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0090 CINDY LANE - Health (2)
90 Cindy Lane Barnstable A= 317 009 0 Commonwealth of Massachusetts 3 " cog Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner information is Owner's Name required for every Barnstable f/ MA 02630 4/23/21 page. City/Town State Zip Code Date of Inspection r 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. A. Inspector Information S /syay Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 13010 T r License Telephone Number ce se Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 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 4/23/21 Inspect&j gignaftre 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 r Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �o 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 page. Cityrrown 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 criteria not evaluated are indicated below. Comments: 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form: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 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 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 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): 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.7/26/2018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 3 of 18 r Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. Citylrown 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 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. c. Other: 4) 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 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 ❑ ® 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 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form 4�i o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner s Name information is required for every Barnstable MA 02630 4/23/21 page. Citylrown 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? El ® Hav large volumes of water been introduced to the system recently or as art 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 Description: 4 bedroom plan and permit on file at BOH Number of current residents: 2 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 125 GPD 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts ,,o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. City/Town 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(gpd) 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: No recent pumping per tenant 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 �= F Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 page. City/Town 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/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): Approximate age of all components, date installed (if known)and source of information: 2002 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 3'6" feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain):. Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts �. F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 3' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) H-10 tank appears to be structurally sound If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g Sludge depth: 6" I Distance from top of sludge to bottom of outlet tee or baffle >12 Scum thickness trace-114" Distance from top of scum to top of outlet tee or baffle >2" >2, Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3yrs to prolong the life of the system t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts 1n ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): 0,1 Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was video inspected, no adverse conditions observed, cover raised to 2' of grade t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts ,�P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 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: t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts �o F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �o 90 Cindy Ln Property Address Paradis Owner Owners Name information is required for every Barnstable MA 02630 4/23/21 page. Cityrrown 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.): Chambers were excavated, they are 6' below grade, cover raised to 2'of grade, damp at this time, no indication of past hydraulic failure 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �e ,t�i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �e 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form 1 - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 TOWN OF BARNSTABLE LOCATION qD� ^' ZW SEWAGE SeLO��—eZ`16 • VILLAGE /J A 2 N 5 J,0 & ASSESSOR'S MAP&LOT 1 INSTALLER'S NAME&PHONE NO.)9,L eN e-'�...-fr SEPTIC TANK CAPACITY..15 O O C—-S/`/ a/ ..� LEACHING FACHM:(type03�S�4— -"Agz c —(size).313'X!,3 X a1 NO.OF BEDROOMS_ `' /� BUILDER OR OWNER SO J' ,e,19AS _ PERMITDATE: b COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any welts exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 4 L alb _ a, &r —J �O xG/FA,✓ ,s"LIT, ouT ,q o_ J 4 ad. , 4 E: 3s, Lp Q Saa<,�nAaies C= 3o, �CIty�J.Jsd i it Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �a 90 Cindy Ln Property Address Paradis Owner information is Owner's Name required for every Barnstable MA 02630 4/23/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope Z Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >210" feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed. 2002 NGW 202" Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: 4'seperation per 2002 compliance ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: TOPO mapping shows the site at 40'msl and nearby surface water at 23'msl You must describe how you established the high ground water elevation: See above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 J Commonwealth of Massachusetts ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 90 Cindy Ln Property Address Paradis Owner Owner's Name information is required for every Barnstable MA 02630 4/23/21 page. Cityfrown 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 LFT 44AI Pave Ti2rM•c ex�sT/�v6j N�s� . r411TE2lbt�. AAA, L�1Cro rim �� A-LE cjD �t,v DPI �-►�� f i _ k �X�gT�N67 c �oFZHE roe Town of Barnstable Barnstable �� Board of Health - A"„el;cac�, nAFzINS-rauLIE , �'� 6�S. 200 Main Street, Hyannis MA 02601 - 0 \fb , � .. 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 28, 2009 Mr. Randall Swetish 10 Wheeler Road Marstons Mills, MA 02648 RE: 90 Cindy Lane, Gerr�e E�a cns A = 317-009 Dear Mr. Swetish, You are granted a variance on behalf of your clients, Joseph and Joyce Paradis, for the setback from the house to the septic absorption system to place an addition onto the house for a full bathroom. The variance granted is as follows: 310 CMR 15.211: The proposed four foot crawl space for the new addition was proposed-to the located 15 feet away from the existing leaching pit, in lieu of the twenty (20) feet minimum setback required. This variance is granted with the following condition- (1) A.lining will be used against the wall of the existing foundation.and line under the flooring of the addition (bathroom) with a 40 mil polyethylene lining This variance is granted because the proposed plan appears to .meet the maximum feasible design standards contained within the State Environmental Co7tle 5 and local Health Regulations. . Siny yours, - L' W ne I er M.D. Chairma Q:\WPFILES\90 Cindy Lane Barn Jan2009.doc �ppSHE r .. DATE: s � P FEE: MASS. 9qj 1639. �0� REC. . BY " Town of Barnstable SCHED. DATE: -Board of Health �aa 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: o f lud, Lam . , &g2,vs ,6 Assessor's Map and Parcel Number: Size of Lot: Wetlands Within 300 Ft. Yes - Business Name: No ✓ Subdivision Name: APPLICANT'S NAME: Phone 'S72fl ��-m�— Did the owner of the property authorize you to represent him or her? Yes // No PROPERTY OWNER'S NAME nn"n�,, nn CONTACT PERSON Name: �. © D'�n l� Name: 24"m Address: Q(1 ert-t--Xy J- Address: 10 Gv`"A4_ Phone: Phone: $ VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) f I-T.2(t dN / �liUL 074 /tG-c J Flo �_- .�f NATURE OF WORK: House Addition R6000❑ House Renovation 0 Repair of Failed Septic System"M > -ra "Checklist (to be completed by office staff-person receiving variance request application) y Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form —" _ Four(4)copies of engineered plan submitted(e.g.septic system plans) J rn _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for. Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee" only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to. the building proposed]) ° Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Paul J.Canniff,D.M.D. REASON FOR DISAPPROVAL , Q:\Application Forms\VARIREQ.DOC s MAIL-IN REQUESTS Please mail the completed variance application form to the address below. Also include four copies of engineering plans, house plans, authorization letter, etc (see check-list below). In addition, please include the required -fee amount (see fees at bottom of this page). Make $85.00 check payable to: Town of Barnstable. Our mailing address is: ti Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Checklist _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered'plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) $85.00 variance request application fee (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only), outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, you must mail the required $85.00 fee. 'Please make the check payable to: Town of Barnstable. The check,must be mailed to the address listed above. In addition, please mail four copies of engineered plans, house plans, authorization letter, etc. (see check-list below): Checklist Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request . Applicant understands that the abutters must be notified by certified mail at.least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ $85.00-variance request application fee (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only), outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage:disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page December 23,2008 Town of Barnstable Board of Health Variance Committee Dear Sir(s), We request a variance to the 20' set back regulation in order to add a much needed full bathroom to our existing three bedroom house. The location of the proposed addition as shown in the attached drawing is the only feasible location for the full bath. Placing the bathroom addition on the gable end of the house as shown gives the largest of the three bedrooms a full bath and gives us the opportunity to remain within our budget because of the efficiency of construction at that location. We authorize Randall Swetish to represent us in this matter before the board. Thank you for your consideration. Sincerely, .0 < ' RIO L Joseph an Aoyvce TOWN OF BARNSTABLE c LOCATION �® ^'�y �f►/✓ SEWAGE #1,00-1� �6 VILLAGE SA 2 ASSESSOR'S MAP & LOT/07 INSTALLER'S NAME&PHONE NO.A21N C" j? r. SEPTIC TANK CAPACITY- /5-0 �l/�o.✓ LEACHING FACILITY: (type13�S60 (size)A 5 X L3 X�L NO. OF BEDROOMS / BUILDER OR OWNER JJD /i �2h'c��S PERMITDATE: I oZ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 6AG4f 0 BD _ 3© ' 13,'- 3 6, s FEE T Board of Health, Yj��Nl7' g�—�/ ,MA. O APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair Upgrade( Abandon X- C-mplete System ❑Individual Components Location D l (( ``L� wner's Namep Map/Parcel# Address C179 2A4k f(L&CU, Lot# LZ !p,)O' Telephone# ✓��'��Z"� . Installer's Name esigner's Name Address D / �VA Address 1729 Telephone# fvB—7 75-- /S4 Z Telephone# Type of Building 'V L j�u� d Lot Size l/ sq.ft. Dwelling-No.of Bedrooms IVIX Qftp Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) gpd Calculated design flow ��Design flow provided gpd Plan: Date ����+�"dZ Number of sheets X10 Revision Date Title .J EZ✓ f� G4 Description of Soil(s) I7-b Old" �� d" �� !� e72' Soil Evaluator Form No. 8 Name of Soil Evaluatof• 4041& Date of Evaluation DZ DESCRIPTION OF REPAIRS OR ALTERATIONS �l/v ���12 r G2Mpey fJ w ¢ as�, /Z•f�3 ` 33.Sd " ��- The undersigned agrees to inst the ve des d- �tfvidual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to t to pl the ab in un rtificate of C �lianceljwd been iss ed by the Board of Health. Signed // Mite Inspections FEE COMMONWEALTH OF MASSACHUSETTS t Board of Health, 66 7-r 6 F-�-�� , MA. 1 APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to,Construct( ) Repair Upgrade( Abandon X- Complete System ❑Individual Components Location AJ � f LL Owner's Name ��} � ► /�(Zfi�� Map/Parcel# Address r0 o 122 f '[L � °(j3D Lot# 4-1 41 g'D R4 n/1 V 9 � � �l��Z� Telephone# Installer's Nam e ���� �Q,�/S'/T �/1 L�(e� 1 e -ner'¢kdam 41 Address Qj� /�I t�/v/� DZGC1/ Address 729 jA1a✓/f/1 vZ5��5 Telephone# Telephone# Type of Building 'V�. u Lot Size(,/ li 7 sq.ft. Dwelling-No.of Bedrooms //����� �f�6 �� /V�/�► OF Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min. required) gpd Calculated /design flow � Design flow provided .�� gpd Plan: Date �CCX/ Number of sheets U�►/G� Revision Date Title Z �50 d/TTJ 2 d'I ��J d/lddd?ll tJ� ! dl/O �d /t /7%i Description of'Soil(s) /1 �� 2 Soil Evaluator Form No. II s Z?Y Name of Soil Evaluator` 4e�pa Date of Evaluation dryA1101V eX4-1142/11- 'v�y.� giCCdf'�M�E BUG/' DESCRIPTION OF REPAIRS OR ALTERATIONS d� /2v�� �y/Z �/^d� L-2• d�O�/ 1 .�i�1j/S G� �>r'g/y��•-1 / � �i'00 h-41 /Z•f��/ 33 .SGD / � S-l�/M SAS�l�tdSfl /�� The undersigned agrees to inst the ab ve des d dual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agr s to t to pl �e the sy a in n u eertificate of C liance Pis been issued by the Board of Health. / Signed Date ��` _ C r Inspections `' ��!l" `V U ' i s No. s FE («/// Board of Health; ��,�� MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgrade),Abandoned at 9 D `dam(�'� JAAkeIt A 5-6 V Q- has been installeA in a or ance with the provisions ppf 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. t dated IC -Approved Design Flow (�pd) t Installer n r\ r' ! Designer: Inspector:/ (�\� (� � , . Date: �lJ — ! P The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. / Y/ FEEIV MMONWEALTH OF MASS C . USETTS �v Board of Health, 1 � . + DISPOSAL SYSTEM CONSTRUCTION PERMIT Per Sion is hereby granted to; Construct( ) epair gr e( ) Abandon( ) an individual sewage disposal system at � (shdN / as described in the application for Disposal System Construction Permit No. ted Provided: Construction shall be completed thi three years of the date th' p �hr it. AIllocal co ditions must be met. Form 1255 Rev.5/96 A.M.Su kin Co.Boston,MA ! Date } t-✓ Board of Health t ' Town of Barn stable P# V- Department of Regulatory Services WE Public I3e4lth Division Date D p 200 Main Street,Hyannis MA 02601 r BAWMANa. 6 D MAM 8 �/0 Fee Pd. pirA�e Date Scheduled (� Time Soil Suitabili Asses m nt for ►S`ewage Disposal : Perfo ed B Wdnessed By� � � ma's q�?7S/�GZ /Fi1r+�6C�� ........... ........ ........ .:.:.:�....:.::::.:::<_,:.::G;h::!Gr::.�'!:�:_•_ P .ii i ::.��.d::ii +x:cr�'e���=�y!'`!y4�fr�'�: .. ... .........:::��_,,::_..._.:.^:...:....... .... ... ,:_:u•,:.,.:,,..u:,uh:!'d:..:::^:,�:::....,,_:...:...,:,.!a't,-..!;na:!:!:ml!in!.a6�6 <,3!'i....___..1'S 1.ai..;C. ...h: ,:'.,.. ,!n• ..a'.:.:. .,,i, :! ,.!. 'i@ri:: � �jr ,. _. �_:'..,;! .. •Y ..i:, s..'��. X. n owner's Name Location Address q0 Und 4 r .1e / �CnP✓+S�6(� 1//GL�}`� Address ��ljCi.VgY�', 12 C Engineer's Name Fc/ sh-le Assessor's Map/Parcel: 317-0 0 C7 �-��_5Q/1(/ .x7✓L NEW CONSTRUCTION REPAIR Telephone# 36 D �9 Gf C�z - Rb '39 C& D2fG� G G S � �(,1;17�ir Slopes(%) Surface Stones /U� 5b^e__/ vas y Land Use /� `9 P T^t� �� ft Drinking Water Well � ft D tances from: Open Water Body �DU ft Possible Wet Area ,ge_120SS s7�J` �7 �20� ft Other �4ft '0� G�gc Drainage Way N 9' ft Property Line E{ s GOGU S �W#R#PN /VQ 'VT!¢Zr av SKETCH:(Street,name,dimensions of lot,exact ocations of test holes&perc tests,locate wetlands in proximity to holes) nd� �79' ¢4 • /2D,Dv B N k c`9 r S ' too) ° zL tta. ���,g s �J,g.vD Depth to Bedrock Parent material(geologic) �_ Depth to Groundwater: Standing Water in Hole: '1,*A r Weeping from Pit Face i P 1 . Groundwater vn ou n Seasonal Hi gh h Gr Estimated 5 g -s � �I Y� .. _.... .. .... ............,,::,:•^r:,:,:.,;,,,w,;gg:!..nr:l4'!!;.!^.'!':'a p!!nn•!mGr^.:n,�;r,r'rG',"'?I ..':n'�;c:r;!!:,u!:!!!�:{ji;i ir�nn!�5i44�hf1';'' d:�x _..;..::•,,,:•,•::•r,:•,.!G'dG^.rG*m: MR: .;;fir.�!..•44•, hr a! � ..c.n:. sl.,,...,f.:�.,n.•1! ' ,..: � .: �; r ..G c..!:.,:,::..iL7..lv:iL,n;:,,., ,'<iNi Method Used: �•• `/ -/ G Ale- in. Depth Observed standing in ohs-hole: !�(�ry L in. Depth to soil mottles: De�th to weeping from side fobs.hole ,� C in. Groundwater Adjustment /V 61 ft- Ftrdex Well#��✓2¢7 Reading Date ✓Cz Index Well level V� Adj.factor 5,9 Adj.Groundwater Level— 17 1� .. ._. .:.�� +:r::�".::::.a_r:'.G:,.-i,hL'rM.:,'r�L.-?-a,,.:r-:.-"-<.fr.r..e....:.:.:!:d:_.h•:.h!r,,!._!�'_;..,.<,;:r'.,.:',!,.w!:•!.`:;..1G:..?•u:.',..rf.!rsh,:15,�,.:+f r_,.r:•�'i a,-'..u+x.^:'�;',v,,:.,.!,u...T.:.'.,Cf,...,;.r.i.�;r„:..�a,.,.,,..$i,r..2,�,i.:.:,a:G:':•:�.,::.d.�a:d,,�d..,.!!�i,a.Tu!.,l;I:i,:,.;.,:v.a;.,.,§,.:nr.u:.d,,.a....u..;i..�r:,.:��_Y y._,:i..1er..1n.u:.,!.G.5.a.ry:y!:'r.hT,:i;r�u:arai'2u:'.i!.a'!�.u,:.a'.,uG:.y,:._,i..:.,{kn.uI.,�^!,�::ei;.:..;.,�"!:._^:^..:,ad nv.�d;.1�.:.:.::L«r!!�h.r_.h.�.,:T,':::q2!-,..:..r.,.x.�:�:::-:.;':_;:�{..•;.:.'.!9�:_^n!�...!•�.it,�R...r,:i^<.,.i!.,.,,.:.:,^,. ._.<.:..!d!....I s.. ..:... ,:-_:,3.a Cu. X14. rUNN ^" =.G.:r:.:� 1 :. ,, � F •: L. _ .,,.r„�.+ i,,;�,.G:_M1•,,�s,:!..v:!�'�...'„.ii�„!�r'��' I , Observation Time at 9" Hole# 1// Depth of Perc �" Z i Time at 6" T-- 1, GdA-aIe Start Pre-soak Time® a "` 5 ptnl Time(9"-61 . t,ta�vvs\ 2 P L End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: _ Additional Testing Needed(YIN) 1. _ T:..:.:. nh.cervntion Hole Data To Be Completed on Back-----,-- ::::>:•;::;;:::.;:>;:<•::.::<•::::::.,:•:::.::..•::::::.:...S.o..-Te........:............. Sotl Other Depth from Soil Harizon Soil Texture Soil Color MottlingStructure,Stones,Boulderes. Surface(in.) (USDA) (Murisell) o- 2� S'A/' G•5�� �0 Z- &¢ aCqa /s. /9 DYd 6�o•�v�^�i9fi` �R� sac QCLI 20'-9. :..;;: Dole#. :.>::::::;::. ..:::;:»<:;::><: . +� •��`<::(�l'3:SF.�X�YY�1T:i�1�'H±C�;L.D�..:;�,.±�>�:;:.::::.:::::;:�::.;::.::.;:..::::::..:•:::....:.. .... :::.......;..... . . Depth from Soil Horizon Soil Texture• Soil Color Soil Other Z? / (USDA) (Munsell) Molding (Structure,Stones,Boulderes. Surface('in.) cy. (/ Pn R-T�Z"1 C EZ : z 3 3 {:i:•::)iiii:::v:i::isS?Ci;>:,>.'$}ij;:.;{•::::.:......::•:.;::•v..:......,.'.::...0. ::>':<.;��'�`'.'��;:}.''..;:...?::;:;:; �{':',{:'::' ''.:•7:;::::,::::Y!::::`ii::::i�....,..,...,';.;..;:•.,,'.............i:>...^..:i:.�..�::.�...�.;.:....<•4:4•:•::.•'•:i:•i,•:v}:v.v:: D .'..( .: :::>::::> >::'•>:>:::>::>:<<>::>:<<>:zn::»;>:::•:::•;:::;•::::•::;.:•:: .. •::•:::;.:...........•.......... :•:•:<;:•:.;:•:::•::::..•:::::::.:•........ Other Dept h from Sol l Horizon Soil Texture Soil Color $O1l Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Lons stengy,° .::.r.>:.;:.::.<::.>:.....::.::::.::.>:.;: . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ° Gravel) Flood Insurance Rate Man• Ah6 e 500 year floo d boundary No Yes V Fib ZS�UI I �'9-85 aar�ni C. Within Soo year boundary No_ Yes Within I o0 year flood boundary No_ Yes Depth of Natur I •12ccuiringfervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? IC_ 5 Vll If not,what is the depth of naturally occurring pervious material? GZ A" S`{ 54 �ertitication L S''L-7,'%q <-' I certify that on /T rl I (date)I have passed the soil evaluator e5camination approved by the istent with Department of Environmental Protection'and that the above analysis was performed by me cons �J�ia•�r/A.X7 �� M 4l ti A L�'{ ZVI � s TOWN OF BARNSTABLE t LOCATION ` © �Na y L,,. SEWAGE #1.0061 VILLAGE rgA 2 ASSESSOR'S MAP & LOT U 9 INSTALLER'S NAME&PHONE NO.Al2 ro SEPTIC TANK CAPACITY SOD 4r, S,00 Get/�.."��GCS LEACHING FACILITY: (type1��) (size) e 31 3 X !,3 •�Co� NO. OF BEDROOMS BUILDER OR OWNER JO /� RAcE'�S ` PERMITDATE: /02 b OoZ COMPLIANCE DATE: S Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f' 5,9 4 �3 • a' D �,fovs! O uT ,. a� �`°�.v�il' 1� DATUM : . SYSTEM PROFILE : NOT TO SCALE VERTICAL DATUM: MSL± ASSUMED MAIN ST 6A BENCH MARK USED: SOUTHEAST CORNER OF SYSTEM DESIGN z` CONCRETE BULKHEAD BARNSTABLE EXISTING 3 BEDROOM DWELLING VILLAGE Q o ELEV. 41.00 TOP OF FOUNDATION w RAISE COVERS TO WITHIN 6" OF FINISH GRADE }- ELEV. 41.00 � ) / DESIGN FLOW 2 _45' CLEANOUT SWEEP z Wn CENTER CHAMBER RISER ' 4 BEDROOMS AT 110 GPB/D 440 GPD v _ FINISH GRADE TO RADE WITH SCREW ON CAP FINISH GRADE RAISE TO WITHIN 6" o z Z ELEV. 40.35 ELEV. 39.8 FINISH GRADE OF FINISH GRADE FINISH GRADE o LOCUS ////.�� ✓� //iC�� //- ///.� - ELEV. 39.4 ELEV. 39.6 REQUIRED SEPTIC TANK N VARIES T P = 37.35_ /,� S ///,� ,\ / / �� l� , N 30'®S=0.025 105.5' S 0.02 T MIN.-3 MAX. COVER ---440 x_2-- _ ------880 GAL.. 4,. T®S=0.02 2®11' S=-.0.01 TOP ELEV 36:62 SEPTIC TANK PROVIDED _1_500 _GAL. 4 PVC SCH 4o O O 0 r� r 00000 „ „ " m SCH 40 --*� INV.= 2 MIN- MAX 0 O c 2 MIN 1/8 -3/8 DOUBLE WASHED PEA STONE = Y o o SIZE OF LEACHING FACILITY REQUIRED 414 38.10 36.35 10 TEE 14 TEE INV.=36.10 O DO 00 0 00 00 N " 4 O O O 0 O O 3/4 TO 1 1/2 DOUBLE WASHED STONE 6" O0 0O �' �' O 00 00 DESIGN PERC RATE ___<_2 -_MIN./INCH 5'-7 1 LONG TERM APPL. RATE -GPD S.F. GAS BAFFLE 5 OUTLET „ / 4 6 /" , „ THREE 4 -10 x8 -6 x2 -8 CHAMBERS 2 4 -1 LIQUID LEVEL 41-4„ D-BOX SIZE OF LEACHING SYSTEM PROVIDED: INV.=35.96 NV.=35.65 Z 5' STRIPOUT AROUND SYSTEM TO "C-2" HORIZON MIN DEPTH .-H - <``,:f Y - ELEV S.A'.S. (12.83' x 33.50') n ELEV. 33.65 MED/COARSE SAND 12.5' f DOWN. ,. 440 0.74 SF GPD _596 S.F. MIN. REQUIRED LOCUS MAP < <�: o 0 0 31.77 INV.=35.76 STRIPOUT (23 f x 43.5 ) v / NOT TO SCALE: PERC #P10-228 6" BASE OF CRUSHED STONE USING 3 CHAMBERS WITH 4' STONE AROUND OR MECHANICALLY COMPACTED FIRST 2' LEVEL TEST PIT #1 ELEV 26.3 ADJUSTED GROUNDWATER DATE: 5/9/02 DATE: 5/9/02 1,500 GALLON SIDEWALL = 2(12:83+33.5') x 2 = 185.3S.F. GROUND ELEV 39.9 GROUND ELEV 40.8 PRECAST CONCRETE BOTTOM = 12.83' x 33.5' 429.8S.F. SEPTIC TANK TOTAL LEACHING AREA. = 615S.F. NO GROUNDWATER NO GROUNDWATER 615 S.F x 0.74 = 455 GPD A 455 GPD PROVIDED.> 440 GPD REQUIRED 15 GPD RESERVE LOAMY SAND A 1oYR 3 2 6„ LOAMY SAND NO GARBAGE DISPOSAL / GRINDER ALLOWED B 10YR 4/2 LOAMY SAND B 12" 7.5YR 5 6 30" LOAMY SAND - C-1 7.5YR 5 6 36„ M SILTY CLAY/LOAM 1OYR 6 3 1 68" LOCUS INFORMATION C-2 C-1 - COARSE SAND SILT LOAM 10YR 5 6 „ 2.5Y 7 4 " C-3 186 ELEV = 28.3 150 CURRENT. OWNER JOSEPH P. & JOYCE M. PARADIS SILT LOAM ASSUMED DTH 2 b 2MP1 C-2 # ADDRESS #90 CINDY LANE 10YR 6 3 - 204" MED/C0. SAND C2 HORIZON C�$ 168" N F FINE SAND - 2.Y 7/3 / N/F N/F P.O. BOX 122 NICHOLS FRASER BROSNAN . BARNSTABLE VILLAGE, MA 02630 " ASSESSORS .MAP 317 'ASSESSORS MAP 317 ASSESSORS MAP 317 2.5 --5 3 212" ELEV = 23.3 210 PARCEL 8 PARCEL 79 PARCEL 61 TITLE REFERRENCE: CERTIFICATE 74728 SANDY LOAM #70 CINDY LANE #25 FRASER. COURT #97 STONEHEDGE 2.5Y 6 3 230" PLAN REFERENCE L.C. PLAN 17994 D, LOT 20 :ELEV - 20.9 B.0.H. B.O.H. ZONING DISTRICT RF-2 RAVE STANTON DAVE STANTON i SOIL EVALUATOR. SOIL EVALUATOR I 1 CBDH FOUND FLOOD ZONE "C", DATED 7/19/02 ED. STONE ED. STONE I I PANEL #250001 0001 C BACKHOE OPERATOR. �Y. ARCHAMBEAULTJ S78 32'50.. I ASSESSORS MAP 317. , SOIL TYPE: �_ INDEX WELL. AIW 247 I I \ - E 8g 23,, . PARCEL 9 PERC RATE. 2 1N. PER INCH ASSUMED C-2 DTH#2 _BONE: B \ - CBDH FOUND LOADING RATE: _0_74 GAL/SF/MIN INDEX WELL 26.6 IRON ROD FOUND S$8'44'30"E 140.12' . _ ADJUSTMENT 5.9 1 I � \ \ f -' -- -... -- � � " '''�.. 8,967f S.F. LOT. AREA 2 � V I 18.5' -- I -� _ , T „ rn # INDICATES DEEP I � \ \ \ \ ,._ �3_2 OAK DTH 4 TEST HOLE -o EXISTING CESSPOOLS 25 INDICATES GROUNDWATER \ I � 4\2.3_ 16 OAK TO BE PUMPED, SAND EXISTI FILLED AND CRUSHED a I m 1 EXISTING \ o GARAG ( -, 1 DTH-1 IN ACCORDANCE INDICATES 'I WITH TITLE V ~ P-5 " 108" INDICATES ADJUSTED GROUNDWATER I ! I L `PAVED DRIVEWAY\ , \„r/CESSPOO 44 PERC TEST J n II 14 OAK } � i�, 10"OAK � GENERAL NOTES: I r- \ 1 I .-�C 40.7 CESSPOOL 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 1 \ 1 1 / ' x 0 20 30 20 60 100 I 1 \ 1 TITLE 'V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 1 i \ \ \��W 1 �' 1 / �'� \\ h FOR SUBSURFACE DISPOSAL OF SEWERAGE.' 1 1 \ 1 \ 1 0 1 / } i \\ EXISTING LEDGE o 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE I I \ i 1 1 1 I } j I, \ROCK GARDEN cn ACCESSIBLE WITHIN 6" OF FINISH- GRADE, WITH ANY REMAINING 1 1 11 i \ 1 � ..D� 40.4I I I I il`� ;� GRAPHIC SCALE: 1 INCH = 20 FEET ACCESS PORTS BROUGHT TO `WITHIN 12 OF FINISH GRADE. 1 1 rn 1 1 1 1 EXISTING C.O. I I i i o 3.` ALL `COMPONENTS OF .THE SANITARY SYSTEM SHALL BE 1 I 1 \ \ \ i DWELLING -� I } ( � BENCHMARK: SOUTHEAST CORNER OF cv CAPABLE. OF WITHSTANDING H-•-10 LOADING UNLESS THEY ARE 1 1 � \N 1 1 1 1 . (3 BED) C.O. BULKHEAD. ELEVATION 41.00 UNDER: OR WITHIN 10' OF DRIVES OR PARKING AREAS THEY 1 1 \ + 1 , 1 � ELEC. MUST WITHSTAND H-20 LOADING. 1 1 w OIL 1500 a 4. THE EXCAVATION-CONTRACTOR SHALL .VERIFY THE LOCATION 11 11 1 � ` MET 15 18 OAK N F OF ALL UTILITIES PRIOR TO ANY EXCAVATION. FILLER 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 1 1 1 m } 1 ANK 41 10"BLUE SPRUCE JOSEPH & J YCE PARADIS „ I I - OR WITHIN 6 OF 'GRADE SHALL BE MORTARED IN PLACE 1 1 I 4 .6 ( 23' O \ ASSESSORS MAP 317 6. FINISH GRADE SHALL HAVE A 'MINIMUM OF 0.02 FEET PER 1 = 1 i } } (20'MIN� \ PARCEL 9 " \ L.C. LOT 20 FOOT OVER THE S.A.S.' AND DISTRIBUTION 80X. 1 0 i I I I DTH-2 , " 7. SEPTIC TANK SANITARY TEE'5 SHALL BE CONSTRUCTED OF I \ 28,967f S.F. SITE AND SEWAGE PLAN SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE 1 1 ( `moo` \ EXISTING BOULDER O 2' DIAMETER .EXPOSED THE FLAW LINE AND SHALL BE .ON THE CENTERLINE AND / Q \ \ O N/F REPAIR / UPGRADE 1 � 1 I \ \ FLAT ROUNDED & SMOOTH CBDH FOUND LOCATED DIRECTLY .UNDER THE CLEAN OUT MANHOLES. 1 } I \ \ 2 OAK McCARTHY 8. THE INLET PIPE:INVERT ELEVATION SHALL BE NO LESS THAN CATCH \ \ ASSESSORS MAP 317 I �n 1 i \ 2 PARCEL 62 90 CINDY LANE 2'INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT BASIN -' 1 / ' } \ \ \ ELEVATION OF THE OUTLET PIPE. RIM 31.03 1 111 STONEHEDGE IN I � \ \ L S84'34 37 W # 9. THE. SEPTIC TANK SHALL HAVE A `MINIMUM, COVER OF 9 INCHES � � 198.08' 10. THE OUTLET SANITARY.TEE .SHALL BE EQUIPPED WITH A GAS 11 / 1 \� 10.0' BARNSTABLE VILLAGE, MASSACHUSETTS ' BAFFLE, .4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC 1 � � (MIN) 5' OVERDIG TO SUITABLE ' 11. `ALL, PIPES .SHALL BE SCHEDULE 40 PVC SEWER PIPE "AND CBDH FOUND MATERIAL (C2 HORIZON - MED/ SCALE 1 = 20 DATE: 6/21 �02 SHALL. BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE BROKEN COARSE SAND) TO BE INSPECTED FIRST TWO 'FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL BY EAS SURVEY PRIOR TO BACKFILLING I BE LEVEL �j PREPARED FOR: 12. 'CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION G--- TO EAS °SURVEY INC. FOR B.O.H. 'AND DESIGN ENGINEERS REVIEW JOSEPH BC J O YCE PARADIS AND APPROVAL. #9 0 CINDY LANE N/F PO BOX 122, BARNSTABLE VILLAGE SHULEY NOTES: CONSTRUCTION NOTES: ASSESSORS MAP 317 , PARCEL 54 1.) CLEANOUTS (C.O.) TO HAVE M A 026 3O 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND #106 CINDY LANE 4" PVC PIPES TO GRADE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING WITH SCREW ON CAPS. L PREPARED BY: WORK ON THE SITE. � 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 2.)FENCE AND GATES TO BE REMOVED ,�1 l�K 0F DURING CONSTRUCTION AND REPLACED `; E A S' SURVEY I N C WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT �Qa � IS 'TO OBTAIN SUCH .DETERMINATION FROM APPROPRIATE AUTHORITY. AFTER FINAL GRADING. 's,� ���^�� n 141 RT. 6A r A. STONE ONE l 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING } MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND I .:: P. O. BOX 1729 1� N� S.A.S. AREA IS PROHIBITED �. , � k� .a SANDWICH MA , 02563 � PH (508) 888--3619 • FAX (508888-2496 °