HomeMy WebLinkAbout0073 HARRIS MEADOW LANE - Health 73 Harris `W. ` ane Barnstable
o
i
� TOWN OF BARNSTnA,,BLE
LOCATIONt-13 HOff 1� Me-'OdDW B SEWAGE# 20(3- OI(o
,VIdAGE'_B c -a- ASSESSOR'S MAP`&PARCEL �Z�14 8
INSTALLER'S NAME&PHONE NO. �„ ��((r(�V(���IDfI Sfl$ • �{"l�-a653
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) nf,l-h4kpr!, (size) & A 3d
NO.OF BEDROOMS 44
OWNER-MQ r 7B el K I n
PERMIT DATE: I- �'{ - 3 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
Al = 32'
Z31=
A2 = 3'1'3''
B2= JT3 "
Ac3= 3z,y,
133= 21 '
Ali - (P7'z•
C
t� ji
Commonwealth of Massachusetts
re Title 5 Official Inspection form E
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a
73 Harris Meadow Lane -
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable g Ma 02668 6-4-2021
required for every -
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. Please see completeness checklist at the end of the form.
Important:When filling out forms A. Inspector Information S( 15Lt(vo .
on the computer, Daniel Hawkins
use only the tab r
key to move your Name of Inspector '
cursor-do not B&B Excavation
use the return key. Company Name
...
374 Route 130
Company Address
Sandwich Ma 02563
City/Town State Zip Code
ram. (508)477-0653 ' S114324
- Telephone Number License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 16.000); 1 have personally,inspected the sewage disposal system at the property address
listed above;the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined
that the system:
1. ❑■ Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approving Authority
4. ❑ Fails
Dan Hawkins Digitally signed by Dan Hawkins
.'Dale:2021.06.09 08:05:31-M'00' 64-2021
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of
10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate
regional office of the DEP. The original form should be sent to the system owner and copies sent to
the buyer, if applicable, and the approving authority.
Please note: This report only describes conditions at the time of inspection and under the
conditions of use at that time.This inspection does not address how the system will perform
in the future under the same or different conditions of use.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18
Commonwealth of Massachusetts
-(p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668 . 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) ,System Passes:.
❑■ 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:
The system was in working order at the time of inspection.
2) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined,"please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
Commonwealth of Massachusetts
ism Title 5 Official Inspection- Form '
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane '
Property Address <
Mark Belkin
Owner Owner's Name
information is required for every West Barnstable Ma 02668 6-4-2021
page. City/Town . State Zip Code Date of Inspection
C. Inspection Summary (cost.)..
2) System Conditionally Passes(cont.): i
❑ 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):
n
❑ 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):
t
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
3) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
a.. System will pass unless Board of Health determines in'accordance with 310 CMR .
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment: . "
t5insp.doc•rev,7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
c Commonwealth of Massachusetts
= -� Title 5 Official Inspection Form
1 - l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
b. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
c. Other:
4) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
El El clogged
of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
15insp.doc-rev.7126t2018 Title 5 Official Inspection Fom*Subsurface Sewage Disposal System-Page 4 of 18
Commonwealth of Massachusetts
ire _ -Title 5 Official Inspection Form '
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont:) - r
Yes No
liquid level in the distribution box above outlet invert due to an overloaded
El ❑ Static or clogged SAS or cesspool
Liquid depth in cesspool is less than 6" below invert or available volume is less
❑ El than %day flow
❑ ❑ Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ E 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.
❑ 0 . y Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ E Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ The system is.a cesspool serving a facility with a design flow of 2000 gpd-
. j El 10,000 gpd.
❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303,therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
5) Large,Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section CA.,.
Yes No. .
'❑. ❑ - the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection a
Area—IWPA)or a mapped Zone II of a public water supply well
f
' ` i5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18
Commonwealth of Massachusetts
-- Title .5 Official Inspection Form
(- - 1�1 Subsurface Sewage Disposal System,Form -Not for Voluntary Assessments
,
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6-4-2021
required for every
page. City/Town, State Zip Code Date of Inspection
C. Inspection Summary (cont.)
If you have answered"yes"to any question in Section C.5 the system is considered a significant
threat, or answered"yes"to any question in Section CA above the large system has failed. The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner
should contact the appropriate regional office of the Department.
6. You must indicate"yes" or"no"for each of the following for all inspections:
Yes No
❑ 0 Pumping information was provided by the owner,occupant, or Board of Health
❑ ❑ Were any of the system components pumped out in the previous two weeks?
El ❑ 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?
El ❑ Were as built plans of the system obtained and examined?(If they were not
available note as N/A)
❑ El Was the facility or dwelling inspected for signs of sewage back up?
E ❑ Was the site inspected for signs of break out?
El ❑ Were all system components, excluding the SAS, located on site?
[j] ❑ 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,
F dimensions, depth of liquid, depth of sludge and depth of scum?
❑ a 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:
x
❑ ❑ Existing information. For example, a plan at the Board of Health.
❑ F-I Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
t5insp.doc•rev.7/26/2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18
Commonwealth of Massachusetts
=, Title 5 Official Inspection F
rm 0
�-
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments:
t . --
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is
required for every west Barnstable Ma 02668 6 4-2021
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
4 .4
Number of bedrooms(design): Number of bedrooms(actual):
458/GPD
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):
'Description:
Number of current residents:
Does residence have a garbage grinder? y ❑ Yes No
Does residence have a water treatment unit? ❑ Yes .❑ No
outside
If yes, discharges to
Is laundry on a separate sewage system? (Include laundry system inspection ® Yes No
information in this report.) .
Laundry system inspected? ❑ Yes 0 No
Seasonaluse? ❑ Yes No
'Water meter readings, if available,(last 2 years usage(gpd)): See below
Detail:
Meter issue per Water Dept. (no reading)
Sump pump? ❑ Yes ❑■ No
current
Last date of occupancy: : Date
t5insp.doc•rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 1
III •' .A .. .^-. a * � •
c Commonwealth of Massachusetts
...................................
wn =_� Title 5 Official Inspection Form
- - i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin -
Owner Owner's Name
information is west Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions:
NA
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: Owner- date of last pump is unknown
Was system pumped as part of the inspection? ❑ Yes ❑■ No
If yes, volume pumped:' gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc-rev.7/26/2018 Title 5 Of dal Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form ;
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane •
Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
0 , 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.Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known)and source of information:
New SAS added to existing tank in 2012
}
Were sewage odors detect ed,when arriving at the site? ❑ Yes ❑■ No
5. Building Sewer(locate on site plan): '
216" .
Depth below grade: _ feet
IY _ w
Material of construction:
❑.cast iron. ■❑40 PVC ❑other(explain):
Town water
Distance from private,water supply well or suction line: feet
` Comments(on condition of joints, venting, evidence of leakage, etc.):
t5insp.doc•rev.726/2018 t Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18. ro
p
Commonwealth of Massachusetts
r0 Title 5 Official Inspection Form
(. --- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668 6-4-2021-
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
1811
Depth below grade: feet
Material of construction.-
concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
1
Dimensions: 000gallons
511
Sludge depth:
3111
Distance from top of sludge to bottom of outlet tee or baffle
4r,
Scum thickness
6"
Distance from top of scum to top of outlet tee or baffle
13'r
Distance from bottom of scum to bottom of outlet tee or baffle
measured
How were dimensions determined?
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
The tank was in working order at the time of inspection. The tank is in need of pumping
at this time and should be pumped every two years for maintenance.
t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
II
r
Commonwealth of Massachusetts
�m go,
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is
required for every West Barnstable • Ma 02668 6-4-2021'
page. City/Town - State Zip Code _ Date of Inspection
D. System Information (cont.)
7. Grease Trap(locate on site plan):
NA
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 r:
• : Date
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
NA
Depth below grade:
Material of construction:
El concrete ❑ metal ❑fiberglass ❑ polyethylene ❑l"other(explain):
Dimensions:
Capacity:
- gallons
Design Flow: gallons per day
t5insp.doc-rev.7262018 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank(cont.)
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
9. Distribution Box(if present must be opened) (locate on site plan):
Orr
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.):
The d-box was in working order at the time of inspection.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
—.11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address s
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6 4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition 4of pump chamber, condition of pumps and appurtenances, etc.):
NA
* 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:
r
Type:
❑ leaching pits number:
❑ Teaching chambers number:
❑ leaching galleries number:
El leaching trenches number, length:
(21)Hi cap infiltrators
leaching fields number, dimensions:,
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18
c Commonwealth of Massachusetts
- Title 5 Official Inspection Form
�- ...-..... Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
j 73 Harris Meadow Lane
`r Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
11. Soil Absorption System SAS cont.
Comments note condition of soil signs of hydraulic failure level of ondin dam soil condition of
( 9 Y p 9, p ,
vegetation, etc.):
The SAS was in working order at the time of inspection. Leaching was dry when viewed.
12. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan):
NA
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form a
P Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
j / 73 Harris Meadow Lane
Property Address `
Mark Belkin
Owner Owner's Name -
information is West Barnstable `} Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
13. Privy(locate on site plan): ,
NA
Materials of construction:
Dimensions
• a
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
a
•
l5insp.doc•rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 '
I '
Commonwealth of Massachusetts
l Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
14. Sketch Of Sewage Disposal System:
Provide a view of the sewage disposal system, including ties to at least two permanent reference
landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters
the building. Check one of the boxes below:
❑■ hand-sketch in the area below
❑ drawing attached separately
No .. ,.L �.C,�C COMMONWLA•I.'CH OF IYIASSACHI.7SETT5 ,.,' red '—`I `
E' BLIC.HEAETH IIIVISIQN BA.RNSTrlBI,E,'NYA3SACHUS
������ �9ts�o�at�p�tern �Clottstructcan�fyrrnit
ennnssi,»iu h�sreby$tm'[SadC nat9,actC a Repair(✓) ,:.0 grade'( Abandgn.( )
System�tiic it at 0-
and as descr{Uod in'dse,ahove A.pp/rcation for I, 1sposal°Systt in S.onstri,cticn PoriiiEt. The app]iotmt x,sco$nlaad lits/har duty;to toin ply
True 5>",d tho faLL4wing hical:provisioita or special conditions..
provided:{;onstni, v t fits completed within three years-pf the date ofthis permit.
. Date rq. -may -- Approved by
TOWN OF. BARNSTABEE i
LOCAT ON_-13 4 rr_a.S_L-''IsrA PQ4,._.....,SEWAGE#!...r2..4?1�.:_....STlt�s.._._._w..,_
VILLAGE �� �,
sCn`'T+s"1 c ASSE$SOR'S':MAP&.PARCEL, $y
INST .R'S NAME 8c:PHONE"NO Q_f Q E�tCwsltiei ca✓> 4!'�'� 1?GS3'
SEPTIC^TANIGCAPACITY ItSC�ca1
I Ez1CMNG TA6 ITY(type)..yni .(-I r`a.-jor's (size) G.ca, 0' l
.Nt7.'6F$EDROC/MS _
OWNERar?2
PERMIT DATE:.+ L L _'l.r�. ._..__ C01viI'I TANCE DATE.
,. :;Separziton T7iistarice Between.the::: ..•. _
_ `MaxTmum Adjusted Grotuidwwat'er .abl'e:,to the F3ottom o£.L.eachitsg Fa�Eiltry
rivate-Watex$apply,Well and I,eachinB'Facili If,an-wells exist on• "
�( S
site of witfiin:20o fent:ofi leaciiing:cueaity): Feet
X.?dge pf-Wet7uad and°L.eaching Fuollity:.{If anywe#]ands,cxist_witlsi_n
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• t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18
I�
Commonwealth of Massachusetts
Title 5 Official Inspection Form
°
___.. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is west Barnstable Ma 02668. 6-4-2021'
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) .
15. Site Exam:
■❑ Check Slope
❑■ Surface water
❑■ Check cellar
FE-1 Shallow wells
No GW @ 120"
Estimated depth to high ground water: feet
Please indicate•all methods used to determine the high groundwater elevation:
El Obtained from system design plans on record
12/20/12 ,
If checked, date of design plan reviewed: Date
❑ Observed site(abutting property/observation hole'within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers "(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
A plan on file at the local Board of Health was used to determine high groundwater.
}
Before filing this Inspection.Report, please see Report Completeness Checklist on next page.
t5insp.doc•rev.7262018 4 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 l `
F
Commonwealth of Massachusetts
(.-A Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
73 Harris Meadow Lane
Property Address
Mark Belkin
Owner Owner's Name
information is West Barnstable Ma 02668 6-4-2021
required for every
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
X■ A. Inspector Information: Complete all fields in this section.
❑■ B. Certification: Signed&Dated and 1, 2, 3, or 4 checked
❑� C. Inspection Summary:
1, 2, 3, or 5 completed as appropriate
4(Failure Criteria)and 6(Checklist)completed
❑■ D. System Information:
For 8: Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
i
l5insp.doc•rev.7262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18
CERTIFICATE OF ANALYSIS , Page: 1 of 1
Barnstable.County Health Laboratory'(M-MA009)
sAcy % Report Prepared For: Report Dated: 10/20/2015 s
Mark Belkin
Mark Belkin Order No.:• G1590755
73 Harris Meadow
Barnstable, MA 02630
3
Laboratory ID#: 1590755-01 Description: Water-Drinking Water
Sample#: Sample Location: !;3 Harris Meadow, Barnstable Collected: 10/17/2015
Collected by: customer Received: 10/19/2015
Routine
ITEM RESULT UNITS RL MCL `METHOD# ANALYST TESTED NOTE
Nitrate as Nitrogen 1.3 mg/L ^ 0.10 10 EPA 300.0 LAP 10/19/2015
Copper 0.20 mg/L 0.10 1.3 SM 3111 B LAP 10/20/2015
Iron " 0.88 mg/L 0.10 .0.3 c SM 3111B LAP 10/20/2015
pH 7.9 PH AT 25C NA 6.5-8.5 SM 4500-H-13 PCB 10/19/2015
Sodium t 211 mg/L• 62.5 � 20 SM 31116• LAP 1 0/2 012 0 1 5
Total Coliform Absent PIA .0 0 r SM 9223 RG 10/19/2015
Conductance 380, umohs/cm' 2.0 y -'EPA-120.1 DCB „10/19/2015
Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a physician.
The water may present aesthetic problems(taste, odor, staining) due to Iron.
Attached please find the iaboratory certified parameter list. Approved By:
_ (Lab_Manager)
J
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605
� D � G
No. Fee_ e
THE COMMONWEALTH OF MASSACHUSETTS Entered in cornr6ter
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftplitation for Mis oral stem Construrtion permit
Application for a Permit to Construct( ) RepairXUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No."13 (,rr jAeajoW Owner's Name,Address,and Tel.No. q
Assessor's Map/ParceL,44 2-71 — -Par C"� --Befk:/n 519g
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
-Bf-8 e�_Xc4vahon 609- M-065 Do W n ftEn 0-ee_f I n
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(0
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date tz��� (� Number of sheets , Revision Date
Title O
Size of Septic Tank /00Q 0 1 f':�X f6-fnQ Type of S.A.S. CAP11C)IN^, �)
Description of Soil MWInU►Ulr�
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 Certificate of
Compliance has been issued by this Board f Health.
Signed Date P b
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
DG
No. v Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Q Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
1 lapplication for Mis osal 6pstrut (Construction Vermit
Application fora Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot Nod"13 orrl 5AeQdO W(j Owner's Name,Address,and Tel.No.
Assessor's Map/Parcetf° M 2-7 9 -"`P44,(ee j l�Q
�Bejbn 5,99 362 - A/r S qq
Installer's Name,Address,and Tel.No. ne�igner's Nam_,Address,and Tel.No.
-Btr3 6)((-avafi6n SDB-q77-D653 00vun e Enr—eerInq
Type of Building: _
Dwelling No.of Bedrooms L/ Lot Size sq.ft. `; Garbage Grinder(P
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 440 gpd Design flow provided gpd
Plan Date y-12 X0 1 12 Number of sheets Revision Date
Title 11 p S Plan c
Size of Septic Tank 000 670� Type'of S.A.S. 9
Description of Soil f T _z ��
0Is F
Nature of Repairs or Alterations(Answer when applicable)
r
a
Date last inspected:
S
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/ofHnealth.
Signed (..2'itJ( X/U Date 1 J 1
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
r �
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )eb1y � �_�(((�(a-t i on
at -7 3 Ain r r f i M tn d im P_.Q has been cons cte in�aJ c dance
with the provisions of Title 5 and the for Disposal System Construction Permit No1J dated
Installer 0 (' I F� Designer — V•!n Ej {1 e I n
#bedrooms Approved dE gn.flow _ ,. gpd
The issuance of this ermit shad jnot be construed as a guarantee that the system will fu%'c�t�Ziiodesne�.
Date I / Inspector—..__._.
-------------- - - - -- - - -- - - --------
No. -^,/ I/� - Fee (/
THE COMMONWEALTH OF MASSACHUSETTS
1 f� PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Vv6 30-18posal *pstem Construction i9ermit
VQmission is hereby granted to Construct( ) Repair(� Upgrade( Abandon( )
System located at r1r 3 r i 5 AeL,jdo EQ m sic
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construc on Inust be completed within three years of the date of this permit. // r
Date Approved by /
. L ,j
FROM :down cape engineering inc FAX NO. :150836213880 Jan. 30 2013 01:32PM P1
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-V FROM :down cape engineering inc FAX NO. :15083629880 Jan. 14 2013 09:06AM PI
Town of Barnstable
Departivaeat of Regulatory.Services �
8 ; -Public Healftl Dlvislon Date
tam -
ryp.a 0206MafnStrno4HyatrulelN.gtrZti�l
Date SJ,aedule<d LJ / Awk1
�"Pa- TaO /l V
Soil Suitability.Assessment for Sewage Disposal {�
rarRe,rwrtsy:•_._.,_, .. _ __._ Wimessedl)y. V'--�•�
Y? LOCATION&l� a INFOZtN NICION
4nmtlmrAddmw 7V Hevl-v M Dw1 N Uwper'sNuma I`
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SIfJGTCH[(street uama,dimensllouus�lo�f lot,cxpei lonadooa cf use lwke tk pmn rests,loMue.weflpuds prmdmiry to 11u m)
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DETER11) ATION FbR SEASON&T,HIG'H WATER TABLE
Mathod Used:_„_.
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pZ tttoweopl,igr1p,asirtooFuba.hota:,._........._, •� QrtatndwpterAdJuerment S.
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Barnstable:CAnSe1<vatl0u Division at Irast one(1)weak prior to beghudug.
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r FROM :down cape engineering inc FAX NO. :15OB36298BO Jan. 14 2013 09:06AM P2
DM.OBSERU TON IIOLE LOG
Depthfrnm MIlietiwu 8011Toxture ,StGlCaror Shc. pthM '
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Flood lnsuranre Dta•to Map;
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WlSIin56ymrbnn0dnry- No_ Yes -..
With'ur CnO-)=rfloadlsamdary Mr)_ Yea
Depth of_N4 v OemningPonaotte 1V Ah—dgi
Doe&at laaat four'feot of nalinally oct=ing pervinue material exist in all araas observed throughout the
urea propoaexl f(w the Fall absorption syetem2 __T
If nnt,what is the depth of hatumny mrairring pervlotvs materint4
CerlalYcat(an (/
Y cer'4 that on ( .-.._..(Ants)I have passai rlta sail ava)ua!or mitminnNon approved by H)c
Deportment of Enviremmantul Protection and that the above analysis wns per.Fnrurfa9 by rna consistent with -
the regnhY 4 training,expar.&B and axparlenra dawriW in�10 CII1215,017.
Daly
' Qa�xYrtcxri.13cmartl,n.voc ,
• � r
Response Environmental, Int.,
March 7,�2002< y ,
Town of Barnstable. !r.+• ?:# .ar t3*t+r .1, "., + R,t y
�. t
Office of'the Town�Manager �. rrr'w,.;a + :tt,,,
- I.�� �`' �
367 Main Street
Hyannis,MA 02601
✓ y .
Town of Barnstable
Board of Public Health&Code
367 Main Street
Hyannis,MA 02601
Re: Availability of A 1 RA®
Release Tracking Number 4-16838
#2 Fuel Oil Release
73"Harris Meadow,Lane
Barnstable,
This is to advise that all response actions relative to the above referenced release have been completed in accordance
with MA-DEP regulations, An A-1 Response Action Outcome Statement and Report has been completed and is
available for review at the MA-DEP Southeast Region office in Lakeville,Massachusetts.
The'report details remedial actions conducted in response to a release of#2 fuel oil at the subject location. No
groundwater, drinking water, catchbasins, or surface water bodies were affected by the release. In response to the
surface release, twelve drums of absorbents and liquid, and approximately 44 cubic yards.of impacted soil was
removed from the release area. Post-excavation confirmatory analysis has displayed that a pre-existing background
(non-detected)condition has been achieved,therefore a condition of No Significant Risk has been achieved.
If you have any questions or comments please feel free to contact meat(508)795-0110.
Sincerely,
lenn S. Goral,LSP
cc: A-1 RAO Report Submittal
563 Main,Street • Suite 211 Worcester, MA 01608 Telephone 508-795-0110 FAX 508-795-0910
A ,
David Bixby.Architect
24 Swamp Road
West Stockbridge,MA 01266
413-232-7834 DEC 1 1 2001
12/6/01 BARNSTABLE CONSERVATION
Ms. Darcy A. Karle
Conservation Agent
Town of Barnstable
367 Main Street
Hyannis,MA
Re: Belkin, 73 Harris Meadows Lane,Barnstable Village
Dear Ms. Karle:
This is to follow up on our telephone conversation regarding the above-mentioned
property.
As I said on the phone,Down Cape Engineering did the survey and septic system
investigation and advised me that there were no wetlands on the property or within a 100'
of the property.
My understanding is4hat"your inspection of the Town wetlands maps confirms this
information and that when the builder applies for a building permit,the Conservation
Commission will be able to"sign off'on this issue and we do not have to file a"Request
for Determination of Applicability."
I thank you for your time and attention to this.
Sincerel
David Bixby, AIA
cc. Mark and Eeda Jill Belkin
LOC AT
i ION SEWAGE W AG E PERMIT NO._
o
VILLAGE
I4NSTA LLER'S NAME & ADDRESS
✓s e /3 4td eye s 5-f 'X4,aclee r 1.4,.
7'l 5 4 5 c G6tNS c P.
B U YL D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED .--� ._
r
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\^\
vU
��
...
.v
No. . . ��------ L(o FEE Iv. .....
THE COMMONWEALTH.OF MASSACHUS5TTS
BOARD OF HEALTH
` ..OF........................... -
t
Appliratiutt -fur 43itipuiitt1 Worbi Tomitrurtiutt Vrrutit
Application is hereby made for a Permit to Construct ( (.) or Repair ( ) an Individual S wage is sal
Sys�t�' at
l l`5 •�
,7 __ F
... .J, -•--•.....-- --•.............•-----
QcJ
atiog address,7- ............. ......... ��® ���NN��S t /✓� ����(D���
Owner Adds
Installer Address
U Type of Building Size Lot .® _ .Sq. feet
.-� Dwelling—No. of Bedrooms...................... .. . ..........Expansion Attic Garbage Grinder (4Je)
per, Other—Type of Building __ 0.*'��___-____ No. of persons.--------^j............ Showers (A) — Cafeteria ( )
d ' Other fixtures ------------------------------ --- -
W Design Flow------------//�- ......................gallons pef person per day. Total daily flow-____ Q._____.________.._.__gallons.
Septic Tank.-Liquid capacity------------gallons Length................ Width................ Diameter---------....... Depth---..____------
xDisposal Trench—No. .................... Width....._...__��t. Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No.-___r_.---__--___ Diameter ��'•G!9L'llepth below i et.................... Total leachin area__._.__________sq. it.
Z Other Distribution box (/ ) Dosing tan ) D � /a� - �" "
~' Percolation Test Results Performed by.-_---.._ �[4/.... Date-----------------------___.-_-_--__-._..
.a Test Pit No. 1_________ ______minutes per inch Depth of Test Pit...__ -___._____.. Depth to ground water.-.._-_.--.---.-------- ¢�
(� Test Pit�No. 2..... ._____n 'nutes per inch Depth of " est Pit.-,._ _...._____�__,�Depth to ground
�water... .................... h(z
Descriptiot? of Soil - .. l� -+P - --- --
----- ---- ---- -
�' -------- ' ,—
�_- = -
--- �,-----.. .----�-�-'-�•. --- -- Cam- ---� -- -- ----- ---- ------ -- ----- ----
Lr Nature of Repairs or Alteratt ns—Answer when applicable.---------.
Agreement: c
_Jk..dam_ ----------------------------
WAX
The undersigned a ees o install the aforedescribed Individual Sewage Disposal System in accordance with
Vim! the provisions of Article XI of the State Sanitary Code— The undersigned,further agrees not to place the system in
° o a io until a Certifi ate of Comp i s b� issued by t e boa of health.
a � 77
"�° ��7J�•� ...... .... . ..... .... .._................................ �-•----Date- -•-------- .
App tca n pproved BY -------
-----
\ Date
Application Disapproved for the following reasons:________________________----------- ........ ""`
.................•----..........-•-.......----- v e
.........................................
Date
PermitNo......................................................... Issued............................ --......-----------•--- ,
Date
r' 1:
No.._ ............... Fi$... .-.`t..................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_....... - --- ----- ----------OF.......................................................................................
Appliration -for Di.spo,ial Works Tonitrnrtion Vrrntit
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
Syst at:
---•--•-..?..2h ......Z �J,E•----------- --••--•-••----------.._ � .. -
Locatio - ddress or Lot N .
n,I p Owner L) Address....J-� .1 !.....C"-'•= /..................................................... ................... /I/�./f/J�-j ai L
Installer Address
'O /'n D f-
U Type of Building Size Lot_.__19...................Sq. feet
Dwelling—No. of Bedrooms-------_____________________•_-_--_-_-.-___.Expansion Attic (Vty Garbage Grinder
p`�., Other—Type of Building __/(4 v ._...... No. of persons---------�............ Showers (N) — Cafeteria ( )
al Other fixtures ---------------------------------- - _
W Desi n Flow_____________1fP.___.._...._..._.____gallons per person per day. Total daily flow.__._ -? .._.....
g g< P P P Y y gallons.
WSeptic Tc,nk 4 Liquid capacity------------gallons Length---------------- Width-------......... Diameter................ Depth....__.____.....
x Disposal Trench—No_ ____________________ Width Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No------/------------- Diameter,l4*C r:!14°Depth below inlet.................... Total leaching area_-_____-._______sq. ft.
z Other Distribution box (f ) Dosing tan ) �/✓ �� �" z ' � 7
`-' Percolation Test Results Performed b ._ [ l �____. _
a Y - ----- - --/•- r Date
,a Test Pit No. 1----------------minutes per inch Depth of "hest Pit..... . _-_____-- Depth to ground water_._--___-_-_---_.__.._-
L7, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water__._-.________-_.._-.___
G -------------
--- -------------------------------------------=
Descriptio of Soil----------- _ /r'��+�!�► - - - �_. `... ...��Lt
w ,� � -�
.
... ...........
U Nature of Repairs or Alter s—Answer when applicable--------—_;&',r.._' �___- �t.c,,,. _____[�__'_
i,
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beer) issued by t-e boa of health.
. .-igned.. . -- ................................................. . ....................
Date
Date
Application Approved By.......... ....
Date
Application Disapproved for the following reasons______________________________ —----------------•--------•-----•-•---•--------•-•- ---------- -•---......
.....................•---•-------••-•--•-•••••----------------••-------...•------•-••--•-•---•-•••--•---.•---------•-----_------•--•---------------•---•-------•------•--------------.-•----------------
Date
PermitNo......................................................... Issued........................................................
Date
Tu�6 THE COMM w T, OF MASSACHUSETTS -
C�g BOARD OF HEALTH��
U
-4.4M► ....OF..........` .
Q.,rdif iratr of from haurr
THIStS T CZR-
,,nY,JI'hat the Individual Sewage Disposal, System constructed (�or Repaired ( )
by---• - I--------�- --=-- , I stiller
at_.... ..G ._. l� pd� -•------•---.. _-__.._..------•-------------
has installed in accordance with the provisions of : r e XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No..._-.__3y�____________________ dated._.. ,1P_`Z.�s.-. _�_____...........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ---------------------------------- QaInspector... ------------ F
-------•---•••-......---•-••-
THE COMMON ALTH OF MASSACHUSETTS
BOARD HEALTH
b77, l
..........OF..... . .. /
No........ ` 5 .. FEE....f-�..�"".....
Dinvo al Uo k� Ila otri tion rrotit
Permission is hereby granted -L --- --to Con..s_tWLc�t.1.( -4). Qo!`l�Rep.ar�ir,n. .ian dvidual�SwD l S tem
o / i
at N
(/
Street ------------------------
_
as shown on the application for Disposal Works Construction Permit o ____ ____________ Dated__�_'_2k_"._7----•-_-----
---f......
........................
DATE._ Board alth
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SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE MARKED
WITH MAGNETIC TAPE OR COMPARABLE MEANS
PROVIDE MIN. 20" DIAM WATERTIGHT (NOT TO SCALE) FOR FUTURE LOCATION. NOTES
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE GEOGRID (ISI 14,000 OR TENSAR BX 1100) ASSUMED QUAD Barnstable Harbor
TOP FOUND. EL.48.7' GEOGRID MUST EXTEND 5' BEYOND THE PROVIDE INSPECTION PORT TO WITHIN 3"OF FINAL GRADE ��
1. DATUM IS
\ FOOTPRINT OF THE CHAMBERS MIN. 18 COVER 2. MUNICIPAL WATER IS EXISTING
MINIMUM .75' F COVER OVER PRECAST 2 SLOPE REQUIRED OVER SYSTEM
3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
PRECAST H-10 H-20 D-BOX
RISERS (TYP.) 4 OZ. FILTER FABRIC OVER CHAMBERS 4. DESIGN LOADING FOR ALL UNITS TO BE AASHO �a°,
2'0 46.7' 4"0SCH40 PVC 0 5
t, PIPES LEVEL 1ST 2' 45.8' H-24, INCLUDING D BOX � o�
a ti�
o F�Bo pogolow
MIN 5. PIPE JOINTS TO BE MADE WATERTIGHT. �10" EXISTING 14"TEE SEPTIC TANK** TEE 45.3E ' o`� 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE Locus
" °°°° ° ° 44.90' WITH 310 CMR 15.000 (TITLE 5.)
GAS BAFFLE ::` °40°00° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND
4' LIQ. LEVEL (ACME OR EQUAL) .; 45.1' 44.93' 80 44.0' NOT TO BE USED FOR LOT LINE STAKING OR ANY
,,.;: •. :: " o0 0 0 o OTHER PURPOSE. Q
.,.: 12 MIN INT. DIM. °c
6" MIN SUMP 8. PIPE FOR SEPTIC SYSTEM. TO SCH. 40-4" PVC.
6" CRUSHED STONE OR MECHANICAL 3/4"TO 1 1/2"DOUBLE WASHED STONE 9. COMPONENTS NOT TO BE BACKFILLED OR a
COMPACTION. (15.221 [2D (12") 1 1/2"=2' CONCEALED WITHOUT INSPECTION BY BOARD OF o
HIGH CAPACITY (H-20)TRAFFIC APPLICATION DBL WASHED STON HEALTH AND PERMISSION OBTAINED FROM BOARD
10 ( 1%SLOPE) I12' 1 1/2"-2" OF HEALTH.
(_l�SLOPE) BL WASHED STONE SURROUNDING CHAMBER BED
LEACHING 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP
FOUNDATION- EXIST SEPTIC TANK 20' D' BOX 5' CALLING DIGSAFE (1-888-344-7233) AND
FACILITY VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE
**INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT 39.0' BOTTOM C1 LAYER OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL UTILITIES AND ALL BUILDING 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE WORK.
SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE ASSESSORS MAP 279 PARCEL 84
SYSTEM CONDITIONS IF NOT SUITABLE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED
SHALL BE REMOVED 5' BENEATH AND AROUND THE
PROPOSED LEACHING FACILITY.
12. EXISTING LEACHING FACILITY SHALL BE PUMPED
AND REMOVED OR PUMPED AND FILLED WITH CLEAN
SAND.
VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE
IMMEDIATELY GRANTED BY THE BOARD OF HEALTH AGENT OR SYSTEM DESIGN.
"
BY HEALTH INSPECTOR
A N
PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED 218 06, GARBAGE DISPOSER IS NOT ALLOWED
BY THE BOARD OF'HEALTH REVISED DURING A PUBLIC ,� EXISTING 4 BEDROOMS 3 BR + DEN
HEARING HELD ON AUG. 4, 2009 DESIGN FLOW: 4 BEDROOMS ® 110 GPD = 440 GPD
2) FAILED SYSTEMS ONLY : SEPTIC SYSTEM COMPONENT TO A° LOT 2 / USE A 440 GPD DESIGN FLOW
FOUNDATION SETBACK, IF AN IMPERVIOUS LINER IS DESIGNED 43,611 t SQ. FT.
AND INSTALLED (10' OR GREATER ALLOWED). ^��' 1.00f ACRES SEPTIC TANK: 440 GPD (2) = 880
RE-USE EXISTING SEPTIC TANK**
� I
LEACHING:
Li tK 4.73 SFAF x 6.25' LENGTH = 29.56 SF PER _:
HIGH CAPACITY INFILTRATOR UNIT
� PAVEED / 440' GPD/0.74 GPD/SF = 595 SF LEACHING
TEST HOLE LOGS ( ' S REQD
ENGINEER: ARNE H. OJALA, PE, SE a� �,� 595 SF/29:56 SF/UNIT = 20.1 UNITS
WITNESS: DON DESMARAIS, RS / / THEREFORE, USE GRAVELLESS SYSTEM OF (21)
i
NOVEMBER 30 2012 ��, / s H-20 HIGH CAPACITY UNITS IN FIELD
,
DATE. CONFIGURATION SHOWN
< 2 MIN/INCH / 21 UNITS x 29.5 SF = 619.5 SF
PERC. RATE _ 7 619.5 SF (0.74) = 458 GPD (OK)
CLASS I SOILS P* 1379948
+
ELEV. ELEV.
Q Q W " i
1 � 12 OA
0n 48.0' 0n 48.0' MA
EM00 owEUM APPROVED DATE BOARD OF HEALTH
A A v� TOP INK- 4&r 8
LS LS
8" 10YR 2/1 8„ 10YR 2/1 .. , \ ELEC
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B B �Cp EAST ,� To TITLE 5 SITE PLAN
LS LS SFIED ST*$ ORNAMENT / ELEC METER 9 OF
O 'E�L_ %0 I
309p 1OYR 5/6 45.5' 30" 1OYR 5/6 45.5, 2 PROVIDE APPROX. 39' of 40 MIL LINER 73 RABBIS MEADOW ROAD
1 49 AT 5 OFF SAS IN AREA SHOWN. TOP
NO. AT EL. 45.8', BOTTOM AT EL. 41.8'f BARNSTABLE
PROVIDE (21) H-20 HIGH CAPACITY 152. L=34.34' �"�
Cl C1 INFILTRATORS IN CONFIGURATION SHOWN, SO BEN -+CTR. OF s
SET ON 3 OF 1 1/2 - 2 DBL. WASHED \ R=22.05 1 � Sys PREPARED FOR
PERC FS FS STONE AND WITH 1' OF STONE AT d �q�F c 1 ELEV Sqc ,'o DAIVf
PERIMETER OF UNITS. PROVIDE 4 OZ. FILTER ' / A' �' MARK BELKIN
" o - - - to AIA m �o OJALA
FABRIC ON TOP OF 6 STONE COVERING PT CIVIL No.4
0980
2.5Y 7/4 2.5Y 7/4 � �
UNITS, THEN PLACE GEOGRID (ISI 14,000 OR W '
TENSAR BX 1100) OVER 6" CLEAN FILL, - _ - - - _ - - �� No.�1F�502o P
108" 39.0' 108" 39.0' EXTENDING 5' BEYOND CHAMBER BED, THEN d 5� V �'F �o �� '� �FSsk°`� DECEMBER 20, 2012
ADD CLEAN FILL AS NECESSARY TO BRING D� ^ / o�F9G�STER �� " q��3U4�t0-
TO SUBGRADE. ADD TOPSOIL AND J 52 S! 1LtA�S Y 4� off 508-362-4541
C2 C2 SEED/GRAVEL AS REQUIRED. L4 5 �_ " ��� "�� sqc. fax 508-362-9880
5 5Y 2 iz OJAI' A I�NIN4 ti `„ downcape.com 0
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LOAM Si LOAM PROP. VENT WITH CHARCOAL FILTER AND
BUGSCREEN (FINAL PLACEMENT BY _ z o Q 02 OJALA
`� down cape engineering, /nC*
120�� 2.5Y 6/3 38,0' 120 2.5Y 6/3 38.0' CONTRACTOR WITH HOMEOWNER �Z.-1c2 p
CONSULTATION) o� �c TE�ti �� civil engineers
NO GROUNDWATER ENCOUNTERED Scale: 1 30' land surveyors
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939 Main Street ( Rte 6A) '
0 15 30 45 so �5 FEET
01 - 199 DATE DANIEL A. OJALA, P.E., L.S. YARMOUTHPORT MA 02675
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