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0101 DEACON COURT - Health
101 DEACON COURT BARNSTABLE A _ 300 061 iY ��..t, � :A• ..,-x-w t :..,; ,.-.-.s .r., -..;a � "+ ^!a'°'°zjz:'+'�'t,R'^`.,,'Syr �a_^_' .L� �...:. .�.,.-.._ �^ � ° ., y. .. F C �€< r .'J. ka � �, J '., Gv , ', f - 0 W K' � x 8! Kr ,. •.Sk f r t, .x.�C % , „• 'y,: � �'._ n � k <• 'a.a'- Via, ?i o y f. ss - - .� � , ..H' + y.. .x � :Sf R✓. '.,, k a . `Tt' ,!. p�} �^ :.ar J y ♦�n. '�., "� ,fi .. A ts.i' ''.' `F7 ..v e' 'La.. ,a .. - ::k', w _*s ,,,a• rt. #, m." a �5�' - 'rt.. ^ « .. .. •: .p; ,. .',: r ® �. � 4a�..� +. 'p, -,� .� ^F»� ..�., ,*?.• a- cs<�.! ,a� Y ,4r, r - t �; s� .r -.,�,. .µ n .. + ' .y.. r• �y ha ' y g ,a 'r '' '.x. Sys IX u : .� ., « ;+ � ¢ °'r � >1 , d r dt.r- .. - `^` tR y �' ,.'.vim a, ,yv ,.�y �' x� •`•�' � {Y-' v Y ^ , ,.."'G � },- ..r 'a •, �y:. e .�r '. t_,x„' �Y - � '� ..x ��' °a s•> < #n�'- � .?Jx '.r� ��' .e., a.a. - - ,s ';',--; -'.,� �r 'F' a. t'G,. "_' :4{� "F,'-a" �. o N.:.• __ .-.r, ry ��, . « $ ^ S^ Nfl��..�',. • 's 3:'.. `*:. + gain., u , 'v t4. 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R �� ea•Yy� . r x ^Abe a v - • ,'.a W y• .'i4 ;.K', .�(, a'H...�.. r6J r,'�a A.,.Y P Gj, - .x. , 15 • 3,. - ,}.: __'k T'' 4��'` e'�,.r 1, 1 N.,!" 7' ice... ,� "it � e.'y.� 5 N 1 k. or _ , <,p. � - `c k�, .a, - _ pia. �•xt '" y• ` r>;f _y 4 et ,xr ..� +",x : C .- ik Y 4. ... .:. � e'! y fiery. �. 4.• +1 11: .:t., >' r 9 r 4,4 v � y y r ' 7 � a T v : r n , r : Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form Not for Voluntary Assessments'' M 101 Deacon Court Property Address William Swift Owner Owner's Name information is required for every Barnstable MA 02630 7/05/2010 page. City/Town State Zip Code Date of Inspection ` Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: ` 1 � key to move your cursor-do not Brian K. Tilton use the return Name of Inspector key. The Building Inspector of Cape Cod R . Company .. teh p y Name . PO Box 307 Company Address rerun '' Eastham MA 02 42 - 6 City/Town State Zip Code 508-255-9343 - 14 S 392• Telephone Number License Number . x - 4 B. Certification I certify that I have personally inspected the sewage disposal system at this address'and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site. sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: 3 �: ® Passes "` ❑ Conditionally Passes ❑- falls , ❑ Needs Further Evaluation by the Local Approving Authority. IL 7/05/2010 spector'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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the „ report-to the appropriate regional office of the DEP. The original should be sent to the system owner- s and copies sent to the buyer, if applicable, and.the approving authority.. .- ****This report only describes conditions at the time of inspection,and under the conditions of use at that time.This inspection does not address how the system will perform in the future sunder the same or different conditions of use. 101 beacon Ct t5insp•b3108, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 1'5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , µM 101 Deacon Court Property Address . P Y Willia m Swift - Owner Owner'sName r information is required for every Barnstable MA 02630 7/05/2010 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D' I A) System Passes: , ® 1 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: All components are in place and functioning as designed. .- B) 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: +. . Answer yes, no or not determined (Y,N, ND) in the ❑ 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's'eptic 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. ND Explain: 4 ❑ 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 <. V pass inspection.if(with approval of Board of Health): 4 ❑ broken pipe(s) are replaced ❑ obstruction is removed 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 101 Deacon Court Property Address ., William Swift Owner Owner's Name information is required for every Barnstable MA' 02630 .: 7/05/2010 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) L . B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ` ND Explain: C) Further Evaluation is Required by the Board of Health: s Conditions exist which require further evaluation by the Board of Health'in.order to determine if... the system is failing to protect public health, safety or the environment: 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in`a manner which.will protect public health, safety and the environment: " ❑ Cesspool or privy is within 50 feet of a surface water a ' ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh - 2. System will fail unless the Board of Health (and Public Water Supplier, if any) , determines that the system is functioning in a manner that potects the public health, safety and environment: t 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. 101 Deacon CtFt5insp 103/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System%Page 3 of 15 Commonwealth of Massachusetts r Title 5 Official Inspection' F®'rm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4N 101 Deacon Court Property Address William Swift Owner Owner's Name information is required for every Barnstable 4 MA 02630 7/05/2010 page. CityfTown State Zip Code. Date of Inspection z , B. Certification (cont.) 8 f S C) Further Evaluation is Required by the Board of Health (cost:): ❑ 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 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. b 3. Other: qa D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes -No t El ® Backup`of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground'or'surface,waters ® due to an overloaded or clogged SAS or cesspool ' Static liquid level in the distribution box above outlet invert due to an overloaded ' h ❑ :° ® or clogged SAS or cesspool 4 ® Liquid depth in cesspool is less than 6" below invert or available volume is less than th'day flow Required pumping more than 4 times in the last year NOT due to clogged or, _ ® obstructed pipe(s). Number of times pumped: F - ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. . El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or, tributary to a surface water supply. 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 101 Deacon Court , 5 Property Address William Swift Owner Owner's Name information is required for every Barnstable MA 02630 7/05/2010 page. Cityrrown State Zip Code Date of Inspection- B. Certification (cont.) §_ D) System Failure Criteria Applicable to All Systems (cost.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feetebut greater than 50 feet a from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with'a design flow of 2000gpd- 10,000gpd. . , ❑ ® The system fails. I have determined that one or more of.the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be . necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes . No n ❑ ® the system is within 400 feet of a surface drinking water supply El ® 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 El ®` Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, y or answered "yes" in-Section D above the large system.has failed.-The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 101-Deacon Ct t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntay Assessments r �M 101 Deacon Court Property Address William Swift Owner Owner's Name _ - information is required for every Barnstable MA 02630 7/05/2010 page. City/Town State Zip Code Date of Inspection C. Checklist * . Check if the following have been done. You must indicate"yes".or"no" as to each of the following: Yes No ® ❑ Pumping information was,provided by the owner, occupant, or Board of Health ❑ Z 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 El 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 ® 0 Determined in the field (if any of the failure criteria related to Part C is at issue ' approximation of distance is unacceptable) [3%CMR 15.302(5)] r 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 101 Deacon Court Property Address William Swift Owner Owner's Name information i e required for every Barnstable MA 02630 7/05/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information a _ Residential Flow Conditions: Number of bedrooms (design): 4 - Number of bedrooms,(actual): 3. " DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 required/ e 454 actual Number of current residents: . Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes `® No Laundry.system inspected? ® Yes ❑ No _ Seasonal use? ❑. Yes ® No Water meter readings, if available last 2 ears usage d 09= 224 gpd/ 9 ( Y 9 (gpd)): :A . '10= 293 gpd Sump pump? f• ❑ Yes ® No Last date of occupancy: i Current - -Date Commercial/Industrial Flow Conditions: Type of Establishment: N/A 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 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): 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 101 Deacon Court Property Address William Swift Owner Owner's Name information is re Barnstable wired for eve _ ." q every MA 02630 7/05/2010. page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) + , General Information Pumping Records: Source finformation: ` Owner u ce o Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons = 9 . How was quantity pumped determined? Reason for pumping: 3 Type of System: Y Y y ® Septic tank, distribution box, soil absorption system,' ❑ Single cesspool w ❑ Overflow cesspool ❑ Y 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. El Other(describe): Approximate age of all,components, date installed (if,known)and source of information: 4/05/2001 . Were e e sewage odors s detected when arrivin gat the site? El Yes ® No 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 101 Deacon Court Property Address William Swift Owner Owner's Name information is required for every Barnstable MA 02630 7/05/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) f Building Sewer(locate on site plan): 2 : Depth below grade` feet Material of construction: a ❑ cast iron ® 40 PVC ❑ other(explain):- y = , N/A Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage,' etc.): " No evidence of leaks or-clogs Septic Tank(locate on site plan): i Depth below grade: feet Material of construction: g ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed b a Certificate of Compliance? attach a co of certificate ❑ Yes ❑ No 9 Y P � ( PY ) --- -------- ------ ------. -------------- ------------- --- - -?-- ----- ;------ ----- --- Dimensions: (� V �.J O Sludge depth 23; - s ,_f - Distance from top of sludge'to bottom of outlet tee or baffle 3 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 17" How were dimensions determined? Accu-Sludge, Baffle Stick and ; Tape measure 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form _ a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , M 101 Deacon Court - Property Address - William Swift : Owner Owner's Name f information is required for every Barnstable ^ MA 02630, 7/05/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cone.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): _ u , Grease Trap (locate on site plan): Depth below grade: N/A .feet,, Material of construction:' ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain); Tn 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.): . f; Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):,. Depth below grade:. N/A o . t V Material'of construction ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene "❑ other(explain): 101 Deacon Ct t5insp 03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page'10 of 15 ' Commonwealth of Massachusetts . Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 101 Deacon Court ° Property Address William Swift Owner Owner's Name information is re Barnstable MA 02630 7/05/2010 required for every Q page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) s N/A Dimensions: , Capacity: gallons Design Flow: " gallons per.day Alarm present: ❑ Yes ❑ No Alarm level' Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy"attached?. ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): 0' Depth of liquid level above,outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-Box level, equal.flow to each outlet, no evidence of leaks or solids carryover.riser to within 1' of surface fi RV Pump Chamber(locate on site plan): Pumps in working order;- ❑ Yes '❑ No Alarms in working order: ` ❑ Yes ❑ No,, . 101 Deacon 6 t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 101 Deacon Court Property Address William Swift Owner Owner's Name ,. information is Barnstable MA 02630 ' 7/05/2010 required for every - page. Cityfrown State Zip Code• " :Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required) If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number,length: ❑' leaching fields number, dimensions: ❑ overflow,cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.):, 3/500 gal. leaching chambers in series with 4' of stone around to 12.8'x 33.5,x 5. Lawn over top, noj evidence of break out, or hydraulic failure. 6"of ponding in center unit, staining to 7" no evidence of solids carryover. 101 Deacon Ct t5insp.-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 101 Deacon Court Property Address z William Swift Owner Owner's Name information is required for every Barnstable MA 02630 7/05/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A f 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 0 Yes - = ❑` No ' Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: N/A F J Dimensions' Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 101 Deacon Ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 15. Commonwealth of Massachusetts ' W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 101 Deacon Court ` Property Address William Swift F Owner Owner's Name information is required for every Barnstable M. MA 02630 7/05/2010 a e. City/Town State ZipCode Date of Inspection P9 p D. System Information (cont.) Sketch Of Sewage Disposal'System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. F� PORCH GAIRAGE SLOPS Al :38' Bl= 33:3" 0 h A2--48.5 W= 2151 ` 3 A3 49-.3"` B3= 4L5' : ,0 ! 101 Deacon ct t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of.15 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form Notfor Voluntary Assessments . 9 ry wM 101 Deacon Court Property Address William Swift i Owner Owner's Name information is required for every Barnstable MA - 02630 7/05/2010` page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope g ® Surface water ® Check cellar ® Shallow wells '14' no water encountered. 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:' pate ❑ 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: T You must describe how you established the high ground water elevation System design plans on file with BOH;hand augered test hole within 50',of SAS no water - encountered to a depth of 14' corrected to estimated high water table using Frimpter method. r s - 101 Deacon Ct f5ins •03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal stem•Page 1 P P S 5of15 ' 9 P Y 9 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 101 Deacon Court z Property Address $. William Swift y 3: Owner Owner's Name information is Barnstable MA 02630 7/05/2010 required for every - page. Cityfrown , , State Zip Code - Date of'Inspection D. System Information-(cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition,,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): . All tees in place and functioning as designed, no'evidence ofleaks`or back up. No need.tokpump at ` this time. Grease Trap (locate on.site plan):=F Depth,below grade: <, N/A , feet R Material of construction: ❑ concrete ❑ metal '. ❑ fiberglass ❑ polyethylene ;-'ETother(explain):_. . Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle 1 . ,4, s - •s Y .} Y.': n4., 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.): w `r J. Tight or Holding Tank(tank must be pumped,at time of inspection),(locate on site plan):.. Depth below grade: M Material`of construction: t' ❑concrete ❑ metal ❑ fiberglass - ❑ polyethylene ❑ other(explain): 101 Deacon Ct t5inspf 03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.'Page 10 of 15 Barnstable Assessing Search Results Page 1 of 2 mofflo' Home:Departments:Assessors Division:Property Assessment Search Results New Search ti NIiW Interactive Maps>> Owner: 2010 Assessed Values: SWIFT,WILLIAM F& CATHERINE R 101 DEACON COURT 2010 Appraised Value 2010 Assessed Value Past Comparisons Map/Parcel/Parcel Extension Building Value: $_269,500 $269,500 Year Total Assessed Value 300 /061/ Extra Features: $2,900 $2,900 2009-$646,700 >. Outbuildings: $0 $0 2008-$694,700 Mailing Address Land Value: $346,800 $346,800 2007-$711,200 SWIFT,WILLIAM F& 2006-$686,000 CATHERINE R 2010 Totals $619,200 $619,200 P O BOX 108 Residential Exemption Received=$92,000 BARNSTABLE,MA.02630 2010 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $122.89 Fire District Rates Towri Residential r Barnstable FD-All Classes $2.43 $7.77 C.O.M.M:-All Classes $1.26 Town Commercial Barnstable FD Tax(Residential) $1,504.66 Cotuit FD-Ail Classes $1.56 $6.87. Hyannis-Residential $1.82 Town Tax(Residential) $4,096.34 Hyannis-Commercial $2.88 W Barnstable-All Classes $2.28 Community Preservation Act 3%of Town Tax Total: $5,723.89 Construction Details Property Sketch Legend Building Property Sketch &ASBUILT Cards Building value $269,500 Interior Floors Hardwood Style Colonial Interior Walls Plastered y �, Model Residential Heat Fuel Gas Grade Average Plus Heat Type Hot Water Stories 2 Stories AC Type None ; i TfS CO q14 Exterior Walls Wood Shingle Bedrooms 3 Bedrooms a Roof Structure Gable/Hip Bathrooms 3 Fullr? P A YTS OAft . Roof Cover Asph/F GIs/Cmp Living Area sq/ft 2,158 Replacement Cost $275,000 Year Built 2001 Depreciation 2 Total Rooms 7 Rooms Land Gross Area sq/ft 4,776 CODE 1010 , AsBuilt Card N/A Lot Size(Acres) 1.62 htt //www.town.bamstable.ma.0 /a es in /2010/di 1 r s ss s s a a ce110ma .as .ma ar-300061 6/30/2010 r P g P YP p P PP Barnstable Assessing Search Results Page 2 of 2 Appraised Value $346,800 Y � View Interactive Maps » Elf", Assessed Value $346,800 _ Sales History: Owner: Sale Date Book/Page: Sale Price: SWIFT,WILLIAM F&CATHERINE R Sep 29 1997 12:00AM C145951 $38,000 SWIFT,WILLIAM F&CATHERINE R Sep 29 1997 12:00AM 10975/159 $38,000 SWIFT,WILLIAM P C87278 $0 ` Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL FIREPLACE 1 $2,900 $2,900 Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK ,Wood Deck = d FOP Open or Screened in Porch TQS Three Quarters,Story(Finished) n t { http://www.town.barnstable.ma.us/assessing/2010/displayparcel l 0map.asp?mappar=300061 6/30/2010_ • ' N-'- 1�'�.� •/ 1'� - � may. )\ r� ,\a�}�.y� ',t 1j•{�+�� x, �l t �� �y' �� ter► f _ 1 Town of Barnstable Geographic Information System July 25, 2010 �+ g s r y E.3ir table T'.�rbc�, ,� �� Maraspin Cieek V r.. I i r. 91 Feet DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:300 Parcel:061 N boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1-=100'may not meet established map accuracy standards. The parcel lines on this map Owner:SWIFT,WILLIAM F&CATHERINE R Total Assessed Value:$619200 are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.62 acres Abutters w E boundaries and do not represent accurate relationships to physical features on the map Location:101 DEACON COURT such as building locations. Buffer S Aerial Photos Taken April 19,2008 ACCESS COVERS MUST BE WITHIN 9- MINIMUM., .- 6 OF FINISH'GRADE' 3' MAXIMUM COVER 23.5 FIRST 2' TO BE LEVEL - - MIN 2- OF PEASTONE 4-or.a PiP9 3/4- - 1 1/2' OIA. 7- 19.25 2- e$ •/• , WASN.ED STONE cas / 1 3 OUTLET 3-500 GAL.LEACHING CHAMBERS. C D-BOX Y114^ STONE AROUND. 12.8'X 33.54 2' 1500 GAL. SEPTIC TANK 6-,CRUSHED STONE BASE PP,OF I L E:NOT TO.SCALE I LAVER T EL EVA T 1 ONS DES I GN CR I4TEP.: I A INVERT AT BUIL61NO: 20.25 DESIGN FLOW:• r { INVERT 1N SEPTIC TAPIR; 20.0 4 BEDROOMS AT 110 G.P.D. PER INVERT OUT SEPTIC TANK:. . .BEDROOM EOUALS 440 G.P.D. .1 INVERT IN DIST. BOX: 19`42 .140 GARBAGE GRINDER ' INVERT OUT DIST. BOX: 19,25 C INVERT IN LEACH CHAMBER: 19.0 a - 'SEPTIC TANK REOUfRc'D: - BOTTOM OF LEACH CHAMBER: 17mO 440 G.P.D. X 20OX - 880 GAL. "I ADJUSTED GROUND WATER: N/A - SEPTIC TANK PROVIDED: 1500 GAL: MIN. �! OBSERVED GROUND WATER: N/A BOTTOM OF TEST HOLE a2: 8.B SOIL ABSORPTION SYSTEM REOUIRED: DESIGN PERC RATE'! 5 MIN/INCH` ` SOIL TEXTURAL CLASS-"I• - _ - _ .EFFLUENT LOADING RATE - 0:74 GPD/SF 5 ,_ v. 440 GPD / 0.74 GPD/SF - 595 S.F. REOUIRED, PROVIDED: 3-560 GAL-LEACHING CHAMBERS W/4' -STONE AROUND, A-614 S,F. 614•5.F.'x 0.74 - 454 G.P.D.' SOIL TEST 'P I T DA TA INDICATES 'U_ INDICATES' x�'• a PERCOLATION = OBSERVED I TEST GROUNDWATER i TP ►1, pTP s2 HORIZON TEXTURE COLOR HORIZON rTEXTURE COLOR P2 8 e' t 0- 22.1 0' SANDY IOYR - SANDY IOYR: �' ^ A LOAM 414 F. A ,LOAM - 4/4., LOAMY 2:5Y B LOAMY 2.5Y ., SAND 6/6 „. SAND 6/6- i 28 19.8 36 .... . .. Cl .MEDIUM 2 SY MEDIUM Z 5Y ' t C SAND 6/4 .SAND 6/4 S48. .........-....: ........... .......... 18:1 54.•=.:..... . ....:..... 18.3 CZ SILT 2 5Y C t 2 5 2 SILT Y` - r .LOAM 6/4 DAM 6/4:: l4 88 14.8 96+ .I. ...... . 8 FINE-MEDIUM C3 /•7 ` FINE-MEDIUM 2.5Y {p SAND - 814 �'" SAND .814.",. l r 105. 148" P10 WATER µ 9.8' I68 NO WATER 8.8 DATE: OCTOBER 29. 1998 +pp+ TEST BY: ARNE OJALA. PE i WITNESSED BY: JER.RY DUNNING <-- PERC RATE: C 2 MIN/INCH - G - f HIGH GROUND-WATER LEVEL COMPUTATION Date: /-?0 10 Site Location: to Peac' Permit: Owner: Phone: ` Contractor: j! ;V;(J +n2 X_-o5pez.4,( C Phone: 8;-7_5��53 3 Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. i (depth is in feet below land surface)' y` Date:^. dsf Flo / 0 mm/dd/yy feet below Is STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well B) Water-level range zone STEP 3 Using monthly "Current lNater,Resources Conditions" determine current depth to water level for index well. r � mm/YY STEP 4 Using Table of Potential Water Level Rise for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 213) determine water-level adjustment. STEP 5 Estimate depth to high water by subtracting the Z;3 water-level adjustment (STEP 4),from 0 measured depth to water level at site (STEP 1). NOTE* Tables 1-9 "Potential INater-Level Rise" are attached as worksheets to this file. monthly index well data: www.capecodcommission.org/wells.html F$3...2 ...:.._ m. THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH ............... OF... I�1 S. .- ,G -, ................. = ?.ppl ration for Bisposal Warks-Tonstrnr#inn' Frrmit Application is hereby made for a Permit to Construct`(L-T`or Repair ( ) an Individual'Sewage Disposal System at Locati •Nddre= or Lot No. 0. address Installer aaara L b p� CI ' UType of Building ., Size ot--- feet .. Dwelling—No. of Bedrooms..__..__...__.----_-------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildiu No. of ersons............... Showers Cafeteria a YP g p ( ) ( ) QOther fixtures ......... ........................... •.. -- ....._................... ................-.... • W Design Flow_-___-.__--__----------_------SSgallons per person per.day. Total daily flow..__..:. .33.0...___. gallons. J C4 Septic Tank—Liquid capacity/0W.gallons LengthQ--k-.....Width:.15./-..I0- -Diameter-, .............Depth �}.......... •Disposal Trench—No---------------------Width_a..............Total Length.......__..._. ..Total leaching area.................-sq`ft.' 3 Seepage Pit No..........I......._ Diameter....la---------- Depth below inlet-----1}.S+,_._-_Total leaching.area..77-2-9...sq.ft. z Other Distribution box (a/f Dosing tank ( ) Percolation Test Results Performed by_.ex1i&/.rr........--�._�a�?'_s__c`?. ---------- Date...la_.=.1/-..0_Z..._... . Test Pit No.3.....4-1--minutes per,inch Depth.of Test Pit_ LID-.......Depth to ground water........................ � G Test.Pit No. ._..�-:Z.minutes per inch Depth of Test Pit.15.4 Depth to ground water..........._........... O SST HQI..,I=..A..3-i -O:i t2��- L-Q i`'L _.JZ'r.- DD`t .Cb-Qy 43 LS�'v •; Description of Soil_.F 11E.__�3.Crl .?... _R/s?.Qr._Lo_o_-:n.I.LZ'..---k4 vl_� .-.__1.1�Q".._NEQ.._.s l�A.;..__... T..E-s7 az. -'* `}i Q '.�V--'----clA- 4----i..s.E ------FFAN.-A Ttc-r,T st)1 Dj IOC` 113'_.._!i�D...S./1 D-; -`l8". ..14 .:'..0 g •.�i1�.E._Fir�r.-n _Nr_saniD; U Nature of Repairs or Alterations—Answer when applicable............... __---__. _------- --------- ___. . -•--4-n, .... ---- ---- - -............ ... ........................................Agre �/The undees'Co in" st the aforedescri Indiy dual ewage Disposal System in accordance-Withthe provisions of • . - u ' o e e un agrees not to place the system in operation until a Certificate of Compliance has beenAispedby board healthSigned .-_•-- ....................... ................ ---- Da e Application Approved By...... _-.�� -� .......................... _ -°•••- �' Dat - Application Disapproved for the following reasonsr-..---••-•-•--_--------_______ ____________...._.....: ._......:--_--:__:_------_-__--- - Date Permit No........_-_.__-----_....._.......-....___ Issued_._.............:.____------ ._:.. ._ _— Date- THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH = z !..::....::_:. .................oF.......1 1.:_L .......:. t...............:., C�Crr�ifirtt#l� of (�mtc}�littacrr _ - - � � . THIS IS TO.CERTIFY, That the Individual Sewage Disposal System constructed ( `-:)'or Repaired, - bY---------•---------------------------1l_..er_T°R:N ---------. I st ue. at__...t_:................. . .._ ................... . t)�_.............................. _....••-_..._.___..................-._...__......-----••-••_..._._ __._._.._ has been installed in accordance with the provisions of TITIZ 47o Th ..... __.•_....._._. dated.............-................................... _< THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-•-•--••............................'_......•••••--•••-•-•-__,._._ inspector - ' THE COMMONWEALTH OF MASSACHUSETTS @ - BOARD OF HEALTH ! _. S 3f o... --- FFE-. -._. �is�osttl 3�IIrks �Cnr����g�#imrn �rra;rgaf 'N . Permission is hereby granted ----.........................................................................................._....--- ' to Construct ( -.)nor:-Repair ( ) an_Individual Sewage Disposal System atNo........ -__..___.___S.=F.-[_. _?_.__._.1_ !.:__......................................................:......................_..___.__ Street - N as shown on the application for Disposal Works Construction Permit No._-_____...._. __. Dated..................._...._ ....._....._._ / P Board of Health DATE.....................................�... - L....__..._ FORM 1255 HOBBS'& WARREN. INC.. PUBLISHERS- z Z O i OWN OF BARNSTABLE LOCAT.ION' /®/ ®. lam; ,i 4A-V SEWAGE # 99 86b �,. cat- VII.LAGE_ 5'i. > ASSESSOR'S MAP & LOT3cU'o�l 73 INSTALLER'S NAME&PHONE NO. �«XC s` 3� SEPTIC TANK CAPACITY J<ejb LEACHING FACILITY:•(type) (size) ?i NO.OF BEDROOMS BUILDER OR,OWNER SOAto r 'k PERMITDATE: f� ® I COMrCCCi'LIANCE DATE: Separation Distance Between the: . Maximum Adjusted Groundwater Table and Bottom off:;Leaching Facility. Feet Private Water Supply Well and Leaching Facility (If,ans i wells exist .on site or within 200 feet of leaching facility) Feet.` Edge of Wetland and Leaching Facility(If any wetlands ,exist 2 within 300 feet of leaching facility") , Feet` Furnished by� V da, 4 t i a 1 ,3 y 1 d eED .� No. �"' �/ �f� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 7 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3ppiication for i!5poml *p5tem Com6truction Vermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System O Individual Components Location Address or Lot No. /01 044co r0 GB unT M Owner's Name,Address and Tel.No. Assessor's Map/Parcel JO O _D 6/ A 0 Qlvo /O6 Installer's Name Address,and Tel.No. Sod 6 NO"a7-50 Designer's Name,Address and No. NQL104� .?A6errs Suxt14YlAo 0"kc. o "T �� I�`�2 �23 .eo 4 6•q C CAAS, S Type of Building: Dwelling No.of Bedrooms 4Y Lot Size r sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow Yd9 gallons. Plan Date 9 Number of sheets Z Revision Date Title S/T& 044-W Od 40.A00 .dam G.iGGI�► SG�lJ1r Size of Septic Tank Type of S.A.S. Description of Soil G*/L S4)0,0 r vAti, /L'31 Lo pnY SAA0 . 31-d' , 440. SA.Qo 6'y-46 yd-r Lo10 26 /6 6 /SN4-/Jio v-0 Nature of Repairs or Alterations(Answer when applicable) 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 Certifi- cate of Compliance has been issued b o [toea2�, Signed Date ' �' Application Approved by Date '— Application Disapproved for the following reasons Permit No. 2Y Date Issued ""' I No. �R riJ �}e+ t Rom.,' Fee ` Entered in computer: THE COMMONWEALTH.OF MASSACHUSETTS y' PUBLIC HEALTH DIVISION - TOWN'OrPBARNSTABLE.,,MASSACHUSETTS es 0[pprication for �Mitpogaf *potetn-Construction Permit Application for a Permit to Construct(/)Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. /b/ z' Owner's Name,Address and Tel.No. L-G7 73 Lu/GL/i9/t> �'CiftiW*-v 1" s' Assessor's Map/Parcel G• �l /06 1 30C> -06y n u 124f k42 9 Installer's Name Address,and Tel No. ✓��'c'>Z�-}U-�750 Desi ner's Name,Address and Tel.No. Avc.11As �,�vctS A641S SvevrsYi,+„6 3 i2G1, ;s 61 C CA5,MA 09(l s �'° i �e i tE;i°!r�%f A. D6 3G Z /3 z Type of Building: f, t° Dwelling No.of Bedrooms l �� Lot Size 76 ,1 5'.S— sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow - gallons per day. Calculated daily flow gallons. Plan Date //-/6- 99 Number of sheets / Revision,Date //-/6 - 9 9 Title_, S17-15' i°LAA�l a� G.oezo i%� /,i�Giifl/ti f1,li/s% } Size of Septic Tank Type of S.A.S. bescription of.,Soil G'1 L S4-D l L U4M /Z-3 C G6-1-7 y 5AL Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r - c i. Agreement: is 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 Certifi- cate of Compliance has been issued b s o Leea lt fry-` # ; Signed " ., Date N Z Application Approved by' Date Application Disapproved for'the following reasons �l�' A Permit No. Date Issued p# ———————————-——————————————-———————————— --- -- THE COMMONWEALTH OF MASSACHUSETTS G40 X BARNSTABLE, MASSACHUSETTS 6y# W01 Certificate of Compliance THIS IS TO qRTIFY,that the Op.-site Sewage Disposal System Constructed(✓)Repaired ( )Upgraded( ) Abandoned( )by at / > <3L/ 7' has been constructed in accordance with the provisions of Title 5 d the for Disposal System Construction Permit No. ,* e✓� dated_' V Installer A,UL�IAr Designer —T T The issuance of this errnp -shall not be construed as a guarantee that the syst ill f et; s desi ed. i �/ ©� Inspector Date � _ No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigool *pstem Construction Permit Permission is hereby granted to Construct( )Repair( )Up r de( )Abandon System located at ''"�' ! ,7 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes 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 thi t. j Date: � � Approved r�`,~;G ✓ ����,� e - r f t-0 WN OF BARNSTABLE LOCATION 019L,c:h r, .vti i SEWAGE # VILLAGE o"i/►/'.*15 j /►'?C. ASSESSOR'S MAP & LOT3(�o—c O 7 S i INSTALLER'S NAME&PHONE NO.A—O��- s— \V 7 D SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) >L ��/ I NO.OF BEDROOMS t BUILDER OR OWNER PERMITDATE: `f Via!—O COMt-, LIANCE DATE: '- VATVL� Separation Distance.Between the: - Maximum Adjusted Groundwater Table and Bottom off'Leaching Facility Feet Private Water Supply Well and Leaching Facility (If anI i wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist zz within 300 feet of leaching facility) Feet Furnished by Town of Barnstable n P# Department of Health,Safety,and Environmental Services ' TIM Public Health Division Date Sl, 367 Main Street,Hyannis MA 02601 HARNMOM 039. °..r rFat+tn+" Date Scheduled +�p Y � * Time _ F a Pd. jn�7 e '-- t{bl` . _.......... } V t, k Soil Suitability Assessment foi�Sewage Das�osal Performed By:_A•OJA t 6 Witnessed By: J� r r 'Punf7 NC7 d. LOATIQN & GNI!.RAL INFORMATION Location Address OaLt, evX ( / Owner's Name W, I f,1C.rrn SCL]l r 10 1 Qe 4(.r1Y1 C 01-+Ir-k' I fbmn"s4G 1ptQ V I 1 Address 13Q X 1 D U S Assessor's Map/Parcel: (J'p - V 3 /� Engineer's Name i NEW CONSTRUCTION _ REPAIR' Telephone# Land Use Slopes(%) 2 —3 v Surface Stones T e 4—Li Distances from: Open Water Body A140_ft Possible Wet Area / / 0 °R Drinking Water Well Drainage Way�ft Property Line 3s ft Other ft "^A9,S}i- S ETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wellands,in proximity to holes) o t . # Z # N , 3S— � `e, d�rco loot u,^ ° ' ar. �.. - r.,eyr-, ..,.�•'2'%db},wi' �w`- .t'. .n 4:< 1r_ .t'.t:i° 1`T'" ;': 'Srl,+,y,.m .: "7 ML.ff�i fir° '. -.. Parent material 1 d / (geologic) Z _ Depth to Bedrock Depth to Groundwater: Standing Water in hole: �ON e Weeping from Pit Face Estimated Seasonal High Groundwater, /V X. DETEItNiA' "I11 POYt SE ASONAL '�'A'T ... Method Used: . ...: Depth Observed standing in hole. /V� �� 2 ,✓p g in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment 4ndex Well N_._ .Reading Date:_ —_ Index Well level..—.-- Adj.factor Adj.Groundwater Level PERCOLATItN TEST nate,�o Timed ##' Observation Holek x�..t`' r, "t n� r ,�+ ,�'• E t� � .+ ' '�Zt,. �;`�;,• •;' `� ` Depth of Perc 2 7 — { Time at 6' .,, Start Pre-soakTime��'° Time _ End Pre-soak & 1/0 10 f' Rate Min./Inch /-e9f 441 w u� Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Mole Data To Be Coin pleted on Back— j Copy: Applicant DEEP OBSERy.. ...N I-IOLE L:(.1G Dote# / Depth from Soil horizon Soil Texture Soil Color S 9 I Other / Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,noulderes. I — i --- C,onslslc.nc�. DEEP. OBSERVATION HALE LOG Hole# . .. . . . Depth from Soil horizon Soil Texture Soil Color Soil Other Surface(in.) — — (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Ld" 2, Am-f34a 2,5-y�/ 5i rf`ui� 7.5`r G/ F,wcvr61fel DEEP.:OB8ERVA•LION I-IOLE.T,OG �olc t : _— Depth from Soil horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldcies. p5istencv.9i Gravel) DEEP OBSERVATXON I30LE L.OG k talc# Depth from Soil Horizon Soil Texture Soil Color Soil i Other Surfaee,(in.) i .(USDA) (Munsell), — Motiling ( (Structure,Stones,tloulderes. Flood Insurance tiate m>p. Above 500 year flood boundary No Yes Y rY Within 500 year boundary No— Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material ;Does at least four feet of naturally occurring pervious material exist in all.areas observed throughout the-- - area proposed for the soil absorption system? -e if.not,,what is the depth of naturally occurring pervious material`? •Y ' ,il "`.' l+c :M't" 'Certification I certify that on DeC _(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 experience d cribed in 310 CMR 15.017. Signature�[ _ 'ate---- -- ACCESS CO VERS, MUST BE WI THIN 9' MINIMUM ' � GENERAL -NOTES ' GRAD 6' OF FINISH 3'.MAXIMUM COVER 23 FIRST 2 TO, /I THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION BE LEVEL OF THE SEWAGE DISPOSAL SYSTEM AND PERMI TT ING MIN 2" OF' PEAS TONE.,,, DIAMPjpE PURPOSES ONL Y 4 314" 112,*-DIA. 0 T2 WASHED ST Nt 241 VERTICAL 'DATUM IS NGVD, FOR BENCH MARKS SPIN �L.�25 19,75 - 19.25 CA 5 MARA 0. .0 SET. Str "E'P AN. S17 L RAFFLE ING CHAMBERS 3 0 E 3 500 GAL, LEACH uTL' r W14 $TONE AROUND. 12.6'X 3J.S'X 2' J. ALL CONSTRUCTION METHODS AND MATERIALS AND D-BOX 1.500 GAL M4 INTENANCE'OF. THE SEPTIC SYSTEM SHALL F SEPTIC TA N 6 RUSHED STONE BASE L CONFORM TO MASS. D.E.P. TI TLE 5 AND LOCA BOARD OF HEALTH REGULATIONS. 4 PROFILE : NoT TO SCALE 4. ALL SEPTIC / I - SYSTEM COMPONENTS LOCATED UNDER AREAS SUBJECT 'TO VEHICULAR TRAFFIC OR GREATER THAN 31 N DEP TH SHAL L' BE CAPABLE OF W1 TH- STANDING H-20 WHEEL LOADS. N VERT _EL EVA T ON' S, : DES .1 GN, CR TER JA '20.25 INVERT AT BUILDING: 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR , INVERT IN SEPTIC TANK: 20.'0 BEDROOMS AT //0 G.P.D. PER /.Q.75 N VERT OUT SEPTIC TA .P.D. c NK:l SEPTIC TANK AND D-BOX SHALL BE REINFORCED IST. BOX., 19,42 . PRECAST CONCRETE AND 'WATERTIGHT. NO GARBAGE GRINDER 19.25 INVERT OUT DIST. BOX: INVERT IN LEACH CHAMBER: 19.0 SEPTIC TANK REOUIRED: 'DIG-,SAFE% 7. BEFORE CONSTRUCTION CALL BOTTOM OF LEACH CHAMBER: 17.0 AND THE LOCAL WATER DEPT. ADJUSTED GROUND WATER: NIA FOR LOCATION:OF UNDERGROUND UTILITIES. SEPTIC TANK PROVIDED: 1500 �GAL. MIN. OBSERVED GROUND WATER: NIA -.6. ALL UNSUIMBLE MATERIAL YA A 8 HOR ZONS AND 80 TTOM OF TESTHOLE *2; 8.8 SOIL ABSORPTION 'SYSTEM REOUIRED, Cl C2 LAYERS) ENCOUNTERED BELOW THE INVERT , MINItNCH- OF THE LEACHING FACIL TY,TO BE REMOVED FOR A SO/I L TEX TURA L CLA SS ell EFF ISF' LUtNT LOADING RATE -'0.74 GPD DISTANCE,,OF 5' AROUND'DOWN TO APPROXiM4 TEL Y 595 S,F. REQUI RED, ELEVATION .14,8 AND REPLACED WITH SAND ,IN �440 6PD 0,74 GPDISF 5. -500 AL LEACHING CHAMBERS ROVIDED: 3 P W14 ' 'S TONE AROUND, A-614 S �F. 9. NO DETERMINATION HA S BEEN MADE AS TO 614 S.F. 0.74 454 G.P.D.� COMPLIANCE WITH DEED RESTRICTIONS OR ZONING SAL T MARSH, REGULA TI ON$. IT �SHALt REMAIN, THE CL ENTS RESPONSIBILITY TO OBTAIN ALL PERMITS. SPECIAL 0 L TES T PIT ''DATAS PERMITS. 'VARIANCES ETC. FOR THIS PROJECT. , INDICATES INDICATES '$ RESPONSIBILITY LOT 73 PERCOLATION OBSERVED 101 IT SHALL, REMAIN ,THE CLIENT TEST GROUNOWA TER TO HAVE THE PO OUNDATION 3 7 DESIGNED TO ACCOUNT FOR THE EXISTING GRADE TP,#2 MARSH 27835 S. F. TP, *11 7.0 AND SOiL ,CONDITIONS AT THE LOCATION OF THE . HORIZON 1EXTURE COLOR T COLOR. PROPOSED BUILDING. Sif 7+ `22.8 0* 22. 1 0* -*,�W 7 . .1- q SANDY JOYR SM 6 SANDY IOYR Ag. LOAM 414 LOAM 414 f/. THIS LOT FALLS W1 THIN FLOOD ZONES A3, (EL 11) TRANS 7-1 '�4 A 3�4 12-- ---------- ........ ............ 21. 12.. .......................................... AND FLOOD ZONE C AS SHOWN ON FIRM COMMUNITY 2.5Y PANEL NUMBER 250601 OOOJ D DATED: JULY 2. 1992 cp LOAMY LOAMY� .2.SY, 12% SLOP SAND 616 SAND 616 tS7A 2.2 ............... ....... ........... ............... /9 8 TRANS`4�-p 28 ... ......... ...... 36-- ----- MED UM 2.5Y C MEDIUM TRA 4-7:,2 01 14 SAND 614 OD c SAND 6 22v SLOPE 9 c 48*. ....................................... 18. 1 54*� ............... /8.3 EDO,& or SILT 2.5Y SILT 2.5y, TRANS 6 LOAM 614 LOAM - 614 , L ............................... 14.8 96*- 14.8 88-- ----------- .... ............... TcB SALT MARSH 5Y FINE-MEDIUU Byw, C3 F NE-MED UM 2. ND -RdA/S A 614 SAND 8 SA 105' !4 k OPE 4Z (F4 �0/ NO WA TER NO WATER 14,7 148- 9.8 166- 8.8 -Iilu SLOPE rRAks\ -3 14.6+ DATE: OCTOBER 29. 1998 Tca 2� TEST BY: AkNE OJALA. PE 0 Or ILOPE WITNESSED Y: JERRY DUNNING , A TE: 2 MINIINCH ANTEC 1-4 PERC R i4. v 15 4 19,0 0 �0? 7.:------------------ -0L/L---------- 50 120.7+ -------------------- ;,0 -.------ -- + tk OPOSED "Et L NG TOF 23.5 c�0 -D aA0AC PROPOSE 25.0 7, -2 26 CH '-9 64 +22.%i� 5�5 / /Soo + T( GAL 7F 5F COAfTA 2 4 SEP TI C TAK CF WOWS .......... .... �2 l+... TP#2 4- 3-500 aq� L A IVO D-00)(LEACH)WO TE P L -'A /V *14 �AROUND' ' P A R CE-L- 61 -A C01V CC 4-IR T MA F� 300 . L 0 T 70 D iS DRAITOE PI T WO vA TP#I SOIL RE SEE O rE 22 21.1_ I SA, R /V S TA S E" 40 20.24. 21,J 'R R E-PA R E-D 10=_0 R ................ BARNSTABLE HARBOR ........... GE PIT W L L A 'M ' S W HYD SP/rLE ELEV-24.11. -A S L iE-, �2 6 ,3 0 F: 0 B 0,�<' 108 BA RIVS 7 SPLIT' RAIL FENCE N 89*20'02*W , 88* 10 2 1 -,I t2.6 EDGE OF PAVE"�nfr 2015 S CA,L iS 0 C 7 7aW'"CE'R 22.2 4 REVI SED: NO VEMBER 1 5. I US A 11 FENCL i DMH E Y N U -C 1. W, Ei A G L. E Sl R V I N G , 9 23 R u,t 0 2 6 7 5 c, u t h p rl�,t , MA Ya rrn A 1( 50iB 4-3 2 No... 9!9-05 EL D:"CF WIEEK CA L C. SAHICFW� CPtCK: [-&N SA H I_ T4� -V 40 LOCUS 10 -','20 , JOB