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HomeMy WebLinkAbout0104 SWALLOW HILL DRIVE - Health 104 Swallow H.M .Drive r ;Barnstable .F/R A =. 336. 070 , I� o . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector. I key to move your cursor-do not Brian K. Tilton use the return Name of Inspector key. The Building Inspector of Cape Cod Company Name PO Box 307 Company Address I Eastham MA 02642 City/Town State Zip Code 508-255-9343 S14392 Telephone Number License Number B. Certification c w 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 ❑ Falls t— ❑ 'Needs Further Evaluation by the Local Approving Authority 7/26/2010 ¢ w s I c�or'sSignature Date r The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of:Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP..The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. k 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disp al System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 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: All components are.in place and functioning as designed. 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. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a.broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address w John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. City[Town State Zip Code Date of inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerwhich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50.feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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. 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection i B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia,nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: { D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or, clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded El N, or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is,.less than %day flow ® 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. 104 Swallow Hill Drive t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments cG ,M 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 0 ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large . system considered a significant threat under Section E or failed under Section D shall upgrade the. system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. .104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments o wM 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ 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)] 104 Swallow Hill Drive t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 4 DESIGN.flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑, Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: 7/26/2010 current Commercial/Industrial Flow Conditions: Type of Establishment: N/A 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: Last date of occupancy/use: Date Other(describe): 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is r equired for every Barnstable MA 02630 7/26/2010 page. City[Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Owner, last pumped 3 years ago. 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): Approximate age of all components, date installed (if known) and source of information: 1/17/2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ® 40 PVC ❑other(explain): Distance from private water supply well or suction line: Town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): No evidence of leaks, back up or clogs. ' Septic Tank(locate on site plan): 2' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: u years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 5'8"x 10'6"x 5'8 10 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 20 3 Scum thickness Distance from top of scum to top of outlet tee.or baffle 511 Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Accu-Sludge, Baffle Stick and Tape measure 104 Swallow Hill Drive t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): All tees in place and functioning as intended, system should be pumped at least every three years as regular maintenance. Irrigation lines are located over inlet, outlet covers and D-box, use caution when digging. Grease Trap (locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 104 Swallow Hill Drive t51nsp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 I •' Commonwealth of Massachusetts W Tile 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: N/A 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 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 level, equal flow to each outlet, no evidence of leaks or solids carryover. Irrigation line directly over top of cover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ 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.): 5 500 gal. leaching chambers with T of stone on sides and 2.5'on ends, lawn over top with 40 mil poly liner at top of grade above system, no evidence of break out, back up or hydraulic failure, center chamber excavated with no ponding or staining. 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan)' Number and configuration N/A Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction ,> Indication of groundwater inflow ❑ Yes ❑ No- Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: N/A Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts ' u Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. Cityrfown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. GARAGE/ OFFICE DECK .T1f(JT TO SCALE W DWELLINCn Al=17:3"B1=40', A2=23' B2=33' A3=31' B3=2$' 01 20 A4=33' B4=36.5' O SLOPE 104 Swallow Hill Drive t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System form - Not for Voluntary Assessments ,. 104 Swallow Hill Drive Property Address John Lennon Owner Owner's Name information is required for every Barnstable MA 02630 7/26/2010 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 11' + no water encountered. Estimated depth to high groundwater: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 11/22/2002 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You'must describe how you established the high ground water elevation: Design plans on file with BOH, hand augered through bottom of SAS,to depth of 11' from surface(7' below bottom of SAS) no water encountered. Corrected to estimated high water table using Frimpter method. ' 104 Swallow Hill Drive t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 HIGH GROUND-WATER LEVEL COMPUTATION Date: Site Location: , � S��I�D,tJ /r �"' _ !Permit:' Owner: JL74A 0v-\ Phone: Contractor: _em s[- -J j"►9 ai5 11 Phone: Notes: Ld c ca-b v� �'4 9 ' S���a�.� �s �`����41i ����� rrv►Nt gb� �l. S� STEP 1 Measure depth to water table to nearest 1/10 ft. fr1 I (depth is in feet below land surface) Date: f � ! I mm/d /yy feet below Is STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: /� d 1 �2� A) Appropriate index well B) Water-level range zone /T /13 STEP 3 Using monthly "Current Water Resources` Conditions" determine Current depth to water level for index well. ` mm/yy STEP 4 Using Table of Potential Water Level. Rise for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 213) determine water-level a b, i adjustment. 0 STEP 5 Estimate depth to high water by subtracting the i water-level adjustment (STEP 4) from 0 measured depth to water level at site (STEP 1). NOTE* Tables 1-9 "Flotential INater-Level Prise" are attached.as worksheets to this file. monthly index well data:�www.capecodcommission.org/welIs.html Cape Cod Commission: USGS Well Data-June 2010 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties,the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey(USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001: Estimation of High Groundwater Levels for Construction and Land use Planning to predict high groundwater levels. For your convenience, we've also provided a link to USGS national data. See the last column in the table and the footnote below. To see what's happening in real time at a separate well in Brewster, visit the USGS site USGS 414630070014901 MA-BMW 22 BREWSTER MA. For further information about any of the data or links on this page, please contact Hydrologist Gabrielle Belfit at the Commission offices (508-362-3828). '. June 2010 USGS Site Number****. Water Record Record Departure from Average** (lin Location Well No. ks to USGS Level* High* Low* Monthly Overall.. , national water- level database) NOT NOT NOT A1W AVAILABLE 230 AT THIS AT THIS AT THIS„AVAILABLE AVAILABLE Barnstable 19.5 26.6 41,3956070164301 TIME TIME TIME Barnstable 24W 21.3 20.6 28.6 2.4 3.1 414154070165001 Brewster BMW 21 8.1 6.9713.61 1.6 2.0 41.451.8070020301 Chatham CGW138 1 , - 22.9 r 20.9 26.61 0.2 0.9 414100070011101 Mashpee MIW 29 7.2 5.6 10.01 0.6. 11 1.2 413525070291904 Sandwich SDW 46.6 45.6 48.2 0.4 0.7 414418070241601 252 Sandwich SDW 46.3 45.8 55.1 3.1 3.7 414124070265901 Truro TSW 89 11.3 10.2 13.01 0.5 0.7 711420206070045901 http://www.capecodcommission.org/wells.htm 8/1/2010 Cape Cod Commission: USGS Well Data- June 2010 Page 2 of 2 LWelifleet] W 7W 9.4 IL7.3 12.8 0.4 1.0 d1415353069585401 BOLD New Monthly High Pink background New Record High * Measurements are in feet below land surface. Measurements are in feet above mean sea level. *x** USGS national water-level database provides historic data,hydrographs, and site maps. Go to Cape Cod Commission Water Resources Office"page Go to Cape Cod Commission Home Page http://www.capecodcommission.org/wells.htm 8/1/2010 I IF 0007 ; f Barnstable Harbor K�N ' r r illilljllllllllllllllIIIIIIIIIIIIIIIIIIIIII VL CP , I srsy ; �1Will G 47 L ( / MIO GAPE HIGHWAY n APE HIGHWAY r PE HIGH 0p;0 �OpP OLD IOWN HOU UP o F�vIN Y �� J m 0 \ i { a9l�i a - arse n4� Shall \ 4 Y 1- Roq nd O � egUaq et Lake ,. a ��1 i i 1 �� i �w�i r C 0 PO 0'� ��o-PYFL0PO "lad � • T' .as � ^4 ,a �aP lam. .. �✓4 -.3 � _'^! ;',1 4ValkL., n a -14 ''=i'�: �'�' Yy, Mr 'F ems;fir •. a „ ,p�, t 4V * lilts li Kr 1 ran u+Y d l '.. 1 '4 Eye alt 1347 it TEST HOLE LOGS ENGINEER: AH OJALA, PE 42.0' w1rNEss: DAVID STANTON LOCUS DATE: OCT. 1, 2002 -I, 3' MAX. PERC. RATE < 5 MIN,/INCH a 39.03' CLASS 1 SOILS P# 10341 z In 0of, Q ELEV.42.2 36.2' ' ,E - - - - _ FILL 2401 Cl SILT LOAM LOCATION -MAP, NOT TO SCALE . 53" 10YR 4/1 37.7' " ASSESSORS MAP 336 PARCEL 70 5' COS VARIANCES REQUESTED UNDER MAX. 6009 10YR 6/6 FEASIBLE COMPLIANCE 15.405: la: REDUCTION IN SETBACK, SAS TO C3 LOT LINE (10' TO 5') FS lb: REDUCTION IN SETBACK, SAS TO 2.5Y 6 6 , 31 .2' 66' FOUNDATION (20' TO 12 ) PERC C4 COS 2.5Y 6/6 132" 1 31.2' , NO WATER 'ENCOUNTERED ". n NOTES PTIC DESIGN: (GARBAGE DISPOSER is - NOT ALLOWED ) 1 . DATUM IS . ASSUMED SIGN FLOW: S BffDR00MS ( 110 rpn) _ 440 nor) r .. .. ... ._ .. __... .-,,.__..._ Town of Barnstable Geographic Information System July 25, 201C, vW IML A. t' Y F • jD• +. ,r s 1 � A &* _ - f a. `•.�• a ICY'' A �.�^` K > +"�� `... �xf '�+ � '� � , r ap ,r . r r - I (� 89 Fe�t DISCLAIM6tES:this map is for planning purposes only. It is not adequate for legal Map:336 Parcel:070 f I N boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:LENNON,JOHN J&BARBARA M otal Assessed Value:$689800 Selected Parcel 1"=100'may not meet established map accuracy standards, The parcel lines on this map _ ' are only graphic representations of Assessor's tax parcels, They are not true property Co-Owner: Acreage:1.21 acres Abutters w E boundaries and do not represent accurate relationships to physical features on the map Location: 104 SWALLOW HILL DRIVE such as building locations. Buffer S Aerial Photos Taken April 19,2008 Barnstable Assessing Search Results Page 1 of 2 Home:Departments:Assessors Division:Property Assessment Search Results New Search �: . : .New Interactive Maus» Owner: 2010 Assessed Values: LENNON,JOHN J&BARBARA M 104 SWALLOW HILL DRIVE 2010 Appraised Value 2010 Assessed Value Past Comparisons Map/Parcel/Parcel Extension Building Value: $318,000 $318,000 Year Total Assessed Value 336 /070/ Extra Features: $25,300 $25,300 2009-$935,000 Outbuildings: $0 $0 2008-$940,300 Mailing Address Land Value: $346,500 $346,500 2007-$945,200 LENNON,JOHN J&BARBARA 2006-$962,000 M 2010 Totals $689,800 $689,800 104 SWALLOW HILL DR Residential Exemption Received=$92,000 BARNSTABLE,MA.02630 2010 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $139.3.5 Fire District Rates Town Residential Barnstable FD-All Classes $2.43 $7.77 C.O.M.M.-All Classes $1.26 Town Commercial Barnstable FD Tax(Residential) $1,676.21 Cotuit FD-All Classes $1.56 $6.87 Hyannis-Residential $1.82 Town Tax(Residential) $4,644.91 Hyannis-Commercial $2.88 W Barnstable-All Classes $2.28 Community Preservation Act 3%of Town Tax Total: $6,460.47 Construction Details Property Sketch Legend Building Property Sketch &ASBUILT Cards Building value $318,000 Interior Floors Wide Pine Style Colonial Interior Walls Plastered Model Residential Heat Fuel Gas - — Grade Average Plus Heat Type Hot Air 1 Stories 2 Sty w/FAT AC Type Central <' Exterior Walls Wood Shingle Bedrooms 4 Bedrooms $ . Roof Structure Gable/Hip Bathrooms 4 Full Roof Cover Asph/F GIs/Cmp Living Area sq/ft 2,924 Replacement Cost $327,787 Year Built 1979 IA Depreciation 3 Total Rooms 11 Rooms - ,PTfI: Land Gross Area sq/ft 6.620 CODE 1010 Lot Size(Acres) 1.21 http://www.i.own.barnstable.ma.us/assessing/2010/displayparcell0map.asp?mappar=336070 8/1/2010 Barnstable Assessing Search Results Page 2 of 2 Appraised Value $346,500 As Built Cards: 1 Assessed Value $346,500 EL M View Interactive Maps >> Sales History: Owner: Sale Date Book/Page: Sale Price: LENNON,JOHN J&BARBARA M Cci,18 2002 12:OOAM 15764/197 $675,000 CLEARY,ROBERT A Feb 14 2001 12:OOAM 13560/041 $0 OLEARY,ROBERT A&LISA M Oct 15 1995 12:00AM 9886/198 $1 OLEARY,ROBERT A&PATRICIA 2492/99 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL FIREPLACE 2 $5,800 $5,800 BFA1 Bsmt Fin-Good 680 $19,500 $19,500 Property Sketch Legend BAS First Floor.Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST. Utility Area(Unfinished) FAT Attic;Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.barnstable.ma.us/assessing/2010/displayparcell0map.asp?mappar=336070 8/1/2010 TOWN OF,BARNSTABLE LOCATION 104 SWALLOW HILL ROAD CUMMAQUaWAGE # 2002. 4B0 MAP3 VILLAGE CUMMAQUID �� b� ASSESSOR'S MAP 6z LOT INSTALLERS NAME & PHONE NO. ELLIS BROTHERS CONST. CO. 362'-6237, .SEPTIC TANK CAPACITY ' LEACHING FACILITY:(type) 5-- $oo 64•c//A- arey(size) f J X y X r2 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER UP30 BUILDER OW6WNE 0 &4156" t., DATE PERMIT ISSUED: 02 DATE COMPLIANCE ISSUED: 1a 3 VARIANCE GRANTED: Yes No TOWN OF BARNSTABLE ' LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT_... ':INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY d LEACHING FACILITY: (type) (size) NO. OF BEDROOMS v BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet J g Y Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I 1 y LIN e v fi . TOWN OF BARNSTABLE LO6,TION 104 SWALLOW HILL ROAD , CUMMAQUaWArGE # 2002.=480 GUMMAQUID MAP3 pp VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ELLIS BROTHERS CONST. CO. 362-6237 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 56o64-C114P4&;e(size) I1 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER 6PUCci BUILDER O OWNE 6 FF(364" Lr,;_A1,A1p V DATE PERMIT ISSUED: / /02 DATE COMPLIANCE ISSUED• VARIANCE GRANTED: Yes No r "33' r � 7 vo 1 LO CAT IONlG � SEWAGE PERMIT NO. . lam VILLAGE _ INSTA LLER'S NAME & ADDRESS B U I'L D E R OR OWNER o L e.a ict DATE PERMIT ISSUED . Jf ' DATE COMPLIANCE. ISSUED '-/S` °�� �a • U THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH OF..........)? Appliration for 11ispoii al Works Toustrnrtiun "ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .: ------- L c�?" �D. Location-Add s •-----'or L�ot�.r.o.---•.............................•-^•--- Ow Address wY------•----------------------- --••--•-•---------------------•-•---------..................� ...................-••••--- ,� lZ' 7�0.. In taller41 Expansion Attic Address Garbage Grinder Type of Building Size Lot...-_______;.. Sq. feet v Dwelling—No. of Bedrooms................. p ( ) g (�) aOther—Type of Building ............................ No. of persons......... .....__._.._... Showers (Z) — Cafeteria ( ) QOther fixtures ---------------- ------------------------------------------------------------- --------------------------------................................... W Design Flow....../`a.............f__ ._ allons per person per day. Total daily flow......... .......................gallons. WSeptic Tank 7L Liquid capacjtYdVjiM&gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench 1—No..................... Widt Total Length.__,--''- .. Total leach' g area..................sq, ft. Z Other,Distribution box ( Dosing to k ) -06 /�C/'rh - 3-3 -7 - /� -- a v ti► T � Percolation Test Results Performed by.. --- ..�........................K.r„___..._._____.___:. Date....J .......... ,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �Zq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil------..... ........ --(tee ------ _ -- U Nature of Repairs or Alterations—Answer w applicable . ------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i I'L1E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issuUbheboard of hea . Sign --- ------- -- --- -!�_ -------------_---------•--- -------------------------------- Date Application Approved BY .._.. Lt/LrG .--------- -- l--- ���// Date L pplication Disapproved for the following reasons:-----••--------•------------------------------------•---------------------------•---------------.............---- .....-----•---•--......--•-------• ....-•---•------------------------------•---------------------------....--------------------------------------••-------------------------•-- Date b y / Permit No.-•-•--•-•-•----•-----------------------= Issued �--•------•----... f. O Date ~y THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH "1-------.OF.......... .............................. Appliration for llhipvii al Works Tnnitrnrtinn amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at dkV 1�,C:Wr �0� __' __ -_ �Oer Address --- .. `• al -.............•---••••-•-•--•--- .......-••-----•----------••--•••-••-••---•• •••••--•--•- -•-•....--•- � Installer Address r�ji�M UType of Building Size Lot____ 4 4____ __*'__._Sq. feet 0-4 Dwelling—No. of Bedrooms.........____ ...............................Expansio ttic ( ) Garbage Grinder (A(.) p., Other-Type of Building ____________________________ No. of persons-------_,7................. Showers (Z) — Cafeteria ( ) Q' Other: ixtures ............................ W Design Flow_j___l� ________________ gallons per person per day. Total daily flow__.__._ ' _gallons. R; Septic Tank rt-•I iquld capacit gallons Length................ Width................ Diameter ° . Depth__. .:. Disposal Trenchf—No_ ____________________ Width___ .... __._._ Total Length.__S_ ........ Total leaching area___ _a4 r..sq. ft.'- Seepage Pit No--------------------- Diameter..................._ Depth below inlet_______ __....... Total leach'?g area..................sq. ft. Z Other,:Distribution box ( ) Dosing t l( ) � /d�� w R, r Percolation Test Results Performed by.______ ___!'j.- _AA !k.....______..X..._______________ Date._._'"_ _ '_____.__.. Vest Pit No: 1________________minutes per inch Depth of Test Pit.................... Depth to ground water......... ........... ,.Test Pit No. .2................minutes per inch,..Depth of Test.Pit.______.____________ Depth to ground water........................ 0 ---•-- � r -•----r-•- --•--- ._ O Description of Soil_...-----p....... ......• l -P. �� � - ___ __________ W ______________ _____________ _________ _________ ....................... .......... ..... U Nature of Repairs Aerations An Wer when a plicable , ^� _ ........... •-------•-----............... . ---• .......... . ad Agreement: Cl Z '0 y/0 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the prsions of TITLi: of,the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issue the board of he h. Sign I.._. Date Application Approved By..-•- f _ l �,�;11Ctrlr6'..................... �r�" Date Application Disapproved for the following reasons Y......................................._____________............................................................ --•................•......._..---•--------------------------..._....•.•--------------.......----------------.::--•------•--••--•--•-•------••-------------•-•----------•---••--------•-----•----•-•-•-•- Date .• ;P6&ieNo.---••-•-•-•••-••••-•--•.._ Issued........................................ r .3 -•---•---•------ ------^-• '--•- -- Date - THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 7� .........2... 1............OF....... .. _.. '�! ' ( ItifirFate of Gam' ' �itturr THIS 0 C R Y, Thatividual Sewage Disposal System constructed ( )'"or Repairedby' B_ . .. : ._.. - -- ---- In ller has been installed in accordance ith the provisions of TIT Z j of Thei State Sanitary Code as describ d in the application.for Disposal Works Construction Permit No......................................... da.ted_..0! "__?--- 7 .._. , THE ISSUANCE,, OF THIS CERTIFICATE'WALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE �I SYSTEM VIAL FUNCTIOI TISFACTORT DA / _ nspector °'• ......... ......• -.....••• _-••- t , : THE COMMONWEALTH OF-MASSACHUSETTS BOARD OF HEALT ................. ........OF.............W.. i.............. No._....L............... FEE..................... ... t Mtn n n nno#r. in amit Permission is hereby granted.:= d ---------------- _ ..__* ..„, to Con c �" r Repair ) an Individ age =�sa`A7. ..:_.. Street as shown on the application for Dispos :Works>Construction Perm No_________ •. ______*ofH4ea1`th ted__..�. " ............ -----o DATE7r. - ' -- ? ----•------------------------------------------•--- FORM 1255 HOBBS & WARREN,'INC.. PUBLISHERS r - F C } I I r i r � r � () 4- sew 14 O 4-1 J 2 7, ��1N Of M l � "r RICHARD �„ �/`t RICHA 1AMES 1 z }AMEs O'HEARNQNE674�4 No, 27e71 �FG►STE��QO LEGEND tia sayi5aa`a SURD`'ems` EXISTINr SPOT ELEVATIONS 0,0 j." EX ISTIN�i CONTOUR- - -- 0 - - - - FINISHED SPOT ELEVATIONS 0.0 .__ FINISHED CONTOUR 0 PROPOSED PLOT PLAN APPROVED- BOARD OF HEALTH ' rVIASS. C AGENTT_#�-- I CERTIFY. THAT THE PROPOSED R d ~OWEARIV, !NC, RL.,St R,S . !BUIi:DING SHOWN ON THIS PLAN IDI MAIN ST. !RTE. 28 , CONEOR"AS 1'U THE: ZONING LAWS WEST DENNIS, MASS . �DATE ; .c'_1� SCALE 1z. 4 7 G.t � Tr LAND SURF `�'C.n ' �;. EY E`' �_ H EE T OF „-.,. ""T^' .,.......,. wus,e.•,o-......a•w...,..._....,,n... ..-,., ,, .. .-,. .:.......,.w,.w.�..�w.aw.,+.W,,.. ..w..•dwc.,,,A Sv L. TEST DIVERT ELEWA i NONS NO`EO: , PATE OF SOIL TEST, ` INVERT AT BUILDING �e'S FT. ''ALL WORKMANSHIP AND MATERIALS WITNESSED BY —Cl'/ INLET SEPTIC TANK 2g- ° FT. SHALL CONFORM TO D.E.Q.E. TITLE ,5 PERCOLATION RATE ---L MIN./INCH OUTLET SEPTIC TANK 97- 8 FT AND THE TOWN OF f-RULES OBSERVATION HOLE 1 OBSERVATION HOLE 2 INLET DISTRIBUTION BOX T7• ° FT AND REGULATIONS FOR SUBSURFACE 1 LEVATION _ ELEVATION= OUTLET DISTRIBU110N BOX 1G: 8 FT. DISPOSAL OF SANITARY SEWAGE E ' _ �'• - / ----Q INLET LEACHING PIT 24,0 FT, Zi Atc TOla3o� ! s✓sso< 4� o� ,,,� a 15'it-Y D. BOTTOM LEACHING PIT 90.o FT. �j�?StJ7r.�77 c.�T n�R.r-� � S,",el L i9C'CO2lJlnr ptti aG.. DESIGN CALCULATIONS s- OIL fl 1 NUMBER OF BEDROOMS . 4 _ 78 . . . . GARBAGE DISPOSAL UNIT... . . . . . . . . . . . NdN TOTAL ESTIMATED FLOW ( L.2 GAL./GR./DAY x.::?_.8R.)... 44 0 GAL./DAY Fz-- st. REQUIRED SEPTIC TANK CAPACITY. . .. . . . . . . . . . .. . . . . ... ? GAL. 144 • ` ACTUAL SIZE OF SEPTIC TANK TO BE INSTALLEIP,.. . /40 0 GA:I , LEACHING AREA REQUIREMENTS SIDE WALL AREA LLGAL./S.F BOTTOM AREA_/ GAL./S.F. ( ¢ GAL. LEACHING CAPACITY ( BOTTOM � SJDEWALL ).. .... . . . .. . r c-, r 'RESERVE LEACHING GAL. o TOP OF 'FOUND. ` LEV.=/�> SCH. 40 CONCRETE 4�� COVERS PVC PIPE CLEAN SAND MI PIT:;H CONCRETE IlB�� PER. FT. \ C VER 2% MIN. PITCH 1t+ of Hof Mee ; i� 12 MAX. Mrs _ I 6 _ ti FLOW LINE , �' g 2 { LAYER OF 1/8" 1/2� ono RJAWS ICHAPO s e�AME° a WASHED STONE O'HEARN o 0•HEAP.N cam» E �C,d :-y No. 27871 O H J No. 694 CAST IRON 3/4 1 1/2" MIN.. PITCH w » ; "o WASH'E-D STONE O y SANItAri'> PER FT. MIST. o >z n n �- b PRECAST LEACHING > SOX c�°- p BASIN OR EQUIV. n w w �` •a. iA_0 ' A +c , O by LOT mil_ J� O GAl_ AC ? i SEPTIC lb ,, R. 0. O HEARN, 191 MAIN ST: t R T t �. r WEST DENNIS MASS. PROFILE OF GROUND -WATER TABLE -Et- EWA E DISPOSAL SYSTEM JOB NO. / 78 CLIENeO �,�,c� t NOT TO SCALE DATE SHEET z OF `- a No. ?00a. � , Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ftplication for �Bigpooar *p5tem Construction Permit Application for a Permit to Construct( )Repair( ))"Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.. I 0 Ll s f vy? e"; r r y- �� ' Owner's Name,Address and Tel.No. Assessor's Map/Parcel Gw-­� 11 &/I i l ytd S &. 0� Installer's Name,Add less,and Tel.No. Designer's Name,Address and Tel.No. l�1�vSaDO�rJ' c�i,.�� pat„ •,_. G�yv! � 7j, a 3ry� 3 /- Type of Buil ing: Dwelling No. of Bedrooms�� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Y) ri v. d 9 a40 Number of sheets Revision Date Title It Size of Septic Tank 7 S o d Type of S.A.S. J _ 0 L psvh� �h y /3ra Description of Soil &-r Nature of Repairs or Alterations(Answer when applicable) S f S-el4L, 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 Ti of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance h een iss y t ' Board�allh. Date ' Application Approve by ozi 4-1 zuy Date Application Disapproved for the ollowing reasons Permit No. 2 0a::?-VLO Date Issued „,. ,,,�, .... r �..,�_._�.. ,.,` :.'...�. .r.. ,G ` - � �% ,;„y�Ari i'"�tl+;iv+• 414.i...s••�i�c!'..�+=�'rlYr.rY-7'+Cr,.,it...a`^g4riik�<vC«r."'�*�pynTM�j�i-'„q.'+:.+'tih'�w�,M+/"+...:T�-.... ��fV • r 4 .. ow �0” Fee V' Pam.'"".�'.�k�{� .g,e y Y. THE COMMONWEALTH OF MASSACHUSETTS Entered in compu der: 1 Yes A, -PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSTTTS 01pprtcation for ZigoM *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1 U 41�S,4,1 J it"- 1i, 1?, 011 t' Owner's Name,Address and Tel./No..l &9 i/3 r rj L ^7,7 G h Assessor's Map/Parcel / (I lZ 11?v 33G Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Cc.� C 5/1-/ Type of Buil(fing: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date h &I/ a a .} Gc-;) Number of sheets Revision Date Title �``"'�••. Size of Septic Tank ) Soo Type of S.A.S. So c 65 �J L �yc 6, '7 C �"} s d f 1° Description of Soil S �' S'cr 1_a Nature of Repairs or Alterations(Answer when applicable) S P S'r�J , C. /� Sl h 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 Title2-5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance harbeeeen issued-by ss ed-by t a�Board o alth. Sign Date �� �— UZ Application Approved by Date /J ?�—o Application Disapproved'for the ollowing reasons Permit No. 2 0 Q- 00 Date Issued l l 26-v? THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance ry THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by t-1 l 1-S 6 c .S Cc» S i A at 1 D W Sw l i oy /1 , l / O rVV--f �H ,�/l fir^5 as been constructed in accordance with the provisions of Title 5 and the for Disposal System Constructioryfermit No. dated /� 102 Installer ri 1 i S QC0'r/'1'cS CC40. CO Designer J-i47n C5�- /-'kf�,,n i The issuance of this permit shall not be construed as a guarantee that the sy i m will function 11;Jesi"" d. Is Date 1 1'�� U 2� Inspector / �✓. �� - No. 20y.?- \111ro Fee J y THE COMMONWEALTH OF MASSACHUSETTS 5 PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Zigozar 6p6tem Cougtructiou Permit - Permission is hereby granted to Construct( )Repair,( )Upgrade( )Abandon( ) System located at [n,�tnSlS�i 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of th' pern! Date: r / Approved by TOWN OF BARNSTABLE N 104 SWALLOW HILL ROAD CUMMAQUI WAGE # 20;02.�480 LOCATION CUMMAQUID tt MAP3 VILLAGE ws. ct�� ASSESSOR'S MAP & LOT INSTALLERS NAME & PHONE NO. ELLIS BROTHERS CONST. CO. 362-6237 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 5oo 61�,CAIA M�y(size) 1 Ar y-I X 17, NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER U1300— BUILDER O OWNE' &14156A" Ld AI)ryc>rJ i.a DATE PERMIT ISSUED: / /02 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No "su tv -3 3` C3 ti rb � _ . �,� TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION ~ OWNER AND INSTALLER INFORMATION.`"'' ADDRESS: 104 Sw*A(,LoQ-) I+, it P , MAP NO. PARCEL NO. OWNER NAME: n' E pz--r* L 6 A Q (A VILLAGE: l` ,:,1 4M AA A C a j i . INSTALLATION DATE: "i ! BY: VI/i) L'o CE TANK INFORMATION K LOCATION OF TANK: 6Ak ( . 61 .. t ° CAPACITY 606 TYPE AGE FUEL/CHEMICAL �..» 5 TESTING CERTIFICATION C<] PASS C ] FA I L';f DATE A VG1 1 LEAK DETECTION Cl� CHECK IF N/A TYRE/BRAND ZONE` OF'`CONTRIBUTION C ] YES . C ]' NO, DATE TO BE REMOVED t91 FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE . } CONSERVATION C ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. CC ]C ]C. ]C ]' DATE PLEASE PROVIDE. A 'SKETCH SHOWING,,THE TANK,, LOCATION ON THE` BACK -OF-THIS CARD ` i PWK is A A 60 1 S. q i,4rvv 6 wigC. - P.O. BOX D BUZZARDS BAY, MASSACHUSETTS 02532 i r y .!a. I',, a TIrV rL45lt` ice'-i' o t to �� - � L' � cv (} h M'lllA1LD kPI�1B/c Ct'1n � _ I' R -9IM,14*9PIC P. Nl1J � i11tKT 0�Mr61 • U . /'-� i � 0.j �,'• � 1 �1 • �'��i! _Il5csF1N4 �. Mi+a- IExls�ta. w►+w+� �` '�� ; / 1Tlj 14 ZA t � �,•a x � 1 OR 1 V i EW 17+iUt'f t i " i-O'' t TOP FN N EL. 43.0' SYSTEM PROFILE TEST HOLE LOGS D ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO ENGINEER: AH OJALA, PE LOCUS MINIMUM .75' OF COVER OVER PRECAST r WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 42 O' WITNESS: DAVID STANTON }. DATE: OCT. 1, 2002 OUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE r ok Frost 2' PR OSEo 1500 3' MAX. PERC. RATE - 5 MIN 71 Cti G I.LON SEPTICJA g,� � � I # 10341 �PE � � • 39.03 CLASS SOILS P j IP TARS (H- 10 GA5 38.rJCI' ti 38.2 C 3 0 0 0 0 0 0 0 ELEV. 6" CRUSHED STONE OR MECHANICAL 171171171171 0 moor] . 4 , 0 . COMPACTION. (15.221 [2]) MIN g 2' 0 0 0 0 0 � 36.2' '' ( 2 % SLOPE) X SLOPE) 0 0 0 0 0 DEPTH OF FLOW = 4 .5 1 �( y TEE SIZES: 10 3/4" TO 1 1/2" DOUBLE WASHED STONE 24„ FILL & m INLET DEPTH = OUTLET DEPTH - 14" Cl LOCATION MAP NOT TO SCALE SILT LOAM FOUNDATION-- EXIST SEPTIC TANK 22' D' BOX 20' LEACHING 53" 10YR 4/1 37 7' ASSESSORS MAP 336 PARCEL 70 FACILITY ,k THE INSTALLER SHALL VERIFY THE C2 LOCATIONS OF ALL UTILITIES AND ALL 5' COS VARIANCES REQUESTED UNDER MAX. 1 BUILDING SEWER OUTLETS AND 6001 10YR 6/6 FEASIBLE COMPLIANCE 15,405: ELEVATIONS PRIOR TO INSTALLING ANY 1a: REDUCTION IN SETBACK, SAS TO PORTION OF SEPTIC SYSTEM. C3 LOT LINE (10' TO 5') FS 1b: REDUCTION IN SETBACK, SAS TO Cn 31 .2' 66 2.5Y 6/6 FOUNDATION (20' TO 12') ; PERC 71.51 N C4 It COS M 2.5Y 6/6 L0T ,7 132" 1 31.2' NO WATER ENCOUNTERED 52,70o sFt - : - � � NOTES: F ASSUMED SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) 1 . DATUM IS , DL51GN FLOW: 5 BEDROOMS (. 110 GPD) = -GPD 2. MUNiCi?AL WI TER is EXI�,T!NG ' USE A 550 GPD DESIGN FLOW 3, MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. UNDERGROUND UTILITIES COME INTO HOUSE HERE SEPTIC TANK: 550 GPD ( 2 ) = 1100 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-, 10 r 12.47 32.as � 5. PIPE JOINTS TO BE MADE WATERTIGHT. SHOELIE LINE + BENCHMARK USE A 1500 GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. + SHOWN APPROX. / / NAIL IN 24" MAPLE ELEVs 42.8' LEACHIN ENVIRONMENTAL CODE TITLE V. ' --.��G _ 2(47.5 + 10.83) 2 (.74) = 172 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE SIDES: 3 �1 DSHELL RIVEWAY �' BRIC c� r USED FOR LOT LINE STAKING. / �t3'6' WALK 4 DECK r'� BOTTOM: 47.5 x 10.83 (.74) = 380 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. TOTAL: 746 SY, 552 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED i1 a 3 3 USE (5) 500 GAL. LEACHING CHAMBERS WITH 3 8 ATE LIN FROM BOARD OF HEALTH. H0 A PR M -- OX. EXISTING STONE AT SIDES AND 2.5 AT ENDS 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING LEACH PiT5 31. 7 �+ ' DWELLING -- C AR 8 +41.7 { s . 32.06 a +41.7 J� �' TF 43.0' =1's�109 10 C AR � � +41.11\ \` N PROVIDE APPROXIMATELY 60' OF 40 oN_ / MIL LINER AT 5' OFF LEACHING ND TITLE 5 SITE PLAN � i cS• T34 28 M PLE `� �f2 Q3 J , 42.32 FACILITY IN AREA SHOWN, TOP AT EL. It 46 c3`O APP OX �� - BRICK WALK �V 39.0', BOTTOM AT EL. 35.0' 100.0 PROPOSED SPOT ELEVATION n OF t3 .1g UG JTILI FCJ PIT REA + 58 / 41. 9 1500 104 SWALLOW HILL DRIVE FLAG E �► GAL ST 32.$ AS g 41.89 1 + 100x0 EXISTING SPOT ELEVATION �? IN THE TOWN OF: _-----'"� m BUS B S£ y o� 10o PROPOSED CONTOUR ( CUMMAQUID ) B A R N S T A B L E + 1 5 743 CA V- e 100 EXISTING CONTOUR 1.93 nj EXI NG �100 HT V77 ��, 41.95.._. PREPARED FOR: gARBARA LENNON .� SE--7 TANK F,, 5' REMOVAL OF UNSUITABLE SOIL 3 0 (REPLA WITH GAL. TANK 41.91 REQUIRED AROUND PERIMETER OF ELEC H`NOBOX 5---- 1 LEACHING FACILITY, DOWN TO SUITABLE SOIL LAYER (C2). 20 0 20 40 60 �3109 co WITH CLEAN MED. SAND. BOARD OF HEALTH M D) ENGINEER TOM INSPECT AND MA 1+' = 20' NOVEMBER 22, 2002 CERTIFY REMOVAL. HALLOW HILL STONEWALL � a�/ APPROVED DATE SCALE: DATE: DRIVE 43.67 H OF off 508-362-4541 M fox 508 382-9880 tIH Of I ,yA�F9 p,` ARNE I,.,ARNE �y OJAL4 N o H, CIVIL dawn cape engineering, inc. U awLA 0.30792 o No.26348 ' e ��•� � TE CIVIL ENGINEERS �`� Nq►/SANa�S � AL G��� LAND SURVEYORS _ - 02--319 • '--319 939 vain -st, yarmouth, ma 02675 ARNE H. OJALA, P.E., P.L.S. DATE