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0305 BRAGG'S LANE - Health
305 3raggs L_ane _ Barnstable A 298 031001 MAR 15'1:5, 38` C -Y. �xj — on �k� a 1 1 t " t i t '.+ t?1 m i f " . TOWN OF BARNSTABLE LOCATION 3®5 D R-4Gk`S LANC_ SEWAGE# -VILLAGE 6AtVSTA3(.0 ASSESSOR'S MAP&PARCEL & ( INSTALLER'S NAME PHONE NO. APEk)1DE CLnZRPA16E ' L 4 757%917 SEPTIC TANK CAPACITY %e 000 GALW I.J. LEACHING FACILITY.(type4.) LC-W G�66* (size) ' C K 34 r NO.OF BEDROOMS 3 OWNER L..YMPA KL!Ft4°J PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A 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) NIA Feet FURNISHED BY CAP1EQy1b& P � ® o A_iz i5 ' 13 A-q ° A-511a.1 ° %-S- 11.3° 1 y + 1 No�/// ^ 1 Fee At0. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: / Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYitatiou for Misposal 6pstPm Construction Vermit Application for a Permit to Construct( ) Repair O(5 Upgrade( ) Abandon( ) J]Complete System ❑Individual Components Location Address or Lot No. 3015 Owner's Name,Address,and Tel.No. QpI L-'YP OA KLGM Assessor's Map/Parcel a l© 3 r oo I PQ &A 3 C7 5AMSiARZ i HA Installer's Name,Address,and Tel.No.S OR 4—n—iai- 7 Designer's Name,Address,and Tel.No. s0$—X-7 3—a377 ? PSSS ffik# e. wAeicj -AAA Type of Building: Dwelling No.of Bedrooms 13 Lot Size �t ��a sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3`)a _ gpd Design flow provided .3 S 3;7 gpd Plan Date I a-10-w f 5 Number of sheets Revision Date �©5 8 AA a&'s c-4x)6 St Title � �` Size of Septic Tank 6)d4::> 6�466D J Type of S.A.S. �j, a4d49a -75; Description of Soil LnAM1,I 5A 0 C��3 r� tcD —EWE <A- b OR 4S,`� � -10-c P4AAe Nature of Repairs or Alterations(Answer when applicable) U,5 je' 6—)Q,!�7 t0( 1,6a() C�AL.� S63�>J iC. —Moy.-7D VEz< E-I'a.o b-;�,0x 17��✓) LC° 62 L0 4-rx16r Gl-keccR�� Cy P?4 3 -OF 66tme0x- , i� OU 5LD€S !01 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Sigma Date Application Approved by , Date �y16 Application Disapproved b Date for the following reasons Permit No. -- j Date Issued FeejlN THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ./1i Yes j PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS n - 2pplication for Disposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair 06 Upgrade( ) Abandon( ) �(Complete System ❑Individual Components Location Address or Lot No. 3 015 5S C ANC Owner's Name,Address,and Tel.No. p 1 L_yN aA K(ZM Assessor's Map/Parcel a�O 3(•(��( P0 oy- 3t-7 13AFPQAR,.G, HA Installer's Name,Address,and Tel.No.S02-411-$QT7 Designer's Name,Address,and Tel.No. SO$—o�'73--a377 FA P CW t v ... S �4 tl 7E�vt Ty p( a of Building: •<' Dwelling No.of Bedrooms 3 Lot Size `f Y,-7�oZ. sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 D gpd Design flow provided .353.7 gpd Plan Date ��a^ (o-eZO� Number of sheets ,/�� ��'-�- Revision Date Title .0 5 8AA eR�_S LAV6 R4RI1?T A_1 Size of Septic Tank 11000 g-544( .00 Type of S.A.S. Description of Soil LOo(sh(y .5AO-P �3 Z ftc5p —F( E s44-&2 `- 2 p�A Ild Nature of Repairs or Alterations(Answer when applicable) U S� EX lS`r11J ( c LWL) S63PT ic- -LAc-ec-ID LIEK ) k-ao D-8, it, , LC G . [.ui"(0 4 <l-&*e8M 5, cv 3 'OF e+'- A- 4�4-'ice d1J LSD _ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in 4 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 Healt Si Date �'�•!B..e � i Application Approved by Date Application Disapproved b Date for the following reasons Permit No. 0-fo ip y 51 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by /qDEG XbG7 at 309 89AQa S LA,0 Ir BA12i-)SI?&�as been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 15- 45( dated I Z11 g I Zo y m � Installer O A McOI DE 6—� E� 5 ULY Designer C 1l 11J� .hJC� .Z1U C- #bedrooms Approved de kgn flow '" ; .33o gpd The issuance of th's pe it shall not be construed as a guarantee that the system wi fun�tio las designed. C Date Inspector Q/ > p ----- ---------------- - - r--------------------- - ------------------------------------------------------------------------------ -------- No. 2_0t� LIT Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS . Bisposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair()� Upgrade( ) Abandon( ) System located at_ D 5 f3 JZA C7 ems' �/}!U€ 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 permit. /� �o_2=� Date ( 5 Approved by 41, U1/05/2016 17:54 5082730367 94461 N. uu liuu %M %M Town of Barnstable Regulatory Services Thomas F. Geller,Director Public Health Division : .,�rrrrn►tate. MAS& 167q �� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 FAx: 508-790-6304 G Office: 508-862-4644 Sew a Permit# ;W 15 " 5/Assessor's Map/Parcel 2q��31 O i Date: 1; Installer & Designer Certification Form Designer: Sc , -Toc Installer: Address: z�y`( Ccow,-e<< ►k �,w Address- 15's Commt ot'u( 54re�t ' we�t�narr�F.d.A 0253�t Mc,s1A ei. >7� 0�6y coS•273 0377 On I;L '� 'oZ©(7 CQPeide. G'��zcpris was issued a permit to install a (date) (installer) , septic system at 30 5 6re� S ZaVi OL based on a design drawn by (address) C E n 5toeec n� , -'vie_ dated Decew\oc.r l(o, 2-015 . (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) s ected and the soils were found satisfactory. ,,,OF JOHN L. r CHURCHILL JR. . (I st ler's Si Lure) ML O esigner s Signature (Affix 1?e gr Here) P ASE RETURN TO ST L PUBLIC HEAL DIVISION, CERTIFICATE nF COMPLIANCIE WILL NOT BE IS$ D U 1 BO 'CMS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU, gAafTice formAcicsignercertification form,doc ' to I� Barnstable Town of Barnstable AlA,nMIMM Regulatory. Services Department Q P 10� Public Health Division m MA'S A 200 Main Street,.Hyannis MA 0260.1 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO , December 14, 2015 CERTIFIED MAIL.# 7015 1520 0001 2273 2558 Lynda Klein F. PO Box 317 Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 305 Bragg's Lane,Barnstable,MA was last inspected on 11/14/2015,by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER O ER OF HE BOARD OF HEALTH mas c ean, R:S.,CHO Agent of the Board of Health b Q:\SEPTIC\Letters Septic Inspection Failures or Future Ev1\305 Bragg's Ln Barn Dec 2015.doc Town of Barnstable + HAEtNSIAHLA • - . pf 9 Regulatory Services Departinent Ea { Public Health Division 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Richard Scab,Director FAX: 508-790-6304 =Thomas A McKean,CHO Feb 6,'2007 ' Rev. 7/6/15 DEADLINES TO:REPAIR FAILED SYSTEMS (Town Code §360-44 and-Title V: 310 CMR 15.000) An'Y'marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA Static liquid level in the distribution box,above outlet invert due to an overloaded or clogged SAS or,cesspool r gg P ❑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 o Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components., etc) . X ❑.Leaching pit or.cesspool with high liquid level,<12"below inlet(per Town Code §360-9.1) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Dv 18 2015 22:12 Jim The Inspector Man 5085349919 page 1 Commonwealth of Massachusetts Title 5 Official Inspection Form P- Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 305 Braggs Lane CIA Property Address Lynda Klem �r= Owner Owner's Name r information is P5 required for every Barnstable MA 02630 11-4-15 r; l page: Citylrown 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 A. General Information filling out forms SI ' I Z q 3 ���tutnururrrr on the computer, `\4OFMgS4,�%� use only the tab 1. Inspector: key to move your 2 cursor-do not James D.Sears ?��c JAMES use the return key. Name of Inspector Capewide Enterprises, LLC ,. o ' Company Name 151 Commercial Street % s INSPE , Company Address Mashpee MA 02649 Cityfrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 11-16-15 ;spZe!itoZrs�signatu`r, ���� Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under'the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3i13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �b Is Nov 18 2015 22:12 Jim The Inspector Man 5085349919 page 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owners Name information is required for every Barnstable MA 02630 11-4-15. page. City/Town State Zip Code Date of Inspection B. Certification (cont) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15,303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Failed Leaching. The system is a 1000 Gal Tank D Box and three Flows 13) 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Nov 18 2015 22:12 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts t Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owners Name Informrequire fo is fy Barnstable required for eve MA 02630 11-4-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s)_The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: Ej 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 Form:Subsurface Sewage Disposal system•Page 3 of 17 Nov 18 2015 22:12 Jim The Inspector Man 5085349919 page 4 Commonwealth of Massachusetts r Title 5 Official Inspection Forma Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owners Name information is required for every very Barnstable MA 02630 11-4-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: " This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in emqq=W is less than 6" below invert or available volume is less than 1r4 day flow A&)eIIiAIC t5ins-3M 3 Title 5 Official Inspection Form:Subsurface Sewage oisposal system•Page 4 of 17 Nov 18 2015 22:12 Jim The Inspector Man 5085349919 page 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "F 305 Braggs lane Property Address Lynda Kern Owner Owners Name information is required for every Barnstable MA 02630 1.1-4-15 page. City/Town State Zip Code Dale of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a,public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 f Nov 18 2015 22:13 Jim The Inspector Man 5085349919 page 6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owner's Name information is required for every Barnstable MA 02630 11-4-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes . No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 330 t5ins•3/13 Tide 5 Official Vspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Nov 1$ 2015 22:13 Jim The Inspector Man 5085349919 page 7 Commonwealth of Massachusetts Title 5 official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary p Y Assessments . 305 Braggs Lane Property Address Lynda Klem Owner Owners Name informationis every Barnstable required fo d for eve MA 02630 11-4-15 page, City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal. Tank D. Box and three flows Number of current residents: 1 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 years usage(gpd)): 2014-54,000Gal 2015-59,000 Gal's Detail.- Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): .Gallons per day(gpd) Basis of design flow(seats/persons/sci t., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins•3»3 - Title 5 Official Inspection Form:Subsurface sewage Disposal System•Page 7 of 17 Nov 18 2015 22:14 Jim The Inspector Man 5085349919 page 8 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 305 Braggs Lane Property Address _Lynda Klem Owner Owners Name information is required for every Barnstable MA 02630 11-4-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 2011 1 2013 1 2015 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page a of 17 s I Nov 18 2015 22:14 Jim The Inspector Man 5085349919 page 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3D5 Braggs Lane Property Address Lynda Klem Owner Owner's Name informationisequir2d for every Barnstable MA 02630 11-4-15 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: 1982 permit # 82 - 06. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2' Net 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.): Pipeing is 4"PVC SCH 40. Septic Tank (locate on site plan): Depth below grade: 14" 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: 1000 Gal. Precast H-10 Sludge depth: 2" 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sswage Disposal System•Page 9 o117 Nov 18 2015 22:14 Jim The Inspector Man 5085349919 page 10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owners Name information is required for every Barnstable MA 02630 11-4-15 page. City/Town 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 26" Scum thickness, Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Tape- Plan Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and covers at 14" below grade. In and outlet baffle's. No sign of leakage. Tank shows signs of back up Grease Trap (locate on site plan). Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain).- Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle- Date of last pumping: Date (sins-3/13 Title 6 Official Inspection Forth:Subsurface Sewage Disposal System-Page 10 of 17 Nov 18 2015 22:15 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts A Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305.Braggs Lane Property Address Lynda Klem Owner Owners Name information is Barnstable required for every MA 02630 11-4-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 Official InspecUon Form:Subsurface Sewage Disposal System-Page 11 of 17 Nov 1.8 2015 22:15 Jim The Inspector Man 5085349919 page 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner owners Name inquired for is every Barnstable required for eve MA 02630 11-4-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x21"-18" Below grade wlone line out. Wall's are gone-need to replace D Box. Note: D Box show signs of being over full in the past Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No` Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): `If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Nov 18 2015 22:15 Jim The Inspector Man 5085349919 page 13 Commonwealth of Massachusetts i Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments p Y ry , 305 Braggs Lane Property Address Lynda Klem Owner Owner's Name information is required for every Barnstable MA 02630 11-4-15 page, Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): Leaching is three flows. Bottom of flows are covered w/solid carry over. Camera out from D Box through flows. Line loaded w/roots, not leaching.Dug up cover of leaching. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool , Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Usposal System-Page 13 of 17 Nov 18 2015 22:15 Jim The Inspector Man 5085349919 page 14 _ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 305 Braggs Lane Property Address _Lynda Klem Owner Owner's Name information is required for every Barnstable MA 02630 11-4-15 page. Cityrrown State Zip Code D. S Date of Inspection System Information (cont.)y Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form!Subsurface Sewage Disposal System-Page 14 of 17 Nov 18 2015 22:16 Jim The Inspector Man 5085349919 page 15 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 305 Braggs Lane Property Address Lynda Klem Owner Owners Name information is quired for eve ry Barnstable MA 02630 11-4-15 page. Citylrown 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 g � N r �1 O TP R t Off s t5ins 3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Nov 18 2015 22:16 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305 Bra ias Lane Property Address Lynda Klem Owner Owners Name information is required for every Barnstable MA 02630 11-4-15 page. City(Town State Zip Code Date of Inspection D. System Information y (cont.) , Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells �o Estimated depth t high ground water: 21' 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: 11-12-81 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: T.H.on Desin plan 11-12-81 no G.W. at 21'. Bottom of flow's at 4' below grade. Bottom of flow's at 17'above T.H Depth Before filing this Inspection Report, please see Report Completeness Checklist on next page. ,5ins 3/13 Title 5 Offaal Inspection Form:Subsurface Sewage Deposal System-Page 16 of 17 Nov 18 2015 22:16 Jim The Inspector Man 5085349919 page 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 305 Braggs Lane Property Address Lynda Klem Owner Owner's Name Information is Barnstable required for every MA 02630 11-4-15 page. City/Town State Zip Code Date of inspection- E. Report Completeness Checklist ® Inspection Summary: A, 8, 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 t5ins•3/13 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 17 or 17 Town of Barnstable . P# M12- �r Department of Regulatory Services Public Health Division DateMAM ,� 200 Main Street,Hyannis MA 02601 F, • rill btK(� Date Scheduled �' � �������./� Time rt_U I " Fee Pd.. -! — � fro Soil Suitability Assessment for Sewage Disposal ;n Performed By: IV,IC"AC.L 91mevrek. 5.I:r 10 Cs,E, Witnessed By: S p LOCATION&.GENERAL INFORMATION Loeation Address J 2 Q � Owner's Name i-,Y M DA K(..[_(-1 R �S C.� Pe rbc!X ;3 � 1-T t3A ' 34C Address Assessor's Ma /Parcel: �q /0 3(/UO( C,a lbw C=r-�i ER I�Qt S P Engineer's NameNEW CONSTRUCTION REPAIR _ �� Telephone# 560. 173-0377 Land Use- SM(PLE 1=9Nue1 D146 [.rN(p ' Slopes M t)`5�1v Surface Stones /V Distances from: Open Water Body >100 ft Possible Wet Area 1 I ft Drinking Water Well y I bG ft Drainage Way I ft Property Line 1 b ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands•1'n proximity to holes) �� 1.11T1)cNC►� Seri E -�-qN' . { Parent material(geologic) 5A V0LJ1CM M&Ne"06 Depth to Bedrock , Igyir Depth to Groundwater. Standing Water in Hole: y' Weeping Prom Plt Face iyy� Estimated Seasonal High Groundwater DETERMINATIQkN FOR SEASONAL HIGH WATER TABLE Method Used: "Deer a.. Depth Observed standing in obs.hole: NO —In, Depth to soil mottles: .; y i qq —in.* Depth to weeping from side of obs.hole: 144 In, ©roundwater Adjutltment_ 'W1 AYA ft. Index Well-4 Reading Date: Index Well Leval Adf,-tl!ctor ,-� AtU.droundwaterLevel„,_ _ PERCOLATION TEST bats �t `�,s i�rs r�,►� Observation I Hole# Tina at 9" _ # Depth of Pere '21 Time at 6" Start Pre-soak Time @ Time(9"•6") End Pre-soak iD.'3Q 4M Rate Min./Inch 'd Z MP I s- Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:ISEPTICIPERCFORM.DOC '� DEEP.OBSERVATION HOLE LOG Hole# I 2 Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,,Boulders. onsistency.%'Gravel) 0-3" d E 3-40 6 -f ya 54. 4190:-1:Ne S40 Z.5 y c1fr, - 105 C-Z 5ttr La4m 2 �y MEOtu. SgovD DEEP OBSERVATION HOLE LOG Hole# Depth from Soil.Horlzon Soil Texture Soil Color .Soil . Other Surface(in.) (USDA) (Munsell) Mottling' (Structure,Stones,Boulders. Consistency,% DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. o en Flood Insurance Rate Map: Above 500 year flood boundary No— Yes _ Within 500 year boundary No Yes. Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area for the soil absorption system? y195 _— proposed rP If not,what is the depth of naturally occurring pervious material? Certification 0.2 7'`I P PP Y ' I certify that on (date)I have passed the soil evaluator examination approved b the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertisepVtexperience described in�10 CMR 15.017. v Doti: Signature Q:\S.EMCVERCFORM.DOC I TOWN OF BARNSTABLE C b�,� �`" `1') L U( V- A T10N 43V-1G -5 t Q/2 r SEWAGE # La-©6 ASSESSOR'SSMAP & LOTX 3l'=� INSTALLER'S NAME&PHONE NO. 4beiL-- 7�>k 10i::!;C-t,- SEPTIC TANK CAPACITY l G U ='g LEACHING FACILITY: (type) - F �c�u�(1 ; �``f`52-�5(size) NO. OF BEDROOMS — BUILDER OR OWNER PERMIT DATE: P( COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility y Feet Private Water Supply Well and Leaching Facility (If any wells exist j 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) t Feet Furnished by �>��ANt\C try i Ov cT3 r r NO O Z. O Fps. THE' COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........7"066,..1J..LOF.... 3. .r h / ..............•------ Appiiration for Mipaaal Works Tomitrnrtion runfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...... .l� 1=.'.��._.'.5...._. .f $ ................... ............................0.......... ---.../............................................... .Locatio Address ._.. ... .. .. ................... Lot No. Owner Address W J Installer Address Type of Building Size Lot. _ cC ..Sq: feet aDwelling—No. of Bedrooms......................................Expansion.Attic ( ) Garbage Grinder WO) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures -------•----------•--------------- W Design Flow........... ......................gallons per person per day. Total daily flow.............. ®..................gallons. W Septic Tank—Liquid capacity./.00gjallons Length.7=4...�Width.4./0/Pf Diameter.- !r./�Depth,_f._-!T_" x Disposal Trench—No.._J............ Width................ Total Length_s2R..._...... Total leaching areal 7`}. ........sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... leaching area..................sc. ft. Z Other Distribution box (4-1 Dosing tank '-' Percolation Test Results Performed ---------- aTest Pit No. 1.� ,.._..minutes per inch Depth of Test Pit....;9�.__.___ Depth to ground water../V_OA�_ (Tq Test Pit No. 2.e.4..Z....minutes per inch Depth of Test Pit..../ `..... Depth to ground water__4k..qe� . ODescription of Soil...°� ...............................�= ...... 4� ` "�� ��---------•------------.---- U - :s��€ cam ��ii�C �c� d =------- �"' j _ -•----------------------------------------------- W ---------------- . - rS!�!!f .......................... 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 TIT..:n 5 of the State Sanitary Code- The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i4s d b t e oar of health.,- Signed "s-- .......... .-`---- ---•-- =-•--•--•--•-•-------------------------•••---- .........................._.... Date Application Approved By....... ` .......................................� _.__.. �. ` '�................ Date Application Disapproved for the following reasons:................................................................................................................................. --••------•------•--•--•-•-•---------•--......--•--•-----------------------------------------------------"--------•----....--•------•----•----•--------------•---••---•------------•----•--•-----•------- Date PermitNo......................................................... Issued.....................•.................................. Date No....Q.An . • " Fu$.. .- ...... y i THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH ..46,1.Ael......0F....1j fc 1 ! � . f f.0 '_.................... ApplirFation for Uiipo-qFal Works Tomitratrtion Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. ......... _.� Location- dress * or Lot No. „Ir ti+e:M+e.. - ............................... ...•.................................................. Owner ........................•-••-•----• Address , . Installer Address Q Type of Building Size Lot.ft.a3A.5 ..Sq. feet U Dwelling—No. of Bedrooms_ ............................Expansion Attic ( ) Garbage Grinder (IVO) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) alOther fixtures ...................................................... W Design Flow....._.....�"� ......................gallons per person per day. Total daily flow._._.......... .X Q..........._._....gallons. WSeptic Tank—Liquid capacity.l00Y.Jallons Length_C<`:_ �yVVidth. '1'���Diameten!'/.........DepthiJ.�..'.`�._ ."" x Disposal Trench—No..__J;:......._.. Width... ............ Total Length..o2Z.-....... Total leaching area_'2-.?.'j .......sq. ft. Seepage Pit No.---___--_--____-_-. Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (4-T' Dosing tank ( ) Percolation Test Results Performed F aTest Pit No. LA_ .....minutes per inch Depth of Test Pit.... -/.......... Depth to ground water..d � ' _. Gz, " Test Pit No. 2_eo5�.s�?_..minutes per inch Depth of Test Pit....Z ..... Depth to ground water.. "'- Z-Z5� .. p Description of Soil................._A ............................... rs ------------------------ ________________________________ ___�!. ..�.. _. /- ._ _.......... .._..__..______._I.Y-MJr.(:: ...... .� _._. J�V. .......................... UNature of Repairs or Alterations—Answer when applicable.._..........................:.................................................................. -----------------------------------•----------------•-•----•---•--------.....--•----•-•------•----------•----------------...------.....----•----------------•------•-------------------••••--......_... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal.System in accordance with Tr�t- °.. the provisions of n: -`- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' u b t e ar of health,,_ Signed--- ................................. /' 6+Date Application Approved BY 1............. Date Application Disapproved for the following reasons:................................................................................................................ ..................................-...................................................................................................................................................................... Date PermitNo......................................................... Issued-------------------•------............................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... `" ., .r�.!`......OF....... .................... TratifirFatle of TontpliFanrr, THIS I��jjT��O CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...................# ��,«. ..••-••-••--....----..........-•••••-------------- -•-------.....--•---•------•---------••----_---_..._----------....--••--......----••••. ...... .... Installer at............. `-----........._ Q'''' .••--•---••---•-------.--._-.-----•-----•---•------------------ has been installed in accordance wi the provisions of TITI3 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----- _L _p��................ dated------------.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......-•....................................•-••----....._..--•-•-.............. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ` BOARD' OF HEALTH �,'..c �.......OF...... /'' ' . 'r.�5` . 1 "' '::.......... 81 A x FEE.. .5 No......... ......... �i��o�aal ork� �on�lrttrr#ion rrnti� Permission is ereby granted............ to ConstrucLI YT or Repair ( Individal Sewa Disposal stem at No........... -----•--- _X. Street as shown on the application for Disposal Works Construction 2crmit No..................1_ Dated.........................-................ �� I• f-- ....... oard of Health DATE - _ - r, ;Z_V... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y r Cg. 2 44. 99 -= LOT /I 03 A)CRIES e 72 c:-22.9. 22-f 5- o 4S, Lit }¢� ToP 1-- Et Z6.6/ 4-0 7-657- /joL E s --r/c 05.9 s rA+/K . p,sr.aox N c2o' il5' �l2ESEgi/E 31 72o ry G/F�COI D To w/V !/vSPE C row S3 % A-1 22.9 J _ 5L. 24. 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I { +. --' •P/TCf/ j /F- %o 00 .._..:.._ -FL-��� i12• _/H RL 4 , r 3: /000 22.45 2c:/.3 2 a106 Z>r�cvso,�s� w/qs� ..- %N✓EST /N✓t 7 1 /,v V,E r- 7- ✓i o° IjC I �. i GALLON 4'M/N. _l L ALL 22.7o ( CAFvgCrTY 22. 3 ct�l .L p EACH I A�ou�,u PT/C TAA,/� ( { 1 - cltt 0V 1, :,v✓�E'T I (N/A TE�7/�f/T) y -� nr�/E,eT �i t LfO� NO GAEgAra G E'/n/zaF� C 8 SEPTiG SysrEM � n's;, tJCT/o,A, aoroM S-.XZ$- 2z4xl:q - z 4 ' A�v s�-z>&s - 4. S AIA L L C O N FO.E N1 -r0 Tr�E MyrA 5 5. S/.DES .2 x Q S!a 'x 2'.S'� j I �5 Lc/V'✓/EO�/�I�/�✓7GGr C,C7UE T//,: G 00.4' 'Z� OF s/E�.4LT,4-� '�GC/Ll4T1CiV SEP7-/G 7'�i/v� D157-AZ1F5L/T-10AY /3"X. /�I f/wIf3E U C-3 C��C�CN1.� 3 NU P/r /�E:/�/r=�,eG`� CONC.��7� - M/N. /�';/ ��.�.��a �G � �-�•�►�I-•l/tit�y . �,L1 T� .G �. .'�I//rl��/ti'�r-1 CD-l/C2ET� JT.�E,vCT,-1 3c7Jt'�, �Sl ° r.+ 'kC�,�f `y+:+,, i No 74P3 C 1-� CA F>. 3.C7 SAL.,`D,4 Y `. r L/,`��c &E-II/ .L,-'- r�.a-,,L l_' 1 k7 T r�/v�vVAy No To r3E LOCA7-2ED O✓� S>/S,-Erb Z�/vL-`S s 5 l T PL A N ALt_ PipES Tc� � k1/A T�.eT(&,-!T S YST� E Uti� / 8E •brr. LOCI T/QiV 13A E/vST,�a , /1-JA. TC J;e oAl Ole v . .8E/n/C.L COT` / A's TEE xrtt� yl -C4. D&L):/J�l IZf� CC2T/.�"y/ T�f�T TIEY ont; �n±<r 41 S T�uc Tci.eE ,S,�y�Ot cJnJ �,E a4:E .AJ ;s w W,4_y L oCArL"40,o/v TrtC'.�,eoca�+.,� ° � ;y Fv, 1r ILL IAI"- .F., 5t /�7`�. ON :�' '; _ /,� BA YS -PE SURVEY CORP. 89 WI,L-LO V.ST YAeMOC)7T-/,c>O 7,, A_`S. - � �- - -- - - -._.-- - - --: •--'-' ---'-':-. t FO.Q,`-1ER�Y CROs�./ELL. [ TLIYt�.� GPRL?O.tZ.4T,�!V J BUILDER . . E.A. FJEADY & SONS INC. TEL- 508-862-2674 . - HIC# 140380 . ADDITION TO RESIDENCE FOR MRS . MILDRED DICKSON 305 BRAGGS LANE BARNSTABLE, MASS. 3 GENERAL NOTES 1. ALL WORK SUBJECT TO TOWN OF BARNSTABLE APPROVAL INCLUDING, HISTORICAL DISTRICT REQUIREMENTS 2. ALL WORK PER MASS STATE CODES 3. PLUMBING & ELECTRICAL WORK BY LICENSED CONTRACTORS DRAWINGS 1. TITLE SHEET 2.EXISTING HOUSE FLOOR PLAN 3. FOUNDATION 4. FRAMING 5. ELECTRICAL & PLUMBING 6. SIDE ELEVATION 7. BAR ELEVATION ADDITION FOR MRS. MILDRED DICKSON 8:SIDE ELEVATION 9. DETAILS 305 BRAGGS LANE BARNSTABLE, MASS. 10. SITE PLAN (BAYSIDE SURVEY CORP) ii. SUB Division SURVEY (Ziis/s) TITLE SHEET ; 4/2/05 DWG #1 44'-8i ~ �~ % I Ty t - 23—6' 1961— 7/16- 25-o' t-1^ 124' (7`` t 101-01 t tin — 1-01 18—0• i EXISTING CONDITIONS ADDITION FOR MRS. MILDRED DICKSON 305 BRAGGS LANE BARNSTABLE , MASS SCALE - / 32 1 - 0 4 / 2/05 G # 2 . .� s 13' EXISTING LIVING ROOM STAIRS I EXISTING BEDROOM I ' I - �- ------------------- ------------------ -------------------------------- o 24' WIDE CRAWL SPACE ACCESS ti 2 X 8, 16' D.C. 2 X 8, 16' D.C. ; o ; 3/4 T & G N 24' x 24' CONCRETE FTG. PLYWOOD I g p 2 x 6 or, 2 x 8 cv 2 x 4 PT. 12' x 12' CONCRETE PIER CONCRETE SILL 2-2x12 BEAM f 10'—0' 8' CONCRETE FROST WALL '---------- ---------------------------------------------------- I L •— ----------------------------------------------------------------------- — 18'-0' FOUNDATION ADDITION FOR MRS. MILDRED DICKSON 305 BRAGGS LANE BARNSTABLE, MASS. SCALE �1 / 4 10 4 3 _ . - / /05 DWG # 3 - F u urS i- Lo? V--J EXISTING HOUSE ' h �10 I j a O t - ti ADDITION t co LO FRAMING s is--o• ADDITION FOR MRS. MILDRED DICKSON 305 BRAGGS LANE BARNSTABLE ., MASS CALF 1 / 4 -_ 1 _ 0 _ � , 14 /2/05 DWG *4 � � S NOTE:, ,. 1. HOMEOWNER WILL PROVIDE SPEAKER WIRING FOR HOME $., ENTERTAINMENT UNIT SURROUND SYSTEM: 2. EXTEND LIGHTNING ARRESTOR SYSTEM AND `TIE TO EXISTING GROUND RODS. DUPLEX FLOOR OUTLET FAMILY / CD c N SWITCHED CEILING OUTLET FAN BY OWNER ELECTRICAL 18`-0- ADDITION FOR MRS, MILDRED DICKSON ry F 305 BRAGGS LANE BARNSTABL. E , MASS . a . 4 /2/05 DWG # 5 FINISH GRADE OVER D-BOX= 89.7'± T.O.F. EL.= 91 .9 ± FINISH GRADE OVER CHAMBERS = 89.9't - 89.6'± GENERAL NOTE S fPROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE ° INSPECTION PORT WITH ACCESS STONE TO CROWN OF PIPE OUTLET TO WITHIN 6" OF F.G. 4 SCHEDULE 40 PVC MIN SLOPE 1 /° BOX TO F.G. (SEE NOTE#21) METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE 2 OF 1/8 TO 1/2 DOUBLE @ FND. EL.= 91 •0'± F.G. OVER TANK EL. = 91 .0'± 5" DIA. OUTLET(S) WASHED STONE CODE AND ANY APPLICABLE LOCAL RULES. „ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PLACE RISERS ON DESIGN ENGINEER. PROPOSED 4" 9" MIN. ' 9" MIN. TOP OF SAS= 87.63' CHAMBERS w/PIPED 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXISTING 4' �� 36 MAX. INLETS TO 6 OF SEWER PIPE SCH. 40 PVC 4 PVC TEE 86.80 36 MAX. BREAKOUT EL = 87.30'- SYSTEM UNLESS OTHERWISE NOTED. Lr" SEWER PIPE FINISHED GRADE 6" 3-1 3" DROP MAX 3„ 9, _ ' 0 0 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2" DROP MIN L 42 I' M PROVIDE WATERTIGHT o 0 0 0 0 0 o a ELEVATION = 87.30' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE @ 1 13" 4" JOINTS (TYP.) = = = O 0 0 0 ��' O o0 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14' .__r87,6'-± SE 4" PVC OUT TO o 0 0' THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE LEACHING FACILITY 1' op o 0 SPECIFIED DROP BETWEEN I o 00 5- SLOPE ALL SOLID PIPE AT 1.0/o MINIMUM. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 87.1N.12" 00 6' $6,95' 2 Oo 2.0 3.0' TYP 3 0, 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF 6.0 (3.0' ) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONE (TYP.) 34.0' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY , GROUND WATER ELEV.= < 77.70' 9.0' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE Z5.80 AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 5'MIN. 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 90.00' TO BE INSTALLED ON A LEVEL STABLE 5 - LC-6 CHAMBERS ESTABLISHED ON A NAIL SET IN AN OAK TREE, AS SHOWN ON PLAN. - BASE- FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EPIPES TO BE LAID LEVEL. TYPICAL CHAMBER PROFILE CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES "CONTRACTOR TO VERIFY EXISTING SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL CHAMBER DETAILS TO THE DESIGN ENGINEER. ELEVATION PRIOR TO ANY WORK& NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. _ _ SWING-TIES _ TEST PIT DATA 11 REGULATIONS.DETERMINATION OWNER/APPL OWNER/APPLICANT MADE IS TO OBTOAIN SUCH DETIERMINATION FROM ING NOTES: +�. �, .. � ,�, DESCRIPTION HCA HC-2 ,1,+' : I `` •� I `�,r.a PERC NO. 14912 APPROPRIATE AUTHORITY. 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF . , *? 6971 INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED EACH SEPTIC SYSTEM COMPONENT. CORNER OF STONE (1) 65.1' 70.6' - ��1UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR EVALUATOR: Michael Pimentel, EIT, CSE CORNER OF STONE (2) 69.5' 64.8' _ -moo • ` TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF _,� .! `` -` + C.S.E. APPROVAL DATE: Oct. 1999 THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST CORNER OF STONE (3) 77.9' 73.8' - `�''' ' �^ � 4 - 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL ~�- - „-- y a= � iy' DATE: December 9, 2015 (4) 74.0 78.9 .., '`� "" 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE CORNER OF STONE BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 'K ,�- �� �.' + ; TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. 3. ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2, - a ; ;^_ al r ' ,� ELEV TOP= 89.80' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, SWING-TIES SKETCH SCALE. 1 - 20 �,�. +, ( ' r:�--�-. ,� y THE GROUNDWATER PROTECTION OVERLAY DISTRICT AND THE >` ,;� '>.Irl ELEV WATER= <77.80 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ESTUARINE WATERSHEDS. HC-2 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE _ < 2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. .�' �` :":,F- ��, a" `` ;d �'�_ '' •, '�-� DEPTH OF PERC = 3"-21" 16. PROPOSED PROJECT IS LOCATED WITHIN: Y `�i► "-. �, - `'jr � � LOCUS i TEXTURAL CLASS: 1 ASSESSOR'S MAP 298 LOT 31-001 HC-1 OWNER OF RECORD: LYNDA KLEM ,;I,.-�,• f ' ►� ,�� A/E ADDRESS: P.O. BOX 317 BARNSTABLE, MA 02630 3" 89 .55' ' ^ Perc ��- 21" 88.05' FEMA FLOOD ZONE X 1, + � '�/`I,f COMMUNITY PANEL# 25001CO558J I A .,, Loamy Sand (2) !` +�" Y_�Q�t # Q' -s �0 B 10Yr 5/6 17. DEED REFERENCE: BOOK 22916, PAGE 135 18. PLAN REFERENCE: PLAN BOOK 350, PAGE 35 LO MAP 298 (3) 48„ 85.80' LOT 117 O a O 'ice ' �+ - 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. o (1) O C-1 Med.-Fine Sand O F ..� ,; '•' t- __ :�. 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY ce) 5Y 6/6 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 3 .o ,"': "� - ti ,� / ,,�,%- ' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A 96 Silt Loam 81.80 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A MAP 298 REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. LOT 31-001 108" 80.80' 44,762 S.F. ± LOCUS PLAN Medium Sand , C-3(P SCALE: 1"= 1000' 2.5Y 6/6 #305 k''0 144"1 1 77.80' EXISTING No Mottling, Standing or Weeping Observed 3-BEDROOM DWELLING TEST PIT DATA ,� DESIGN DATA LEGEND TOF-91.9'± i / PERC NO. 14912 / f INSPECTOR: David W. Stanton, R.S. 50xO' EXISTING SPOT GRADE NUMBER OF BEDROOMS (DESIGN) 3 EVALUATOR: Michael Pimentel, EIT, CSE 50 - EXISTING CONTOUR / 86 DESIGN FLOW 110 GAL/DAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 1999 APPROX. WATERLINE TOTAL DESIGN FLOW 330 GAUDAY December 9, 2015 r� i� C 5., PROPOSED CONTOUR LOCATION / BIT DATE: ( \ DRI�EVV DESIGN FLOW x 200 % - 660 GAL/DAY 50 PROPOSED SPOT GRADE 1 AY ,` - I TEST PIT#: 2 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 89.70' GAS EXISTING GAS LINE > > �'� / W--� <77.70' CP w c / \Ei ��`-- �✓ `'� W+-W - E/T%C tt�� +S �Q� ELEV WATER = E/T/C EXISTING UNDERGROUND UTILITIES MAP 298 w _�� Tic - \ =/T%� U.P. #18A �� � � � PERC RATE _ � � \ I W W- EXISTING WATER LINE LOT 31-002 INSTALL 5 LC-6 LEACHING CHAMBERS�-PROPOSED � _ t�,� DEPTH OF PERC = �s DISTRIBUTION BOX l3- _ w/ AGGREGATE TEST PIT LOCATION 10"OAK r TEXTURAL CLASS: 1 ' 4"SPR CV SIDEWALL CAPACITY EXISTING 1,000 GALLON SEPTIC TANK 4 (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY EXISTING TANK TO BE - UTILIZED IN THIS DESIGN �l vw (34.0'+ 9.0') (2 ) (2' ) (0.74 GPD/S.F-) - 127.3 GAL/DAY 011 89.70' \ A/E PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE 12"Q�K TP 2 - �� �'� �' � l� �� 3" 89.45' EXISTING DISTRIBUTION a �cL �. , ���P BOTTOM CAPACITY ® PROPOSED DISTRIBUTION BOX BOX TO BE REMOVEC 12"MAPLE 69 89xT Q,, '`0' � (APPROX. LOCATION ONLY) / ' Q (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY FLOW DIFFUSERS TO BE ABANDONED !;' 3 � ��� (34.0'x 9.0') (0.74 GPD/S.F.) = 226.4 GAUDAY Loamy Sand PROPOSED LC-6 CHAMBER (APPROX. LOCATION ONLY) rn C = po B 10Yr 5/6 10 FiP�E 14�OLAK � � O , , TOTALS: 48" 85.70' REV. DATE BY APP'D. DESCRIPTION --- - -- \ TP 1 TOTAL NUMBER OF CHAMBERS 5 PROPOSED SEPTIC SYSTEM UPGRADE L6' 89x8' TOTAL LEACHING AREA 478.0 SQ.FT. RHODObkNDRON 10"OAK TOTAL LEACHING CAPACITY 353.7 GAL./DAY - -40"-OAK Benchmark Med.-Fine Sand , `� 1 �, PREPARED FOR: (TYF°,OF 6) �O� Nail in Oak Tree C-1 2.5Y 6/6 � JOHN L. �r ,o"OAK Elev. = 90.00' cHURcy4iLL JR. ,;... CAPEWIDE ENTERPRISES a CIVIL Approx. M.S.L. � - N0.41807 96" 81.70' `, r LOCATED AT Silt Loam PROPOSED 5-LC6 CHAMBERS C_2 WITH AGGREGATE 108" 2.5Y 7/1 80 70, �P 305 BRAGG'S LANE � ��R � C-3 Medium Sand BARNSTABLE, MA 02630 � 2.5Y6/6 / g`L / \-PR. INSPECTION PORT 144" 77 70' SCALE: 1 INCH = 20 FT. DATE DECEMBER 16, 2015 ; 0 10 20 40 80 FEET No Mottling, Standing or Weeping Observed � - PREPARED BY. RESERVED FOR BOARD OF HEALTH USE JC ENGINEERING, INC. 2854 CRANBERRY HIGHWAY / EAST WAREHAM, MA 02538 SITE PLAN _ 508.273.03377 SCALE: 1"=20' Drawn By: BSM Designed By:BSM 1 Checked By: JLC JOB No.3341