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HomeMy WebLinkAbout0051 STONEHEDGE DRIVE - Health 51 Stonehedge Driye�r ' Barnstable����.¢(,rt�+ ,bg � � ,•k r, � .�, A= 317 - 058 4 I l �I i i i - o4/it;/zoitt 11 :43 5o>izr3oasr #5948 P. 001/001 Town of Barnstable Regulatory Services = a Richard V. Scali,Interim Director RAMS ABLF. > Public Health Division t679 ♦� Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790.630� Installer& Designer Certification Form Date: N 16'Za18 Sewage Permit# av C1'3-7 X Assessor's Map\Parcel 3 7 t Designer: , �"C Enckttle"Isl 170C._ Installer: Cgetw�de.. kwk.�yerfse Address: 2$5 y C-Can'verry �iA wa V Address: t 3 Cohnm erc(o j S4((ve f Cask wartJu►am' »a oz53 NAsk(�aei N(1 0 2 y 9 on !o a4 =a,o 17 Caee,,.)C& r:n�t4p_�tW was issued a permit to install a (date) (installer) septic system at 5y -ongh' ggg Jrive- based on a design drawn by (address) '-'G &1nQnroc�A %nL, dated,JUITC. 2-01A (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e, greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to fallow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was construe cc with the terms of the RA approval letters(if applicable) �o�� N ssycy�s JOHN L �—a Cr__�— e CCHUR ILL JR VIL Installe ' Signature) .41 s signer's SZTO (Affix igne s St mp Here) PLAAS RETURNSTABLE PUBLIC HEA 11 D IS N. CERTIFICATE OF COLOLIANCE WILL NOT BE ISSUED UNTIL BOT IS FORM AND AS- BUILT CARD An RECEIVED BY M BARNSTABLE PUMQC HEALTH DIVISION. THANK YOU. QASeptieTesignerCertification Form Rev 8.14.13.doe BIt 3CJ845 P:9166 3978 j 1 1 i i DEED RESTRICTION Whereas,Dorothy J. Pettibone,Nancy Pettibone,James Pettibone and Linda Pettibone,of c/o 51 Stonehedge Road,Barnstable,Massachusetts(collectively,"Owners"),are the owners of Lot 4A,shown on a plan of land recorded with the Barnstable County Registry of Deeds in Plan Book 250,Page 99,located at 51 Stonehedge Road,Barnstable,Barnstable County, . _ Massachusetts,record title to which is evidenced by deed recorded with said Registry of Deeds in Book 11776,Page 118(hereinafter,the"Lot");and Whereas, Owners have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home on the Lot as a pre- condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; and Whereas,the Town of Barnstable Board of Health;as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,is requiring that the agreement for the restriction on the number of bedrooms in any house constructed or maintained on the Lot be put on record with the Barnstable County Registry of Deeds and/or the Barnstable Registry District of the Land Court,as applicable,by recording this document. Now,therefore,Owners do hereby place and impose the following restriction upon the Lot in accordance with their agreement with the Town of Barnstable Board of Health,which said. restriction shall run with the land and be binding upon all successors in title: The dwelling constructed or maintained upon the Lot shall contain no more than four(4) bedrooms unless and until it is connected to the municipal sewer or the Board of Health of the Town of Barnstable permits otherwise. Property Address: 51 Stonehedge Road,Barnstable,Massachusetts For title,see deed recorded with said Registry of Deeds in Book 11776,Page 118. (signatures on following four pages) I' i I I I i I Executed as a sealed instrument this day ofn19 2017. Dorothy J.Pothbone,by Nancy Pettibone,her attorney-in-fYct,pursuant to Durable Power of Attorney recorded with said Registry of Deeds in Book 30416,Page 300. STATE/COMMONWEALTH OF TY) County ofS�— i On this 1 day of. OC,hy\ol {r ,2017,before me,the undersigned notary public,personally appeared Nancy Pettibone, 0 who proved to me through satisfactory evidence of identification,which was ; n nr b L ,or ❑ who is known by me and to me known,to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose and as her free act and deed,as attorney-in-fact for Dorothy J.Pettibone and as the voluntary and free act and deed of Dorothy J. Pettibone. Notary Public J� •My-Commission Expires:��� � j- a iid ,a6 t w� I •a(;A. 1� � O N �bNe ; ro`• f I+ 2 1 - 1 1 ! i ! ' t r .j 1 NI i Executed as a sealed instrument this day of 2017. i • i is Nancy Pe ' one j STATE/COMMONWEALTH OF (Y)06_dhtJCrftS I; County of )24 c' On this 9 day of �jc� b =T ,2017,before me,the undersigned notary public,personally appeared Nancy Pettibone, ❑ who proved to me through satisfactory evidence of identification,which was . Y1n ¢'-Dt` ,or ❑ who is known by me and to me known,to be the person whose name is signed on the preceding or attached document,and acknowledged to me that she signed it voluntarily for its stated purpose and as her free act and deed. !! f JactY,anc�t ��e-V- ,Notary Public My Commission Expires: y�l t p f. AMANDA FRED�TtE Notary PWife_ ��.\ Massachusetts' n Commission xpUes AvF 20 g is i. i f i 3 i i i • _ i I Executed as a sealed instrument this day of � ,2017. i 01A P James Pettibone STATE/COMMONWEALTH OF/I/ County of� ,y1�,1'f ..✓��-C. On this / day of Ug'h - 2017,before me,the undersigned notary public,personally appeared James Pettibone,JK who proved to me through satisfactory evidence of identification,which was /'i/.cit ( /r C j-c ,or ❑ who is known by me and to me known,to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose and as his free act and deed. Nota3 Public My Commission Expires:, J./ Y ALYSSA K. STARKWEATHER Notary Public ! COMMONWEALTH OF MASSACHUSETTS f My Commission Expires August 5. 2024 d y� i Zr r-j aisr �" i 5 i i 4 ' i i ' I I I I Executed as a sealed instrument this �d day of. C�GT02. ,2017. I I Linda Pettibone STATE/COMMONWEALTH OF Cs /`(A. /h County of ,a ' ��h c15'rU dl o r compleb bog ,is certificabI on�y Cup +denlrly the individual vfha signed the document to which this oertKcate Is alb d,and nof-tlGe:tEuthtuiness,a ccuracy,vrvalidity+of that document. On this /01_� day of C)c fA.o r ,2017,before me,the undersigned notary public,personally appeared Linda Pettibone, who proved tome through satisfactory evidence of identification,which was CA ark yerij or me 4me*,%,to be the person whose name is signed on the preceding or attached document,and I. acknowledged to me that she signed it voluntarily for its stated purpose and as her free act and deed. TIMOTHY KAY COMMISSION#2100535 ^_ 'sKee t° NOTARY PUBLIC-CALIFORNIA SAN FRANCISCO COUNTY COMM.EXPIRES FEB.20,2019 e' k."'V Notary Public Ivey Commission Expires: 6,Mjij 70,44 20 i9 I I i 5 - RARNSTABLE.REGISTRY OF DEEDS John F. Meader Register. ® Complete items 1,2,and 3.. 7SJignaturea Print your name and address on the reverse 0 Agent th t w n return the card to ou. r ❑ d eE so a e ca y - - a Attach this card to fire back of the mailpie , d by(Printed Name) D f D lived or on the front if space permits.. • d Ir L" 1. Article Addressed to: N�` D. Is delivery address different from item 1 s If YES,enter d ' Prop ID:317078 ANDRE G. &CARLENE E. DUPREY S 73 24 FRASER COURT BARNSTABLE, MA 02630 �5 K O - 9630 II I II II I I IIII I I I I II I II I I I I IIIII Il l l l I II II I I 3. Service Type _..._. do Express@ ❑Adult Signature---�--'-'— ❑Registered Mahn" ❑Adult Signature Restricted Delivery ❑Registered Mail Restrict! 9590 9402 1704 6053 7382 46 ❑certified Mail@ Delivery ❑Certified Mail Restricted Delivery ❑Retum Receipt for ❑Collect on Delivery Merchandise 9 AMA&Ah,mher ffrancfPr frnm.tP.rWrP lohPII ❑Collect on Delivery Restricted Delivery ❑Signature Confirmations 7 015 1520 0001 1850 0963 ail Restricted Delivery all ❑Riestricted nature Delivery lion PS Form 3811,July 2015 PSN 7530-02-000-9053 boff - J O'3J Domestic Retum Receipt i • • •MPLETE THISSECTIONON a Complete.items 1,2,and 3. A. Signature, a Pdntyour name and address on the reverse X ,% :Agent so that we can return the card to you. ❑Addresse 10 Attach this card to the back of the mailpiece, B: Received by(Printed Name) C. Date of Deliver or on the front if space permits. 1• D. Is delivery address different from Item 1? ❑Yes Town of Barnstable If YES,enter delivery ap ress below: [3No Board of Health 200 Main Street Hyannis, MA 026013. Ii I Illlil I'll III I I I II I I IIIIII II II I I I I I II III ❑Adult Signaturece eRestricted Delivery ❑R:eVgtered Mail El PtiQdty Mail Restrict. 9590 9402 1704 6053 7383 07 ❑Certified.Maii@ DelNery ❑Certified Mail Restricted Delivery ❑Retum Receipt for ❑Collect on Delivery Merchandise 9 Grtinla N!lmher(fransfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation* — ❑Signature Confirmation _7 015 1520 0001 1850 0970 I Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 _ � Domestic Return Receipt , a Con A. Si ure o Print y:.. i ss on the reverse 0 Agent so that we c,. . au. ;tnE Lard to you. Addressee' o Attach this card to the back of the mailpiece, B: R cei y(P ed, ""^.qc: ery or on the front if space permits. 1. Article Atidresseri to s delivery address d m item 1 es If YES,enter delivery add w: ❑No Prop ID:317073 JANE W. HEATLEY \� 46 STONEHEDGE DRIVE V, _ BARNSTABLE, MA 02630 II I Illl/I IIII III I II I II I I II IIII I)I I I IIIII I I III 3;Adul;Signature ❑Registered MallTm Service Type ✓J a...- ' ❑Priority Mall ss® ❑ alls" ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 1704 6053 7382 60 ❑Certified Mail@ Delivery ❑Certified Mail Restricted Delivery ❑Retum Receipt for ElCollect on Delivery Merchandise 2. ArticiP Nnmher(Transfer from service lahell ❑Collect on Delivery Restricted Delivery ❑Signature Conflrmationn" ail 7 015 1520 0001 1850 0949 ail Restricted Delivery ❑Riestricted gnature Delivery lion .PS Form 3811,July 2015 PSN 7530-02-000-9053 6 0 3 Domestic Return Receipt o Complete items 1,2,and 3. A Sig ture t n �` o Print your name and address on the reverse \1 Agent so that we can return the card to you.reverse -Addressee ved by(Printed I!U ne) C. Da a Attach this card to the back of the mailpiece, B• Receije of Delivery or on the front if space permits. b�Kda/� F��St / `f..7 1. Article Addressed to: D. Is delivery address different from•iterrt;l?;-' Yes, If YES,enter delivery add vd:'' p o Prop ID:317077 LORRAINE P. FRASER TRUST S �� 3531 MAIN BAKNSTABLELE, MA MA 026303. � II I IIIIII IIII III I II I II I i IIIIIII II I I IIIII I II III D Adult Signature Restricted Delivery ❑Degiistered Mail Resice Type 0 Priority Mail tricted 9590 9402 1704 6053 7382 53 ❑Certified Mail® Del very ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise Delivery Restricted Delivery ❑Signature ConfirmationTm 7 015 1520 0001 1850 0956 all ❑Signature Confirmation ail Restricted Delivery Restricted Delivery over 5500 PS,Form 3811,July 2015 PSN 7530-02-000-9053 60P — 3 S Domestic Return Receipt ® Complete items 1,2,and 3.. nature p Agent © Print your name and address on the reverse X Addressee so that we can return the card to you. Received b (Prin d Name) C. Date of Delivery io Attach this card to the back of the mailpiece, X or on the front if space permits. (L J 1. Article Addressed to: D. Is delivery address different from item 1? Yes If YES,enter delivery addressaelow, No Prop ID:317059 ' ' , \ KEVIN C. MAYNARD& QNDY P..MUGNIER SINE STREET BELCHERTOWN,MA 01007 (AUG III IIII III I II I II I I IIIIIII II I I II II III I III d. Se a Ty r' ❑Priority Mail Express® II I III ❑Adult Sign" �,.- ❑Registered MaiIT1° ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Cerffied Mail® Delivery 9590 9402 1704 6053 7382 84 D Certified Mall Restricted Delivery ❑Return Receiptfor ❑Collect on Delivery ❑Signature Confirmation'2. Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery all ❑Signature Confirmation 8 5 0 O 9 2 5 ^�it Restricted Delivery Restricted Delivery 7 015 1520 0001 1 PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt i V o Complete items 1 2�and 3. A. Sinature , /� ❑Agent o Print your name and address on the reverse '^G C Addressee so that we can return the card to you. R ceived by(Prig.—I N J C. Dale of D livery o Attach this card to the back of the mailpiece, ` A L} 2�, L I I Z or on the front if space permits. 1J`� 1. Article AdgrrMf!d to! D. Is delivery address different from item 1? Yes dP If YES,enter delivery a res below: [3No °r.•. Prop ID:317072 ' 'MICHAEL L.GOLONSKA & JANE A.BOYLE PO BOX 437 COLLINSVILLE,CT.06022 3.�tl IIIII IIII IRFJ IIIII I I IIIIIII II I I IIIII I II III 11❑dultSignat Signaturere Restricted Delivery ❑Reggis eyed Mice Type 0 Priority Mail ail RRe�cted II 1 , Delivery 9590 9402 1704 6053 7382 77 ❑Certified Mau® ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature Confirmationn" 2. Article Number(transfer from service label) ❑Signature Confrmafon 7 015 1520 0001 1850 0932 dl Restrri2icted Delivery Restricted Delivery 4411 r,.r.,�n t Dent��an_n9-Mn-fan53 Af)9 Domestic Return Receipt I • • ' D-, I. • u7 C3 rF Er Certified Mai Fee 0' $ _r Extra Services&Fees(check box,add fee as appropriate) ❑Return Receipt(hardcopy) $ ❑Return Receipt(electronic) $ Postmark 0 ❑Certified Mail Restricted Delivery $ '',� .`_' Here, O []Adult Signature Required $ . ❑Adult Signature Restricted Delivery$ - y O Postage r m _<. Total Postage and Fees �) Sent To e,G i one, Tbrom [7 street Apt. o,or PO ox No -------------- - - M,lop e,• ( • •' i :Gt:!,data items 1,:.., ',nc'3. A. S' nature ' tint your name and addressor the reverse X ] _ ®A9e"t k so that we can return the card to you.. �'��� ICEL M Addressee B.Rgceived by ted Name) to of Delivery G Attach this card to the back of the mailpiece, J or on the front if space permits. -V-A.td3 &41 Z A U 1. Article Addressed to: D.Is delivery address different from item 1? :13 Yes �n2��or If YES,enter delivery address below:, yy (y i �I Sfo f 7 heaf�196 U��. Bar�s�b/e, Ong oa�3a it I IIIIII III III I II II I II I i IIIII I I I II I I II I III 3. Service Type O Priority Mall Exptorer s s® 13 Adult Signature oRegistered Mall oCeSnature Restricted Delivery ❑Registered Mail Restrict ed ad Mail@ Mme9590 9402 1934 6123 0978 69 Certified Mail Restricted Delivery ryRep ❑Collect on Delivery handise 2. Article Number(transfer from service label) O Collect on Delivery Restricted Delivery 0 Signature ConfirmationTM -- •may) D Signature Confirmation 7 015 1730 0001 4990 0591 l Restricted Delivery Restrictd Delivery PS Form 3811,Juiy 201.5'P5N 7530-02-000-9053 Domestic Return Receipt MM/ • • � MrMM/ - 9 - ® 0 e a ro rq Er e O - �t �.. .,3( A Y? Ain rYax � 4. L-n ce fled a' ise co $ fl� r-qExtra Services&Fees(chatk ypx,ad r te) El Return Receipt(hardcoPY) rq []Return Receipt(electronic) $ Post 0 ❑Cer ied Mall Restricted Delivery $ ❑Adult Signature Required $ a V ❑Adult Signature Restricted Delivery EZI $ \M C3 Postage ru Ln 7 Prop ID:317057 Ln s TOWN OF BARNSTABLE CONSERVATION COMMISIO uSPS C3 200 MAIN STREET Q r` HYANNIS, MA 02601 �" r" No. ���� � ^ � ` XV Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21pplitation for 33isposar 6pBtem Construction permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 15-CaI,1 L402E b-OVE Owner's Name,Address,and Tel.No. 9;-kr r,jjrqjLB WANc,Y Assessor's Map/Parcel 1 y X serla. w4v C &UC Installer's Name,Address,and Tel.N . .S®R"417—vi-zl Designer's Name,Address,and Tel.No. S®$-r-7 3 ®37 7 cope-WtbG E,�T�R15�S �L EI�C�I+�t � b.lC &t W_G`*C_ 15Y Type of Building: ' t I Dwelling No.of Bedrooms Lot Size �ol : sq.ft. Garbage Grinder( ) Other Type of Building RCS�:� �14r L No.of Persons Showers( ) Cafeteria(' ) Other Fixtures Design Flow(min.required) 4 D gpd Design flow provided Lt"=:j► gpd Plan Date OL a,1..(D('� Number of sheets ( Revision Date Title �T�� f:. t)&.O E; l "�iEZ3C� Size of Septic Tank �000 C=4C Type of S.A.S. Description of Soil M Cp 1 r L j=>E S AAa�(P Nature of Repairs or Alterations(Answer when applicable) ICIF 1S)a5XL&1 C= (3pG CAU 019 IV Lre4> 14-aAD &0;6 -tn (4) >oo t.L bE-Jy GCS Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o ealth. Si Date ��d" (q Application Approved by Date_ )Lk �"- Application Disapproved by Date for the following reasons Permit No. ao t Date Issued to 1.4 Fee t N+ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes - PUBLIC HEALTH DIVISION - TOWN,OF BARNSTABLE, MASSACHUSETTS ' 2pplication for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 51 5-towis,, b_0.kV0':Owner's Name,Address,and Tel.No. ; • ,.._ ».,..��nsfc.,I,�ct�_•�,�•�'�• AIC�f �^.�ls""7'C�M3L�NE ; Assessor's Map/Parcel ( 1 .f '� &?� W V' Installer's Name,Address,and Tel.NJ 507_tR7-$qT7 Designer's Name,Address,and Tel.No. 150%-c)73`®377 CdI�CW►DC- �NT�2pd215�'S �L LNG—�,laJe��A�C.�G t� • t t ►c C.� t. s T CRMOOW 4W`f E�GcrasE4. f�t•!c�'� t Type of Building: Dwelling No.of Bedrooms Lot Size Rol 4c, sq.ft. Garbage Grinder(. ) j . Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required); '�"�D gpd Design flow provided `4'�t gpd ' Plan Date (,.-��('� Number of sheets ( Revision Date Title Size of Septic Tank (A 000 C-aw-OIJ Type of S.A.S. D'scription of Soil �� P •1 ,t Nature of Repairs or Alterations(Answer when applicable) l_1ST - 5-Cl C= ( oapo C•.j"oru S Pric_T ✓V, M k.J FLI�0 14 a-o 0-A MD 1'40 >0t-, 6M44001 k`-10 Gb4•A�t�Qd CQJ r '3 5 F6-r OF �dt6RA Ors 5 l n E A-K j) 3 80 ctyr a k) ekia 5, Date last insr cted: Agreement:,' T�e undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in r 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 o ealth. _ �� ^ i Si e --- Date C i"� pplication Approved by �r M -•, ^= -,. Date �a -�t((„1 `"" .� ��..� application Disapproved by �« Date for the following reasons -- � --�-------�, , Permit No. 4 I Date Issuedto f ----- ---------- -------------------------------------- ' ---------------------------------------------- ------ ------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance t THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( r") Repaired( ) Upgraded A Abandoned( )by 42A Pswi-De G-011GOOL at,r S T Lid ) Qt� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. v1 J?)-dated Y f 4 Installers A,PEw'Ll)& V`� wA21S Designer aL EtiC_l Lit-GUOL-11. #bedrooms Approved design flow — 4b gpd The issuance of this permit shallnot be c'nstrued as a guarantee that the system wi'1 funct�as igned. l ) Date j� C� Inspector -------- ------------------------ ------- - No. ot - 3 �-- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION=BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit i Permission is hereby granted to Construct.( ) Repairs( ) Upgrade( ) Abandon( ) System located at tj S'Z fl ¢4�t' roF pki U& t�d�SZ�Ef�G F 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. t r � Provided:Construction��s Abe.com�"� — ted within three years of the date of this permit. I Date r Approved by V , a � e 4 Town of Barnstable Barnstable FSME T o Gy , Board of Health - Al-AmedcaCRY i BARN `erg 200 Main Street, Hyannis MA 02601 'DrFol° 2007 Office: 508-862-4644 Paul Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald Guadagnoli,M.D. August 29, 2017 , Mr. Michael Pimentel w JC Engineering, Inc. 2854 Cranberry Highway , East Wareham, MA 02538 RE 51 yStonehedge„Road,,Barnstable;,MA „ ' A ,317 058. Dear Mr. Pimentel, ` You are granted variances on behalf of your' clients, Dorothy and Nancy Pettibone, to construct an onsite sewage disposal system at 51, Stonehedge Road, Barnstable. The variances granted are as follows: 310 CMR 15. 211: To install the leaching facility 10.6 feet away from the house foundation, in lieu of the twenty feet minimum setback required. 310 CMR 15. 211: To install the leaching facility five (5) feet away from the front and side property line, in lieu of the ten feet minimum required. , 310 CMR 15. .211: To install the leaching facility 5.1 feet away from.the water supply line, in lieu of the ten feet minimum required. r Section 360-1 of the Town of Barnstable Code: To install the leaching facility 94.6 feet away from a vegetated wetland, in lieu of the minimum 100 feet setback required. ; These variances are granted with the following conditions: (1) The applicant shall record a properly' worded deed restriction, signed by the owner of the°'property, at the Barnstable County: Registry of Deeds restricting the property to four (4) bedrooms Q:\WPFILES\Pimental Pettibone 51 Stonehedge Drive 2017.docx maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (2) The septic system shall be installed in substantial compliance with the engineered plans dated July 26,. 2017. ` (3) The designing engineer shall supervise the construction. of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance.with the revised engineered plans dated July 26, 2017. These variances are granted because the proposed plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations. The engineer designed the septic system to be located in an area to attempt to maximize setbacks to wetlands. Sincerely yours, , a u I JY. CanniV,,;, D. D. ' Chairman Q:\WPFILES\Pimental Pettibone 51 Stonehedge Drive 2017.docx TOWN OF BARNSTABLE _ N LOCATION 1 OA'E EbG,G__'D(R SEWAGE# ®1�I 3 VILLAGE 3Aizjo5-rwNL& ASSESSOR'S MAP&PARCEL�I INSTALLER'S NAME&PHONE NO.QA?E t_ L_0 r_- E r dais Gs 4'7 7y:2 SEPTIC TANK CAPACITY 1 i o oo Q,4LLwis o i LEACHING FACILITY:(type��� 5 �is4e. A_ �S(size) it's NO.OF BEDROOMS �- OWNER 040-Tw,, &AA6=_S Li�aA C'Z�1 r� C PERMIT DATE: 10-Xq COMPLI� `� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility NIA Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) MIA Q Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYQAQC wi ip 6 �� �� A t - 114 f off` R.3 . 24 ' A_yr 2(o 0 A_$ = '4 1 A �'aoHc a 4-� 34 o � a '4 p ' _ 51.2 o , '5- t o)oATEit leht Town of Barnstable Barnstable THE tp , . . : Regulatory Services Department UAmmicaCfty MRNStAB1E, ' MAS& Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 " Richard V.Scali,'Director ' FAX: 508-790-6304 Thomas A.McKean;CHO CERTIFIED MAIL47015 1730 o001 4990 059.1 August 9, 2017—SECOND NOTICE a PETTIBONE, DOROTHY J 51 STONEHEDGE DR BARNSTABLE, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located'at 51 Stone Hedge Road,Barnstable,MA was inspected on 03/08/2017 by James D. Sears,`certified Title V Septic•Inspector for the State of Massachusetts. r The inspection of the septic system showed that the system "Fails" under_the guidelines of 1995 TITLE V (310 CMR 15.00) due to the'following: • Backup of sewage into the house due to an overloaded or'clogged SAS or cesspool. ; You are ordered to repair'or replace the septic system',within sixty (60) days from the date.you receive this notification. Failure to repair/replace the Septic system within the deadline period will result in future enforcement action. PER ORDER,OF THE BOARD OF HEALTH . % Thoma'sMcKean, . • . �- �� R. CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\51 Stone Hedge Road Barnstable- SECOND NOTICE.doe �ZHE DATE: $95.00 FEE*: w BARNUMBLE, C\� /n� ? MA&S. � V l� Eo +A'�� � Town of BarnstableC,BY: ta SCHED.DATE: Board of Health T / 0 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION Property Address: _51 Stone Hedge Drive,Barnstable,MA Assessor's Map and Parcel Number: Map 317,Parcel 58 Size of Lot: 20 494 s.f. Wetlands Within 300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME: Nancy Pettibone Phone Did the owner of the property authorize you to represent him or her? Yes X 's No PROPERTY OWNER'S NAME CONTACT PERSON Name:_See attached page for all owners Name: Michael Pimentel,EIT,CSE Address: Address:2854 Cranberry Highway,E. Wareham,MA. 02538 Phone: Phone: 508-273-0377 EMAIL:—mpimentel@jceng-ineeringinc.com VARIANCE FROM REGULATION(List Res.) REASON FOR VARIANCE(May attach if more space needed) See attached Appendix A NATURE OF WORK: House Addition House Renovation Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application). Please submit copies in S separate,collated packets. Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for Innovative/Alternative septic system(when proposing an I/A system,only). Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). *$95.00 variance request application fee collected (No fee for lifeguard modification renewals , grease trap variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. W:\JOBS-ACTIVE\3833 - 51 Stone Hedge Drive (Capewide)\Board of Health (Variance)\Ola - Variance Application (5 copies now) .docx �r I MAIL-IN REQUESTS Please mail the required fee amount of $95.00 (if applicable), along with five (5) completed variance application packets to the address below. Checks should be made payable to: Town of Barnstable. Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 For septic system variance requests, each of five packets must include: 1) Variance application, 2) Letter for the Board with further information on the reason for the septic variance request (Optional), 3) Engineering plans, 4) MA DEP Approval letter for an Innovative Alternative. septic system (if an I/A septic system is proposed, only), 5) Floor plans. In additional to five septic packets, 'nlust include a copy of the seven (7) page checklist, authorization letter, copy of abutters notice, and fee. (see checklist below). . For -grease trap variance requests, each of five packets must also include a full menu. (see checklist below). Checklist _ Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g. septic system plans) Five(5)copies of MA DEP approval letter for Innovative Alternative septic system(when proposing an I/A,only). Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only) $95.00 variance request application fee (No fee for lifeguard modification renewals, grease trap variance renewals [same owner/lessee only], outside dining variance renewals [same owner/lessee only], and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Owner Addresses Nancy Pettibone 42 Setter Way,PO Box 518,Cummaquid, MA 02637 James Pettibone—38 Hemenway Steet Apt. #23, Boston, MA 02115 Linda Pettibone— 144 Parnassas Street, Apt. #19, San Francisco, CA 94117 R JC ENGINEERING, Inc. � Q y Civil & Environmental Engineering QO'0 2854 Cranberry Highway ' East Wareham, Massachusetts 02538 Ph. 508-273-03 77—Fax.508-273-0367 APPENDIX A Due to the physical constraints of the property and the existence of a wetland within 100 feet of the proposed septic system,the following local upgrade approvals and local variance are requested. Local Upgrade Approval Request: In accordance with 310 CMR 15.401 - 15.405, the following local upgrade approvals are requested from 310 CMR 15.211 & 15.221 (7): (1.) A 9.4' waiver (20.0' - 10.6') for the setback from the SAS to house foundation. (2.) A 5.0' waiver (10.0' — 5.0') for the setback from the SAS to front and side property line. (3.) A 4.9' waiver (10.0' — 5.1') for the setback from the SAS to a water supply line. (4.) A 0.6' waiver (3.0' — 3.6') for the maximum cover over the SAS. Local Variance Request (wetland): The following local variance is requested from Article 1, Section 360-1: (1.) A 5.4' variance (100.0' - 94.6') for the setback from the SAS to the wetland. FIRST FLOOR PLAN • 131 13' DINING ROOM �2 LIVING ROOM b> CL. BATH GARAGE BEDROOM 2 W7 D io KITCHEN 12' BATH BEDROOM 1 in 13' 12' CL. SECOND FLOOR PLAN BEDROOM 3 STORAGE CL. 18't BATHROOM HALLWAY N BEDROOM 4 12' EXISTING PREPARED FOR: FLOOR PLANS 'NANCY PETTIBONE for PREPARED BY: 51 STONE HEDGE DRIVE JC ENGINEERING INC 2854 CRANBERRY HIGHWAY In EAST WAREHAM, MA 02538 Barnstable, Massachusetts (508) 273-0377 21 Noo..2f!�. Fimic . . ... THE COMMONWEALTH OF MASSACHUSETY,�S�BJECr TO APPEst3oll L O� BOARD OF H E A LT HNRNST'A13LE CONSERVATION _.....O F........................... O®�ot�IttSStO�I........... ............ Appliratiun for Diipuiial Workii Tontitrnrtiun rantit Application is hereby made for a Permit to Construct ( !!:1j or Repair ( ) an Individual Sewage Disposal System at: �/ Q..._/JJ�.../d n.E�:a k ...................................I ..A.---- -•-----••--------........----------....------. ocatio �Addres r Lot No. r.. . ............................... Owner ddress A .......... Installer Address 1� Q Type of Building Size Lot ®/ Y......._..Sq. feet U a Dwelling—No. of Bedrooms......_._ ______________________________Expansion Attic (A/o) Garbage Grinder /u) aOther—Type of Building` i-d.kn.c,-_______-• No. of personr-----__---_--------------- Showers (�) — Cafeteria Wo) Otherfixtures ------------------------------------------- -- ------------....... W Design Flow............DLO......................gallons per person per day. Total daily flow__._: gallons. WSeptic Tank—Liquid capacity.i .Q_e►gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.....f.............. Total Length.................... Total leaching area-____ sq. ft. Seepage Pit No------ ............. Diameter........6--------- Depth below inlet.................... Total leaching area -_-Q_...sq. ft. Z Other Distribution box (,'�) Dosing tank ( ) aPercolation Test Results Performed by...'l-t'-h__iIek. .... Date..../.2 ............. Test Pit No. ........minutes per inch Depth of Test Pit___Z_d?...._...._.. Depth to ground water_ \(_A_k1..t.,_.. IZ Test Pit No. 2...%Z.........minutes per inch Depth of Test Pit-----`fa.`_....... Depth to ground water..lAl9__ri_9t...___ P4 .......................................................••.................. ••---- -•-•-- . -----••-•-•------•--•-••----••-••-•-----•_._........_. Description of Soil....... !`S f A t�F �'�ai�f ................ AZ W ------- - ; ;, _ j UNature of Repairs or Alterations—Answer when applicable_C,n-r,5.e-,— IV-..`114�z Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dis osal System in accordance the provisions of I?:.T p of the State Sanitary Code— The undersigned ur r es not to place the system in operation until a Certificate of Compliance has bepp issued b the oar o It Signed = �` -- .._.. / D ------•--......•..--•---.Application Approved B f t � ` .......... ....... Date Application Disapproved for the following reasons---------------------------------------------------------------•--------------------------------•-••--......._... ....................•---....-•----•-----......_.....--------------•--•----••-••-•-----•.---•- Date PermitNo......................................................... Issued---.....-----------------.......................... Date f pFTHE 1 ' 0 4 DATE $95.00 FEE*: / t • BARNSTABLE, * ;,�- � y MA .9 o CD Town of Barnstable RE" SCHED.DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 �7 e� FAX: 508-790-6304 Paul J.Canniff,D.M.D. Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION Property Address: 51 Stone Hedge Drive Barnstable MA Assessor's Map and Parcel Number: Map 317,Parce158 Size of Lot: 20,494 s.f. Wetlands Within 300 Ft. Yes' X Business Name: ----- No , Subdivision Name: APPLICANT'S NAME: Nancy Pettibone Phone Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME i CONTACT PERSON Name: See attached nape for all owners Name: Michael Pimentel,EIT,CSE Address: , Address:2854 Cranberry Highway,E. Wareham,MA 02538 Phone: Phone: 508-273-0377 EMAIL:—ml2imentel@ic'engineeringinc.com VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attacif if more space needed) See attached Appendix A NATURE OF WORK: House Addition House Renovation Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate,collated packets. R' Five(5)copies of the completed variance request form "y Five 5 copies of engineered plan submitted(e•g•septic s stem plans) Five(5)copies of MA DEP approval letter for Innovative/Alternative septic system(when proposing an I/A system,only). Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer of registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). .*$95.00 variance request application fee collected (No fee for lifeguard modification renewals grease trap variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days priorto meeting date 14 VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. W:\JOBS-ACTIVE\3833 - 51 Stone Hedge Drive (Capewide)\Board of Health (Variance)\01a - Variance Application (5 copies now) .docx MAIL-IN REQUESTS Please mail the required fee amount of $95.00 (if applicable), along with five (5) completed variance application packets to the address below. Checks should be made payable to: Town of Barnstable. Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 For septic system variance requests, each of five packets must include: 1) Variance application, 2) Letter for the Board with further information on the reason for the septic variance request (Optional), 3) Engineering plans, 4) MA DEP Approval letter for an Innovative Alternative septic system (if an I/A septic system is proposed, only), 5) Floor plans. In additional to five septic packets, must include a copy of the seven (7) page checklist, authorization letter, copy of abutters notice, and fee. (see checklist below). For grease trap variance requests, each of five packets must also include a full menu. (see checklist below). Checklist _ Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for Innovative Alternative septic system(when proposing an I/A, only). Five(5)copies of labeled dimensional floor plans submitted(e.g. house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only) $95.00 variance request application fee (No fee for lifeguard modification renewals, grease trap variance renewals [same owner/lessee only], outside dining variance renewals [same owner/lessee only], and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Owner Addresses Nancy Pettibone—42 Setter Way, PO Box 518, Cummaquid, MA 02637 James Pettibone 38 Hemenway Steet, Apt. #23, Boston, MA 02115 Linda Pettibone— 144 Parnassas Street, Apt. #19, San Francisco, CA 94117 JC ENGINEERING, Inc. Civil & Environmental Engineering 2854 Cranberry Highway East Wareham, Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 . APPENDIX A Due to the physical constraints of the property and the existence of<a wetland within 100 feet of the proposed septic system, the following local upgrade approvals and local variance are requested. Local Upgrade Approval Request: _. In accordance with 310 CMR 15.401 - 15.405, the following local upgrade approvals are requested from 310 CMR 15.211 & 15.221 (7): (1.) A 9.4' waiver (20.0' - 10.6) for the setback from the SAS to house foundation. (2.) A 5.0' waiver (10.0' — 5.0') for the setback from the SAS to front and side property line. (3.) A 4.9' waiver (10.0' — 5.1') for the setback from the SAS to a water supply line. (4.) A 0.6' waiver (3.0' — 3.6') for the maximum cover over the SAS. Local Variance Request (wetland): The following local variance is requested from Article 1, Section 360-1: (1.) A 5.4' variance (100.0' - 94.6') for the setback from the SAS to the wetland. FIRST FLOOR PLAN 13' — ——13' DINING ROOM LIVING ROOM Em CL. BATH. GARAGE BEDROOM 2 W D Zo' KITCHEN 12. BATH' BEDROOM 1 I. SECOND FLOOR PLAN BEDROOM 3 STORAGE 18' - CL. BATHROOM HALLWAY iv BEDROOM 4 _ 12' EXISTING PREPARED FOR: FLOOR.PLANS ' NANCY PETTIBONE' for PREPARED BY: 51 STONE. HEDGE DRIVE JC ENGINEERING INC 2854.CRANBERRY HIGHWAY. , in EAST WAREHAM, MA 02538 (508) 273.0377 Barnstable, Massachusetts I JC ENGINEERING Inc. Civil & Environmental Engineering 0 2854 Cranberry Highway East Wareham, Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 MEETING NOTICE Dear Abutter: You are hereby notified that there will be a public meeting on Tuesday, August 22, 2017 at 3:00 PM in the Hearing Room Public on the second floor in the Barnstable Town Hall, which is located at 367 Main Street, Hyannis, MA 02601. This meeting is to present waiver and variance requests associated with a Septic System Upgrade located at 51 Stone Hedge Drive, Barnstable, Massachusetts. Due to the physical constraints of the property and the existence of a wetland within 100 feet of the proposed septic system, the.following local upgrade approvals and local variance are requested. Local Upgrade Approval Request: In accordance with 310 CMR 15.401 - 15.405, the following local upgrade approvals are requested from 310 CMR 15.211 & 15.221 ,(7): (1.) A 9.4' waiver (20.0' - 10.6') for the setback from the SAS to house.foundation. (2.) A 5.0' waiver (10.0' — 5.0') for the setback from the SAS to front and side property line. (3.) A 4.9' waiver (10.0' - 5.1') for the setback from the SAS to a water supply line. (4.) A 0.6' waiver (3.0' — 3.6') for the maximum cover over the SAS. Local Variance Request (wetland): The following local variance is requested from Article 1, Section 360-1: (1.) A 5.4' variance (100.0' - 94.6') for the setback from the SAS to the wetland. The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis, MA Monday through Friday (excluding holidays) from 8:30 a.m. to 4:30 p.m. f Board of Health Abutter List for Map & Parcel(s): 1317058' Direct abutters (no set distance) and the properties located across the street. I f Total Count: 7 ��: Close Map&Parcel Ownerl Owner2 Addressl Address 2 Mailing Country Deed CitystateZip BARNSTABLE,TOWN CONSERVATION HYANNIS,MA 317057 200 MAIN STREET 2858/114 OF(CON) COMMISSION 02601 , 317058 PETTIBONE, DOROTHY 51 STONEHEDGE DR BARNSTABLE, MA 11776/118 ] 02630 MAYNARD, KEVIN C& BELCHERTOWN, 317059 47 PINE STREET- 25111/87 . MUGNIER,CINDY P MA 01007 317072 GALONSKA, MICHAEL PO BOX 437 COLLINSVILLE,CT 25022/50 L&BOYLE,JANE A 06022 317073 HEATLEY,JANE W 46 STONEHEDGE DR BARNSTABLE, MA 13533/201 02630 317077 FRASER,LORRAINE P LORRAINE P FRASER 3531 MAIN STREET BARNSTABLE, MA 28095/290 ' I TR TRUST 02630 317078 DUPREY,ANDRE G& 24 FRASER COURT BARNSTABLE, MA 30055/113 CARLENE E 02630 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 7/26/2017. I I. J v - 1 Stable,� _........-._.._.... t •.., lad?.� t_ too _�r1 L lAa( to 11 ................ .......... _..._........__.....t.___ ._._.:� � Y rnftw i ---- 06 ._-.- �._ ......_ -117 � c l �arhy sW�ar t'1nr _ --- - - -- ------ - _ _ ---- _ ...... _...._._ .......... _ ..,.w_ ..... __,.f..- ..._._.....--.._._. _,....,,.,._.......,. .,......._.,.....__...._._.,.,,...�. _....—..... _...... ......., .......... ... ��.. . _ w.._ ... 11.1 _ ._....._.. _ ;... 66 ie •d wd Ls: Le Liez-zz-ona Town of Barnstable Geographic Information System July 27,201.7 .318007 317014 #58 93554 317091 CN D 299071 #3512 6A _ #34e0 rk gT f 3170" #3565 Z 317076 317043001 #3555 #3609 ok 1A 317075 317005 #3517� 31704# a • � � 31 317004001 #3485 317074 #0 7 „ •.31705 6 31700 #0 :;.:::.: ::. 317043 #30 #3611 317073' 317041 # #3641 51 317004002 299059003 If 43 #3475 317072 #60 A 317007a ''#24 Z #50 ,'` 317059 •.•.:.•.•.•.i'd:.•::....... 7' 317071 #72 299059001 317004003 FA45EQ Cr 317008 317070' 0 6 #70 317060 #84 317079 #25 #85 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:317 Parcel:058 Board of Health - - e . boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map Abutter List Type-D u irect abutters(no set distance)and the properties'located . are only graphic representations of Assessors tax parcels. They are not true property across the street. EE Abutters boundaries and do not represent accurate relationships to physical features on the map such as building locations. Buffer: -- Nancy.Pettibone a42 Setter Way PO Box 518 Cummaquid,MA.0263=7 July 26, 2017 i Board of Health Town of Barnstable 200 Main Street ; Hyannis,MA 02601 Re: Declaration ofAuthoriiation 51 Stone Hedge Drive,Barnstab.Ic,-MA 02630 Dear Members of the Board' Let it be known that I,Nancy Pettibone(owner of 51 5tone.Hedge Drive in Barnstable, Mtissachutcal), do hcrablt authotri_o�JC'Efngtt�earvig,llu;. �f L l WnrC►gun, MA 8233$ to represent my interest regarding the upgrade of the sewage disposal system located at 51 Stone Hedge Drive,Barnstable: ►vIassachusetts in meetings bath public and private: Sincerely; Nancy Petit one i Town of Barnstable 1r# r� 3 ' Departinent of Aegulatory Sorvices Public Health Division Hate ' S MARS 200 Mala Shoat,Hyannis MA 02601 Date Scheduled_ � Time Fee Pd. • .:>:� �P �aU�CV. Soil SuitabiI (�Assessment for Se e Disposal Pl:rformed.Ey: M (Yf) �1 f''I174.4, r Witnessed By: LOCATION&.GENERAL IN i ORMA.TION Locallon Address Owner's Nome 2f S�vf�C ltct ��iv i+t( Q > Address Assessor's Ma/Parcel;` L'�C��'n�% CrUit3 �CSt ' p 3 t�� Engineer's Name NEW CONSTRUCTION e I RRPAArR Tel e liana Ik Land Uao• IleS.l 7Ph`�rnl Id IN♦;I/t rl� — t' J Slopes(%) �p 7ea� Surface Stones _/_ Distances item: Open Water Body (t Posslble Wet Area `/`Y' ft Dr1nk(ng Water Wcll 7 60 tt Dmihage WeY�g: Proporty Line 5 R Other ft SIMTCIIC(Street name,dimensions of lot,exact locations of test holes&pore tests,locate wetlands In proximity to(roles) Parent matedat(geologic) �IG.T�M C Depth to bedrock> ' Depth to Oroundwater. Standing Waterlo Hole:_ Wasping from Pit Facs I C J Estimated Seasonal High Groundwater D TEATON FOR SEASONAL-EIGH WATER TABLE Method Used:_ ( O ,2(Y(J on y^ > i Do rih Obaorvcd atanding in obs.hole:�3.[ le, Depth io still moults: "•L hl,' De�th to weeping from side of obs.hole: -2 l Z In, Omundwater Adjustment �ft. Index Well-4 Reading Data: — Index Wall levo! •• Adl,dhetor Adj.OmundwateaLevel PERCOLATION TEST, butt I Y7 Observailon Hole 0 t r Time at 9" Depth of Pero JV Time at 6" Start Pro-sonk Time @ _ Thaio(9"•01 — ( ., andPto-coek Soe Steve GYi-odx'JI,) fcw('TJ RateMln./Taoh. U (t SS�YYt�ct a�fEil EWcvr (' 2 )Jib rry -VP . Site Suitability Assessment: Slte Pesscd_11?S _ Site Fallad: _ Additional Tesdng Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back ***If percolation test is to be conducted within 100'of wetland,you must lirh't notify the, Barnstable Conservation Division at least one(1)week prior to beginning. Q..MVFICU'BRCFORM.DOC D+ I ROBSERVATION HOLE LOG � Hole# ITT Depth from Solt Horizon - Sall Texture Still Color Soil. Other Surface(In.) (USDA) (Mansell) Mottling (Stnucture,Stonei;Boulders.. /� c + 1 - tsis[ancy.%'Gravel) a—4 Q ^ L06141 Loam RY(r .5/6 _ -13a" -a M4—Fw �4 1 SY :1 S% G rage l DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sall Texture Sol]Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Soil Other Surface(In.) (USDA) (Mansell) Mottling (Structurs,Slopes,Boulders,. DEEP OBSERVATION HOLE LOG' HG1e ` Depth ftnm Sall Horizon SallTdxturo Sall Color 81311 Other Surface(In.) (USDA) (Mansell) MQltling" (Structure,Stonet,Boulders, Flood Insurance Rnte Man: r' Above 500 year flood boundary No Yes Within 500 year boundary No Yea Within too year Hood boundary No. Yet _. 3)euth of NatuCnllV Occurring Pervious Material Does at toast four fcot of naturally occurring pervious mtiterlal.oxist in all areas observed thrpughout the area proposed for the soil absorption system? e S If not,what is the depth of haturally occurring pervious material? CerN_ fleation I certify that on "� 7'� g� ,fdateJ I havepessed the soil evaluator examination approved by the Department ofBnvironmental Protection; d that the above analysis was performed by me conslstent with the required training,ex rdse nd exp `i nco describod In 10 CMR 15.017. Date Signature Q:WaFrrj 1nRCPORM.DOC Town of Barnstable r# Departitnent of Regulatory Services s' �we F Public Health Division MAM Hate ' S (8 200 Main Street,Hyannis MA 02601 r icy Date Scheduled Time _ Fee Pd. ;�:• D I Se spos�'ZSol Surtab Assessment or a Dr T Performed-By: 611 Rh'1 Qn T e �,TT C S G Witnessed By: LOCATION&.GENERAL INF'ORMA.TION Location Address �' Owner's Name�! 5?om6 tfv U-f tJ D o ROT c+ PEr7f p©Ajj-:5' s- Address Assessor's Map/Parcel:, C''li'L �AG t�•28esa ' Engineer's Name NEW CONSTRUCTION REPAIR _ Tel 4 /e hone Land Use � lopae � Surface Stones_ •/lf /.� Distancoa ftum: Opon Water Body ft Possible Wot,Arca LT ft Drinking Water Well 7 ASV ft Dlalhage Way ft Property Una 5 ft Other ft SKETCHe(Street name,dimensions of lot,exact locations of test holes&pera tests,locate wetlands-in proximity to holes) S-e Parent material(geologic) �(,T�nJ C i, Depth to Bed►roak Depth to Groundwater. Standing Water In Holo: I�� •13 GS Weeping from Pit Fnoo ! C G Estlmnted Seasonal High Groundwater DETE "TATION FOR SEASONAL'B IGH WATER TABLE Method Used: h _ Dc th Observed standln In obs.hole: � ��l D g In, Depth to loll mottleet • � � In.' ., Do �th to weeping from side of obs.hole: 7 [ ;Z In, Groundwater Adf uettoent ft. Index Well-# Rending Dato: Index Well Imwoa Adl,•fhetor, _„_Adj.di undwater•1.eVel.,_, i PERCOLATION TEST Date 17 ' IMN Obscrvat u` - •... Hole# - LL Time at 9" Depth of Pero Tltno at 6" Start Pro-soak Tlmo @ _ Tlmo(9"•6") — .� ff End Pro-soak Gh I �(S `ew�T, Sep- e v 01 y RateMIn./Inch . 8 (�'SSUYYt�G�,> C]kf-�FWiM -2 SOl' t C Site Suitability Assessment. Site Pesaed l6 51tp Fallous Additional Tcating Noo ad(YM) Original: Public Health Dlvislon Observation Hole Data To Be Completed on ack— ' I ***If percolation test is to be conducted within 100' of wetland,you must fir t notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICU'BRCF0RM.DOC I I i DEEP.OBSERVATION HOLE LOG Hole# 1 + 2 Depth from Sol Horizon Sall Texture Sdil Color Soil. Other Surface an.) (USDA) (Mansell) Mottling (Stnucture,Stone;Boulders. a lsistency.96'Oravoll Loan, ]Yr 5)6 &MI 15Y -1)i — 5% Grave I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sail Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) j,- ,Mottling (Structure,Stones,Boulders. _. t 7'1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Soil Other Surface(in.) (USDA) (Muasell) Mottling (Structure,Stones,Boulders,, DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Sall Color Boll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders, Flood Insurance Rate Map: Above 500 year Mood boundary No Yes Within 500 year boundary No.', Yes ' Within 100 year flood boundary NI0-- Yes . pel)th of Naturally Occurring Pervious Ma urlal - Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposed for the soil absorptibn system? Ye 5 If not,what is the depth©f naturally occurring pervious material?,�.... .. Certification I ce^rilfthat n °27 g?(date)I have passed the soil evaluator examination approved by the Department of Bnvlronmental Protection d that the above analysis was performed by me consistent with . the required training,expprNse nd ex p 1 nce described in 10 CMR 15.017. Signature Datr3 7 2k'l Q. HPrWflRCPORM.DOC TOWN OF BARNSTABLE %06ATI0N J1 .�St�, SEWAGE # � VILLAGE 1"G ` t�u ' MAP LOT 0�-5ioq 9 � ASSESSORS INSTALLER'S NAME & PHONE NO. 6,-;-iS ( ..- Core -562- 57 p _ ( SEPTIC TANK CAPACITY /Cabo LEACHING FACILITY:(type) (size) OCR NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER RA3LAC- BUILDER O OWNER 0 CAt/j f�6 Ups— IqDATE PERMIT ISSUED: L al)q IqDATE COMPLIANCE ISSUED: 4411 VARIANCE GRANTED: Yes No r { � ,�`� � � ;�'zr ,�) L �� � - . �y �k � -� �, �� t 4 yy w No:.. .-.[.SJ.. / _ . .. Fes$.. THE COMMONWEALTH OF MASSACHUSETTS �® BOAR® OF HEALTH =74=t3M::�t TOWN OF BARNSTABLE Application is hereby made for a Permit to Construct ( ) or Repair (/an Individual Sewage Disposal System at .._.16...�:. .11J..11f........ ... at rI resflf 4Sel........................ Own - Ad r s Installer Address Q Type of Building . Size Lot............................Sq. feet V Dwelling No. of Bedrooms........................................_...Ex ansion Attic a g— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures W Design Flow............................................gallons per person per day. Total daily flow------------- ..............................gallons. 1:4 Septic Tank—Liquid capacity............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. Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of.Test Pit---................. Depth to ground water........................ a' .-•--•••-----••--•----------•--•••••---------------•--••-------....•-----..............-••---.---•--......................................................... 0 Description of Soil....................................................................................................................................................................... x U .-----------------••---.......-•---------••••••-----..._......-••••---•--•---------•-------------------•-••----•----•---•.....---•----------•-•---------••••••-------------......_....-•-----••----•--•-. x -•••••••---------------------------•--------------------••- --••--------------------------••------------------ ---- - ---------- --------•- ----------- U Na f Repairs or Altgxgtions—Answer when applicable... _.. ._. '. 04 �=.z;Y_ .. �.-.f o..._..d�I-./1,,i/kt_.7--- ..--------------------------------------------------- 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 the board of health. Signed ----...�1' .'...,U�....� 7r -1-.. -.....l�1 Da re - Application Approved By ......... - Application Disapproved for the following reasons: ......... ........................................................................... ............................................ - ----------- Date Permit No. ........... .-.. �.d ............... Issued ........................--- --------------------------------------- Da te No._.7a--_Id 9 FR$.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g TP4WN OF BARNSTABLE ltr�atiou for %Voiial Worko Tomitrurtiou Vautit Application is hereby made for a Permit to Construct ( ) or Repair (Vf**an Individual Sewage Disposal System at: ----------- ......................................... atLo A ress or of No. Owne/l ............. -----2..? 1 4 c�..1-1Z Z.../. -:._G�<Ve Z . Installer Address +� Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms................_`�--------------- -------Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ________________ _________ No. of persons............................ Showers ( ) — Cafeterias'( ) Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............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. ,4 Z, Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... G%4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-------................. a ............................................................................................................................................................ 0 Description of Soil..........................................................................................................................`- ......................................... �i1 .....................................................................•..._............................................_._..............._..........•.._........•...__..................................._ •/ -------------!,_.--___-__----__-___-------_____--------._ ... ........................................................................................................................ U Nature.of Repairs or Alterations—Answer when applicable__.___._ ..__a - . ..r._; .:...............:..... ✓.v .9 �}' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environme% 4Code—The_,undersigned further agrees,•-of tto ace,the system in operation until a Certificate of Compli�efi�ef issue; yOtf( board of health. - 17 Signed -- -- ---------------------- ------------------------ ------------------------------------. Application Approved By .......... ................. -.. .................. 3 _'D�e�_ c? ................Daze------ Application Disapproved for the following reasons- ------------------------------------------------- -------/--- ------------------- -- -------------......-------- --- ---- ------------- - -------- -- - - ----------- --- --- ---------------------------------------- ---- ----------------------------------------------------------------- ---------------......................... Permit No. ---------- -... .... o-?................ Issued ........----- Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Q-11untyliattc.e THY]S T CERT Y That th Iindivi Se ge Disposal System constructed ( ) or Repaired by ..... .........................................: .......= ..................................-------- .......... S-� Jl ll/�y't2 .C1G'G Installer NG2l �C ................................... -----------�- ---�-L----.f--J--f------------------!------------- ------------- ------ ------------------ -- --------- at has been installed in accordance with the provisions of TITLE 5 QQf_The Sta c �jironmental Code as described in the application for Disposal Works Construction Permit No. ........1.... .. ........... (.. dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SSATISFACTORY. DATE'1 , _ ... Inspector `� t . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9a TOWN OF BARNSTABLE - � No........................ FEE.. ............... Permissionis hereby granted.......-----fiGlS................................................................................................................... to Construc_t-_( ) or epair (1') an Individual.-Sewage Disposal Sys at No...... ........................................................... Street 1O n' as shown on the application for Disposal Works Construction Permit No./..._ .t-`.7._ Dated.......................................... . . ----- _ DATE. Board of Healti --------------------------------------•---•--•-------.........------------.... FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS L 0 C A T 10 N dr" SEWAGE PERMIT NO. � A�iJk ;Z22a VILLAGE �3Afl.•��S 7)4l3L�� INSTA LLER'S NAME i ADDRESS � � A, ,5��3�i7►Ay-) SUILOER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 4 33. �•' 3cr IRV- . N OV.lye-- - . F�s..r .. ..............� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ .............I......O F.........................--------.........------•---....._.....---- Appliration for Uhipaii al Works Tonvitrurfisty, am it-­­­ Application is hereby made for a Permit to Construct (AT or Repair ( ) an Individual Sewage Disposal System at: ,�r l_._._. o n .� 1p....r.... okn idile ...................................!.'A..................................................... ocatio VAddres yr Lot No. Qr . JC.a...i .!'lk °.L''.. . ............................... .�f-----'"r * ..�!:..._ Y. • Owner ! ' ddress Installer Address r1 UType of Building Size Loi;14 ..........Sq. feet Dwelling—No..6f Bedrooms........... .._ ....................Expansion Attic' (Yu) Garbage Grinder Oo) p-I Other Type-of?Building Q 6't)+ _. °No,., of persons.............t ;..._$____ Showers (a) — Cafeteria. (AU0) ' Other fixtures --- --------- ---- =`-- ------- --- = W Design. Flow..... . ......... .gallons per person per day. Total'daily flow.... - -......._gallons. WSeptic`Tank—Liquid capacity10_0-0gallons Length................ Width__'_..........._ Diameter--.-_----------------- :....__....... x Disposal Trench—No..................... Width __r......._. ._._ Total Length .... Total leaching areaIt sq. ft. Seepage Pit No......!_------------- Diameter........ Depth-below inlet_.:.:...._...__....,Total leaching are sq, ft. .a Z Other Distribution box (p --Dosing tank ( ) Percolation Test Results Performed by.._.Wt..A A.�N. _I �' Q r 4l_h____ Date w /-2 ,.1 caret , ., Test Pit No 1 minutes per inch Depth of~Test Pit / i Depth„t� ground„rv�ater r3, Test Pit No 2.. ._.._..minutes per inch Depth of Test Pit J(1 1Depth to ground water A10 _._._. . Description of Soil G!_ 2 /, ....... '`-�-� . ^�..e. ..... *ems W ................... ( ............... �...._...._.____ ..__.__ ._ / V Nature of.Repairs or Alterations—Answer when''applicable.- ' .= . . ._ .� 0 Agreement: The undersigned'..,agrees to, install the aforedescribed Individual Sewage Disposal Svstem,in accordance`` the provisions of i: "5 of tfie'State Sanitary Code The undersigned furtl:der agrees not torplace the system in operation until a Certificate of Compliance has bepi issued: the ar oj health. t . Signed........! .....4.. • • •-•-••--•----•--........................................ /2, Application Approved B `.Tr= i ��` l --------------- i --2��- �------•--- Ap Date Application Disapproved for the following reasons:_...------.j----------•---•--•--•-•--•-------- --•--••-•-•-------------------••-----•----•---••-------•------- .................•--•-••-•-•-----....-----•-•----------------------------.._ ... . ------------------------------... ---- F Permit No................. a ,. `. Issued. - Date ._.... f, Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , 1 �fx.!r�r...........O F....,ri' ....................................... Trtifiratr of fro mpli attrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( r Repaired( ) -------------------- _..._..------. t At, at.............-- • -�.4-•---..... ._.._. has been installed in accordance with the provisions of T r j of The State Sanitary. Code as described in the application for Disposal Works Construction Permit No - '/.�' '['............... da.ted_............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION S TTISFACTORY. DATE---•---•--••.............••-••••.... P-,.A Inspector-•--•-. � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i ............0 F......��:�1 .............. +,► � y No. .�/.._��__. .. FEE........................ Disposal Workv T.Wmitrurtion ramit Permission is ereby granted.... ............................................................... ' to Construct or Repair ( ) an Indivi ual Sewage Disposal S stem ---------------------------------------------------- Street as shown on the application for Disposal Works Construction Permit No..................... Dated..________..._...._._..................... r ,1 ' /� ---------•-------•--•------•-•------•-- Y�PHealth < ATE.........---_------•ITT�---------------•-----------................--------J. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 7012 1010 0000 2847 8643 m • • '.s • '2 1'O N i y N N n' N l�D e Complete items 1,2,and 3. A. Sig ture 0 Agent x N =o * Print your name and address on the reverse X ��.1/_ _ 2 so that we can return the card to you. �CZ Addressee +i °° a y 3. B. R eived by(Pd ed Name C:,Date f Del' ery " m T m- m ,o 4 Attachthis card to the back of the mailpiece, �' am O „ 0 ., v or on the front if space permits. _ ` `C tMl/i d` � Cd y . x 1. Article Addressed to: D. Is delivery address different from Rem 1 Yeof 9 Efi If YES,enter delivery address below: 0 No. H Cn O � PETTIBONE, DOROTHY J O 51 ST'ONEHEDGE DR Z BARNSTABLE, MA 02630 d l7 ' -3 Service Type ❑Priority Mail Express® C� • II I BIIIII IIII III I III II I II I I I I IIII I II I II I III o Adult Signature Registered Mail o O ❑Adult Signature Restricted Delivery- ❑Registered Mail Restricted Certified Mail® elivery 9590 9402 2480 6306 7766 67 ❑Certified Mail Restricted Delivery eturn Receipt for �r ❑Collect on Delivery !!! Merchandise n�_ _--- ❑Signature ConfirmationT^' 2: Article Numher?rancfar.fmm %ate���� i Delivery Restricted Delivery g O fail f7 Signature Confirmation J 7 012 1010 0000 2 8 4 7 8643 tail Restricted Delivery Restricted Delivery over 0) PS Form 3811.,July 2015 P.SN 7530-02-000=9053 Domestic Return Receipt n IKE Town of Barnstable .-,Ba,,rttable . . °* Regulatory Services Department MURMNSTABLE, I � Public Health Division eo"AAA 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 ' Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8643 April 10, 2017 PETTIBONE, DOROTHY J 51 STONEHEDGE DR BARNSTABLE, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 51 Stone Hedge Road, Barnstable, MA was inspected on 03/08/2017 by James D. Sears, certified Title V Septic Inspector for the. State of Massachusetts. The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to-the following: • Backup of sewage into the house due.to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE ARD OF HEALTH a Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\51 Stone Hedge Road Bamstable.doc I - f 1MEr Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA'02601 . Office: 508-862-4644 Richard Scab,Director FAX: 508-79076304 'Thomas A.McKean,CHO p Feb 6, 2007 Rev.-5111116 DEADLINES T.O'REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15,000) _ An"X"marked in the ❑ is the failure criteria and associated repair deadline . 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of eftluent,to the surface-of the ground 4. ❑Pumping more than 4 times during the last year not due to clogged or obstructed p e. ackup of sewage into the house due to an overloaded or clogged SAS,or.cesspool•, ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any.portion of the SAS, cesspool, or privy below high groundwater elevation - - ❑ Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water'supply well with no ; acceptable water quality analysis. (This system passes if the water analysis ; indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA _ q -Single Cesspool-. ❑Any``conditionally passed systems" (broken,cover,relocation of apipe;relocation. of a driveway due to H-10 components, etc)' fj ❑Leaching pit or cesspool with high liquid level,<12"below inlet (per Town Code §360-9.1) o Leaching facility,with standing liquid level at or above the invert pipe (per Town �w Code §360-20 h) OTHER Repair deadline: V-2 Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc 3177- AST Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name -•] information is Barnstable ✓ MA 02630 3-8-'17 required for every t� page. City/Town State Zip Code Date of Inspection N 4D Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When ling out forms A. General Information c oln the computer, ```�� -\t10F use only the tab 1. Inspector: key to move your O? ' '•yG cursor-do not James D.Sears = JAMES m use the return -�' Name of Inspector key. Capewide Enterprises A*-.•Cl� �I Company Name .,� .• ``�. 153 Commercial Street ii� �Sr I N S?`- \\`N Company Address foam Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S1623 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 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 3-9-17 nspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �o vs " !e } Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 M ; 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town 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: Failed system leaching. The system is a 1000 Gal. Tank D Box and pit. ' 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. El Y ❑ N ❑ ND (Explain below): r t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i f Commonwealth of Massachusetts w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ 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 ❑ 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 ❑ N ❑ 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 16.303(1)(b)that the system is not functioning in a manner which will protect public health, safety,and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts' W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is Barnstable MA 02630 3-8-17 required for every 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 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 w ® ❑ 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 is less than 6" below invert or available volume is less than %day flow jztT t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. Cityrrown 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: ❑ ® 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.] ❑ ® 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 Elthe 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. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 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? ® ElWere as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption,System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): . 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal. Tank D Box and pit. Number of current residents: 2 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? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Present Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ .No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. Cityrrown 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: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool . ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained 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): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1981 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): ' Depth below grade: 19"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.): Pipeing is 4" PVC SCH 40. Septic Tank(locate on site plan): 9„ Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal. Precast H-10 2" Sludge depth: t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town 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 28" 1 Scum thickness Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Tape Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and covers at 9" below grade. No sign of leakage or over loading. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts ' W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 51 Stone Headge Road Property Address j James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: ' 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Stone Headge Road x Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. CityrFown State Zip Code bate of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): " D Box located and cked w/camera. Pump Chamber(locate on site plan)* - Pumps in working order: ❑ Yes 0 No* " 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is a 600 Gal. precast pit. Pit at 34" below grade w/cover at 17". Pit is full, not leaching. Need to replace leaching. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. City/Town 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.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i t5ins.cloc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 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 rl "Nl— Rtv o ao 3 o t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is Barnstable MA 02630 3-8-17 required for every - page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells N° Estimated depth t high ground water: 10, feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record 9-2-77 If checked, date of design plan reviewed: _ Date ❑ Observed site (abutting'property/observation hole within•160 feet of SAS) ❑ Checked with local Board of Health -explain: ❑l Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high groundwater elevation: T.H.on design 9-2-77 no G.W. at 10'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 te Commonwealth of Massachusetts w v Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G1M , 51 Stone Headge Road Property Address James Pettibone Owner Owner's Name information is required for every Barnstable MA 02630 3-8-17 page. CitylTown 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— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 r "�� pC Fs,JrJ 6AT�O�S '�„ 1R • ..r"' - t"i.rr. rw;•v • ,a + jr .•�! � t u4 4g ar Qcl� z _ . 3 '+ t L �i�._1..-- � R.E � �� - � � � t�' � '�;+�••`�!•r�t�-w t-'t... � v�„ k � .�.'�� + = t��yta'� '�'�r w* ,�`k "`1.,+. "� d •Z?k<3 $i fly 'Y.«.i"v5"�'�S`'Y+y' r �} •",- `�F ♦ Y +¢ yf E O+A Clip... ri. � - � � �_ ,�`�`�••,,r•� -�,3''fw`A.r s'�'byr.•'`.�,�. �x �'irta++,N �s�+•��"� s�rw,,,y�1�`+; �^ �, .y���„x.s,,r +,• e, n- ti'n'°'..,-/�!'j E�r 'u'T.�'"�s .rl•d''' ,, r'S } ?".:�a ." .." 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FRO FILE �'oFy 1 R0*P0sEp SEWAGE YsTEX4 _ A R.nl S R t_E h G U T O!J,5� S y'ST EM l7 C 51 4nNEC To To Towni OF T t_A AND STA IF- TITLE SZ FUR SveSuZFRCs= I%ASP'05AL Ut" S2wAc<E\. - /�,t_l_ PIPES S11AlLr be SLREVOLE 40 P.�1.� . � cwaR HLL PkFE5~ P SHP.LC V3E ojLoc0 :F.ouT .�lVttN EXGc O'UT cF TNE'" D/F WNir-ri 'SNAIL ZiE Lt�EI_ o > - ��2 1�E �tiLS� 2v Fw T� + _ �E51L�F-1 -FLovJ 3 4 $tDiZoo�lS *RIFT i1c�' GAL?DAY . PER �.R• ' 330 G,4L;DA)' 30 A GAL 0 sE G +lv E�R '"• L E ALH � cCCFfAP V5C + n!�'. .• $ x ,EFFGG-TiVEV A2EA `5106 x/O X K ZrS_= 47/ �. k c 4 a�oTT O M'4` x �p x f_���•__ :�` �° a `.,. ~T r Y' �• rt 1 C T A L '.FL O tU ..r•... Y f `, G J ,1 A. t t_ou) Y _ � DWt/ou GQQ5A6E 30 2 t G *LDA CM E t_o .. 4 3 Y t2 s v Pe v �.� ��-• .n � - _ - .' - s_.. -` .• �,� `_ i�'�ACE i G/ _BAl �� t s . aF irr .• w _ ' sf. �G �✓�N �D�2.02oL S N:= eT_ 2_0 3 i SiY- WILLIAM LIEBERMAN' Y REGISTERED PROFESSIONAL ENGINEER LICENSED REAL ESTATE BROKER 235 TIMBER LANE IMARSTONS MILLSI W. BARNSTABLE, MA 0266E 16171 428-2592 July 13, 1982 Town of Barnstable Office of Board of Health 367 Main Street.... Hyannis, Massachusetts 02601 Subject, Lot 4A Stonehedge Drive Barnstable Village Gentlemeni In reference to the septic system installed at Lot 4A Stonehedge Drive, Barnstable Village, I have in- spected the system and this is to certify that the design was ad.heared to and a Certificate of Completion should be Issued . It is to be noted that the Builder (Joe Gibson) elected to use a pit with the minimum effective depth i .e. 4' rather than 6' which is preferable. 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S 1 t ,• •i /i '. a _;fig,. { s•��' {, _ r .r p ♦ r,. r n EL tO-25 //-�- y K r V Luz ve Jo LOT 3A .� - '',• g .n<.',~ DJra� - 'i•o 1. ,�-�.. � �. s` � ` .'� < ., �g �':'A" "' LEQLFtD�L?• �y S^L 4 er•' -�. 'kr..' r -.a.v �"r ..t. Y YZy,.••.:.r,t � .�y1 1 4- µPPOPOSED ,-40f US r AND S EW'AG � L( A TKO+ti r : s Y. w. S T: AND S E WAG E �PLA,1! � ` 3 BEDROOM S rW 6 L E '.FA;iv s` OARD 0E 6E A6 D W.E:L L/NG OR ~D T �' 3 EAR fSA&4 ' Aijt) EeLciT' L4�' r ,' t�lIl_LIkM LIE: ME.- "� C; ue� T ) Ji- _ _ `, - . _ 7"Im®is It LAN e NAe TDoS MILLS fat � �r'r�,° f _;.: ,� � ` 1A�NSTAR'i_ MA. D�2 t i 4-A t Ilk t IV Its' Deaf go 0A ESP,r TO WASn, LLg.le�J'H r y �7TaNC . _- 3 ' _ M^ � R` ~ �{.w.K • .. _"r" _""" ..� ti+� r "s'. "tea' "'r � ....� ,...i~'� # __. E 41 s rt I-ol to f A., E�J ,o LOT Zv ' _ �,r .IApi24, 1`3` $ Eo2G,c . �o� .Ie ZLS LET# t )e 0 A., 4 l3 67 ro r © 2 s t; e wcc.L 1; 7" E Of q -rye _ �Q t1E i 14'At� in Lo-r 4� t i. FINISH GRADE OVER D-BOX= 33.7'± PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE _- �`T.O.F. EL.- 37.3 FINISH GRADE OVER CHAMBERS 32.5' - 34.1 j-H-20 RISER WITH WATERTIGHT SLOPE @ 2% MIN. OVER SYSTEM 3/4" TO 1-1/2" DOUBLE WASHED 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION PROVIDE EXTENSION RISER , STONE TO CROWN OF PIPE--, FRAME AND COVER TO GRADE H-2� CONC. RISER WIT H J1rATERTlGH�T ME I HODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTALWITH COVER OVER {NLEi & OUTLET TO WITHIN 6"OFF G. CAST IRON FRAME AND COVER TO INSPECTION PORT WI FH ACCESS CODE AND ANY APPLICABLE LOCAL RULES. FINISH GRADE GRADE OVER ALL PIPED CHAMBERS BOX TO F.G. (SFE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED @ FND. EL.= 35.0'± F.G. OVER TANK EL. = 34.4�± 5" DIA. OUTLET(S) \ STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4" SCHEDULE 40 PVC 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PROPOSED 4" 9" MIN. FMIN SLOPE 1% 3.6' MAX. TOP OF SAS= 30.50' SYSTEM UNLESS OTHERWISE NOTED. 1 2g �0 SEE NOTE 23 - �SCH 40 PVC 4 PVC TEE- 36" MAX. I ; I i BREAKOUT EL = 30.00 I i i 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN I� SEWER PIPE I f \ I I ELEVATION = 30.00' FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE SAS. UNLESS A 6" 3" 3 DROP MAX L=8'± t I 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 2" DROP MIN 3' 9„ MIN SLOPE@,- PROVIDE WATERTIGHT 13" � JOINTS (TYP.) ��a o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 4' PVC IN FROM _ ��----11 + 14" SEPTIC TANK 4" PVC OUT TO \ \ \ \ L� \ 00 o \ \ o 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. CONTRACTOR TO PROVIDE LEACHING FACILITY -� ©Q -� ---' ��j ,--' j� j (�jn o G. o r--' --� r--' -' --' o 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SPECIFIED DROP BETWEEN 12" 6"oa o00 L-, �---, I--, I -1 `-1 L-� o o �� �� �� u U 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 29.97 MIN. 29.801 2 \ 00 0 oCD FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS SHALL VERIFY SIZE 48' VERIFY CONDITION OF \ 00 0o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH AND CONDITION OF EXISTING TEES \_GAS BAFFLE 6" CRUSHED STONE 0 0 0 0 oo AND DESIGN ENGINEER. EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o0 0 0 0 0 TANK NECESSARY COMPACTED BASE I 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 33.00' 3.0' ' $ 5' (TYP) ( 3.0 I 3 5' I I!,-3� �5� .--( ESTABLISHED ON A HYDRANT BONNET BOLT AS SHOWN ON PLAN. 3 OUTLET DISTRIBUTION BOXE (4.83) h 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION j TO BE INSTALLED ON A LEVEL STABLE 40.0' -• TYP. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV= < 22.30' 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES REPORT ANY DISCREPANCIES PIPES TO BE LAID LEVEL. 27.50 * 11.83' TO THE DESIGN ENGINEER. EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK CROSS SECTION VIEW 4 - 500 GALLON H-20 CHAMBERS 17 ± 4' MIN. �HANARPP F-Nr) `�/IP\Ai 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC- STRUCTURES SHALL BE MADE WATERTIGHT. TYPICAL CHAMBER PROFILE *PER TOWN OF BARNSTABLE 1992 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING NOT TO SCALE NOT TO SCALE -_` - NOT TO SCALE GROUNDWATER COUNTOURS MAP REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. WF-312. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED NOTES: WF-4 �` .�' `7i. ' ' Cobbs 1W/1 •r • , UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR . .J: • W J;,, !� ; � t PERC NO. 15373 TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. 1- MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF + /�"s fi K. Donald Desmarais P • , , �f. ; : + „ ;?� �;1 INSPECTOR: H T HALL BE FREE OF ALL DIRT DUST AND FINES. EACH SEPTIC SYSTEM COMPONENT. J f/,, •/'• .?, ,/� .,,1�... f/« ;. 13. DOUBLE WASHED CRUS ED S ONE S I '' rl. ••.1; tom'/ yr 9 EVALUATOR: Michael Pimentel, EIT, CSE T LOCATION OF " � ���''-'' *: ..a sr " '• '•• Oct 1999 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN HE O .�t=���-��-..• 1P •f• r� , . J' • x C.S.E. APPROVAL DATE: �►, ij' - R � ti. •tr ; MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST i / `. MM •�\i € DATE May 24, 2017 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL � MAP 317 ' \�' S FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. / ,. � TEST PIT#:_ 1 _ PARCEL 57 J l I�"r.� � h- �},,,� ��� - 15 CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2, ELEV TOP = 33-30' '�' Jj',: --�" � ' ' �'` �- 't.= �- SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. AND THE ESTUARINE WATERSHEDS. 01�'• ' Q`s °x �� 1Y '� „ f.� ELEV WATER = < 22.30' WF-5 16. PROPOSED PROJECT IS LOCATED WITHIN: PERC RATE = see sieve results below •4�t i _ r,�• ASSESSOR'S MAP 317 LOT 58 P ' !• ( �, 1 ;�" ' DEPTH OF PERC = OWNER OF RECORD: NANCY, JAMES, & LINDA PETTIBONE SWING-TIES MAP 317 I z . •s ;' ` ''` n R CFC , TEXTURAL CLASS: 1 ADDRESSES ESSES 42 SETTER WAY PO BOX 518 CUMMAQUiD MA 02637 --- O LOT 58 I W w w - -- (RESPECTIVELY): HC-1 =HC-2 HC-3 20,494 S.F. W table 1,1 '.=�-= '. %{1 � .,< 38 HEMENWAY STREET, APT. 23, BOSTON, MA 02115 DESCRIPTIONa ,,� �; -- o�� N 4 6 zj LOG'U S f' . I( " � s C ,r e Q 144 PAMASSAS STREET, APT. 19, SAN FRANCISCO, CA 94117 CHAMBER CORNER (1) 33.6' 10.6' - 55� ,1g56 Y ' / ,q ' .�1 * . ;-= ��- 0 - 33 30' FEMA FLOOD ZONE X "` -. fJ bS r/ Sandy Loam CHAMBER CORNER (2) 38.6' 1 21.3' - WF-6 , 32 97 IOW m �. y,•� *.. e - '. r� A lOYr3l1 COMMUNITY PANEL# 25001C0558J U z _ 4" �` CHAMBER CORNER (3) - 50.5' 69.4' ' � ' ° /� *�• � It �•� �; 17. DEED REFERENCE: BOOK 11776, PAGE 118 i, B Sandy Loam CHAMBER CORNER (4) - 47.0' 60.9' / / N ? - �. _ o.It �i` f --` ! 1 OYr 5/6 18. PLAN REFERENCE: PLAN BOOK 250, PAGE 99 / 1 �`*-- _ ._ / ,. 16" 31.9T 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. / �._ s � ,. j �� 20, PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY • , � r" rn / u, . i y . \ >�". Silt Loam °° W O '' .� \ fr r.. C-1 2.5Y 6/6 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY O w �" � ' k • '*"is ^3 p- s` O d rl PURPOSE. o �J ; i FOR USES OF THIS PLAN OTHER THAN ITS INTENDED � ' , A: * �4 ✓ °ft y �1 36" - - 30.30, 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A ILL � ; 1 -{- . t d _ ` DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A J I 0 ., REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. o ! ' ° = / «\ 1� ' • "� --� 22. THE FOLLOWING LOCAL VARIANCE IS REQUFSTED FROM ARTICLE 1, SECTION 360-1. - AND Med.-Fine Sand (1) A 5 4' VARIANCE (100 0' 94 6') FOR THE SETBACK FROM THE SAS TO THE WETLAND WF-71 ,C,? � J /I,` � I r� �,\ C-2 2-5Y 7/1 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE c� c� (5% Gravel) APPROVALS ARE REQUESTED FROM 310 CMR 15.211 815.221 (7): / 0" (1.) A 9.4' WAIVER (20.0' - 10.6') FOR THE SETBACK FROM THE SAS TO HOUSE FOUNDATION. LOCUS PLAN � (2.) A 5.0' WAIVER (10.0' - 5.0') FOR THE SETBACK FROM THE SAS TO FRONT& SIDE PROPERTY LINE. I SCALE: 1"= 1000' (3.) A 4.9' WAIVER (10.0' - 5.1') FOR THE SETBACK FROM THE SAS TO A WATER SUPPLY LINE. /gyp �;, op 132" 22.30' (4 ) A 0.6' WAIVER (3.0' - 3.6') FOR THE MAXIMUM COVER OVER THE SAS. N No Mottling, Standing or Weeping Observed 24. OWNER /APPLICANT / CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL o I S FOR THIS PROJECT. DESIGN DATA REQUIRED PERMITS AND APPROVALS WF-8 � � �-r, �,, 15373 . . PERC NO. _E LEND P INSPECTOR: Donald Desmarais NUMBER OF BEDROOMS (DESIGN) 4 - 50xO' EXISTING SPOT GRADE 83x EVALUATOR: Michael Pimentel, EIT, CSE Benchmark I DESIGN FLOW 110 GAUDAY/BEDROOM `� EXISTING CONTOUR N¢J��`�•1� r,AS / I E Brant B.B. C.S.E. APPROVAL DATE: Oct. 1999 S �� I TOTAL DESIGN FLOW 440 GAUDAY DATE: May 24, 2017 50 PROPOSED CONTOUR 1 _34. Approx. M.S.L. i UPS DESIGN FLOW x 200 % = 880 GAUDAY / N .� Pc x30 9 TEST PIT#- 2 50 PROPOSED SPOT GRADE � _ _-- G USE EXISTING 11000 GALLON SEPTIC TANK ELEV TOP 33.30' / 1--- GAS `� I �+ ELEV WATER = < 22.30' EXISTING GAS LINE EXISTING UNDERGROUND UTILITIES m / } PERC RATE _ -- HC-3 :�,a�'. TP 2 / L_Ll �_D____-._D__.--.-.-D---� f - EXISTING WATER LINE p BUSH (TYP) �, 'ti• _ INSTALL 4 500 GALLON H- 20 CHAMBERS � �i ��„ / 33x3' _ DEPTH OF PERC = �_ f w/ AGGREGATE EXISTING 1,000 GALLON SEPTIC TANK R c; EX. LEACHING TEXTURAL CLASS: 1 SIDEWALL CAPACITY x31.3 CATCHBASIN ■ TEST PIT LOCATION +/ `:�:!�-i�ii�G � d � (TYP OF 2) (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.66 GPD/S.F.) = GAUDAY ■ ' BC)X 0 "sF � - 7 '' TP 1 � I (40.0' + 11.83) ( 2 ) ( 2' ) ( 0.66 GPD/S.F.) = 136.8 GAUDAY 0„ 33.30' I A Sandy 10Yr 3/1 m PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE 33x3' BOTTOM CAPACITY 4" 32.9T L] PROPOSED H-20 DISTRIBUTION BOX / LENGTH x WIDTH 0 66 GPD/S F. = GAUDAY � 6; I PROE=�i;+�Lu ,�:._ � ( ) ( ) Sandy Loam � / , #51 STOOP H-20 D-BOX !' ^� (40.0' x 11.83') (0.66 GPD/S.F ) = 312-3 GAUDAY B ( 10Yr 5/6 ! PROPOSED 500 GALLON H-20 LEACHING CHAMBER ,,,. EXISTING 16" -� 31,97' 2 1-3-18 MCP JLC Replaced exist. water line with new sleeved water line 4-BEDROOM NEW WATER LINE (TO E, - car x31.5 SLEEVED) AND CONNECTED t \ TOTALS: 1 9-11-17 MCP JLC Added 50-ft wetland offset HC-2 t Silt Loam DWELLING TO EXIST. CURB STOP '� _ - I 4 G-1 2.5Y 6/6 _ REV. DATE BY APP D DESCRIPTION TOTAL NUMBER OF CHAMBERS t .00 TOF = 37.3'+- HC-1 '%� .--" f ''��/ (4) r``� PROPOSED 4-500 GALLON TOTAL LEACHING AREA 680.5 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE H-20 LEACHING CHAMBERS 36" 30.30' TOTAL LEACHING CAPACITY 449.1 GAL./DAY tN °� "As 6, W WITH AGGREGATE ��,P` �q0y PREPARED FOR: b i \ O ��� JOH L. Gin WATER LINE (APPROX_ r� i - 3� -'-' Q (3> 1 CHUR ALL JR. y CAPEWIDE ENTERPRISES LOCATION PER TIE CARD) / . - _5 0 _...i Med.-Fine Sand _ -"� SIEVE ANALYSIS RESULTS N a�Bo� 2.5Y 7/1 '' C-2 LOCATED AT PROPOSED CONNECTION OF NEW - ' -� (Soil sample taken from C-2 soil in TP11 (5°� Gravel) rsry SLEEVED WATER LINE TO EXISTING UTILITIES LINE TO BE 34� .i - WATER LINE WITH COMPRESSION FITTING TEMPORARY RELOCATED .i '� 40.0' ' � I 51 STONE HEDGE DRIVE ./ .----- SAND 71.6°l0 wE- `, - ' \ ' BARNSTABLE, MA 02630 NEp SSON DR �. !i ,, _X FENGE i ! I CLAY 22.3%0 CRUS i ( 132" 22.30 SCALE: 1 INCH = 10 FT. DATE: JULY 26, 2017 .-� 0 PER TITLE 5 ALTERNATIVE TO I 0 5 10 20 40 FEET i ELECTRIC I PERCOLATION TESTING GUIDANCE No Mottling, Standing or Weeping Observed �� °F "�ss�c PROPOSED \ I RANSFORMEP L INSPECTION PORT \ � FOR SYSTEM UPGRADES o (EFFECTIVE DATE: MAY 3, 2006) r JOHN L. �^ PREPARED Y: PROPOSED 4" PVC I UNDER POLICY BRP/DWM/PeP-P00-4: a cHURc L JR. JC ENGINEERING, INC. VENT; EXACT NO Sof 2854 CRANBERRY HIGHWAY LOCATION PER � SOIL TYPE: "UNCOMPACTED" ��,w OWNER MAP 317 EFFLUENT LOADING RATE FOR ��. rs � EAST WAREHAM, MA 02538 S_( 55 4 SITE PLAN PARCEL 59 CLASS 1, 70-85/o SAND = 0.66 GDP/SF 16g.23' ASSUMED PERC RATE = 8 mpi � 508.273.0377 SCALE: 1"= 10' Drawn By: SJI Designed By SJI Checked By MCP JOB No 3833 PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE FINISH GRADE OVER D-BOX = 33.7 t FINISH GRADE OVER CHAMBERS = 32.5' 341'- . T.O.F. EL.= 37.3 t ° 3/4 TO 1-1/2 DOUBLE WASHED f PROVIDE EXTENSION RISER H-20 RISER WITH WATERTIGHT SLOPE @ 2/o MIN. OVER SYSTEM STONE TO CROWN OF PIPE 1_ UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION - WITH COVER OVER INLET& FRAME AND COVER TO GRADE H-20 CONC. RISER WITH WATERTIGHT METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL OUTLET TO WITHIN 6" OF F.G. CAST IRON FRAME AND COVER TO INSPECTION PORT WITH ACCESS 2" OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. i FINISH GRADE 35.0'f F.G. OVER TANK EL. = 34,4'f 5" DIA. OUTLET(S) GRADE OVER ALL PIPED CHAMBERS BOX TO F.G. (SEE NOTE 21) STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE @ FND. EL.= DESIGN ENGINEER. 4" SCHEDULE 40 PVC MIN SLOPE 1% 3.6' MAX. TOP OF SAS = 30.503. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PROPOSED 4" 9" MIN. SEE NOTE 23 SYSTEM UNLESS OTHERWISE NOTED. SCH. 40 PVC 4" PVC TEE 36 2950 MAX. ' BREAKOUT EL= 30.00' SEWER PIPE � 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 3" DROP MAX 3 9 L-8't ELEVATION = 30.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 6" 3" 2" DROP MIN MIN PE@_ SLO7% PROVIDE WATERTIGHT o 0 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 13" 4" PVC IN FROM JOINTS (TYP.) 6 ��� THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. + 14 SEPTIC TANK 4" PVC OUT TO 0 0 0 0 0 0 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. CONTRACTOR TO PROVIDE • LEACHING FACILITY o0 0 0 0 0 SPECIFIED DROP BETWEEN - o0 0 0 0 o o 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL 12 6" TC:>p o0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK SHALL VERIFY SIZE 48" VERIFY CONDITION L OUTLET TEE 29.97 MIN. 29.80 2 0 0 0 0 0 00 0 0 FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONE o 0 0 0 �_1 0o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY I o0 I 00 _ o L__J o AND DESIGN ENGINEER. TANK NECESSARY COMPACTED BASE 3 0, I 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 33.00, 3 8 5' (TYP) I t 3.0 I 3 5' I 4.83' 3.5' ESTABLISHED ON A HYDRANT BONNET BOLT AS SHOWN ON PLAN. I OUTLET DISTRIBUTION BOX 111 TO BE INSTALLED ON A LEVEL STABLE 40.0' (TYP.) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 22.30' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT PIPES TO BE LAID LEVEL. 27.50 11.83' 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 4 - 500 GALLON H-20 CHAMBERS *17't 4' MIN. rl"IMARI=R FN F) \/IFrA1 TO THE DESIGN ENGINEER. CROSS SECTION VIEW TYPICAL CHAMBER PROFILE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONIC. STRUCTURES SHALL BE MADE WATERTIGHT. T � < J r� H-20 CHAIVIRFf-< I_-.1�..:TAILS *PER TOWN OF BARNSTABLE 1992 ��� T I� T � � �'����' �� � I H--L O D I������ I�I�NI PDX DETAIL 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING NOT TO SCALE NOT TO SCALE NOT TO SCALE GROUNDWATER COUNTOURS MAP REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM (v,� '�ST PIT :TA APPROPRIATE AUTHORITY. NOTES: WF1I I • ••y . '',. • '•'� • "/• ` •Vl1�J�S 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED t ' /' .f;1� ; :r' :•� *a ` PERC NO. 15373 •}i, 1�. , .. . • v�1 �` UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF (� ^ 1 28, �; , .>�. �f .,� , ; , � INSPECTOR: Donald Desmarais TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. EACH SEPTIC SYSTEM COMPONENT. !. •'" •? • ;� �` ' i EVALUATOR: Michael Pimentel, EIT, CSE t, ,I r'1h y� 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. 2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF i �� + ;�'�'-'-- • ' � .�.• a - C.S.E. APPROVAL DATE: Oct. 1999 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST �� � L. ' CDM�NER�E +� '` r� May 24, 2017 _ PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL II ,�..� ' ` �`�1 � +. DATE: Y MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. , MAP 317 <"4 TEST PIT# 1 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. / j Qom', FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PARCEL 57 ` �' y 1`�' ELEV TOP = 33.30' 4.1 �• ` a, r' 'd'� '� 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2, / � ® `� 'r .' �� acS AND THE ESTUARINE WATERSHEDS. -- -- .30_ , I ,�l ;j.•yl ��� ELEV WATER= < 22.30' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. WF-5 I 1 t . /� PERC RATE = see sieve results below 16. PROPOSED PROJECT IS LOCATED WITHIN: • \ '! ' - //{• MAP 317 LOT 58 P �,��• ( , I :; ' DEPTH OF PERC =_ _ ASSESSORS _ SWING-TIES MAP 317 I z i "j!' - �� OWNER OF RECORD: NANCY, JAMES & LINDA PETTIBONE O LOT 58 w w ' /="6 it • tjt + �. ;, • ' TEXTURAL CLASS: 1 _ ADDRESSES DESCRIPTION HC-1 HC-2 HC-3 .� 20,494 S.F ± I w a � { *y �' ( ) 42 SETTER WAY PO BOX 518, CUMMAQUID MA 02637 _ a �="" �� `ti'71 RESPECTIVELY I - o��16 a N i • LOCUS t �� Iru 1"e e 38 HEMENWAY STREET, APT. 23, BOSTON, MA 02115 CHAMBER CORNER (1) 33.6' 1&6' S� 5 C4 •i •. ,_t • '�.�', 011 33.30' 144 PAMASSAS STREET, APT. 19, SAN FRANCISCO, CA 94117 5 ,�'(9' CHAMBER CORNER (2) 38.6' 21.3' - WF 6 I O o �• "V..'.'.,�'� ' � b5 !1 •,_`�..�= Sandy Loam % o • • A FEMA FLOOD ZONE X / I co - I; �, r` '. ' �>. - q„ 10Yr 3/1 32.97' CHAMBER CORNER (3) - 50.5' 69.4' P O 5 : II. �' u COMMUNITY PANEL# 25001C0558J �ry w a ; � � '' �;I If •` c Sandy Loam •l�• I �:;f`` �� B 10Yr 5/6 17. DEED REFERENCE: BOOK 11776, PAGE 118 W CHAMBER CORNER (4) - 47.0' 60.9' / __, •I 7 16" 31.97' 18. PLAN REFERENCE: PLAN BOOK 250, PAGE 99 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Silt Loam CIOU, O ' ,, ` '. �_ C 1 CID W 2.5Y 6/6 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY / Q •� I• . �• .�~, .� • a' ' , r FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY S ` w I '� V' ��• �� // f. �S 36" 30.30' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. Uj 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A I} . s P" • ' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND 1,0 WI YHIIY Jj,"v'r•` f=iN(bri o*RADE. A / I O I `� � r i`` ;+_ • Med.-Fine Sand REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. WF-7 ti. iv'n 2.5Y 7/1 22. THE FOLLOWING LOCAL VARIANCE IS REQUESTED FROM ARTICLE 1, SECTION 360-1 �� C 2 (5% Gravel) (1) A 5.4'VARIANCE (100 0' -94.6') FOR THE SETBACK FROM THE SAS TO THE WETLAND 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE LOCUS PLAN APPROVALS ARE REQUESTED FROM 310 CMR 15.211 & 15.221 (7): (1.) A 9.4'WAIVER (20.0' - 10.6) FOR THE SETBACK FROM THE SAS TO HOUSE FOUNDATION. SCALE: 1" = 1000' (2 ) A 5.0'WAIVER (10.0' -5.0') FOR THE SETBACK FROM THE SAS TO FRONT& SIDE 1 I N �00 132"1 22.30' PROPERTY LINE. No Mottling, Standing or Weeping Observed (3.) A 4.9'WAIVER (10.0' - 5.1') FOR THE SETBACK FROM THE SAS TO A WATER SUPPLY LINE. (4.) A 0.6 WAIVER (3.0' - 3.6') FOR THE MAXIMUM COVER OVER THE SAS. TP�T PIT r)AT ' i I DESIGN DATA ' A 24. OWNER/APPLICANT/ CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL WF_g I I r , , f „1 ; yi -_ Y PERC NO. 15373 REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. IN NUMBER OF BEDROOMS (DESIGN) 4 SPECTOR: Donald Desmarais 't� 1 Benchmark EVALUATOR: Michael Pimentel, EIT, CSE LEGEND DESIGN FLOW 110 GAUDAY/BEDROOM Hydrant B.B. C.S.E. APPROVAL DATE. Oct. 1999 _ 50xO' EXISTING SPOT GRADE GAS Je Elev. = 33.00' TOTAL DESIGN FLOW 440 GAUDAY May 24, 2017 __ SN DATE: Y - 50 - EXISTING CONTOUR Approx. M.S.L. I _ GPS DESIGN FLOW x 200 % = 880 GAL/DAY TEST PIT#: 2 =n- PROPOSED CONTOUR GAS x30.9 ' USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP = 33.30' Jv �AS ', �' 50 PROPOSED SPOT GRADE I GAS GAS / _ \ / - I ELEV WATER = <22.30' _ ` 7 HC-3 'p t" ~-., \ TP 2 / _-D_----D-A ® � EXISTING GAS LINE PERC RATE = -D _ �/ BUSH (TYP) % INSTALL 4 - 500 GALLON H- 20 CHAMBERS EXISTING UNDERGROUND UTILITIES � � j 33x3' � i DEPTH OF PERC = w/ AGGREGATE TEXTURAL CLASS. 1 _ EXISTING WATER LINE LP I �- EX. LEACHING SIDEWALL CAPACITY x3l CATCHBASIN I ' EXiSTiNG I (TYP OF 2) (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.66 GPD/S.F.) = GAL/DAY EXISTING 1,000 GALLON SEPTIC TANK D-BOX TO BE �/ SLEEVE TP 1 ! (40.0'+ 11.83') ( 2 ) ( 2' ) ( 0.66 GPD/ S.F.) = 136.8 GAL/DAY 011 33.30' ABANDONED - A-� �-- -� I PROPOSED I I Sandy Loam ■ TEST PIT LOCATION SEPTIC PIPE % ■ / c 33x3' / I BOTTOM CAPACITY q,: 10Yr 3/1 32.97' •tS► ► PROPOSED (LENGTH x WIDTH) (0.66 GPD/S.F.) = GAL/DAY Sandy Loam PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE #51 is XiSTING ',000 GALLON SEPTIC TANK STOOP / H-20 D-BOX /' -PROPOSED 40 MIL (40.0'x 11.83') (0.66 GPD/S.F.) = 312.3 GAL/DAY B 10Yr 5/6 GEOMEMBRANE LINER, 16" 31.97' ❑ PROPOSED H-20 DISTRIBUTION BOX EXISTING � - �. TOP ELEV. =30.5' PROPOSED 500 GALLON H-20 LEACHING CHAMBER • / x 31.5 BOTTOM ELEV. =26.5' 4-BEDROOM 2 TOTALS: Silt Loam DWELLING HC '�`� �'� �+., ' TOTAL NUMBER OF CHAMBERS 4 C-1 2.5Y 6/6 TOF 37.3'± *�, / (4) PROPOSED 4-500 GALLON TOTAL LEACHING AREA 680.5 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE HC-1 �„/�.--�o ---.-- �-• (1) _ 1 H-20 LEACHING CHAMBERS ....�" 1 I WITH AGGREGATE TOTAL LEACHING CAPACITY 449.1 GAL./DAY 36 30.30' �,��►U `\ PREPARED FOR. 1414,1144 O N WATERLINE " -- / (APPROX. LOCATION �- �r-�` -34% O (3) CAPEWIDE ENTERPRISES Med.-Fine Sand PER TIE CARD) \ �_ �' - SIEVE ANALYSIS RESULTS 2.Fi 7/1 �I CHU Htt_L JR. O i 1 -ELECTRIC (Soil sample taken from C-2 soil in TP1) C-2 ° ��,=� LOCATED AT i✓ . _: . .�_ ": (5/o Gravel) �';-'. o TEMPORARY REL ./ `40.0 r , Box ' ° ,Is a �C 51 STONE HEDGE DRIVE SAND 71.6/o O S�oNE pR�VE ° BARNSTABLE, MA 02630 SILT 26.1 /o .CRUSNE �, (..2') cr I CLAY 2.3% � 'o_ ► � SCALE: 1 INCH = 10 FT. DATE: JULY 26, 2017 132" 22.30' 127 I PER TITLE 5 ALTERNATIVE TO No Mottling, Standing or Weeping Observed I zN OF o s io zo ao FEET PERCOLATION TESTING GUIDANCE -� ? cs PROPOSED FOR SYSTEM UPGRADES o JOHN L c PREPARED BY: INSPECTION PORT (EFFECTIVE DATE: MAY 3, 2006) CHURCH&LJR. JC ENGINEERING, INC. �X L PROPOSED 4" PVC UNDER POLICY BRP/DWM/PeP-P00-4: fMAL NO -41 VENT; EXACT SOIL TYPE: "UNCOMPACTED" 2854 CRANBERRY HIGHWAY is LOCATION PER MAP 317 % EFFLUENT LOADING RATE FOR I f q ° EAST WAREHAM, MA 02538 o 55. 41"VJ OWNER PARCEL 59 508 CLASS 1, 70-85% SAND= 0.66 GDP/SF I 3 SITE PLAN ASSUMED PERC RATE = 8 mpi .27377 S76 { 165? Drawn By: SJI Designed By: SJI Checked ec ed By MCP JOB No.3833 SCALE: 1" = 10' FINISH GRADE OVER D-BOX = 33t PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE �+ �!F�.7 + G.7 .._ T.O.F. EL.- 37.3 FINISH GRADE OVER CHAMBERS = 32.5 - 34.1 E A L IU l.�T E S t f PROVIDE EXTENSION RISER H-20 RISER WITH WATERTIGHT SLOPE @ 2% MIN. OVER SYSTEM 3/4" TO 1-1/2" DOUBLE WASHED 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION - WITH COVER OVER INLET& FRAME AND COVER TO GRADE H-20 CONIC. STONE TO CROWN OF PIPE. RISER WITH WATERTIGHT METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CAST IRON FRAME AND COVER TO INSPECTION PORT WITH ACCESS CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.- 35.0'f F.G. OVER TANK EL. = 34,4'f 5" DIA. OUTLET(S)FINISH GRADE OUTLET TO WITHIN 6" OF F.G. GRADE OVER ALL PIPED CHAMBERS -•. BOX TO F.G. (SEE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4" SCHEDULE 40 PVC PROPOSED 4" 9" MIN. MIN SLOPE 1% 3.6' MAX. TOP OF SAS = 30.50, 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL � " PVC TEE 36" MAX. , SEE NOTE 23 I SYSTEM UNLESS OTHERWISE NOTED. 4 SCH. 40 PVC 29.50 BREAKOUT EL= WE 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN � 1 SEWER PIPE 6„ 3„ 3" DROP MAX � _ � ELEVATION = 30.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 2" DROP MIN 3 9 + MIN SLOPE@I% L 8 t PROVIDE WATERTIGHT 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 4" PVC IN FROM JOINTS (TYP.) o � THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 1 f 14 SEPTIC TANK 4" PVC OUT TO 0 0 0 0 0 0 0 0 0 O �� 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. CONTRACTOR TO PROVIDE ! LEACHING FACILITY 0o o THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSALSPECIFIED DROP BETWEEN o 60 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 29.97` M N. 6 29.80� 2 00o 0 0 = = = �� oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS SHALL VERIFY SIZE 48" VERIFY CONDITION OF o0 00NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH AND CONDITION OF EXISTING TEES GAS BAFFLE 6" CRUSHED STONEEXISTING SEPTIC AND REPLACE AS o000 o AND DESIGN ENGINEER. OVER MECHANICALLY o 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 33.00' TANK NECESSARY COMPACTED BASE 33.0 8.5' (TYP) - 3.0 T I 3.5' I 4 83' 3.5' ESTABLISHED ON A HYDRANT BONNET BOLT AS SHOWN ON PLAN. j OUTLET DISTRIBUTION BOX (TYP.)TO BE INSTALLED ON A LEVEL STABLE P 40.0' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= � 22.30� THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT PIPES TO BE LAID LEVEL. i 27.50 *17�t 11.83' 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 4 - 500 GALLON H-20 CHAMBERS 4' MIN. djFif�MF-i•t CiVU wli-vil TO THE DESIGN ENGINEER. VIEW i 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. • ICI _ t. TYPICAL CHAMBER PROFILE H-2O CRAMBEIr� DETAILS *PER TOWN OF BARNSTABLE1992 CROSS SECTION V 5 C i I v i t- VN\ t-'(-�l r ILA, H-20 D I6 1 R I _._ .� I 1 .- N HUA DETAIL I 111. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING GROUNDWATER COUNTOURS MAP NOT TO SCALE I NOT TO SCALE NOT TO SCALE REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM WF-3 f , •`C , n PIT TA �"F�-� - T I-) APPROPRIATE AUTHORITY. NOTES: WF 4 / ; •S� '�• I •;'� /�,�; Cobbs 12, ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED #. �r l•ll ••/ , PERC NO. 15373 •?�• .f{• ' • . ;; :. : • . K . UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF P � + h ; ! ; .( '� ,: 1 �y� INSPECTOR: Donald Desmarais TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. EACH SEPTIC SYSTEM COMPONENT. -Z '•�_ •jJ• '-�••f�/••'�' �'� ��• '/� �1 EVALUATOR Michael Pimentel, EIT, CSE �� `� - l•.j l• M,� •' �i • r 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. 2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF "� :I •''f= '�s - '•• •• i' a - C.S.E. APPROVAL DATE: Oct. 1999 • THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST f' �� 1+ CQA,fMER E .�f .i ! 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE a DATE: May 24, 2017 PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL I. MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA, MAP 317 �� '1f �` �, ' s TEST PIT#: 1 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, PARCEL 57 , / ° FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2, ! Zz �` j 1 •�,;; ��; .� ELEV TOP= 33.30' _ AND THE ESTUARINE WATERSHEDS. �' Q�S� 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN �I +•� ;l�n � ' ELEV WATER = <22.30' SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. WF-5 ��, , • .� PERC RATE = see sieve results below 16. PROPOSED PROJECT IS LOCATED WITHIN: • \'� ( , I T L "1�. ASSESSOR'S MAP 317 LOT 58 P ;�(• Y-, ,,~ DEPTH OF PERC SWING-TIES MAP 317 ►- .�i• - ( �i ~, �'` , ., OWNER OF RECORD: NANCY, JAMES, & LINDA PETTIBONE LOT 58 � � ' . TEXTURAL CLASS: 1 _ � . /1", ��' ,�'� �' • .•' r �" ADDRESSES 42 SETTER WAY PO BOX 518 CUMMAQUID MA 02637 DESCRIPTION HC-1 HC-2 HC-3 20,494 S. ± w a ra�lr-�• ti • �� ! 1,L uJ + • Jt u (RESPECTIVELY). Q LOCUS -- e e 38 HEMENWAY STREET, APT. 23, BOSTON, MA 02115 CHAMBER CORNER 1 33.6' 10.6' - 0 56 0, N / • + ��l •� 144 PAMASSAS STREET, APT. 19, SAN FRANCISCO CA 94117 33.30' �' • b5 r �� -� 0 Sandy Loam FEMA FLOOD ZONE X CHAMBER CORNER (2) 38.6' 21.3' - WF 6 W m •��.� _ - ,� ��• ..,, L, /; •. ' Ile A 4„ 10Yr 3/1 32.97' CHAMBER CORNER (3) - 50.5' 69.4' P , C g .^�• ij. I 1 l 1i COMMUNITY PANEL# 25001CO558J ey u a }) 1.I ;i '' ° Sandy Loam •�(. -w.f : 'r B 10Yr 5/6 17. DEED REFERENCE: BOOK 11776, PAGE 118 LU CHAMBER CORNER (4) - 47.0' 60.9' j - ` "'it '' N I •I -- '+ ~�' '� - 16" 31.97' 18. PLAN REFERENCE: PLAN BOOK 250, PAGE 99 / \ ~ +�' `�'� •.���- �`' �� r - � '�1111 Silt Loam 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. ' �„ o� Lll O ,- it ��^ , C-1 2.5Y 6/6 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY If I• �,.J ' •~.� �' ' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 36" 30.30' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. LU , � ` st ' , 21. A 4" PERFORATED SCH, 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A / LU b • t ;} ` '' WITHIN 3"OF FINISH GRADE. A DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO W / Z ! " r Med.-Fine Sand REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. 2.5Y 7/1 22. THE FOLLOWING LOCAL VARIANCE IS REQUESTED FROM ARTICLE 1, SECTION 360-1 (n / ��i� C-2 (5% Gravel) (1) A 5.4'VARIANCE (100.0- -94.6') FOR THE SETBACK FROM THE SAS TO THE WETLAND 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE APPROVALS ARE REQUESTED FROM 310 CMR 15.211 & 15.221 7 : LOCUS PLAN (1.) A 9.4'WAIVER (20.0' - 10.6') FOR THE SETBACK FROM THE SAS TO HOUSE FOUNDATION. SCALE: 1" = 1000' (2 ) A 5.0'WAIVER (10.0' -5.0') FOR THE SETBACK FROM THE SAS TO FRONT&SIDE 132" 22.30' PROPERTY LINE. Yr No Mottling, Standing or Weeping Observed (3.) A 4.9' WAIVER (10.0' - 5.1') FOR THE SETBACK FROM THE SAS TO A WATER SUPPLY LINE. (4.) A 0.6'WAIVER (3.0' - 3.6') FOR THE MAXIMUM COVER OVER THE SAS. EX LEACHING Pl t TO BE PUMPED. 1 DESIGN DATA I �-% I H I I L)A I H 24. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL WF-8 \ "� FILLED WITH CLEAN, COARSE `� PERC NO. 15373 REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. SAND AND ABANDONED ---�� �' ,-` / INSPECTOR: Donald Desmarais NUMBER OF BEDROOMS (DESIGN) 4 Benchmark EVALUATOR: Michael Pimentel, EIT, CSE DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE. _ 50x0' EXISTING SPOT GRADE GAS F I Hydrant B.B. Oct. 1999 I r-_ -y r ` \y���R GAS / Elev. = 33.00' TOTAL DESIGN FLOW 440 GAUDAY DATE: May 24, 2017 _ _ _ _ _ _ 1 J + S 50 EXISTING CONTOUR _3,_ -� ✓1-' GAS Approx. M.S.L. DESIGN FLOW x 200 % = 880 �.- ' GAL/DAY TEST PIT#: 2 -� 50 PROPOSED CONTOUR �N �.- �p x30.9 yam' USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP = 33.30' GAS f <� `� / 50 PROPOSED SPOT GRADE GAS / G GAS ELEV WATER = < . _ 'i'% S -.� \ TP 2 l/ \ �----� / ® EXISTING GAS LINE �_D- D -1 PERC RATE _ ' / INSTALL 4 - 500 GALLON H- 20 CHAMBERS� w t3USH (TYP) �'\ \ � � - ,/ � - � DEPTH OF PERC - EXISTING UNDERGROUND UTILITIES 33x3' - � �4 ( I w/ AGGREGATE EX. LEACHING _ EXISTING WATER LINE ' TEXTURAL CLASS: 1 v SIDEWALL CAPACITY + % x31.3 CATCHBASIN `.� -; NC) (TYP OF 2) (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.66 GPD/S.F.) = GAUDAY EXISTING 1,000 GALLON SEPTIC TANK _) E1+.:)X TC? t3E \ # SLEEVE (40.0'+ 11.83') ( 2 ) ( 2' ) ( 0.66 GPD/S.F.) = 136.8 GAL/DAY F=.i+, Ni-Gh�C_t) _., �_� _ I PROPOSED TP 1 1 0„ Sandy Loam 33.30' SEPTIC PIPEry I BOTTOM CAPACITY A 4• 10Yr 3/1 32 97, % TEST PIT LOCATION �. c 33x3' CO* LENGTH x WIDTH 0.66 GPD/S.F. - GAL/DAY -- PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE PROPOSED ( ) ( ) - Sandy Loam #51 ` ''� '�'G ' ''`��' t,ALL()N i STOOP '� ' r rr H-20 D-BOX / PROPOSED 40 MIL (40.0'x 11.83') (0.66 GPD/S.F.) = 312.3 GAL/DAY B 10Yr 5/6 �' f -., I 1 GEOMEMBRANE LINER, Q PROPOSED H-20 DISTRIBUTION BOX TO LSE t.i-CI!_!7E IN THIS _..._-.----_•7 0 (. 16" 31.97' EXISTING I.�`,/ C1�T _-_ _._ .__ 1 r TOP ELEV. =30.5 4-BEDROOM & \ x31.5 BOTTOM ELEV. =26.5' TOTALS: PROPOSED 500 GALLON H-20 LEACHING CHAMBER DWELLING HC-2 '�' ""•-� C 1 Silt Loam t-- TOTAL NUMBER OF CHAMBERS 4 2.5Y 6/6 TOF= 37.3't �,,�s�' / (4) 1 �----PROPOSED 4-500 GALLON TOTAL LEACHING AREA 680.5 SQ. PROPOSED SEPTIC SYSTEM UPGRADE HC-1 �,/ �� -�.�• �"""� H-20 LEACHING CHAMBERS TOTAL LEACHING CAPACITY 449.1 GAL./DAY 36" 30.30' I ��6, (!��-" ' WITH AGGREGATE ���'�•,, PREPARED FOR: WATERLINE �34� O (3) �� CAPEWIDE ENTERPRISES / APPROX, LOCATION J N L. ( PER TIE CARD) -"'' it I - 0' ""'1 Med.-Fine Sand F CHv -Hff1 R. �.. . _ SIEVE ANALYSIS RESULTS O , i C-2 2.5Y 7/1 ,� ,� LOCATED AT j 34\ ' i L�EC RIC (Soil sample taken from C-2 soil in TP1) (5% Gravel) � o UTILITIES LINE TO BE TEMPORARY RELOCATED ; �% o' •�� I Box �'s c 51 STONE HEDGE DRIVE DURING (7nt Ri or•TInki -1 OR�vE� a? ��•- \ SAND 71.6% �R' SCONE i I r , SILT 26.1% BARNSTABLE, MA 02630 CLAY 2.3% -- -- -CRv (2) cr ` ' 132„ SCALE: 1 INCH = 10 FT. DATE: JULY 26, 2017 � \u?� I PER TITLE 5 ALTERNATIVE TO No Mottling, Standing or Weeping Observed tHOF o 5 �o zo ao FEET PERCOLATION TESTING GUIDANCE PROPOSED FOR SYSTEM UPGRADES o� JOHNL ue PREPARED BY: INSPECTION PORT iEFFECTIVE DATE: MAY 3, 2006) CHURCFfIL1.JR. -4 JC ENGINEERING, INC. PROPOSED 4" PVC UNDER POLICY BRP/DWM/PeP-P00-4: �� 2854 CRANBERRY HIGHWAY rX�X� VENT; EXACT SOIL TYPE: "UNCOMPACTED" LOCATION PER MAP 317 EFFLUENT LOADING RATE FOR �s o 4�'W OWNER CLASS 1, 70-85% SAND= 0.66 GDP/SF EAST WAREHAM, MA 02538 576 55 SITE PLAN PARCEL 59 508.273.0377 165 23 ASSUMED PERC RATE = 8 mpi SCALE: 1" = 10' Drawn By SJI Designed By:SJI Checked By: MCP JOB No.3833 l i. L --