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0251 OLD CRAIGVILLE ROAD - Health
251 Old Craigville Road Centerville V A = 247 110 II�� ,/� �QECYG[FpC me�LG p �J oyz IN UPC 12543 No.53LOR tpo `oNSJ�r HASTINGS,MN 04/24/2004 08:27 5085805516 AVON STAPLES 137 PAGE 01;01 a , April 23,2004 Mary James 313 Tong Pond Road Plymouth,MA RE:Eleanor E. I3WKPwlod &Loretta D.Reed 245 Old Craagville Road,Hyannis,MA Dear Ms.James: I Eleanor E.Bacquelod &Loretta Reed of 245 Old Craigville Road,Hyannis,MA,agree to l=t permission to you,the abutter at 251 Old Craigville Road,Hyannis,MA,to cross our driveway to allow BORTOLOTTI CONSTRUCTION INC.,to put a septic system, on your property of 251 Old CmjgQle Road,Hyaunis,MA. This agreement is made per the Bortolotti Construction's letter dated April 21,2004 to YOU re$arditng the section"Repair the Abutter's processed stone driveway:Finnish and tnstatl'/•"blue processed stone mix to level grade and repair any rutts developed during the septic installation" Sincerely, Eleanor E. od .oL.�,e �I Qk 1�4� 1 P2g136 12--44a DEED RESTRICTION WHEREAS, Mary E. James Of (owner's name) 313 Long Pond Road., Plymouth., MA (address) Is the owner of 751 W d Craiguille Roam located (address) At Hyannis, MA 02601 251 Old Craigville Rd. , Hyannis, MA 02601 MA(hereinafter referred to as Book 2179 -pagP 159 and being shown on a plan entitled"Subdivision of Land in Barnstahlp, (gVanni c) N A, 1 tCof Plan of Lot—, ;at "Crai ayi T le park" ] duly recorded in Barnstable County Registry of Deeds I Plan Book 62 ,Page 145 Or on Land Court Plan Number WHEREAS, Mary E James as the owner of said lot has agreed with the Town (owner's name) of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS the Town of Barnstable Board of Health, as a precondition 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, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THEREFORE, Mary F James does hereby place the following restriction (owner's name) on his above referenced land with his agreement with the town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. 251 Old rrai guil le Road, Hyannis, ma may have constructed upon (address) the lot a house containing no more than tui� ( bedrooms. Mary E. James agrees that this shall be permanent deed restriction (owner's name) �p14tE Aa,_ DATE PER swat 039- RSc. BT"— C.J ° `" Town of Barnstable,.. Board of Health w 200 Main Street,Hyannis NIA 02601 w M Office: 509-862-4644 Swan 0.Rask,RS. FAX: 509-190-6304 Sumner Kaufman,M.S.P.H Wayne A.Miller,MD. VARIANCE REOUEST FORM oC�ON 2S1 0 Cret14v le Road - Hyahn� 5 Property Address: r Assessor's Map and Parcel Number. QP 2'7 pG1 U Size of Lof: 47 70 �� Wetlands Within 300 Ft. Ices Business Name: No_C� Subdivision Name: APPLICANT'S NAME: V40A b. Cov9�1-114OWr KS Phone 569 3(Q' -00% Did the owner of the property authorize you to represent him or her? Yes No PROPERTY 0M2jER'S NAME CONTACT PERSON Name: 'Mary Jume5 Name: Oavid C0M4gw6wr Address: 313 Long Pond PA. PI wiVA, Address: 43 Tria 4, ' WA y �e C /��c,hQw�c�, , Phone: 7W 74-6 5�2G4 Phone: 5019 ?64 ' 05QY VARIANCE FROM REGULATION a-AA u &) REASON FOR VARMCE(May attach if more space needed) 310GMR 15.al - tA;V,;M0WA S4tbkk &*,,ttes 52 MQ11 04 - e Vire5 V gr'Putice5 +o I) C•5 a fPOM I:QS +D PL. &front f14 K vi: v'w, 5rze S-a em , KWIShlj) taq k -rd PI-- 3 it .S Fe S 4 ' ro -Fhd- vt Ca5e- F-ov 4)4 ;t I-Qhk 1-0 -Fin y 5J�"P O SAS 'to ode NATURE OF W ORK: House Addition House Renovation 0 Repair of Failed Septic System Ch (w be eompkted by office jiaff person recetvbtg varlmice request applicatfon) Four(4)copies of the completed variance request form Four(4)copies of enginvered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plats submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent himlher 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 Tide V andlor local sewage regulation variances o°ly) _ Full menu submitted(for grease trap variance requests only) ` Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same ownerAeasce only],outside dining variance renewals[same owaedlewee only],tiad variances tb 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 Susan 0.Ruk R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.K REASON FOR DISAPPROVAL Wayne A.Miller,MD. Q-\HEALTH\Application Forms\VARIREQ.DOC H Y IA Town of Barnstable i abgq. Board of Health ��� ATO ,�A 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. April 26, 2004 Mr. David Coughnowr, R.S. 43 Triangle Circle Sandwich, MA RE: 251 Old Craigville Road, Hyannis Dear Mr. Coughnowr, You are granted variances, on behalf of your client, Mary James, to construct a replacement onsite sewage disposal system at 251 Old Craigville Road, H ls. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located five and one-half (5.5) feet away from the front property line, in lieu of the ten (10) feet minimum setback required. 310 CMR 15.211: The septic tank will be located five and one-half (5.5) feet away from the front property line, in lieu of the ten (10) feet minimum setback required. 310 CMR 15.211: The soil absorption system will be located eleven and one-half (11.5) feet away from the foundation wall, in lieu of the twenty (20) feet minimum setback required. 310 CMR 15.211: The septic tank will be located eleven and nine (9) feet away from the foundation wall, in lieu of.the twenty (20) feet minimum setback required. 310 CMR 16.211: The soil absorption system will be located four feet below finished grade, in lieu of the three feet maximum allowed according to Title 5 the State Environmental Code. Q:WP/CoughnowrJames The variances are granted with the following conditions: (1) No more than two (2) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) 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 two (2) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) A polyethylene liner shall be installed between the foundation and the leaching trench, in accordance with the submitted plan. (4) The applicant shall submit a written agreement which includes language regarding all costs/work associated with repair and restoration of the driveway and landscaping on the north-easterly neighbor's property will be borne by the applicant soon after the completion of the septic system installation. (5) The septic system shall be installed in strict accordance with the engineered plans dated revised March 15, 2004. (6) 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 submitted plans dated revised March 15, 2004. These variances are granted because physical constraints at the site severely restrict the location of a soil absorption system due to the very small size of the parcel. The proposed new septic system appears to be designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Si rely ur ay i Ier, M.D. Chai erson i Q:WP/Coughnowdames 77 Town of Barnstable moo`THe rosy r NAP o* Department of Regulatory Services (. R R Bnrwsrasre. Public Health Division Date i • / v MASS.i659. m�Q 200 Main Street,Hyannis MA 02601 , .f prfD MA't� r Date Schedule d �t Time _ Fee Pd. Soil Suitability Assessment for Sewage Disposal • Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address 251 01 A cr i v`It e Ro( Owner's Name MCA f� �awbfi'S w1 $ Address 1 LD1'lg AO yGr P- Assessor's Map/Parcel: Z417 P10 Engineer's Name �av1A D• V1fJ41' NEW CONSTRUCTION REPAIR V Telephone# 1509 3(14-es Slo (% dV• 4 '1 Surface Stones e-W Land Use ReSi weh I1 lGl P )--� ` lOG t tt Drinking Water Well �00 .�' ft Distances from: Open Water Body �0 b ft Possible;Wet Area_ (�"r ft Other ft Drainage Way ��� } ft Property Line ?__ SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) A \ Q O� � V 9O NO V Q Parent material(geologic) PtotICX44 DV&"4g Depth to Bedrock �0 14 e - Depth to Groundwater: Standing Water in Flole: Weeping from Pit Face gbh(, Estimated Seasonal High Groundwater DETERMINATION FOR SE SEASONAL HIGH WATER TABLE Method Used: g%rw S tq b 1 e Cie DeP 2 in. Depth to soil mottles: in. Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: in. Groundwater Adjustment 7+.�.___— Index Well# W►v-29 Reading Date: ► 0 Index Well level _ Adj.factor �-2 Adj.Groundwater Level�Q.2 ZOrte G PERCOLATION TEST Date3 g 04 Time 1 P M Observation 1 Time at 9" Hole# .V1/ ?Z 1 h Time at 6" { Depth of Perc Time(9"-6") Start Pre-soak Time u 1 :�3 End Pre-soak Rate Min./Inch 2 1 Site Failed: Additional Testing Needed(Y/N) Site Suitability Assessment: Site Passed�_ — 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 first notify the Barnstable Conservation Division at least one(1)weelc Prior to beginning.: Q:HEALTH/WP/PERCFORM 1 . jvl!jjt!,r VJ53l'tt v L-111v1'q r1vLL' Lvtz AJLUIU rr Depth.from. `' Soil Horizon Soil Texture Soil Color Soil Other Sarftice(In.) (USDA) (Mansell) Mottling (Struottire,Stones,Boulders. t;nesists;noy %drayel).... 0-10 AP Sa%,d�r Loam w ,'71Z *%e Fri4blto co-SO (; B bar.y 44 COU4/4 %5W FriC46le- so— Cr5z C tAeft.i/m `.XIr� d0 � 4 One C a�5e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil . Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Man: / Above 500 year blood boundary No_ Yes V Within 500,year boundary No V/ Yes _ Within l00 year flood boundary No v// Yes Depth'of Naturally Oeeurring Pervious Material Does at least four feet ofnaturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e If not,what is the depth of naturally occurring pervious material? Certification / I certify that on l (date)I have passed the soil evaluator examinatibn approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 1.5.017. Signature �S Datef�l+ (,Or WOQ Q:HEALTH/W P/PERCFORM r# 40 Town of Barnstable 10,�77 pF THE .Department of Regulatory Services rsrA Public Health Division sasrers. Date MARA- v� a y � 200 Main Street,Hyannis MA 02601all i fD Mt+ Time Fee Pd. M Date Scheduled `'1� �'l �i . Soil Suitability Assessm'ent for Sewage Disposal Performed By: Ca�0i0Ow r l`J Witnessed By: LOCATION& GENERAL INFORMATION Location Address 251 W Cr%ifv i �l(� Rd Owner's Name Mu P`/ 'SC )AG 5 Address ;13 Long PO ti d t')]f 1-I,yut4 H i 5 ply moo+ti, KA p�G3 Assessor's Map/Parcel: 0 Engineer's Name � �� -C.OV ftai' NEW CONSTRUCTION REPAIR V Telephone# 5� 3 6+ (��• Land Use Rn I Ae,h+t A( Slopes(%) Surface Stones ��✓ Distances from: Open Water Body 10 b'1' ft Possible Wet Area l0�t ft Drinking Water Well it Drainage Way 00 + ft Property Line } ft Other 8 SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) i �o. \ V Q ov Parent material(geologic) Proticla,41 00-414y Depth to Bedrock �014 e g WeeP in from Pit Face Depth to Groundwater: Standing Water in Hole:: j` Estimated Seasonal High Groundwater 0 + 't- . DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: ears+g bl e C K Dep* K4e-0t4S Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment Y+.�. ft. Index Well# W kf-2a Reading Date: ► O 4 index Well level t Adj.factor '3•Z Adj.Groundwater Level 20Ke G PERCOLATION TEST Date 310104 Time I P IA Observation ` Hole# Time at 9" Depth of Perc 721 h Time at 6" vt Start Pre-soak Time cQ ' 0 S Time(9"-F) "A Lri End Pre-soak ' ►CS- fi,� Rate Min./Inch- 2 t eeded(YIN)Site Suitability Assessment: Site Passed Site Failed: Additional Testing N 'AJ e' 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 first notify the Barnstable Conservation Division at least one(1)week prior to beginning. 1 Q:HEALTH/WP/PERCFORM r PEEP OBSERVATION HOLE LOG Hole# Depth.from ``'Q Soil Horizon Soil Texture Soil Color Soil Other Surface(in,) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cdnslstencv.l/Wravell.�____._. - l 0 A p ,ctvA y Loam 0` i,2-A sae Fvi ak CO 50 liar+,y Sand to ,4/q- ywe SO or► (7)2 C VAe4'1 tJ►� 1i1(� 10 �{ �4 e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) _ r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# other Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 't Q Flood Insurance Rate Map: / Above 500 year flood boundary No_ Yes V • 4•'� r.. Within 500,year boundary No_ Yes / Within 100 year flood boundary No ✓ Yes Depth of Naturally Occur"rinse Pervious Material ervtous in exist in all areas observed throughout the Does at least four feet of naturally occurring p f area proposed for the soil absorption system9 q e.5 If not,what is the depth of naturally occurring pervious material? Certification A I certify that on �1 � (date)1 have passed the soil evaluator examinatibn approved by the A and that the above analysis was performed by me consistent with Department of Environtnental Protection the required training,expertise and experience described in 310 CMR 1.5.017. , -, �0 Signature Datet �� J �? Q:HEALTH/WP/PERCFO.RM } f� No. (3 (_ j�{ 10 a� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MA SACHUSETTS 21pplication for tigool bpgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade VQ Abandon( ) ❑Complete System ❑Individual Components (i=Add(� orLotNo. a�i �j�]] (D(A-t4V1t lF_ /� Owner's Name,Address and Tel.No. 7 OX ?o01 d essor's Map/Parcel Installer's Name,Address,and Tel.No. �f�rJ "h.1C Designer's Name,Address and Tel.No. Z C0 rJ ST/L MA.R3-%V-m rv% wu ✓A4- .9399 Type of Building: Dwelling No.of Bedrooms Lot Size C0M sq.ft. Garbage Grinder( ) Other Type of Buildings No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow `4- Ci gallons. Plan Date tb/O c1 Number of sheets ` Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil a_Z eLA-mil Nature of R�airs or Alterations(Answer when applicable) k7S �t1L �(h� ��11 d Q,o t_q,&fn c-7A-U/-. 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 Enviro enta�Code�andnotto place the system in operation until a Certifi- cate of Compliance has been issued by thi oard f Hea h. Signed Date Application Approved by Date y -26 6 t- Application Disapproved for theVI—lowing reasons Permit No. 00 4 SS Date Issued I o tr No. 200 J f fL v( p�. Fee THE COMMONWEALTH 04 F MASSACHUSETTS Entered in computer: / Yes PUBLIC HEALTH DIVISION -TO.WNOF BARNSTABLE, MA SACHUSETTS N' ZIpprtcation for Diopozaf 6p.5tem Construction Permit Application for a Permit to Construct( )Repair( \)Upgrade V,.)Abandon,'( ) ❑Complete System ❑Individual Components Locatio Address or Lot No. aSl G\ D t 9 0VI LlE- Owner's Name, ddress and Tel.No. cE'✓ P v��f~P ' �d►1.�. ,✓V�'°r-• o�(o o► 4L �1/���S Assessor's Map/Parcel ~ In er's N' ee,Addresls,and�'el.'NoV&,J Designer's Name,Address and Tel.No. 7. �G tLA MA,1L8_\1.N) ✓v+ k\,U 1Vu1 9399 s Type of Building: r Dwelling No.of Bedrooms Lot Size y75O sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons ' Showers( ) Cafeteria( ) Other Fixtures . � Design Flow �y gallons per day. Calculated daily flow gallons. Plan Date 24t&/0 C/ Number of sheets � Revision Date Title Size of Septic Tank tType of S.A.S. Description of Soil 'S.5 , Nature of Re airs rAlterations(Answer when applicable) AS AIN-. ry?.-� /emu� S'� 'or 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 Enviro ental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Boar ea h. --- Wl' I Signed -� Date Application Approved by ^.�.i`A Date AA v Application Disapproved for the flowing reasons Permit No. D Vu -/ S Date Issued / a THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired ( )Upgraded (D<j' Abandoned( )by Qc,�`�W-1 (✓V N S i-7tN 0-r o at ?a i 0 L,6 tl(AAZ let-"Us been constructed in ap cordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a t J dated /2 6 G t Installer Designer The issuance of thi perindsh 11 not be construed as a guarantee that the sj tte.Swill fuUction as d . 4ed. � Date o Inspector — - - r- -------------------------- — No. Fee r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1=i!6poga1 *p5tem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(V,)Abandon( ) System located at .::P I uL --1 6-6 CA- y v-,k E_ /1-o-�-b f 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 us/t be completed within three years of the date of t i is pa Date:_ 1, / Approved by v TOWN OF BARNSTABLEU. LOCATION�7n 0/w /i z) SEWAGE # VI:LAGE_� ���"n°�'"'1/� ASSESSOR'S MAP & LOT �� 0 INSTALLER'S NAME&PHONE NO. 406464, C N� <�c�,�•� /�¢-�� SEPTIC TANK CAPACITY /Sod CA LEACHING FACILITY: (type)%n-,y 5 (size) NO.OF BEDROOMS A BUILDER 0 �'f PERMITDATE: COMPLIANCE DATE:- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �� Feet Private Water Supply Well and Leaching Facility (If any wells exist _ on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet Furnished by &� e `/d s� :0, 19 L_ TOWN OF BARNSTABLE , M�L0CATIONX6' - e SEWAGE # VILLAGE � ?mil L �7� ASSESSOR'S MAP & LOT-2 — INSTALLER'S NAME&PHONE No)l,--1 SEPTIC TANK CAPACITY LEACHING FACILITY: (type /Y. (size) NO. OF BEDROOMS Q BUII.DER OR OWNE _• 6�! PERMITDATE: MPLIANCE ATE: Separation Distance Between e: Maximum Adjusted Groundwate able and ttom 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 Leac 'ng Facility(If an wet ds exist \\within 300 feet le n ) Feet Furnished , I Town of Barnstable °per Regulatory Services Via• ' "o s�irisa�a�. Thomas F.Geiler,Director ' AM � Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 4p r� l 2q, Zoo+ Designer: QUID J). C©UG N 13-W OW K Installer: �/��/a 0114 Address: TN W(oL,C C 1196LE" Address: On C0s15trVC,-',0,, l oc- was issued a permit to install a (date) ,p (installer) septic system at 2S V Cfa ig-VI'll e R°f based on a design drawn by (address) NViD CQQQJ4W0WR. RS dated MgtI`A 1S, 2,004 �R udSid) (designer) VI 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. 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 follow. OF DAVID ' (Insta i s Signature) CouUF .."^t9 ei i U.�.'� Q y �qNl T.Aa�P� � S (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. TANK YOU. Q:Health/Septic/Designer Certification Form I TOWN OF BARNSTABLE LOCATION Ol W C�Aqv111e J)Ab SEWAGE # -:?eVV- /23' VILLAGEga,7Ld^v�I/2 ASSESSOR'S MAP& LOT 0- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY If-ad C�L LEACHING FACILITY: (type) aG 4 (size) NO. OF BEDROOMS BtUDER 0 '1 PERMITDATE- COMPLIANCE DATE:' Separation Distance Between.the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �t Feet Private Water Supply Well and Leaching Facility (If any wells exist _ on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet Furnished by TcS 6nv .rva�L i l . � 1 v 1 1 y 1 R 1 1 1 bop •\b 41 %QQ v KI T- B BED CHEN ILC- A ROOMEL CL CL BA DINING LIVING BED ROOM ROOM ROOM L A UNDR Y/FO YER FLOOR PLAN FOR 251 OLD CRAIGOLLE ROAD - HYAFINIS SCALE: I in = 10 ft 4 DATE; 5/24/01 PROPERTY ADDRESS: 25.1 _Old Crai2yille Road Hyan is n — ,Mass. ------ ------ �. On the aboYe data, I Inspeoted the aeptlo ,ayotorh at the above address. ThI3 system conslsta 01 the following; RECEIVE® 1 . 2-6 'X8 ' block cesspools. 2 . Cesspools *are in series. JUN 6 2001 Based on my Inspection, I cerllfy the following oondltl n&NOFBARNSTABLE 3 . This is not a title five septic system HEALTH DEPT. 4 . This is a sewage system. 5. The sewage system is. in proper working order at the present time. - 6, 1 -cesspool cover was broken.Has been replaced. 7. Overflow line to #2 cesspool must' be. replaced.Orangeberg tee is S I Q N AT U R E t broken off.Mary James has been1made aware. N a m e :_I-L Ap s St m t tL..)U-, Company; Joa:,ph-P ;, Nacomb:r-b Son , Inc . Address ;_ Box_ 66--- --____ CencorvilleL HaJ_0292-0066 phone;___ 508_775;3338-______ THIS CERTIFICATION 00C3 NOT CONSTITVTE A, OVARANTY OR WARRANTY JOSEPN P, MACOMBER & SON, INC, Yinkr'-0911p9oIi-LvachfI#IdI Pumptd 4 IniWl#d Town sow#r Connuclonc P.O. Box 66 75.Je38orYIr75-641Z26J2-0066 r'. r ,per 4 y �\ COMMONWEALTH OF MASSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 251 Old Craicfyille oad CV0- d yannis,Mass. Owner's Name: Estate Of Arminda R_ Keyes Owner's Address: Mary .Tamps 311 T.nnrr -Do-na DAad "lymouth,Mass.02360 Date of Inspection: S/q d /n j Name of Inspector: (please print) .TncPnh PP Mae-omher Jr. Company Name:J P Macomber R snn Inc. Mailing Address: Aox 66 renf-crvi 1 1 o M Telephone Number: 508-775-3338 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 the inspection.The inspection was performed based on my gaining and experience in the proper function and maintenance of on'site sewage disposal systems. I am a DEP approved system inspector pursuant to Sgctlon 15.340 of Title 5(310 CMR 15.000). The system: ✓ /Passes _ Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails LInspector's Signature: ,Date: The system inspector shall mit 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 authoriry. Notes and Comments ****This report only describes conditions at the time 6f 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. Title 5 Inspection Form 6/15/2000 page c r Page 2 of 1 1 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Old Craigville Road r - Owner:Estate Ot Arill-MuckA. Date of Inspection: Inspection Summary: Cbeck A,B,C,D or E/ALWAYS complete all of Section D A ystem Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 3 0 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: A new overflow line from the main cesspool to the second replaced. A new cover as een i main cesspool. Mary James has been made aware o e necess ! . e airs I �ystem donditionally 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. Adg-he a tic tank s 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 ist ibution box ue 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 distribution box is leveled or replaced ND explain: d1y 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: 2 Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 251 Old Craigville Road Hyannis, ass. Owoer:Arminda R. Keyes Date of Inspection: 5 24 01 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. I. S%-stem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: AQ Cesspool or privy is within 50 feet of a surface water ,i)& 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. A&)The system has a septic tank and SAS and the SAS is less than 100�egt but 50 feet or more from a private water supple well''. Method used to determine distance /IU,4) "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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. Ocher: The sewage system consists of�two 6 'X8 ' block cesspools in series. A R2w--ov—e—r—f1owvneeds to be installea. r to high and the s not present. Installed 1 -new cover on the main cesspool. Old cover was 'badly broken. 3 - I Page 4 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:251 Old Craigville Road Hyannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5/2 4/01 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 bove outlet invert due to an overloaded or clogged SAS or J cesspool ZRe quid depth in cesspool is less than 6"below invert or available volume is less than 'h day flow quired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped i. /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. _ � y portion of a cesspool or privy is within 50'feet of a private water supply well. �y 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] (YesfNo)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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no tthe system is within 400 feet of a surface drinking water supply v e system is within 200 feet of a tributary to a surface drinking water supply _ _ the system is located to a nitrogen sensitive area(Interim Wellhead Protection Area 1WPA)or a mapped Zone 11 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 3 10 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 251 Old Craigville Road yannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5 24 51 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 - 7 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 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 com pone nts,.6KcIuding 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: Yes no Existing information. For example, a plan at the Board of Health. _'I,/_ 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(3)(b)) 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 251 Old Craigville Road Hyannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5/2 4/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):j Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms)• Number of current residents: 0 Does residence have a garbage grinder(yes or no): 'V0 Is laundry on a separate sewage system (yes or no):AZ2 [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): A)8 Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): #JDow Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): A)A Grease trap present(yes or no):_LJ A Industrial waste holding tank present(yes or no):ALA Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: AIA Last date of occupancy/use: Ai - OTHER(describe): A)�Q GENERAL INFORMATION Pumping Records Source of information: A)e ►4r7A�1�r4� Was system pumped as part of the inspection(yes or no): If yes, volume pumped:/gallons--How was quantity pumped determined? hk4oma, Reason for pumping: W1 -A SG2/Q/C .�yo� TYPE OF SYSTEM 1!0 Septic tank,distribution box, soil absorption system Single cesspool Overflow cesspool Privy AD Shared system(yes or no)(if yes,attach previous inspection records, if any) dk Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) A)O Tight tank N11 Attach a copy of the DEP approval /1�Other(describe): N4 ApproxLmate age of all cpryponents, date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):.+d 6 i Page 7 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propene Address: 251 Old Craigville Road Hyannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5 24 01 BUILDINC SEWER (locate on site plan) Depth bcloµ � grade: r „ Materials of construction: cast iron 06 40 PVC other(explain): Distance from private water supply well or suction line: Id,'— Comments(on condition ofjoints, venting, evidence of leakage, etc.): Joints appear tight No evidence of leakage System is vented through the house vent. ' SEPTIC TANK ,(locate on site plan) Depth below grade: V.4 Material of construction: J�concrete&kmetal,tfiberglassV olyethylene , Aother(explain) If tartk is metal list age: M Is age confirmed by a Certificate of Compliance (yes or no): _(attach a copy of centficate) Dimensions: A2 Sludee depth AM Distance from top of sludge to bonom of outlet tee or baffle:Aft Scum thickness: I)A !0!stance from top of scum to top of outlet tee or baffle: A)A Distance from bonom of scum to bonom of outlet tee or baffle: �m_ Hoµ Acre dimensions determined: A/54 Comments (on pumping recommendations, inlet and outlet tee or baffle condition. structural integrity, liquid levels as related to outlet riven, evidence of leakage, etc.): _Septic tank is not present CREASE TRAP4411e(locate on site plan) Depth below grade:&//9 !material of constmction:4fA concrete V—metak&fiberglass 4.4 polyethylene41A other (explain): af�Q Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bonom of scum to bottom of outlet tee or baffle: A4? Date of last pumping: 4),f Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural (ntegriry, liquid levels as related to outlet inven, evidence of leakage, etc.): r,reace i-rafl ;s�nnt_{ireQent 7 I ' Page 8 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 251 Old Craigville Road Hyannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5/14/01 TIGHT or HOLDING TANKA"(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: _411107 Material of construction:4g_concreteW.4 metal y�_fiberglass LA Polyethylene A�4 other(explain): Dimensions: A).4 Capacity: A gallons Desien Flow: gallons/day Alarm present(yes or no): Alarm level: V— Alarm in working order(yes or no): Date of last pumping: Ali_ Comments(condition of alarm and float switches,etc.): Tignt or holding tanks are not present. DISTRIBUTION BOXp&_q(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): is ri u ion ox is not present. PUMP CHAM BER44k-(locate on site plan) Pumps in working order(yes or no):. /� Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Pump chamber ; s not present - 8 Page 9 of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 251 Old Craigville Road Hyannis,Mass. Owner: Estate Of Arminda R. Keyes Date of Inspection: 5/2 4/01 SOIL ABSORPTION SYSTEM (SAS): !/ (locate on site plan,excavation not required) If SAS not located explain why: Type —&-dleaching pits, number: ,6.26leaching chambers, number:Q d leaching galleries, number: leaching trenches,number, length: 2,0 leaching fields,number,dimensions: Q YES.overflow cesspool, number: 1 N.Q_ innovative/alternative system Type/name of technology:Prior 1965 Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Loamy sand to medium boney sand.No signs of hydraulic failure or on in .Soi s are dry.Vegetation is normai.A new , overflow line from the main cesspool to the #2 cesspool mus e replaced. L'ne is to high and has not got a tee set up. CESSPOOLS: (cesspool must e pumped as part of inspect ion)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: r-- 4 Depth of solids layer: /_ *X Depth of scum laver: LX AA Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): Same as ahnva PRIVY4jhr,f,(locate on site plan) Materials of construction: Dimensions: ,UjA Depth of solids: ,UA Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy is not prRAent 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 251 Old Craigville Road Hyannis,Mass. Owner: Rstate Of Arminda R. Keyes Date of Inspection: 5 24 01 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. • 0 0 w S/ono C RA / 6 vi'//P RO 10 Page I I of I I ' OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C I SYSTEM INFORMATION (continued) ProperT Address: 251 Old Crai ville Road H annis Mass. Owoer: Estate Ot Armon a R. Keyes Date of lospectioo: 5/24/01 SITE EXAM Slope Surface water I Check cellar Shallow wells d Estimated depth to ground water feet Please Indicate (check)all methods used to determine the high ground water elevation: Obtained from s stem dcsi tans on record • If checked,date of design plan reviewed: % 1 � - erve site(abutting property bservation hole witho 150 feet of SAS) cked with local Board of Health•explain:,d/m '44/ eQecdy�+/ Necked with local excavators, installers. (attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used- water contours maw r�„-et;, Miller Model Il r-rllT-rrntTr.rr— rnrnr•nTs.rrllrrt asnrsrar:-.T^r`Aer1TR*Rtm+tsr'+t7r17s1nvlf7'+ �.m�.�rr�...S-.r... TOWN OF Barnstable BOARD OF IIEALTII 0 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION I1 -.zn^r•.-:.r—-..:�^.-rnmr.+n-riTrt 1'Ta.eTT7•n�i7-rrz-t rnvrre��anesr�+sr 1n.. .,.1rrr•r.•�r —..A -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED .. 1 STREET ADDRES 251 Old Crai ville Road H annis Mass. S 9 v , ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME Estate Of lkrminda R. Keyes PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & Son Inc,-." ' COMPANY ADDRESSBox 66 Centerville,Mass. 02632 Street Town or City State-zip COMPANY TELEPHONE 609- ) 775 - 3338 FAX (508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at ID his address and that the information reported is true , accurate , and omplete as of the time of -inspection . The inspection was performed and any ecommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Chec one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public heap)► or the environment as defined .in 310 CMR 150303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this for►n . System FAILED* The inspection which I have con tcted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 3.10 CMR 15 :303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date ne copy of this tification must be provided to the OWNER, the BUYER ( where applicable and the BOARD OF HEAL711. * If the inspection FAILED, the owner o7r"operator shall upgrade he syste within one year of the date of the inspection , unless allowed ortrequiredm otherwise as provided in 3.10 CMR 16 . 306 . partd .doc r VARIANCES REQUESTED PLAN REFERENCE CONTOURS o ��° HYANNS. M" r 310 CMR 15.211 - MINIMUM SETBACK DISTANCES PLAN BOOK 62 PAGE 145 40 ASSESSOR'S MAP: 247 .� �° - ! LOT: 110 SPOT GRADE 40.35 + > Locus $ glow 10 FOOT SETBACK FROM PROPERTY LINE TO SAS 35 + REQUIRED. VARIANCE TO 5.5 FOOT SETBACK REQUESTED. MINIMAL GRADING PROPOSED � 2) 10 FOOT SETBACK FROM PROPERTY LINE TO SEPTIC TANKtaw REQUIRED. VARIANCE TO 5.5 FOOT SETBACK REQUESTED. sr,� 3) 20 FOOT VARIANCE FROM CELLAR WALL TO SAS c �o Fr N REQUIRED. VARIANCE TO 11.5 FOOT SETBACK REOUESTED. ° M 4) 10 FOOT SETBACK FROM CELLAR WALL TO SEPTIC TANK REQUIRED. VARIANCE TO 9 FOOT SETBACK REQUESTED. LOCUS M A P 5) 3 FOOT MINIMUM DISTANCE FROM TOP OF SAS TO FINAL NOT TO SCALE GRADE REQUIRED. VARIANCE TO 4 HOOT SEPARATION REQUESTED. NOTE 3 NOTE I THIS SYSTEM IS SIZED FOR A = U EXISTWG SEWER LINE TWO BEDROOM FLOW. A DEED w� (� Z A IS TO BE REPLUMSED RESTRICTION LIMITING THE Q— _ QW �y � 36ftx4ftx2ft INSIDE BASEMENT AT �o w o LEACHING TRENCH HOUSE CORNER B. DWELLING TO TWO BEDROOMS iv �- J IS TO BE SOUGHT BY OWNERS. W W TO BE REMOVED NO TE 2 4 ft TO BRICK GALL INSTALL A 40 MIL POLY - \ / TRENCH BETWEEN TRENCH C>CD< LINER 5 FEET FROM THE ° EANOUT13 TO GRADE LEGEND �J X r 54 / � 1 AND FOUNDATION U)Q = w LL j 1500 GALLON '• 40 rC�,1,.o SEPTIC TANK OU p z w w s ►��`F\ -USE H-20 UNIT \ D LU.c m O)O1 6 q WATER D-BOX 0 B.9s� �--� '9} GATE WATER 0 TEST PIT n , A0,s'04, EXISTING CESSPOOL ! N � VEM 40 O �� PPE qg LJ_.J 40 G' UTILITY POLE45/ 40 $ _v z Kv/ w Y � \ LOT /3 s w w 0 z H `9 A - 47 3f •= ? Q J BENCH MARK p AE 50 1 . LL m Q r O <LL < TOP OF CONC BOUND 40 _\ O a O tam Z O ELEVATION - 4150 - �_ SEWAGE DISPOSAL SYSTEM PLAN J O (5U rl USGS DATUM ASSUMED t & V — IN o � � O � _ b TO SERVE EXISTING DWELLING 0 WV MARY E. JAMES n < ul) o — cy 251 OLD CRAIGVILLE ROAD HYANNIS MA LL 00 L GG� ECO-TECH ENVIRONMENTAL PLAN �Q°N� y SANDWICH MA 0256 �; G 3 0 43 TRIANGLE CIRCLES D SCALE: 1 in - 20 f t` Q uu 9 c10g��P� 508 364-0894 OV SgNI P �S ETE-1571 I FEB 16 2004 I/2 THIS PLAN IS TO BE CONSIDERED A DRAFT F$AN UNLESS IT LL BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER�vo S P d �(i slO q- ORIGINAL PLANS INTENDED FOR SUBMITTAL TO THE BOARD . 1 OF HEALTH WILL BE SIGNED N BLUE AND STAMPED N RED. SOIL - TEST . LOG DESIGN CALCULATIONS DATE OF TEST: MARCH 8. 2004 SOIL EVALUATOR: DAVID D. COUGHANOWR. RS DESIGN FLOW: 2 BEDROOMS X 110 GPD - 220 GPD WITNESSED BY: DAVID STANTON. HEALTH AGENT NO GROUNDWATER ENCOUNTERED SEPTIC TANK: 220 GPD X 2 DAYS - 440 GALLONS TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION - 40.75 •- DISTRIBUTION BOX: USE 6 OUTLET D-BOX DEPTH SOL USDA SOIL SOIL COLOR SOIL OTHER SOIL ABSORBTION SYSTEM: A 36 ft x 4 ft x 2 ft LEACHING TRENCH CAN LEACH (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING Abot - ( 36 x 4 ) - 144 sf 0-10 Ap SANDY LOAM 10 YR 2/2 NONE FRIABLE A s d w - ( 36 ; 36 4 . 4- ) x 2 - 160 sf Ato.t 304 sf 10-50 B LOAMY SAND 10 YR 4/4 NONE FRIABLE Vt 0.74 x 304 - 224.9 GPD 50-132 C MEDIUM SAND 10 YR 6/4 NONE LOOSE USE A 36 ft x 4 ft x 2 ft TRENCH. Vt - 224.9 GPD > 220 GPD REQUIRED GROUNDWATER ADJUSTMENT LEACHING TRENCH DETAIL 2 fT EFFECTIVE DEPTH - EXISTING GROUNDWATER LEVEL BASED ON BARNSTABLE GIS - -NOT TO SCALE DEPARTMENT RECORDS 36 ft OBSERVED OW: 16.0 18 ft I8 ft INDEX WELL: MIW-29 " ZONE: C READING: JAN 2004 JOIN PIPE CAP LEVEL: 8.1 END ADJUSTMENT: 3.2 f t v ADJUSTED GW: 19.2 NOTES VENT PIPE ND-sox 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. ' 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM, 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2--0' BEFORE PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF--THE SEPTIC TANK 9) SYSTEM IS NOT DESIGNED TO WITHSTANDV-EHICULOAN oLOADING. DO NOT -TO SERVE EXISTING DWELLING . PARK OR DRIVE VEHICLES OVER SEPTIC ,SYSTEM. 'QW',\ 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT] BEFORE STAR`fING WORK. R MARY E. JAMES 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL `AND TRUE TO GRADE ON A LEVEL 251 OLD CRAIGVILLE ROAD HYANNIS MA STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH SIX INCHES OF CRUSHED STONE HAS BEE.N+,°PLACED�'TO MINIMIZE UNEVEN SETTLING = ECO-TECH ENVIRONMENTAL 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-1571 JPEB 16 2004 2/2