HomeMy WebLinkAbout0265 BEARSE'S WAY - Health 265 Bearse°say �-
Hyannis ;P
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NOV
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rOwN y 2004
DATE tiF FeARn,
Ty o�p�geCF
PROPERTY ADDRESS 26 5 A,A bin
p
Ryann.iz, Na. MAP Jai ® -
02601 PARCEL
On the above date, the:#eptio system at the address above was
Inspected.
This system consists of the following:
gaUon ze/zt.ic .tank
2.• 1-d.iata.igut.ion gox.-
3.• 3-500 gaiion ieach.ing chamgeaz with 4' oj0- .6tone a2.2 aaound.,
Based on Inspection, I certify the following conditions:
5.•7h.iz .ins a t.it2e dive aept.ic hyztem (95 code),
6.•74e zept.ic zyztem .i.6 .in /21topea woak.ing oadea at the /22eaent t ime.-
7.-Vazte watea to .invent /2.i/2e .in eeach.ing chamge .s ass 22".,
• N
SIGNATURE
Name: Robert A. Paolini '
Company: JoseRh P. Macomber & Son Inc .
Address: P..O. Box 66
Centerville, Mass 02632
Phone: 508-775-3338 or 508-775-6412
A.
• JOSEPH P. MACOMBER & SON,: INC..
Tanks-Cesspools-Leachfields
Pumped .&.installed
Town Sewer Connections
P.O. Box 66 . Centerville, MA.026.32-0066
775.3338 775-6412
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRGNMSNTAL AFFAIRS
DEp tTMENT OF +NV1 OI4IVC NTAL PRO MIDN
A TITLE 5
OFFICIAL INSPECTION FORM—•NpT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART•A
CERTIFICATION
Property Address: ,2 6.5--aa rd n AA o__I�I'O y
Owner's Name:
Owner's Address: c n m o
Date of Inspectional �/0 8/0 4
Name of Inspector: (please print)C? P� p a c.-e is
Company Name: ��, m� o m eat _ .S,,o n 1-A c. :
Mailing.Address: .
en a/w c e, abb..02632
Telephone Number: 5 0 8—7 7 3 3 3 8,____
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system.at this address and that the.informatiou 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 MR d5:•000). The sy$tem:
xxz Passes
-Conditionally Passes
Needs Further Evaluation.by the Local Approving.Authority
Fa-i
Dater
Inspector,.s Signature.
The system inspector shall submit'a copy of this inspection report-to the.Approvinp Authority.(Board of Health or
DEP)within 30.days of completing this inspection.If the system is a,shared system or has a design flow of 10,000
gpd.or greater,the inspector and the system owaer.stiall`sub the report to the er,if appropriate tthffi$pprothie g
DEP.The original should be sent to-he system ovmmet aid Vol?*o yes sect to the bv� ei,if app
authority.
Notes and Comments
«*«*
Irhis'report only describes conditions at the time of inspection-and under the conditions of use at-that
^ tiine�This inspection does not address how the system will perform in the future under the same or di eren
conditions of use.
T"eno,fr;em Rnrn, 6/15/2000. . page I
Page 2 of 11
OFFICIAL INSPE,CTI<ON FORM--NOT:FOfR-VOLUNTARY ASSESSNIEENTS.
SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION.FOW.
PART'A
CERTIFICATION(continued)
Property Address:6 5 Beaaee.s Uajj
Ny,nnni&rMn.--
owner: /'4; e e a a c n cr e a a
Date of.Inspection: p y Ll1R j n 4
Inspection.S.nurmary: Chfek A,.B C;D or.E-/ALWfAYS compleWall of Section
A. System Passes:
_ 1 have not found any information which indiCates`t'haf and+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:
B. System Conditionally Passes:
no 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.
no. The septic tank is metal:and.over20 years old*or the septic-tank.(whether-m%al.ornot).is structurally
unsound,exhibits substantial:infiltration or exfiltration.or-tank.failure is-iminen;: System-will pass inspection ifthe
existing tank is replaced with'a complying septictank.as. ppF Fed by.the2oasd 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:
no 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. .
obstruct on it removed
distribution box.isleveled,or.replaced
ND explain: .
no 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): W.
broken pipe(s)are replaced
obstruction is removed
ND explain:
Page 3 of 11
OFFICIAL p;Sp.ECTION FORM-NOT OR E IiNSP�CTI '1N CORM TS
SUBgtWACE SEW 1�GrE SROS�►L
PART:A . .
'CER.TIFICAMON•Oontinued) :
Property Address: 2'` 3 .64` Gl u
Owner:. 7 a s Ma/•I/I1 O O 11 ,
Date of Inspection: r6E4
•
C. Further Evaluation-is.Requited by the Board of Health:
_�_ Conditions.exist which require fwther..evaluation-by.the Board,ol'-Heaithsin orfler.to:deterniine ifthe system
is,failing to protect public•health,safety or the environment.
1. System will pass unless Board-o Heal.th determines�in accordance with 310.CMlEt 15:3031 that the
system is not functioning i$.a•maupermbieb wlll•protect public health,safety.a>Yfl•tbe:.enYiroument:
n o Cesspool or privy is within,50 feet of asurface water
of•a bordering vegetated wetland or a salt marsh.
no Cesspool or privy is within 50.feet
2. System will fail unless the Board•of Health(and Public Water Supplier;Af any),determtnes:that the
system is functioning in a manner.that protects the pablic health,safety and environment:
no The system has a septic tank and soil ebsorption'system.(SA•S).:and the SAS is within 100 feetofa
surface.water supply or-.tributary to asurfface water-supply.
n o The system has a.sepric'tank and SAS and thecSAS is iwitltin a Zone 1 of a••public waterfsupply.
n o The system has a septic tank and.SAS:and the SAS is within:.50 feet of a private.water.supply well.
The system has a septic tank and SAS and the'SAS is less than 100 feet..but 50 feet or.1hore fionl a
private water supply well"*.Method used to determine distance-
**This system passes if the well water analysis,performed at a)CEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from-pollution from.that
that Ili other
ity and
the.presenee of ammonia nitrogen and nitrate nitrogen is equal to or.less than 5 ppm,p o
vi failure.criteria are triggered.'A copy of the analysis must bo attached to-this form.
3. Other:
Page 4 of 11
OFFICIAL•INSP.:.ECTION FORM NOT TOR VOLUNTARY ASSESSMENTS'
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION:FORM
PART A
CERTIFICATION(continued)
Property Address:26 5 Bea 2 u u Oat/
B4gnn,i4, —
Date of inspection: j t ng Zb-
D. System Failure Criteria applicable to all systems:.
You must indicate."yes"or"no"to.each.of the:followirig,for all:inspections:.
Yes No : '
_ x,--(-. Back�up.of sewage•:into-�f etjty.:or.systeni component due-1aoverloaded:oi clogged SAS,or.cesspool
_ x'.Discharge:or ponding of effluent to the.surface Otho.- round pr...surfacematers due to.anoverloaded or
clogged SAS or cesspool
x Static liquid level in the distribution box above outlet invert due to an overloaded or dogged SAS or
cesspool
_ x Liquid depth in-cesspool is less thank"below invert or.availablegvolume is less them Wday flow
_ x Required pumping more than 4 times in the last year NOT due to vlogged of obstructed pipe(s).Number
of times pumped -.
x Any portion of-the SAS;cesspool-or privy is below High ground water elevation.
x Ariy.portion of cesspool or privy is within 100 feet of a surface water supply.or tribptary to a surface
water-supply.
x Any portion_ofa-cesspool•or.privy iavithint.Zone!1 ofapublic.well..
x Any portion of a cesspool-or privy is within.50 feet of a private water supply well.
x Any portion of a•cesspool or-privy is lessthan 100 feet but-greater..than 50 feet from a.private water
supply well with no acceptable water quality.analysis..[This.system.passei 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 pollutlow.from:-04factlity and:thg 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-niust be attached-.to this foriq.]
rzo .(Yes/No)•The system falls.•I�have determined that.one ormore.of:the:.bove.failurc.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 1A;00.0 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 '
x the-system is within-400 feet of a surface driinking•water supply
x- the systeiin.is within 200 feet of a tributary to a surface drinking water supply
x. the:system is located in a nitrogen sensitive area(1nterim Wellhead Protection Area—IWPA)or a mapped
77 Zone II of a public water supply well '
If you have-answered"yes"to any question in Section E the system is considered a sioificant 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 tinder Section D'shall upgrade the system in accordance with 310 CMR
15.504.The system owner should contact the appropriate regional.office of the Department.
4
Page 5 of 11
OFFICIAL INSPECTION-FORM=NOT FOR V-0LUNTARY ASMSMENTS
9t$SURFACE SEWAGE DISPOSAUSYSTEM INSPECTION FORM
PART D
•CHECKLIST
Property Address:265 .Bean-se,. Uay
lluanni,6.^na.-
Owner: lu z P_ P]n r(Jci/P-za
Date of Inspection: 11`/08�404
Check if the following have been dpne You must indicate"yes"or"no"alto each.of the following:
Yes No
x _ Pumping information was provided-by the Gwner,occupant,or Board.of Health
— x Were any of the system components pumped out in the previous two weeks?
x Has the system received normal flows in the previous two week period?
- 1
x Have large volumes of water been introduced to the system recently or as-part of thisinspection?
x _. 'Were as built plans of-he system•obtained and examined?(If they were not available•hote is N/A)
x Was the facility.or•dwelling inspected for signs of sewage back up?
x Was the site inspected for signs of break out?
x Were all system components,excluding the SAS,located on site.?
x 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,dimgnsions,depth oT liquid,depth of sludge and depth of scum?
x _ Was.the facility'owner(and occupants if diff6rent from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and locatiod of the Soll Absorpfion System(SAS).oa the site.has been deterntiued based on:
Yes no
x Existing information:For example,a plan at the Board of.l?Iealth.
_ x Determined in the field(if any of the failure criteria related to Part C is at issue approx"imetion-of distance
is unacceptable)[310 CMR 15.302(3)(b)f "
Page 6 of 11 /
OFFICIALJNSPECTIOVYQRM''-NOT FOR V,.OL.UNTA:RY ASSESSMENTS
SURSMACE SWWAGE DISM.Sa SY$T KINSPECTION FORM
PART.-C
-SYSTEM-INFORMATION
Property Address: 265 /!ea2hes Idau
Kiaann�h. Na.-
Owner: J LL Ma dju o o n
Date of Inspection: 1161 Q R I n 4
FLOW'CONDITIONS
RESIDENTIAL
Number of bedroAttts(des}gn):• 4 Number of bedrooms{actual): 4
E DSIGN flow based on*3'Y0 CIVIA l5.2.03':(for example:-110"gpd i#•ofbedrooriis)'
Number of current residents:-., 5
Doestesidence have a garbage grinder(yes or no):2Q_
Is laundry on a separate sewage.system(yes or-no):. a o Elf yes&eparate inspection required]
Laundry system inspected(yes or no):rye•s
Seasonal use:(yes or no):n.o
Water meter readings,if available(last 2 years usage(gpd)):
Sump pumQ(yes or no): nA
Last date of occupancy: 12a e.6 en t
COMMEkWUM&USTRJAL
Type of estab r t:__ na
Design flaw on•310 CN IR.15.203):. na od-
Basis.of d6i..flow(seats/persons/sgketc.):, na
Grease traps resent(yes or no):n a
Industrial waste holding tank present•(yes or no):na
Non-sanitary waste discharged to the Title 5 system•(yes or no): ry.
Water-meter readings,if available: na
Last.date of occupancy/use:
OTKR•(describe)•.
QENERAL INFORMATION
Pumping Records
Source of information: 7.'l.-'8 a c o m 9 e a
Was system pumped as part of the inspection(yes or no):41e6
If yes,volume pumped:1000 gallons--How was quantity pumped determined? mea su zed
Reason for-pumping: mn i n.t ni,n r v . ;_,rr•..:
TYPE OF SYS-TEM
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/Alterhative.technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank. _Attach a.copy-of the DEP.approval
_Other(describe):
Approximate age of all components,date installed(if known)and source of information:
.eeachin4 uR•4zaded 2001 /
Were sewage odors detected when-arriving at the site(yes or no):1' t)
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM IN FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:26 5 Pp n n e � /.i. .,
Owner: minnniA /-
Date of Inspection: j j 1 n R 1 n 4
N `
BUILDING SEWER(locate on site plan)
Depth below grade: z n
Materials of construction:_cast iron �40 PVC_other(explain):
Distance from private water supply well or suction line: 1.p, f
Comments(on condition of joints,venting,evidence of leakage,etc.):
Zoz't�s a�nea2 t.iaht •No ev-.de•nce 01 .leakage Syztem vented
thaough house and teaching vent.
SEPTIC TANK&,e- (locate on site plan)
Depth below grade: Z'
Material of construction: x concrete metal,_fiberglass_polyethylene
_other(explain) —"
If tank is-metal list age:no Is age confirmed by a Certificate of Compliance(yes,or no):_(attach a copy of
certificate)
Dimensions: 5 ' 8'h- h 4' 69w.ide%8' 6'.Fong
Sludge depth: 0
Distance from top of sludge to bottom of outlet tee or baffle: n e .+LLd e
Scum thickness: 0 g
Distance from top of scum to top of outlet tee or baffle: „o
Distance from bottom of scum to bottom of outlet tee or baffle:2 O iS r u m
How were dimensions determined. k n rl m a e
du2i'a �nsaect�on Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural irate
as related to outlet invert,evidence of leakage,etc.): 8rity,liquid levels
um tank. eve•2 2- eaz s,• Tank a eats �Lt/luctu zai e �sou'd. No
evidence o leaks e. Inlet and outlet tees sae in ace.•
GREASE TRAP:'o (locate on site plan) _
Depth below gradd.za ,
Material of construction:_concrete_metal fiberglass_polyethylene other
(explain): -- _
Dimensions: n a
Scum thickness: n a
Distance from top of scum to top of outlet tee or baffle: n a Y
Distance from bottom of scum to bottom of outlet tee orbaffle: n a
Date of last pumping: n a
( Pumping
Comments on in recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage etc.): '
G2ea�e t2a�. not p2ese'� .
TMA T++o+wM;n„Fnrm 4/1 C/,)NUI 7
i
Page 8 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
-SOS RF A10E SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26 5 Beat.6e s Blau
Owner.• l7nrQ;i,o;en
Date of fbspection; 11/D 8/0 4
• x �
•
TIGHT or HQ-J DING TANK:,%o (tank must be pumped at time of inspeotion)(locate on site plan)
Depth below grade: nn_
Material of construction: concrete metal fiberglass___polyethylene other(explain):
Dimensions: na
Capacity: na gallons
Design Flow: na gallons/day
Alarm present(yes or no): na
Alarm level: na Alarm'in working.order(yes or no):
Doty of last pumping: na
Comments(condition of alarm and float•switches,etc.):
Tight o z ho-ed.ing tanks not ./22e.6ent.-
DISTRIBUTION BOX:ue.6 (if present must be opebed)(locate on site plan)
Depth of liquid level above outlet invert:2n
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.):
Pox he7.t 31Prrfoon PA_•Nn 9uir,onr,9 nZ .D.onkngp info nn nti;t n.e _
0 q Y. N n A;Q Q 6 GLT �LGLQf.A�6 6 g1b?i(T 6L i'61b,
PUMP CHAMBER: n' o (locate on sife.plan)
Pumps in working order(yes or.no): na
Alarms in working order(yes or no):na
Comments(note condition of pump.chamber,condition of pumps and appurtenances,etb.):
10um.,? rhamPon nnf Fr�no.tonf_
8.
Page 9.of 11
OFFICIAL INSPECTION FORM—'NOT FOR VOLUNTARY ASSESSMENTS
�• SUBSURFACE-SEWAGE.IIISPOSAL.SYSTEM INSPECTION FORM
PART:C
SYSTEM INFORMATION(continued).
Property Address: 265 Beaitzez Vau
- Hc nnn1.t. Na.,
Owner,-
Date of inspection: Z j-/n Q/n ,
SOIL ABSORPTION SYSTEM(SAS):r'�•(locate on'site plan,excavation-not required)
If SAS not.located explain why:
oca.ted .ee /2age10 •
Type
leaching pits,number:_
leaching chambers,number: 3 _
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.):
So iiz al2l2ean dau •No evidence o� hydaaa eic jai-eulte.
Vvnvon�ioit n^nvaa�s noitma.e
CESSPOOLS: n o (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:' it a
Depth—top of liquid to inlet invert: na
Depth of solids layer: na
Depth of scum layer: n a ,
Dimensions of cesspool: na
Materials of construction: n rz
Indication of groundwater inflow(yes or no): raa_
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
Cezz12ooez no.t 121te6en.t.
PRIVY:a o (locate on site plan)
Materials of construction: na
Dimensions: n a
Depth of solids: na
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
l2 ivy no.t R2ezen.t
Page 10 of 11
Ol�MCiA INSPE 3 TQN FORM NOT�'SYSTE .INSEECM. O�FGRM- S �
S�SUMACE'SEWAGEMIS� OSAL'PAR
SYSTEM PMRM-AT-ION(rontmved)'
Property Address: ?
Owner: n
Date of Inspection:
SKETCH OF SEWAGOISPOSA,L SYSTEM referonrze landmarks Provide a sketch of the sewage disposal system including ties totwatt uppler ente stthe building. Dr
benchmarks•Locate all wells within 100 feet.Locate where public.
10 -
Page 11 of It
SP
OFFICIAL
INSPECTION FORM—NOT FOR VOLUNTARYTION FORMSSMENTS
SUBSURFACE SEWAGE DISPOSAL
PARTCYSTEM INSPECTION
SYSTEM INFORMATION(continued)
Property Address:
Owner: /3 i P1! l7aaaag o n_
Date of Inspection:
SITE EXAM
Slope
surface water
Check cellar.
Shallow wells
ound water _feet
Estimated depth to gr
Please indicate(check)all methods used to determine the high ground water elevation:
lens on record-If checked,date pf design plan rgvieweda
Obtained from system design p
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:
r-, You must describe how you established the high ground water elevation:
used; '''' & Miller model 12 1
used-USGS observation w
used- 'Technical bullet, — —
wa er a eva ions.
Leaching
Pit
Groundwater: Feet Below Bottom;of Pit High Groundwater Adjustment 1.8 ft per FLirnptejMethod
Therefore,the.vertical.separation distance between the bottom
of the leact ing pit and the adjusted groundwater table is
feet;
• tt
a•mtnrh r•n.•rs�•rrafr.—arRrnt�I�'RRasrT.IR1fr.�Taesfr�R�R�.ffsT4Zfs�'�7ttI11sA
TOWN OF __ 130ARD OF 11EALT11
SUDSUIIFACF SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CEIITIFICATION
' tRR aT.•Pa' •Tr•1t•ter
.^•a't'1 ter•:'.1��t If.�•T.a'TRa1'aR•RlRr.rnars,re'.ta+r-Rr.`�n•t rlff'rr.7tRaamr �
—TYPE OR 'PRIHT CLEARLY—
PROPERTY INSPECTED
STREET ADDRESS 265 degltzee Glau -
ASSESSORS MAP , DAL.®,,CK AND PARCEL # ,• a•
OWNER' s NAME [3ili macl2uzen
PART D - CERTIFICATION
NAME OF INSPECTOR ea ?¢o cni
COMPANY NAPfE Joseph P Macomber &1' n I nc
COMPANY ADDRESS Box 66 CentervilL,t MA n94 7
Street - To" cr city State LIP
COMPANY TELEPHONE ( 508 775 - 3338 FAX t 508,E 720 1578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system a•
0%this address and that the information reported is true , accurate., and
mw omplete as of the time of �inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on.
site sewage disposal systems ,
'Check one:
xxxxx System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
Ilealtll or- the enviro..jament as defined in 310 CMR. 15 , 303 , Any failure
criteria: not evaluated are as stated in the FAILURE CRITERIA section of
this. form.
System FAILED*
The inspection which I have co.n cted has found that the system fails t(
protect the jiublid health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART,,C -,FAILURE
CRITERIA of this inspection form.
Inspector 5ignature, Date .
One copy of this certtfieatibn must -be provided 'to. the QWNER, theBUYER
here applicable ) and the. 130ARD Or HEALTH. .
* If the inspection FAILED, we owner or.11,operator shall upgrade ' the system.
within o'ne year of the date of the inspection., unless allowed or required
otherwise as provided in 340 CMR 16 . 3-06 ,
1. part'd :do�
- TOWN OF BARNSTABLE
LOX:ATION r eARSPS wA,Y SEWAGE # 00�— �
VIL�AGE j11S ASSESSOR'S MAP & LOT 13 c —no,�
INSTALLER'S NAME&PHONE NO: T A /4 A C U.M i9 e A r So Al
SEPTIC TANK CAPACITY /6 6 6 O L a,
LEACHING FACILITY: (type) w eLL C (size) 3 G t %3 •- A
NO.OF BEDROOMS
BUILDER OR OWNER AC• e
PERMITDATE: I 1 f �— COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Welland 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
r _ .
P M o y
a
' t
FRIEDLINE& CARTER ADJUSTMENT, INC.
436 Main Street, P. O. Box 338
Hyannis, Massachusetts 02601
Tel. (508) 771-3232
FAX (508) 790-234
TO: O Building Commissioner or Inspector of Buildings
Board of Health or Board of Selectmen
O Fire Department
TOWN OF Barnstable -
TOWN HALL
Hyannis, MA
RE: Insured: HOLMES, Sandra
Property Address: 265 Bearses Way
Hyannis, MA
Policy Number: 0839324
Type of Loss: Mold
Date of Loss: 4/15/2007 ;
File#: 106151
Claim has been made involving loss, damage or destruction of the above captioned
property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143,
Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate,
please direct it to the attention of this writer and include a reference to the captioned
insured, location, policy number, date of loss and file number.
On this d e;I caused copies of this notice to be sent to the persons named above at the
addresse indicated above by First Class Mail
4s �'
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J. F. MCNAMARA
Adjuster
0 5/10/2007
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No. FEE
COMMONWEALTH OF MASSACHUSETTS
4A�PPLICATION
Board of Health, �.f VAS 1 c� r-Q MA.FOP DISPOSAL S YSRM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair(-r-lul`pgrade( ) Abandon( ) - ❑Complete System & dividual Components
Location -RGS ec-2�-S t,v A Owner's Name
Map/Parcel# 3 j 0 O S Address �,�5 g •�s=S (.t/IA
Lot# Telephone#' '77g-- L1a 5.�.
Installer's Name MtgL /V,-,�-C-�r Designer's Name Yankee Survey COri
sultants
Address L.7-K-4ceul1l AddressP.ORox 265 Unit 5 Industry Road
Telephone# Telephone# Marstons Mills,Mass. 02
5 508-420-5553 �� �� ft.
Type of Building Lot Size / y s q.
Dwelling-No.of Bedrooms Garbage grinder r
Other-Type of Building No.of persons Showers ( ),Cafeteria�(+�)
Other Fixtures U
Design Flow (min.required) L11,10 gpd Calculated design flow y yG Design flow provided 7 S gpd
Plan: Date -.a3—0 Number.of sheets .Z Revision Date
Title SrtgJ IL CA JJ
Description of Soil(s) S«r 2CA N
Soil Evaluator Form No. Name of Soil Evaluat l��.t R Date of Evaluation O�•
DESCRIPTION OF REPAIRSORALTERATIONS Adding 3-500 gallon leaching chambers to a
P-X; Gtin 1000 gallon septic tPn,k-. 33 5 'X1 2 ' 1 0"X2 ' Omitting leaching pit
i
The undersigned aI
s to' tall the abo described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a es to p c e syste o ration until a Certificate of Compliance has been issued by the Board of Health.
Signe Date 1 0/3 /0 ,
Inspections �&w /� �
E No. (/ r, FE
ACHUSETTS
OMMONWEAklEt
634,E s '�. -e
•1t Boar of Health, MA.
APPLIWION F®R'`DISPOSAL SYSTEM CONSTRUCTION PERMIT `
r �l
Application for a Permit to Construct( Repair(�pgradeO Abandon( - ❑Complete System C7 Individual Components
Location Pam'2 Sr S KJ I� Owner's Name . /Q ,-c V t'P w - S
Map/Parcel# O D S Add ess ��'S `� `�S S 1 w►'4
Lot# Telephone# -7"7$— L/o� t
Installer's Name Designer's NamcYankee Survey Consultants
Address AddressP.013ox 265 Unit 5 Industry Road
02
r•
Telephone# 77�_- 3 O Telephone# Marsturis i" ,twla s.
5 - � 508-4?.0-5553 T-
Type of Building; Lot Size sq.ft.
1 ti
Dwelling-No.of Bedrooms Garbage grinderd
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min. re uired) gpd Calculated design flow G 1 Design flow provided gpd
Plan: Date a _0), 'Number of sheets R�l(eSion Date
Title IyG �/4 t 1
Sew Coo N �;.::..�..
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluat ^P % J Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS Adding 3-500 gallon leaching chambers to ab
existing 1000 gallon septic tank.33.5'X12 ' 10"X2 ' Omitting' leaching fit,`
. r 3
.,-..The undersigned agr es t�stall the ab to d scribed Individual Sewage Disposal System in accordance with the provisioiis:of TITLE 5 and
further aees to 0 o y7o' a syste in o eradon until a Certificate of Com fiance has been issued by the Board of Health.
10/30�0 •
Signe `� N Date _j.
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Ins ections vets ��jz r' �l(� J
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N . D FEE
COMMON LT14 ®F MASSAQIUSETTS
Board of Health, �� 5 � MA.
z.,
f• CERTIFICATE ®U C®MPLIANCE
Description of Work: &VI ividual Compsonent(s) 0 Complete System Y
The undersigned herel?y certify that the Sewage Disposal System; Constructed ( ),Repaired (Upgraded ( ),Abandoned O
by: l M AI:4rJ o- (�e v^ J.P. Jr.
at o1C.S 11 6A K S GO04�K Hyannis,Mass.
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) ay�dttl�e,approved design plans/as-built plans relating to
application No. r , dated . Approved Design Flow (gpd)
Installer m 14 CUYH a/_ JP= &! Son I nc. �'
Designer:y14/,/(,-e Sy/V!!, -CtGehSUCrK14'Inspector: W ' Date: I I1
6 7-
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
No .J/ FEE$50.00
COMMONWEALTH OF MASSACHUSETTS
Board of Health, �`� to��``y ke MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
IT
Permission is hereby granted to; Construct( ) Repair'( Upgrade( .) Abandon( ) an individual sewage disposal system
at �cS 151:i4 2 L )O H S�S c.
annismass.�' � as describedA'n the application for
Disposal System Construction Permit No .. dated O
Provided: Construction shall be compl l ed* in r e years of the date o h ;f lP'conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston MA Dat�BV Board of Health t (/
t r
TOWN OF BARNSTABLE .
LOCATION S j' G'A/�`S PS WAX SEWAGE #
/
VII,LAGE y�AN�/iS ASSESSOR'S MAP & LOT 31 b — 0
INSTALLER'S NAME&PHONE NO: /�- -lit A C A4 15 e A- r S o Al
SEPTIC TANK CAPACITY /�d 6 O O L/7
i LEACHING FACILITY: (type)-gyp I�R Y w eLL S (size) V 3 G t / A
i NO.OF BEDROOMS
A
BUILDER OR OWNER tiC.
PERMITDATE: !/01' 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
GAI?A & d'
Al 0.
�A /r
.G ys'
� S
i� s
r
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TOWN OF BARNSTABLE
r
LOCATION C;(06- SEWAGE # O U
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. C` A ff � AN D SCEs\C
i
SEPTIC TANK CAPACITY 1 DOCK
LEACHING FACILITY:(type) PR -c,�.S'� !P'+� (size) Lct�b
NO. OF BEDROOMS PRIVATE WELL OR 3LIC WATER,_
BUILDER OR OWNER ��`��� \�`C aU-c-e4U
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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'ASSESSOR'S MAP NO. D PARCEL ���U
I0CA'T10 K SEWAGE P.ERMIJ . NO.
-LA G E
I N S T A LLER'S NAME A ADDR-ESS- . _
PA`c-N
S U I L D E R. OR OWN ER
DATE PERMIT ISSUED
0AT E COMPLIANCE, ISSUED r� `��
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NO. .I.....^... O o FEB. ...... .
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
ApplirFation for Bifq' pusFal arks Tonstrurtiurt ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
................_. ...... .................................................
• Location Address ^�A Q or Lot No.
............... .iU.e..r.�........................... .-....-•-•-- .......... •.. ...........-----------••------•-••---.........
4 w
GV Q 5 P �L ......... PON.. � ..... �.......................................
pq Installer Address
UType of Building . - Size Lot............................Sq. feet
Dwelling—No. of Bedroom ------
Attic ( ) Garbage Grinder ( )
`4 Other—T e of BuildingNo. of persons............................ Showers — Cafeteria
a
� Other fixtures -----•------------------------------------------------.--------•-••-•-•------------•------------------------------------------........._.........._...
W Design Flow............ ................gallons per person per day. Total daily flow::: ......................gallons.
W Septic Tank—Liquid*capacity............gallons Length................ Width................ Diameter......--........ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.......1--------------.Diameter......VD-t...... Depth below inlet......6_._....... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................--.
(Z, Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water----.................--.
x -------------------------------------------------•------------------.................---------------.........................................................
0 Description of Soil....................-..........................................................
x
V
----•------------------------------------------------------------------------------------------------------------------------- -------- -------•--•-----.�..T••........�. l..
V Nature of Repairs or Alterations—Answer when a pli ble.---_- .C-f-ITT-G���________.._C �___ _ _ _ C
--- r�`.-e------cam ---------�.ass--�............................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State.Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Com lianc has been is ed by )z.a d of h th.
-��
Signed ........... .............. = - ,,......... . . ....------. i...
,./
Application Approved By� �
......................... ... .......-.-. -....-----............................................-- I........... .. .... .
Dare �
Application Disapproved for the following reasons:
................................................................................................................................................................................................................ ........................................
Dare
PermitNo. ................................................................. Issued ------------------........------------------................--------
Dare
F$s No.��—
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE '
Appl ration for DisVusal Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct ( )~or Repair an Individual Sewage Disposal
System at:
Location-Address or Lot No.
------------------
— -- - --—_--
aG ..Q.�--L 11��f y� P<� --------------- ---..• , - "`_-` —----- __
Installer Address
Type of Building Size Lot---------------------Sq. feet
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building Nor of ersons--•------••--•--•--•-------• Showers
a YP g ---------------------------- P ( ) — Cafeteria ( )
dOther fixtures -----------------------------------------------------•----------------•--•----------------------------_----------------------------------- -
WW Design Flow.............2---ter._.------------gallons per person per day. Total daily flow__-__ _�_D---------------------gallons.
C� Septic Tank—Liquid'capacity------------gallons Length................ Width_______---._.__ Diameter---------------- Depth----------------
'Disposal Trench—No..................... Width--------------------Total Length-------------------- Total leaching area----------------_sq. ft.
Seepage Pit No.------ Diameter......V O._._.._ Depth below inlet"----6---------- Total leaching area---------------sq. ft.
z Other Distribution box ( ) Dosing tank ( )
'"' Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------
a Test Pit No. 1-__-•-__-___--••minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
Li. Test
`Pit„No.�2--------_:_-----minutes per inch Depth of Test Pit----------------_.. Depth to ground water-------------------------
M .. w _ -------------------------------------------------------------------•---------------
Descriptionof Soil......-�-------------------------------------------------------------------------------------------------------------------------------------------------
c.� -•--------;•------------ ---------------------------------------------------------------------------------------------------------------------------------------^..�----------
W ----------------- ------
V Nature of Repairs or Alterations—Answer when a pli ble------- ---(-{ Z- ------------ ---�T---- - -.
----------------------------------------------------------------------------------------------
Agreement:
F The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Co e—The,undersigned further agrees not to place the
system,in operation until a Certificate of Compliance as ben iss ed by e_board of health.
_ Signed - -`4- I
p 1 - = - .. ---- - ,
X lication Approved By
�+ f'd
!Application Disapproved for the following reasons- -----------------------------------------------------------------------------------------------------------------------------------
Permit No. Issued -----`-----------------------_-----
Dam
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BAR�TNSTABLE
(gerttftrate of Compliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x )
by ... tk� -----------------
-- - - -- - -
at ------------_-------------------------------------------------
has been installed in accordance with the provisions of TITLE 5 f The State Environmental V 7da, cribed in
the application for Disposal Works Construction Permit No. ...___���__"-_ _________ datedTHE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A-GUARAAT THE
SYSTEM WILL FUNCTION ?IS A ORY. Jf'�
/ r
DATE / Inspector------- -b -- __.......... nspecto
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
r-� �O du
No.--- 3. Fse.----- —
Dispinal Works Tanghluffm lirrmit
Permission is hereby granted----------d--- _L�1(`/(� •5- 1=-= - ----------------------------_ _
to Construct ( ) or Repair (, an Ind* "dual Sewage Disposal System /
lQ IJ'Z°G1✓S2 _1.� VI ! -{-------------------------------------
at No..__......__.-.--------._.__._�._ -�_-------___---------______..�_ street
o
as shown on the application for Disposal Works Construction Permit No 9�_--3�------- Dated_ ,!�-•--_-•_----___-----_._
_ -- -- - - - - --------------
Board of Health
DATE----- ��,1._....... -------------•-- ---
FORM 36508 H Q WARREN INC PUBLISHERS
• R
VO f 3 0
Fas2 -
THE COMMONWEALTH OF MASSACHUSETTS
BOARD
�j�OF HEALTH
n
........OF.....,dVc� o.�.' s`.7.`
Appliratinn for Dispaoal Marks Tamitrnr#iun rani#
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
................c .....___. ors ,_ _.... ............. 4 y. .&IS.....---------------------------...---........_........
Locat'on- ddress 4 or t No.
.....----- s�SJ�.Y?�. .,..... !4! .` 5: 1� __..U__lG .. u . N ........_vas....................
Owner Address
a ........ V4 ........................................
...... ' t s.a.t S.----.• ?.4•V15..................
Installer Address
Type of Building � Size Lot............................Sq. feet
Dwelling—No. of Bedrooms........3..:.........................Expansion Attic ( )Showers (Garbag Grinder
Cafeteria ( )
`4 Other—T e of Building . No. of persons..................
a Other—Type ng --------------------
d Other fiiures ..
W Design Flow....�.6.............................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.
3 Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
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........................
Oa ..•----••---------------•---------...•-•••-•-••---••-•-•----.....•-----...-••---•---••-•--...................................................................
Description of Soil........................................................................................................................................................................
W
U •--•---••••---••---••--••-•---•••--•--•--•---•----•••.....•-•------------------•--••----.......---••-••---------•••••---•....-•---•--•--•............•••--•--............•-•-•-........----...--••------
W ----------------------------------•----------------------------------------------------------------------------------------------------------------• - -.....-•--
U Nature of Repairs or Alterations—Answer when applicable------ �"...... .....
. ....e �� ss.Pe�.►---...........................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iIliL.F� 5 of the State ar Code— The undersigned further ag ees not to place the system in
operation until a Certificate of Complian as been tss t and of he
Sined- --------- ----•-... ----... . ... . ............................. .QQ�L -•--
Application Approved By------•----•-••-------- •••-• ------. •-----•-- ---•--------•--- ------------- 0- D Y�-...
Date
Application Disapproved for the following reason -...............................................................................:..............................
-
--------------•--- ------------------... -----------------
.---------------------------------
...-----------------------------------
-----
...----------------
Date
PermitNo......................................................... Issued_....................................................._
Date
p-• i Fss............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_�C JJVL .......OF....,,
Applirntion for Uiiposnl Works Tanstrnrtion Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
................_��-.(0.s.. ..V�!;� «rS
Location Address r or t No.
�D�'ReC Address
r Installer Address Y
Type of Building Size Lot............................Sq. feet
a_ Dwelling—No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( )
aOthet—Type of Building ...............:........... No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures ...................=
WW Design Flow....C�. ..... .........__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................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........................ p
W ......................................................................................................•......
O Description of Soil..................
....................._..........__._..........
---------------------•----•-••----------•......------•---•------------------------------------•-----------•------....... ••----------•-••••-------•---
x
W •--•-•----------------•--- .----...-------------•------•---.......-------•----------•------------------•--------••------ --- ..i'. - ------------------------
U Nature of Repairs or Alterations—Answer when applicable.-----1A.0V.._.__ . I f
�I �! l- e--Ii t'...._.� -..
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLF, 5 of the State Sanitary Code—The undersigned further ag ees not to place the system in
operation until a Certificate of Compliance,as been Issued-lzy treo-rd of health.
y. =St ned.: ::...... :.:.::: . •.--
- --...--•- ...
Application Approved By....... --
ate
Application Disapproved for the following reason ....
....-•-•----....-•...........................................•----------•--------•------.....--------......----------•-....------•---------•---------- ............................................
Date
Permit No............................
............................. Issued...........................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
^T vl.�......OF.......... .........V.I ..'�K_....
..........:..............
- Trrtif irntr of Gamplinnrr
THIS 1�T-0 CEReTF�Y� hat the In ividual Sewage Disposal System constructed ( ) or Repaired ( ---
b . .
Installer
at............... .......... • t`.J!.igw wl.S .---------••••....----•-•--.....
has been installed,in accordance with the provisions of TIT11 5 of The.State Sanitary.Code as described in the
application for Disposal Works Construction Permit No......-r� '?__..`1 dated.........`_ -/.1_ .(—/.-.........
I /-
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
��? 2 l ��n
DATE ......... ........... Inspector.........
yam:
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH ✓ '
� -
��� �. -� ...........OF........ -: �,. .�: ...................... 2 No... FF.E.................}......
�i posnl Works tTonitrnrtion permit
Permission is hereby grant ----- .................. c, -------------------- --------------------------
to Construct ( ) or Repair n Individual Sewage Disposal Systgm� v C
atNo............... h ..-,--- -�1 =1� -----•---------------------
Street.
as shown on the application for Disposal Worl:s Construction Perm- No..................... 1�tcd..........................................
u. oard of t calth
DATE............... -- --- ll-- ..................................
HYANNIS
j
SRUCE
G.
" s MURPN\/ 9c�sS1i��
h No.749
SqIAVIIT AR�� A.M. 310/6-1 . 5�
1'30'E / y
°
N6925 29 °` ' LocUs
ASPKAE HYANNIS
DRIB EAST
55' NCB° LOCUS MAP
ELEM.
4p X, FE 2
° - \
°
CB/DH C,A / PLAN REF• 17201I
ZONING.•. ""RB""
BENCHMARK I W G.0.P.D.: "AP"
TOP OF STAKE - ASSESSORS MAP 310
ELEV.=41.96 '\ o \\EXISTING 12.� � W
\\\ o \\\ SYSTEM
P, N. 3z o
, ; \ I
173 656TP
0 N O
i I 23 0 SPACE
SE N
A.M. 3101435 ; ,--�� N C 0
265 SEPTIC SITE PLAN
0 # 7 A. M. 310105
I
1 AREA=16 488f S. F.1 ECIC 0 3• PROJECT LOCAT/ON
1265 BEARSES WA Y
o_12 2 HYANNIS, MA.
°O t ------�0.3 , /CK o
CO 10 R, APPLICANT•
BILL Ma c Q UEEN
, --- �1 191.25 „E, YANKEE SURVEY CONSUL TANTS
_----3 , °_ N80°4 7 4 7 P.O. BOX 265
o -°�° UNIT 5, 40B INDUS TR Y ROAD
° FENCE A.M. 310/4 MARSLL , MA. 02648
PH(508)428T�0055NS I-SFAX(508)420-5553
CB/DH SCALE.• 1"-20' IDA TE.- 9123102
G•
A.M. 310/1 REV REV.
�� JOB NO. 53247 SHEET 1 OF 2
EL. = 43.1 _
719P OF FOUNDATION f J
20 MIN.
I
10' MIN. CONCRETE COVERS
i 4" SCHEDULE 40 P. VC
EL= MIN PI7L^H 118 PER FT
2"LA YER OF
CONCRETE CO PER 1/8"-112"
/ / ♦ � / / / / / / / / / ♦ / WASHEDS719NE
6' MAX ♦ / / .� ♦ . EL=41.0
4" CAST IRON PIPE
�~L (OR EQUAC'H L MINIMUM 6'MAX
P/7 1/4 PER FT TINC D-BOX�XIS
a CLEAN SAND
7/5 FLOW LINE
EXISTING EL=370
1 �+
00
INVERT mNy 14" _ o00o O o000 °° o
EL.= 40.6 ADD CAS INVERT 6 SUMP LEVEL 00 o0000000000
°o 00000000000 00° °
BAFFLE -39.55 INVERT 6 SUM c'° o°° 00000000o00 ° 0�8 -34.2
INVERT EL.-___ INVERT o 0 0 0 0 0 0 0 0 0 0 ° 8 EL.-_ _
EL.=39.8 EL.= 3915- NEW EL.=38.4 -- `gyp
Xz INVERT INVERT DISTRIBUTION' (3) 500 GAL LEACHING CHAMBERS
00 __IOQQ__GALLONS EL.=39.40 EL.=_38. - BOX EL.=36.2
-- -�
EXISTING SEPTIC TANK 719 IF MBE W4 TER TESTED ORE THAN ONE OUTLET 12.8' X 33.5' TRENCH FORMAT/ON
PLACE ON 6" STONE SOIL ABSORPTION
314- 7V 1-112- SYSTEM (SAS
DOUBLE WASHED SMNE ) ti
PROFILE OF NO OBSERVED WATER TABLE (9114102) ELEV.= 28.5 _
7. 7 ADJUSTMENT (Al W 230, ZONE D) USGS PROBABLE WATER TABLE ELEV.= 2_9.2
SEWAGE DISPOSAL SYSTEM C.I.S. WATER TABLE (CROOKED POND) ELEV.= z1.5-
NOT TO SCALE OBSERVATION HOLE I ELEV.= 41.5 _
PERCOLATION RATE S2 MINI INCH AT _54" INCHES
DEPTH HORIZ TEXTURE COLOR MOTT OTHER
0"-24" FILL
` 24"-27" A SANDY LOAM 10YR 512
27"-4' B LOAMY SAND 10YR 716
GENERAL NOTES 4'-125' C MEDIUM SAND 10YR 714 PERC
1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. NO WATER ENCOUNTERED
TITLE 5 AND THE TOWN OF -BARNSTABLE---- RULES AND
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. SOIL TEST
2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO 9114102 SOIL TEST DONE BY BRUCE G. MURPHY, R S.
WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST
3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DESIGN CALCULATIONS.'
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. NUMBER OF BEDROOMS . 4
4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL GARBAGE DISPOSAL . . . . . . . . . NO
BE MORTERED IN PLACE. TOTAL ESTIMATED FLOW
5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH INSTALL.- ( 110__CAL/BR/DAY x __ 4 BR) 440 CAL/DA Y
DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO (3) 500 CAL LEACHING CHAMBERS
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. WITH 4"STONE ALL AROUND EXISTING SEPTIC TANK CAPACITY 1000 CAL
6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 128' X 33.5' SOIL CLASSIFICATION . . . . . . . . 1
IS TO CALL "DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS DESIGN PERCOLATION RATE . . . . . < z MIN./IN.
PRIOR TO COMMENCING WORK ON SITE. EFFLUENT LOADING RATE . . . . . . •74 GAL/DAY/S.F.
`• 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS l LEACHING CAPACITY (AREA X RATE) 454 CAL/DAY
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. (33.5X12 8X 74)+(33.5+33.5+12 8+12.8)X2X 74)
8) PARCEL IS IN FLOOD ZONE___"C"_____.
9) LOT IS SHOWN ON ASSESSORS MAP DLO_ AS PARCEL _5_____. r PACE 2 OF 2 J,p 53247
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