWNER OF RECORD: DAVID T. AND ANGELA C. ABATE LEACHING PIT TO BE PUMPED, \ jp� �!-y 0Q . p /~ j 5r / - t FILLED WITH COARSE SAND " TP 1 ABANDONED AND ABANDONED \ \ �,9 N ' + ?("..) * © . `� ADDRESS: 10 JERUSALEM ROAD 1 \ \ \ O O Y ,� �1� o � 0" 76.00' COHASSET, MA 02025 00 0 �d I m • S , FEMA FLOOD ZONE X w \ Agtr \ \ • • O \ Fill COMMUNITY PANEL# 25001 C0558J / FpOR/ js \ \ -,. 11 17. DEED REFERENCE: DEED BOOK 27816, PAGE 297 o �\ V� \ \ �`� ter, 18. PLAN REFERENCE: PLAN BOOK 260, PAGE 42 LL.o TP 1 LP / 1�/ \ \ \ • , to © � ` 60" 71.00' 19 ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. .�,/ / C \ PROPOSED 1,500 GALLON O ` � �� 0 �� � Loam Sand w� C \ H-10 SEPTIC TANK B Y 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY ,76x0 ZONE 11 fJ Q, _ 10Yr 5/6 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING'WILL NOT ASSUME ANY LIABILITY (ABANDONED) / \ \ Benchmark FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. Nail in 20"Oak 108" 67.00' 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A cb C)c Elev. = 80.00' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A U 9s / CO #172 \ Approx. M.S.-L. 1 ( ; I REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. 78, \ / EXISTING SHED C Loamy Sand w/silt& 22. CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL REQUIRED PERMITS AND 3-BEDROOM � \ 6) pockets of FS; some APPROVALS FOR THIS PROJECT. �O U.R/ ;� DWELLING .{-5-� \ / LOCUS PLAN cobbles & 5%gravel �3 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE\ ( a20" APPROVALS ARE REQUESTED FROM 310 CMR 15.221 7 : TOF=81.5'± 61 j8 _ o SCALE: 1 - 1000 (1.) A 1.6 WAIVER (3.0 -4.6) FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. SWING-TIES ry �o 'a2 \ q p o�N� PR. INVERT DECK 80x , 16" 168TP2 " 62.00' (2.) A 3.0'WAIVER (3.0' -6.0') FOR THE MAXIMUM COVER OVER THE SAS. HC DC M°j \ \ Rp\ �9s EL.-77 50' 4„ 80 No Mottling, Standing or Weeping Observed DESCRIPTION oa� o� �Ow�-W SEPTIC COVER IN (1) 31.2' 20.9' _ ' C \ T� 3 RESERVED FOR BOARD OF TEST PIT DATA TEST PIT DATA \ qs 5 O PROPOSED 4 SCH. HEALTH USE PERC NO. TPT-19-110 PERC NO. TPT-19-110 �q 4 82x 40 PVC VENT 50x0' EXISTING SPOT GRADE SEPTIC COVER OUT(2) 35.5' 13.4' MAP 298 , s - \ -- 80-/ O �ti 84 INSPECTOR: David W. Stanton, R.S. INSPECTOR. David W. Stanton, R.S. - 50 - - EXISTING CONTOUR CORNER OF STONE (3) 53.7' 16.8' LOT 68 FIRE PIT EVALUATOR: Bradley Bertolo, EIT, CSE EVALUATOR: Bradley Bertolo, EIT, CSE � ._\ � CORNER OF STONE (4) 63.3' 29.3' - 23,074± S.F. PROPOSED INSPECTION PORT\ 82 C.S.E. APPROVAL DATE: July 29, 2003 C.S.E. APPROVAL DATE: July 29, 2003 PROPOSEDCONTOUR \ / / DATE: August 15, 2019 DATE: August 15,2019 r 501 PROPOSED SPOT GRADE CORNER OF STONE (5} 52.0' 35.3' �Q 82- _ / / 8g CORNER OF STONE (6) 39.8' 25.9' �� 6 �// \ 86 TEST PIT#: 2 TEST PIT#: 3 GAS EXISTING UNDERGROUND GAS �. g4' �a Ba \ 88 ELEV TOP= 80.00 ELEV TOP= 82.00 - - U/H 14 -- 90 � � ELEV WATER= <70.00 ELEV WATER = EXISTING OVER HEAD WIRES 0 ?88, ,92 --go , PROPOSED TWO (2) 500 GALLON < 72.00' 8 PROPOSED H-20 � H-20 LEACHING CHAMBERS W/ PERC RATE - <2 min./inch PERC RATE -_ W W- EXISTING WATER LINE 39"IN a SURROUNDING AGGREGATE DISTRIBUTION BOX o�o „ DEPTH OF PERC:= 60 -78 TEST PIT LOCATION DEPTH OF PERC = ?� TEXTURAL CLASS: 1 TEXTURAL CLASS: 1 O O O PROPOSED 1,500 GALLON H-10 SEPTIC TANK MAP 298 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE LOT 69 (MAP 298 DESIGN DATA o" 80.00' 0" 82.00' LOT 70 A Sandy Loam 0 PROPOSED H-20 DISTRIBUTION BOX NUMBER OF BEDROOMS (EXISTING) 3 Fill 8" 10Yr 3/2 81.33' PROPOSED,500 GALLON H-20 LEACHING CHAMBER NUMBER OF BEDROOMS (DESIGN) 3 24" 78.00' B Sandy 10Yr 5/6 m #172 DESIGN FLOW 110 GAUDAY/BEDROOM EXISTING SHED 20" 80.33' 3-BEDROOM {� TOTAL DESIGN FLOW 330 GAUDAY B Loamy Sand w/Silt& DWELLING ;r \ o = 660 pockets of FS Loamy Sand w/Silt& DESIGN FLOW x 200 /o GAUDAY 1 OYr 5/6 C-1 pockets of FS REV. DATE BY APP'D. DESCRIPTION 28 10Yr 5/6 ----- -- _ - ---- --- ---- TOF-81.5'± � USE PROPOSED 1,500 GALLON SEPTIC TANK 60" 75.00' 48" 78.00' C PROPOSED SEPTIC SYSTEM UPGRADE DECK (3 Perc PREPARED FOR: 7 78" 73.50' 2) ?8� 4) INSTALL 2 - 500 GAL. CHAMBERS w/ AGGREGATE s3, Medium sand CAPEW'IDE ENTERPRISES O NOTES: C 2.5Y 6/3 Medium Sand O 2p 3, SIDEWALL CAPACITY C-2 2.5Y 6/3 LOCATED AT C (1 O h EACH MAGNETIC IC SYSTEM COMPONENT"KING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY 172 BRAGG'S LANE (25.0 + 12.83) ( 2 ) (2 ) (0.74 GPD/S.F.) = 112.0 GAUDAY (6 ' BARNSTABLE, MA 02630 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE 5 PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT BOTTOM CAPACITY SCALE: 1 INCH = 20 FT. DATE: AUGUST 15, 2019 DATA SHOWN ON THIS rj8 PLAN" REPORT TO ENGINEER AND LOCAL BOARD OF (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 1 120" 70.00' 120" 72.00' of I 0 10 20 40 80 FEET HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY No Mottling, Standing or Weeping Observed No Mottling, Standing or Weeping Observed �N 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN THE GROUNDWATER - - - N L `�� PREPARED BY: �U PROTECTION OVERLAY DISTRICT, ESTUARINE WATERSHEDS OR ZONE II. CIVILL JC ENGINEERING, INC. TOTALS: No. 41807 2854 CRANBERRY HIGHWAY 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY TOTAL NUMBER OF CHAMBERS 2 c� EAST VINAREHAM, MA 02538 SWING-TIES PLAN SITE PLAN FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS TOTAL LEACHING AREA 472.2 SQ.FT. � IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL TOTAL LEACHING CAPACITY 349.4 GAL./DAY 508.273.0377 SCALE: 1"=20' SCALE: 1"=20' NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. ------- Drawn By: MCP Designed By:MCP Checked By:JLC T JOB No.4768