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0585 OLD JAIL LANE - Health
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MENOMONEE ....... .......... . . ..............NONE..... ........... ...... .......... . ............. �..�...........C........�....�.=�C�MOMEMMEN TOWN OF BARNSTABLE LOCATION 59,5' OLD ,AIL L#4 SEWAGE# ZOZI -080 VILLAGE JAWfMAI$L,( ASSESSOR'S MAP&PARCEL (0 INSTALLER'S NAME&PHONE NO. T D 0$ 'S S SEPTIC TANK CAPACITY I QQ0 LEACHING FACILITY.(type) s . C�+FAmIN PAS (size) Z•$ ZS' NO.OF BEDROOMS 3 / OWNER PERMIT DATE: 3 ZI COMPLIANCE DATE: 3 ZA ZI Separation Distance Between the: `` ,, 11'l Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 1\b TVA-'® 10 Jeet 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 04DJS CO. 3 C D �LC, L-J 90 , 3Z 0 -�j z 3�.5 ass No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ��/ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pphtation for MispoSal *pstem ConstCUttion 3pPrmit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components 1\ �a Location Address or Lot No. 5,25 O(_b �'�l L, Q A k)6 Owner's Name,Address and Tel.No p A 4� 1 0S RV- tARWo 7 ew s;13 Assessor's Ma /Parcel Installer's Name,Address,and Tel.No. .7 0;F-477-iF9—T7 Designer's Name,Address and Tel No. svg-�L_% '-®317 tzo 'u, 13 Lj5J2z eo -Tc Type of Building: Dwelling No.of Bedrooms Lot Size 1�e �4 3--rE- sq.ft. Garbage Grinder( ) Other Type of Building Q.SS[a jTiA-C. No.of Persons Showers( ) Cafeteria( ) Other Fixtures ` Design Flow(min.required) 3-30 gpd Design flow provided .3 07s�p gpd Plan Date j "'l® "';to a-t Number of sheets Revision Date Title 595 04-D 1,41- LAJF l WS 7, Size of Septic Tank P.O 00 CLDK)_S Type of S.A.S. [.2 5�>o AJ C�•6 a5z5 *ZO Description of Soil l 1.1 o4it7b C&)- 46-EF- 264N Nature of Repairs or Alterations(Answer when applicable) Q 5 6 40�tS7U.)6 t r Uzi alaziC) Sz;p?'f- irJK- 'M U6kV:04ale- 7D <4�!) il ob G464-d 449fe4a)(1` OiWA40&xg 11-2 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 _ Date Application Disapproved by Date for the following reasons Permit No. O I 6 Date Issued 3 / T ' �Lj „No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: „ 1 °-�� Yes PUBLIC HEALTH DIVISION - TOWN:OF BARNSTABLE, MASSACHUSETTS ,. ap lication for Nsposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) Complete System ❑Individual Components }"'` 4 n Location Address or Lot No. S-�s V�,� T�1 �� Owner's Name,Address,and Tel.No. C> ���1. I�Ri_, P. KAR�1�1 t.?�6Z Z Assessor's Map/Parcel a fie; L-D WSZ” 7 Installer's Name,Address,and Tel.No. j Og_q 77-$g-T'7 Designer's Name,Address,and Tel.No. 5'4$-;t"t 3-O 3777 Ro'j�_Zt'rr (3 d0 k Q0 SG C:k)42 rNEaU"& 33i c- r Type of Building: Dwelling No.of Bedrooms r Lot Size 7$, $ 3¢sq.ft. Garbage Grinder( ) Other Type of Building DE<�t�- jok,, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3c� gpd Design flow provided 3 gpd Plan Date 7J 16 ,Z,o 2-1 Number of sheets f Revision Date Title_ 95 OLD TAIL. 640E 8AW57. _G, Size of Septic Tank d a 0c)" Gg4LW S Type of S.A.S. L/12) ' Description of Soil I=1)y C .5j¢xj b (Z� NAA/ ,a Nature of Repairs or Alterations(Answer when applicable) (J 5 E /�3`77 ,/ (579ILLAX) SC.;7YL 7b l?Q 31 C�44.axi 4.o /A.X_r CHP6wA,9_,S u-z o Date last 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 3 j;Z 3 Application Approved by i c i' Date Application Disapproved by f„ Date 14 for the following reasons 'l r� Permit No. r�-O�- I - t5�V Date Issued'' t 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned O by P,0 Cm i A d a 1Z at 5gsz &j) T&l_ L4pff:, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 0�/"60dated "' J Installer hfj � Designer G ��(J(�C��l/L, 3`�()C„ 3Q #bedrooms Approved design flowd gp The issuance of this permit s all not be construed as a guarantee that the system will f'^wioti 1 as desi ed. Date I2+�1 7 Inspector cJ t i � K - --------------------"----_-------------------------- --1 --------------- ---------- - - -------------------------------- No. 2-0 - ( _ O✓ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS bisposal 6pstem Construction Permit Permission is hereby granted to Construct( ) -Repair(X) Upgrade( ) Abandon( ) System located at 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. / f Provided:,Construction must be completed within three years of the date of this permi / Date '- Approved by \ Y Town of Barnstable. �tM ro o Regulatory Services ' s .� Richard V. Scali, Interim Director anMsr AB MAM Public Health Division a639• .0 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3-25-21 Sewage Permit# =1 08n Assessor's Map\Parcel 276/54 Designer: —�G Evlcltrleeti(15� Installer: . Robert B. Our Co., Inc. (RBO) Address: ZSSy Crav►b2.rry Address: 363 Whites Path t;a54 ut)acx�naav► , N 62-53$ South Yarmouth, MA On 3111 V . RBO was issued'a permit to install a (da e) (installer) septic system at_585 Old Jail Lane based on a design drawn by (address) �C �o,5 ioe-e.Ci t) 10C, dated 3-10-21 (designer) X 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. Strip out (if required) was inspected and the soils were found satisfactory. 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. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed i lance with the terms of the AA approval letters (if applicable) S9 yG c • � JOHM L v CHURCHIIL JR. H ( staller's n ure) CML .11 - P o� ?SE'RIETURN ner's Signature (Affix De t p Here) PL TO ARNSTABLE PUBLIC HEALTH D ._ SION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc r, s \' 90 �•• �yso �1 .A 7�D[c, S T:4 T 1116 f�'ici=: i , CG2/ l FILD PL o PLAN TOP FO UN.D.�I T/Q^/. FEAT . FQ,e fF•�/✓r% /�i ,;:':1f:�' �!`�I/N/�s,'UM e3[U/LD/�vG S�TI�AC� OArG v/�j; s6 FQON— SIDE BySHORT - H _ ENGINEE-RI-NG ' DESIGNING BUILDING305 r DENNIS.MASS. ram/LE Commonwealth of Massachusetts Title 5 Offi-cial Inspection?"Forr Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 585 Old Jail Lane V Property Address Mark Loewen Owner Owner's Name information is {. required for Barnstable . _ MA 02668 09/26/07 every page. Cityrrown State Zip Code' Date of Inspection Inspection results must be submitted on this forma Inspection forms may not be altered in any way. A Important: A. General Information When filling out ' forms on the computer, use 1. Inspector. only the tab key to move your Robert J. Bortolotti - ' cursor-do not, Name of Inspector use the return ' key. Bortolotti.Construction;Inc.. Company Name P. O. Box 704-45 Industry Road Company Address Marstons Mills MA 02648 Cityrrown State Zip Code 508-771-9399 Telephone Number License Number B �Certification t I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system.- Passes ❑ Conditionally Passes, ❑,iails [-],.Needs Fudh t6rvaluation by the Local Approving Authority hao i. lyr pector'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 f`— s 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 DER The original should be sent to the system owner ,ti t and;copies sent to the buyer if applicable,'and:the approving authority. • r ****This report.only describes condition's 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 g the same or different conditions of use. ' t5insp•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.-,Page 1 of 15 Commonwealth of Massachusetts v Title 5 official ,Inspection Form j Subsurface Sewage. Disposal System Form -'Not for Voluntary Assessments w ; 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required-for Barnstable MA 02668 09/26/07 every page:. City/Town State Zip Code Date of Inspection" B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/a/ways.complete all of.Section.D A) System ?asses: _ I have not found an information which indicates that an of the failure.criteria described y y.- in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria.not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or.more system components as described in the"Conditio,nal Pass" section.need to be replaced or repaired.The system, upon completion of the replacement or repair, as.approved by the Board of Health, will pass. Answer yes;.no or not determined (Y, N; ND) in the ❑ for the following statements. If"not determined, please explain. ❑ The septic tank is metal and over 20 years.old# or the septic tank(whether metal,or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying;,septic tank as approved by the Board of Health. A metal septic tank will" ass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is,less than 20 years old is available. ND Explain: ❑ 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 removed t5insp 08/06 Title,5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 i Commonwealth of Massachusetts Title .5 Official `Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Old Jail Lane Property Address Mark Loewen b Owner Owner's Name . information is required for Barnstable - MA 02668 1 09/26/07 every page. City/Town State Zip Code Date of Inspection B. Certification•(cont.) B) System Conditionally Passes (cont.): ❑• . ; distribution box is leveled or.replaced, .. ND Explain: c The system required pumping more"than 4 times a year'due to broken or obstructed,pipe(s). The system will pass inspection`if(with approval of the Board of Health): ❑ broken pipe(s)are replaced. ❑ obstruction is removed s ND Explain: ,. C) Further Evaluation is Required by the Board:o_f 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. 9. System will pass unless Board of Health'determines In accordance with 310 CMR 16.303(1)(4)that the system is not functioning in a manner which will protect.public health, safety and the environment: . ❑ Cesspool or privy is within 50.feet of'a surface water Cesspool or privy is Within 50 feet-of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health.(and Public Water Supplier, if any) ri determines that the system is functioning in a.manner that protects the public health,; safety and environment: ❑3 "The system has`a septic tank and,soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. . The system has aseptic 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. l5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth.of Massachusetts Title 5 Official Inspection dorm• Subsurface Sewage Disposal System'Form,".Not for Voluntary Assessments �M 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is Barnstable MA 02668 09/26/07. . required for every page. cityrrown State Zip Code Date of Inspection. B. Certification (cont.) C Further Evaluation is Required-by-the Board of.Health cont ❑ The system has a septic tank and SAS and the-SAS is less than 100 feeteet but 50 feet or more from a private water supply well**. Method used to determine distance: **This.system.passes,if the well waterranalysis, performed.-at a.:DER certified laboratory„for coliform bacteria indicates absent:and the resence:of ammonia nitrogen and nitrate';nitro en_is equal to or . p g 9 q less than 5 ppm,,provided that no other failure criteria:are triggered'. A copy of the analysis must be attached.'to this.form. 3. Other: D) .System<Fallure Criteria .Applicable to All Systems You must indicate"Yes".or,-"Noll to each of:the following for all inspections: Yes_ No Backup of sewage into facility or system component due to overloaded or Y p. ❑ clogged SAS or.cesspool ❑_ [IDischarge or ponding.of effluent to the surface of.the ground or surface waters due to an overloaded or clogged:SAS cesspool' . Static liquid level in the distribution box,above,outlet invert due to an overloaded ❑ - or-clogged SAS,orcesspool . a Liquid depth in cesspool is less than 6' below invert or available volume is less than'/_day flow Required pumping mor6than 4 times•in the last year NOT due to clogged or Ell obstructed i e s Number of times•pumped: Any portion of he SAS, cesspool:or privy 9 9`is below hi .h round water elevation. Any portion cesspool or privy.,is within 100 feet of,a., water supply or El Eltributary,to a surface water supply: t5insp 08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•0ege'4 of 45: Commonwealth of Massachusetts u W Title 5 .0fficial Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments � 585 Old Jail Lane , Property Address Mark Loewen Owner Owner's Name _ - information is required for Barnstable MA" 02668 09/26/07 every page. Citylrown State' Zip.Code Date of Inspection g B. Certification (cont.) D) System Failure Criteria Applicable to All Systeins,(cont.) Yes No ❑ ❑' Any'portion of a cesspool or privy is wittiin,a Zone 1 of a public well: El I ❑, Any`portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform,bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain.of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- ❑ ❑ 10,000gpd: The system!ails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15,303, therefore the system fails. The system.owner should contact the Board of Health to determine what will be necessary to correct the failure.' E) Large Systems:.To be considered a.large system the system must serve a facility.with a design flow of 10,006gpd to 15,000 gpd. -.For large.systems, yo&must indicate either.°yes' or"no"to each of;the following; in addition to the questions in Section.D. Yes No y ❑ ❑. ' the system is within 400 feet of a surface drinking water supply ❑ ❑ ' ri 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 If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15, I Commonwealth of Massachusetts u W Title 5 Official . Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is rewired for Barnstable MA 02668 09/26/07 every page.ev a e. Cityrrown State Zip Code Date of Inspection .. C. Checklist Check if the following have been done. You must indicate"yes" or,"no" as to each of the following: .Yes No:.. ••- Pumping information was provided by.,the owner, occupant,.or Board of Health M 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? El ® 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? K. ❑ Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected forthe'condition-of the baffles or tees, material of construction, dimensions, depth of liquid, depth of.sludge and depth of scum? M. 0 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•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 r Commonwealth of Massachusetts Title 5 Official"Inspectio Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments"` 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required for Barnstable ' MA 02668 09/26/07 every page. CityTTown State Zip Code Date of.inspection D. System Information.: Residential Flow Conditions: r Number of bedrooms (design): 4 y ¢,Number.of'bedroom, (actual): 4 { DESIGN flow.base.d.on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 4 Number of current residents: Does residence have a garbage grinder?.M „� ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required]- ❑ Yes. ® No Laundry system inspected? El Yes ® No Seasonal use? ' ,, ❑ Yes ® No Water meter readings,-if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: " ' r current Date r Commercial/Industrial Flow Conditions: Type"of Establishment: F. Design flow.(based on 310 CMR 15:203): Gallons per day(gpd) ' Basis of design flow(seats%persons/sq.ft., etc.): Grease trap present? f. . . ° ❑^ Yes ❑ No Industrial.waste,holding tank present?. ❑ Yes ❑ No Non-sanitary waste discharged to the Title{5 system? ❑ Yes El No Water met er,readings„if available: Y Last date of occupancy/use: Date, Other(describe): t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15, w . ------------- Commonwealth of Massachusetts Title 5 Official Inspection Form a a Subsurface Sewage.Disposal-System Form,-Not for Voluntary Assessments 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required for Barnstable MA 02668 09/26/07 every page. City/Town , State Zip Code Date of Inspection D. System Information (cont.) General Information _Pumping laeoords: Source of;information: Pumping History unknown Was system pumped as part of the inspection? ❑ Yes ® No 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 fromsystem 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: Age Unknown Were sewage.odors detected when arriving at the site?, ❑. Yes ® No. t5insp•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts .w Title 5 OfficW . lnspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required for Barnstable MA 02668 09/26/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site'plan); t Depth below,grade: r.. ^s feet Material of construction: y ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: 'feet Comments (on condition of joints, venting, evidence'of leakage, etc:): • t. A Septic Tank(locate on site plan): Depth below grade: 'feet Material of construction:' ® concrete El metal' ❑ fiberglass ❑ polyethylene - ❑ othery(explain) If tank is metal, list age: years ;ls age ccnfirmed'�by ar ertificatexof Compliance?£(attach a copy of certificate) ,_❑ Yes ❑ No 85'x6'x5'. Dimensions: 3 31 Sludge depth. bistance from top of sludge to bottom of outlet tee or baffle Scum thickness rDistance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 1 How were dimensions determined? Physical observation t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth.&Massachusetts Title 5 Official: lns•pection Form•. Subsurface Sewage Disposal,,System Form-Not for Voluntary Assessments 585 Old Jail Lane Property Address p Y Mark Loewen Owner Owner's Name information is required for Barnstable... MA 0266.8 09/26/07. every page. City!Town State. Zip Code- Date of inspection D: System Information (cont.) Comments (on pumping recommendations, inlet and outlet.tee or, baffle condition, structural integrity, liquid levels as related.to outlet invert, evidence of leakage;etc.): It's a 1000 gallon precast septic tank with covers 18"to grade, it has plastic inlet and concrete outlet tees with 2" scum and 3" sludge at time of inspection. 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.): 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): t5insp-08106 Title 5 Official Inspection Form:Subsurface.Sewage Disposal System Page 10 of 15 i Commonwealth of Massachusetts Ti • ' • , _ Title 5 Offi i c a Ins ection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments M 585 Old Jail Lane - Property Address P Y Mark Loewen Owner Owner's Name information is Barnstable MA 02668 ' 09/26/07 required for • every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) _ V Tight or Holding Tank(cont.) Dimensions: j . t , Capacity: a ',gallons Design Flow: gallons per day Alarm present: ❑ -Yes ❑ No Alarm level: Alarm in working order:, ❑ Yes ❑ No Date of last pumping: Date- Comments (condition of alarm and float switches, etc.) . *Attach copy of current pumping contract(required). Is copy attached? , ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan); Depth of liquid level above outlet invert working level 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 is 28"to'grade and working level at time of inspection, Y Pump Chamber(locate on site plan): Pumps In working order: ❑ Yes ❑,,No Alarms in working order: El Yes ❑ No ;. , t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of15 Commonwealth of Massachusetts u v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required for Barnstable, MA 02668 09/26/07; ' every page. City/Town State Zip Code. Date of Inspection D. System Information (cone.) Comments(note condition of pump chamber, condition,of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required),:. . If SAS not located, explain why: Y i j Type: ® leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length--. .. ❑ leaching fields. number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: condition.of soil signs of hydraulic failure level of ondin dam soil condition of Comments note o p( 9 Y p 9 vegetation, etc.): It's a 1000 gallon precast leach pit,with cover and top of pit 28"to grade, water,level was 28 below inlet pipe with no indication of staining of being any higher at time of.inspection. l5insp•08/06. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts' Title 5 OfficialInspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is Barnstable MA "' '02668 "'N ` 09/26/07 required for , every page. City/Town State Zip Code `Date of Inspection D. System Information (cunt.) 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, . Q Yes ❑ No ' Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privy'(locate.on site plan)`. „ S Materials of construction:., Dimensions . Depth of solids Al, Comments(note condition of soil, signs of hydraulic failure,,level of ponding, condition of vegetation, etc.): t5insp-08/06 Title 5 Official Inspection Form:Subsurface Sewagebisposal System-Page 13.of 16, Commonwealth of Massachusetts Title 5 Official. inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 585 Old Jail Lane Property Address Mark Loewen Owner Owner's Name information is required for Barnstable... MA 02668 09/26/07 every page.a e. Y Cit /Town. State Zip Code Date of Inspection e D.-System Information (cont.) Sketch Of Sewage..Disposal.System: Provide a sketch of the,sewage disposal system including ties to at least two permanent reference landmarks or'benchmarks. Locate all welis'within.100 feet. Locate where public water supply enters the building: 000 (�y Cx ocD IIon l5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System,•Page 14 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 585 Old Jail Lane . Property Address Mark Loewen . Owner Owner's Name information is required for Barnstable MA, 02668 09/26/07 every page. City/Town State_ Zip Code : Date of Inspection D. System' Information (cont.) " Site Exam: ❑ Check Slope A, , ❑ Surface water ❑ Check cellar Shallow wells . Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: El -Obtained from system,design plansson record . If checked; date of design plan reviewed: F ' Date Observed site.(abutting property/observation holewithin'150 feet of SAS) ❑ Checked with local.Board of Health -explain: . ❑ Checked with local excavators, installers-(attach documentation) Accessec'USGS database-explain: rA You must describe how you established the high ground water elevation: l5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 'e Permit Number:- Date: Completed by:.. . HIGH GROUND-WATER LEVEL COMPUTATION Site Location. .: � Lot No. l l Owner:` ` -e- Address: Contractor: ". Address: =``7 Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. .......: .... .... ........,Date{ c : .r month/day/Year STEP 2 Using Water-Level.Range Zone and;Index Well.Map locate , site and determine: e OA .Appropriate index well.°..... ... ....... ....... zq7 O Water level 'range zone ....... ... .:.. .. .. .. r.• - , . .. ,. STEP 3 _.,Using monthly report"Current Water Resources.Conditions,, determine current depth to water level for index well .......... . . ........ ®� month/year. STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A);,current depth to water level for index well (STEP 3), ° ,and water level zone (STEP 26) determine wate"evel adjustment ........ . ......:. ` STEP .5 Estimate depth to Iiigh water �by subtracting the water level adjustment (STEP 4) from measured depth.to.water _ r devel•at site (STEP 1) :.. ........ Figure'11,Reproducible computation form 15 .. • I t Town of Barnstable. oFIME Regulatory Services BARNsrABLE ; Thomas F. Geiler, Director 9� 1639. •0� Public Health .Division ArFO µp,�A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: .508-190-6304 ' Ia This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts,Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future i nor does this Division agree with any technical observation s and interpretations contained within this report. - In addition,by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. Town of Barnstable ' �p 1FIE Tp� ti Regulatory Services BARNSCABLE, Thomas F. Geiler, Director 9�A 6MASS. •�� Public Health. Division rFD�,�A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 8, 2007 Korde & Assoc 321 Billerica Road Chelmsford, MA 01824 Re: 585 Old Jail Lane, Barnstable, MA 02630 The septic system located at 585 Old Jail Lane, Barnstable,MA was last inspected on February 22nd, 2997,by Patrick M. O'Connell, a certified septic inspector for the State --of-Massachusetts-.— The inspection of the septic system showed that the system"Failed"under the guidelines of 1995.TITLE 5 ( 310 CMR.15.00) due to the following: _._. Back up of sewage into facility or system component due to overloaded or clogged SAS or cesspool. D-Box is deteriorated and leaking. Tank has all solids,no liquids. Level is at%2 capacity indicating tank is leaking. You have 60 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALLEPARTMENT omas A. McKean,R.S., C.H.O. Agent of the Board of Health Y J f " COMMONWEALTH OF MASSACHUSETTS F EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS m � d DEPARTMENT OF ENVIRONMENTAL PROTECTION Jq At 4W TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION / .7-1 /4� Property Address: 585 Old Jail Lane Barnstable MA Owner's Name: Option One Mortgage Co. Owner's Address: Same Date of Inspection: February 22,2007 Job#07-34 Name of Inspector: PATRICK M. O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: �,., Ilrnrrr� Passes Conditionally Passes Needs Further Evaluat• by the Local App ving Authority �4K -X— F =u 0' 0 Inspector's Signature: � Date: 2/22/07 f! 7 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 flo'u.of 10,0001 gpd or greater,the.inspector and the system owner shall submit the report to the appropriate regional 41f e of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the,approving authority. ' ra Notes and Comments: Leaching pit has previously been full to top. W- r'I ****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. r Page 2 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section.D } A. System Passes: 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. R Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying 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. 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 removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 585 Old Jail Lane, Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,;if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I 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 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 form. 3. Other: Page 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ X Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X_ Any portion of a cesspool or privy is within a Zone I of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ 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 _Yes_(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. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd M You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well "to an question in Section E the system is considered a significant threat If you have answered yes y q y g ,or answered "yes"in Section D.above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 585 Old Jail Lane, Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _X_ Pumping information was provided by the owner,occupant, or Board of Health _X_ Were any of the system components pumped out in the previous two weeks? _X_ Has the system received normal flows in the previous two week period ? X_ Have large volumes of water been introduced to the system recently or as part of this inspection N/A Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up _X_ _ Was the site inspected for signs of break out s _X_ _ Were all system components,excluding the SAS, located on site _X _ 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 _X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems.'? t• The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no _X_ Existing information. For example,a plan at the Board of Health. _X_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CNIR 15.302(3)(b)] r - ' Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT_S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 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): 330 Number of current residents:0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Two years total: 98,000 gal.= 134 gpd. Sump pump(yes or no): No Last date of occupancy: Unknown # COMMERCIALANDUSTRIAL Type of establishment: Design flow(based an 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(yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): r , GENERAL INFORMATION , Pumping Records: None ` Source of information: Was system pumped as part of the inspection(yes or no): No ; If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_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: 1983 Were sewage odors detected when arriving at the site(yes or no): No I Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 BUILDING SEWER: XX (locate on site plan) Depth below grade: 2' Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting, evidence of leakage,etc.): . SEPTIC TANK: XX (locate on site plan) " Depth below grade: 2' Material of construction:_X_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:8.5'long x 5.2'wide—1000 gal. Sludge depth: 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 baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity; liquid levels as related to outlet invert,evidence of leakage,etc.): Tank has all solids no liquid. Level is at 1/2 capacity indicating tank is leaking. GREASE TRAP: No (locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): I Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 TIGHT or HOLDING TANK: No (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: gallons/day 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: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" 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.): Box is deteriorated and leakinE. PUMP CHAMBER: No (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 of pumps and appurtenances,etc.): Page 9 of I I • OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 585 Old Jail Lane, Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) � I If SAS not located explain why: Type _X_leaching pits,number: One 6x6 pit. leaching chambers,number: leaching galleries,number: _leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: _innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): Leaching pit was empty at time of inspection,high stains indicate pit has been full to toy CESSPOOLS: No (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 or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: No (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.): s, Page 10 of l l OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 585 Old Jail Lane, Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 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. Old Jail Lane Water Service e #58d 31 36 2 30 4 .32 .�, Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 585 Old Jail Lane,Barnstable Owner: Option One Mortgage Co. Date of Inspection: February 22,2007 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water 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) _Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: A perc test will be performed prior to repair to determine groundwater elevation. 1/4/2021 ShowAsbuilt(1700x2800) LOCATION _ ;.E AGE PERMIT NO. 107"--4t / OLD/ JAIL A ILL,- VILLAGE 8,,,,P/117/ INSTALLER'S NAME ADDRESS 1�o _ iali✓L,��T S�r,�� 7� .cJ�.�.rrsr6i<' BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2S� Yl nuvn�U https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbu ilt?mp=276054&sq=1 1/2 v v z o N rm A m � tA1 N v S � s v °4� v `� In 0 �. � i � �� � � / i � / � �`�` � i i� / � � �-� �� � r _ � � � / 0 � � �� � � � �� � „` ",�\ s - � ` � �\ � a 1 �� �`y r�� o -\ Y m ° 0 � c � R FOc F ty � I I I 0 I ys I n n J a L ---- ---------- m I Om i P 1!o"z B"Foundation Vent I l �> I I I v".e"ANmi"um van+P I i c I I I I I I _J ___L___J L___J I I I I I I "•-� r--:-1 r--- ji- � P _ F a I I •� 4 F I I m i c 0 x I I I Sig pI j _ 0 3 a I I E> c p T, Ei +I ' P SIB\I I I I`•06 n r_u_ > I I o �o �n L _J I I n I I I I I Co"x B"Foundation Vent j � I I I o".e^aiuml"um oe"+ line of oily% _ I Q __--________I . r ' —� _I I nl I S 19i1 ++� Of-ii ° p s ° D' �No 0 2 v m £, S 3 I.o ®® p E 0 n I _ IN m z z rn IM A IM a 03 N T d G°pyrlght®2012 by Ic5A desi'31— pp p qq pp�Y 4 [ - DRAWN BY: S 0 A These plans are protected underFederal l i\�ACT# 11../V I PROJECT: 2 2 Y x 4 4 AJJi4-ion for: m y Copyright Laws.The original purchaser of this I�ENNETH yAI�LE=�J�. > plan is authorized to construct one and only _ Professional Building Designer p z one home using this plan.Modlfloation or H 1 x��jj `1,+ N reuse is prohibited without express written I �IG and IGA��N LOE yy CN permission of the Designee 1 O m KSA design 5.8. Any diauepenUta,errors and/or omissions tons. A mes diffiens dr LOCATION: awlntheB LO"alnedon h notesedocuments O REVISIONS: PROFE55IONAL BUILDING DESIGN g shall lig brought to the attention Preliminary pesigns 2 1/1 2 COMMERCIAL•RE51PENTIAL C'-BeJ Old Jail Lane the Designer of constructlori'roceeding with Revised designs %/2&/1 2 Cape Cod•Massachusetts P oI-HNGhubmission 4/4/1 2 1 Ma cons[roftioncons[i[utestheaany[ante GI18n8G85te•G05C8 Rice 1�arnsa'able I_I ofncle.arrorsntsend any ca CGOdcksade5l tom•www.ksadeal tom - -IlA /PJIOL /L01. 2 7lo/O 9i 4 dis become the errore and/or of the omissions Ganstrut}ion Plans�i/2 I/12 P 9^ 9^ P k become the responsibility of the P.O.Box 114q•Hyannis.MA o 2601.508.71g0.3g22 - building contractor. c W. n _ _____ +'p P i � P O' p ±.'� n. d T � s 'n 3 a I� •D ' � @ i P 3.A. C 1 a s o Q P .Bv a I `-------. -- --- -----------� I e T 1° 10 �q d �, gal Oraf}era 9IG"o P m •P S c o > N II l° II ♦ ° ♦ - II +m c0 ti a ON P 0°.tom. 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The orlglnel purchaser of this I�eNNerN yA171-E�J�. fn T plan Is authorized to construe[one end only y -1 2 ll Professional Building Designer al>T Z y T o Z one Home using tnls plan Modlf cation or reuse iso rohbted of the express written M �� and r �•�1N LOEyy E� permission of the Designer: rn O A KSA 1e desina_ Any discrepanc ies,CYYO8nd/Or onI99iOPB a Pm LOCATION: In the n0[es,d menBions,and/or n'a REVI510N5: PROFESSIONAL BUILDING DESIGN drshellbeb ought to the attention oies y PI—limin ary peaigna%/2 1/1 2 COMMERCIAL•RESIDENTIAL ry e,rj 4VIJ�A11 LAne the of don.t,-rer uotI.r+Pro—ding withrior W the ' �eviaad designer Gape Cod•Massachusetts co p O�HHGhubmiaeion 4/4/I 2 L ne[rofthe onaticuteataedany ranee Guanacaste•Costa Rica �Arn�•S"1 AI7I ea MA of these do and any ca ecodoksadesl neom•www+ksadesi com MA /�IOL /C_o•I' 27lo/O 9P4 die betenales.errors and/or omissions Gana}rULtian Plana ei/2 1/1 2 p g 9^ P k become the—p—lbinty of the P.O.Box 1 1 49•Hyannis,MA 02601.505.1 g0.5922 building contractor. J i 2 2._0e A .o ® f Oa N � .a R ' R V ` a AndersenmTW 904lo(Terr.+one) 'E! � - o 1-2 1/B"x 4'-B 7/B" Q i P 0 � p O � P ro �. .: i':_____ o R o +3 0 } p S c 3D< i Ander.enmTw9044l,(7err...r.) - o.9'-2 1/B"x 4'-&7/B" R a ru PGloe s _i r 'Therin.T w a S + 6 a o < � 0 ° " And¢reonm rW 9 0 4lo(Terr.#onel -0 2 1/B"x 4'-e,7/B" ______________________________________________ • ____-.---_P __________________________________ 8� Andar.an.Tw,o,m tTarr,#o.a) yelux+vr�aoo n -0 J ______________________f_-------------------------- ---- _ eAnderoenm W904lo(Terr.tcnel -. --- - AndananeTyy9094fTerra#cnel yalv.•Vh000 -e 1/B•x,'-B'1/0• r.e.,99/9•.,G 9/,• P f9 U?+ e +�AZ l°� S19i1 m yn . 5 +" .. Oo po x4 o rot �i n n i _ 1 # ",-1 0" m 7'B" m `7 GN Lb, ay Ps m j N !� Copyright 02012 by l design•.a: DRAWN BY: Z 1 A These plans are protected underPederel FWACT# 1 d6,t PROJECT: 2 V X 4 41�addi•i'ion for: - - m A p Copyright Laws.The Original purchaser of this I`ENN6rN yf•I7LE� m t plan Is authorized to construct one and only c 0 Z one home using this plan.Modification or Professional Building Designer reU5e 19 pr0hiblLed WiL„OUL a%prCs9 written I �� AnJ I/ �'� i-0e )(/1�f N ; p permission of the Designer. r N 1 1 r `Xl( KSA design y p 5.d. _ A G Inthe not 6 dl C elon9,and/or es one ° PROFESSIONAL BUILDING DESIGN LOCATION: d g contained these d—ments 0 REVISIONS: _ shall be brought to the attention 21 re 19 of Plinnin.r fJeei ns%/ / COMMERCIAL•RESIDENTIAL the De9lgner prior to the commencement Y q 8 Old Mail Lane of construction Proceeding with �evis¢d designs 9/2 B/1 2 Cape Cod•Massachusetts L 1_ t�.{ construction cdnstitute9 the acceptance oIcHHGhubmi—on 4/4/12 Guanacaste•Costa'Rica f—' c,4 atA y. ••la of thesedocuments and any a /1'�l0� /Lct 271oi4 el5orep lee,errors and/aroml951one Gmnr f'r ULf•ion f l4ns r9/2 1/12 cap—dok-design.Odm•WWw.k6ade5ign.dOm M P k become the respoonLraotor.nelblli[y of the P.O.13O%1 1411•Hyannis,MA o2801•508.790.3922 builGing G 0 F c 0 ° a E 1 J 01 i ceilin I ne ppp���'Y"Z I p • 0 Ander*enoT W904G( Andernm 7W y 04G(Terrwtan¢1 Q P T r T a a � x 4'-0 7/B" :+ +' r.A.9'-2 1/B"x 4'-B 7/0" Q � r I P is I I •m I ____ealinq line a \ - f- ---i1--�'\- ----- ----- l°f S10i1 • - - OECP i �} r M is Z ca m m A ') z rn s j N d Copyright®201 3 by K5A design..v: Ip q q 4 , - DRAWN BY: I A These plans are protected under Federal �PROJECT# 188 I PROJECT: 2 V X 4 4. Addikion for: - M p D Copyright Laws.The original purchaser of this• I\ I�EI�hIErN yAI7LE�J�. rn 0 plan is authorized to construct one and only -1 Professional Building Designer Z one Home using tnls plan.ModlFication or �/ `1 reuse is prohibited of the express written I �IG And rAP—IN LO1yy CN 3 permission of the Designer.. _ A KSA design Any discrepancies errors and/or omsslons ❑1 m the notes dimensions and/or' L REVISIONS: PROFESSIONAL BUILDING DE516N LOCATION: drswaileeontaainedon th Seddo tints O Preliminary peaignc 9/2 I/I 2 COMMERCIAL•RESIDENTIAL 585OId Jail Lane the Designer prior to the commencement „ of construction Proceeding with Pevi�ed d—igne 9/25/1 2 Cape Cod a Massachusetts - construction constitutes the acceptance OIcHHG ePubmi—ion 4/4/1 2 Guanacaste•Costa Rica 13arnsa'able,Ma of these documsente and any �10e / discrep les.error and/or omissions GOnb4'rl1L}ion FIAn4 ems/2 1/1 2 capecod®ksadesign.com ww.ksadesgn.com MAP/ k LOB 2 7 fo/05 4 become the responsibility of the P.C.Box 114g•Hyannis,MA 02601.505.1 90.59]3 + -building contractor. 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K 4 /j�/� /jy� , 11� r 1� 1� L Li YY films O m + ► S \ d si(/1n,, Any ascrepaoclee,errore and/or omissions A fn FROFE5510NAL BUILDING DESIGN LOCATION: '"thenotes.elmen thee:and/or drawings notes.d1 enthee.and/or s O REVISIONS: aMig brought to the attenelon of COMMERCIAL•RESIDENTIAL the Designer prlor to the commencement �' Pra.hminary fJaelgne 9Y2 1/12 8 DId JLlil Lane of constr,cticn.Proceemng with R-evieed deeigne 9/2 B/12 Gape God•Massachusetts L �..{ construction constitutes the acceptance OIc14146 hubmi—ion 4/4/12 Guanacaste•Ooste Rica 1'�'at'ns'I"ablet � IA of these documents and any ce.cod®ksedesi com•www.ksadeei n com 1"(a /I'�'COL /Lod- 2 7&/O°7 4 disuep ties.errors a d/or omissions ' Gone}ruo}ion Plane ai/2 1/1 2 P g" 9 _ P k P y becomethe Yes onslbllit of the P.O.Box 1149•Nyannie,MA 03601.308.'i90.39]3 - builping contractor o � o > << 3 N F d > C U u m@ ? A 3 m ? w m. o _ x = _ 3 P t 3 p p - + A O s �. y. + + C P `. � � S A E B �- g � •A t 9 � � A A � � >L � o < book shelves -� Q ? n + ° i S n 71 0 + N ._J 3 9 � � ° R f 0 < i S U + rn s - _ x @ L a n T � i P < Q p + �. , ° a + + f_ + + + MAE ^S�67' s Srli � o M z z m m A m Cl j LP d 0opyright 02012 by K5A design..4: p Rq Rq q PRAM N BY: = e A The,epiansareprotectedunderPederal FWACT# h5b I PROJECT: 2 2�x 4 4'Addi -ion for: m j 0opyright Laws.The original purchaser of this hADLEP—-JP-. Y 1 M plan is autnorized to construct one and only j - Professional Building Designer Z S Z One home using this plan.MOdificetion or C re115e,prohibited of express written 1 ^M� t-Ar-IN L-oe t e1 � 1 permission of the Designer. rr N 11 r `l(1(`1`1 A } 1�5A.design=.T. Any discrepancieeerronand1oromIselone O m In the no. dimensions,and/or ° REV151ON5: PROFE5510NALBUILDINGDEVON LOCATION: 1 drehan,Inbe brought to the attention of contained on these ta ^ Preliminary fJeziyns 0/21/I 2 _ COMMEPCIAL•RE51DENTIAL eJB� Odd Jail Lane. - the Deslgnerpriorto the commencement ofcoretrprior Proceeding with �e�ised designs 9/2 6/1 2 Cape Cod•Massachusetts coretrucuon constitute,the acceptance OIcHHG hubm scion 4/4/1 2 Guanadaste•Costa Rica }�arnsa'able,Ma of thesedocumseannd/or any. ca ecodoksadesi ncom•www.ksadesl n.com -MA /I3�OL /LO�- 2 7 fo/O�J 4 die become le,error dior omission, Gons�Ne+ion Plnns S/2 I'/.I 2 p ni, 9 P k becomethe gresponsibliftq contractor, the P.O.box 1149•Hyannis,MA 02601•50a."i90.3922 - building conCredCOr. FINISH GRADE OVER D-BOX= 86.O'f � _ ' ��--++ A' T.O.F. EL.= 90.3 + FINISH GRADE OVER CHAMBERS= $6.0 85.5 t a E N I-��� I V��� f PROVIDE EXTENSION RISER � 0 3!4"TO 1-1/2" DOUBLE WASHED REMOVABLE WATER-TIGHT COVER OVER SLOPE 2/o MIN. OVER SYSTEM STONE TO CROWN OF PIPE I WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION OUTLET TO WITHIN 6 OF F.G. 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2"OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.= 89.6't F.G. OVER TANK EL. = 89.5#f 5" DIA. OUTLET(S) STONE OR GEOTEXTILE FILTER FABRIC - ----- -""" - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE TOP OF SAS= 84.33' PLACE RISERS ON ALL DESIGN ENGINEER. -EXISTING 4" PROPOSED 4" 9" MIN. W'MIN. CHAMBERS w/PIPED 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE SCH. 40 PVC ' BREAKOUT EL= 84.00INLETS TO SEWER PIPE 36 MAX. ( 83,50 36"MAX. � OF FINISHEDIGRADE SYSTEM UNLESS OTHERWISE NOTED. - ff �� 3" DROP MAX �1 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 3" 9" 6 3 2" DROP MIN _ MIN.SLOPE0�% L=80 t PROVIDE WATERTIGHT ELEVATION =84.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4 PVC IN FROM �-JOINTS (TYP.) I �wQ 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" �'`, *$6.4' SEPTIC TANK 4" PVC OUT TO 0 0 O 0 0 0 0 = = O 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 00 CONTRACTOR TO PROVIDE -- - LEACHING FACILITY o0 00 �� o 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN ! oo INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL 1z' , 2' o0 0 0 00 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF� OUTLET TEE 83.90 MIN. 83.73 00 a, 0 0 0 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE 00 C� 0 CDR D 0 0 0 0 CD FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY oo 0 0 NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 4.0' 8 5' (TYP) 4 0' 4 0' 4 0' AND DESIGN ENGINEER. ' 5 OUTLET DISTRIBUTION BOX TYP) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 90.00 TO BE INSTALLED ON A LEVEL STABLE 25.0' ( ESTABLISHED ON CORNER OF STEP AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 81 .50' GROUND WATER ELEV.= < 75.50� 12 83 9_ CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS ��?`� -, 5' MIN. �,riAMt��l� L;`,L) v Ii=V' CROSS SECTION VIEW � � 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES ''CONTRACTOR TO VERIFY EXISTING TANK PROFILE � TYPICAL CHAMBER PROFILE ?" 1� ,..`.. ,-��... TO THE DESIGN ENGINEER. DIS i mibu i ION BOA L)ETAIL CHAM TAILS ELEVATION PRIOR TO ANY WORK & SEPTIC j 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT NOT TO SCALE f NOT TO SCALE NOT TO SCALE _. _. _ f, 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING T ! F ST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM MAP 276 t APPROPRIATE AUTHORITY. PERC NO. TPT-21-20 LOT 55 �- '+; _ F • t 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED �' � . ,'t. ) INSPECTOR: David W. Stanton(BOH) S85°40'43 E \ 06 *-`' � ``` -''` UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR • �c -� �,o ,, �� /_y[, •{ f< j�. EVALUATOR: Brian Wallace, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. I vj a �' C.S.E. APPROVAL DATE: Oct. 23, 2019 .cy.I �� -- '� 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. DATE: February 26, 2021 LOCUS ""�=� • j " 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE S rAO A j q LO v v • TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. S / ` • �Jt ' '� ELEV TOP= 85.50' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, s? n ,r a,r SWING-TIES © 89 ram? , / OF q�� -; �+�� "' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). �, 4/0 � �* ' ELEV WATER= < 75.50' DESCRIPTION HC-1 HC-2 / � '�yyC ,�c ' ;; _ _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN qy PERC RATE- <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. CORNER OF STONE(1) 34.6' 21.6' ( �f `- � DEPTH OF PERC= 26 `ag L j° __ _ 16. PROPOSED PROJECT IS LOCATED WITHIN: CORNER OF STONE (2) 47.0' 31.4' ? / �� 3 fr , .� ,f + a TEXTURAL CLASS: I ASSESSOR'S MAP 276 LOT 54 N CORNER OF STONE (3) 58.0' 49.3' / � �� i � �'-- / --` .. � Sp} ` • � _ OWNER OF RECORD: MARK AND KARIN LOEWEN m CORNER OF STONE (4) 48.5' 43.8' 0" 85.50' ,.� � � � ��* - ADDRESS: 585 OLD JAIL LANE W Fill 85 25' BARNSTABLE MA 02630 FEMA FLOOD ZONE X MAP 276 \ i � � �' � .ti � •� �. r� COMMUNITY PANEL# 25001 C0558J > 1 29' 83.33' LOT 55 \ Q4RC ��O ° 17. DEED REFERENCE: BOOK 21854, PAGE 75 .,- 33 - `C 81.83' 18. PLAN REFERENCE: PLAN BOOK 342, PAGE 86 ZONE 11 19 ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. i a "` .� � 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING VY%LL NOT ASSUME ANY LIABILITY 17TJ x \ ':� 3 5Q �a 1 A "` FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. cv / `OC : w _1{ Fine Sand .. ate, EXISTING 1,000 GALLON E "`" 10Yr 614 h +� Benchmark �� „ - , _ `'� "" - ' 11 - C 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A a SEPTIC TANK TO BE ,- DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A �* N Corner of Step - > --- t UTILIZED 4N DESIGN- 1 Elev. =90.00' . 86 !/ REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. Approx. M.S.L. Bb- TOF=90.3'± =P� l / LOCUS PLAN 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL 3 m i REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. \ / SCALE: 1"= 1000' EXISTING LEACHING PIT TO 8 / No Mottling, Standing or Weeping Observed BE PUMPED, FILLED wl 8 // F�� 88 / _ CLEAN SAND & ABANDONED-----_ ✓ 'QoR asFo _ / T P- T I T D A T A - DESIGN DATA ' LEGEND 6" EXISTING �� PERC NO. TPT-21-20 LP 3-BEDROOM / 50x0' EXISTING SPOT GRADE / � INSPECTOR: David W. Stanton (BOH) . . NUMBER OF BEDROOMS 3 DWELLING / / b EVALUATOR: Brian Wallace, EIT, CSE - - - 50 - -- - EXISTING CONTOUR " DESIGN FLOW 110 GAUDAY/BEDROOM MAP 276 � TOTAL DESIGN FLOW 330 GAUDAY C.S.E. APPROVAL DATE: Oct. 23, 2019 _��, � 10' , a` / .,, DATE: 50 PROPOSED CONTOUR LOT 54 co o - February 26, 2021 50 PROPOSED SPOT GRADE 7 ±S.F. _ \ / / DESIGN FLOW x 200 /o = 660 GAUDAY TEST PIT#: 2 8,843 HC 1 C / USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 85.50' EXISTING GAS LINE U Oi / 1 // ELEV WATER= <75.50' EXISTING UNDERGROUND UTILITIES �'" � TREE CLUSTER ,/ / L/ I' a �\ SHRUB (TYP) ( HC 2 _ _ _ i=' INSTALL 2 - 500 GAL. CHAMBERS W/ STONE PERC RATE = W - w EXISTING WATER LINE Q 90 \ DEPTH OF PERC= / SIDEWALL CAPACITY % TEST PIT LOCATION ( \ s /18 / / TEXTURAL CLASS: I (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY �V (25.0' + 12.8T) (2 ) (2' ) (0.74 GPD/S.F.) =112.0 GAUDAY __ ^1 (' EXISTING 1,000 GALLON SEPTIC TANK PROP 0(b "D-BOX"----------- 2) �� BOTTOM CAPACITY 0" 85.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE C TP 2 / Fill � / 85x5' /� MAP 276 (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 3" 85.25' / \9? // / (4 / LOT 2 (25.0' x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY C3 PROPOSED DISTRIBUTION BOX 12 PROPOSED 500 GALLON LEACHING CHAMBER o TOTALS: TP 1 / TOTAL NUMBER OF CHAMBERS 2 �,'� ^ ' ' REV. DATE BY APP'D. DESCRIPTION ~ 85x5' J TOTAL LEACHING AREA 472.2 SQ.FT. - -j PROPOSED PROP TWO (2) 500 1" � INSPECTION GALLON LEACHING TOTAL LEACHING CAPACITY 349.4 GAL./DAY Fine Sand PROPOSED SEPTIC SYSTEM UPGRADE PORT CHAMBERS wt STONE C 10Yr 6/4 `90, ` �� PREPARED FOR: 4 00 4 / ROBERT B. OUR CO., INC. NOTES: 16°' LOCATED AT 29g. , - 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF N75° >>,g3, APpr f 585 OLD JAIL LANE EACH SEPTIC SYSTEM COMPONENT. 26•W COC. -E _ EXISTING BARNSTABLE, MA 02630 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE S,. E - SHED -- PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT ATE E 120 75.50 SCALE: 1 INCH = 20 FT. DATE: MARCH 10, 2021 DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF H/GNV� 0 10 20 40 80 FEET HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. �VARI,gSL AY(/�O No Mottling, Standing or Weeping Observed t� °Fs� �lOrH) ��` 6) �`` - _ _ .i. I JOHN L. PREPARED BY: 3.) PROPERTY IS LOCATED WITHIN THE WELLHEAD PROTECTION OVERLAY RESERVED FOR BOARD OF HEALTH USE I o CH CHILL JR. H JC ENGINEERING, INC. DISTRICT AND MASS DEP APPROVED ZONE If. �� NO. 418 2854 CRANBERRY HIGHWAY 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY SITE PLAN- = EAST WAREHAM, MA 02538 FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS S508.273.0377 IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL SCALE: 1"=20' NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.5557