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HomeMy WebLinkAbout0137 MAUSHOP AVE - Health 137 MAUSHOP AVENUE Barnstable A =y278 - 046 - 001 _ i I r� Commonwealth of Massachusetts d-7s?- 0q&-001 Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments j� 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner O I w wner's Name ,-, Information is t required for every BARNSTABLE MA. 02630 10/23/2020 page. Cityrrown State Zip Code Date of Inspection � rid 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 on the computer, use only the tab Christopher Maki key to move your Name of Inspector cursor-do not Cape Cod Septic Services use the return Company Name key. 350 Main Company r� Company Address W Yarmouth MA 02673 City/Town • State Zip Code 508-775-2825 SI-14423 Telephone Number License Number B. Certification I certify that: I am a DEP approved system Inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete,as of the time of my inspection; and the inspection was performed based on my.training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 10/26/2020 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 16 r Commonwealth of Massachusetts r Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r~ 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is ABLE MA 02630 10/23/2020 required for every BARNST � ' page. City/Town State Zip code Date of Inspection 4 C. Inspection Summary Inspection Summary: Complete 1,2 21, or 5 and all of 4 and 6. ' 1) System Passes: f' r ® I have not found any information which indicates that any of the failure criteria described . in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. ' Comments: SYSTEM IS IN WORKING CONDITION 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): — s t51nap.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r Commonwealth of Massachusetts 4 < Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form-.Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name Information Is required for every BARNSTABLE MA 02630 10/23/2020 t. � �- T. page. City/town State Zip Code Date of Inspection C, Inspection Summary (cont.) 2) System Conditionally.Passes (cont.): ❑ Pump Chamber pumps/alarrms not operational:`System will pass with Board of Health approval if pumps/alarms re 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 replacedr ❑ Y ❑ N ❑ ND(Explain below): 0 obstruction is removed ❑ Y 0, N, ❑ AND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping-more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the'Board of Health): ❑ broken pipe(s)are replaced • ❑ Y ❑ N '❑ ND,(Explain below): ❑ obstruction is removed, i ❑ Y ❑ N•:M❑ ND (Explain below): • 3) Further Evaluation is Required bythe Board of Health: r ❑ 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. t a. System-will pass unless Board of Health determines in accordance with 310 CMR 16.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5lnsp.doc•rev.7/2 812 01 8 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 + c Commonwealth of Massachusetts 1 Title 5 Official Inspection Form10, l� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 137 MAUSHOP AVE v Property Address s. BRIAN BURBIC Owner Owner's Name - information Is BARNSTABLE MA._. 02630 f required for every 10/23/2020 • page. City/Town State Zip Code, ` R'- Date of Inspection C. Inspection Summar ❑. Cesspool or privy is within 50 feet of a' surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetlandor 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: r ❑ 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. r ' ❑ 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 failurecriteria are triggered. A copy of the analysis must be attached to this form. c. Other: r 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 ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ' ❑ ® Discharge or ponding of effluent to the surface of the ground'or surface waters due to an overloaded or clogged SAS or cesspool l5insp.doc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts r r . Title 5 Official Inspection Form • ` Subsurface Sewage Disposal System Form Not for Voluntary Assessments 137 MAUSMOP AVE Property Address F BRIAN BURBIC Owner Owner's Name information is BARNSTABLE MA 02630, 10/23/2020 required for every =� . page. City/Town State Zip Code ' Date of Inspection C. Inspection Summary,(cont) k F s 4) System Failure Criteria Applicable to All Systems (cont.) Yes No ❑ ®" Static liquid level in the distribution box above outlet invert due to,an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow., w ' Required pumping more than 4 times in the last year NOT due to clogged or 4 ® obstructed pipe(s). Number of times pumped: r ❑ Z Any portion of the SAS, cesspool or privy is belowhigh ground water elevation., ❑ ® Any portion'of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of.a cesspool,or privy is within a Zone 1 of a public water supply , well ❑ . ® Any portion of,a cesspool or privy is within 50 feet of a private water supply,well. Z" Any portion of a cesspool or privy is less than 100 feet but greater than 150 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 2t)00`gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one,or more of the above failure criteria exist as described in 310'CMR 15.303-E 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 iswithin 400 feet of a Surface drinking water supply ' ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection. Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Offlclal,Inspection Form:Subsurface Sewage Disposal System Page 5 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form ii Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 137 MAUSHOP AVE V Property Address BRIAN BURBIC Owner Owner's Name information is required for every BARNSTABLE MA 02630 10/23/2020 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 ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A) } ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® '❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 • Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name Information is required for every BARNSTABLE MA 02630 10/23/2020 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 6 Number of bedrooms (actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 Description: � 1 Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings-, if available last 2 ears usage '19- GPD '18- 9 ( y 9 (gpd)) GPD Detail: Sump pump? ❑ Yes ® No Last date of occupancy: CURRENT Date t5insp.doc"rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form` Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information Is required for every BARNSTABLE MA 02630 10/23/2020 page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Typeof 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 i Water treatment unit present? ❑ Yes ❑. No If yes, discharges to: k 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: 6/12/2020-CC SEPTIC SERVICES-MAINTENANCE Was system pumped as part of the inspection? ❑ Yes ® No If yes;volume pumped: gallons How was quantity pumped determined? Reason for pumping: r w t5insp,doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 18. chi Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 r 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is BARNSTABLE MA 02630 10/23/2020 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ., ❑ Single cesspool P ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any), ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy,of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2017 PER PERMIT ON FILE AT BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 22"+' feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: 101+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): LINE CHECKED WITH SEWER CAMERA AND WAS FOUND TO BE CLEAN AND PROPERLY PITCHED l5insp.doc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 18 { I c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments z 137 MAUSHOP AVE f Property Address BRIAN BURBIC l Owner Owner's Name information is required for every BARNSTABLE" MA 02630 10/23/2020 page. City/Town State- 4 lip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1211feet Material of con'structiom. ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) 6 _ • If tank is metal, list age: r years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1500 GALLON H-20 RATED Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle •Scum thickness Oil Distance from top of scum to top of outlet tee or baffle , Distance from bottom of scum to bottom of outlet tee or baffle ` ESTIMATED 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, eta): 1500 GALLON H-20 RATED TANK IN GOOD CONDITION. PVC TEES IN PLACE AND CLEAN. TANK AT NORMAL OPERATING LEVEL,COVERS 12 BELOW GRADE 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �7 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owners Name Information is required for every BARNSTABLE MA 02630 10/23/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site,plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: ` p gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name - information is BARNSTABLE MA 02630 10/23/2020 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): Depth of liquid level above outlet invert EVEN 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.): DISTRIBUTION BOX LEVEL AND WATERTIGHT t5lnsp.doc•rev.7/26/2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owrier's Name Information is required for every BARNSTABLE MA 02630 10/23/2020 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): n Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No` Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): J 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: 1 Type: ❑ leaching pits number: ® leaching chambers number: 5-500 GALLON ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is required for every BARNSTABLE MA 02630 10/23/2020 page, City/rown State Zip Code Date of Inspection D. System. Information (cont.) 11. Soil Absorption System,(SAS) (cont.) r. , Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 5-500 GALLON CHAMBERS FOUND DRY DURING INSPECTION WITH NO EVIDENT STAINING, 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration' Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev,7/26/2018 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewa9e Disposal System Form-Not for Voluntary Assessments 7 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is required for every BARNSTABLE MA 02630 10/23/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) \ 13. Privy(locate on site plan): i Materials of construction: Dimensions F Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): { t51nsp.doc•rev.7/28/2015 Title 5 Official Inspection Form:Subsurface.Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <e Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °r 137 MAUSHOP AVE v Property Address BRIAN BURBIC Owner Owner's Name information is BARNSTABLE M/A 02630 10/23/2020 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 r • F • f t, t5ine .doc-rev.7/2612018 P Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 li c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is required for every BARNSTABLE MA 02630 10/23/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope i ® Surface water. ® Check cellar ®`Shallow wells r Estimated depth to high ground water: +20' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: . 2016 Date ❑ Observed site(abutting property/observation hole within 150 feet of„SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators;'installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: ' TEST HOLE DATA PER PLAN ON FILE AT BOH, NO WATER ENCOUNTERED AT 12' l • Before filing this Inspection Report, please see Report Completeness Checklist on next page. t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 137 MAUSHOP AVE Property Address BRIAN BURBIC Owner Owner's Name information is required for every BARNSTABLE MA 02630 10/23/2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section.. ® B. Certification: Signed & Dated and 1,2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria) and 6 (Checklist) completed ® D. System Information: r 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 r t51nsp.doc•rev.7/26/2018 Titte 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 F Al::- :5v FI - z9 34 a_ httpsl/townofbamstable.us/Departments/Assesoing/Property Values/HMdlsplay.asp?mappar=278046001&seq=1 1/2 1 TOWN OF BARNSTABLE LOCATION 7 b17j�yIS��U� SEWAGE# VILLAGE �J ASSESSOR'S MAP&LOT ZT� Or-/ L INSTALLER'S NAME&PHONE NO. ���Cf �Sjf_ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO.OF BEDROOMS r BUILDER OR OWNER eT��� PERMIT DATE: 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 Q�j 30 � 3 = � 5 i o g S 3,1 = z9 " 1 b c) C�` IZ , No.,)d 1 (Q 0-3`1 x Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLAtion for Disposal *pstrm Co permit Application for a Permit to Construct WRepairviKupgrade(+) Abandon( ) Complete System ❑Individual Components Loca, tion Ad �� --���/�'� 6� Owner's Name�ddreand Tel.No. ��' Assessor'sMap/Parcel Ins ler's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. o. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow(min.required) D gpd Design flow provided 660 gpd Plan Date Number of sheets Revision Date o Title f Size of Septic-Tank D� Type of S.A.S. Description of Soil tce c�. T 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 of Health. Signed . Date Application Approved by V Date G W Application Disapproved by Date for the following reasons Permit No. o�c�((p Date Issued 7 f!6 (1(e y s v Y No. �:� k t THE COMMONWEALTH OF IV ASSACHUSETTS Entered in computer: Yes ✓ PUBLIC HEALTH DIVISION.- TOWN OF BARNSTABLE, MASSACHUSETTS i Tippfication for Disposal,6pstrm Co 'it' "tion permit Application for a Permit to Construct RepairL�Jpgrade Abandon( ) Complete System El Individual Components Locat'o Address or Lot No. AUK- ' 6" Owner's Name Address and Tel.No. �, Z y— Assessor s Ma /Parcel 7� to Ins ler's Name,Address,and Tel.No.s—• Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size S sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) 15; d gpd Design flow provided 6 0 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank IS- t j -'���/f/6/ Type of S.A.S. 1-1 $ Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: r � The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. -•. Signed 7� �y �•'� $� Date T��d_ Application Approved by Date Application Disapproved by Date for the following reasons . > Permit No. oZ ((p 1 l4 Date Issued :7/!�5 --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS S 1S r "vl° 1 /1. BARNSTABLE,MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(,,I' Repaired( ) Upgraded( ) ' Abandoned( )by u / , at � �.����� �U�s has been constructed in accordance __71 J—h with the provisions of Title 5 and the for Disposal System Construction Permit No. D I b r da ed Installer, /�� Designer 90(WA1__ #bedrooms p Approved design flow �/f� gpd The issuance of this e it shall not be co struAd as a guarantee that the system will ctioo Date p , has+ design d. V 4 Ins ector h :------------------------------------------------------------------------------------------------- No�� 1�� �?j Fee l �. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct(l/� Repair( ) Upgrade( ) Abandon( ) System located at III and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. t Date I to Approved by Town of Barnstable Regulatory Services Thomas F. Geffer,Director BARNSPABLE 59 M^ss. g PublicPublicHealth Division i6 • ♦® mp�D iwa��' Thomas McKean,Director 200 Main Street,Hyannis,NU 02601 Office: 508-862-4644 Fax: 50.8-790-6304 ICnsta➢Iler�?i& Desia ner Certification Form Date: 1 Sewage Pernnit# olG- 3yAssessoi' I�ila�iallFarcell °1 7� // Designer: owe .e rrL22v1 Instailler: e C 11 Address: 3 � ��r q Jt Address: 3J b On P issued d a permit to install a (date) (installer) septic system at r"(Qxwkj�l based on a design drawn by (a ess) 0 o dated �� 1 designer) V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes.such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above,was installed with major changes: (i.e. greater than 10'lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in.accordance with State &Local Regulations. flan revision.or certified as-built by designer to follow. OF Aq S'cry J Dr ivIEL n OJP (Installer's Signature) Cis.1 No 4G502 o o UT C vti (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLIE PUBLIC IC HEALTH )IDMSION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS (FORM AND AS 7BUMT CARD ARE RLOIEMD]BY THE IBARNSTABLIE PUBLIC HEALTH DMSION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doe ii Al Town of Barnstable P Department of Regulatory..Services Public Health Division Date �a�(5 a679 200 Main Street,HyMAM unais MA 02G01 6 � p Date Scheduled a Time Fe*e Pd. t10 0 Soi urtability Assessment for Sea e :Das 0, ;�/ W c Performed-By: f)at"l,-e ( G&(-)See 1 Vey - Witnessed By: l3 act �,®c.ATION& GENERAL INFORMATION Location Address �-- Owner's Name Z Iv(QTAQ Address /1 Assessor's Map/Parcel: TV, / O'�� Engineer's Namc f.JV P ` NEW CONSTRUCTION --L)(— REPAIR //T'•jelephone# es % Land Use: Wodd Slo — P ( ) � IVSurface Stones 'P� Distances from: Open Water Body (00 tt Possible Wet Area ft Drinking Water Well / G ft ;>lGiri rr �) Drainage Way ft Property Line >6 61 f[ Other ft SIMTCH:(Street name,dimensions of lot,exact locations of test holes& ere tests,locate wetlands-in proximity to holes) , 7.g� II " T92 CI W Q 1� Q 7 p, Pa Parent material(geologic) c,(rnC i,�� JU� Depth to Bedrock Depth to Groundwater. Standing Water in Hole: /t/��- . Weeping from Pit Rae. 4 / Estimated Seasonal High Groundwater AI/ A DET RNIINAMNFOR SEASONAL EE[GH WATER TABLE Method Used: LI/ F— Depth Observed standing in obs.hole: Id. Depth to soil mottles: In, Depth to weeping from side of obs,hole: Itt, ©roundwa orAdjunment . Index Well# -- --Reading Date:- Indox.Well Iayel _ Ac41,Actor—Adj,GroundwaterLeyal—, PERCOLATION TEST Duke III l(4 Thun 16Y.'CG Observation I' /, ^°• , 1:t- Hole# Tlmv at 9" ' `•l Depth of Perc Start Pre-soak Time @ w I v 30 Time(9"-V) End Pro-soak 10,1 I o 'I Rate Min./Inch L�``7�� t-)L 17 Site Suitability Assessment: Site Passed Sirg Failed: Additional Testing Necdcd(YIN) Original: Public health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Dlylsion at least one(1)we&prior to beginning. Q:\S EPTIC\PERCFORM.D O C �i ,- DF-EP.OBSERVA.TION HOLE LOG- Hole# _ Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other ' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stoned;boulders, o i ten:y.%%ravel) 'LIS ASS- 1�Z '�� �,/�;►� . '�°Yg 6� • DEEP OBSERVATION HOLF,LOG• .Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) ;..^.a Mottlingy (Structure,Stones,Boaldets. o is en %Grave �- SL la S/g Sgs;w Ip F5 616 YF) 6r� DEEP OBSERVATION DOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Sail ,Other* Surface(in.) *(USDA) (Munsell) Mottling (Structure,Stones,boulders. Co i to c p e S L lG Y _54 YZ ]DEEP OBSERVATION HOLE LOG Hole# �- Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structura,Stones;Bouldars, e • D `� � � 1O l Cor mistoncy, 6 • g— SL lc) Y �� o Yk 6�y Flood Insurance Rate Map: Above 500 year;Flood boundary No Yes Within 500 year boundary No v' Yes Within 100 year flood boundary No-7 Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious aterlal exist in a]i areas obgerved thrpughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious matoriall C_ertiication I certify that on � (date)I have passed the soil evaluator examination approved by the Department of Bnvironni ntal Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in�10 CMR 15.017. Signature Dalb Q:MPTTaPEliCVQRM.DOC 0 Y _ kNaPW0.LL - ICNFE WELL . 14 a v _M.._DaSH I ,0 _Llvt��p otzi-�l 4. " boy 1 - I C9 0 oysus.:. Lc-H 000 I p© hEF 000 E Y2: .M_G.L-Oftf W-umv.RY. 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VbutiTED 66oVE, k i I I ............. a —-- -- ..... _ ...._..._._._ _..-- __.._ __ -. ........_....----- 1 c, U / I 130 rLT u ,mod b J r.: kv l� _ T- , l ` • C[ncT i I i I I i ! III r — =gGnaq:?L� I I i f i Do t : E r-, - I I 15 • Hf .ter I 7 r J 77 it I i E i • 1 k { -- -- -. -- , I i,l ` _ - -. ;7-E f ._ - _ 1 r .. a--------.._—_... .---------_. --------� N LJ-- , ' E I , E i l . D �. o'(G4l,ScN?a:rnP sef�ab - MA - _ y lI (( L j 1 r1 ( , r CO Ut'rer_rY — R , { i r (� �r 1 a' \i t LEGEND SYSTEM PROFILE A SYSTEM LL COMPONENTS TAPE OR BE (Hot 10 9FNE) COMPARABLE MEANS FOR FUTURE LOCATION. ACCESS MIN.S OIWIT WATERTIGHT . -89- EXISTING CONTOUR ACCESS COVERS TO WITHIN 6'OF DN.GRADE 2°PFJSTONE OR GEOTE%IIIEGRADECONCRETE COVERS 70 WITHIN'3'GRADE ��. X 99.1 EXIST.SPOT ELEV. \ TOP FOUND.EL. 129.7 FILTER FABRIC OVER STONE -[99}--- PROPOSED CONTOUR 122 MINIMUM.7S'OF COVER GVER PRECAST 2S SLOPE REQUIRED OVER SYSTEM lO6• NOTE 2'MIN.WALL PREct41 H-x0 THICKNESS REQUIRED BLOCKS OR (98.4] PROPOSED SPOT EL NSF ) 4-oSCH40 PVC M ppTT�ppLLLL PRECAST RISERS - LOCUS TAHl T.-9UMP PIPES LEVEL 1ST Y 11.A• - CSNPONEMS 4, - . Y _ YM.UR.ebL I (TYP.) S TEST HOLE (.- ENDS SIDES 105.03. 2� IT SLOPE OF GROUND ° 4119.5 116.65' WEE SFPRC TIN%10TIE � 118.60' ��� I��, M 1p,IAVTt WATERTEST D'BOX cQx UTILITY POLE ACNE oR EMWL FOR LEVEWE11 SS - r;�.: 104.53' 104.36' 1oz2 FIRE HYDRANT -. ..... •°o °° °°o°°` LCjje HVIE H9f ALL WMBA9 MAY APPEN M efV MG " °•)°°oeo"•e°"e •vie°•vi . +...;^°•^'e•:�e�• 3/4°-1-1/2*DOUBLE WASHED STONE 4'MIN. H-10 500 GAL TEACHING CHAMBER BY ACNE PRECAST OR EQUAL �.• ALL AROUND PRECAST STRUCTURES (5)UNITS RE By B.CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE 50.50'%12.83' �6' COMPACTION.'(15.221(21), -THE INSTALLER SHALL VERIFY THE - LOCATIONS OF ALL UTILITIES AND ALL CZ'Sx SLOPE) - (18 a SLOPE) (1 x SLOPE) - BUILDING SEWER OUTLETS AND - LEACHING _ 96.o'sonoM.TH-1 ELEVATIONS PRIOR TO INSTALLING ANY FOUNDATION- 23' SEPTIC TANK 78' D' BOX 18, FACILITY NG GROUNDWATER FOUND LOCUS MAP PORTION OF SEPTIC SYSTEM - NOT TO SCALE ASSESSORS MAP 278 PARCEL 46-1 LOCUS IS WITHIN FEMA FLOOD ZONE X (AREA OF MINIMAL FLOOD HAZARD) AS SHOWN ON COMMUNITY PANEL#25001CO558J DATED 7/16/2014 - - -MAP 299 PCL 66 7 ,-- 2S�.5z. < EMILY W KELLY k CONRAD WESSELHOFT - _ -1536 PARKSIDE DR EAST \\ J ✓ `.. ✓ \--� _�-.� \//. \ 1p"H, SEATTLE, WA 98112 MAP 278 PCL 47-12 "'"-� \n✓\.- �„ `\\ \l.1�' )-- \ L BARREL HILL TRAIL - HOMEOWNERS ASSOC. TR - ' ANDREW MAHER TR 140 MONTVALE ROAD 1✓ �' `' '� - u \ \ \ - WESTON, MA 02497` A. ENGHMARK \ CONCRETE A_ 1 \ 1 1 p RE$f _ `r -149.0 NAVD8� / / / \ �, ) _ .-,9�_\, o . ( e /1 S \ \ \w l "\ _ MAP 299 PCL 93-3 J z , 1 } iL,OTI C Y- �T06 \ MUELLER FAMILY REVOCABLE TRUST 7�0 405"\E `� '89,9 Of $ 1 J / 1 ---✓ -�-\ \ \ \ \ \ 350 BOYLSTON ST'UNIT 105 - N-84� 6 _f ` \ NEWTON,MA 02459 \ \.� � > > ( 1 ( NAIlIRAL s7 /J 123 r r \FACE RFXAININ r _ , WALLiDESIGN'BY oROPOID �uEmrlTOF izs.7 8.5 11 \ PAVED DRIVE NOTES z7,. \ / NAVD 88 v '/ r 7r�'15" 1.DATUM IS 2.MUNICIPAL WATER IS AVAILABLE 3.MINIMUM PIPE PITCH TO HE 1/8"PER FOOT. 4.DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS 70 BE AASHO H-12(H-20 TANK) 5.PIPE JOINTS TO BE MADE WATER71OHM MAP 278 PCL 46-2 - 6.CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH BEACH POINT LLC ' - 310 CMR I&G00(TITLE 5.) WE MONNALE ROAD _ WESTON, MA 024937.THIS PLAN IS FOR AR BE USED FOR LOT LINE PROPOSED OR ANY OTHER WORK ONLY D NOT TO ' I� ONORMET♦:BOUN PURPOSE. " B.PIPE FOR SEPTIC SYSTEM ID SCH.40-V PVC. - SYSTEM DESIGN: �. 42 NA 9.COMPONENTS NOT TD BE 13ACKFTLLED OR CONCEALED GARBAGE DISPOSER IS NOT ALLOWED WIND T INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. 1 / 10.CONTRACTOR SHALL BE RESPONSIBLE FOR CAWNG PROPOSED 6 BEDROOM DWELLING _ _ _ \ w S CP6 i ( ( I: I DIGSAFE(I-8B8-344-7233))AND VERIFYING THE DESIGN FLOW: 6 BEDROOMS®110 GPD 660 GPD LOCATION OF ALL l•}lDERGRDUND 8 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF MURK. USE A 660 GPD DESIGN FLOW ZONING;.'SUMMARY 11.ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5'BENEATH AND AROUND THE PROPOSED SEPTIC TANK: 660 GPD(2)- 1320 ZONING DISTRICT) RG RESIDENTIAL DISTRICT - LEACHING FACILITY. N USE A 1500 GAL.SEPTIC TANK ( / MIN. LOT SIZE ;� 65,000 S.F. LEACHING: MIN. LOT WIDTH; 200' l / - SIDES:2(50.5+ 12.83)2(.74)=187 GPD MIN.LOT FRONTAGE 20' - MIN. FRONT SETBACK 30' - BOTTOM 50.5 x 12.83(.74)= 479 GPD - -- - - - MIN SIDE SETBACK 15 TOTAL: 901 S F 666 GPD MIN REAR SETBACK 15 TEST HOLE LOGS MAX BUILDING HEIGHT 30 // 1 USE(5)500 GAL. LEACHING.CHAMBERS(ACME OR EQUAL) SITE IS IN OLD KINGS HIGHWAY HISTORIC DISTRICT ENGINEER: DANIEL E.GONSALVES, SE #13587 WITH 4'STONE ALL AROUND WITNESS: DONNA MIORANDI, RS SITE IS WITHINTHE AP ZONE - DATE: 1/2/2014 ( PERC. RATE _ < 5 MIN/INCH MA _ APPROVED DATE BOARD OF HEALTH 1 - CLASS ) SOILS P{1 14258 _ 1 TITLE SITE PLAN ELEV. EItV. � - ELEV. ELEV. _ for o. 4 toe 4 4 108, 4 107' ! OF . A A 10" 10YR 3 2 106.2' 3" 10YR3/2 07.T 6" 10YR53/2 07.5' 8' 10YR 3 2 06.3' fir. #k137 .MAUSHOP AVENUE s SL G BARNSTABLE, MA B B 28" 10YR 5/8 05.T 24" 10YR 5/8 106' SL. - PREPARED FOR SL �. 28" 10YR 5/8 104.7' C1 C1 28" 10YR 5 8 04.7' FOYR 6 6 Fs W/SILT BEACH POINT- LLC - 10YR 6/6 10YR 8/6 I " - 84" 101'- 86" 100.8' PERC vERc DATE: MAY 13, MIS _ .I) J Scale:1"=20' - 0 '10 20 30 40 '50 FEET C C2 C2 C �y,1NOF N1 DANIEL. . DANIEL A F.S.W/SILT FS FS FS W/SILT ( DANIELA 11' A I[� EF 508-362-880 1OYR 6/4 1OYR 6/3 IOYR 6/3 10YR 6/4 I - OJALA OJALA _ '�/do,cape.com 0 CIVIL Na 40980„ T .downCa pe.com 132" 96' 132" SIT 138" 98' 120" SIT - o eeo e4e `•° R 0 - down cope engineer/ng,ine,. BIONA E°G YT9' 1'-IT. NO GROUNDWATER ENCOUNTERED S / civil engineers - DATE DANIEL A.OJALA, P.E..P.L:S. (11Ily�' land Surveyors- DCE #16-138 I 93YARMOUTHPORT AdA 602675 8-138 ALL SHALL TE SYSTEM PROFILE MARKEDS WITHC MAGNETIC TTAPE OR BE LEGEND COMPARABLE MEANS FOR FUTURE LOCATION. PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) 99 - EXISTING CONTOUR ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE o TOP FOUND. .EL. 129.7 FILTER FABRIC OVER STONE X 99•1 EXIST. SPOT ELEV. \ 122' 2% SLOPE REQUIRED OVER SYSTEM 108' od 6q -[99]- PROPOSED CONTOUR MINIMUM .75 OF COVER OVER PRECAST �ol�io NOTE: 2" MIN. WALL BLOCKS OR PRECAST 198.4] PROPOSED SPOT EL. RISERS (TYP.jO THICKNESS REQUIRED PRECAST RISERS LOCUS TH1 20 PIPESHLEVEL 1ST 2'40 PVC COMPONENTS icr t.: 6' MIN. SUMP 4' H-10 TEST HOLE 12. MIN. INT. DIM. INV'S EL. 104.2 4' ENDS (Np•) SIDES 105.03 2� SLOPE OF GROUND '� 1 18.85' TEE 15D0 GAL H-20 TEE , EE ,�000�000 ®Q®® 0 ®M®® ®F1®® 0 --®®®� ;00000000 SEPTIC TANK 1 18.60 > o 0 0 0 O O O o O o 0 0 0 0 °°O°o°O°o°o WATERTEST D'BOX 000000°ono 0000°°000 m, 4' LIO. LEVEL °0000°000°°000 0000°000 QO�®®®®®®®® ®®��®®Oa®® °-°-°0000 g• 0� `L GAS BAFFLE Oo�oP�°•+°-' . FOR LEVELNESS N ))-°-°0000° Q��®®0®a��® ®®®�®®®�®®® o0000000 000000 102.2 UTILITY POLE ACME OR EQUAL 000.00°oo 0 0 0 0 0 0 0 0 0 o gS 104.53' 0000 0000 ° Q FIRE HYDRANT 104.36 °°000°000 °O°O°O°O O +':;.. :...•:. ,:•;.. <- :_ • .:�:. .::....-..: --` Lane oo NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING 000000000000°°000000°°°°°°°000°°°°°°000°o°o°o°0000000 °0000°°„°°° 000R 00000000°o0 p �o 0 0 0�000°0- 3�4"-1-1�2" DOUBLE WASHED STONE 4' MIN. H-10 500 GAL LEACHING CHAMBER BY ACME PRECAST OR EQUAL. ALL AROUND PRECAST STRUCTURES (5) UNITS REQUIRED Ro 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 50.50' X 12.83' COMPACTION. (15.221 [2]) � �- *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL UTILITIES AND ALL ( 2'5% SLOPE) ( 18 % SLOPE) ( 1 7. SLOPE) ELEVATIONSUILDING SEWER PR OR TO INSTALLING ANY FOUNDATION- 23' SEPTIC TANK 78' D' BOX 1 g' LEACHING NO BOTTOM TH-1 LOCUS MAP FACILITY NO GROUNDWATER FOUND PORTION OF SEPTIC SYSTEM NOT TO SCALE ASSESSORS MAP 278 PARCEL 46-1 LOCUS IS WITHIN FEMA FLOOD ZONE X (AREA OF MINIMAL FLOOD HAZARD) AS SHOWN ON COMMUNITY PANEL #25001 CO558J - - _ DATED 7/16/2014 7 N 2s1 - MAP 299 PCL66 ,5 EMILY W KELLY & CONRAD WESSELHOFT �4 2? -1536 PARKSIDE DR EAST tv SEATTLE, WA 98112 MAP 278 PCL 47-12 BARREL HILL TRAIL HOMEOWNERS ASSOC. TR ANDREW MAHER TR / 140 MONTVALE ROAD /^ WESTON, MA 02-49� 1 _ \ \ 97 1 \ \ \ � CONCRETE BOBENCHMARK:U D� � � � r � f � 0 '4ESE � � �-99 � \ �\ \ � _ �.0 NAVD8 l RV \ I J \ f Oco A\ \ J - cco Go o � � ,- � �--•� �, � � � /� � � ,� � --1 ~ � � \ \ \� � ___,. 12) MAP 299 PCL 93-3 � Z 7�, ( /LOT \ MUELLER FAMILY REVOCABLE TRUST N g4k�4'05"� 89, Of SF - s ���� s \ \ \ \ NEWTON, MA 02459UNIT 105 � CP \ \ \ l S 12 l l \ l DECk 1 � l NATURAL ST0�1E�� �125 1 I \ FACE RI ININ WALL�ESIG,N'BY rOTHOS J E1215Y , DWELNNG �4 41 01 l 1 i PAVED \ DRIVE I \ l / � 2 � DR I CO� � � �/ 0 � f � � ( � r NOTES `� ;71.26, 1. DATUM IS NAVD 88 2 40' TU 1 g \ AVAILABLE � 2. MUNICIPAL WATER IS 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. J? f 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS TO BE AASHO H-ID (H-20 TANK) 5. PIPE JOINTS TO BE MADE WATERTIGHT. MAP 278 PCL 46-2 f ` `� / l l J✓ 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH BEACH POINT LLC 310 CMR 15.000 TITLE 5. 140 MONTVALE ROAD ( ) WESTON, MA 02493 N �• .� ,,( " �/ / 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE USED FOR LOT LINE STAKING OR ANY OTHER ENCHMAR C: PURPOSE. / ON ET1= BOUND rVM1 � 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. SYSTEM DESIGN. ,� r \ 1 ` 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED IS NOT ALLOWED ✓ \ / / ` / 1 / / / WITHOUT INSPECTION BY BOARD OF HEALTH AND GARBAGE DISPOSER1 PERMISSION OBTAINED FROM BOARD OF HEALTH. PROPOSED 6 BEDROOM DWELLING 1 I 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING w DIGSAFE (1-888-344-7233) AND VERIFYING THE DESIGN FLOW: 6 BEDROOMS ® 110 GPD = 660 GPD LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES / USE A 660 GPD DESIGN FLOW / PRIOR TO COMMENCEMENT OF WORK. ZONING. SUMMARY ` 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ^ N (� I REMOVED 5 BENEATH AND AROUND THE PROPOSED SEPTIC TANK: 660 GPD (2) = 1320 ZONING DISTRICT: RG RESIDENTIAL DISTRICT LEACHING FACILITY. USE A 1500 GAL. SEPTIC TANK MIN. LOT SIZE 65,000 S.F. N f > / LEACHING: MIN. LOT WIDTH 200' 1 1 l SIDES: 2(50.5 + 12.83) 2 (.74) = 187 GPD MIN. LOT FRONTAGE 20' MIN.. FRONT SETBACK 30 BOTTOM 50.5 x 12.83 (.74) 479 GPD MIN. SIDE SETBR,;K 15' MIN. REAR SETBACK 15' � f TOTAL: 901 S.F. 666 GPD r• � � l TEST HOLE LOGS MAX. BUILDING HEIGHT 30 / l USE (5) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) I IN PINGS HIGHWAY HISTORIC DISTRICT ENGINEER: DANIEL E. GONSALVES, SE #13587 WITH 4' STONE ALL AROUND SITE S OLD WITNESS: DONNA MIORANDI, IRS SITE IS WITHIN THE AP ZONE DATE: 1/2/2014 PERC. RATE _ < 5 MIN/INCH MA CLASS I SOILS p# 14258 APPROVED DATE BOARD OF HEALTH IT I T L E 5 S 01 T E"m F"w"'I' mL A N ELEV. ELEV. ELEV. ELEV. o» Q 107' o» Q 108' o„ Q 108' 0" 107' OF A A A A 10" 1 OYRS3/2 106.2' 3" 10YRS3/2 07.7' 6„ 1 OYRS3/2 07.5' 8„ 1 OYRS3 2 06.3' #137 MAUSHOP AVENUE B B BARNSTABLE, MA SL SL ' B - B 28" 10YR 5/8 05.7 24" 10YR 5/8 106 SL PREPARED FOR SL - 28" 10YR 5/8 104.7' C 1 C 1 28" 10YR 5/8 FS W/SILT FS W/SILT LLC „ 10YR 6/6 101' 10YR 6/6 100 8' BEACH POINT, $4 86 PERC ® . .� fit,0 9gsJ�\ PERC � �'j /�Q` , E��G� DATE. MAY 13, 2016 OANIEI A. ��� c� OJA4 t� ' O Al r >, , iL � � � N�. 4"> � e.�a Scale: l = 20 No,4650 �z r °r- s 0 10 20 30 40 50 FEET ins e, C �� C C2 C2 t1Os o�' DANIEL ti�� FS W SILT FS FS FS W/SILT ° ©F,NIELA. GNm A off 508-362-4541 / 10YR 6 4 l Q OJALA OJALA U� fax 508-362-9880 1 OYR 6/4 10YR 6/3 10YR 6/3 / No 40980 I downcope.com 132" 96, 132" 97' 138" 98' 120" 97' �o��Fc TER�� °K�s `-°� .� p �' f� . P down ca a en ineeri0 i0 ONAL E NO GROUNDWATER ENCOUNTERED S ss, civil engineers DATE DANIEL A. OJALA, P.E., P.L.S. land surveyors DCE # 6- 36 939 Main Street ( Rte 6A) YARMOUTHPORT MA 02675 16-136