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Home My WebLink About0032 MIDPINE RD - Health .32 Midpine Road Bamstable P ' A = 350 024 II . E A , t-`:_tom+y-s Y Page I of 1 Miorandi, Donna From: Dmeyer369@comcast.net Sent: Tuesday, January 29, 2008 9:38 AM To: Miorandi, Donna Subject: RE: Test Log Help Hi Donna. F I have been asked to give a price for a perc test for a new lot in cummaquid heights. I was curious if you could track down some'results for an adjacent lot, so I can formulate an estimate for this work. I anticipate a large strip out, so I have to plan the equipment/work accordingly. If you could just tell me how deep the silt loam/clay layer went for#32 Midpine Drive, I would appreciate it. House #32 was built in 1997. Thanks so much for your help. Darren 1/29/2008 k tT No. � _ Fee—��`-'----r--- — - BOARD OF HEALTH TOWN OF BARNSTABLE AppiicationArlVe[[ Congtructionpermit Applica "on is her b gTade for a p rmit to Construct ", ter ( ), or Repair ( )an individual Well at: -- ------9t Location — Address Assessors Map and Parcel Owr}er Address ox o 3a o� Installer.— Driller Address Type of Building Dwelling ------ -— — --- - Other - Type of Building------------ - No. of Persons--------------------- Type of Well � �� ------ Ca acit /-< Purpose of Well--- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private ell Protection Regulation — The undersigned further agrees not to well in operation un ' Ce ' icat ce has been issued b the Board of Health. lace the Y P P Signed —__---- --- -�� -- ate -7)1 — -----—— Application Approved By — — (1 date Application Disapproved for the following reasons:— ------------ ------ - -- ------- — --- ---------- ------------- date Permit No. W UG 3 ---- Issued ZF f � — -------- -- —— date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CJETIFY,� t the Individual Well Constructed (�QI, Altered ( ), or Repaired ( ) bY----------�K -c-' �'' --— -//- ---- -------------- - ---- - - ----- -- Installer at------- -�r` ,Y� ^ b ir has been installed in a ordance with the provisions of the Town of Barnstable Board of Health Private Well Pro ection W�c�3-3) 3 Regulation as described in the application for Well Construction Permit No. ------------------Dated-- - -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- --- — - -- Inspector-------- -- --——------ No. vj�Do 3=_ �_ Fee --f '--------- BOARD OF HEALTH TOWN OF BARNSTABLE AppiicationjorlVell Con5tructioriVermit Application ihereby-made for a permit to Construct (mil;-Alter ( ), or Repair ( -)an individual Well at: f Location Address Assessors Map and Parcel -- Ow er Address Installer — Driller Address / Type of Building Dwelling --- --— --- - Other -,Type of Building------------------ No. of Persons---------------------------- Type of Well CG --------- Ca acit Y yp P --- ------,-------- Purpose of Well---��-'L-__—_-------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Ce ' icate/6"I orn 'ance has been issued by the Board of Health. Signed —-------- - - -- ---- date ' Application Approved By ' --�"S ----— Idate Application Disapproved for the following reasons: ------- -- ---- i ------- --- --------/ ---r----------- date — W a v d -- �- ---- Issued'7 1�� - - -------- - - - µ Permit NO.------ — date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of ComPhance . z 16 4, THIS IS TO CERTIFY, at the Individual Well Constructed ( , Altered ( ), or Repaired ( ) c-� d--- - - -- --- -- Installer at- — � ------- ------- ----_--—--- has been installed in accordance/with the provisions of the Town of Barnstable Board of Health Private Well Pro ection w.�u�3- 3> -�; 3- Regulation as described in the application for Well Construction Permit No. --------------------Dated—� - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. I i DATE- ------ — - -- Inspector----- ----- — —------ y BOARD OF HEALTH TOWN OF BARNSTABLE Ve[[ Congtructionpermit Fee_ Permission is hereby granted , C f`Ar- -------- ----------------------------- to Construct O, Alter ( ), or Repair ( ) an Individual Well at: - - - street as shown on the application for a Well Construction Permit No.- ti/� a C10 3_ — Dated- '7 /fr 3 ---------------------------------- U Board of Health DATE — JIJN-23-2063 10 :47 All OJALH 5083629076 P. 71 /y N LOT 103 ti a � r CQir�N• lly ✓ ��5E-� � F4'.)Nb, l} 1 f�16�471br-9 ,y / 4742, J l?F a 55,2' 11i v14 Pie`161— Ct4om,-ocTAI& JF-) $ Sir ! 26,350 R ;g VAvp IRMGATION WELL S ETCH PLAN JOB # 9-6-209 ISSUED FOR HEALTH DAP•:APPROVAL LOCATION : 32 MIDPINE RD, CUMMAQUID, MA SCALE : i" = 40' DATE 6-23--03 PREPARED FOR: off s�d- 2W454, Daniel and Jennifer qjj�tla taa boa W-0680 �alr� cepe ergineering, i =. (� CIVIL XmNOINEERS}{t< LAND $011VEYORS W�::LL INSTALLATION: Clifford Well Drilling 930 main, et, yarmouth, ms. N LOT 96 LOT 103 2'20 �s. LOT 95 LOT 102 �b CONC. FOUND. TF = 55.2' 1 LOT f 04 4. 26,350 sf Jam` v ,- 9 69, 10�g0 R=186. 14 Iv� L=168. 14 �R vA7 -/01�,IS j)"gol UtJY i 1 JOB # 96-209 LOCATION 104 MIDPINE ROAD CUMMAQUID, MA SCALE 1" = 40' DATE 4uc-u4; �� lqy 7 PREPARED FOR: REFERENCE LOT 104 PB 229 PG 101 R USSE GIBSON, JR. I HEREBY CERTIFY THAT THE STRUCTURE { Of M,qS SHOWN ON THIS PLAN IS LOCATED ON THE t� �i'cyG GROUND AS SHOWN HEREON. c ARNE H Off a0b-M-4s41*0 508 IL N Np 30M2 own cape engineering, inc. ISTE cn-M nlZGnqrX-RS E�0 svxv�oxs ± I 9 LAND mam d Ya-rw . rM 02675 DATE I .,y COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PR CT�ION RECEIVED s JUN 0 6 2003 j TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 NTARY OFFICIAL INSPECTION FORM G SUBSURFACEE D SPOSAL SYSTEM FORM MENTS PART A CERTIFICATION Property Address: 33Midpine Road Cummaquid(Barnstable),MA 02637 Owner's Name: Russell and Jamie Gibson Owner's Address: 3tMidpine Road Yarmouth Port,MA 02675 Date of Inspection: May 28,2003 Name of Inspector: REED C.ELLIS MAR 3 J Company Name: ELLIS BROTHERS CONST.CO- Mailing Mailing Address: 23 ENTERPRISE ROAD, PARCEL P.O.BOX 59,YARMOUTH PORT,MA 02675 SOT A Telephone Number: 508-362-6237 'I— 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 was performed based on my function and maintenance of on site sewage disposal systems.I am a DEP training and experience in the proper approved system inspector pursuant to tion 15.340 of Title 5(310 CMR 15.004 The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails J 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 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 t ****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 some or different conditions of use. 1 r Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32 Midpine Road, Cummaquid(Barnstable),MA 02637 Owner: Russell and Jamie Gibson Date of Inspection:May 28,2003 Inspection Summary: Chec( ,B,C,D or E/ALWAYS complete all of Section D A,., rSystem Passes: Iy o I have not fo any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: L�� ' �} .L C ►J-Z B. System Conditionally Passes: Iv One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replaceme rit or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*o the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration i r tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank a approved by the Board of Health. *A metal septic tank will pass inspection if it is structur illy sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is avail ble. ND explain: 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 obstruction is rem ved distribution box is leveled or replaced ND explain: The system required pumping more than 4 time a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Heat ): broken pipe(s)are i eplaced obstruction is remo ed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 Midpine Road Cummquid(Barnstable),MA Owner: Russell and Jamie Gibson Date of Inspection:May 28, 2003 C. Further Evaluation is Required b the 9 y Board of Health: Conditions exist which require further evaluation by the rd 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 im ccordaace with 310 CMR 11303 1 system is not functioning in a manner which will rote ( )that the p public health,safety and the environment: — Cesspool or privy is within 50 feet of a surface water — Cesspool or privy is within 50 feet of a bordering vq etated wetland or a salt marsh 2. System will fail unless the Board of Health(and Publi Water Supplier,if any)determines that the system is functioning in a manner that protects the public ealth,safety and environment: _ The system has a septic tank and soil absorption syst (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water suppl . The system has a septic tank and SAS and the SAS i within a Zone 1 of a public water supply. — The system has a septic tank and SAS and the SAS i within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS i less than 100 feet but 50 feet or more from a private water supply well**.Method used to determined stance **This system passes if the well water analysis,perform at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that th well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is qual to or less than 5 m provided that no other failure criteria are triggered.A copy of the analysis must attached to this forme 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 Midpine Road, Cammaqu id,MA Owner. Russell and Jamie Gibson Date of Inspection: May 28,2003 D. System Failure Criteria applicable to all systems: You must indicate"yes"or`4nd'to each of the following for aD inspections: Yes No/ i _ V acku of sewage into facility or stem component due to overloaded or clogged SAS or cesspool P g ty system P ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or logged SAS or cesspool _-V Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool quid depth in cesspool is less than 6"below invert or available volume is less than''/a day flow - R�pquired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of unes pumped y portion of the SAS,cesspool or privy is below high ground water elevation. An portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface ter supply. portion of a cesspool or privy is within a Zone 1 of a public well. y portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 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 arettriggered.A copy of the analysis most be attached to this form.] Af v -� (Yoe The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must se e a facility with a design flow of 10,000 gpd to 15,000 g You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in additio a to the criteria above) yes no the system is within 400 feet of a surface dr' king 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 a rea(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. a owner or operator of any large system considered a significant threat under Section E or failed under Secti n D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropr' to regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 32 Midpine Road Cummquid(Barnstable),MA Owner: Russell and Jamie Gibson Date of Inspection:May 28,2003 Check if the following have been done.You must indicate es"or"no"as to each of the following: Y 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 th 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: no Yo 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)] I 5 Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 4&Midpine Road, Cammquid(Barnstable),MA Owner: Russell and Jamie Gibson Date of Inspection:May 28,2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 � DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: !6�_ Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes r no):;W[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): 7 s usage J 2_ `U�' �DOo2 goo? /31 Water meter readings,if available(last 2 year )): _. Sump pump(yes or no):it/n Last date of occupancy. !%L� COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):_ gpd Basis of design flow(seats/persons/sgketc.): Grease trap present(yes or no):, Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system es or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records d 441ePt__ Z eS Source of information: _;'2�G ? - e_ Was system pumped as part of the inspection(yes or no): If yes,volume pumped:/sallonq-•How was uanti umpe determined? Reason for pumping: .�L 2,�- ;V'V, !-9� VE 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 currant 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 cXnponents,date installed(if knowp) d s ur formation.. Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Midpine Road, Cummaquid(Barnstable),MA Owner: Russell and Jamie Gibson Date of Inspection:May 28,2003 BUILDING SEWER(locate on site plan) Depth below grade:d- Materials of constru ion:_cast iron 40 PVC other(explain): Distance from private water supply well or suction line: � Comments(op condi ion of joints,venting,evidence of 1 age,etc.): SEPTIC TANK: locate on site plan) i 2 ' Depth below grade: ?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):T(attach a copy of certificate) 61 Dimensions: O)( Sludge depth: 1�n _ U Distance from top of sludge to bottom of outlet tee or baffle: 2� Scum thickness: 23 4 y Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Yro e Comments(on pumping recommendatiods,inlet and outlet ted or baffle condi on,stru integrity,liquid levels as related to outlet invert,evidence of leakage, c.)1 �- 04- 9 5 IAE 1JC t—u—" 14 7�"*- A- : GREASE TRAP:(locate on site plan) Depth below grade:_ Material of construction: concrete mewl_fi glass_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: Comments(on pumping recommendations,inlet and o itlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of l l OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Midpine Road Cummaquid(Barnstable),MA Owner: Russell and Jamie Gibson Date of Inspection: May 28,2003 Iv V TIGHT or HOLDING TANK: (tank must be pump 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: gallonstday Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: b Comments(note if box is level and distri udon to outlets equal,any evidence of solids carryover,any evidence of 1 a e into or out of box,etc.): Ue5uA L-A1� ' • ��► � ¢i-�s S � �WS a QQ LO :✓ y 1_ 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,condition f pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Midpine Lane, Cummaquid(Barnstable),MA Owner. Russell and Jamie Gibson Date of Inspection: May 28,2003 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type , leaching pits,number:_ ' P1�kleaching chambers,number: f0 J Cip�p f h�rU1i s /N leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,dampp soil,condition of vegetation, eV* e,q.4* C-W cc 00 CESSPOOLS: (cesspool must be pumped as part inspectionxlocate 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 or no): Comments(note condition of soil,signs of hydraulic&ailIr e,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 failure- level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Midpine Lane, l �, Cummquid(Barnstable),MA 1VAY/ Owner: Russell and Jamie Gibson Date of Inspection: May 28,2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanentreference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. `t roll" 1 V' 10 Sty Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Midpine Land, Cummquid(Barnstable),MA Owner: Russell and Jamei Gibson Date of Inspection: May 28,2003 SITE EXAM _ Slope Surface water Check cellar > Shallow wells e Estimated depth to ground waterl� feet Please indicate(check)all methods used to determine the high ground water 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) ecked with local Board of Health-explain: E� ecked with local excavators,instal (attach doc og) . AccessedUSGSdatabase-explain: ,� C.Y y`✓q s You must describe how you established the high ground water elevation: q v c,/ 23 TOWN OF BARNSTABLE 6.1 Q LOCATION , �� / ' i YYgj ?tnL. RD, SEWAGE # VILLAGE ASSESSOR'S MAP & LOT �S�—oz4 INSTALLER'S NAME&PHONE NO. 1 l rQwn SEPTIC TANK CAPACITY i;S0- LEACHING FACELITY: (type) (size) NO.OF BEDROOMS 3 BUILDER OR OWNErR� .�ki P 6 . -50n PERMTTDATE: s l 7 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 I within 300 feet of leaching facility) Feet Furnished by c � 6, 7 71 G ,d� , f i 3, 7 b Ho US e No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYicatiou for �Digoot *pgtem Construction Vermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El'Complete System O Individual Components Location Add ss or, of No. Owne 's Name,Address-an Tel.No. 3,(7—-V?2 7 Set, al- Gar ceL. Assessor's lap/Pa�c el '3S0 y' .V, k,,X Iq i3 "Smk Installer's Name,Address,and Tel.No. A i- Designer's Name,Address and Tel.No. Pow-, 6 4,0c Type of Building: Dwelling No.of Bedrooms Lot Size�sq.ft. Garbage Grinder( ) Other Type of Building Sihr� —r.�%9 No. of Persons Showers( Z) Cafeteria( ) Other Fixtures_ Z J Design Flow '.3 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Alee7_" Title Size of Septic Tank �''— -,0 Type of S.A.S. 0 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: DESIGNING ENGINEER MUST SUPERVISE INSTALLATION AND CERTIFY IN WRITING Agreement: THE SYSTEM WAS INSTALLED IN STRICT The undersigned agrees to ensure the construction and maintenance of the a6FP9FRT1b% s�' ge 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 is d this Board of Health. Signed Date Application Approved b Date � Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHU@IrING ENGINEER MUST SUPERVISE INSTALLATION AND CERTIFY IN WRITING BARNSTABLE,.MASSACHUSE TUS SYSTEM WAS INSTALLED IN STRICT Certificate of (complianceCORDANcETOPLAN. THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(Repaired ( ) Upgraded( ) Abandoned( )by at r P ' f //-e 4 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. . �`/ ice dated F'�e 'q Installer Design Aldo The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector r ._ T x. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 2ppritation for Migotar 6pgtem Conttruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El-complete System ❑Individual Components ' Location Address or Lot No. �� .� ` /ter °' Ow�ny�'s Name,Address and Tel.No. 3,(Z— el 72. Assessor's.MapMarcel -550 v. ba !1 r(�fl!^S�� ✓. lX63 a Installer's Name,Address,and Tel.No. A i- Designer's Name,Address and Tel.No. -^' POW~ <✓t/i ^S%�� ' j Type of Building: y.V Dwelling No:of'Bedroonis. 3 Lot Size 2 4, 3 ;�"sq.ft. Garbage Grinder( ) Other Type of Building Sih�l� F �wr/� No. of Persons Showers(Z) Cafeteria( ) j Other Fixtures 2 VZ 4A,4 ` - - Design Flow 13 gallons per day. Calculated daily flow gallons. Plan Date 3?—Z^ 916 Number of sheets / Revision Date A/071-0 Title Size of Septic Tank /.T-6,0 A4. z Type of S.A.S. IV14-,,-0 40 .3 H4, Description of Soil X 47-`3/ .�•rsRl�'I I 1 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 jin 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 is t is Board of Health. Signed a - Date Application Approved Date Application Disapproved for the following reasons Permit No. 7— /.72 Date Issued ——————————————————————————————————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS =� Certificate of Compliance p J?X THIS IS TO CERTIFY, that the.On-site Sewage Disposal System Constructed(L-)Repaired ( )Upgraded( ) Abandon d( _)by ' at ! 4i Af, < has been constructed in accordance I' with the provisions of Title 5 and the for Disposal System Construction ermit Noy ''� dated Installer Designer z D",W/Y The.issuance of this permit shall not be construed as a guarantee that the system will function as des Date Inspector I No. "' ------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS wioo!6ar*p�tem Con�truction Permit Permission is hereby granted to Construct( )Repair( )U rade( ) bandon( ) 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 permit. Date: f) Approved by 44P 3S0 P LOCUS ZONING SUMMARY ` '11FR/ON SOT '0 BARNSTABLE ASSESSORS MAP 350 PARCEL 24 0.605 ACRES± ZONING DISTRICT: RF-2 RESIDENTIAL DISTRICT o ROSS I WITHIN D ZONE C AS LOCUS uo� R� _ SHOWN 'ON OMMUN COMMUNITY PANEL #2250001 MIN. LOT SIZE 43,560 S.F. w 0001 D ,DATED 7/2/1992 MIN. LOT FRONTAGE 150 (NOT-IN A FLOOD HAZARD ZONE) MIN. LOT WIDTH 150' o 79 �Z' HIGH NATURAL STONE Y MIN. FRONT SETBACK 30' MIN. SIDE SETBACK 15' RETAINING WALL MIN..REAR SETBACK 15' ►- ' EXIST. SHED 4si Note OKH Historic Q EXI SHED 220 MAX. BUILDING HEIGHT 30' so) s' approved plan, approved lSo SITE IS LOCATED WITHIN THE AP AQUIFER a� at 4-27-10 •meeting. PROTECTION OVERLAY DISTRICT PROP. PA110 MqP SITE IS LOCATED WITHIN THE OLD KING'S 3S6 HIGHWAY HISTORIC DISTRICT _ MODIFIED `5°?�� t #S40 ./0 ' PROPOSAL: ADD IN-GROUND POOL WITH / ' ,' ` 8 2 TEXTURED CONCRETE PATIO, MODIFY DECK PROP. �,� o°:�� '��/ . M/op/HF ROS PRIVACY DFEENC FENCING, LANDSCAPING. OOL FENCE AND 49 POOL `�� <<' S PROP. 4 POOL S hoc Y „ EXI G o b I� - 20 X41 � ECK GATES�/1L�1RM TO Note: All gates to be self EXISTING LA 1MI AREA l \closing, self-latching, alarms \ � on „g rage and slider door to oo: A oor „ oa all t de alarm \TH M ala qs F ROCKS o PROP. PAT1 s w Q� 9 S v P EXISTING 3 BEDROOM HOUSE DANIEL cyG J ti R• GN #32 MIDPINE ROAD ��' ,' \`� ; � � A' OJALA o PROP. POOL FENCE �Q P OJALA CIVIL a Z o O door \� ' , m`: P�Q- �No.40980� o No.46 02 N alarm _ :, ,\ � '.; 6 O li w , r7 / G 1 o S L O / U � � ` O A G 2 O I L 5 N � J L LQ � . �.o DA Dh0.R�lI= �. 9 . V, � PROP. EVERGREEN SHRUBS F � CD /' o,�. o A 'OJA� � . OJALA CIVIL o EXISTING SHRUBS o \ F /' 0 40980e Nd,48502 o TYP. �0 �� o� �� S SURV InEXISTING LAWN AREA Plan 4Q MAP 350 PARCEL 24 p 26;350 SF (O.o05 AC) 49 %a AGO /'GF'eP 32 IN** R LOCUS y �c, pQ /. F,O QmmiqM, MA Prepared for Daniel & Jennifer 0jala off 508-362-4541 cr ROCK t- �: �g �186• ,� O/. fax 508-362-9880 R 8' '' I downcope.com N o L�16 / 94ryy i ��Py down c4 a eo inee�in inc. P WOODEN CY �Q Q o# �� X FENCE E�� 5- � �e� � 9 R-9. X EXISTING NA AL BUFFER RISER w O / civil engineers land surveyors Scaly: 1"= 20' DATE: 4-5-2010 W 939 Main Street ( Rte 6A) I YARM0UTHPORT MA 02675 DICE # 10-008 -- -- ------ 0 10 '20 30 40 50 FEET t 10-008 O.DWG SEPTIC PROFILE TEST HOLE LOGS ----.-•-�-.� �-- --------_ _____._ T.Q.E. A7 EL. {NOT TO SCALV a ACCESS COVER TO WR}HN d' OF FIN. GRADE s ACCESS COVER (WA'ERTIG�iT! TO ENGINEER:--- fr' YY[T?411r 6' OF FIN. GRADE --' ,_ } +Gad 1NiM/>1At .7S' OF COVER OVER PRECAS- / 2% SLOPE REOUWED OVER SYSTEM � � r`'1'"VESS � � �'` RUN if PIPE f r =.lc 75 -_ ---GALLON $E.P'lC �• !t".." �'► "', '1—r""e'.""ter- ---- -` Q. Rt RATE _ TANK ( 41, "LASSSOILS � -.•,, � ~~�: r CR[1SHU, STONE OR ME�!4ANiCk DEP'i-+ OF FLOW COMPACTION.TION. (15.2211 (2]j 1 I TEE SIZES: r-Zx St-(7Pc i aP M _ t G. LOCATION MAP --—. A.SStSSORS'-MAP — +r ,:� ?AR0E� • GH µ �aa w.Ga-rr. -- ------------ � ► I- F./L,ND.ATiON-- I S[Pr� TANK - — _� — - S' 3CX ------ -- �EAl4- G tir yjXjE. M ZONE: — — ---- s z. . � SETBACKS, F'RON7, = 1 SIDE 4!. Mks? _ - : , 4 z _ _. ...,._.,.__-....- _. REAR r C 1 i�12.` V 1 DATUM ',S lam. yr l SE; C DESIGN.- 'GARBAGE J�M'�Q tJ -- ---- L. MUNICIPAL 'NATER iS ix`✓ r_ __ ._ I - 3 MINIMUM P!T�^ti Tc BE 8" RFR -J i' 1 DES G�� ;:"-OW: BEDROOMS ; S GPD', '.� ? �-" - _ I ...... 4. DESIGN SADi'vG - :�'R a._ °RECAST !ti1T�' @E .4Q.SN�-��_ . :!S= a �?NK �;pr DESIGN' F:�JW 5. PIPE ,;O N'S - - E MA E WATERTIG► CEt''C �AN4(: �0 tom^ Z_ i v[�� 'A' tit1S ,-• C - , - 'T S �� 6 -GNSTR C; Dti A� '_ R A ,�� -`-- � E'' �£ IN A�,.-. � dv. MASS SAL ON SEPTIC TANKENVIRONMENTAL. CODE T T'E )V T`ri'S PAN `S :'OR PROPOSED WORK ONLY r `SOT TO BE �JSt[' FOR LOT SINE STAKING _ _ 8. PIPE' FOR SEPTIC _YS'tM '7- SCN. 4Ct-4" PVC. .. .., ., •_s `� ` ( 8x_ :►v+ 01.4 - 33 .�P� C,n,MPONE'4TS tip" _v tSE 3At KFIL.EG OR G4i�t-EAi£D W:T / H0L {� r M' ' ;Pv r�SPeC' C 3'� 3GARC OF ALTH AND °E RM SSIGJ!� D8'AitiE- �'I ROM 9flAR5 '� HEALTH. 41 . , _ r ( 1r ...�• .....- / , a. fire G% ✓'G"�'•C.A- V''j�"�_( 4- `�e- . �.�i.. �"i' ,� _iri/^ _•_..� ,r` �r sf ,'� -�""-- '"" - c,., ;ci t ,�_;:�.-� ram, �_t•,1 Cat 4 ��-.:�. .� ��. �� _: I T E AND SEWAGE P LA N OF _ - . S",.l'T _.___ . . -__ .._.-.. _ _ ___ _j. - ^c, �.� c .�„, - s , ►s. TY l`HE TOWN OF: , 80ARD OF HEALTH rays •.�: -+".. ,.:, , l _ _ PREPARED FOR: r APPROVED DATE CI Feet SCALE: _ DATE: down cape engineering, inc. k'o Of tH of y AME CIVIL ENGINEERS A , + LAND SURVEYORS PHONE 508-362-4541 FAX 508-362-9880 JOB# - 939 main st. yarmouth, ma ' , OJA P.L.S. DATE ; -_._,_w:.a•�4is`.`a3xc.�icx��:.:F:zius.kslE":. ::s-ryr,.,c..-4k;r::».....zl' s3,c+»v.*3.4..tiei:.s_.a«xs:,.4: , 4d9.,.'A'1k.:-.w:.;*+...v..,,:...-,;..-::.ai=s Ai .s_.:1. :.' .. :,&r �t,:.ra::.:=