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HomeMy WebLinkAbout0146 COBBLE STONE ROAD - Health 1 � 146 COBBLESTONE RD. BARNSTABLE A I. r y.. J "� - ,r .r [L:�• — - �q #�,+ j e ti. � r, � � L F !- r ,e .ry''� ,r � .. 7 ? , � 1 .rY -F i'° r ..P Y ! n , I a :.�7 u ` k� d :r TOWN i7O'F BARNSTABLE LOCATION�y L CbW� L(W WG d SEWAGE# ;9 _ VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. ?41- 604� lC SEPTIC TANK CAPACITY oo f LEACHING FACILITY:(type)`2) [ l �fL((��L1� (size)) NO.OF BEDROOMS OWNER G PERMIT DATE: qCOMPLIANCE DATE: q 30 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 ea ' Facility(If.any wetlands exist within 300 feet of leac in ility) Feet FURNISHED BY I . 25 L Z _ ►b�` �' No.2.0 Ici — �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pphfation for -Mispo8.al Opstem Construttiun VErmit Y." Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. M Owner's Name,Address,and Tel.No. Assessor's Map/Parcel AOr, S 1 ee,� p�j � o , Installer's Name,Address,and Tel.No. �(©, p 6�s��/ Designer's Wame,Address,and Tel.No. Type of Building: `nu sq2 Me r Dwelling No.of Bedrooms Lot Size �_sq.ft. Garbage Grinder(/W Other Type of Building 04aev)sons Showers( V<Cafeteria( , Other Fixtures Design Flow(min.required) (1 gpd D gn flow provided 6&> !!5�6q!S. gpd Plan Date 1 �� Number of sheeets- Revision Date Title Size of Septic Tank / L Type of S.A.S. Description of Soil /fitly Nature of Repairs or Alterations(Answer when applicable) Date last inspected: 40 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 Environmej and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' ed Date Application Approved by Date ,O Application Disapproved Date for the following reasons 4, Permit No. 2 Date Issued \ Al No. - �...w Fee ✓ THE COMMONWEALTH OF MASSACHUSETTS Entered m computer: Yes PUBLIC HEALTH_DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppfication for Bis�osaY pstem Teo struction Permit Application for a Permit to Construct( Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. `�le�'}.�c � Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �yj1 �� ( �, Zeh Installer's Name Address and Tel.No. Designer's Warne,Address and Tel.No. 'yy f Type of Building: "�Ll AS �q k v � t Dwelling No.of Bedrooms Lot Size 7_c� sq.ft. Garbage Grinder Other Type of Building �f sons Showers( k) Cafeteria(AA Other Fixtures Design Flow(min.required) gpd D gn flow provided m 1{ ��� - gpd —yc�7 - —ten --: Plan Date Number of sheets Revision Date l Title 'S4,4., AAl Size of Septic Tank Type of S.A.S. g �_ G���r 1.0 02w/ Description of Soil ,(��00� / 4 Nature of Repairs or Alterations(Answer when applicable) air m�Jilw/► AL aa,h Date last inspected: /n /yi 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 Environme Lt Code and not to place the system in operation until a Certificate of f Compliance has been issued by this Board of Health. _ Si ed Date Application Approved by Date Application Disapproved b Date for the following reasons J Permit No. Date Issued A/ zo/q --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( >&f Repaired( ) Upgraded( ) Abandoned( )by att o / /- 4y w een constructed in accordance with.the provisions of Title 5 and the for Disposal System Construction Permit No dated Installer+ ! h y(i V M�� Designer 11I,\In t Er td� #bedrooms 0"�'At, Approved design flow gpd The issuance of this qermit tall not be construed as a guarantee that the system will fur Dclions d signed. Date U i Inspector CA No.Zn 1 • Fee } THE COMMONWEALTH OF MASSACHUSETTS j PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Vsposal 6pstrm Construction Permit Permission is hereby granted to Construct VORepair( ) Upgrade( ) Abandon( ) System located at 5 4 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 permi. _ Date Approved by Town of Barnstable Regulatory Services • shlr�isrA � . Thomas F.Leiter,Director Public Healtb I?ivis ou o Thomas McKean,Director 200:Main Streeii 11yahnis,MA 02601 Office: St78-$624644 Fax: 509-190-6304` 11statler&Desitroer Certification Form. Date: Sewage Permit# t q-" Asse.ss"or's Map\Parcel ? :j Designer: DA"OA& ME I NCa '[ Installer: 9pn, Cis s C�,1i-G�� �v�nY1 Address: Q [ � Address: t on �"6-ZO i 9 �a t<,\ was issued a permit to.instalt a,- (date) installer} Septic system at (�(_o (�y�N �. P�R�Ns.,'���F3�� based on;a desigzt drawn',bg � (ad a s)` dated; ( (designer g ' T certify that the.septic systeni';reft:rcnced above.was installed::substautially.according,to the design,which,may`include minor approved.cbanges such as.lateral relocation of the . distribution box and/or septic tank:: .11 certify that:the septic system referenced above was installed with major changes(i.e greater than 10':lateral relocation of the SAS or any velical sclocatiou.of any component:. of the septic system)but in accordance;with;State&Loca1 Regulations. Plan:revision or certified as-buil.tby designer to.fallow: 3 b' r C]JA j astaller s Signature) � �€��� ��n , � (Designer's Signa e) ( fix.Desi.gner s Stamp Here) LEASE URN TO 11ARNSIABLE P gLIC TMAt,H 'DI SI 0. CF:RTItt.CC"U. 01F CUMI'C IANCi WILL NM I3E-ISSUC+D UNTIL B4TIT 'TIUS FORM AND AS-DUII.T' CARD ARE ",CF,r ED By-TIC BARNSTAiTTI,,I'TLRJLIC MALT I DI"•VISION. THANK YOU., Q:Health%SepU,clDestgtw CcrOdcaYion:Form 3-2b:0�.doe Town of Barnstable Building Department Services s i Brian Florence,CBo Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablemaxs Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I l` ti�O ,as Owner of the subject property hereby authorize_ OrI -4-,P,W to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspecti s are performed and accepted. r Signature o er Signa of Applicant H 0 ((�-J Awwel Print Name Print Name l 0 Date i s--.;7'7. _7' r 7-_.zs�.s^„^s LIVING Roots (BELOW) A / REMOVE XIS INGHAY ' FT BARN"'DOORS' o _- - ---.- msloped ceiling I I I � 3,-_10" I $nae well EAVE IZN _ EAVE D D D 4y3 ��J_9. �_m.�._.___B•_2r L 16'.-0' DORMER I :SECOND,: . FLOOR. ( LOFT 1/4" = t ALL CONSTRUCTION TO BE PERFORMED IN STRICT COMPLIANCE WITH THE MASSACHUSETTS STATE BUILDING CODE, NINTH EDITION AND WOOD FRAME CONSTRUCTION MANUAL FOR ONE— AND TWO-FAMILY DWELLINGS FOR EXPOSURE B WIND LOADS — 110 MPH I ANY STRUCTURAL ENGINEERING REVIEW, IF NECESSARY, I IS AT THE DISCRETION OF THE BUILDING COMMISSIONER y AND WILL BE THE RESPONSIBILITY OF THE OWNER � r r REMOVE. EXISTING EXISTING & 0 1 2 4 8 12 WINDOW RELOCATED (RE-USE) r: WINDOWS .•,;� ..:_..., :.,,,a ... :... .•max -..:.....vm 2'6" wo i`' PROPOSED. GARAGE CONVERSION knise{ - °'� MOLLY WATERHOUSE I 1 V-7' NEW 146 COBBLE STONE ROAD NEW, existing " . LIVING - - - vc tee —FIRST FLOOR PLAN ' ' A If 6 !01 � KITCHEN ( cerrng ROOM 3� --DOOR & WINDOW SCHEDULE• , i 9 FEBRUARY 16, 2019 6'-6 x 4'-0' II EXISTING +{ N - ENTRY ROOF L. gas - STL COLUMN t t`• •&a WATERHOUSE- - .:•; - fireplace KEY ITEM QUA. DECRIPTKYN ROUGH OPEN'G NOTES CLO. w1NDaw 3 AND. ic23s CASEMENT .8 1/8•x 41 3/a' . - ( 1 AND.-#CW345.C SDAEK _.a 1/0.x-53 3/$. ECRESSABL£ T>• .:.. ; ::-- .;v l �' C 4 AR0.fA21 XWNtNG 124"SJ$'-x 24 5/$" WBL UE SR1D POCKET a . .: 3 AND. $AXW31 AWN:NC 38 1/2'x 36 1/2' REMOVE 'Ib d'6 i ( @ g•_3' 'a' i I DOOR '•A 3/0 x 6/$FtAtF vEW F.C.OR. Ja i/Y x AS 1/2 WINDOW — pair of �, IEXISTING ——- p @ PATIO DOOR 1 AND.OLCO6668R 72'x 60' 7. bi—pass 36 xso - USE:ANDERSEN SERIES 400 H—P LOW E CLASS "occeaaiCd = COLOR TO MATCH EXISTING i oherer p F'1 °��• 'OPTIONAL INTERIOR J EXTeR10R,GRILLE SYSTEMNEW - I J(��) ,.�D BEDROOM ;n v NEW ,VERIFY.Ait: ROUGH OPENINGS PRIOR TO CONSTRUCTION E A {�! ii 1_ BATH. VERIFY Ali W"WORK PRIOR TO,PURCHASE .� I II exwatl�g .. _It` { f. ! o •:I coiling height shelves v - ;� $4'�V! FLOOR { .. @�c`� a !. •y _ . .:.pocket oc. ( 1/44" _ 1' ) NEW 10'-7" 12'-4° tJTILlTY ,a../d AREA = $6Q S! . CEO.. , ; _, i ( INTERIOR ) REMOVE REMOVE i EXISTING EXISTING i LEGEND. GARAGE DOORS DOOR L------------------- —————————— © EXISTING OVERHANG O —— _-—— DENOTES 'WALLS. DOORS. ETC. TO BE REMOVED i 4,-3 1 2'-3'. 9'-7" g'-7" 2'-3" 4'-3 }" DENOTES NEW LAYOUT 1 ��l(n � ' :ME■E ■■■■■■■■■■■■■■■■■■� E■E■ r ' ► ! ;f ■■■E EM■■E ■ ME■■E ME ME ME■EE - w - ■■■ MME■■■ ■■■■■ ME■■■ o _ ■■ ME■E■ 1 ■■■■ MMEEMN ONE ■■MEE■■ MMMM■MME■MMM■MMEME ME■M■■ r MMMMMM■MMMOMMMMME ■E■E■E OMEN M■MMEMMMME MEN■■MEMO ■■■■MMMMEMMMME■M M■■■■■EEE■■OOEMEM■E■■MMMMMME■■■ ME mmmmmmmm MEMMMMMMMEEE■■MM■■MMMMEEM■MEMMEM MM■M�MMMMMMEME■FEMME■MMMEMEM■MM■ ■■EMME■■M■MMEEMMMEMEMEMMEMMMMEEM ■■E■ME■EE■■EE■■■■■MEEME■E■■■■■■E ■■■■■E■EM■EE■E■ MEMO■■MMMMMMO■ ■EMM■MMM■MMMEMMINN■MEM■MMM■M■MEMM■ ■■■■ME MEN MEME■■■■MEMMMEMMMME■EEE NEON■E ONE®■■■■■■■■■ME ENE M■MEM■■■ mom 0 WE 0 MI imommommosommomimmom 0 MEMO NNOMMEMEM NEI 0 ME No sommommommoommmomons moommomm limis I MIN 0 1,, 0 milmis moommommoommommomm IN millimmom mommom 0 mommommommoommmmoomm Dommoll 11 SOMEONE MEMEMONESSOMMEMMEME ■MENNEN Nou SOMEONE u i=i MEMO■�a i ME un No ii��� �ONa� ■-M lommommomm mmor � qM�i lipi.r.m. iii i■ i i ■ MONSOON ... , , _...... . : I ; . . { - " _.. _.. _ i � r j ..,.. r V-7 , 4 ` i I ............. ........... . ...... . ........ ..........I .......... ....... ...... ... ........ t { , 1 r u F d i J I , AA { s 1 , . i , I i r i i n � i { 1 { , r i r , ..s.r t , . X ' r r r ' I , I a Gi .... ...... ..... t i � , , r i tr :.IT �_.i._ �._� _._. .............., 4.. _ .......... I IV ....................................... c� I ' i I , ° 1 ! l f —•i i 1 ; : 4 . i r ' I 1 , i r , r , i . , i d , r , t Y r , 1 ....v.......! , I w,.i:................,r. ,.,.,.... ... , r -- y l t , : : t,. . .�...a__..,, ,.. �- •�, �.�` .,.�.,,.x..,, ask. , , lL i ............ __ _... t r 1 f +' i i gg i , 1 t� , J. . ) { { L�✓— 1_ ! i : :.. t i ! t , : { , : i : i f _ t • / _ i l , _. % , t , { � 1 1 i , , I K� , w_. I I S i I : r. a ' 'I t , _ _ L .D�k9b F i i I I , i r 1 % , � 1 i + t ( I 1 44 ' t : y � I t r 1 . I l 1 y , .............. .......... ........... .......... ........... , I 1 t 1 ' r I I 1 I , , y , t ± , i Property Location/. '46 COBBLESTONE ROAD MAP ID:316/.064/001// Bldg Name: State Use•''10 Vision ID:2631 . Account# Bldg '1 of l Sec#: I of 1 Card l of 1 Print Date. L7, CONSTRUCTIONDETAIL CONSTRUCTIOIVD' TAIL CONTINUED Element Cd. Ch. Description Element Cd. Ch. Description Style 07 Modern/Contemp odel 01 Residential Foundation 08 Mixed WDK 42 Grade C+ Average Pius Stories 2 2 Stories Bath Split 0 3 Full-0 Half 14 1 MIXED USE Exterior Wall 1 14 Wood Shingle Code Description Percentage Exterior Wall 2 11 Clapboard 1010 Single Fam MDL-01 100 42 Roof Structure 03 Gable/Hip Roof Cover 03 sph/F Gis/Cmp UAT Interior Wall 1 05 Drywall BAS nterior Wall 2 COST/MARKET VALUATION 16 16 BMT 1 Interior Floor 1 12 Hardwood Adj.Base Rate: 25.77 Interior Floor 2 278,589 Net Other Adj: .00 10. 42 US7 Heat Fuel 3 as Replace Cost 78,589 D 2 27 15 7 Heat Type 5 of Water yB 1985 4 C Type 3 Central EYB 1998 FUS 11 Bedrooms 4 4 Bedrooms Dep Code 131313 BAS Full Baths Remodel Rating TQS Half Baths ear Remodeled 9 p BAS 2 Extra Fixtures ep% 8 4 20 FUS 9 Total Rooms 9 9 Rooms Functional Obsinc Bath Style External Obsinc Kitchen Style Cost Trend Factor Y2 Status /o Complete Overall%Cond 12 eprai%Oval 28,400 f Zn --. Dep Ovr Comment Misc Imp Ovr isc Imp Ovr Comment Accessory Apt Cost to Cure Ovr Cost to Cure Ovr Comment OB-OUTBUILDING& YARD ITEMS(L)/XF.BUILDING EXTRA FEATURES(B) Code Description Sub Sub Descri t L/B Units Unit Price Yr Gde DD Rt Cnd I%Cnd I Apr Value •GR6 Gar w/Lft Avg L 896 44.38 1985 1 100 27,400 DCK Wood Decking L 682 17.68 1999 2 100 7,300 EN Emergency Gei L 1 5,550.00 2014 2 100 5,300 FPL3 Fireplace 2 stogy B 1 6,811.00 1998 1 100 5,600 FA Bsmt Fin-Avg B 480 17.36 1998 1 100 6,800 PO . Ext FP Opening 1 1,832.00 1998 1 100 :.,1,500 BMTBasement-Unfit 72 26.01 1998 1 100 16,900 No Photo'On R®cord BUILDING SUB AREA SUMMARYSECTION Code I Description Living Area Gross Areari Unit Cost Unde rec. Value BAS First Floor 1,471 1,471 125.77 185,014 BMT Basement Area 0 672 0.00 0 US Upper Story 391 391 125.77 49,178 QS Three Quarter Story 286 440 81.75 35,971 UAT Attic,Unfinished 0 672 1254 8,427 DK Wood Deck 0 682 0.00 0 Ttl. Gross iv/. a 2 148___ 4,328 _2,215 �, 278 589 Commonwealth of Massachusetts a- o(aq_ oo( Title 5 Official Inspection Form ; Subsurface Sewage Disposal System Form - Not for Voluntary Assessmentsa 146 Cobble Stone C? Property Address I"Q.' John Hartjen Owner Owner's Name ?% information is required for every Barnstable ✓ Ma 02630 10/31/18 rA page. Cityrrown State Zip Code Date of Inspection,4 0 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. Inspector Information sly l ail Lf( filling out forms on the computer, use only the tab Michael DiBuono key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. 35 Content Lane Company Address VQ Cotuit Ma 02635 City/Town State Zip Code 508-364-9587 S113522 Telephone Number License 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 11/5/18 [Dsfector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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 Commonwealth of Massachusetts ,14P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 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: System contains a 2000 Gallon septic tank as well as a distribution box and two leach pits. No signs of back up or failure noticed in distribution box 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 A Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 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: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is 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 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. City/Town 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 '/2 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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityfrown 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? ❑ ® 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)] i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 II Commonwealth of Massachusetts g Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Description: . Number of current residents: Vacant 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 191 GPD 9 ( Y 9 (gP ))� Detail Sump pump? ❑ Yes ❑ No Last date of occupancy: 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone v Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (coat.) 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: Not provided Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/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: 7/5/1993 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): System is vented at the roof line t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - Y Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 2000 Gallon If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: 3 Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 30" How were dimensions determined? Tape Measure 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 is at normal level l5insp.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 146 Cobble Stone ` Property Address John Hartjen Owner Owner's Name information is Barnstable Ma 02630 10/31/18 required for every _ page. Cityrrown 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 i� Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 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): Depth of liquid level above outlet invert Level and at normal level with no signs of failure 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts lip Title 5 Official Inspection Form IQ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. City/Town 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: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching.trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 p Y rY 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No signs of failure at distribution box 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 hy draulic dr uli failure, g y a c a ure, 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 146 Cobble Stone v Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown 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 1411, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is Barnstable Ma 02630 10/31/18 required for every page. City[Town 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 l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 11/5/2018 Assessing As-Built Cards lYL du T d/ld -U6 LOCATION SEWAGE PERMIT NO.. r �•S /ii 2 It -/O 5�Z VILLAGE INSTALLER'S NAME i ADDRESS 7 s s,.-/-/- �o� l r3g�ti I U I L D I R OR OWNER • a �tice DATE PERMIT. ISSUED DATE COMPLIANCE ISSUED as B5 r aru f- 3•> • y7 yb yg http://www.townofbamstable.us/Assessing/H Mdi splay.asp?mappar-316064001&seq=1 1/2 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form I,. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10+ ft 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: 7/5/1993 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: Test hole data on plan 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 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 146 Cobble Stone Property Address John Hartjen Owner Owner's Name information is required for every Barnstable Ma 02630 10/31/18 page. City/Town 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 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 No................�( .3A3 PROVED. .. Fps..��? .........._ � ;st$zar IilB COIIS9TV$tiOII COIDm38gR COMMONWEALTH OF MASSACHUSETTS �- a,y BOAR® OF HEALTH ,' signed Dat TOWN OF BARNSTABLE 13� Appliration for Utupu.aal Works Tonutrnrttun Pamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ---...----- Location-Address or Lot No. --• ................................................ Owner Address r ------------------------= • r-# ... cxr-L' --------------------------------- Installer Address UType of Building Size Lot.................... .....Sq. feet �-, Dwelling—No. of Bedrooms.....3..................................Expansion Attic ( ) Garbage Grinder ( ) a Other—T e of Building .............. No. of ersons....._._............._______ Showers a YP g -------------- P ( ) — Cafeteria ( ) d Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/l,&ugallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___-__�-____.. Diameter.......G_......... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank ( ) a "Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f-T4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground.water_.__................___. P4 , -•••--------•-•--•--•-----------•--•-•.....-•--------•--•...............................•••---...............................:.............................. 0 Description of Soil....................................................................................................................................................................... W U ••-•-•---------•--•----------•------•-----------•--•----------•---•-----------------------------•---•----------------------------•---------------------------•---....------------ W --------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.__-_-__- ............ ,1IV���� .L.-•-----•-----------------------------------------------------------•-- -------•-------•••---.--------••----------•---------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned.further agrees not to place the system in operation until a Certificate of Compliance as en issued the b and of health. Signed ............ -------------------------------- Application -- ----7- -- ----- Dace Approved By ---- ------------- Da Dace Application Disapproved for the following reasons: ........................................................ - ------------------- ------------------------------- --- ------------------------------------ ---------------- -- ---- ................................................................................... Dace PermitNo. ......7.../------2 3-- ----- ---- ------------- Issued ............................................................... .......................... ...-.. Dace . —ram No+:/ :.............. FEB�?,�..�....... THE�CO^ON®ALTH�OFUASSACHUSETTS \ �t /"R OfHEALTH P' TOWN OF BARNSTABLE Appliratiun for Uiupuual Works Tontrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal sy#et/4t: r -- ....� ......... ,:,..y - Z --- -------------------------------------------------------------------------------------------------- J or Lot No. ---------------•--.............................O ...r.......••--••..................._...._.... ..........-------.......------.._............•---................................................. Owner Address a ------ ------------------------------------•------ ------••------••-------------------•---------.... Address g 3 Size Lot............................Sq. feet Type of Building v Dwelling No. of Bedrooms............................................Ex anion Attic �-•, g— p ( ) Garbage Grinder ( ) a Other—Type of Building _________________•-,--_-____ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow.............................../��!..gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid I_i ui capacity............ adt16. . Lent Total Lengthidth.............�Total leaching area...Depth......-sq. ft. P 9 P Yg g x Dis oral Trench—. Seepage Pit No................ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '_'.. Percolation Test Results Performed by.......................................................................... Date--------------:h-.................. i Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.............' .. Depth to ground water........................ a' ••••---••----•-•....•---------•-----•••.....•••--•--------•••--•------•-••.........................•......................................................... Description of Soil................................. .. 'r -....._....:-••-----•----------•--•--•---•---•-......•-----•-••---------••--•-•---------------••----•-••••------------••-•--•--•......--•-----••-------•------ W� ----------------------------------------------------------------------------------•-••-------•......-------------- ,tv - U Nature of Repairs or Alterations—Answer when applicable..........................................................................................C.. -----------------------------------------------------------•------•------------•-------••--••--•--•---------••--------------------------------.._..--.................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental-Code—The undersigned further agrees not to place the l system in_operation until a Certificate of Compliant has been issued"By thelboasd of health. Signed -- -- ------------------ --- ---------------------------------------------------------------- Date Application Approved By ------------------ ----- Dace Application Disapproved for the fo wing reasons: ----------- ------------------------- -------- ------------------------------------------------------------------'----------- ...................................................................................I...................-----.........---- ----..................................--------------------...................... ....-..............................---- Date PermitNo. .. .....9 f--------3- Y........................... Issued --------`-----------.Date..................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD,OF HEALTH TOWN OF BARNSTABLE (1Pr#tftra#e of C autpltttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 1 1�1----- Installer at ........ --------------------------------------------------- -- ------------- -------------------------------------------------- has been i st lld in act r ante with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ........�f w....3-3y............. dated ...._-----------------------------------_----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTO Y. 1 _ l j .... Inspector .... 1/ DATE ............................ ---- --- G----..........----•---�... ....-------------- ------- ------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q� TOWN OF BARNSTABLE No....71 .... FEE.... .......... Diupuua1 Works 01AIntrnr#inn ami# Permission is hereby granted............. , 10- ---/-'l-='-.'!!M "-------------------------•---•---------------•------.--..--.-----.-.--.------------------ to Construct ( ) or Repair ( an In)( vidual Sewage Disposal System atNo.................. -.ire--� tzpn-" ems_ A -------------------------------------•------------•--•----•-----------------•-----•--•--•---- L� Street Q'��� as shown on the application for Disposal Works Construction Permit No.:.................. Dated.......................................... ------- ------ �' _ �j� DATE _ d - j ..oard of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i ADDRESS � g R UILOf R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �a �� r� bru e1� r y7 yg No...........6..1 !019 FEB........5a:..........._ TH9 COMMONWEALTH OF MASSACHUSETTS 3/6 16 f BOAR® F HEALTH ...7(7.c<J l/ ..................OF....41 Appliration for Dispnstt1 Works Tonstrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................- ........................................................... ......_....... -/ .................................. `4 ---AWr / ocatio AddreIL t E/_-.'A�Al-�lJ�� ._d � _._. .........lo��..�a '. .. � O ddress a --- , Installer SFE �/A J n y n lk Q Type of Buildingl""- Size Lot..,�0-- &A. .......S . feet U � q-"1-90 q Dwelling—No. of Bedrooms_'.. .................... ansion Attic ( ) Garbage Grinder (AV) '4 Other—Type T e of Building No. of persons............................ Showers � YP g -------------•-•------...... p ( ) — Cafeteria ( ) Otherfixtures --------•----------------------------------•-----------••------------------------------------•-----------•-••-------••--------------•---------------- WDesign Flow...............<?...................gallons per person e� day. Total�D�jow-_ FI-- ...:........ga�Ions. WSeptic Tank—Liquid capacity.l gallons Length___ _._.�._:: Width................ Diameter..._.__.____-_•- Depth. _.`S!.. x Disposal Trench—No..................... Width.................... Total Length.._....._j__....... Total.leaching area....................sq. ft. Seepage Pit No......-------------- Diameter....(a........._--- Depth below inlet...Y............. Total leaching areaAJ...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by............. .......QT �' t Q° e Date_._. ` _...._..._-. l Test Pit No. L.4.2....minutes per inch Depth of Test Pit.., ._(....._... Depth to ground water._,.-ram....__. (i, Test Pit No. 2................minutes per inch Depth of Test Pit____/ O....... Depth to ground water-_-P-!----a-t�- ---------------------------- ........................... ........................................................................ O Description of Soil.... ... .. ... -- ------••-------•-----•-•-- -- -------•.._._. i.. U T . ."I W = x U Nature of Repairs or Alterations—Answer when applica --t� �.----- --•--•---------------------------------•--•----------•--.. ..................................-.................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in oper 1 a 'ertificate of Complian e issued by he oard of ealth. 7 Signed.. ... .. - D Application Approved By....................... ..... � tg� Date Application Disapproved for the following reasons:-----••-------••-•----------•-----------------•-------...-----••-------------------------------•-----...------.. .....-------•---------------•-----•---.......---._..........--•-•---------•- Date PermitNo--------------------------------------------------------- Issued....................................................... Date No.......... .L° `�a FEs......a ............... T H r COMMONWEALTH OF MASSACHUSETTS �'' BOARD OF HEALTH 7!�J. w_�...............•----OF... ......_....... Appliration for Disposal Works Tonstrnrtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_........_.............................................. . ..... ...... ..' '6&�c . . c � — �/�� /Locatio`x/v- Add C .r. / f / .! Owners Address ............ .-....... Installer Address G Type of Building Size Lot. y�!��./__.___..Sq. feet Dwelling—No. of Bedrooms... ....................................Expansion Attic ( ) Garbage Grinder bp) aOther —Type of Building .•..........................-No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow...............�.,.a.....................gallons per person per day. Total daily.flow..3- ..0.. ......--.......gallons. `� W .._Septic Tank—Liqu>d capacity� ��.gallons Length._ __. .... Width_y._A .. Diameter................ De._ pth!a._. x Disposal Trench—No..................... Width.................... Total Length.....................Total,leaching area....................sq. ft. Seepage Pit No.....I.............. Diameter... ............ Depth below inlet.`'tl............ Total leaching area�.��c-.d.-....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by........ % /1,t^' ".r ~: ?' - -----------•-•.• Date._.- -/`y--•-•--•........_. Test Pit No. 1_�_.2.....minutes per inch Depth of Test Pit-�.S G..�_...__ Depth to ground water.ems- _°........ L4 Test Pit No. 2................minutes per inch Depth of Test Pit... Y° Depth to ground a O Description of Soil.............. / V ..............................��/:r-/�.'=............ .. ,/l-'t-rf- --- ,-----•-•-=` `---•.....................................................( Lt�f2�`Z-,.ram 'irc. .................7 /L?�1�f j� r. = ------... ........•-------...--•-------•-..- •----d..•,z:<� ....�._ � e_------.... ^' u r U Nature of Repairs or,Alterations—Answer when applicable...................._...._._.................._................._....._........._..... --•----------------------------------------------------------------•------------•------..........----------....-----------------------------....---z................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in oper yu 1 a ertificate of Compliance has been issued by the board of.health. Signed ................. ••��-----••.........• ................................ !�~ Date APPcation Approved By................ . --•-- .. ...... � -. .:::.............. ---- ... w Application Disapproved for the following reasons:..........................................:................................................. Date -- .....................................................................•---------------.........------•----••..........-•••-----•-•-••-----•••-•--...•---•-••-••-------••--•----•-•-•••••-----•......-•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS .BOARD OF.-HEALTH - -- - j ..........................................OF..................................................................................... Tutifiratt of Tuntplianrr. y THIS IS TO CERTI-�Y, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b .....�..--------•----------_r t���.''.��.Lam;..... ^ • - -- +�_ Installed- has been installed in accordance with the provisions of TITLE. 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No C!-..10_.`i_ ...... dated................................................ --------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON RISE AS A G ARANT Y THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. ? Z— -5 / ................... . -----•--•-------•-----•-. Inspector .... ---_-•---- --••....... . ....._--•--•....... THE COMMONWEALTH OF MASSACH SETTS BOARD OF HEALTH OF.....................•---••-••............•---••..................................... No;......................... FEE..:S•o................ Disposal Works Tonstrwtion frrutit Permission is hereby granted.................. � .__:.--f:%':_%_._.. �/ -••------------------•-----..........-•-...........•---•........... to Construct ( ) or Repair ( G) an ndividual-)Sewage Disposal System atNo. f>... ......•..... ------... ='=---------•------------------------------•-------•---•------.......-------•-•............................ Street as shown on the application for Disposal Works Construction Permit No, ."14.. Dated---- --- f)f t3�� ............./� .. .,--------------•--------------------------- ---------- J� 7 DATE.-------���- --�--t�---�•--- - --------------------- Board of Health---\�� FORM 1255 A. M. SULKIN, INC., BOSTON k , Y r f SECTION,T' SEWAGE 4VN SEPTIC TANK'` LEACFF 4-z-,Ca v — "p„BOX — TOP OF FDN - Z.<1 `� "" W i>l /4•r►, (�1 I / MS �i1G^iY,/fc �1Y �a►aSu►sYat sAK?Ct E irk t.. w�i�.— Z.Z� C cso 6.{- w> n+>,t ►a O ( l)sr / C44sTA.n„{ >iic d!b- tGi p: 1DlI►.tA El.t1^tS2�o. l — T WASHED STONE CQ , ". r"a•rT' 1e�,ap St�LAC.F� wrcH C.�.�A�.+ G�+�si~. Sa.�. .YL , 4 k tiIN- SI, OUT J . . • '• IN` OUT• ` _ �r •���� -1-••{ f SEPTIC .e- ± , J li• l , •5L TANK -t.Z 1O ca ELEV. ELEV. ELEV. ELEV. ELEV. ELEV, 1 n� I .-►� t.r' i ELS?V i ,Ot ly 41 OF AA -142 WASHED STONE !: J/ f"f• ��p7 s'^� �. (\O - it /� .E • •i„' / / ' '1J mot""' n iA ' ± TEST HOLE;LOG I Z q IQ,c /,/ o TESTuBY' B.C).1- Ga Al r A,. � 12,'•'` G WITNES \ 7:_ ! f / ;. 'jtv+w- TeST•DATE ' . BEDROOM HOUSE / ' tzZc�(, ►►ttT DESIGN }' T.H. i<c 1' .I�i $ { T. I. 2 4ji'.?'E EIEV. Gib`. ELEV. �• '� .// / / �r ,[ r i i iMatss{ txi�arr+ nx{ NO i "" DISPOSER DISPOSER / 4 t� '� c.�,l IZ ; .,5 73•a PERC RATE . MIN/IN. - ` ;.� .» FLOW RATE 40(GAL./DAY lie SEPTIC TANK 44_0 ((.5)_ C. 10 ccs REQ'D SEPTIC TANK SIZE LEACH F"7,7 ,•� �+C.+�w e�� ea.�w�! ACILfT -th `�� •` _`,,.,•• `•:�'' 1..-� ���,• �ei� t�y:s�^' S.0' � i Saw�o r. c Ix SIDE Wr<\LLt - ri � -ISc/•' - 12,5 i 3'1"E 'b G/D. iP`�3• '1rJ.F ' BOTTOM I..c9.) R "� G/D. J« 7 , TOTAL. y { ZO,I•D'i Q2� .3 f�rt�• ' �. lbr ' f/ (f1 '� r 3 y ' �L • MC'.iyf,'.'SA,t•w(1. 1�iR '.. I♦ ♦ r - �+ _ • M NN , 1 ( USE: `r�sea LEACHI G rPi'� �� r.. 4 t „per �,• �. 0 WATER ENCOUN EREDZZI w 1 NOTES;'(UNLESS'OTHERWISE NOTED) i. ATUM"fMSi;l+ fAKE`N FRONF. ...� F�3ht »:Cj QUA_DRANGLE:MAP: 2.MUNICIPALWATE9r ?. ._ .._AVAILABt£ r' ifJ� 3.PIPE PITCH:Vi'!PER FOOT I^1, tQ�. y � _ �!� � � '. � ' *� �. 4 d•DESIGN WADING-FOR ALL PRE-CAST UNITS:AASHO 44 S.MIN:GROUND COVER OVEWAI L SEWAGE FAC141fi1E$:(1) FT. l � ^ ^- Q-' —bISTAI� EASCERtdFIEtT a' 6.PIPE JOINTS S�HALL'EE MADE WATER TIGHT.• �R` ARNE I�, �n f •' � `: �. � •• +.•CONSTRUCTION DETAILS TC1!)£`'ACCOROANCF_WITH COMM,OF MASS, i OJALA • / � _ {. STATE ENVIAONMENTALCODE•'fITL'e St S� ,L✓ CIbIL SI PLAN:. h I t . � � •{ 3 �" M No. ,. �♦ r +�" ls. , i�+'1.C� .t Yr'S\Cr1�1 �I.wW r vw1 1. 4-t.YA A ENGINEER �G>,I �1� !i�� y - ` �;. 5w►vo S>� AEF. .LZ L eta s , PREPARED F.OR `. CIVIL.-ENGINEERS LAND SURYEYQk _ _' r r_ �..., .�w. .l_ -� r '. - ..+...w»-•rL e-- -r '-- +,y ,;,rTO P a BOARD OF HEALTH RED:LAND SU.RVEYpR CONTouRS'..tEicistwca,' $Al.15lBL , t 'F ' ' ✓C? (R.ROPOSED)-�0-0-0-0� i APPROVED ;'DATE. )MA �.� &C$ r . r E II r"+._- •-._. ._.�'._-r..�•.�,;,-....r.,LL.1L.r�.. - _- _ _.r,.=_.w. i,.L....dr,..._.+.... _.-__ia.....+i.s. X: .i •. ar... 't. . � W 4,{-:' ✓• 4'. w.r� iy4. iYt "',% { w W � - .....tom«..:..�-,-. .. 3 .ice. . i. sy �,.... :1.• SECTION -. SEWAGE o " —SEPTIC TANK,— — "D" LEACH BOX — — + •� -`— C, / 'j? v TOP OF FDI / i Y` Mc".l A1aYy AuAsurroe+`.�`A- •• /�tl. i^275 ZL+ OOGJ S, .•- wT�P�«o.vt> U - - (IVISL)*" �+ C�Iraa1`pf.cC lb il+. :A 'I R. L.E#�G1a WASHE+4STONEI/'-rc* 10Q t— y 7 PiT fiA1+JCSry W 1 S K C t,BAN,.4 G?P� ►E r4v0, N /moo t, , kQ IZ - ...... - OUT.. • * Zii G7 - - f , '++ G STANK v •}/ Q ^++1}�' � / w � �O .I J Z. � f+l• .` , - [1R'.1S. , • y r - t.h. t �..•^ y.+•' rc • _ ELEV. r4. EL£V'I ELEV. ,+ ELE l S $5 N? 4 ..RA PI i OJHI J1:Ti;11 [.ti ` .,..,— tom. \ t %-kE NAS. "l£STIFI£..D THJ�'r "TIl ,. ELEV, 'ELEV. ,l.C++ �I••., �-+++ l..�S' _ /' /• � '�� ,� i .�1 1 tP1'CS Op�i1:E Ct�. ryS. T: so ZticAT •o l=�•S A nrio< w A 5 s,x Pv5 E fl 1� -Tk E �`��• I .rs' / / / �`.�• 1 t Jr.S F AS -i\fif WASHED STONE Y6 �• /f tk i. {�Y d 4j' ^/ 01 UAT�on� S1'aFwaLt S 13VIL'('. [ j / k; �• ! `. .INSTALU;.$.' �S JULIyS P• 'NkOQkN - sz •" , �g ., ,�`� � •, .,,/• •< t A t✓'L. �Q �/ TEST HOLE,,LQG �r�7 d� � A C. !c ac�+�a �citiBc �3.0,1"7. fly � �1 1 ' 17-; TEST BY , - � �f/ G F. WITNESS: �IvG TEST OATS 'I 3 gyDESIGN BEDROOM HOUSE d I �tLcr�,Irc T:H: ec .�9. T.H. + 2 ' , ,(i '` 1�� l �, I'� t' =0G7tr , +1 ELEV, N `' ✓� �r t /rx �.", '� t�" . h ELEV, QG: DISPOSER DISPOSER I ' '1,3.o PERC RATE MI(�t/kN. ."' u• r: FLOW RATE `440(GAL.IOAv) r' . E + w�► s,� eip SEPTIC 1ANtC 440 ((.�� � 1Ac�ts � y Q 4 / J �'�; �' '{GT.'� W Z REO'D SEPTIC TANK SIZE . .�,; r � ( � 4. 72'•g - 3 �. s��. c.s�r LEACH FACILIl SIDE WALL ' �� =' fS (Z.S')' zITO G/D. BOTTOM ! <- fi`. .` * TOTAL �Sg, -I� = 4Z'i.3 G/c,. - Av s�., 3"17® 79 ,4/� 15G" l010.4 1S5`!31° •c USE: �6ca - LEACHI G 'S _ ^�� ' I. N 0 V; WATER ENCOUNTERED s y O-E QvCJjJ 1p NOTES:' (UN LESS'<OTHERWISE NOTED) , El=�g.<I As-Bull, LoC1�' oas J F {�� ,- '� N ,5 ,��' . L(�ATUM(MSL) TAKEN`F,ROM .._-OUAORANGLE MAP' Uo-�I S A140 Q SFi`tS y• 2JMUNICIPAI.;WATER __ \_ .__ _ ,AVAIIA$LE `3.PIPE'PITCH tp•�PER FOOT :. 't�, �� To ttCJusc A 4:DESIGN'LOAOING'FOR'ALL-PRE-CAS'f.UNITS:A/�15H0 -14 I� 44 $ "� �1 CWY �y�" r ` �•. _ + 5.1MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1'1 F r,'9 " » '� �� �DISTANCE AS CERTIFIED ARN C;H. - ' . 6.PIPE JOINTS SHAC'L 6E',MADE•WATER,TIdHT' �.CONSTRUCTION DETAILS TO BI A,C0ORDANCE.WITH,,COMM.OF MASS. +, (•}JALA l _ - : :SrATE'ENVPRONMENTAL COD_ E TIjLE`5 ' �-, I L.4 r CIVIL w d \ ' SITE' - PLAN �, t �.` Y t•i+. I�O.. LocuS: iit[a i, lA t4> ..,,, � `Y 4tRA.M GR '+lw�.sb ��,, � EN4a1NEER. - A /,/�A' day �y y t t p 5rti+i 'Ga >;. � REF: 1,,.C.g G.�Q mot' � A PC �rF SI •Jy t ,y>?. L , + ay" • Lrvfo� "�4•i.-+�- ' _ r I ♦ •• �y _ s WD�JH 'CdPe 'fin 14 OrI RREPAF3Eb'FOR, CIVI(- ENGINtERS'. t r ' :t LAND r — r .— T RVOFEW_TH R G: ANO$U winSt- x ft3dAho o F SCALE �.' (rRrsrlNa� .r '1�1E:figE3►r~Er CONTOURS APPRovea 'Da ». MA �� r , r CJk ►. Arse3 , , w i w ,,. ".. . _ - t � :., �. ,a.. _ -. . .� <, , + r ,. • .( , . , ....._ .. -. t ,'�. ..�sr ., - .:w. cI .,. .,:i�r ..*¢ . . �S'f�a •+ r`', ,aa -SECTION - SEWAGE 4 � \ 0 40,�� 0 t c� 0� AV ' a —SEPTIC TANK,— — "D"BOX — — LEACH c�2►G�2� s• uT��>,.� / I TOP•OF FON $'2.'.r:� ., 'P.11nc�vC. Ar•af .aaa I'C",AP�,.a�- %►ram., z'z�>� ZZ� oc3c� S.•{: - ws.•-r...�..,� f ¢/ (MSL)4► A —"2 OF tr®TO 4a' * I i <?wt3 �I.IaC!✓ I{ CiJF�I>".1 I aa>a0. WASHED STONE t Cn�� S. (,� / 0 / i } / A OUT+ IN• OUT+ i f' tEITTtc i `•-7�.G', -1�. Z� TANK ,.. °-. ELEV.ELEV. ,. EL . r ELEV. ELEV: ELEV. } E�6 OF N4"-14r"' WASHED STONE ca'C.,� TEST HOLE°LOG 1 z Id/ f,/ jf n TEST BY arm,.ra, .G, ,1 H ;JAvCc�Bl � �f /f t ! I i �'� I wG G i 2. g4•- WITNESS TEST DATE BEDROOM HOUSE , DESIGN T.H. 1 19 $ T.H. * 2 t Oct I ELEV. QC « ELEV. NO � a MIN/IN.RATE Sc + fa tt. T J I3.ca DISPOSER DISPOSER PERC " *^ ;,. •,, FLOW RATE 440(GAL./,DAY .k = i'a2vw►:1 Sre ccq SEPTIC TANK4CS (1.5)= /' �. r / _T N'2 REQ'D SEPTIC TANK SIZE t2r> �� ." +�'? ✓ j� "�q •0 1 �i r ' $4.. -12. ,�..� s�. ,� LEACH FACT LIT ti 1 ' r^ 7 '. SIDE WA • y' ,� / 4 s < ' 6 ZT 15 a. >e 3`I�1. ..•- _°� .-� �y 8L Z.S 00 -BOTTOM - So.�-`tom ►,,> I s �'',+ G/D. .� 4 14 TOTAL ZoI 0_1 GI;.E?A�•t� ir iw.w>7 {Sla, I X 2Z= 4•d'•2.. � ,, • .t �"'� 15�" 106o.4s tSa" c USE: LEACHING 8 e cl cf-i ( .o �� l N 2 WATER ENCOUNTERED o �x :�tj� ` I DF�y�I f(p W i Q /!�l/ / ti 0. 1 f .NOTE S' (UNLESS ,OTHERWISE. NOTED) co" G1<74.4. V' o� 1.DATUM(M$L)*°TAKEN.FROM:.._ .QUADRANGLE MAP, lic 2,MUNICIPAL WATER_._ }. ~ AVAILABLE 3.PIPE°PITCH. 44"PER FOOT ��,A OF �p � 4.-DE$IGN9LOAOING FOR ALL PRE-CAST UNITS:AASHO* -44 �+' S GWY ' tC I 5,.MIN GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. —O—DISTANCE AS CERTIFIED ff✓�~�--•^• . `1� 6.RIPE JOINTS'SHALL BE MADE WATER TIGHT' 4 � fiFIPlE H. " 7.CONSTRUCTION DETAILS TO SetACCOROANCE WITH COMM.OF MASS, S OJALA t . . STATE ENVIRONMENTAL CODE TITLE 5 �4` -1Z.,•4- rt.3 CIVIL � PLAN- STATE ��. SITE AN .L r n ' ,. G17R1w ew 3A..t> r ENGINEl;R f REF: 1..aT S �+ -,Ise tpir.4- /r C Q f N � >•r.•. d� H �ilg� CJQ� ��.+ PREPARE[ FOR; V j N�� ,T `�•• , CIVIL ENGINEERS x I r• , ` Af214tSTABt.E ND Q)( RECi.--- — ——— � LAND SURVEYOR ^4! Nl�O^t7 XSTG) SCALE ^APPROVED DATE CONTOURS _ C/ , �• ATE FI. ... ..� . :�'' ..t -. _ ,. *Y ? .,r _ ..... .. ... .. -.' .. I..., "i •I .. -. �+.� 1._ _. - _"ii' _.. .. . - _ 't� _ ... ., — '�',_. __s.. ..,._._ �_. _4YS':�• ���Zi/..�l Si-'{"'".� � i SYSTEM DESIGN. ACCESS FOR ROUTINE MAINTENANCE E G E N D MUST BE PROVIDED FOR ZABEL FILTER. NOTES INSTALLER MUST FOLLOW ALL o GARBAGE DISPOSER IS NOT ALLOWED PROVIDE QUICK DISCONNECT FOR PUMP MANUFACTURER'S SPECIFICATIONS FOR 1. DATUM IS NAVD 88 99— EXISTING CONTOUR � O X gg,� EXIST. SPOT ELEV. EXISTING 4 BEDROOM DWELLING TOP FOUND. EL. 74.7' PROPER FILTER INSTALLATION o o�� NOTE: 110t GAL. RESERVE 2. MUNICIPAL WATER IS EXISTING PROPOSED 1 BEDROOM IN GARAGE PROVIDED IN PC —[99]— PROPOSED CONTOUR 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Rote 6q DESIGN FLOW: 5 BEDROOMS @ 110 GPD = 550 GPD _ ALARM AND CONTROL PANEL \\ \\\�\\`\\/\i�y;��```� MIN. 2" WALL THICKNESS 4. DESIGN LOADING FOR ALL PROPOSED PRECAST [98.41 PROPOSED SPOT EL. USE A 550 GPD DESIGN FLOW TO BE INSTALLED INSIDE �� �� TH1 ' BUILDING. ALARM TO BE ON ���� UNITS TO BE AASHO H-LQ m owe O USE EXISTING 1250 GAL. SEPTIC TANK & INV. IN 72.3' �— TO EXISTING LEACHING SEPARATE CIRCUIT FROM PUMP 2" PRESSURE LINE "' 5. PIPE JOINTS TO BE MADE WATERTIGHT. Locus TEST HOLE EE ADD A 1500 GAL. SEPTIC TANK FOR GARAGE 72.5f * ZABEL FILTER 14" TEE SLOPE TO DRAIN BACK ° ° 6. CONSTRUCTION DETAILS TO B IN ACCORDANCE c�O°'re FLOAT SWITCH ALARM ON °°°°°°°°°°°°° 6 MIN. SUMP E CE oc o 2% SLOPE OF GROUND LEACHING: OUTLET TEE W/EXTENSION WEEP HOLE '�°��o°'°°°° 14" MIN. INT. DIM. WITH 310 CMR 15.000 (TITLE 5.) o SETTINGS: USE EXISTING TWO 6'X6' LEACHING PITS W/ 1' STONE PUMP ON 6" 10THIS SIDE 00 GAL. IN CHECK VALVE 76.5t'* 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND gra9gs o UTILITY POLE .:: (854 GPD DESIGN) 5" WORKING RANGE OF BAFFLE NOT TO BE USED FOR LOT LINE STAKING OR ANY FIRE HYDRANT E .�'����� 5„ MYERS SRM 4 6" CRUSHED STONE OR MECHANICAL OTHER PURPOSE. NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING �� SUBMERSIBLE 4/10 HP PUMP PUMP OFF 12 SYSTEM (OR EQUAL) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. MA o00 00000 00 (ON BLOCK) INSTALLER SHALL CONFIRM EXISTING 9• COMPONENTS NOT TO BE BACKFILLED OR APPROVED DATE BOARD OF HEALTH o00000 0000 0 00 000o D-BOX ELEVATION AND ITS Route 6 SUITABILITY FOR RE—USE. REPLACE CONCEALED WITHOUT INSPECTION BY BOARD OF WITH NEW D—BOX APPROPRIATE TO HEALTH AND PERMISSION OBTAINED FROM BOARD ( 2 % SLOPE) 6" BAFFLE SITE CONDITIONS IF NOT SUITABLE. OF HEALTH. MIN. NEW TEE REQUIRED. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR FOUNDATION 10' 1500 GAL. SEPTIC TANK/ 56' EXISTING CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP PUMP CHAMBER COMBINATION D BOX VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000't *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL WORK. UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 11. EXISTING SEPTIC SYSTEM SHOWN AS PER TIE ASSESSORS MAP 316 PARCEL 64-1 CARD ON FILE AT THE HEALTH DEPARTMENT. CONTRACTOR TO CONFIRM LOCATION AND SUITABILITY OF EXISTING SEPTIC COMPONENTS PRIOR TO ANY WORK ON THE SITE. 12. WETLAND FLAGGED BY BRAD HALL OF BLH ENVIRONMENTAL CONSULTING. 13. INSTALLER TO VERIFY THE ELECTRICAL SYSTEM ZONING SUMMARY IS SUITABLE FOR PUMP CONNECTION. ELECTRICAL PERMIT REQUIRED. ZONING DISTRICT: RF-2 RESIDENTIAL DISTRICT MIN. LOT SIZE 43,560 S.F. MIN. LOT FRONTAGE 20' MIN. LOT WIDTH 150' MIN. FRONT SETBACK 30' 16\ �� MIN. SIDE SETBACK 15' 64 \ o� o \ MIN. REAR SETBACK 15 /••./ y� \\ ��N o MAX. BUILDING HEIGHT 30' c) \ I � SITE IS LOCATED WITHIN THE AQUIFER �� 6� /• I \ o o N \ PROTECTION OVERLAY DISTRICT 6� 0 1 `' Z OWNER OF RECORD -62 � \ ✓ p 1 `� w \ MARK S. STRATIL & MOLLY T. WATERHOUSE 146 COBBLE STONE ROAD o� °y�� 1 ` BARNSTABLE, MA 02630 N j REFERENCES 1° 2.34, I "� �o • y 1 �� DEED BOOK 31704 PAGE 151 \ PLAN BOOK 371 PAGE 99 ° \ � o p a PROX. LO ATION �3 F EXISTIN WATER r^ INE V.I.F � SEE NO 10 EXISTING GARAGE TO BE CONVERTED TO A 1-BEDROOM PR FAMILY APARTMENT � ��� • �^ � G EL CO ERED POSED o D IA ENT NCE EXISTING Qy) 1 °-gym,, GARAGE TOP OF FNDN ' EL. 74.7 o j —� i 6o LO \ �� cl) 64,629tS. PAVED) - 6° I WETLAND=22,00 ±S.F. DRIVE SLEEVE ISO R LINE b°, PLAND=42 29 S.F. 59 WATER LINE 0� `S- r� 0• o ? I EN H K 60 / 6 \ rn 6 0 \��� AG S KE J �Lo 6.75 � 60 # ORK LIMIT INE ILT ENC / PLAN E Rv AREA- k ; —� DECK S I T HE:I OF DE IG PLA i i• l v �h 146 COBBLE STONE p s9 EXISTING BARNSTABLE, MA �, .• � v! � � DWELLING y FIRST FLOOR PREPARED FOR ,S9 420 � � EL. 82.5 1 MOLLY WATERmh"OUS \ �0 6h \ DATE: APRIL 18, 2019 8 'moo 6E 6 6 / � 80 ��78 87 9 i. �� %• � 82 Scale: 1"= 20' 0 v 0 10 20 30 40 50 FEET S9 A \ off 508-362-4541 �7r�NIEti h ? DANIEI_A. \ I fax 508-362-9880 0 1R �AILA ` downcape.com @ 6 0 � � 1 c ^ , down cape eagineefing, inc. °\s,SroN-r-Er�G��'�, ` o� civil engineers ^ °� �� . � land surveyors DATE DANIEL A. OJALA, P.E., P.L.S. 939 Main Street ( Rte 6A) YARMOUTHPORT MA 02675 DICE ## > 9-077 i i �z SECTION - SEWAGEo Y, c IF 010 L vi 0 U SEPTIC TANK BOX — LEACH TOP OF FDN c, 1- -(NISEI* 2-OF'STO L12" WASHEDSTONFOTrsfyL 0 _�7 lo, cl IN OUT IN OUT K_ "i C)C>4�D G _ I 1 11 1 / SEPTIC Z_ TANK ELEV. ELEV. ELEV v 4! ELEV. .. ......... -- - - --------- It- ELEV. ELEV. M I WASHED STONE )< C---,4w— TEST HOLE LOG 4 ' TEST BY u2 I�2--2, WITNESS TEST DATE DESIGN BEDROOM HOUSE T.H. o 1 N ELEV ELEV. NO DISR DISPOSER -17 POSE PERC RATE M!NIIN- FLOW RATE- f7t�(GAL/ SEPTIC TANK T. .i,_44_C�), REO'D SEPTIC TANK SIZE 7 4-EACH FACILITY tpSIDE WALL G/D. 'k v 4s BOTTOM G/D. i 1 ..r .0 TOTAL zr. 3 �i 4 9 c� -t G/c; I �?,- 0-* -F> USE: LEACHING O ' --WATER FNCOUNTFPED IW _T—f+_1 J NOTES: (UNLESS OTHERWISE NOTED) 1. DATUM (MSL) + TAKEN FROM --------------- ...._QUAD RANG LE MAP 2.MUNICIPAL WATER-------- --_------------------AVAILABLE 3. PIPE PITCH: im"PER FOOT 4. DESIGN LOADING FOR ALL PRE-CAST UNITS* AASHO - •44 % 5. MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. DISTANCE AS CERTIFIED 6. PIPE JOINTS SHALL BE MADE WATER TIGHT WINE QJ Ai-A 7. CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM OF MASS. cl -4 SITE PLAN STATEENVIRONMENTAL CODE TITLE 5 ;-) CIVIL z c= No x 30 LOCUS: ;1 -1 4 ik- LA60 T 'v-,h,." "JE*"- etl, ENGINEER C4 I-q REF: PG. . %Sib" 12-7- " down cope engineering PREPARED FOR: f7 ;-:--_ It,I CIVIL ENGINEERS Ivi'c"ED C-- v BOARD OF HEALTH LAND SURVEYORS ". / REG. LAND SURVEYOR 40 1 L r" 18 9" main SL SCALE (EXISTING) ------------- BIL-E (PROPOSED) APPROVED --DATE MA CONTOURS DATE SZ- i lz 14 4 1 ,/ -T"` Grp' 4:rA- f/ 1—.)l ",, � �-_ � �`�"t-� ! Lam- '"� w-.; �� L;,y .' �.�,,,,•. ., Lor- a G — _ — � zi 1. C? . x� rip f � {P S t f - : ! �� --+ ---72 Illy { ,v `tit l; i �. t✓' T �✓ © v�t t� !E,�L,,t �-' Ea p � t� t i �Gjt #a. F2�a�+4 GJ} 17;h ,k ; tea'(, - d• �.. i - ` — 1 ` J 4, , `, /j '� � r�l 1 `\ _ ___.:�t.�.__�� ��•�'"�C. �Tti�-..?"� �•I��.. 8+i C'�;'1",�t h.��'r-, '�'j,�'�N'1 LL 1 � - t Cr-:.47-1 t~t4 } � �S` B V i f``t- �� �tQ CK -IF)U� H tiC A L—T Ei cl . t c�.NE r `RNE .` � ' Jib v BQ .- cf �t� .c, 7 AL f ..