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0058 OTTER LANE - Health
58 Otter Lane '. A = 351 —010 - 002 Barnstable q K 1 u S a TOWN OF BARNSTABLE LOCATION 0 q-1me SEWAGE# VILLAGE O-I SESSOR S MAP&PARCEL 351--010—dot INSTALLER'S NAME&PHONE NO. i-AW-P ` 60$--S?6-,Z(Ne SEPTIC TANK CAPACITY 10A, LEACHING FACILITY:(type) 7 ;ci u.,4 (size) 'K6 S9 NO.OF BEDROOMS OWNER CA GS l GG PERMIT DATE: (-- v® COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �k r; 3 _ �lM. .. .,,_i Sl T e - � FI �J � � � � �� I ..�. .. � � � � . � � � �, � �_. - �� � •t c { d No.&U(D 1 -iree i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes I zV"PYtcatiou for �DtZpOal �&pgtem Con0truction Vermtt Application for a Permit to Construct( ) Repair(Upgrade(%f° Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. 6C,/`^S, e Owner's Name,Address,and Tel.No. Jame }� Assessor's Map/Parcel st ler's Nam Address,and Tel.No. h Designer's Name,Address and Tel.No.bew ( j 1_, � �9"/�?dt'/� �� �,,� �______---mTTT��✓' — Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (4/9 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '33© gpd Design flow provided 3 o gpd Plan Date z�/'p� Number of sheets Revision Date Title Size of Septic Tank 16 0,C Car_.® �i�f� Type of S.A.S. Descriptiop of Soil .ems a� A epvo,�, 10 YA c kk —C4 Nature of Repairs or Alterations(Answer when applicable) �Sa D l�o Tl-sv�1< LX 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 A-VI -4, il Application.Disapproved by: Date for the following reasons - Permit No. ��� Date Issued s computer:in com THE COMMONWEALTH OF MASSACHUSETTS EnteredP PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ' Yes 12("PYication for.Dt5po5al *pgtem: QCon5truction Vermtt Application for a Permit to Construct O Repair(V�Upgrade('41612"Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Pal -I—A- I talle 0 Name"55-h,of f Tiled 110 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder (r✓� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 6P �jy �a gpd Plan Date — Number of sheets Revision Date Title , Size of Septic Tank Type of S.A.S. tDe sc 'ptio of Soil vc- fl© ` 6 r U 11SU ) .e1 � test - o eS 3 L� Yt" Nature of Repairs or Alterations(Answer when applicable) I So e y T1'n< —3 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 thi§Board of Healt . Signed .. :. lY 1. , Date F Application proved G"``• r' /.y �',.G <. Date Application'Disapproved by: Date for the following reasons r. Permit No. ao t? i Date Issued �30 — /0 t +r --—————————————=— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance F THIS IS TO CER(�FY that the On-site wa Disposal Sy tem Co ucted` `�K.�epaired (Y ) Upgraded Abandogad-(.. )b "� s at •7 / been constructed in accordance d with the pr vi ns of Ig 5 an�r Dispo al Sys s ruction Permit No.�,.') date w Installer ¢-•-• / Designer I #bedrooms Approved desi flo ® gpd The issuance o /pe fi hall not be construed as a guarantee that the system will ion as designia Date /_p Inspector -------------------------------------------- No. L V ' Fee /VU i'`�� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS x1h5pool 6potem C 3l.5trurtton Vermtt Permission is hereby gr d to t ( / Repair b U grade ( ) Aban n ) System located ate^G G� "/ 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 orb special conditions. Provided: Co strucction must be completed within three years of the date of this permit. , Date v l C? Approved by ► /`� �"� FROM :down cape engineering inc FAX NO. :15083629880 Jul. 22 2010 09:19AM P1 Jul 20 2010 11 : 45RM HP LRSERJET FRK P. To*n of Barnstable Regulatory Services i 1 Thomas V.Geller,Director mum Public Health Division Thomas McKiesin,Director 200 Mein Street,Hyannis,MA 02601 Office; 508-862-4444 fwc: 508-790.6704 �Ip tailor dt DedMK Certiltiastion Form Date; &wage Permk# �d��— � Aawmlor's MapWamel #4W/ r r Ueaigaer. Lataller: � �� Address: _ . Address; on _ -� t* r—VS044 issued a permit to install u ata) In fir septic Syst®m ntt,..... bawd on a design drawn by dated deli - 1i v_ 1 certify that the septic system refemncM above was installed subet ntnalJ . ac;c w*n .to the dpsi*n, which may include minor approved changes such ae lateral relocation of the distribution box and/or geptie tank. 1 -rrtify the' the septic system mfcrcnced above was installed with ma-or Obliges i.c. greater than 10 lateral relocation of the SAS or any vertical relocation o any component Of the septic system)but in aoawdenee with State.&Local Regulations. Plan revision or ClIlified as-buiit by designer to follow. �ytl� OF M4spI ArsVisw0 °. UANI£L - A, of OJgLf� No.40980 �Faa,4`0�' (Dosgnc-r's ignatu.e / P era OF Q:F,in WUpdWIkWppW Celli GrAtIm Y arm 3,76-04,dao Commonwealth of Massachusetts qii Title 5 Official, Inspection Form L, L 3 e ry Subsurface Sewage Disposal System Form Not for Voluntary Assessments wM V 58 Otter Lane,--- Property Address - James Rice Owner Owner's Name -- - information is required for every �P.O. Box 369, Cumma uid MA 02637 April 29, 2010 _ - p page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms. ay not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, O nM use only the tab 1. Inspector: IU,-J 1LJ( key to move your cursor-do not TroyWilliams use the return ---------=------------------- - key. Name of Inspector Troy Williams Septic Inspections r� Company Name — - - ---- —- _ — ----- — 19 Hummel Drive _ Company Address -- ---- - - — a South Dennis-.-- -- MA 02660 City/Town - - ---- State-- --- Zip Code (508) 385-1300 _ S1682 Telephone Number License Number B. Certification 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 junction 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: ❑ Passes j .p ❑ Conditionally Passes ® Falls.. ^; ❑ Needs Further Evaluation,by the Local Approving Authority a � CD -- _2,__ ____ Apnl 29, 2010 l� a zv Inspector's,Signature / Date The system inspector shall submit a copy of this inspection report to the Approving Author(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. ****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. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage aposal Syste •P�e to 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . 58 Otter Lane, Cummaquid Property Address James Rice Owner Owner's Name information is p O. Box 369, Cumma uid MA 02637 Aril 29, 2010 required for every 4 _P page. CitylTown State Zip Code Date of Inspection B. Certification (Cont.) 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. Check the box for"yes", "no" or"not determined" (Y, N; ND)for the following statements..If"not determined, please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank"as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20,years old is available. ❑ Y ❑ N ❑ ND (Explain below): N/A ._ t5ins 09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 17 E Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.- Not for Voluntary Assessments 58 Otter Lane, Cummaquid Property Address James Rice Owner Owner's Name information is required for every . Box q p O B 369, Cumma uid _MA 02637 Aril 29, 2010 _ � page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑' Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): N/A ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The. system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): N/A 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 El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh i5ins•.09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 58 Otter Lane, Cummaa uid Property Address James Rice Owner Owner's Name information is P.O. Box 369, Cumma uid MA 02637 m Aril 29, 2010 required for every q _ P page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: N/A D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool . ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑. ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than /z day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Otter Lane, Cummaquid Property Address James Rice _ Owner Owners Name information is P.O. Box 369, Cumma uid MA 02637 A rll 29, 2010 requir@d for every q � page. City/Town State. Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: N/A. ❑ ® Any portion.of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑. ® 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.] . Ej ® The system is a cesspool serving.a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ 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: For large systems, you must indicate either,"yes"or"no" to each of the following, in addition to the questions in Section D. 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 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. 15ins 09/08 Title 5 Official inspection Form:Subsurface Sewage Disposal System•.Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 58 Otter Lane, Cummaa uid Property Address ------ —— — James Rice Owner Owner's Name -- —_— ----- ------ - information is P.O. Box 369, Cumma uid MA 02637 April 29 2010 required for every q , page. City/Town 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 ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ® Have large volumes of water.been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: - ® ❑ Existing information. For example, a plan at the Board of Health. El® 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)) D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 ---- Number of bedrooms(actual): : — DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd.x#of bedrooms): . 330 gpd t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 It Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Otter Lane, Cummaquid Property Address — — -- — James Rice _ Owner Owner's Name -- --- -- — -- - information is P.O. Box 369, Cumma uid MA 02637 Aril 29, 2010 required for every _ � _ __p r ___ page. Cityffown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? El Yes ® No Water meter readings, if available last 2 ears usage d 09=141,000 gals. g ( y g (9p )) 08=157,000 gals. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occuRied Date Commercial/Industrial Flow Conditions: Type of Establishment: N/A_ Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? El Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N/A l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °w 58 Otter Lane, Cummaquid Property Address James Rice___ Owner Owner's Name information is p O. Box 369, Cumma uid MA 02637 Aril 29 2010 required for every -__-g P , page. City/Town State . Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: • N/A Date Other(describe below): N/A General Information Pumping Records: Source of information: No pure ng info available. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: N/A gallons How was quantity pumped determined? _N/A Reason for pumping N/A Type of System: ® Septic tank, distribution box;soil absorption,system , ❑ Single cesspool ❑ Overflow cesspool Privy. ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach'a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ' ❑ Other(describe): t5iA•09I08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System,-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 58 Otter Lane,_Cummaguid Property Address James Rice _ Owner Owner's Name information is P.O. Box 369, Cumma uid MA 02637 Aril 29, 2010 required for every � _� page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Tank, d-box& leach pit were installed on 8/6/85 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): _ Depth below grade: 18"+feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): -- Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.):: Flushed lines and found clear at the time of inspection. _ Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: N/A years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8'X 10.5'X 6' 1500 gallon Sludge depth: 4'' E° 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Otter Lane, Cummaquid Property Address James Rice Owner Owner's Name information is P.O. Box 369, Cumma uid MA 02637 Aril 29, 2010 required for every q _ _p page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) 2' 8„ Distance from to of sludge to bottom -- - P 9 of outlet tee or baffle Scum thickness r Distance from.top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? . Probe/measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet and outlet tees were present. No evidence of leakage or damage was found at the time of inspection. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal fiberglass ❑polyethylene ❑ other(explain):, Dimensions: N!A Scum thickness N/A _ Distance from top of scum to top of outlet tee or baffle, N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A Date t5ins•091W Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 58 Otter Lane, Cummaquid Property Address James Rice Owner Owners Name information is 0,P.O. Box 369, Cumma uid MA 02637 April 29 201 required for every q _ page. Cityrrown 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.)'' N/A Tight or Holding Tank(tank must be pumped'at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ poi eth lene y y El other(explain): Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per.day Alarm present: ❑ Yes ❑ No . Alarm level:. N/A Alarm in working order: ❑ Yes ' ❑ No Date of last pumping: N/A Date Comments (condition of alarm and float switches, etc.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t t5ins•09/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 T of 17. • • v w Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M •'y 58 Otter Lane, Cummaquid Property Address James Rice Owner Owner's Name - information is p O. Box 369, Cumma uid MA 02637 required for every � _ _ April 29, 2010 page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level with 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.): D-box was found level and in working order. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order ❑ Yes ElNo Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): N/A Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: N/A l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17, Al 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments °M 58 Otter Lane, Cummaquid Property Address James Rice Owner Owner's Name information is required for every P.O. Box 369,_ Q Cumma uid MA 02637 April 29, 2010 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leachingIts 1 -6'X6'with 2' of P number. stone ❑ 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.): Soil was sandy. Leach pit was found with water level.approx. 4"below inlet with walls found stained u to inlet line. Leachin P does not have a minimum half day flow required ed 6 th— y q _by Town of Barnstable. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan).- Number and configuration N/A Depth-top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑. Yes [] No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page_13 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Otter Lane, Cummaa uid Property Address James Rice _ Owner Owner's Name information is uid m P a.O. Box. Cum MA 02637. Aril 29, 2010 required for every �— p page. CityfFown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.).- N/A Privy (locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). N/A t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 a i z t e s Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 58 Otter Lane, Cummaguid _ Property Address James Rice _ Owner Owner's Name information is p O. Box 369, Cumma uid__ MA 02637 Aril 29, 2010 required for every q _ _ P page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately - - - - - A Z = 2 LI 3 Lt + Give. 2t t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments °.N 58 Otter Lane, Cum_ maquid Property Address James Rice Owner Owner's Name information is p O. Box 369, Cumma uid required for every _ 4 MA 02637 April 29; 2010 . page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 1T + Estimated depth to .high r.igh ground water'. feet - — - Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 4/4/84 Date ® Observed site (abutting property/observation hole.within 150 feet.of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: SDW 252 Zone A 45.6 _0'adjustment You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at a depth of 16.0'. Groundwater adjustment was 0'at the time of inspection. Bottom of leaching at 8.5'was found not to be located in the high groundwater level at the time of inspection.---.- Before filing this Inspection Report, please see Report Completeness.Checklist on next page. 15ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Otter Lane, Cummaa uid Property Address -- --- James Rice Owner Owner's Name — --- ---_ — information is P.O. Box 369, Cumma uid MA 02637 Aril 29 required for every 4 _ _ ._�_ , 2010 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimalted.depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15ins•09I08 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 i Y: a 'J f , Town Of Ba rnstaWe pit �TRE r IDepartincart of Regulatory Services DatePublic Health Division 200 Main Street,Hyannis MA 02601 9 Date Scheduled �� V� Time �0 Fee ll°d1. `oil Suitability Assessment for Seipage l isposall LOCATION & GEN]ERAL INORNI[ATI<ON Location Address Q`�e�.. L444— Owner's Name^ k/ " ' t��iT✓�5 Addess Cx. Assessor's Map/Parcel; Cngiueer's Name 0 LA) �p NEW CONSTRUCTION REPAIR Z�— TelephoneIt 36od, Land Use" ��jl f 4wC Slopes(%) 'rIMO�l Xi�� Surface Stones Distances from: Open Water Body It Possible Wet.Area _ft Drinking Water Well y V ft i Drainage Way /V ft Properly Line Ft Oilier ft , SKETCH, (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands'i6n pra(inuly to hales) ir ��. 10 Aa Parent material'(geologic) ee ct"p �`� Depth to BetlroJ k _. Depth to Groundwater: Standing Water in Hole:_ Weepilig I)oill.N Pllop Estimated Seasonal High Groundwater DETEMUNATION FOR SEASONAL HIGH WATEI R TABLE Method.Used: Depth Observed standing in obs.hole: /V la, Depth to Soil illrmlIM: -Dcplh to weeping from side of obs.holc: _ In. Grondwuter Adjustment,e Index Well lF Reading Date: Index Well level _ AdI•faeto,' A41.(Jr0L Iflwllter UVO ]PERCOLATION TEST Observation Hole# Time,at 4" _ Depth of Pere Tulip at G" � 1 5latt Pre-soak Time @ ZI;6 il5 Time ff'.4-) End Pre-soak- Rate K6./Inch G L t4h N' Site Sullabiiity;assessment: Side Passed Sk-Failed:_T Additional Testing Needed(Y/N) Original: Public Hedtth Division Observation Hole Data To Be Completed on Flack-----v-- '1� I u Ft g�er.•colatioti.lest is to l)e coxiductecl ivit➢liai 100' of W lllland, yota ni usit lIl¢-sit u otiEyY ItllRc .Barnstable Conservation Division at least one (A) weels prior to begiaminag• , DEEP.OBSE VAT16 HOL + LOB Depth from Soil Horizon Hole �' Surface(in.) Soil Texture(USDA), 5ai1 Color Soil —�--- (Munsell) •F Mottling Other D 1� g (Structure,Stones;Boulders, L S j0� Con isteac a' ravel N14 _ 5 Z S✓ L, 0 D Depth from -REP OBSERVATIO1QTH®LIB L®G Soil ilorizon �Iha]t? # v2 Surface(in.) - Soil Texture Soil Color _. _ .. (USDA) Soil Otter (fvlunseii) Mottling (Struclure,Stones, Boulders. / Consi ncy,%Gravel Depth from D E]EP O-B SIERVATION ITOLE, Soil Horizon ®� I�f®]�# Surface(in.) Soil Texture Soil Color '�` --- (USDA) Soil (Muusell) Mottling (Structuree,tStones,Boulders. /) /1 / /4- Co siste e Oher vel C� C�crraC,�— Z- -7j DER P OBSERVATION HOLE LOG Depth from Soil Horizon Dole'#— _ Surface(in.) Soil Texture Soil Color Soil (USDA) Other (Munsell ) Mottling ! (Structure,Stpnes, Boulders, Consi ten c a 1 RAI Pr - 1 i E1110d Insurance flute Map. �i Above 500 ydar.lodboundary No Yes x within 500 year boundary No Yes Within 100 year flood boundary No Yes{^y Depth of No aill 0c n raring Pervious_— aterlr�� l�oe at least four feet of naturally occurring pervious materinl exist in all areas obsel•ved throughout area proposed for the so' � ou hout P. Soil abs i; the orption s stem? � 1f not, what is the depth of naturally occurring pervious matafia'l _ : �er an 19N00n A certify that on (date)I have passed the soil evaluator examination approved by the Department of.Environmental.Protection and that the above analycjs,was performed by me consistent with 010 required training, expertise and experience described in CIO CMR 15.017. Signature_ Date • Q\S."PTICIPERCP'ORM.DOC i -010-0701 LOCATION SEWAGE PERMIT No. ® ®7Te.-z too/ G VILLAGE evkuuw.,g u/to I I N S T A LLER'S NAME & ADDRESS )e,o /Va tJ11xk)!e-iJ S U I L D R E OR OWNER DATE PERMIT ISSUED6 DATE COMPLIANCE ISSUED g 6 � r i ecil Gu No........-F-:�..... ,b F�$.... .. b THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH W.IV.._.........OF...........%5. . ..IV-5%�!rG�'- AS_lira ion for Disposal Works Tonstrnrtion Pumit • Application is hereby made for a Permit to Construct (&I or Repair ( ) an Individual Sewage Disposal System at: 677071? Z,7 3 ................ •- ......................................................... -•--.....-------••-••----••.......-----.......----•-----...........-------•---...........-•.....-- Location-Address or Lot No. .....T�t_9c�.......A.................................................................................................•----•-.... .......------------.....-----------••-----. .............................................. Owner Address W �08.�✓ ... 2rn/l�J� Installer Address Q Type of Building Size Lot.._ .6Cc......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) ok Other—Type T e of Building No. of persons............................ Showers W yP g ---------------------------- P ( ) — Cafeteria ( ) a Other fixtures ------------------------- ------ .... W Design Flow................ ............._.___..gallons per person per day. Total daily flow...............Gz0.................._gallons. PSeptic Tank—Liquid capacity.r•Ev_.gallons Length_9'G_:/.._.. Width... Diameter________-___--- Depth..4�R'.. Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area............_..__...sq. ft. Seepage Pit No---------/--------- Diameter.._../0.`...... Depth below inlet.....!L......... Total leaching area...4ZZ.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by._.!!�P?M ..... .................. .�yB _... a a Test Pit No. 1---4-_y__.minutes per inch Depth of Test Pit..��7._.....__ Depth to ground water.._1Sz_.:_....-.. (i Test Pit No. 2..G...Z..minutes per inch Depth of Test Pit....l .......... Depth to ground water-----`............. W •---•------------------•--------•---...........----------------......_•---------•...--------•---•---......................................................... 0 Description of Soil_...G '-.� " lNoop � yt �SvB=sP�c '--'v47G' /Z4"- /.f� ' L�&7Zs o� .S.gfva Ce,,1 6,Z_ V ............................................ ----•-------------------...-----------•----•------•------------......-•-------•---•---••-------•----•------..........---_...------•-----------. W -------------- ---------------------------------------------------------------------------------------------------------------------------------------------------•------------------- ------ V Nature of Repairs or Alterations—Answer when applicable................................................................................................ ............................................... ----................----------------................----•----------•-----------------------------------•--------------------------------•......---.----- Agreement: he undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with n L T = 5 of the State Sanitary Code— The undersigned further agrees not to place the system in AP I ' to of Compliance has been issued b the bo rd of health. Approved By__. - .-- 11.1..'I1. _ .� .__-�_..•_.. •-•--------•--------•---•-------------- ate Disapproved for the following r.easons--------------------------------•-----------------------•----------------------------------------------.......... .................................................................................................................................................... Date PermitNo.......................................................... Issued........................................................ Date No............Z.S -,2 .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7e-WAI.............................I.............OF....... ..................................................... Appliration for Disposal Works Tonstrurtion "rrmit i Application is hereby made for a Permit to Construct (J'} or Repair an Individual Sewage* Disposal system at- 677F7e 7- 1,1-1> .............................. .................................................................................................. Location-Address or Lot No. . ................................................................................................. .................................................................................................. e. ,Owner I Address Roo6t-A?7- le 11'e_7.A26A11CA1 �r 4- S-5 .................... ..............................04------------------------------------------------------------------ n--ife---------------------------------------------- s;a r Address Type of Building Size Lot________ .......Sq. feet U Dwelling—No. of Bedrooms..................2...........................Expansion'Attic Garbage Grinder WOther—Type of Building ............................ No. of persons............................. Showers Cafeteria Otherfixtures .................................. ..................................................................................................... Design Flow................6_� ZZO ............................gallons per person per day. Total daily flow.___._._..____...............................gu.1lons. Septic Tank—Liquid capacity?��17�a..gallons LengthjO!._!� ...... Width--'d'4....... Diameter................ Depth. Disposal Trench—No_.................... Width_....___..__________ Total Length.....................Total leaching area....................sq. f t. 7_97 Seepage Pit No.........4--------- Diameter..... ... Depth below inlet................... Total leaching area__ sq. f t. Other Distribution box Dosing tank Percolation Test Results Performed by...--F1/,*;eD..... --------_------------- DateZ�-'_ ....... 14 Test Pit No. 1_24_"-....minutes per inch Depth of Test Pit.-/'9 ---- Depth to ground water_.. ............. 44 Test Pit No. 2_L_...Z'_--minutes per inch Depth of Test Pit_..........7---------- Depth to ground water----—-------- .............................................................................................................................................................. 12,4 —7tw0-.5;Po 4 -e*y 0 Description of Soil....!;�............................................14---------------------------------------------------------------------------------------------------------------- ............................ .0'4: "g9'A/0 C/P009VCC_Z_ U . ......... .................................................................................................................................... W Z .................................................................................................... ................................................................................................. U Nature of Repairs or Alterations—Answer when applicable.-.............................................................................................. ........................................................................................................................................................................................................ Agreement: / 7'he undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with e7rovision of TIT Lrjl 5 of the State Sanitary Code— The undersigned further agrees not to place the system in o rat n U iC Ah/cate of Compliance has been issued by the board of health. ...............I........................................................ ------------------------------ -._Signed-------------- tion Approved By --. 1...!�_........................................ .......... ............ ....... ate pplication Disapproved for the following reasons:.............................................................................................................. ....................................................................................................................................................................................................... Date PermitNo....................................................... Issued_........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Intifirair.of (toutpliattrr THIS IS TO CERTIFY, That the Individual Sewage-Disposal System constructed (,,-) or Repaired by...... v: -=--------------------- - ---------------------------------- ------------------------------------------------------------------------------------------------ ....... (---) Installer at........ ... —a'i...q.................K.. ........e— ..... C. ....... .................................................................................... 7 9 has been installed in accordance with the provisions of Tj'_1 f E, of State Sanitary Code s dpscribed in the application for Disposal Works Construction Permit No_____________ .......J#.......... dated_...._. ................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAANTEE THAT THE SYSTEM WILL FPNI:TION SATISFACTORY. DATE............... ............................................ Inspector----- . ..... ......bC ... -------------------------_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 70-V/A/........... e e-4-' ...................... .OF......................................__--_------ No...........- .................................... ............. FEE.:::'................. Disposal or 5 woustrudivit ;prrmit Permissionis hereby granted.............c."?. .................................................................................................................. to Construct (&o, or�Repair a.n Indivi nal Sew e Dis I System at No.....L.;!�.... .........��_Uee ............................................................ ............................................................................... Street 130 "0 J" as shown on the application for Disposal Works Construction Permit No...�!', .......... Date 5.... .................. ..........................�(. .............................................................Board of Health DATE..........................................................................., FORM 1255 A. M. SULKIN, INC., BOSTON 'Mtiy�`y � i AV, r QI U1 AV ID V• r ' r � ir. a tt' i I - 0 � I46I • y �, I � I b i Z � z o I'A lit I I to I U L. . ZC.zG. . ... TOP OF FOUNDATION s CONCRETE COVER CONCRETE COVERS 1.50 a 4"CAST IRON OR SCHEDULE 4 2 MAX. ' 12"MAX. �� P.V.C. PIPE 4 SCHEDULE 40 P.V.C.(ONLY) ' PITCH 1/4"PER.FT. PIPE- MIN, LEACH PITCH 1/4"PER.FT. PIT PRECAST INVERT • a LEACHING EL.•Z3.7.G.. \—INVERT INVERT p • ; PIT OR SEPTIC TANK Z3 3o DI ST. z3 0 W S:' EQUIV. e INVERT — EL... .. r. . . . BOX EL....,.7 ' : >x . /.Soo.. ,, GAL. INVERT �° cF�a o ;:i; 3/4°TOIV2 EL.Z3.5 EL INVERT , W o. a WASHED p e ° ;� w STONE A3 3 ez./[So 8� PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE TIME.?.-3o Piy vow .TAco6 BOARD OF HEALTH TEST HOLE 03 TEST HOLE a4 ENGINEER ELEV. . 7-7-8cz . . . ELEV. .A 90. . DESIGN DATA : f� NUMBER OF BEDROOMS CL4y !?. . . . . . . . . TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA 78:s. . SO.FT. /PITle.P.P. Et. /1.47 S „ 88. /44 SIDE LEACHING AREA . . �. . . . . . . SQ.FT./ PIT/47/.G'PD. d�ss►�,o - GARBAGE DISPOSAL !Y°^'L� . .(50% AREA INCREASE) M��Fi!vt� Sq,va; TOTAL LEACHING AREA SQ.FT 6a�rvdz : + � B PERCOLATION RATE ?1!9 . MIN/INCH Avo w4rV19. LEACHING AREA PER PERCOLATION RATE . .. SQ.FT�C,P !9i D, . y.WATER ENCOUNTERED NUMBER OF LEACHING PITS an/� .P!T��/T1� APPROVED . . . . . . BOARD OF HEALTH ��• fG-�zTOf gS7aN ON / � S/�t5 DATE . . . . . . . . AGENT OR INSPECTOR ZH OF �Igss e l o� GnT 3 Uvv LeT ¢ , H PETITIONER : f ry�3 A/I R/Ce- 1 • t i t i = `IJ t a/ PAUL T. ANDERSON Regional Environmental Engineer .947-423-1, Sxf: 6'80-684 February 11 , 1985 This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act, General Laws, Chapter 131 , Section 40 ("the Act") : Name James H. Rice c/o CCB&T, 307 Main Street, Hyannis, Massachusetts 02601 Owner of Land Same City/Town Barnstable Location Otter Lane This project has been given the following Wetlands file number in accordance with the Act SE 3-1260 The following information is missing and must be forwarded to this office for a complete filing in accordance with the Act: ( ) Locus Map ( ) Notice of Intent ( ) Plans (x) Wetlands Regulation should be reviewed prior to hearing. Coastal Bank Buffer ( ) The plans for the sewage disposal system appear not to meet the requirements of Title 5 of The State Environmental Code. Review with the Board of Health. ( ) Application has been forwarded to the Licensing and Permits Section to determine if a Chapter 91 License or Permit is required. A decision regarding Chapter 91 jurisdiction will be issued by the Licensing and Permits Section. ( ) Detailed Notice of Intent Form 3 must be submitted. Issuance of a file number indicates only completeness of the file and not approval of the application. cc: Conservation Commission ( ) Board of Health ( ) Coastal Zone Management ( ) Water Pollution Control i HIGH GROUND-WATER LEVEL CDMPUTATIO14 [Site Locat ion: D77Z''72 / C�M�'�'�4��� A Lot "No. 3 g ' Owner: %"ers .eiG�`� Address: Contractor: i'v Address: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. . . - . . . . . . . . . . . . . . . . . . . . . date STEP 2 Using Water-Level Range Zone and Index Well Map locate .. site and determine: TZ)k, we zSz A) Appropriate index 11 . . . . . . . B) Water-level range zone . . . _ . _ p.z STEP 3 Using monthly report' Current Water Resources Conditions" determine current depth to 917 water level for index well . . . . . . 4 mo yr STEP 4 Using Table of Water-level AST_EP2A ustments for index well , current depth to water level for index well (STEP 3) , and water-level zone (STEP 2B) determine O, Z- water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP $ Estinate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water level at site (STEP 1) . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Figure 3 -7- co � , ;�, d /LA IE IV ►,.,, 411 lK '�F�b 5�� ,� : � �• �l y Pf Ita • yg I - D y �, r4 c= f I'` �\ � r fit,• cps�' b I I I b tA y I zt �- lit •, �`} SHE .Z of Z SNG-ors L. . ZC,zG. . ... TOP OF FOUNDATION s„ CONCRETE COVER CONCRETE COVERS Z,So •e a 4"CAST IRON 2"MAX. OR SCHEDULE 48 12"MAX. Jvwr P.V.C. PIPE 4"SCHEDULE 40 P.V.C.(ONLY) PITCH 1/4"PER.FT. PIPE- MIN, LEACH 1� PITCH 1/4•PER.FT. PIT PRECAST `—INVERT e Q :: LEACHING ° EL..Z3.7.4.• INVERT INVERT ! • ! PIEQUIV. e , T OR SEPTIC TANK EL Z3,3o pIOX' EL 23r97 ' ; >_ ° INVERT — a; EL.23• .. GAL. INVERT INVERT G� �a °' :;�: 3/4"TOIV2' � EL.Z'31 � ZZ o � �: WASHED EL.. . Y .. 'p o e I � � ;� W •;` STONE ' B —► --6'DIA. Ns. ♦o' DIA_ EZ. m PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P- 304 z SOIL LOG WITNESSED BY : DATE TIME.?.-3° J'9ca6/: BOARD OF HEALTH TEST HOLE TEST HOLE r¢ a--ZGEF ENGINEER ELEV. . ?.7.• 80 . . ELEV. .48.9q, wooVIDA", DESIGN DATA : -SIB-Sole SvB•Soic, NUMBER OF BEDROOMS !? Y TOTAL ESTIMATED FLOW : , z2 ? . GALLONS/DAY BOTTOM LEACHING AREA 78:''. . . SO.FT. /PITle.P.P. EZ, /7.47 144'� SIDE LEACHING AREA. . �88: ✓4.. SO.FT./ PIT/47/.CPD. EZ. /C.cjo o�c SAvo GARBAGE DISPOSAL No�/G� (50% AREA INCREASE) 6a 9 •SAD TOTAL LEACHING AREA ZG?. . . SQ.FT it &z.//.so EZ• �Z.�jo PERCOLATION RATE 77'✓a . MIN/INCH 5L 1"p s wt) f 1`1t" /Vo WgTt�72 �^"'T°`•7e' LEACHING AREA PER PERCOLATION RATE . .. T�C SQ.F ,P.p• .!?''.WATER ENCOUNTERED NUMBER OF LEACHING PITS .Qn/E� .P!T��/T/5/ APPROVED . . . . . . . . . . . BOARD OF HEALTH • fC TD` oSTD/V�` pn/ Ae-6 S/DES; DATE . . . . . . . . AGENT OR INSPECTOR 9�" ra.` ASH OF M Lo7-te3B4^1D 4, *tc OT!Z'� c� v K0 L_E`I cry) N TS PETITIONER sanrtaa�a�' S ti�3 N, RIC,E" ` r �v / om*�eo gaa4 PAUL T. ANDERSON Regional Environmental Engineer 0,2846' 947--123-1, eat: 680-6,Y4 February 11 , 1985 This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act, General Laws, Chapter 131 , Section 40 ("the Act") : Name James H. Rice c/o CCB&T, 307 Main Street, Hyannis, Massachusetts 02601 Owner of Land Same City/Town Barnstable Location Otter Lane This project has been given the following Wetlands file number in accordance with the Act SE 3-1260 The following information is missing and must be forwarded to this office for a complete filing in accordance with the Act: ( ) Locus Map ( ) Notice of Intent ( ) Plans (x) Wetlands Regulation should be reviewed prior to hearing. Coastal Bank, Buffer ( ) The plans for the sewage disposal system appear not to meet the requirements of Title 5 of The State Environmental Code. Review with the Board of Health. ( ) Application has been forwarded to the Licensing and Permits Section to determine if a Chapter 91 License or Permit is required. A decision regarding Chapter 91 jurisdiction will be issued by the Licensing and Permits Section. ( ) Detailed Notice of Intent Form 3 must be submitted. Issuance of a file number indicates only completeness of the file and not approval of the application. cc: Conservation Commission ( ) Board of Health ( ) Coastal Zone Management ( ) Water Pollution Control r Completed by HIGH GROUND-WATER LEVEL COMPUTATION Site Location: 07�72 c`r le,94D � i D Lot No. Owner: �%s}ric�s �ic�� Address: Contractor: fj�GG . SL//�u�H'�/.�I Address: Notes: qk STEP 1 Measure depth to water table to nearest 1/10 ft. date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and. determine: 57)k, A) Appropriate index we . ZSz.well B) Water-level range zone . . . . . _ D-Z, STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth to ./ 7 water level for index well . . . . . . mo yr STEP 4 Using Table of Water-level Adjustments for index well TSTEP 2AY, current depth to water level for index well Nir (STEP 3) , and water-level zone (STEP 2B) determine water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP 5 Estinate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water level at site (STEP 1) . . .Figure 3 THEODORE A. DUMAS REGISTERED SANITARIAN MASS. REG. #b 19 April 13, 1985 To Whom It May Convern: I have this date inspected an excavation on a lot on Cove Iaa Barnstable, this work was performed by the Robert Our Co, for William Shanahan. I certify clay has been removed in an area measuring Fourteen feet deep and thirty four feet in diameter,. Respectfully Submitted, OF c TH G OS. =ST ��' �NATARX /. Ln Ll C � O Q 30"x52" V I to 56"z41" T tY 30"x52" 30'x52' 30"z52" 1 Yu V EXISTING LEFT ELEVATION / nl r�'lJ EXISTING) GARAGE SIDE ELEVATION � O I .SCALE: I'-0" O z w co a I t NEW DORMER NEW DORMER NEW DORMER 19-i• f Ll! w z LLJ r! - o w O w 2953 2953 w c� 2951 2947-2 2953 2953 2953 (2)29x59 (2)29x59 (2)29z59 '' r SHEET I OF 3 ��IIII ��I'' 30"x52" Lam' PROP OSED LEFT ELEVATION PROPOSED ,GARAGE SIDE ELEVATION SCAL`EJ1/4" I'-0" JOB: 1009 DRAWN BY: KW DATE: 2/I5/I I o� 9 0 m x n Z' 23 v G� O A n m r b m � rn D m z O w z z o� AJ ril LE III 3 v w x 0 �I 0 BEICKLER RESIDENCE FINE LINE DESIGN D m 58 OTTER LANE ARGHIT -GTURAL j N GUMI�AQUID 1"IA 8 WEST BAY ROAD OSTERVILLE, MA 02055 w ELEVATIONS PHONE: 508-420-1236 l . 9 Ap QC a �1 HVI DORMER O O ND - - -- N In � n m n u 3353 w 35 3/4x53 3/4" D 2 nw Op3 � nw D mg p� w - m � w o w Z m "33 3/4x53 3/4" w O > O w w D (\may a O T O rZ O m ID O Cp AOmo� O Z r �o ®a v m �-n Z 07 3�/4'x53 3/4' DORMER 10 9'-O' 17'-0' h r BOOKS i or I I BOOKS _ m ` 3357 N\ 33 3/4"x57 3/4" 29'-0'ul - O n vq N Z 07 3/4'x53 3/4' O n N 3357 A 33 3/4"x57 3/4" V' O D'-7 In' N o 'C) (2)1I 7/0"LVL /u TRANSFER M ABOVE r31. m -NI zIA �I�O LIM l mX m m A o = g0 u Y s O � Q' rFm m Im I 4 n X a 7C 2941-2 O _ O m a nr 3341 ------ _ 33 3/4"x41 3,4" z i p W 19'r0' T Tz3 N � O z OAdu 70 m D T n I r ZFA n c 96010X V b � P I 9 1/2" LVL R D O m 5T P o � N n9 Y J O = mm �xc �z mgz �3 \ O D N BEICKLER ESIDENCE FINE LINE AR�H�TECTURALDESIGN mz " m 56 OTTER LANE cuNMAQuiD NA 8 WEST BAY ROAD OSTERVILLE, "A 02055 f 9 W PLAN PHONE: 508-420-123(3 d •"r��'^� t a� '`�' .. '.� c f"' � _ �'•asn �# '��as s �F ,i� ;� � �» �, Fl a 3 �itS i• f�... -,•ti' d t�, ..."•a-..,.,.�.R�.a '`,.�►:.s±=- a«f?,:... - s r �` ,,. h..:r„: ,. . - AC, ,�'*r„� s4 c+a4_ qc ''' SO-,y 'grin ,� —.yj ,+ $7 ,�`�'.L, a A•�. ^�?r s `," `°a e, .3,ti. W j, D a QQ O I�W14NM s s¢aw �u4r+ p 'I WIND01,SBo ow It O " w ��+W! I p DID I,I b ►R i mmaa ao ow m o u 'b Ip r ° u y w ai _ i o qwUM d WIND" • � � i .. . ice 3 of - 'f f � •' _ g�. ;wv .. BEIGKLER RESIDENCE _ 55 OTTER LANE FINE LINE ARGHITETURALDESIGN curlMAQu I D MA 8 WEST BAY ROAD-OSTERVILLE, MA 0255 o PLAN PHONE: 508-420-12-90 .o .. , t Y Y Y ey It e klo m d Ip aaa6 - ee s N4fa6 ei4 0 a ; Izz 2�as-a O _ f - •'-a� �__ eoolce ' emcs saw - - ae IV~e/4 ' - 29'-0' - IZ � 87 e✓�516ee$i4 { es'v4 7 d4 la'-7 1/2- (2)a 7/eTPAM"am' -- � - dr - • as ea5cx ai4 0 r A �p z 77 4 �p • �vrl ua u�pe t! e - ; .. - BEIGKLER RESIDENCE- ARGHITEGTURAL m z m 58 OTTER LANE FINE LINE DESIGN m GUMMAQU I D MA 0 8 WEST BAY ROAD OSTERVILLE, MA 02655 FLAN PHONE: 508-420-12��. 0 SYSTEM DESIGN: NOTES • SECURE COVERS TO PREVENT UNAUTHORIZED SYSTEM PROFILE ALL MARKED WITHCMAGNETIC TA SHALL PE OR BE y Barnstable Harbor LEGEND GARBAGE DISPOSER IS NOT ALLOWED AccEss (NOT 70 SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROX. NGVD Locu PROVIDE WATERTIGHT 99 - EXISTING CONTOUR DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 110 GPD ACCESS COVER TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORTS TO 2. MUNICIPAL WATER IS EXISTING X 99 1 EXIST. SPOT ELEV. USE A 330 GPD DESIGN FLOW \ .2' ACCESS 5COVER AT F N. GRADE WITHIN 3" OF FINISH GRADE sec 2X SLOPE REQUIRED OVER OF R OVFR PRECAST SYSTE 25.5 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 99 PROPOSED CONTOURMINIMUM ' SEPTIC TANK: 330 GPD (2) = 660 MINIMUM 1' of c R o 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS �98.4) PROPOSED SPOT EL � OVER POLY TANK TO BE AASHO H-]Q USE A 1500 GAL. H-10 POLY SEPTIC TANK •0. FILTER FABRIC COVER ` TH1 �• 16.1"(1.34') PIpH4ES LPLV;y-T 2• OVER UNITS 5. PIPE JOINTS TO BE MADE WATERTIGHT. Cb Q ? Z 4 22.91' PROPOSED 1W_ 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH �} TEST HOLE LEACHING: 22.5 Y GALLON POLYETHYLENE 6' 310 CMR 15.000 (TITLE 5.) ado a SEPTIC TANK 2% SLOPE OF GROUND 4.72 SF/LF x 4' LENGTH = 18.88 SF PER STD. GAS _ (H-10) QUICK 4 UNIT BAFFLE o 000.0 0000000 00 6" "MIN. SUMP 22•16 00 c 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO o UTILITY POLE 0 ,0000.000�0,°0,0�0 °o0 12 MIN INT. DIM. 0 6T BE USED FOR LOT LINE STAKING OR ANY OTHER ' 21.49' PURPOSE. 330 GPD/0.74 GPD/SF = 446 SF LEACHING V FIRE HYDRANT REQ'D '••...5..:.: o �g 22.49 •Z2 _ sA � DEPTH OF FLOW = 4' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING 446 SF/18.88 SF/UNIT = 23.6 UNITS 6" CRUSHED STONE OR MECHANICAL COMPACTION. (15.221 [2]) PROVIDE SPLASH PLATES� COMPONENTS O BE BACKFILLED OR CONCEALED 24 STANDARD QUICK 4 UNITS PROPOSED (SEE DETAIL) WITHOUT INSP INSPECTION BY BOARD OF HEALTH AND THEREFORE, USE GRAVELLESS SYSTEM OF -(24) REQUIRED TEE SIZES: (NO STONE PROPOSED) PERMISSION OBTAINED FROM BOARD OF HEALTH. STANDARD QUICK4 UNITS IN FIELD CONFIGURATION INLET DEPTH = 10" MIN. BELOW FLOW LINE 8•89' OF 3 ROWS OF 8 UNITS OUTLET DEPTH = 14" MIN.' BELOW THE FLOW LINE 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCUS MAP LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES 24 UNITS x 18.88 SF/UNIT = 453 SF > 446 (OK) ( X SLOPE) I ( 1 X SLOPE) PRIOR TO COMMENCEMENT OF WORK. NOT TO SCALE 1 *THE INSTALLER SHALL VERIFY THE iBOTTOM TH 3 & 4 EL. 12.6' 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE LOCATIONS OF ALL UTILITIES AND ALL NO G-W ENCOUNTERED REMOVED 5' BENEATH AND AROUND THE PROPOSED ASSESSORS MAP 351 PARCEL 10-2 BUILDING SEWER OUTLETS AND LEACHING ELEVATIONS PRIOR TO INSTALLING ANY FOUNDATION EXIST. SEPTIC TANK 17' D' BOX 18' LEACHING FACILITY. FACILITY PORTION OF SEPTIC SYSTEM f MA 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND - _ REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. APPROVED DATE BOARD OF HEALTH r t VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE \ IMMEDIATELY GRANTED BY THE BOARD OF HEALTH AGENT OR \ 1 BY HEALTH INSPECTOR EXISTING SEPTIC SYSTEM, CONSISTING OF 1500 GAL. SEPTIC TANK, PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED D'SOX AND LEACH PIT WITH STONE TO BE REMOVED AND ALL BY THE BOARD OF HEALTH REVISED DURING A PUBLIC UNSUITABLE SOILS WITHIN 5' OF NEW SAS SHALL BE REMOVED AND \ REPLACED WITH CLEAN MED. SAND. HEARING HELD ON AUG. 4, 2009 F 1 2) FAILED SYSTEMS ONLY : SEPTIC SYSTEM COMPONENT TO TEST HOLE LOGS FOUNDATION SETBACK, IF AN IMPERVIOUS LINER IS DESIGNED AND INSTALLED (10' OR GREATER ALLOWED). I ENGINEER: DANIEL A. OJALA, PE, SE \ � T 4 WITNESS: DAVID STANTON, RS 4 160 SFt DATE: JUNE 3, 2010 5' REMOVAL OF UNSUITABLE SOIL REQUIRED PERC. RATE _ < 2 MIN/INCH AROUND PERIMETER OF LEACHING FACILITY a DOWN TO SUITABLE SOIL LAYER. REPLACE \ N N \ WITH CLEAN MED. SAND, TO MEET N \ CLASS ( SOILS P# 12950 SPECIFICATIONS OF 310 CMR 15.255(3) 5 FAILED FAILED 24.33 ELEV. ELEV. ELEV. ELEV. 7H.1-4 011 4 24.4' p" 24.4' p" 26.6' C 4 26.6' X 13 LP I T_ 6.1 1 AL�TH 2 jv,1\ CEDAR S S S S N 4:, 6" 10YR 3/2 6" 10YR 3/2 4" 10YR 3/2 4" 10YR 3/2 BENCHMARK: USE'TRP OF x 31.t6 '�� 7-/� 8" C DAR FOUNDATION THIS AREA 4 _ B B B ELEV. ,26.2 - PUMP KND - 0' REMOVE ' LS LS LS -- LS� 28 • 1 _ 2 ,� � EXIST. ST � �/ 2.5Y 6/6 „ 2.5Y 6/6 2.5Y 6/6 „ 2.5Y 6/6 PROVIDE APPROX. 67 OF 40 MIL LINER AT 5 OFF SAS > 36 36 21.4 (WHERE ABLE) IN AREA SHOWN. TOP AT EL. 22.5', BOTTOM �00 6 9 �� 0 4 00 \ 21.4 36 3.6 6 23.6 6.0 0' AT ELEV. 18.5't 11 DECK 2w ' 25.82 251 r0 // // 1 X/Cy/A PERCF //1 23 TIGHT SANDY TIGHT SANDY TIGHT SANDY TIGHT SANDY SAS DETAIL (DIMENSIONS) �j �46 EXISTING ,LOAM�� LOAM LOAM/ �LOAM'� 24 TOTAL UNITS frP.�9 5.53 DWELLING ' I� TOP LING 2s.os WEEP ® 180" 2.5Y 6/4 g,4' WEEP ® 180" 2.5Y 6/4 9.4' 120" 2.5Y 7/3 16.6' 120" 2.5Y 7/3 16.6' FND. 15' 15' m EL. = 26.2 I N 26.00 PERC 25.62 ) O IZ C2 C2 C2 C2 27.40 27.67 I G .22 SILT LOAM SILT LOAM CS CS -FLAGPOLE 2.5Y 6/1 2.5Y 6/1 2.5Y 7/4 2.5Y 7/4 x 4.94 24.35 23.65 Q2 _ ELEC. `1G .26 / W METER 11 24.14 21 2 228" 5.4' 228" 5.4' 168" 12.6' 168 12.6'" W N 1 1 Q 3 l NO G-W ENCOUNTERED E D OTTER ° 1¢ . GARAGE 3.85 UG IRR. NEAR EDGE DRIVE ON SLAB LANE 2.05 2 22.47 STONE '�1` '�'` DRIV ��:• 2 �O 6 2.02 k T1TLE 5 SITEPLAN 94 -X 21.56 x 21.86 11 12F..,V x 21.5 � \ 0 F 1:10 58 OTTER LANE x 19.61 x18.1 x17.63 � •2 O' 20.36 230't CUMMAQUID x 15.90 x 12 4 /o PREPARED FOR I `S 1.41 x 5.91 x 19.25 I x 6,48 xt° 9 18.0 M/M JAMES RICE O�c.Q GO x 10.12 x 10.12 8/* x 9.96 JUNE 10, 2010 \x 5.60 x 20.31 15.2 x10.22 ���KOFMgss� ���o\SE�_3 20' 6j SCOle: 1' = yO DANIPLA. f360� oN b OJ O ALA + ' ° 0 10 20 30 40 50 FEET vro 11.20 V, .48502 � fl � . x 17.93 �o o ` o off 508-362-4541 x 12.61 �^(� y fax 508-362-9880 u.. �� � y.,. , tLA. yGN °` L yGN downcape.com R OJALA 0 ALA y • down cape engkeeh#7g, Inc. 502 q No.40980 �o �p civil engineers land surveyors / 939 Main Street ( R to 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 10- 109 10-109