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0111 CRANBERRY LANE - Health
CRANBERRY LANE Bamstable ♦ = 234 0•6 00 Commonwealth of Massachusetts !. Title 5 Official Inspection FormVt h1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� 14 Property Address c 1 11g 17 Owner Owner's Name �'.-. ��information is D 1 required for every � '/ o�c7/ " page. City/Town State Zip Code Date of Insp ction Ly A"sta, Le.- Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:when filling out f A. Inspector info lation 51=#/8 to k3 on the computer, // l use only the tab a rY1' D ke.,1 1 key to move your Name of Inspector c f cursor-do not use the return Company Name key. O Q_ J / 1 S Q U Company Address �^ 7� pL .0 CiS G rM _ 00 6 qol Cityi Town State Zip Code t 8 Telephon(m(Sber ) License Number • c 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 syst 1. Passes 2. M Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4_' ❑*gnature 1 ins 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. ?itle 5'ffida.Inspection=onn:Subsur,'ace sewage p:sposai System•Page of 18 Sinsp.doc-rev.7126/2018 Commonwealth of Massachusetts Title 5 Official Inspection Form IN Subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address O Owner Owner's Name �' 9 information is 6. 13 l/ Q 1e � a required for every .—�v! � 1 � L L/� page. City/Town State Zip Code. Date of Insp ction C. Inspection Summary Inspection Summary: Complete 1, 2: 3, or 5 and all of 4 and 6. 1} System ses: 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: • l 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass' section need to be replacedp Y - 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): r 'me 5 ot5aai inspecaor,For;n:suosurace sewage sposa system-Page 2 of t8 t5insp.00c•rev.7ra/2018 Commonwealth of Massachusetts ,lp Title 5 Official Inspection Form C. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address ds _ c74- Owner Owners Name information is I l / ?1 a �3 required for every �QN'i'�P-V, & Oa6✓vim / AP page. City/Town State Zip Code Date of Ins Action 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): i ❑ 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.71252018 Title 5 Offidai nspecnon Fo—,subsui-sce Sewage oisposai System•Page 3 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address /" 0 Owner Owners Name 11-e, /information is plot4er.�l required for every (f page. Cityfi"own State Zip Code Date of Insp ction 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 ail inspections: Yes No Backup of sewage into facitity or system component due to overloaded or ❑ clogged SAS or cesspool ❑ CDischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Title 5 Of5d2i inspecton Form:Suosurface Sewage Disposal System'Page 4 of 18 t5insp.tloc•rev.726/2018 Commonwealth of Massachusetts P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 z— Property Address 1 ST� Owner Owner's Name information is 2(�l ITV! f�{ AN na �3� a, /3 9 required for every page. Cityfrown State Zip Code Date of InspAction C. Inspection Summary (cunt.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ;11�, Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ?oO' Liquid depth in cesspool is less than 6" below invert or available volume is less than '/�day flow ❑ 2relo, Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: . ❑ M/o- 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. L-7 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.] n 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 C.4: 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 ❑ El Area 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.71262018 - 7itle 5 r fioai Inspection Form:Subsurface Sewage Disposal System•Page 5 of 1a Commonwealth of Massachusetts Title 5 official inspection Foam Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Ccrh r� Property Address Owner Owner's Name a 0 / ✓v / 0p)( 3p� �7 !s information is q ( re uired for every e Date of Ins bon Q Cityrrown State Zip Cod P Page. 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 ❑ umping information was provided by the owner, occupant, or Board of Health ❑ ere any of the system components pumped out in the previous two weeks? ❑ as 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 breakout? 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 L� ❑ 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. 0 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)] Titie 5 o`5dal lnspectlor corn:suosurface sewage Disposal System Page 5 of 18 t5insp.doc•rev.7/262018 Commonwealth of Massachusetts IA Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Z_41 Property Address _ 0 Owner Owner's Name /' lei information is / „N,�� v! e required for every L/ page. CityiTown State Zip Code Date of Ins9fiction D. System Information .1. Residential Flow Conditions: 3 3 Number of bedrooms(design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of be 33n Description: lJ��iJN /(O✓) � � ` Soo ws - 0 Number of current residents.- 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 M_'O'No information in this report.) Laundry system inspected?. ❑ Yes No Seasonaluse? ❑ Yes No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes No Last date of occupancy: Date • Tide 5Ot'fidai!nspecdon=onn:Scbsurface Sewage Disposal System•?age 7 of t8 t6insp.doc rev.7@6/2016 Commonwealth of Massachusetts ,. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address L Owner Owner's Name information is �h �` /^ required for every ebb pC 9 page. City/Town State Zip Code Date of I spec O n D. System Information (cont.) 2. Commerciaillndustrial Flow Conditions: C 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: Was system pumped as par of the inspection? ❑ Yes No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.tloc•rev.7126/201,8 -itle 5 Offidai!nscection=oan: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 Property Address 10� Owner Owners Name I,� information is �N`�G✓�/� & -z required for every page. Cityi7own i State Zip Code Date of Ins ection D. System Information (cont.) 4. Type of Sy r 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 UA system by system operator under contract ❑ Tight tank.At a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of into mation: a40 at w S oho%d Were sewage odors detected when arriving at the site? ❑ Ye ' No 5.' Building Sewer(locate on site plan): Depth below grade: feet Material of constructi;'40 ❑ cast iron PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): • -aje 5 07-cal inspection roar.sutsurface sewage Disposal system•Page 9 of 18 t6insp.dx rev.7/2620t8 Commonwealth of Massachusetts Title 5 official Inspection Form `i� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments / /I rao4e. �e Property Address Owner Owners Name information is �d` ,36L � required for every - QN ✓�/� page. Cityrrown State Zip Code Date of Ins cU"o n D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: feet Material construction: ncrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: x Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Q Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? v/4e_ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): �V1 o CoHc/�rph, Le Ow�s t5insp.doc•rev.712 612 01 8 iae 5,tmoaj inspecnon=o gin:SLosudace Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address dS Owner Owner's Name information is Cem_�rV4 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 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.): S 8. Tight or Holding Tank (tank must'be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: 4 ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Tile g Cffiaa'.inspection Donn:Subsurface Sewage Disposal System-Page 11 of 18 t5insp.doc rev.7l26i2018 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name / Of �q information is e�-�erv�i XY Ud/ �j d, IS required for every TT ii b J page. CitylTown State Zip Code Date of In ection D. System Information (cons.) 8. Tight or Holding Tank(cant.) 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 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.): /V0 S1s A100 t5insp.doc•rev.7/25/2018 71tie 5�1Cai:.specaon co.__suosurtace sewage Disposal system•?age 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 'j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address 1 OS / "l Owner Owner's Name ? information is 64?94,�,✓y1f/k 1( �d&3, /. required for every page. Cdy(rown State Zip Code Date of Inspkcbonl 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.): r * 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. Soo I0. 4�4 S ❑ leaching pits number: ❑ leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovabveiaitemative system Type/name of technology: — -- Tine 5 crnoai lnspewon=c,m Suos,face Sewage Disposal system•?age'3 of 18 t5lnsp.doc•rev.'126/2018 7y Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address oS �• Owner Owner's Name 1 71 l 9 information is required for every t./��.�y✓`` DpLG�X/` � r 3 V� w page. Cityfrown State Zip Code Date of lnspe 'on 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.): p o'►c/r N S494,e epN c -N. t J14 5 &t'ee 4S dl-c-,ffle -! "# Nam. 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.): ?itie 5 affcai inspection Fom:sucsuttace Sewage 01sposai system•?age 14 of 18 t5insp.dx-rev.W2612018 Commonwealth of Massachusetts -. Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address I T 5 Owner Owners Name OS information is required for every page. City(fown State Zip Code Date of Insp coon D. System Information (cons.) .13. Privy(locate on site plan): Materials of construction: Dimensions 2 Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): f t5insp.doc-rev.7126/2018 T itie 5 Offiaa;nspecoon=oum.Suosurface 5ewage Disposal system•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address S Owner Owner's Name information is required for every page. City/Town . State Zip Code Date of Inspe on D. System Information (cont.) 14. Sketch Of Sewage Dis oral System: Provide a view of sewage disposal system, including ties tout least two permanent reference landmarks or nchmarks. Locate all wells within 100 feet. Locate where public water supply enters Vra Check one of the boxes below: etch in the area below attached separately - i i I 1 i _ I 1 l �Rm ti f i l ,I 1 � � i - l a - 0-3 Title 5 CfBdai irspectlon=om:Subsuface Sewage Disposal System•Page 16 of 18 t6insp.doc•rev.712612018 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address CdS� Owner Owner's Name information is required for every QI- /�• page. City/Town State Zip Code. Date of Inspec on D. System Information (cons.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked; date of design plan reviewed: Date ;,__ bserved site (abutting property/observation hole within 150 feet of SAS) Checked with loca 4 oard of Health - explain: Ell Checked with local excavators. installers- (attach documentation) Accessed USGS database-explain.- You must descri ow you established tth high ground water ylevation: a f/�Ca Gt� 7LZ7 l C a` -tom(%� I t4 WC 14914 vI v uI'lf N Before filing this inspection Report, please see Report Completeness Checklist on next page. t5insp.dx-rev.7l262018 -;tie 5 5aa7�rs�ewon=or:3u0sutace Sewage Disposal System•Rage 17 of is Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name Q information is ✓� ��63� �/ required for every La V, page. City/Town State Zip Code Date of Insp ion 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 (F �ure 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 . y 7 ine 5 aai inspecon=orn:suDsufPace sewage otsposai system.?age 16 of 18 tsinsp.doc.rev.7/26/2018 1108/03/2016 08:04 5082730367 4*4935 P. 001/001 0 °M Town of Barnstable Regulatory Services Richard V. Scali,Interim Director BARNBTAHI.E. _ - %L Public Health (Division FQ ' Thomas McKean,Director 200 Main Street,Hyannis,MA,02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date:` Sewage Permit# Assessor's MaplParcel 2 3 y - Designer: 5G Installer: Gaee_W iae l nk-t(ease-s Address: 2b5q Cranberry �i+WA� Address: 15*5 r~'OWIW►e.c-ctol s�reCi East. lUarebuOY► , M i} C On I s t 3v ao1 Cgewirle 6444-eftses was issued a permit to install a . ..(date) (installer) septic system at _C Can\efr GQ1'1 e: based on a design drawn by (ad ress) 'S C En,5tnetxic,c� dated duly '(a 2016 (designer) v I certify that theseptic system' referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspe-cted.and the soils were found satisfactory. 1 _certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-byitt by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed ' e with the terms of the IW approval letters (if applicable) 1h OFMgs� v .toHN L CHURcmiu ift y ](IanslMlitur NO 1 isoy esigner's Sign" e) (Affix Des' er amp Here)! PLEASE RETURN TO BARNSTABLE PUBLIC HEALT DI SION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q-ASepriclDesigner Certification Form Rev 8.14-13.doc 4. � � - ' � { t✓ / a VVV � _ l t ' -- ? ti � � _. i P e _ �' - � - �. ..r i ' ... .. .. 1 - 4� F.. `� �. � � ; � , ,. - r,� - - � l .. _ - - .. .� � 4� � ' t • � c. i a. ' � .. - y 1�� i, -ra ' � � { � . -� w _ 1 Town of Barnstable Department of Regulatory Services I' ,�,�� a Public Health Division Date D rEn Mid�,� 200 Main Street,Hyannis MA 02601 Z m Date Scheduled /.2 1 & 0''i �my Time Fee Pd._ Soil Suitability Assessment for Sew •ge Dispos Performed By:hAud Rimenk , Ej ' CJE7 Witnessed By: v f O A L C TI ON&.GENERAL INFORMATI ON Location Address Owner's Name 7 t t t C �)AROSr.48c Pff�c s Sa�tr� �n�� t Address I, t C LV 8"Ji. . C�e�l3�Y. a2cse3 c�G.: , Uie4 F�—�t bG L'�Tt�C•d Assessor's Map/Parcel: ` .023 ,O G(p /00, r Engineer's Name ZC g!5.jai aj E?a2rvP�1 pr NEW CONSTRUCTION REPAIR _ X Telephone# °Z si F ,l • Nel ., �J ° ' Land Use• D � t 1y��,, rn Slopes(96) ,t Surface Stones Distances from: Open Water Body >)0(3 ft Possible Wet•Area 40 0 ft DrinkIng Water Well Zw—ft Drainage Way 0 ft Property Line 10 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fJn proximity to holes) Sep 4�"e3 P6 ,{ Parent material(geologic)O� W Depth to Bedrock Depth to Oroundwater, Standing Water in Hole: > I G7" "J Weeping from Pit Face > ���ar �✓�' Estimated Seasonal High Oroundwater DETFRNIINATION FOR SEASONALHIGH WATER TABLE Method Used: D,pC n Se,^yo Q� ' >Depth Observed standing in obs.hole: In. Depth to sell mottles: �� la. Depth to weeping from side of obs.hole: ln, Groundwater AdJMtment &JAftit. Index Well-# — Reading Datc: Index Well level Adj,factor, ,a-� Adj.Groundwater Level„p PERCOLATION TEST bate � .,.., Thne , Observation Hole# Time at 4" Depth of Pere Time at 6" Start Pre-soak Time® _ y Time(9"-6") End Pro-sonk 7l Perc 44 Performed. by ok.rS on RateMin./Inch Sep�►tijUPir )S; (Arc Y 6lo7) Site Suitability Assessment: Site Passed—/� Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----=---- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conseirvation Division at least one(1)week prior to beginning. Q:ISEPTICkPERCFORM.DOC , DEEROBSERVATION HOLE LOG Hole# I v 2— Depth from Soli Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. iOrn yr wnravcl) Lam, Tim C- Barg ao5 I X- Vint SO* nA PS DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil.Color Soil Other Surface(in.) , (USDA) (Munselij Mottling (Structure;Stones,Boulders. s DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munscll) Mottling (Structure,Stones,Boulders.. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, consistency, 6MMal) Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No v+ Yes Within 100 year flood boundary No.. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring per Yes, ip us material exist in all areas observed throughout the area proposed for the soil absorption system? 1'es _— If not,what is the depth of naturally occurring pervious material? ... Certification q I certify that on 1()-. -7_ �/ (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and xperience described in 10 CW'15.017. Signature' Date 7' to Q WEPTIOPBRCFORM.DOC J TOWN OF BARNSTABLE LOCATION I Q C40 $4 4M LAOG SEWAGE# VILLAGE &P,A1ST4(a,U'n�' ASSESSOR'S MAP&PARCEL A3 ® Cyo INSTALLER'S NAME&PHONE NOCC f;—gyll SEPTIC TANK CAPACITY t ®r) .G A"O pj LEACHING FACILITY:(type) 5co C-AC CWAfi BftS (size) 1:1 e% NO.OF BEDROOMS OWNER P141(.1P S 56f&tA 00L40 P10 PERMIT DATE: `7-J 3 — A®1(c, COMPLIANCE DATE: g-2-.1010 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NIA Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) VIA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _ AJJA Feet FURNISHED B YCAPj LtJt C LLC. A^3 R-'I - �i i•�1 B e � A-5= 34.9 F fkbt4 t' G $a 3 = It-4 B-q 23 ® ® I r Q 3 01. C.2 =21.2° f No. dlJ. a Feel THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. PN`<-1 P t 5tlG� 00U�Yl pl© Assessor's Map/Parcel '�� i ill dp_.+tii PjJS'T14$CL Installer's Name,Address,and Tel.14o. 5024 77-ft 7 7 Designer's Name Address,and Tel.No.50$"a73"037T CAnEU2IDE 6�iTag4(5Z9 1"C. —Tc ekiw aekl�ucz =#jC_ 153 Q.r ;18514 C9 t`J7IV t,WA726-tE494, Type of Building: Dwelling No.of Bedrooms 3 Lot Size �l l�� ' sq.ft. Garbage Grinder( ) Other Type of Building M l aj5)J-rtA _ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 3q T, 41 gpd Plan Date "7"6 r ®C(v Number of sheets Revision Date Title i It <!MJ\ eMX1 V LAAC )34RMSTT$8C L_ Size of Septic Tank 1000 C- 0& I Type of S.A.S. (A 56o GA-4-L-01k) Description of Soil F/N6 5626! 1- ' Nature of Repairs or Alterations(Answer when applicable) W F_ &XI ST lOCy 1_.660 EA44�Dx) 56_Pr(C- ?A-IJK _rO N60 W'20 D-80K, L A) 500 1—C- C.H lJ�,. Gl-I/A6ce$E S Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health i2 // Signed C�� / Date 7 1 7 (e. Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Q R Date Issued v No. ..!(11-h,i �_I. � t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION,,- TOWN OF BARNSTABLE, MASSACHUSETTS 01ppl tatlon for 0IBtlnal *Pstem ConBtrUttlon 3permit Application for a Permit to Construct( ) Repair K Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /(/ej4A"04SR y IN 9 Owner's Name,Address and Tel.No.� ^ a, EHietl� t StfEl Oou�P10 Assessor's Map/Parcel ,4Tt1cJ$T149 C.+E Installer's Name,Address,and Tel.Ao. 509-q'17—n-17 Designer's Name,Address,and Tel.No.Sog"A73"63-17 CAPC— W 1 D 6 &jTaq Qt,SZg L L G. SG Coca ac-4 NCt ;r"C_ 11-53 PA o r sue' a�stf cR,4x�3 �►G�JA �4w Type of Building: Dwelling No.of Bedrooms 3 Lot Size 5, IAA sq.ft. Garbage Grinder( ) Other Type of Building R&S l D 7�/AC_. No.of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow(min.required) 330 gpd Design flow provided ,34 gj`'�- gpd Plan Date —(o— O Number of sheets Revision Date Title [it (_"O P V LAA.9 e472]y o�JaiL� C Size of Septic Tank ( ,pnn G&L-4& ^Type of S.A.S. � �Qn C_A45tL0&j ClJoAk(A Description of Soil Nature of Repairs or Alterations(Answer when applicable) USE &XIc5T I NEn6 60 f;,A<,! 8W 51;Pr(L PAWK "Th P6 J 14 2o D -80���o�t1 boa G�4u0Al W I'Tc f q r6gr nF AQG&GC✓A'Tr Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health -7112 Signed Date Application Approved by Y�^�'( .t�—.d.�_ Date n Application Disapproved by Date .+� for the following reasons Permit No. 1 (V Date Issued ( (� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certifirate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(k Upgraded( ) Abandoned( )by CA PF_L._)l DI✓ C S � at 1uG s4 S7A4(.E has been constructed(in a^c�cordance with the provisionso and-the for Disposal System Construction Permit No. 0/�b _A ,fated Installer [050FE ac�� ( �iQ(� Designer �C. l�)y�(N�t �� xlJ G, #bedrooms 3 Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will Ifni if ct o designed. Date a. ( � Inspector +` { -.- -. - ,- No. d-O Fee 100, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal fppstem Construction i3ermlt Permission is hereby granted to Construct( ) Repair(A Upgrade( ) Abandon( ) System located at ..r I i ; f 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. i Provided:Construction must be completed within three years of the date of this permit. `"J Date lD Approved by L n. 13 8/03/2016 08:04 5082730367 :4935 P. 001/001 Town of.Barnstable Regulatory Services Richard V. Scali,Interim Director S a��tN8TABIE. _ MAM I Public Health Division F4 +`� Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 6-3+1 6 Sewage Permit# a014�-.Z'J Assessor's Map\Parcel 2 3 y Designer: 'SC- Tor Installer: Gaee-wide G"k--rP�(ses Address: 2b5ti Cra.nberC% �ig WAJ Address: 1 gv►et-cfo� 6�(ee.+ ewt u orcViaor , H a c z 5 M a s4, e e�� ri A o 2(a Li 9 R On 7 —t 3-a®i f® G,aeewcde &v44feaMS was issued a permit to install a (date) (installer) septic system at' III C ran�&exr Gafi e- based on a design drawn by (address) a S C rn,5ciriwin c) To _ dated TO If (a 20(6 (designer) v I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank.. Strip out (if required) was inspected and the soils were found satisfactory. 7 1 certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic seP Y but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. 1 certify that the system referenced above was constructed ' e with the terms of the IW approval letters (if-applicable). 1h OF 4f4S CHURCHILL Jot CI 4 ' (lns I 's Si to NO 1e07 A 9p�FP lS esigner's Sign e) (Affix Des' er amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC IWALT DI SION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION, THANK YOU. Q;\Septiclpesigner Certification Form Rev 8.14-13.doc 0?34-- a(h - 00/1, TOWN OF BARNSTA 3LE 1 � � LOCATION Ia..v C `�� �c s :, L" �-- S..WAGE , , PILLAGE &,tnS ASSESSC3R'S MAP' & LOT —, INSTALLER'S NAME & PHONE NO. �` �i�S�d�i, 77�-• SEPTIC TANK CAPACITY , 006 y l 10tA S LEACHING F ACILITY:(type) n�'�" Q` �- (size) l;U Uy 4^ Ua�S NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER 4 . BUILDER.OR OWNER � UtvQ Cy� DATE PERMIT ISSUED: DATE C.OUPLIANCE ISSUED: VARIANCE GRANTED: Yes No ��� � � �" \ FcUN T � y�` S ' � � � �� � � � ' � � � � �� � 3`� � ; � � i 3 � 1 � ( � d } i ,. � ' .:t 5�-��-f- __ 4 BARNSTi4B�E OpROV4 OF CO�MAN.SERVATION ? ISSION 3N s , y 5- Fxa.... ... .`...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1�VJ .�—.N............oF.......` NS 'eSQL........................... 1 Appl ration for Disposal Workii Tonotrurtion jJprntit Application is hereby made for a Permit to Construct (� or Repair ( ) an Individual Sewage Disposal System at^N Location- I .. --.... .00( t No...... ......................... J l 1 ---.... URN ........... .S_......... .............. ... -._.... ------------ ---- a .Y...:.Cam_. �L.............................S Co ..... ...... .dre .l..l. .......f. ................ .Installer Address Type of Building r5 Z� ..Sq. feet YP g � Size Lot........ .........•--.... U Dwelling - No. of Bedrooms............... .:...........Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building .........:.................. No. of persons.-..-............. .......... Showers ( ) — Cafeteria ( ) d Other fixtures ........................................ ............ gallons per person-per day. Total daily flow. ? 4.J................ lons. Design Flow. t t. . P P � a Y' ��. --......._.. W l N W Septic Tank—Liquid capacity_�Q®gallons Length._. _. .... Width:.5�?......... Diameter................ Depth---_-_0.... x Disposal Trench-No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..........�......... Diameter........(.Q._... Depth below inlet.......6......... Total leaching area.&)...0..sq. ft. Z Other Distribution box Dosing nk 12� QQ Percolation Test Results Performed by...................................................... .�i Date................... 5.? .......... 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 4- ..... .. •-- Description of Soil..... Q ah.....�� ..... .... .l. H dT....� .... ..... t... ..��. +.. .. V _ .................•--...._...........---•-••---•-......... ........................ W U Nature of Repairs or Alterations—'Answer when applicable............................................................................................... ...........................................•---....-•---...............-................--•-...............•-••-------••--•------•--------••------••----................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of,ITLZ 5 of th ate Sanitary Code— The undersigned further agrees not to place the system in operation un 1 a rtificate of pliance has beenissued by the board of health. Signed......l.i:�7 ........... Da PPlicatio At BY - Date Application Disapproved for the following easons:.............: ....................................----...--•---..............._.........._._........_. ........ . ............_ Date PermitNo.......... ----------.................... -7 Issued..............................................:...:.... Date j (> ;N0.............. ...... FEji.... THE COMMONWEALTH OF MASSACHUSETTS �B'OARD OF HEALTH ..................... ....................OF..... ........................... Appliration for Uispasal Works Tonstrurtion Permit Application is hereby made for a Permit to Construct (V) or Repair an Individual Sewage Disposal System at: ----------------*......-------------------------------- Location- or Lot N o* Q.............................. .....L ................. ..............................................%............................................. 0-" Add7519g111,5711.61• 'C \ -:s ............................................... ........................................ .... ......................................... Installer Address Type of Building Size Lot feet ............................Sq. U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Builaing ............................ No. of-persons............................ Showers Cafeteria 04 Other fixtures ............................................................................................................... Design Flow............hn ......................... . .......................gallon per person per day. Total daily flow...........................................gallons. di�� M.gallonLength. I... ' Diameter.................Depth-Septic Tank—Liquid capacity s .&k.),* Width;.V!�!.. Length I " Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area..:�...............sq. ft. Seepage Pit No.. .......... ......... Diameter....... Depth below inlet...... .......... Total leaching area_&1D7....sq. ft. Z Other Distribution box Dosing-tank 0.4 Percolation Test Results Performed by.......J�.04.iQ.... C-77 Date._...... ....................... ..... W.;.....*......... Test Pit No. I................minutes per inch Depth of Test Pit... ...... Depth to ground water.........................44 Test Pit No. 2................minutes per inch Depth of Test Pit.............._..... Depth to ground water...... ................ ..........................t..................................................... ......... 0 ...........it......................... ....................................................... Description of So .......o' L x -t-S, , — .................. ...................... �ry it. ................................................................................... ................. . .. ........ ------- ..... ---- __-- .......................... ............................................................................................................................................................................. Z U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ..................................................................................w.................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT,LZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of qrh7pliance has been issued by tfije board of.health: Z� Id /0 Signed.._...... .................................................. .....14�' '�;'........... Date pplication ppro roved B .... ...... ............................... /,--)— y- .. ............. ................ Date Application Disapproved for the following Jeasons:.......................................................................................................... 4 ...........4............................ ......................................................................... ................................................................................. Date PermitNo.........................................--------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.......61.9.��..................................................... Trrtifiratp of TomPliatta Application At v THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (V') or Repaired by...........I..:i..... . ..................................................................................r......................................................... . l .............. A at_...4.0.T....... ...... Z........Z. y&.. Installer *-Y7nI . .................................... ................. ...... has been installed in accordance with the provisions of TITLE -of The State Sanitary Code as described in the ...... -:>� ................application for Disposal Works Construction Permit No.-Y 111 ............ dated_...:_...c>l -3.L.-A� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.... I ................................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............7.0.w..�........OF......... ........................... No .................... FEE........ Dispood Forks Tonstrurtion Permit Permission is hereby granted......` I b W/-S('()I-I_ f.............................................................................................................................. to Construct ( LKor Repair an Individual Sewage Disposal System A --- at No......tAY......Z.......!�?ell 05 ....4:J....l.....a.................H- .................................4...... .....��.... Z4 ...................... Street as shown on the application for Disposal Works Construction Permit No_____________________6 ":. 30-9'6 Date....__...._........._.....................' ...................... �_L d.... ....................... Boalrd'oi—Health DATE..... .................. APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION Lj I GZzs NO. r- 6 / 0 VILLAGE 3A 2� Spa C. _ s DATE APPLICANT A FEE__ ADDRESS TELEPHONE NO. (Non-refundable) ENGINEER ,,—TELEPHONE NO. DATE SCHEDULED ✓ (Applicant' s signature) C 0 0 0 o 0 0 • 0 . 0 0 0 0 0 0 O 0 0 . . . 0 O O . 0 0 0 • . . • • • 0000 0 . 00 00 . 00 0 0 0 000000 00 00 0000 0 0 . 000 ASSESSOR'S MAP & LOT NO: Z34- G<- SOIL LOG SUB-DIVISION NAME DATE_ TIME A<�> A EXPANSION AREA• YES NOIJ�-Y'F—ENGINEER: TOWN WATER V/PRIVATE WELL. BOARD OF HEALTH tZ C4k EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percol-ation tests, locate wetlands in proximity to test holes ) NOTES: -- + �-�A►J 3G Iz 2--�n�p.��-r TH ti tt.1 - ' Sy x , 3/ PERCOLATION RATE: TF..ST HOLE NO: i E'LEVA'I'ION: TEST HOLE NO: ` EliEVATION: 2 Ns zti`• 2 3 3 4 4 5 saws( 5 6 6 7 8 8 g g ��1 ZOF 4t.4s` 10 10 ' ��� RICHARD 11 13i 11 R. ' 12 +L c�a FAtRBANK v 5 12 No. 20204 1� A 14 14 PO sus 15 N a VJ.QTEP,-- 15 16 16 ; SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELDLEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED .ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P. E. AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT 1 Il Lei �2 5 L O CATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS n ;r West C_ ble, . -s. OHS S UILOE R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 1 /' Yz1 7' F/o a d. --- A SUBIECTTd-77 ARaYAl�� ,� BAttNST LE CONSERVA410N ,r I TOWN OF 5PRl�ST 8Lj A55E55QRS MAP Z3� LOT LOP HIN. Z PE gSTO�E r I$SION LU Ted ,5 ,S.,. FG S (1 ?D. 101MIN. ._ . .. �. SETPACKS: FRour=30 SIDES 1�: REAR SEPTIC TANK D15T. Dol, LEACHIM6 FACIL17 I 7(1 LZ. 4r,51. �' - o p F L� j,�ttDO 4S: oo �iO U lE :L P b s�X 1Amp.- - .. � I Oi .`n`�a�' SECTION SEGJAGE 51 .<Co 5 L o�3.► in ` {JRSNE ry TH 1, _3�ti� 4g• i� TEST HOLE LOGS DESIGN FOR �, D 1,�1 e Lr 1,I f�f C I `" TEST aY: DOWQ G}1Pf E:NE•�. PERC.RATE-<2 MIN.//N. I Q DATE : q 25 136 FLOW RATE II0 GAL. DAY L ITWER WITNE5.5: 5EPTIG TANK ZZO �} REQ'o. SEPTIC TANK I coo P 60r04 - T II T�I I EL- LEACHING FACILITY 510F WALL ( )%41I,Z GID I _ FIOR�ZON — BOTTOM T 10/2 = ,0.5 I 0 2�III A$8 44,0' — TOTAL 2�1 r�'SF. = � GID >. a�lCbuT 3S X,1 SC7 ....-�'"y { V �. �.x FIlJ� — I PIT 10' EFF DIP). U5E L EACHI/VG 6 I RVE t_ _ GR _ NOTES ;J;. s�N .30.00`~ 1. DATUM(MSL)t TAKEN FROM N Y A LI I S QUADRANGLE MAP, I3Z"- 35,0' — 2. MuN1CIPAL l,IATFR 15 AVAILABLE 3. DESI&M LOADIN6 FOR ALL PRECAST U1JIT5:MSNO-HIQ-94 ISO' 33.51 Q.PIPE dOlNTS SN Lt BE A MME WATER TIGHT. I EpGE OF WET LAN � 38 i .5. CONSr)WCTION DETAILS TQ BE 1N ACCORDANCE AIlTH COM4.OF MASS. STATE ENVIRONMENTAL CODE TITtE 7L :. ��1. 4- THIS PLAN FOR PROPOSE0 MORK ONLY/IND S+IODt-D Nor ` FTC—R 8E USED FOR PROPERT'Y:. t xm sTAKtma. lJ0 W E:EA'1DVS L-•Q6UITAgI.� titer-r�r� . ;aFTI���►J I� NCOvNTERE `t� OF, SL . 4S,o ,CAND 3q.o �p- Id AP_oul tp lvQ ftr�p Zcs'L..A s vjr if �y RAND H. L. 16toL U M �aN n. ► •`' JG 'off ARPdE a� EA ( _SITE. _AN0___SEMA6E PLAN AEA. LErJENa: ; . doc�r� came enq�ne��-frrq ---- LOCUS : LoT l I CRP*JaFZ,Z' U1.41 -Ni ti v �l qfO ado t C%VtL ENGINEFaits !(( y COAPToue5 (Ex15T_3 — :. rs���Fe►st�a`� `F'�rlokie< E�`G�� REFERENCE: AGE, f3`~-S lC�► LAND SURVEYORS DATE AR CONC.80UND 89 C$ PREPARED FOR: g2ra Main St.Yarmouth,Ma B RYS I D E tU►L D I NA � T HOLE 3 board of health SCEL I Llo�uo._ .6b-� ► 6— 2 _:: - APPROVED: 17ATE -- ►��sT3t.� �� DATE: �- FINISH GRADE OVER D-BOX= 555.0'f FINISH GRADE OVER CHAMBERS = 53.5' - 55.0' PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE r F NI I`P A I N 0TF q T.O.F. EL.= 57.3 t SLOPE @ 2% MIN. OVER SYSTEM 3/4" TO 1-1/2 DOUBLE WASHED PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6" OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE OUTLET TO WITHIN 6" OF F.G. MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.= 56.0'f F.G. OVER TANK EL. = 56.0't r5" DIA. OUTLET(S) STONE OR GEOTEXTILE FILTER FABRIC 1 I 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PLACE RISERS ON ALL DESIGN ENGINEER. PROPOSED 4" SEE O 22 6.0' MAX. TOP OF SAS='49.00' -\ CHAMBERS WITH I 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL 4" PVC TEE SCH. 40 PVC 48.00 SEE NOTE 22 48.50 INLET PIPES TO 6" OF_� SYSTEM UNLESS OTHERWISE NOTED. BREAKOUT EL= SEWER PIPE I FINISHED GRADE 6" 3" 3" DROP MAX 3„ 9„ L-28't i 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2" DROP MIN MIN.SLOPE @ 1% PROVIDE WATERTIGHT ELEVATION =48.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM JOINTS (TYP.) � 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" SEPTIC TANK 4" PVC OUT TO 0 0 0 0 C� 0 O 0 THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE • LEACHING FACILITY o0 0 0 0 5. O � � 0 � o SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. � SPECIFIED DROP BETWEEN 12�� o0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 48.42' MIN. 48.25' 2 0 0 0 °° � 0 0 o� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK SHALL VERIFY SIZE 48" VERIFY CONDITION OF \ AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONE o o 0 000 oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o _ NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE I ( 1 I I AND DESIGN ENGINEER. 3 4.0 8.5' (TYP) � I 4. 4.0' 4.83' 4.0` I OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 53.06' TO BE INSTALLED ON A LEVEL STABLE 25.0' (NP.) ESTABLISHED ON A NAIL SET IN AN OAK TREE, AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 46.00' GROUNDWATER ELEV= < 40.83' 12.83'- 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 H-20 GALLON CHAMBERS 5' MIN. CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES I� NI TYPICAL CHAMBER PROFILE u (''u TO THE DESIGN ENGINEER. P_rPROFILE H-20 D I STRI P I IT 1 ONI BOX DETAIL H-20 CHANA H� 1 ) 1 9(1 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOT TO SCALE NOT TO SCALE NOT TO SCALE -_----- 1 - ---- ----- - - - n 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING +��r T T�ST �,,!-r n A TjA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM { _ y Jl r PERC NO. 15085 APPROPRIATE AUTHORITY. ,>/, , o RBt� . . 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED T0.4V ni +� j, INSPECTOR: David W. Stanton, R.S. UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR I ! EVALUATOR: Michael Pimentel, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. IGEv C.S.E. APPROVAL DATE: Oct. 1999 113. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. DATE: June 23, 2016 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE �� `) ' MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. TEST PIT#: 1 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ELEV TOP= 54.50' r ' , ' r \ _ < 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN ELEV WATER- 40.83' ,. SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PERC RATE _ < 2 min./inch* 16. PROPOSED PROJECT IS LOCATED WITHIN: °° CRANBERRY LANE SLEEVE SEWER PIPE 10' EACH i ASSESSOR'S MAP 234 LOT 1 �- #j LOCUS' ., t• DEPTH OF PERC = a (50'WIDE LAYOUT) SIDE OF WATER LINE CROSSING t--' --__ i; �a r ' "• •. �� OWNER OF RECORD: PHILIP J. & SHEILA DOLIMPIO i TEXTURAL CLASS: 1 m Elf ._ EDGE OF PAVEMENT _ _ f '-0�� be •J � . � � �,�' ADDRESS: 111 CRANBERRY LANE n i _ ___-_ _ ""_'.� „ �.. `i • , i . • j BARNSTABLE, MA 02632 • t S80 - f--� Y` 011 54.50' ( °05'21"E - - "" ; Y\, • ,A Fill COMMUNITY PANEL# 25001C0562J / FEMA FLOOD ZONE X BONE -� 70 00' ing C Point.) � ' + •. 24" 52.50' 17. DEED REFERENCE: DEED BOOK 6607, PAGE 88 "" I ShirIe ►`a�� •` ► 4 B Loamy Sand / BIT. -�4, ' •,` rn f a` ;• . -a 10Yr 5/8 18. PLAN REFERENCE: PLAN BOOK 426, PAGE 8 DRIVEWAY f. PY BUSH (TYP) �1 � 36" 51.50' ( �� t • 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. , - R Q�7"s Loam Sand R 175.00 n y 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY LP .� L-33.19 Nyes 1 r �,� C-1 2.5Y 6/1 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY � Pt `•, �{t Tight FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. �\ 17 PINE v� 6 9 00 21 A 4 PERFORATED SCH 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A TP 2 4 ►� • 'J , i ~ 54x5' r • �� ,. 6„ 4 DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A z REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. _-------.._ \ _ -v Stone o 16.2' �\ 28" BEECH 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.406,THE FOLLOWING LOCAL UPGRADE 3 % TP 1 y Fine Sand r < . 2) O 54x5' \ 18" PINE C-2 2.5Y 6/6 APPROVALS ARE REQUESTED FROM 310 CMR 15.211 &15.221(7): kS3. (1.) A 5.50'WAIVER (20.00'- 14.50') FOR THE MINIMUM SETBACK DISTANCE FROM A 5% Gravel FOUNDATION. - LOCUS PLAN ' LSA ��\ (2.) A 3.00 WAIVER (3.00'-6.00') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. £_ O (3.) A 2.40'WAIVER(3.00'-5.60') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. WALK SCALE: 1" = 1000' _ PROPOSED 4" PVC VENT PIPE; 164" 40.83, 23. OWNER /APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL �.. , y `° EXACT LOCATION PER OWNER REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. iy �; No Mottling, Standing or Weeping Observed �_: h 10.0 \ 9 9 P 9 �� ?Ir �.� STOOP r�. IR � 14. DESIGN DATA LEGEND .,. _ tv " PER SOIL LOGS DATED SEPTEMBER ..,- . a, \ 26" OAK \ i 25, 1986 (PERC No. P-6104) CONCRETE '1 (4) m 10" OAK NUMBER OF BEDROOMS (DESIGN) 3 i 50x0' EXISTING SPOT GRADE (1) 50 EXISTING CONTOUR DESIGN FLOW 110 GAUDAY/BEDROOM ---/- �, I #111 54 12.6 ~Y` S3_ TOTAL DESIGN FLOW 330 GAUDAY 9T SIT r)n T#A r� PROPOSED CONTOUR PERC NO. 15085 1 rn ( EXISTING __-- 53 25" PIN o _ 660 50 PROPOSED SPOT GRADE DESIGN FLOW x 200 /o - GAUDAY 0 GARAGE 3-BEDROOM 1 ' INSPECTOR: David W. Stanton, R.S. MAP 234 I DWELLING USE EXISTING 1.000 GALLON SEPTIC TANK EXISTING GAS LINE N I 5? \ EVALUATOR: Michael Pimentel, E1T, CSE LOT 2 rri I TOF=57.3't C.S.E. APPROVAL DATE: Oct. 1999 EXISTING UNDERGROUND UTILITIES - DATE: June 23, 2016 HC 2 EXISTING ELECTRIC & CABLE LINE I INSTALL 2 - 500 GALLON H-20 CHAMBERS TEST PIT#: 2 Benchmark �. w/ AGGREGATE ELEV TOP = 54.50' EXISTING TELEPHONE LINE Nail in Oak SIDEWALL CAPACITY ELEV WATER= <40.83' EXISTING WATER LINE Elev. = 53.06' �- (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY Approx. M.S.L. PERC RATE _ �� TEST PIT LOCATION PROPOSED H-20 DISTRIBUTION BOX (25.0' + 12.83') (2 ) (2' ) ( 0.74 GPD/S.F.) = 112.0 GAUDAY } DEPTH OF PERC = EXISTING 1,000 GALLON SEPTIC TANK PROPOSED 2-500 GALLON BOTTOM CAPACITY TEXTURAL CLASS: 1 H-20 LEACHING CHAMBERS (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY ' -- - - - ---- ---- PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE s WITH AGGREGATE (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAL/DAY PR. INSPECTION PORT 0" 54.50' PROPOSED H-20 DISTRIBUTION BOX TOTALS- Fill PROPOSED 500 GALLON H-20 LEACHING CHAMBER TOTAL NUMBER OF CHAMBERS N TOTAL LEACHING AREA 472.2 SQ.FT. B24 Loamy Sand 52.50' PROPOSED SEPTIC SYSTEM UPGRADE 0 TOTAL LEACHING CAPACITY 349.4 GAL./DAY 10Yr 5/8 MAP 234 0 36" 51.50' PREPARED FOR: LOT 1 15,128 S.F. ± CAPEWIDE ENTERPRISES m C-1 Loamy Sand 2.5Y 6/1 Tight LOCATED AT 66" 49.00' 111 CRANBERRY LANE I BARNSTABLE, MA 02632 NOTES. SWING-TIES i - SCALE: 1 INCH = 10 FT. DATE: JULY 6, 2016 C 2 Fine Sand a 5 10 20 40 FEET 1.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF DESCRIPTION HC-1 HC-2 1 2.5Y 6/6 THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST 5% Gravel ��,LAIiH oF,� PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL CORNER OF STONE (1) 17.0' 24.1' "ssy� PREPARED BY: BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. RESERVED FOR BOARD OF HEALTH USE '"�iv U_ JC ENGINEERING, INC. CORNER OF STONE(2) 21.7' 45.5' Ck�RC R c�;�4� -, 2854 CRANBERRY HIGHWAY 2.) ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE 2 AND 164,. 40.83' n '4I THE GROUNDWATER PROTECTION OVERLAY DISTRICT. CORNER OF STONE (3) 31.7' 51.7 aka - EAST WAREHAM, MA 02538 SITE PLAN No Mottling, Standing or Weeping Observed r�rEREn - CORNER OF STONE (4) 28.T 34.4' ( - 508.273.0377 SCALE: 1° = 10' _ Drawn By. SJI Designed By:MCP Checked By:AC JOB No.3631 _ FINISH GRADE OVER CHAMBERS= 53.5' - 55.0' PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE r E�V E RA I- NOTES T.O.F. EL.- 57.3't FINISH GRADE OVER D-BOX= 55.0't _ SLOPE @ 2% MIN OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED . PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS `/ ✓ METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE OUTLET TO WITHIN 6" OF F.G. MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2" OF 1!8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.= 56.0'f F.G. OVER TANK EL. = 56,0'f 5" DIA. OUTLETS) STONE OR GEOTEXTILE FILTER FABRIC f -- -- -- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE fPLACE RISERS ON ALL DESIGN ENGINEER. PROPOSED 4" 5.6' MAX. 6 0 MAX TOP OF SAS= 49.00' CHAMBERS WITH 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SCH. 40 PVC 4" PVC TEE SEE NOTE 22 4$.00' SEE NOTE 22 INLET PIPES TO 6" OF BREAKOUT EL= 48.50 FINISHED GRADE SYSTEM UNLESS OTHERWISE NOTED. SEWER PIPE j 6 3" 3" DROP MAX 3„ 9„ L-28't 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2" DROP MIN MIN.SLOPE t% PROVIDE WATERTIGHT ELEVATION = 48.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM ��JOINTS (TYP.) 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14 SEPTIC TANK 4" PVC OUT TO O O D o 0 0 O o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. j LEACHING FACILITY o o CONTRACTOR TO PROVIDE oo o o 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN o INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL , 12" 6" , o0 0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. OUTLET TEE 48.42 MIN. 48.25 2 o 0 0 o I SHALL VERIFY SIZE 48" VERIFY CONDITION OF \ ao � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 00 AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONE o 0 0 00 oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 4 4' AND DESIGN ENGINEER. 4.0 8.5' (TYP) - I q.p 4.0 I 3 OUTLET DISTRIBUTION BOX 4.83' 8- ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 53.06, TO BE INSTALLED ON A LEVEL STABLE 25.0' (TYP.) ESTABLISHED ON A NAIL SET IN AN OAK TREE, AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET , GROUND WATER ELEV.= 40.83' 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION j PIPES TO BE LAID LEVEL. 46.00 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 H-20 GALLON CHAMBERS CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW TYPICAL CHAMBER PROFILE - TO THE DESIGN ENGINEER. {�k �K� .��- �� r � H-20 DiSTF�ii�! I� Ir�I�� SOX DETAIL �i-2U _ �-H UE I Hil. 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. I NOT TO SCALE 1 NOT TO SCALE NOT TO SCALE ----- -- _._ - ---- - ---- ---- ---------- -- - --- --- h - � --- p 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT n A T`/ REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM Jl I APPROPRIATE AUTHORITY. PERC NO. 15085 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED Ra .fT y INSPECTOR: David W. Stanton, R.S. R I TOW UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, O - `� EVALUATOR: Michael Pimentel, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. C.S.E. APPROVAL DATE: Oct. 1999 ; 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. DATE: June 23, 2016 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE '1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. TEST PIT#: 1 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV TOP- 54.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN �'��, yam:• % l � ss. �6g.,, ELEV WATER = < 40.83' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PERC RATE _ <2 min./inch' 16. PROPOSED PROJECT IS LOCATED WITHIN: 00 _ _ CRANBERRY LANE SLEEVE SEWER PIPE 10' EACH {j J LOCUS ls:�•�J• ' DEPTH OF PERC = ASSESSOR'S MAP 234 LOT 1 a ;a ' r (50'WIDE LAYOUT) SIDE OF WATER LINE CROSSING I ` ' � �"' -1i � ' '` . •� " i'` OWNER OF RECORD: PHILIP J. &SHEILA DOLIMPIO � N V f r 'C-_..__ , TEXTURAL CLASS f%C --� .� A�1gf `. L 1 -_.. ._-�. -- _ _ -_.. ( EDGE OF PAVEMENT �.- -: • � � � ' ADDRESS: 111 CRANBERRY LANE f r -- C . . BARNSTABLE, MA 02632 S8p° T - ASS - - E.iC--- �\_ X_X - ' • �: FEMA FLOOD ZONE X j 05 21.E \ - I - ---- --- ---r ---- T - I - r _t �. :• Fill COMMUNITY PANEL# 25001C0562J 9 rn C Poin ..... r • M 24" 52.50' n z ng Shirle •, ,' ;1`; r B Loamy Sand 17. DEED REFERENCE: DEED BOOK 6607, PAGE 88 ; BIT. ' , : . - ;•, 't 10Yr 5/8 18. PLAN REFERENCE: PLAN BOOK 426, PAGE 8 DRIVEWAY _ P \ BUSH (TYP) - - - Y' 36" 51.50' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. ,t _ airs `'' • Loam Sand 56 R=175.00 '` \ Y 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY N yes �. t P C-1 ASSUME ANY LIABILITY r>, - >� 2.5Y 6/1 FOR SEPTIC SYSTEM UPGRADE JC ENGINEERING WILL NOT ASS -:. L=33.19 - _____ P / ({ Tight FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. TP 2 17" PINE •� y v�. �� 54x5' \ • i4 S'"` '� • 66" 49.00' 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A µ _ •'/ DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A �1 REMOVABLE THREADED CAP SHALL BE PLACED k_N THE TOP TO ALLOW FOR INSPECTIONS. --16.2' 28" BEECH Stoney O ' 22 T r \ t 3 TP 1 • Fine Sand N ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE O 54x5' C-2 APPROVALS ARE REQUESTED FROM 310 CMR 15.211 &16.221(7): 2).. ,. �s 18" PINE 2.5Y 6/6 kS 5% Gravel t 3,5 (1.) A 5.50'WAIVER (20.00'- 14.50') FOR THE MINIMUM SETBACK DISTANCE FROM A FOUNDATION. LSA LOCUS PLAN (2.) A 3.00'WAIVER (3.00'-6.00') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. O _ (3.) A 2.40'WAIVER (3.00' -5.60') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. WALK �' q SCALE. 1 - 1000 164' 23. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL °� �'� PROPOSED 4" PVC VENT PIPE; 40.83' EXACT LOCATION PER OWNER REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. 10_0 Sg � _ No Mottling, Standing or Weeping Observed ,,� - �,4,.��r �,I/�,�;F �,h •�` STOOP ��.. O o 14. oAk; ! DESIGN DATA LEGEND PER SOIL LOGS DATED SEPTEMBER CONCRETE _ / - o 25, 1986 (PERC No. P-6104) , HC 1 4 �; - � 5 , 5 5 � u+ 50xO' EXISTING SPOT GRADE m `' OAK NUMBER OF BEDROOMS (DESIGN) 3 4 tW,r, .,,� 50 -- EXISTING CONTOUR = (1 DESIGN FLOW 110 GAUDAY/BEDROOM ------ - 54 12-V D I T n A T #111 63- t TOTAL DESIGN FLOW 330 GAUDAY T 50 PROPOSED CONTOUR I EXISTING 53 25" PIN ° _ 660 PERC NO. 15085 50 PROPOSED SPOT GRADE w N i 3-BEDROOM ` 4 DESIGN FLOW x 200 /o - GAUDAY 0 GARAGE ` INSPECTOR: David W. Stanton, R.S. MAP 234 0 DWELLING USE EXISTING 1,000 GALLON SEPTIC TANK EXISTING GAS LINE I LOT 2 m i TOF=57.3't 52 ' EVALUATOR: Michael Pimentel, EIT, CSE J C.S.E. APPROVAL DATE. Oct. 1999 EXISTING UNDERGROUND UTILITIES 13" OA i DATE: June 23, 2016 EXISTING ELECTRIC & CABLE LINE j HC-2 ' INSTALL 2 - 500 GALLON H-20 CHAMBERS TEST PIT#: 2 Benchmark w/ AGGREGATE ELEV TOP = 54.50' EXISTING TELEPHONE LINE Nail in Oak ` SIDEWALL CAPACITY ELEV WATER= <40.83' EXISTING WATER LINE ~ Elev. = 53.06' I Approx. M.S.L. ' (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY PERC RATE _ ■ PROPOSED H-20 DISTRIBUTION BOX 1 (25.0'+ 12.83') (2 ) ( 2' ) ( 0.74 GPD/S.F.) = 112.0 GAUDAY ■ TEST PIT LOCATION DEPTH OF PERC = ' PROPOSED 2-500 GALLON BOTTOM CAPACITY EXISTING 1,000 GALLON SEPTIC TANK TEXTURAL CLASS: 1 H-20 LEACHING CHAMBERS (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY WITH AGGREGATE PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAL/DAY I PR. INSPECTION PORT 0" 54.50' 13 PROPOSED H-20 DISTRIBUTION BOX TOTALS- Fill �O PROPOSED 500 GALLON H-20 LEACHING CHAMBER TOTAL NUMBER OF CHAMBERS 2 - --._-__�- --� N TOTAL LEACHING AREA 472.2 SQ.FT. B24 Loamy Sand 52.50' PROPOSED SEPTIC SYSTEM UPGRADE oo° TOTAL LEACHING CAPACITY 349.4 GAL./DAY 10Yr 5/8 j MAP 234 o r, 36" 51.50' PREPARED FOR: LOT 1 15,128 S.F. ± � ; CAPEWIDE ENTERPRISES t C 1 Loamy Sandffl w 2.5Y 6/1 Tight LOCATED AT 66" 49.00' 111 CRANBERRY LANE BARNSTABLE, MA 02632 NOTES: SWING-TIES SCALE: 1 INCH = 10 FT. DATE: DULY 6, 2016 Fine Sand o 5 10 20 ao FEET 1.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF C_2 2.5Y 6!6 DESCRIPTION HC-1 HC-2 THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST 5% Gravel *�r;Eau"of ,y PREPARED BY: PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL CORNER OF STONE(1) 17.0' 24.1' RESERVED FOR BOARD OF HEALTH USE 'bh111 9` . JC ENGINEERING, INC. BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. BUR L CORNER OF STONE(2) 21.T 45.5' C4rML 2854 CRANBERRY HIGHWAY 2.) ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE 2 AND 164" 40.83' n �41°1p CORNER OF STONE (3) 31.7' S1.7' ' EAST WAREHAM, MA 02538 THE GROUNDWATER PROTECTION OVERLAY DISTRICT. No Mottling, Standing or Weeping Observed SITE PLAN CORNER OF STONE (4) 287 34.4' �ltr - 508.273.0377 SCALE: 1" = 10' Drawn By: SJI Designed By:MCP Checked By:JLC _ JOB No.3531