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Home My WebLink About0012 HARBOR HILLS ROAD - Health 12 HARBOR HILLS RD, CENTERVILLE A= 247 074 _ �1/D �QEcvc�o�o �J y� UPC 12534 No.2_LOR ° HASTINGS,MN Pf Commonwealth of Massachusetts Executive Office of Envirolunental Affairs ik Dept. of Environmental Protection One winter Street,Boston,Ma. 02108 John Grad D.E.P. Title V Septic Inspector P.U. Box 2119 Teaticket, MA 02536 WILLIAM F.WELD (508)564-6813 Governor ARGEO PAUL CELLUCCI ''?• Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART A �r�ivEO l.w CERTIFICATION LLL r� IT �101/ 1 3 1999 Property Address: 12 HARBOR HILD'RD.W.HY—AINMRT MAP 247 LOT 074 Address of Owner. lulu Date of Inspection: 10/2/98 (If different) fiWNOFgq t, Name of Inspector: JOHN GRACI GLYNN;428 CENTRAL.AV.MILTON MA �AITHDt I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) 4a; Company Name,Address and Telephone Number: CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: x Passes This Inspection Is based on criteria defined In Title V _ Conditi n IIy Passes code 310CMR16.303.My findings are of how the system Is performing at the time of the inspection.My Inspection does _ Need F ther Evaluation By the Local Approving Authority not Imply any warranty or guarantee of the longevity o►the Fells septic system and any of Its components useful life. .Inspector's Signature: Date: lo17f98 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Co1hpllance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, Is cracked,structurally unsound,shows substantial Infiltration or exflltralion,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised WW/97) One Winter Street • Boston,Massachusetts 02108 is FAX(617)556-1049 0 Telephone(617)292-5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL AV.MILTON MA.02186 Date of Inspection:101`21e8 _ Sewa4e backup or.breakout or high.static water level observed.in.the distribution box is due to a broken. or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced —The system required pumping more than four times a year due to broken or obstructed pipe(s). Tile system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 40ther -- -- — — -- ----- D] SYSTEM FAILS: You must Indicate either"Yes"or"No"as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. nisrhwge or ponding of effluent to the§urface of Ills ground or`LIrf1JCe water§No to an overloaded or clogyed cesspool. SAS is in hydraulic failure. (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 12 HARBOR HILL RO.1N.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL AV.MILTON MA.02188 Date of Inspection:10►2198 Dj SYSTEM FAILS(continued) Yes No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revlaed 0427)97) SUBSURFAC E SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 Owner: CLYNN;428 CENTRAL AV.MILTON MA.02180 Date of Inspection:1012199 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: ,c_ — Pumping information was requested of the owner,occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this inspection. x As built plans have been obtained and examined. Note if they are not available with N/A. x — The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. _c_ — The site was inspected for signs of breakout. x _ All system components, excluding the Soil Absorption System,have been located on the site. x The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge,depth of scum. x The size and location of the Soil Absorption System on the site has been determined based on — — The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is — — unacceptable)(15.302(3)(b)) (revised 0427)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL".MILTON MA.02186 Date of Inspection:1012198 FLOW CONDITIONS RESIDENTIAL: p.d./bedroom for S.A.S. Design flow: 0 V. Number of bedrooms: J Number of current residents: 0 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings, if available:(last two(2)year usage(gpd): rda Sump Pump(yes or no): No Last date of occupancy: nla COMMERCIAL/INDUSTRIAL: Type of establishment: nle Design flow:0 gallons/day Grease trap present:(yes or no) !Lo Industrial Waste Holding Tank present:(yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) Ne Water meter readings,if available: nle Last date of occupancy: We OTHER:(Describe) We Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Na System pumped as part of inspection: (yes or no)No If yes,volume pumped:0 gallons Reason for pumping: rUa TYPE OF SYSTEM Septic tank/distribution box/soil absorptions system x Single cesspool x Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any) I/A Technology etc.Copy of up to date contract? Other: APPROXIMATE AGE of all components, date Installed(if known)and source Information: ORIGINAL SYSTEM IS 40 YEARS OLD WITH A NEW PIT INSTALLED APPROXIMATELY 10 YEARS AGO. Sewage odors detected when arriving at the site:(yes or no) No (revised 04127)971 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL AV.MILTON MA.02186 Date of Inspection:1012199 SEPTIC TANK: (locate on site plan) Depth below grade: Na Material of construction:_concreate_metal_FRP_Polyethylene—other(explain) If tank is metal, list age rda . Is age confirmed by Certificate of Compliance No (Yes/No) Dimensions: Na Sludge depth:Na Distance from top of sludge to bottom of outlet tee or baffle: Na Scum thickness:Na Distance from top of scum to top of outlet tee or baffle:Na Distance form bottom of scum to bottom of outlet tee or baffle:Na How dimensions were determined: rda Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Na GREASE TRAP: (locate on site plan) Depth below grade: rda Material of construction: _concrete_metal_FRP_Polyethylene_other(explain) Dimensions: Na Scum thickness:We Distance from top of scum to top of outlet tee or baffle:rda Distance from bottom of scum to bottom of outlet tee or baffle:Na Date of last pumping, Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Na BUILDING SEWER: (Locate on site plan) Depth below grade: 4' Material of construction:_cast iron_40 PVC_other(explain) Distance from private water supply well or suction IineNa Diameter: nla ,rvsmments: (conditions of joints,venting,evidence of leakage,etc.) (revised 04127)87) I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL AV.MILTON MA.02186 Date of Inspection:1012l88 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: rda Material of construction:_concrete_m eta l_FRP_Polyethylene—other(explain) Dimensions: We Capacity: rda gallons Design flow: ria allons/day Alarm level:era /�larm in working order?_Yes_No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) rda DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: nia Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box etc.) Ne PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_ves Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) rda (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 12 HARBOR HILL RID-W.HYANNISPORT MAP 247 LOT 074 Owner: GLYNN;428 CENTRAL AV.MILTON MA.02186 Date of Inspection:1012 DB SOIL ABSORPTION SYSTEM (SAS):x (locate on site plan, if possible;excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: rda Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers, number:rda leaching galleries,number: rda leaching trenches,number,length: rda leaching fields, number, dimensions:rda overflow cesspool, number:ma Alternate system: rda Name of Technology:_nra Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.THE PIT WAS EMPTY AT THE TIME OF THE INSPECTION.WE DID NOT INSPECT UNDER NORMAL USE. CESSPOOLS:x (locate on site plan) Number and configuration: ONE Depth-top of liquid to inlet invert: EMPTY Depth of solids layer: rda Depth of scum layer: rda Dimensions of cesspool: 31M. Materials of construction: CINDERBLOCK Indication of groundwater: rda inflow(cesspool must be pumped as part of inspection) rda Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) MAIN CESSPOOL AND ALL COMPONENTS ARE STRUCTURALL SOUND.RECOMMEND PUMPING SYSTEM EVERY YEAR PRIVY:_ (locate on site plan) Materials of construction: Na Dimensions: rda Depth of solids: Na Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) rda (revised 04127l8T) V� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 GLYNN;428 CENTRAL AV.MILTON MA.02186 1012198 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) 0iL 9 u4 Pape ! of 10 (revised OWTI97) d SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 12 HARBOR HILL RD.W.HYANNISPORT MAP 247 LOT 074 GLYNN;428 CENTRAL AV.MILTON MA.02186 10/2199 Depth of groundwater 10. Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers X Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS MAPS AND CHARTS (revised04)27197) page 10 of 19 TOWN 9F BARNST LE f LO(,AT1ON \ SEWAGE # VB.LAGE SSESSOR'S MAP & LOT 241 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.TTY: (type) ( ��ST �� (size) OL NO.OF BEDROOMS BUILDER OR OWNER (--:: \ v^ PERMITDATE:. COMPLIANCE DATE: l7 �cf Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(tea Iands exist within 300 feet of leaching facility) \� Feet Furnished by � � i _ .._. _ � .. __ - ..� . .. _._ � _ �a� � F -� r.. ..._..w_.._........_.�..___.._--�._._.�.._ - ..r _...__.._....._.__..._...(�....(.�� is •� ' U�l - _ .a __. ......-.. ... �,M�. LOCATION SEWAGE PERMIT NO. VILLAGE �v oIz INSTA LLER'S NAME i ADDRESS <;< BUILDER OR OWN E,[R DATE PERMIT ISSUED .DATE COMPLIANCE ISSUED J v1 �� I No84.......11Aq_;?-- Fus.....$ 5....00........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .............................Town...OF......B.. rn-stalbe....... Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 12 Harbor Hill, _ -------- .................-................................................................................ ""tion-Address or Lot No. John Glynn........................ ..... ..Hill-a.&i...,...Wp-st...H,yanniapD-tt,...MA02672 Owner Address a -A•-&--B..Cesspool_.Service............................................ 12$..M-ah4gs...'P,xxa�ce.,_._H,y-annis,..M.....02601..... Installer Address Type of Building, Size Lot............................Sq. feet �.. Dwelling.�No. of Bedrooms............. ............................ Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons....... Showers ( ) — Cafeteria ( ) 0 Other fixtures ------------•-•-•-------•--------------------•----•--------•-------------------------- W Design Flow..............................:.............gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Len gth.....................Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •----------------------------------•...-•----------•--••---•------•-•-----......--•---•------.-------- ----------------------- •---------------- ---------- O Description of Soil....Sarx3-•.................................••••-•-----•.......••--•••-•--•••-•••-•••-•-•---•-•-•-•............--•-•.... W V ......-•-•-••-•••-•-••-•----•••••-•-•-••-•-•••••-----•-•-•-•••-••-•••-•••-•••-•-•-•-•-•---....••••••---•••-•-•••••-----•••-•••-••-•---••-•-•-•-•-•••••••..................• •-•••--•--•-•............. W ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••••••........._...... U Nature of Repairs or Alterations—Answer when applicable.___inagala.at.:! -_oX_-a..l,.0.00__ga.11on..Izre-cast stone packed leach pit- (overflow). .........................•----------------------------------------------------•--------------------------.•••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT E 5 of the State Sanitary Code— The undersigned further agrees not place the system in operation until a Certificate of Compliance has isst4ed by the boar ne .. .�_. .. g .......913/80......... A Application Approved B ................. Date PP PP Y ••... ...=--•-••-• -•i = �/..8/80......... r Date Application Disapproved for the following reasons:................:. -------------------------••----...--•--------------•-----------••-•••-•-••••......--•- Date Permit No..............80- /W80 ----•--------•------------------------ Issued...........9,- --------._........_...----------- Date No.80-...y9". :.. FEs....�...5.00 ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..•-----.....................T own..O F......Barn stalbe ---------------------------------------•---------.....----- Appliration for Uispoo al Works Tonstrurtion ami# Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 12 Harbor Hills Rd., West Hyann spo ------- --------••-------•-•..............•----••------•--•-•------••----•----------•------- John Glynn Location-Address or Lot No. ..........y_.......-•--•----•-------•---••-----••...............•--•----•-•••----••--• 12 Harbor Hills Rd...,-..�est__H.!annisport,•-_.... 2 caner Address w A & B Cesspool SerA�ce 128 Bishops TerracItL Hyann3s�__�_..-_02601..-__ .................••-••--•--... .. Installer Address UType of Buildings Size Lot............................Sq. feet aDwelling f—No. of Bedrooms................_-______-__.__________.._.__Expansion 2 Attic ( ) Garbage Grinder ( ) p-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . w Design Flow............................................gallons per person per day. Total daily flow......................................._..._gallons. WSeptic Tank—Liquid capacity............gallons Length................. Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................_................................................. Date-___......_,-.---_.-__---__-__.._....... ,--111 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_---_.__--_-______-_---- 44 Test Pit No. 2.........._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------• -••--------••_..._._..••-•-•..._..--•---•---._...-....---•-....•-------......-.........•-••-•-.:.........-------•--•-•-.............----- Descriptionof Soil 5a17d ....................••---------------------._.....----••-•------------------------•----------------•--------------------------•--......---------•--•-- x w x Nature of R ai s r Alterat•ons Answer hen applicable---installation of a 1,000 gallon_pre-cast U stone packed each prt �verflow . •---------------------------•--•-----------------------.._..---._...--•-------------._...........-------•-------------------------------------------------..-------------------------------•--•---...__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT?,;:. 5 of the State Sanitary Code—The undersigned further agrees not place the system in operation until a Certificate of Compliance has issued by the boar of h - Application Approved BY-•-•-------•f` 4 ..................., ....` ........................... �d Date Application Disapproved for the following reasons-----------------------•---------------------------------------•------------------------------•-...---•---••-.... .............................•----•------------_.._..-------------•---•--.....-•--------•--•-••---------•---..._...••-•-•-------•-----------------•••------••------------•---•------------------------- Permit No. 80- - .•.. Issued............ 8/$� ...........- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................T own.............OF.:............Barnstatile.......----.-----........................... Trdifirat e of Tomplitanrr TT I TO A LB CER FY That 8I iv•dual wa Disp al a ya S em nstrbv (— '� ed X) esspoo ervice, ZM s, bY.................................................................................................................................................................................................... 12 Harbor Hills Rd., West Hyann&sport.taM 02672 John Glynn at.............................................................................................- has been installed in accordance with the provisions of TI ` f� state Sanitary Cod , ibed in the application for Disposal Works Construction Permit No_____________ ............ dated-----------...-� .................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS GUARANTEE THAT THE SYSTEM V)(.ILI,(pyFUNCTION SATISFACTORY DATE.:.g� ,................................................................... Inspector.. ----- ....... ... . w THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TownBarnstable $ 5.00 80-� •2 ..........................................OF................-....-..-.....--...................--.-.....--........-..-.-....-.... •No......-- ...... FEE........................ A & B esspool o�k� �o��r�r#ion �[rrttti# �. ._._._.._...__ ervice Permission;is'hereby granted......................................................................... ._...•----------------.._......----==. ._.._........---•-•--- to Consl�e c118.rb)o1�rHia;ld.; Sd' i� iSve Disa'o6 '- John Glynn atNo............................................... •---•-•--•----••-•--_......_.......-•--•-----••------•-------------•---•----•------..._.:..------..._...-••--•---------•-•---•......_...--••-- S as shown on the application for Disposal Works Construction P m`it- No �w_. a�te,{d_.:___9._-_8/80................. ................................ 9/r/80 Board of Healt DATE........................•--------....--•----•--•-----------••---•-----•----•-•-- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS N......80:... �7 F:zs.... .... ...QO........ THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEALTH T!W1J...OF...-..Barx�s.fa�1e....... ApplirFation for UispnsFai Marko Tnnstrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: MA.....02601 ...Lot #14 •--••••••-•••••••••••........._•-•---•--------•••--•-- Location-Address or Lot No. .T_nhn..CaxpRrLter............. ....Q26a2.............. Owner Address a A..&.-B... ............................................. 128.. HYa3M5- MA-...0260__1__ _ Installer� Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.........3................................Expansion Attic ( ) Garbage Grinder ( ) 'k Other—Type of Building No. of persons---A----------_----------- Showers — Cafeteria Q, Other fixtures ---------------•----------••••••-•••---•-•••-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No-------------------_ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---•••••••-•••••••----•---••--•.......... -------•------------------------- Date........................................ � Test Pit No. 1................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 •••--•---•••--•-•---•--••••-••--•-•-•-••--•-•-•-....-•---•-•-------••...............•----------_...•........................................................ 0 Description of Soil...........................�aIld.-.--........--•-------•--.._-...---------...---------------------...--------------................................................. W UNature of Repairs or Alterations—Answer when applicable.___.installation•-of- a••pre--cast 1•.000••&allon torte-•packed-•leach-•pit-•-(oyerflow)•........................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage.Disposal System in accordance with the provisions of TITIZI 5 of the State Sanitary Code—The undersigned further agrees not o place the system in operation until a Certificate of Compliance has_been issued by the bo d health. Signe - ._....... --• ........ 8180 ,Q Application Approved By................ --- 9a ,80 Date Application Disapproved for the following reasons: ........................................................... Date Permit No......§�0 ............................................ Issued..........9/-8/80 -•------------•••••••-•-•--••-- Date ;i ii �. No.-----$0-...... U FPS .$....5.aa........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... .....Town.... ......Barnata tle...... Applirtttion for Dispaiial Worka Tonstrurtinn rrutit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 47.Waller_Rd.,-...Hyanni� MA 02601 Lot #14 _ -------------------- -------------..........--------------------------------------.-...-..---------------- Location-Address or Lot No. John Ca �X1 r............................................................... _5.2e m_,_-AQmteryJ. ].a.....A----.0.2.632-----.....--- Owner Address a A & ---M.A.....Q26Ql.... Installer Address UType of Building Size Lot............................Sq. feet 1-1 Dwelling—No. of Bedrooms..........3...............................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons....4..................... Showers — Cafeteria a' Other fixtures .................................. e. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter--------------.. Depth................ x Disposal Trench—No..................... Width.............._..... Total Length.................... Total leaching area.......,............sq. ft. Seepage Pit No----_--------------- Diameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by......................................................................... Date........................................ a a 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 •---•--------------------------------------------------------------------------•-------...------•-----......._........----...-------------------------.....-- Descriptionof Soil S...nd:...-•---•---•..................•--•---•------------------------------------------------------------•-------------------------.----- x W U Nature of Repairs or Alteration —Answer when applicable____installation of.a-_p2'e-Cast 1 0002llon stone packed leach pit s(overflow). .•. ---------------------------------------•------------------------------------...........-.....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until'a Certificate of Compliance has been issued by the bo rd health. r / f 8/ Signe�cJ�.�� L _ ;/�,C'c Q'- �; - 1�.... ----•-9 80....... Application Approved By...................R.c.:�- ........... •-•9ja8/80 Date Application Disapproved for the following reasons:-----•--------------------------------------•------------------•----........................................... ------------------------------•--.............--•--••---•-----------------------•--------------•...••---..__.._..............----•---•-••-----•---------- ............................................... Date Permit No.......80............................................. Issued........... � 8/80 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................T.own...OF..Barnstable .......................................................... Trrfifirtt#r of Toutplitturr I THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired (X ) by A & B Cesspool Service, 12 Bishops Terraee, Hyannis, MA 02601--r--775-6264............ 47 Wally Rd., Hyannis, MA 02601 IJ'M Ca enter at ............. .•-- .------ -------------------- ---•---- •------ - -----...-•-------- .•-------- has been installed in accordance with the provisions of T TLE, 5 of The State Sanitary Co cf e a$ described in the /� / , application for Disposal Works Construction Permit �'o.._�'____ _ _________________ dated_...._-._-..8.80.___________._.__..-...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUEDAS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... /..../80................................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 80- .......Town.................OF..................Barnstable.....-----.............................. $ 5.00 No.................. ... FEE............----........ �t��t�t�ttl nrk� ��an��r�tinn rrutt� A & B Cesspool Service Permission is hereby granted.............................................................................................................................................. a Ivi� 5PwagJ . p�srto Cov'lailAyorRcfyis � oharpent� ; atNo...................................................................................................................................................._..._..------------------................. Street as shown on the application for Disposal Works Construction PereNo,/. ated.._.__9/_8/80................... - � di' /p� � DATE............. (P{•80................................................... of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS