HomeMy WebLinkAbout2653 MAIN ST./RTE 6A(BARN.) - Health 2653. Main Btreet/Rte 6A (Bern)
Barnstable F/R
A _ 258 043
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9 y- Ors M' �Ae !(
Town of]Ba rnstiable P�- �� 7-�
�E 12103
' Department of Regulatory.Services
Q,rZ=� 4 lt .
Public Health Division Date
200 Main Street,Hyannis MA 02601
Date Scheduled ,�jID�J Tulle
Fee Pd.
Soil suitabilio .A.ssessmentfor Se e .Disp®sal
Performed By
-- Witnessed By: a
]LOCA 17e & QgNERAL INFORMATION
Location Address '�S�ri d CI�L`'•6 Owner's Name
�1-/ Address /
Assessor's Map/Parcel: 2-3d/C2t./00 Z ` - Engineer's Namc l�U�,J►t
NEW CONSTRUCTION !!! REPAIR /
Telephone# Csoe �B� — 4(,5-Y/
Land Use:
Surface Stones
Distances from: Open Water Body—C ft Possible Wet Area )*IA— ft Drinking Water Well ft
Drainage Way ft Property Line � ,
��`�ft Other ft
SIMTCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
'120
/uT'( .ko4 •
Parent material(geologic) Depth to 13adroclt L D
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Faae
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: ��11� O
Depth Observed standing in obs.hole: w(� In, Depth to soil mottles: Itt,
Dcpth to weeping from side of obs.hole: In. Groundwater Adjustment
Index Well# Reading Date: lndox Well 1pvol Adj.t'aclor- Adj.Groundwater Level,,,,,,
PERCOLATION TEST bate o xln,a �e
Observation
Hole# Tima at 9" Z L 6
Depth of Pero 72 Tlme at G" 12;Z0.
-- v
Start Pre-soak Time Time(9"-G") P _
End Pro-soak �/i y�•
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) / v
Original: Public Health Division Observation Hole Data To Be Completed on Back-----
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation D1viSion at least one(1)week prior to beginning.
Q:\S EPTICIPERCFORM.DOC
DEEP-OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other
Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders,
mmisistclipy,%Gravel)
yS- 13Z Lg 6fZ;9v-fL-57��f
nepm from DEEP OBSERVATION HOLE LOG Hole Z-
e Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsis en, %Gave
1 raw S� � •S' �/y sto gy - �Ci�s
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other.
Surface(in-) (USDA) (Munsell) Mottling (Structure,Stones,Bouidcrs.
o i tc r, G e
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders,
Consistency,
y
Flood Insurance hate Map:
Above 500 year flood boundary No— Yes .
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 obstrved throughout the
_ area proposed for the soil absorption system? 11-1-1t.-A--1
If not,what is the depth of naturally occurring pervious material?
Certification I certify that on Q9.4 (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 expert ce described in�10 CMR 15.017.
Signature Datb
Q:\S.FPT1aPE1ZCP0RM.D0C
u TOWN OF BARNS/TABLE
�.-OC :"XOPd cS3 //,qT/S7 '�,j SEWAGE #c2603
<< fz / P
'"$` '_LASE ��'�1.1�Ah/t' ASSESSOR'S MAP 8z LOT
�vS_A.LLER'S NAME&PHONE NO, , �C� /:<s�e�
SEP'`11C TANK CAPACITY
,j LEACI.IMGFACILITY: (type) i /� �1 s t� (size) �O X '
O. Or BEDROOMS
R JILDER OR OWNER 7ZYC)',l IS^ bAc 1V-
PERMII'DATE: ����� 1�COMPLIANCE DATE:ja
/
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 100 feet of leaching facility) Feet
Edge of-Wetland and Leaching Facility(If-any wetlands exist
within 300 feet'of leaching facility) Feet
Furnished by
0
IV
01 .
14
OD
d
a
No. � 6 � Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in comute pr: /v .
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Application for Mtgogaf *p5tem Congtruction Permit
Application for a Permit to Construct( )Repair(✓TUpgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. / 2 - Owner's Name,Address and Tel.No.
Assessor's Ma /Parcel �A2!)s%f10/G soy Anne kCe C0 n Re l
p ase/y a6s3159,..sT 09,e4- Q-I /.
Installer's Name,Address,and Tell.No. Designer's Name,Address and Tel.No.
C1�Tc+z,r4�c `lam-��Gbt t 3C��S
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size'v/�(OQ-± sq. ft. Garbage Grinder(A/C}
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow S)3® gallons per day. Calculated daily flow gallons.
Plan Date 5 U i TT• t? - a003 Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. 7'"F /6 X 30
Description of Soil 4J
Nature of Repairs or Alterations(Answer when applicable) e UJ C 500�,-317
_Z),j:_JAZZ � /i)D t� 1Tr9 Jat.j ,>7 5- dtk-eI e
Ij
Date last inspected: MUST SUPERVISE
DESIGNING ENGINEER IN WRITING
Agreement: TION AND CERTIFY STRICT
1 ST LLA TALI,ED IN
The undersigned agrees to ensure the construction and maintenanINS W#iN n-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code ana11 Lt¢,Y)MeTe�� tem in operation until a Certifi-
cate of Compliance has been iss d by this B of Hea
Signed " Date /�/ 003
Application Approved by •-s . Date
Application Disapproved for the following reasons
Permit No. Date Issued o3
No. Fee
THE COM'Mqm,� IEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION'�_'TOWN OF BA6'NSTABLE, MASSACHUSETTS
Ofpplication for Migpo!6A *p!Aem Com6truction Vermit
Application for a Permit to Construct Repair PTUpgrade Abandon El Complete System El Individual Components
Location Address or Lot No. 5 T Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
58AIJ -.-265 3ST 0,),24- 3Z, -1Z/8
Installer's Name,Addi6ss,and Tel.No! Designer's Name,Address and Tel..No.
C.
Type of Building: t
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(19
Other Type of.Building No. of Persons Showers 6feteria
,bther Fixtures
.,.LDesign Flow D ' 1 2
es gallons per day. Calculated daily flow gallons.
Plan Date 9 u UZ Number of sheets Revision Date
Title
Size of Septic Tank --Type of S.A.S. /T C,
Description of Soil )2, -So,'/Ary - C V,
Nature of Repairs or Alterations(Answer when applicable) DPP OJ C
C/
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
on until a Certifi-
cate of Compliance has been isped by this Bo of He It r
Signed Y
Date lcev / 003
Application Approved by
Date I C. 7 g/
Application Disapproved for the following reasons
Permit No. o 0 Date Issued
i f
—--------- THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage-bisposal,#System Constructed Repaired(k—)Upgraded
Abandoned by
at 1Zi/iv 7/* -T,)b has been constructed dan e
6 c
0.
with the provisions of Title 5 and the for Disposal System-Construction Permit N 7 dated,
A�
Installer Q cc �/O-C
Designer
The issuance of this pe t s all not be construed as a guarantee that the syste 10A s ign
Date Inspector .
No. Qoo- s_,�,7 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
x1h5poat *pztem✓ 3permit
Permission is hereby granted to Construct Repair Upgrade Abandon
System located at AS 3 T'.."J,
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:Constructi n in t be completed within three years of the date of this permit
Date: 7� Approved by
tel.(508)362-4541
939 main street rt 6a fax(508)362-9880
yarmouth port
mass 02675 down cape engineering
civil engineers& land surveyors
structural design
Arne H.Ojala P.E.,P.L.S.
Daniel A.Ojala,P.L.S.
land court
Timothy H.Covell, P.L.S.
surveys
December 1, 2003
site planning
7E_C�,
Thomas McKean, RS
sewage system Director, Barnstable Health Department 03 .
designs 200 Main Street
Hyannis, MA 02601 TOWN OF BARNSTABLE
.. - HEALTH DEPT.
inspections
Re: 2653 Main Street, Barnstable
permits
Dear Tom:
In November of this year, Down Cape Engineering, Inc.
performed a soils removal inspection as required on the
approved plan at the above-referenced location.
This is to certify that the soils removal was completed
satisfactorily.
If you have any questions, please do not hesitate to call
me.
Yours truly,
Arne H. Ojala, E, S
Down Cape Engineering, Inc.
cc: Joy Anne MacConnell
TOWN OF BARNSTABLE
l&&SI.- SEWAGE# �S'ZGy
VII:LAGE `,9d e6jdie ASSESSOR'S MAP& LOT LS8`ay3
INSTALLER'S NAME&PHONE N0. `DegT
?.SEPTIC TANK CAPACITY Sara •-4 Al
L EACHING FACILITY: (type 2 �I G ice• rt(h+cr/itgj
NO.OF BEDROOMS 1
.,.::BUU DER OR OWNER
.:.:PERMTTDATE: �I` Z �'�� COMPLIANCE DATE: , = 13 21S
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
: Furtiished by
' i
A_°f q-
TOWN OF BARNSJTABLEL
LOCATION 53 iA S�- f -�/ SEWAGE #J003
VILLAGE ASSESSOR'S MAP &LOT 2-D .3
j INSTALLER'S NAME&PHONE NOI aca l r`s7 —
SEPTIC TANK CAPACITY toy,
LEACHING FACIL=: 4 ej— 1 (size) �O t
NO. OF BEDROOMS 3 �°►
BUILDER OR OWNER 'Sc Al ANn 6c lc).-tnc_ti
PERMITDATE: //— COMPLIANCE DATE: iN l7Q
0a
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply We11 and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wedand and Leaching Facility(If any wetlands exist
widen 300 feet of leaching facility) Feet
Furnished by
BACK �a . �l�� 6-a - 5q
{ A
3
3°
TOWN OF BARNSTABLE
I;�CATION 76 3-3 l>�6. IteleS� SEWAGE #
�f,LAGE T3��e6Ar6Ie ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY i s-Z-)-4 A-t— �
LEACHING FACILITY: (type �2r-t�C -•
NO.OF BEDROOMS
BUILDER OR OWNER
PERMIIDATE: GI Z�-�� COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
_ �
��
_ _ _.
. I.
� � ���
� � � � � � �
�� � e
r�
z.55s-e::� 3
No. Fee
y
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Zipprication for Mf5pont bpotem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade(i/)Abandon( ) LJ Complete System ❑Individual Components
Location Address or Lot No. 265 Owner's Name,Address and Tel.No.
Assessor's Map/Parcel J �r �T jdolw le
Installer's N e,Address,and Tel.No. / Designer's Name,Address and Tel.No.
el60e,51-
vl9
Type of Building: ?
Dwelling No.of Bedrooms i3 Lot Size sq. ft. Garbage Grinder(__41e
Other Type of Building PNo. of Persons —Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow Uc3l/ gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. 3
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) )rl7_/&L G- L10�/'�
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 y thi d Healt ,/
Signed Date
Application Approved by Date Z Y2157
Application Disapproved for the following reasons
Permit No. Date Issued L —Z-7 _I
No.
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Application for �Digonl *ppgtem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade/Abandon( ) /CompleteSystem [:]Individual Components
Location Address or Lot No. 74 Owner's Name,Address and Tel.No 5-3 Nt�lil
.
Assessor's Map/Parcel
.a Installer's N e,Address,and Tel.No. Designer's Name,Address and TeL No. p
�o61oGo //C sr`
7 7'1 9399
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( �
Other Type of.Building of Persons Showers( ) Cafeteria( )
Other Fixtures )
Design Flow 40 • f gallons per day.I Calculated daily flow 33e,� gallons.
Plan Date Number of sheets Revision Date
Title -
Size of Septic Tank rDD Type of S.A.S. 3 ®•�l'l/�%ZE��'S
Description of Soil
Nature of.Repairs or Alterations(Answer when applicable)
t •
Date last inspected:
Agreement: - a
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 y th' d Healt .
Signed Y Date
Application Approved by - Date
Application Disapproved for the following reasons - ---
/J i
Permit No. �, '� Date Issued �7 -?, 7 �
THE COMMONWEALTH OF MASSACHUSETTS Z 5';1 a`13
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CEIZTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(�
Abandoned( )by Aep oCd f G ri'S
at Zk!573 ,f 2-X-J WWA7 5 /V,S�4-plle has been constructed ccdan�e
with the provisions of Title 5 and the for Disposal System Construction Permit No. Z61V dated
Installer Designer
The issuance of this permit shall no qbe construed as a guarantee that the syste wil.function as designed.
Date Inspector
Qj
-- yy -- ------- — - 2
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
xi5po5al *potem Construction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade(1/)Abandon( )
System located at
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 this ermit.
Date: y—Z �� Approved by�-�w .G �
10/9197
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A
DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT
ENGINEERED PLANS)
y
hereby certify that the application for disposal works
constructionp signed permit si d b me dated `//7,3 6/ ? concerning the
Y
located at Z6 J 3 meets all of the
property
following criteria: -'
There are no wetlands located within 100 feet of the proposed leaching facility .
There are no private wells within i�:o feet of he proposed septic.syste i
There is no increase in flow and/or change in use proposed
/Therea no variances requested or needed.
ar
If the proposed leaching :acuity will be located ithin::0 feet of 3nv wetlands. the bottom of:he
P P
proposed leaching faciiiry will M be located less than founeen %i tl lea above the maximum adiusteq
groundwater table elevation.
Please complete the following: l
Elevation(a
ccording ro the Engineering Division
magi7'`
A)Top of Groun
d Ele g
. ) p
(according to Health Division well map
B)Observed Groundwater Table EIevation ;i
SIGNED: DATE
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
i
(Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, ;.
this plan should be submitted].
A
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bwtb folder:oat Fi
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Cn ���
TROY WILLIAMS P y s
SEPTIC INSPECTIONS
Certified by MA Department of Environmental Protection (508) 385-1300
19 Hummel Drive
South Dennis,,, MBA 02660
.\ COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE, OFFICE OF ENVIRONMENTAI,AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM
PART A RECEIVED
CERTIFICATION
MAY 0 8 2003
Proper-IN Address: 2653 Main Street
Barnstable,MA TOWN OF BARNSTABLE
Owner's Name: Joy Anne MacConnell
HEALTH DEPT.
Owner's Address. P.O.Box 816
Barnstable,MA.02668
Date of Inspection:_ May 7,2003
Name of Inspector:-f Troy M. Williams
Company Name: Troy Williams Septic Inspections
Mailing Address: 19 Hummel Drive
South Dennis,MA 02660
Telephone Number: (508)385-1300
CERTIFICATION STATEMENT
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%%,as performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. 1 ant a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system-
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority)
Fails 4
Inspector's Signature.✓ 5,,,,,1 Z.J :.__, Date: s/7 /a 3
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of I lealth 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 and copies sent to the buyer, if applicable,and the approving
authority:
Notes and Comments
Although system meets the minimum requirements set forth by the Massachusetts Department of
Environmental Protection,certification is not to be construed as a guarantee of future working condition
of system,piping or components. This inspection represents the conditions of the system on the Date of
Inspection noted above.
***'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 saute or different
conditions of use.
Title 5 Inspection Form 6/15/2000 pane 1 of I I
II
Page 2 of 1 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSUR
FACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
2653 Main Street
i
Owner: Barnstable,MA
Date of Inspection: Joy Anne MacConnell
May 7,2003
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
___. 1 have not found any information which indicates that an f the failure criteria described in 310 CNIR
15.303 or to 310 C•MR 15.304 exist. Any failure criteria not aluated are indicated below.
Comments:
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 ill pass.
Answer yes, no or not determined(Y,N,ND)in the------ for the following statements. if"not termined"please
explain.
_The septic tank is metal and over 20 years old* or the septic tank(whether etal or not)is structurally
unsound,exhibits substantial infiltration or exfiltratiou or tank failure is imnti nt. System will pass inspection if the
existing taut: is replaced with a complying septic tank as approved by the and of Health.
•A metal septic tank will pass inspection if it is structurally sound,not aking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break ou r high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled neven distribution box.System will pass inspection if(with
approval of Board of Health):
b en pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The em required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will
pass ins tion if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
Y f
Ry
ti� g�t
, i
Page 3 of 1 I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property.Address:
2653 Main Street
Owner: Barnstable,MA
Date of Inspection: Joy Anne MacConnell
May 7 2003
C. Further Evaluation is Ikequired 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.
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 a ronment:
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 rsh
2. System will fail unless the Board of Health(and Public Wat Supplier,if any)determines that the
system is functioning in a manner that protects the public be th,safety and environment:
_ The system has a septic tank and soil absorption stem(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface wat supply.
_ The system has a septic tank and SA id the SAS is within a Zone 1 of a public water supply.
The system has a septic tank a SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic nk 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 pas s if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria and v the organic compounds indicates that the well is free from pollution from that facility and
the presen of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure teria are triggered.A copy of the analysis must be attached to this form.
3. Other:
�
3 � �r
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 2653 Main Street
Barnstable,MA
Owner: Joy Anne MacConnell
Date of Inspection: May 7,2003
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_ Backup of sewage into facility or system component due to overloaded or clo2Led SAS or cesspool
�z 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 or clogged SAS or
cesspool
Liquid depth in cesspeel is less than 6"below invert or available volume is less than day flow
,L Required pumping more than 4 times in the last year NQT due to clogged or obstructed pipe(s).Number
of times pumped
Any portion of the SAS,cesspool or privy is below high ground water elevation.
AIM Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
— 6i/,4 Any portion of a cesspool or privy is within a Zone 1 of a public well.
— v& Any portion of a cesspool or privy is within 50 feet of a private water supply well.
ivl 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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility 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 forma
y C S (Yes/No)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. l
E. Large Systems:
To be considered a large system the system must serve a facility with a desi flow of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following: .
(The following criteria apply to large systems in addition to the criteri ove)
yes no
the system is within 400 feed of a surface drinkin ater supply
the system is within 200 feet of a tributary a surface drinking water supply
_ the system is located in a nitrogen sitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone 11 of a public water sup p ell
If you have answered"yes"to an uestion in Section E the system is considered a significant threat,or answered
"yes"in Section D above the 1 ge systQlntt ha}s failed.The owner or operator of any large systep considered a s r
signi�icent threat undtr Se on E or failed tindtrr Section D shall upgrade the system in accordance with 310 CM�t
15.304.The system o. r`should contact the appropriate region office of the Department
, " aE, '
1
4 s - VS..
`
Page 5ofII
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:
P y
2653 Main Street
Owner: Barnstable,MA
Date of Inspection: Joy Anne MacConnell
May 7,2003
Check if the following have been done.You must indicate'yes"or"no"as to each of the following.:
Yes No
information was provided by the owner. occupant, or Board of I h alth
_,/ Were any of the system components pumped out in the previous two weeks
✓ _ Has the system received normal flows in the previous two week period'?
Have large volumes of water been introduced to the system recently or as part of this inspection?
_ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
✓ _ Was the facility or dwelling inspected for signs of sewage back up?
- _ Was the site inspected for signs of break out
✓_ .-_-__„ "ere all system components,excluding the SAS, located on site '!
Wec6 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:
Yes no
_ Existing information. For example,a plan at the Board of Health.
_✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)J
.•, .
I
Page 6 of I
OFFICIAL INSPECTION..FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:
2653 Main Street
Owner: Barnstable,MA
Date of inspection: Joy Anne MacConnell
May 7,2003 FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): a
DESIGN flow based on 310 CMR 15.203(for example: 110 god x#of bedrooms): 33 0
Number of current residents:
Does residence have a garbage grinder(yes or no): Aio
Is laundrN on a separate sewage system (yes or no):AID [if yes separate inspection required)
Laundry system inspected(yes or no): /v111
Seasonal use: (yes or no): /vo
Water meter readings,if available(last 2 years)usage(god)): Dz- o 3 = 1/!,o 51-0ff =sC,odo'-uo� s .
Sump pump(yes or no): Iva
Last date of occupancy: O c , <<<.
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): _ _gpd
Basis of design flow(seats/persons/sgft,etc.): _
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):_
Non-sanitary waste discharged to the Title 5 system ( s or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: A/o n., n c;&I«
Was system pumped as part of the Inspection(yes or no): Na
If yes,volume pumped: gallons-- How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool
—Privy
_Shared system(yes or no)(if yes,attach previous inspection records,if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
Other(describe):.
Approximate age of all components. date installed(if known)and source of information:
J Hs fa. t1 . J S/ Is / 98 bar c-s 12
Were sewage odors detected when arriving at the site(yes or no): € �
F
• x� 3 w'r:
aP
6
r.
I
Page 7 of I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
2653 Main Street
Owner: Barnstable,MA
Date of Inspection: Joy Anne MacConnell
May 7,2003
BUILDING SEWER(locate on site plan)
Depth belu%�grade: 18 " 4-
Materials of construction: _cast iron Z40 PVC__other(explain):
Diqanc•r fron. private water supply well or suction line: N1.1
Comments(on condition of joints,venting,evidence of leakage,,etc.): ``--
. L 1 �'+2.[� I h G r GIN:k T"7�lI N!� G I G N✓ (:)N I N S/7 - C. y H ,
SEPTIC TANK: Z (locate on site plan)
Depth below grade: oZ . S ' rn s r s ✓ 4z I
Material of construction: ,/concrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of
certificate)
Dimensions: __ U . 5- "X 6. l SdU /10 h
Sludge depth:---
epth:
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or bafflc:
Distance from bottom of scum to bottom of outlet tee or baffle: /6"
I low were dimensions determined: r'ry b, /
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
PV���S Wc✓c . _i� /,,Jo✓Ft� r ti�;�a✓_ SLv.r• _I�� �_IJ v +-./w1 7��....1 c.�,,�c✓�.
N I.�.f �• •.d U iI f 's 4�J . _i- I S r %1. ;..�__. ✓i�!.c e% c< Ole'
b��K✓/, ; r fo �C-Ijti� -t-�" lc iN tb�J_ :+. W I
6)c ;hT Pc� r�++ wo.f '^/�javo�c. y'� G 6c�� o.i�Ic F IN✓t.r(- .
.GREASE TRAP:_(locate on site plan)
Depth below grade:_
Material of construction:_concrete_metal_fiberglass_polye ylene_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 r baffle:
Date of last pumping:
Comments(on pumping recommendations, ' and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of le e,etc.):
1
7
I
Page 8 of I l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
2653 Main Street
Owner: Barnstable,MA
Date of Inspection:Joy Anne MacConnell
May 7,2003
TIGHT or HOLDING TANK: (tank must be pumped at time of inspec ' n)(locate on site plan)
Depth below grade:
Material of construction: —co I ncrete metal fiberglass olyethylene other(explain):
Dimensions:
Capacity: gallons
Design Floe. gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working orde yes or no):
Date of last pumping:
Comments(condition of alarm and flo switches, etc.):
DISTRIBUTION BOX: ,ol (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: 0.60 j 4-
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.):
6._..6oir moo v !,A 6—_ c,.4.0✓� oy+l�� t N v�r
ow N/iy hu+ CX/9 + 'r't.-. I 'fi la P, C + .r �ac.�IG ./r, ivy �o �►� !ti
�ro.. /0vcS���'G
PUMP CHAMBER:___(locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,conditio pumps and appurtenances,etc.):
8 ;
Page 9 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
2653 Main Street
Owner: Barnstable,MA
Date of Inspection: Joy Acme MacCotmell
May 7,2003
SOIL ABSORPTION SYSTEM(SAS):-.3,/ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits, number:_
_ 1 leaching chambers,number: 3 /t'l max; z h I }., �, �s 1 t '2 y X
leaching galleries,number:
leaching trenches,number, length: —
leaching fields,number,dimensions: _
overflow cesspool,number:
innovative/altemative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
etc.):
:j k A-
CESSPOOLS: (cesspool must be pumped as part of inspection)(loc on site plan)
Number and configuration:
Depth—top of liquid to inlet invert: -- -� - -
Depth of solids layer: ----- — --
Depth of scum laver.
Dimensions of cesspool:
Materials of construction:
---
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of raulic failure, level of ponding,condition of vegetation,etc.):
PRIVY: (locate on site plan)
Materials of construction: _
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic fa' re, level of ponding,condition of vegetation,etc.):
k ,
r
9
• Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FpR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2653 Main Street
Barnstable,MA
Owner: Joy Anne MacConnell
Date of Inspection: May 7,2003
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.
1
1
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95
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Page I l of 1 I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
2653 Main Street h
Owner: Barnstable,MA
Date of Inspection: Joy Anne MacConnell
SITE EXAM May 7,2003
Slope
Surface water ✓
Check cellar
Shallow wells
Estimated depth to ground water feet Adjusted high ground water elevation/3.$ feet
Please indicate(check)all methods used to determine the high ground «ater elevation:
_Obtained from system design plans on record- If checked,date of design plan reviewed:
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)
V Accessed USGS database-explain:-At,,J zN 7
You must describe ltow you established the high ground water elevation:
G��✓�._. ova w4t .� �v..t� l+o
_0.r c r1 UL .. 4Y .I� � .c�G pp— T' �"._. - • �� ..Nil y/.-�� t �U G4�'t t 4.__G �✓ l7 tµ
/� Nta./ t�S•f . . Jot I M 4✓cQ-
'10 S 3po 4-5- c> I` C��..y - Due. �Z� � t9✓-cam✓ (. c- 7' v
�f�D/r Y't p a...✓ 7"�l'(�o✓ t�1✓¢.S 4-t G-c�f 1,v•. t bl"lo c rC-�.�� -f c.-(a/.� b.,c�I 1a f- c�4 a.< w'�
7 3 A. 3 '
1-01
This report has been prepared and the system inspected as of the date of inspection. This report is not a
warranty or guarantee that the system will function properly in the future. There have been no warranties or
guarantees,either expressed,written or implied, relating to the system,the inspection and/or this report.
1I t
,;BARNSTABLE
HARBOR
off. 508-362-4541
fax. 508-362-9880 u)J
0
do wn Cape,:engineering, inc o
a
CIVIL ENGINEERS HIN
LAND SURVEYORS P D r RTE 6A
LOC S
939 main st, yarmbuth, ma .02675
- R R.
"POND VILLAGE"
LOCUS MAP SCALE 1 " = 2000'
ASSESSORS MAP 258 PARCEL 43
ZONING DISTRICT: RF-1
YARD SETBACKS:l
- - FRONT = 30'
SIDE = 15'
��• 20.74 REAR = 15'
PLAN REF. PB 136 P 131.
FLOOD ZONE: C
ELEVATIONS APPROX NGVD
0
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t°9.65 Oj 176 \ ALL ROOF RUN—OFF TO BE DIRECTED TO
9.03 8\� >2 DRYWELLS OR STONE TRENCHES
WETLAND FLAGGED BY HAMLYN CONSULTING
-1y8.51 �k1\ �) (2005)
\ R \ S
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9 16.80 3.9 FIELD AREA
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SITE -PLAN
SHOWING PROPOSED, ADDITION
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()F #2653 RTE. 6A
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�Q DANIEL oyGN IN THE TOWN OF:
t A. BARNSTABLE (VILLAGE )
OJALA
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P R USSELL FISCHER
q�0 SURVEY �' I �'S / I
30 0 30 60 90 Feet
DANIEL A. OJALA, E, PLS DATE'
SCALE: 1" 30' DATE: MAY 25, 2011
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FLOOR PLAN ^��w,a<°°�^°�^�- NORTHSIDE NORTNSmE HEREBY EXPRESLr DESIGN
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PRCPMA411KS na n a warn NOT TO BE REPRODUCED
®"°n'T'°" DRAWINGS wxAnlxmalaw•oswaw[o ASSOCIATES SHEET NO. au<m mrtaa a awlmaw w M CHANGER OR CONED A ANY DRAM
DATE: n va a sllucnwu 06N1a106 w. �- TORII T MANNER AININC0EHEH
LOI S DEMKO ^`°"°`"a°N90E "°� EXPRESS VR T N PERMISSION THE
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A , 2653 MAIN STREET 6S"'a w fM°" ° O�°t°` RESTDQlML a COMMERCIAL DL9CN E7PI7E55 IENTTOF PERYI59Gr1 CHECKED
10/17/06 euaw omwtrJlr ow/an•®¢la Isl :w ml¢r•»Jelamlrowr•w oze�s AIA CONSENT OF NORINSIOE
BARNSTA BLE, MA. ran•ac•A o.srAorn sera.e w r paei a�—ulo eooel xx—oen DE9ON.
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ELEVATIONS ".PRva NORTHSIDE DESIGN
,��.,Iml wlo a aNalwll;ew NORmsoE MO+Eer EI�REsr
0 1 ] 4 n Ft.PPnG11011 A W5ne1CnM FdWt%IM"S COMMON LAW
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PROPOSID AIM DRAWINGS � m MI.ua�a wrr�w�
SHEET NO. ac ro oalPe a P.mue R ne 01ANGID OR COPIED IN ANY DRAWN
DATE a P ASSOCIATES T�CR M�NNTR wuTSOEWi
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'2"3 MAIN STREET 141 MmN—=lo •TNMIOMR/PORT•w 02673 AMD-CORSMT OF NORTRSOE
BARNSTABLE, MA. �i : m "" c�0» -mlo coo»xa aem DES m
i
SYSI I PROFILE TEST � IGL� L_C7GS I BNR'N STAB L.E
EXISTING
�ACCESS COVER TO WITHIN 6" 0� FIN. GRADE 'NO3' TO SCALE} HARBOR-- - --~
VENT W/SCREEN
ACCESS COVER (WATERTIGHT) TO ENGINEER; A.OJAI A DOWNCAPE EP�iG.
MINIMUM .7;3' OF COVER OVER PRECAST ,J
WITHIN 6" OF FIN. GRADE 2% SL-)PE RK TI RFD OVER SYSTEM WHITE R S 1
a 25.5' . . 25.0t WITNESS:
SAM WF
v DATE: 9/18/Q3 HIN kH•lY r
RUN PIPE LEVEL 2" DOUBLE —_ PQtKfL TE 6A
J,-SHL'D PEASTONE — '
4 FOR FIRST 2 \ LESS THAN 2 MIN/IN
EXISTING i`•c�o v � r � PERC. RATE - __.,_._._. ___ 'L�C. S� �^
9" MIN
t GALLON SEPTIC 18.16' Q' �J
,I CLASS 1 SOILS P# 1 g572 _
TANK (H- 1 ) GAS /
__r_ _ 24.3'
BAFFLE _
-- 2 4.1 1'
F �_..J "POND VILLAGE'
2:�.90' PERC IN B HORI7O(,I --- _
_ EI-.EV. C
DEPTH OF FLOW 4 1 0` $ o ,� V 24 3'
( 7. SLOPE) 1 .._ w� _�- _ _ 2u op, ___
'TEE SIZES; ( SLOPE) 0
INLET DEPTH - '0 4 3/4 TO 1 2' i;>OUBLE WASHED STONE 23.30' A, LSAND
\.23-3W A, LSAND -
OUTLET DEPTH - 14' 10 YR 4/4 16 10 YR 4/4 23.0 LOCUS M r SCALE 1 200
16 23.0
B F.S. B F.S.
FOUNDATION— EXIST. SEPTIC TANK 5' PUMP CHAMBER 63' ' ; ACHING
._ D BOX 12' S� 10 YR 5 6 10 YR 5/6
'AC ILITY 30 / 21 .8 30 — -- 21 .8 ASSESSORS MAP 259 PARCEL_ 4
C 1 M/F,SAND Cl M/F.SAND ZONING DISTRICT: RF-1
2.5Y6/4 2.• '1'6/4 YARD SETBACKS:
6$ - - 18.6, FRONT = 30
ALARM AND CONTROL PANEL �' 6�
1 t3,6' SIDE = 15
-----ems--�-. , < � i 8... SANDY SAN DY
TO BE INSTALLED INSIDE
BUILDING. ALARM TO BE ON 72" C2 SILT GLEY 72 , C2 SILT GLEY 18.3 REAR — 15
WATER TIGHT
SEPARATE CIRCUIT FROM PUMP INV, IN 18.1 — S',AL ll LOAM L OAM
1000 GAS,. H-10 s T l_l✓ -- - �-- 1 t3.3' PLAN REF. - 136P 131
- 1OYR 6/1 1OYR 6/1
800 GAL.+ �- FLOOD ZONE: C
' ALARM ON SLOPE PRESSURE I_IP+:' (OXIDE
FLOAT SWITCH RESERVE 1/4" WEEP HOLE TO ALLOW DRAIN BACK STAINS) 120 � 14.3
SETTINGS: PUMP ON
4" WORKING RAI I-IE g" OPT. CHECK VA- ,.V` 120 14,,E
MEYERS SRM 4 _
4d, _ _ ( ;SUBMERSIBLE 1 ;.3 A,? PUMP
PUMPTC:`F� 4 j, SYSTEM (OR EQlAL)
PUMP CHA � , .� � R
(FACTOt'Y WATERPROC.F.
NO WATER OBSERVED
A D (ADD 10' FOR NIGVD)
SEPTIC C _'SIGN: (GARBAGE DISPOSER IS NOT ALLOWED 1. DATUM IS
DESIGN F OW: 1 10 = C � l,._ �_ BEDROOM.. GPD) 330 GPD MI_I ► �•T-i�aGT_,�.
(. _ 2. MUNICIPAL C I PA L. \�/1 T t.i� I
,>•. c l)Jt:. H , ...J .,hL/ llL.7i'viv t'L..L,vJ . .__.. . -..0 -- rolPl7_M0V'AL C"
4 'Vi ✓ivi ". ' , _.
., sUNSUITABLE
76
s
REQUIRED ARO, ID SEPTIC Tr°,:�IK: 4. DESIGN L.OADINf, I C R ALL PRECAST UNITS TO BE AASHO H- ._10
PERIMETER OF - _330x2=660--0 E 15C�0_MIN PER CODE
LEACHING FAt.1i. 'f1', 5. PIPE JOINTS TO BE MADE WATERTIGHT.
RE— USE 1� Q_ GALLON SEPTIC TANK (SEE NOTE 1 1) CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
>> DOWN N 5U FA(,.
a` "LE
6 ENVIRONMENTAL i TITLE y - - \ ,r SAYER,(el. 2 ;, NG: L CODE I LE V.
LEACHING:
_ REPLACE WITH SIDES: -- 0 7. THIS PLAN IS FOR {'RO°OSED WORK ONLY AND NOT TO BE
LOT � Erg j`�^ �`•�``�. G�4' l7 CLEAN MED. SA40. _ USED FOR LOT LINE STAKING,
21,400 G. FT.",, N N 9' ENGINEER TO BOTTOM: .. 30x 16 =480SF,
8. PIPE FOR SEPTIC SYSTEM TO SCH, 40--4" PVC.
49 O INSPECT AND
CERTIFY REMOV L. TOTAL: �180 S.F. 0.74 355 GPD 9. COMPONEN(S r1pT TO BE BACKFILLED ^� CONCEALED WITHOIJT
\\ ��
9` SHE Pi ,� '- � ; INSPECTION FAY BOJaRD OF HEALTH AND PERMISSIONOBTAINED
USE S STD INFILTRATORS IN A FIELD AS SHOWN FROM BOARD OF hEALTO
SPACED 4'8" BETWEEN WITH 2'4" AT SIDES AND 10, PUMP &. REMOVE (OR FILI_ W/CLEAN SAND) EXISTING FAILED
1 '2" AT ENDS FOR A 16 'x3O EFFECTIVE AREA.
SEPTIC SYSTEM COMPONENTS.
5 11 VERIFY EXISTING SEPTIC TANK TO BE WATERTIGHT AND
,
1 DOES NOT ALLOW 1HE INFILTRATION OF GPOUND WATER.
�_Q '" . 17E N
LEGEND
° ~- y 4 00.0 PROPOSED SPOT ELEVATION OF
S.T. 265,E MAIN STREET
C. ~ 100x0 EXISTING SPOT ELEVATION
COMP NENTS `\ IN THE TOWN OF:
FAIL D PROPOSED CONTOUR BARN STAR LE (POND V1 LI-AG E)
100 -- - EXISTING CONTOUR PREPARED FM
�� joy ANNE MocCONNE�_L
BENCH MARK TOP of coNe. �
BOUND ELE`/AT-ION = 19.1
- 30 0 30 60 90
BOARD OF HEALTH
WETLAND LINE MA SCALE: 1 -30, DATE: SEPT. 17.2C?03
APPROVED DATE _ _ _
---
of( 508-362-4541
j fox 508 362-9880
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down cape engineering, inc, ��PL1N of MqJ � ,Ali OF M
ARNF AIR
CIVIL. ENGINEERS
LAND SURVEYORS No.zeafa ; . �f� � !��
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