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0120 RAILROAD AVENUE - Health
- j y 1 f I P 1, I TOWN OF BARNSTABLE LOCATION 49-6 41�P D,_4R SEWAGE# 17e/0�7 7 2/ VILLAGE. ` tJ s IQ ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. CW6 rn A b�t e0�ic SEPTIC TANK CAPACITY —0 3 C�'2-0 LEACHING FACILITY:(type) WC j�S (size) tJ O S x iZ FS3.X`'a= NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �J 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 � �ro N i ' 3 { AV /7 57 No:a l� 1 � Fee " ' .01 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppfication for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) OComplete System ❑Individual Components Location Address or Lot No../Z© moo,%<- e- Owner's Name,Address,and Tel.No.X /J�arvrif>�c�/Pi T i /7ifr/i vcu i[.fq 6e-,r Assessor's Map/Parcel In`s ler's.Name,Address,and Tel.No.�j'oP yy�- ��'�'� Designer's Name,Address,and Tel.No.so� �6�' y✓'`S// Tub/ �lu�l�/ol e-aPG C'criaL- - — a r o-�- Type of Building: / Dwelling No.of Bedrooms Lot Size 7��!/S' sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) "o gpd Design flow provided gpd Plan Date y�3�,� Number of sheets Revision Date Title /G AP S- Si,Ae 'elf Size of Septic Tank S O® Type of S.A.S. Description of Soil Z�o ,e S'o<.u( Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt �Signed Date0/Z_T/ZtF Application Approved by ' /' Date ''LL Application Disapproved by Date o� for the following reasons ,72, Permit No. Date.Issued «� . . No.-a V 1 1 1 r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9pplitation for ZIBpioSal *'stem Construction Permit Application for a Permit to Construct Repair U " ad Abandon r' Com lete System Individual Components PP ( ) P (� Ply ) ( l) P Y ❑ P Location Address or Lot No. ?O /Po.%u a� .9+/ Owner's Name,Address,and Tel.No. M1 � t Assessor's Map/Parcel ;79q �� mod,• Ins_ ler's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 51a d'-��a- %✓`r/ �+•.p.e..�-;,...,<..�.�a.•r�-- Type of Building: Dwelling No.of Bedrooms Lot Size %z! �/S_:? sq.ft. Garbage Grinder( ) 1 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) eq, �© gpd Design flow provided gpd Plan Date �Z,131� Number of sheets e Revision Date Title ire/-P .S S/ ram' /-moo.ate / Size of Septic Tank / Epp Type of S.A.S. Description of Soil ti !. Nature of Repairs or Alterations(Answer when applicable) J_ 5 U C� Z 1,1 r-s�fi1 G /1i'_.4 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.. t, . , /S�ig�ned � ,.�'e.- z -'' Date Appliation Approved by L�L�^''_1 Date Y Yrtf':Sr° {{ . - f (S Applteahon Disapproved by rn 1(�^�rr.w .�P Y Date /�S z for tlu following reasons -�P - �lA /!Cc�, ,N.Q r C -z/� a`lti r� � (9" Permit No. Date Issued -t- - f THE COMMONWEALTH OF MASSACHUSETTS ` BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On Sewage Disposal system Constructed( ) Repaired(c;)/ Upgraded( ) Abandoned( )by at 120 has been constructed in accordance - with the provisions of Title 5 and the for Disposal System Construction Permit No.,�Ql -/k-hated Installer .� _..�= �' Designer #bedrooms Approved design flow _ A";� 6 s gpd The issuance of this permit shall not be' construed as a guarantee that the system will functio 8stgned. Date J j 1 Inspector . No. .� � � � � . . . .. _ . _ - _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction i9ermit Permission is hereby granted to Construct( ) Repair((/)� Upgrade( ) Abandon( ) System located at /.�C� �S'a�i/r�c�/ ✓2 /1+s,,�rfc /,•® and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructionj must be completed within three years of the date of this permit., f / Date // t� 1 n Approved by _ yt`j i�0 tf d�aat�, Rtgu����n°g' He IV BARNSl'ABT E, As ion, Thomas m par6ctop OQ Iau�tiree$, yaaanans,N!�IA`® 601 Office: 508=862-4644! Fax: 508�" 63Q4• lustaUer=&Desn�ner Cerfi ication Form , llDtee. `3 l a Ie �e lea°u�n '.2a�8 � E4sess®r9 1�[a �ngce 2q coo D7 f D .7.. )IIF-►V U 1.1� { fJ�r Y V� I�IVLD�I�VI� G-W. � �m�/ �r o r•�s y n ellogrzzev Ca ,I s issued a,17.0 o dnstaA a. ( ate) ,(instal er) septic system at - ZD f� ' }� VE. � . ..based on a'desgn drawn by (address). dated I certify'that'tha septic system,referenced above'was installed substantially accor'ding-, the design, whchiay include:znino approve cl:changes such'as lateral relocation.of"the d stribudon box and/or septic tank.; I'-cex-*,,*hat the septic system referenced abovcwas`installed With,,Inajor changes (i e -� greatier than l0' lateral relocatioz<,of the A S or anyverbcal relocation of any:component. of the septic system)but in accordance-pith State&Local Regulations., Plan revision or certifieci'_as built by designer to follow. (installer sSignatrre) Ss, � t �oNaL ' 7. M =a. (Designer's Signatm ' (Afdx,Desiguer's:stamp Here) ]?LEASE .RETUAN .TO ]BAINSTABLlE PbRL id, J8[EA:LTH IDI[rt1ISM. CERTIFICATE .6P CQWLI[ANCE WH.E NOT BE ISSN UNTIL BOTH TMS FORM AND AS-BUILT CARD ARY RECEN EID BY THE BARNST BL}E PUBLIC HEALTH DIVISION 7[78CA K YOU ;Q HealtWSep-iC/Desigaer Certification Form 3-26-04.doc' r �: a Town of Barnstable r# Department of Health,Safety,and Environmental Services tm Public Health Division Date �+. 3.67 Main Street,Hyannis MA 02601 �.0 HARNEMABIA - rtn 9. Date Scheduled ! [ L Time• .Fee Pd. Qil 0 Soil Sisitability Assessment for Sewa e Disposal tl� Performed By: Witnessed By: l�s ' • �!�(�{{y�� �:. •y .:::.:.:.:.:::::::.:.:..........................:: Location Address . Owner's Name QGi�rgnD ,u( Address Assessor's Map/Parcel: 99 �/" Engineer's Name ow NEW CONSTRUCTION REPAIR Telephone# ��✓ �'p� S�f Land Use tvaod-e Slopes % e p f ) s"-` �� Surface Stones � Distances from: Open Water Body f 'R Possible Wet Area—'�Q� :it Drinking Water Well >100 ft e Drainage Way >06, R Properiy Line 3G n Other R SKETCH:(Street name,dimensions of lot,enact locations of test holes&perc tests,locate wetlands in proximity to holes) t • Parent material(geologic) 1 �� / �O� (geol g ) / Depth to Bedrock Depth to Groundwater: Standing Water in hole: Nl C Weeping frotai Pit Pace 1� c Estimated Seasonal High Groundwater s'U ..:.:.::::.......... L• E R1 •T. A U Method vsea:• ...�' ,:• Depth Observed standing in obs.hole: in. Depth fo'soil mottles: in, Depth to weeping from side of obs.hole: in. Groundwater Adjustment R, Index Well#__-.-,_ .grading Date: _ Iddex Well level.-- AdJ.factor Adj.Groundwater Level :::::f...:::.::::::::::..::.........:::::::::::.::::.::::..........:..::: Observation Hole 9. 1 Time at 9" I t�` ,�' r l i 2 Depth of Perc Time t - - Start Pre-soak Time© J . Time(9 .g") I W(Jd End Pre-soak �V J Rate Min./inch Site Suitability Assessment: 'Site Passed Site failed: Additional Testing Needed(Y/N) IV y Original: Public Health Division Observation Hole Data'To Be Completed on Back a Copy: Applicant -- .......... ' ..:�:x:•:.•..�.::v.yrtL:y::n•.:...:.......;;.:.:;. ,. ...Y•.:Y�+y;.•..,.:.:..r.,....F..:: ;f .......1....... ':Y:•� >v•:Y}}i'ry;;:::ti::rtl:ALL:�i:•:::•y:;::•:(:r:i'{(:i;}::i^it Depth from Soil 1lonzon Soil Texture Soll Color Soil Other Surface(in.) (USDA) (Munseli) Mottling (Structure,Stones,Boulderes. a SL 10A `12- 3y-7 Z- C- L S toyk bfo "q Yk0/` 5; L- .::: .[..::.::,.:.:v.:n:n.,.,::.y.•.�...v:a:..::::::•..:::.:::.::..:t::.;..i.:qn...Fin::r•:..y.a::y:n::•'•t:}:Y'r'W:::i.�r:•::v:;:;y::::.;;:'>ii:•i'i';^::,'•;}:::i::i:•>it{Y+a.:•:::i}::•:Y:;{}:<:•::J}:•i a5.: •i::{•+i'•i}:..}•.}:•:t•f;,.:};+..}: t:n:<•:ii:,.;};:.:'•;:r, • ,�j?.::;{.{::•A}}+::i$:�t•'�b;:t4S}:t:}'•:: :{•i'fi.}:t• { i � { •t rr R eJl �r•0it... ()tiler So�I Horizon Soil Texture Soil Depth from Color S Surface(in.) (USDA) (Munsetl) Mottling (Structure,Stones,Boulderes. 0 -3& 5 joyR y/ 3&-72' C1 L 72-5-0 C2 1S QOy9 b paces S; L ....................... .::.... .........::............:..:..:..:::.........:,...,:..:.::''t. {+ j ... .,r. }i}:ii{i}:'i•}:::i'r:ii•::ir'r.....r. i+r:5::'•'r:':%2•:L•i}:ti+.•:i<if:... .... .. •:.tii.':i;r•'r••:.i:: , .. •.mow;.:;., .;; ...... .. Depth from got l Horizon Soil Texture Soil Colar Soil Other Surface(in.) (USDA) (Mhmsell) Mottling (Structure,Stones,Boulderes. _Consisten6 % 10Yk VQ F : �• '�'�1 �y Y nn�•� ;5•t! �r'��{{ �••�• 117�:�`Jit �L•J..` r:�an�;,�'./.,,.;•1ty;?I��''aiT2'isita}.}:•o-:a}:•:(.i• o11 iicr Soil Colo' Soil" Other Depth from Soil[•forizon �S i T Texh r I l i Surface(in.) (USDA) (Nunsell) Mottling (Structure,Stones Boulderes, Consistency,° Gravel) lQ-z 13 5 L S; L. 2,�7 Flood In'sumitee Rate Man; Above 500 year flood boundary No Yes Within$00 year boundary No Yes Within 100 year flood boundary No Yes DOM of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e 5 .If not,what is the depth of naturally occurring pervious material? Certification I certify that on -C—// l« (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.0/17.r,^� Signature ,lam �,�,� �� ..----Date � 10 7 D6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage.Disposal System Form -Not for Voluntary Assessments Pro ertyAddress ON ner OW er's Name information is �js.r14e� l�R ®Zti30 required for every page. City/Town State Zip Code Date of Inspection, Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. hnpooutf When A. General Information filling out forms on the computer, use only the tab 1. Inspector. key to move you cursor-do not 4DAjc,e�� A� use the return key. Name of Inspector Company Name 0 � Si A�£T Company Address / p ran &),_6,44/1JJr R m�6b CJ City/Town State t! B! Zip Code �, "08 e 77�s 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 function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5(310 CM IS.000). The system: jk Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority �/zZ_Ll In pector's Signature Date T The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner ,and copies sent to the buyer, if applicable, and the approving authority. ***"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•3113 Title 50fficial Irspection Form Subsurface Sewage Disposal System•Pagel of 17 1 x Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Addr ffl /L y Ojv ner ON ner's Narne information is ��� gy 6�30 required for every r�-E- page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E L alwayscomplete all of Section D A) System Passes: I have not Bound 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: .S�PTf C Tr4k lC Sh104 t-A BC. 10U n-c P E6 A:�>R, 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): t5ns•3/13 Title 5 Official Ins pection F orm Subsurface Sewage Disposal S)stem-Page 2 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address &may O,v ner Oav ner's Narne information is y p��5 j4d� r � required forever J page. City/Town State Zip Code Date of Inspection B. Certification (cont.) d ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if. pumps/alarms are repaired. 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 0 ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ IN , ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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 mannerwhich 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 t5ns•3/13 TiUe5 Official lnspecfionForm Subsurface Sewage Disposal System-Page 3of17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2+/L P,6A6 AUC Property Address Ow ner Qnr ner's Name inforis equiredton forevery 81+kNS/.RQS 1W 6243d Q-5-' page. City/Town 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: a **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 must be attached to this form. 3. Other: 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 t.5ins•3113 Title 5Official Iris pecbon Form Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts j - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 12-40 Property ddress O,v ner Ory ner's Nacre information is required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ IX Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ M 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. ❑ +�1 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.] ❑ K The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ P The system fails. I have determined that one or more of the above failure criteria exist as described iri 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 16,000 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 ❑ (4 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. t-9ns•3/13 Tibe5 Official Iris pec bon Form Subsurtace Sewage Disposal System-Page 5of17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments A Property Address Oav ner ON ner's Name information is � �5 r � I 02630 �� to —/6 requiredforevery 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 ❑ /VIA 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? ❑ (9 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? M ❑ Was the site inspected for signs of break out? CS ❑ Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered,,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth-of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: , ❑ Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): �� t5ns•3/13 Titie 5 Official Ins pection F orm Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface//SS^ewage Disposal System Form -Not for Voluntary Assessments Property Address Qnr ner /)l6 i y Onr er s Name �/ information is !d � required f or every �'�'�5 ✓� `''— 36V page. Cityfrown State Zip Code Date of Inspection D. System Information Description: - Number current residents: u er c e t x Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system?(Include laundry system inspection Yes ❑ No information in this report.) Laundry system inspected? X Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available last 2 ears usage d dc,� 9 ( Y 9 (gP )) //1 Zo/Y Detail: Sump pump? ❑ Yes [9 No Last date of occupancy: AJIA Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5iins•3r13 Title 5 Official Ins pectionForn[Subsurface Sewage Disposal System•Page 7of17 r Commonwealth of Massachusetts ' W Title 5 Official Inspection Form Subs��u//-rfagce Sewage Disposal System Form -Not for Voluntary Assessments Property Address /11�—ZILS/ y Ouv ner Ory nQ ,se Name 2 requiredforevery QA�'.!�i44PG.� M,,4 00,9630 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: �{ Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes No If yes, volume pumped: gallons , Howwas 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/Altemative 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 (descri be): I t5ins•3113 Title5 Official Ins pec ban Form Subsurface Sewage Disposal System-Page 8of17 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Ory ner ON ner%Name information is U614�,, 5 71_ �.i E �, ,4 0�9 yr required for every %V �"T',Jc-FG. �''if J l/ b page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes EV No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ 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.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: a concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: yearn Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ns-3M3 TiUe5 Official Ins pec ton Form Subsurface Sewage Disposal System-Page 9of17 I - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property dress Ow ner Ory ner's Name information is � f p't.�,r-5 4 p� AM D��D requiredforevery r ,t/ y page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) ; 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? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Dept h bel ow g ra de; 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 t5ins-3113 Title5Official Ins pectionForm: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 Property Address ON ner Oer ner's Name information is �n e , 15 r 4lo required f or every 1�7�-w O 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.): Tight or Holding Tank(tank must be pumped at time of,inspection) (locate on site plan): Dept h bel ow g ra de: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: 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 t5ins•3113 Title5Official InspecfionForm Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 12-P JA/L 40& Property Address Ow ner Ow ner's Name information is „ /s 10 0�sQ �—�!�_�6 required f or every �/`� page. Cityfrown 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 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.): N 67 Pump Chamber(locate on site plan): Pumps in working order: ❑' Yes ❑ Ne' Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption,System (SAS)(locate on site plan, excavation not required)` If SAS not located, explain why: t5ins•W3 Tifie5Official Iris pecfionForm Sut%urfaceSewagaDisposal System•Page 12 of 17 r r Commonwealth of.Massachusetts' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M /� 01ILZ--L� Property Address Orru ner GN ergs rre information is 61 y's71_10 �^ nri1 6��0, required f or every _ RCN ?�J(�� page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Type. leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length:' ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 141-7 6 �O t 7- i��?LS7ZWE f— tn E n1:54;, EEC T%©A3 /U0 /dN-r Or /T I If 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 ElYes ElNo t5ins-3113 Title50fficial InspecfionForm Subsurface Sewage Disposal System-Page 13 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Syst/e//m�F[o�rm -Not for Voluntary Assessments r / Property Address' - aN ner ON�,er Nar e information is y.(011e 57 M required for every '�� page. Cityrrown 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.): 4 Privy (locate on site plan): Materials of construction: y Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): . A t5ins-3M3 Tibe50fficial InspecfionForm Subsurface Savage Disposal System-Page 14 of 17 i, Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Aqdresti /(J oN ner Ojv �7 / information is Nar required for every 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 P, F_ A. I 13- i '6 -Z �Fz Asa � ' ®® lCoc A Ptr l0 SToA)F` A-3 s3 5ns•3/13 Title50fficial InspecfionFomr Suburface Sewage Disposal System-Page 15 d 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 12-D 9rfIL I&A13 46)C Property Address ouv ner's Name information is f J�� 6�3 Q J�/0,`6 required for every �./!/° c�. !""/fi page. City/Town State Zip Code Date of Inspection I D. System Information (cont.) Site Exam: Check Slope - ® Surface water L� Check cellar ® Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water•elevation: Obtained from system design plans on record Pam— Y - g® If checked, date of design plan reviewed: pate ❑ 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: Before filing this Inspection Report, please see Report Completeness Checklist on next page. 1_9ns• /13 Title 5 Official Ins pectionForm Subsurface Sewage Disposal System•Page 16of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary,Assessments Prope A[d�r'e0ss ��J M �L Ojf ner OjvAer'g Name information is ry+✓�I ✓ p /� O required for every page. City/Town State '. Zip Code Date of Inspection E. Report Completeness Checklist 9 Inspection Summary: A, B, C,'D, or E checked Inspection Summary D(System Failure Criteria Applicable to All Systems)completed L System Information—Estimated depth to high groundwater L� Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file a - , .. a 'y , a t5ins•3f13 a, f Ttfie50fficial InspecfionForm Subsurface Sewage Disposal System-Page 17 of 17 AsBuilt Page 1 of 2 Az ����06c�TOWN OF BARNSTABLE LOCATION y, SEWAGE +Y ✓�3c VILLAGE ym_&ttt _6 ASSESSOR'S MAP & LOT. `T`f 'D C-,b n INSTALLER'S NAME & PHONE NO. 1 7/ t� jZ �1�r- `103 AW SEPTIC TANK CAPACITY /Cg r D . 1 t O LEACHING FACILITY: YPe� (size) /0 C [7. � . .._... �0 NO.OF BEDROOMS UBLIC WATER BUILDER OR OWNER LrrC-eL�C.��J�.. 'd-CL� Lt DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ �� r VARIANCE GRANTED: No 400 pk e K r� h http://issgl2/intranet/propdata/prebuilt.aspx?mappar-299066&seq=1 5/23/2016 ��(7Qi 6O TOWN OF BARNSTABLE' LOCA=N '. •' �" "" ' SEWAGE #c/6" VILLAGE &ymA_—t e ASSESSOR'S MAP & LOT Q'f? INSTALLER'S NAME & PHONE NO: Y=gj4"j"'0 s �3 SEPTIC TANK CAPACITY ��"p -� LEACHING FACILITY:(type) (size) NO. OF BEDROOMS J .___ UBLIC WATER BUILDER OR OWNER q0y& L, DATE PERMIT ISSUED: -DATE COMPLIANCE ISSUED: VARIANCE,GRANTED: - No PE c- K t No.__ql!___-Y1 - 1�rQa .A� THE COMMONWEALTH OF MASSACHUSETTS � 11.1-1P� BOAR® OF- HEALTH 1� TOWN OF BARNSTABLE 31/0 3 Appliration for Disposal Works Tonotrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ((i)' an Individual Sewage Disposal System at ...��� �-_.. 1 .. - _...------- •-• ---- --- � X Add s or Lot No. .. ........ .. ... . .........._...............•-----•. -----•- Owner r dre ---------------------------------------------------- Installer Address d Type of Building Size Lott? D b Sq. feet U Dwelling/—'-No. of Bedrooms._.................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Pa Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow...................._.......................gallons. WSeptic TankJLiquid capacityZPi PV.gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area.....:..............sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) p Percolation Test Results Performed by___________________________________v..................................... Date1 _. ..........................� Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water_._/�Zf:........... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_________________-_____- ----- ODescription of Soil��:> X-` -J -----------•----------------------------------------------. .......................- ................................. ----------------- ----------- ------------- --------------------------- •-------------------------------------- •----------------------------------- _-•------------------•-------------_----- W UN ure of Repairs or Alteratio s—Ans er when applicable____ , .__ ._ �°S_.�'o_______________ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t e board of health. Signed --- --- ----------- ----------- --P------------------...---- --------------------------------- -------,�------a------------------------ Dale ApplicationApproved By ------ -------- ------------------------------------------------------ --- -----1 te a D. Application Disapproved for the following reasons- -------------------------------------------------------------------------------........................................................ --------------------------------------------------------- ------- -- ---- -------------------------------------------------- -- -- ---------------------------------------------------------- -------------_---------------------- i ' Daze Permit No. .(7Q.''�7r-a--------------............------ Issued t.:- 9.�--------------------- ------------ [e No._`_?.q Fes$....:& -... r " ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH cl �1 TOWN QF BARNSTABLE 1,131103 Appliration for Dis iisal Works Tons#rnrtiun Prrutit Application is hereby made for a`Permit to Construct ( ) or Repair (4,�'an Individual Sewage Disposal System at ......�` --= -�=�-- -.-..._..... ...-'------------------------------------------------------------------------------------------- ...-- e�tdr/ or Lot No. ...... - -- - v----------------- `------•-•- - Owner I t dress W a Installer Address f/i, L_Ofb Type of Building -' �, o xt G Size`lot.``- _____ ________________S feet V 11 Dwelling(�No. of Bedrooms____________________________________Expansion Attic ( ) �~ Garbage Grinder( ) '4 Other—T e of Building ............................ No. of er=sons: __ Showers ( ) — Cafeteria ( ) t 4 Other fixtures ='............' ' TF `----------------- =---------------' ----•- ----...__....=........................ Design Flo w____. .............................. ._gallons per person per day: Total daily flow............................................gallons. x Septic Tankx~;L quidcapacity ?gallons Leng`thC ___ _ Width..............__'Diameter ,_____._.___. Depth`._________-. Disposal Trench—No-...:______ __- Width___ ..__._.__-+ Total Length..............____ Total leach>ng area....................sq. ft. Seepage;Pit.No_____________________ Dia�tte> __._..__r_______. Depth,below inlet...........i:...._. Total leaching area..................sq. ft. 'y Z Other Distribution box ( )- Dosing tank (?, ) ? t -, r =� PercolationtTest Results Performed by Date_f _- -------`- ---C'------ a _YTestL Pity No. I________________minutes per inch `Depth of Test Pit____________________ Depth to ground water___/L f------------ G >Test Pit No. 2................minutes per irich Depth of Test Pit.................... Depth to ground water........................ 0 Description of .... � ............................................................................... = x 4 ,�. ` .. A W ------------------------------------------_----------------------------------------------------------------------------• - ---- --U Na ure of Repairs or Alterations—A�nss er when applicable-AL 'l', 'Gv ' _ .1�o v < � s -`---r-•--•--•----------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individualwage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned furtfi,�er agrees not to place the system in operation until a Certificate of Compliance has been issued by t e board of 1"ealth. Signed ----- --- -- -------- ------- ---------2�--------------------------- �2- d ------- -------Date----------------- Application Approved BY ...... ....�'�-- - -...---- -�1�`--r --------------------............................................................ -----�� Application Disapproved for the following reasons: -------------------------------------------------------------------------------------------------------------------------------------- ...., r i/ Date Permit No. - .�.'"SJ�. ----------------- ............ Is/sued /--. --'-%�..`- 1'.-.. --�/ date .. THE COMMONWEALTH OF MASSACHUSE-rTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfertifirate�4,ClTvmy tanre THIS IS TO Cr ART Y, That the Individual Sewage Disposal System constructed ( ) or Repaired by----- � ---------------------------------- ----------------Installer ' ,..----�.,-G�-..�.-0 - ------------------------------------------------------------------------------------------------------------------------- at ......1y4... -��te �� �s %r%"�✓/ - L has been installed in accordance with the provisions of TITLE 5 of The Staatt Environmental Code as escribed in the application for Disposal Works Construction Permit No. ......t2---=3�;,_ -_---------- dated ---1Z-.�-1/a-------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED- S A GU, TE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � / t.. `��-...................----------- Inspector �� /w: .-_,---- DATE --------- 0 ...-... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9� -�� TOWN OF BARNSTABLE No..................... FEE. .-4-2............. Disposal sal arks Tuntrnrtiun rrntit Permissionis hereby granted- -------------------••---- `----------------•--------------.._..----•-•-----------......--•-------------...............___-_.... to Construct ( or Repair (V) an Indiividua) Sewage Disposal System Street � � ,.+.-.�. as shown on the application for Disposal Works Permit No._, Dated____J4 ............... n DATE...- /-/--•--�---yJ_,A0..................................................... Board of Ilre�lth FORM 36508 HOBO REN.INC..PUBLISHERS f I 1 ° 1 � a 1 10 5 C" a I I o es I II I I'. U��>v h1EM B¢aFAE V"cc'L I c ..00.0 MG11I917ry6 Sy'Si6M Q I 3/9••aT'o-fEC I r _1 'rrfGH�b fti4iR.Sfvr�M 1 U ` v1 I I tt I T � Llvlu �ooM I � —� o i +c- idu�T✓b G Q IF i __...._... C -- ' L 13 I ,L _.... � � Wig• -' I N ul 3 ✓ jCbl. �,.-I.�. � perp, � Ii r I I 1 1 I Sl\ h . . ___.._. _._...... e I i - --- I c° I I v/vU t*oM ,r�nf 1 2 j Ix,c�oM jvaoM ^�Jr E�bRb��M 3'i — N ......... "" yR 10 V L— ---- _ - c luA j�j I � a f -4—� I\\ II i \ ;p Uu i vo --- ! --- .. fseT �' r, faro I , 9r III _ ------ - ' n � a 1 `CQ, P rv£ frr;Fs>; 'rF.� ;,y»: r.s •r e LIVING ROOM xa ! 1f1 �i ="1 DEC • . DINING ROOM `� ����• �s g gag "f BATH " KITCHEN & N I ;<.g'�'s�.2:d�•�.(�+:!;Y?::`fr ,<Av%/i?;< ..tsS.'i'• w- - � I . AGE STOR 0 BATH 'f3: <:%'^ 'ry% :'4Y7.d...,',1....tc%'!�;'1.':'t•fE:: 1 . BEDROOM ,.<::, �.:,,.<".. ::t, l 1 1 . Match DRESS G M ' �, ; ; Exiting BUNK - 1 Finch ROOMs, ; { s;. ROOM x. DECK , s3$<<;r,1>•2;'`:<^+'�:.%'`iu�*e"f#r,F,yr •r w� s�.?)z3^ ':E?�� .air: 'iix;-, 1, C� � � •� 1 . Z 1 1 1 Relocated W �a•w.CS. :s^".. ..` . :'ar^sa+.' - .: -:s:. ::'-.q`^ -,"+'1 ,J,,, '�r. :..e4^ i.:.,: ' ,..y -.>,a, ',fy{.a ,a,. �f...,.r:.,.. ,Y .,y.r- _ 'y: .}.. .•.:�_,7•y.^-C:..'r; TOP FOUND.EL 94.5 SYSTEM PROFILE �OM ONXP M„,Y , E , BE PROVIDE MW.20'DYM.MTERRONT DIGIT to SOME) COMPARABLE MER6 MR FUTURE ICG710K. CF COYFR HNTFW G"OF FIN.WIDEy'PEASIONE OR.CEOR70111E RUER FAB CONCRETE COVERS TO"IRHM s•.GRUDE, 4 RIC OVER STONE i ACCESS COVERS 70 L YIY.7mv .. :._ �BE.SLOPE RFDIARFD OVER SYSIFM 84'-B5' �Ry THICKNESS REOUIRED 5f.00H9 OR ev".. ri 415C11i0 ARC' � 5 . '- - e-.mL PAv H4PES LLYEL IS<a• [IDS ) 4 L SDEs 62.03' c •82.2' 81.8T +� u�vocG`n.rc rR '� 81.62 • Ao¢ wAa.4"T mVnE, rY~'.S'x WASERT EST 1RO'80x LOWAAM MEMO *THE INSTALLER SHALL VERIFY THE Bt.9'. 81.32'` >°$ =80° 79.2' _ LOCATIONS OF ALL UTILITIES AND ALL •' Y•E- - BUILDING SEWER OUTLETS AND0..°:!e=1.�.^(T9a°d.°v°7= >°°e,�B°��. N-10 wD.Gnu.LEoa1iH0 CHAMBER By MBE PRLuaT'DR EOUAE, ELEVATIONS PRIOR TO.INSTALLING ANY 3H'-I-1/2•DotIME WASHED STONE 4'uW. (5)IHAM . i PORTION OF SEPTIC SYSTEM L S'CRUSHED STONE OR ALL AROUND PRECAST.STRUCIWFS T WYPACRDHL(15.221(2)) .._: OVER&L DINEWSONS TO OUTSIDE OF STONE:30.90 112AS' LOWS MAP SCALE i"=20oe't a"55x UMO (.1_x MOPE) -MDPQ eL.s emmY TN-H ASSESSORS MAP 299 PARCEL 66 NO GROUNDWATER FOWm LOCUS IS WITHIN FE"FLOOD ZONE X F MOTES. FOUNDATION- 11' SEPTIC TANK'.- 13' - _. 12" ..LEACHING - L 0'BOX FACILITY (AREA OF MINIMAL FLOOD HAZARD)AS Y T.DATUM 6 SHORN ON,COMMUNITY PANEL 025001C0558J IIfl DATED 7/16/2014 4F4 Z MUMDIPAi WATER IS MOSTINg LE.GEND i. 3:.MINIMUM PIPE PITCH70 BE 1/B OT."'PER FO 4.DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS -IS- OWING CONTOUR 70 BE AASHO.H-14. X pfN1 . OUST:SPOT'EIEV. f 5.PIPE JOINTS TO BE MADE WATERTIGHT. - IB PROPOSED wMOUR B.CONSTRUCTION TITLE DETAILS TOBE W AO:DIt0ANI3i WITH ) SYSTEM DESIGN: 310 CYR 15.000(T71F�5.) (OBI' PROPOSED SPOT d. 7:THIS PAN Is AM PROPOSED WCi ONLY AND AN NoT-10 THi GARBAGE DISPOSER Is NOT ALLOWED BE USED FOR LOT LOE STAGING OR Y OTHER' '7RT HOLE: . PURPOSE. . SWPE OF GROUND PROPOSED.6 BEDRQOMr DWELL@JG S.PIPE FOR SEPTIC SYSTEM 10 SGL 4o-4•PVC. - r'Cta UIOJIV PO 'DESIGN FLOW: 6.BEDROOMS•110 GPD-=660 GPD B.COMPONENTS Not TO BE BAQIFLLiFD OR.CONCEALED , -. WKHOUT INSPECTION BY BOARD OF HEALTH.AND 860 GPO DESIGN HYDRANT x. , USE A PERMISSION OBTAINED FROM BOARD OF NEALIIL. 4W HHImH1�Aa NROG HHAY AIIOR W arlo .SEPTIC:TANK: B6D GPD(a). 0 ' 10.CONTRACTOR SHALL BE RESPONSIBLE FOR CM10No . pGSAFE(t-88B-N4-72.U)AnID KPoEYUNO THE .. .- -._ USE A 1500 GAL.SEPTIC TANK IDGlION.�ALL UNO[RORWFID A OVERHEAD UTAJTES PRIOR TO COMLE7NCFJNDtT OF TIGER. 11.ANY UNSUITABLE MATEFMAL 04CM/TM D SNML_BE LEACHNG: L REMOVED 5'BENEATH AND AROUND Tiff PROPOSED f SIDE5:.2(80.5+1283)2(.74)= iB7 GPD IZ DOSTI FACEAC - BOTTOM 50.5 112.83.(.74)'.=479 GPD 12 REMOVED NO LEACHING AND FILL'SHALL BE PUMPED AND ITEIIOV£p OR PUMPED AND RUED MTH Ll£AN BAND. .94' TOTAL- 901 S.F. 666 GOD T3.UPE LANDSCAPE PLAN BT rARYOUTN PORT OL4G! '� 5865 USE.(5)500 GAL LEACHING CHAMBERS(ACME OR EQUAL) caoLNP DATED JANUARY B,20IB j� WITH 4'STONE ALL AROUND No FIND 76' E S 7 2755"E (1J.'lJi S 74' - - _ a 1 - TEST HOLE LOGS 2 ENGINEER:DANIEL E GONSALVFS SE #13587 WITNESS: DON DESMARAIS•.RS - . - .DATE: 6/9/17 ® UNSURABLF PERC.RATE < 5 MW/INCH SOIL _, n CLASS I -. .SOILS P� 15369 ^S N ELEV. Q ELEV. 74.0'.._O• 74.5' - tE T SL SL. + „pf1oN 14 -1 OYR 4/2' 1� 1OYR 3/1 B.: B _ - P 2 P C sL sL . -ExlSrlrro b - 1.46 S.F. IOYR 4/4 tOYR 5/4. c - .. 34,' 71,2' :36' 71.5•' RARVE 10YR 6/6 2SY 6/4-. - - D'✓D 5'REMOVAL OF UNSGTAi SOIL IHGIYtFD -1 C2 C'i L6 BONN 7 PdDRDA OF IEAFJIOIG FAQITY, 75 ODIW TD N VIOD SDL UYIX RE7+IATE M/CS, M/CS CLEAN�•SAND 3W TD I POCKETS OF - POCKETS.OF 7s SIECOICATGIIG OF]10'w0t T6.259(3) SiL SiL 10YR 6/4 10" 6/4. . -- 1$6•. .61.0' 166" '61.5' . .. NO GROUNDWATER'ENCOUNTERED T , ELEV. ELLV. 74.0' Q .4 74_5' 116 f r f. q _SL SL. OY'1R 3/1 to• 70YR 3/1 T - 24• 104 4/4. 72.0' 26"' IOYR L4/4 72.3' G G. �•fK//�G 4 - MS MS ' 0 - POCKETS OF POCKETS OF SS .SiL a g - 50 2.5Y 6/4 69.8' 48" 2.5Y 6/4. 70.5' BENCHMARK: IRON PIPE -86:S3'NAVD88. 93 EXISTING _ 2 CIH DWELLING oa 7 BO'' 42SY_6/1 116 5' .90• 2.5Y 6/1 67.0' - DECK PIBC .FS Mac FS ,POCKETS OF POCKETS OF • �• ) - SiL, SiL •R - - a 156' 2.5Y 7/3 161.01 1s6' I 2.SY 7/3 61S' NO GROUNDWATER.ENCOUNTERED. � y• CABANA[ _ i,AAB .SS. .A. 94 / ACE l N .a2' . T , SLAB63 TITLE 5 SITE PLAN L N 5 L 4c D OF IF D "1 #120 RAILROAD AVE. BARNSTABLE, MA IP MD N 64'15'20' PREPARED FOR . ANDREW MAHER i DATE: 4-25-2018' REV.: 1 18-2019 0. 10 20 30 40 50-,FEET . sAytM�' d HN • df SOB-362-4541 OANIELA V' RIM 50➢-382-9880 .. OJALA ONI�L .00WTxOpe: m O 446 Jow* ca66M OJMApHr' fQdlRttllga,(AC 2 ,eTe EASH • civil engineers 'N44AL GNGaV . .land surmyors I- 9.79 Mdn Stceet(.RtO '6A)YARMOUTHPOR1' MA 02675 DICE #l8=04.5 DATE DANIEL A.OJALA•P.E.J P.Ls' 18-045 MAHFROWO \ TOP FOUND. EL. 94.5 T COMPONENTS BE PROFILE MARKED WIHMAGNETICTAPE OR Q eti�a (NOT To SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. eta PROVIDE MIN. 20" DIAM. WATERTIGHT o ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE o 2" PEASTONE OR GEOTEXTILE �. FILTER FABRIC OVER STONE 6y 84.5-83.5' MINIMUM .75' OF COVER OV R PRECAST 2% SLOPE REQUIRED OVER SYSTEM 80.8-78.6 NOTE: 2" MIN. WALL PRECAST H-10 BLOCKS OR o 0 RISERS TYP.) THICKNESS REQUIRED o 2'0 81 .60' 4"OSCH40 PVC MORTAR ALL PRECAST RISERS ,o Q rooq m �S s" MIN. SUMP PIPES LEVEL 1ST 2' 4' COMPONENTS Locus 12" MIN. INT. DIM. ENDS (TYP.) INV'S EL. 77.0 4' , SIDES 77.83 10" 14" EE �16,5' 80.45 1500 GAL H-10 o°o � � oppp pp p ppp ' TEE TEE 80.20 > o 0 0 0 ❑��� O �Q�Il PP®� O �M�� o°o°o°o° qU OC SEPTIC TANK •. >°o°o°o°o ��m01�®ppp °°O°O°O°O°O WATERTEST D'BOX O >°°°°°°°° 4' LIQ. LEVEL ° ° ° ° ° ° ° ° ° ° 000a0000a®a 00000aoa000 ° ° ° ° ° o o ° ° ACME OR EQUAL GAS BAFFLE ' o�o�o ono_• FOR LEVELNESS N ;00000000 �Op p I��OQp I��poop Op I�Op p ,00000000 , r Brag9s *THE INSTALLER SHALL VERIFY THE 77.35 77.19 °°°°°°°° °o°o°0 75.0 LOCATIONS OF ALL UTILITIES AND ALL oo00000000000000000000°000000000000000000000, BUILDING SEWER OUTLETS AND o°o° I °o°o°o °o°o H-10 500 GAL LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. (5) UNITS REQUIRED ELEVATIONS PRIOR TO INSTALLING ANY ALL AROUND PRECAST STRUCTURES PORTION OF SEPTIC SYSTEM 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 50.50, X 12.83' �O(�' Ic n/�e COMPACTION. (15.221 [2]) In y y y 1 y, SCALE 1"=2000'f ( 8 % SLOPE) ( 23.75 % SLOPE) ( 1 % SLOPE) 61.5' BOTTOM TH-1 ASSESSORS MAP 299 PARCEL 66 NO GROUNDWATER FOUND LOCUS IS WITHIN FEMA FLOOD ZONE X FOUNDATION- 15' SEPTIC TANK 12' D' BOX 12' LEACHING (AREA OF MINIMAL FLOOD HAZARD) AS NOTES FACILITY SHOWN ON COMMUNITY PANEL #25001 CO558J DATED 7/16/2014 1. DATUM IS NAVD 88 2. MUNICIPAL WATER IS EXISTING LEGEND- 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 99- EXISTING CONTOUR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS X 99.1 EXIST. SPOT ELEV. TO BE AASHO H-110 -[99]- PROPOSED CONTOUR 5. PIPE JOINTS TO BE MADE WATERTIGHT. 198.41 PROPOSED SPOT EL. SYSTEM DESIGN: 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 310 CMR 15.000 (TITLE 5.) TH1 GARBAGE DISPOSER IS NOT ALLOWED TEST HOLE 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE USED FOR LOT LINE STAKING OR ANY 'OTHER 2%PURPOSE. SLOPE of GROUND PROPOSED 6 BEDROOM DWELLING �� 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. �Q� UTILITY POLE DESIGN FLOW: 6 BEDROOMS ® 110 GPD = 660 GPD USE A 660 GPD DESIGN FLOW 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED FIRE HYDRANT WITHOUT INSPECTION BY BOARD OF HEALTH AND NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRANANG PERMISSION OBTAINED FROM BOARD OF HEALTH. SEPTIC TANK: 660 GPD (2) = 1320 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING USE A 1500 GAL. SEPTIC TANK DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. LEACHING: 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE SIDES: 2(50.5 + 12.83) 2 (.74) = 187 GPD REMOVED 5' BENEATH AND AROUND THE PROPOSED BOTTOM 50.5 x 12.83 (.74) = 479 GPD LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND 94, TOTAL: 901 S.F. 666 GPD REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. -5658.65 USE (5) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) GRANITE 3 . v WITH 4' STONE ALL AROUND BOUND FND .26 S 76 02'55" E S 74,5 0„ E s 6� Vol W ° N TEST HOLE LOGS ���P� N 63 �' ENGINEER: DANIEL E. GONSALVES, SE #13587 WITNESS: DON DESMARAIS, RS DATE: 6/9/17 UNSUITABLE PERC. RATE _ < 5 MIN/INCH SOIL D CLASS I SOILS P# 15369 "N 6k V- 'n ELEV. ELEV. 111) c N Z 0» 4 74.0' 0,° 4 74.5' A A SL cc V 14" 10YR 4/2 16» b 1OYR 3/1 e6 B B AP 2 PA CE SL SL 6� 6,4 S.F. 1OYR 4/4 1OYR 5/4 1. 6 AC 34" 71.2' 36' 71.5' o EXISTING 2 WAY �" STING DRIVE C1 C1 EASEMEN TO RAILRO AVE /LS j LS 1OYR 6/6 2.5Y 6/4 �N3 72" 68.0' 72" 68.5' jN �5REM .z -ZIN1C2 C2 68 �JJAL OF SUI BLE RE IRED 75 AROU PERM TER F L LNG F CILIT DO W TO S ITABLE 01 LAY EPLA M/CS M/CS CL N MED. TO EET POCKETS OF POCKETS OF i SPECIFI FI ATIONS F 31 31 C R 1 55(3 76 SiL SiL 68.4 100% RESERVE AREA - 156" 1 OYR 6/4 1 OYR 6/4 X 61.0 156" 61.5 N PROVIDE 85' MIL R AT 5' [ 8.6] �� NO GROUNDWATER ENCOUNTERED OFF AREA SH TOP T I I n ELEV. 77.0', BO M AT EL. .0't O 74 I �9 s]so_ ELEV. ELEV. -- --L ' _ m Q 81 r �0 69. 0" 1 74.0' 0" z 74.5' 76 [s2] I A A �/ SL SL C) I , 8> a 12" 1OYR 3/1 10" 1OYR 3/1 �8 I TJ B B O L SL i 8 24" 1 OYR 4 4 ' I lull / 72.0 26" 1 OYR 4/4 72.3' 5 TOF= 80 83 C1 C1 89 s I MS MS 85 [8 8 8 m POCKETS OF POCKETS OF SZ 8� 86 [8 Ss i SiL SiL 50" 2.5Y 6/4 69.8' 48" 2.5Y 6/4 70.5' 88 ] 86 IP g9 3 9] 8� C2 2 BENCHMARK: 0 O] IRON PIPE 9 ° g2 /SiL /SiL EXISTI86.33' NAVD88 93 DWELLIING [92]] 89 g0" 2.5Y 6/1 66.5' 90" 2.5Y 6/1 67.0' C3 C3 DECK PERC FS PERC FS [93] POCKETS OF POCKETS OF g6 SiL' SiL [94] 9'�s 95] 156" 2.5Y 7/3 61.0' 156" 2.5Y 7/3 61.5' .9;J [ Q , , a 92- NO GROUNDWATER ENCOUNTERED 0 0 IP FND g4� 5.42' N 64' 9S W TITLE 5 SITE PLAN 96 D OF IP D #120 RAILROAD AVE. � � _ O 0 . BARNSTABLE, MA 11111111111 251.52 IP FND N 64-15020" W z PREPARED FOR ANDREW MAHER DATE: 4-25-2018 Scale:1"= 20' 20 30 40 50 FEET oFrd`Ole l��NOFr�q c_ ti C DANIELA. �s o� DANIEL ti� off 508-362-4541 �o OJALA 4 z A. I fax 508-362-9880 CIVIL Cn dt OJALA downca e.com No.46502 No.40980 P 0 �0����,STe��o��w �op 0 down cape engineering, inc. �® SS/ONAL E�G �0 3S RV��aQ- civil engineers land surveyors Ll Z _ 939 Main Street ( Rte 6A) � � �� U YARMOUTNPORT MA 02675 LICE # 18-045 DATE DANIEL A. OJALA, P.E., P.L.S. 18-045 MAHER.DWG