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HomeMy WebLinkAbout0205 BISHOPS TERRACE - Health 205 Bishops Terrace Hyannis 1��A= 251 196-a _y t t. JP No. 4100.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYicatton for �hgpoq;al *pgtem Con5tructton Vermtt Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 7 7 5—8 0 9 8 205 Bishops Terr, Hyannis Lee Sarkinen Assessor'sMap/Parcel 210 Buekwood Dr, Hyannis Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 2 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answerwhenapplicable) Install'.a new Title 5 leach system to the plans of Eco-Tech. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sign Dateffa Application Approved by Date -Application Disapproved.by: Date for the following reasons. Permit No. Date Issued 1? No: 0096 )-0..01 .c N ,.,* Feel 00.<:00 t THE COMMONWEALTH OF.,MASSACHUSETTS Entered in computer: a �t) PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes µ application for �3igpogal A&pgiem Cow5tructi0n vermtt Application for a Permit to Construct O Repair O Upgrade O Abandon O ❑ Complete System ❑Individual Components t P Y Location Address or Lot No. Owner's Name Lee Sarkinen Address,and Tel.No. 7 7 5—8 0 9 8 205 Bishops Terr, Hyannis li Assessor'sMap/Parcel 216 BUckwood Dr, Hyannis * Installer's Name,Address,and Tel.No. 7 7 5--8 7 7 6 Designer's Name,Address and Tel.No 3 6 4—0 8 9 4 ` elm .E Robinson Sr Septic Eco-Tech PO BOx 1089, Centerville 143 Triangle Cir, Sandwich Type of Building: ` Dwelling No.of Bedrooms 2 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Instal laa new Title 5 leach system to the plans of Eco-Tech. 1 Date last inspected: Agreement: .. The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of y'j"-Compliance;has been+issued by this Board of Health. p' / Sign�dK�-- -,_i.t!! �pp .4l) _ /i !� /) Date � 7/j/y�r� Application Approved by / li It - ea a J� Date Application Disapproved by: r -y Date for the following reasons /'r3 1 r . Permit No. Date Issued f THE COMMONWEALTH OF MASSACHUSETTS l�w Qr BARNSTABLE, MASSACHUSETTS sarkinen Certificate Of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System-Constructed ( ) Repaired (X ) Upgraded ( ) Aband. d.( ),b Wm E Robinson Sr. Septic t 01 5 Binh ps Terrace, nyannis at h�s bbeeen,constructeedd in—accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�!/(/ `7 dated Installer Designer #bedrooms --- Approved design flow D 1 0 gpd The issuance of this pe it hall not be construed as a guarantee that the system will function as designed. Date �2 I � Inspector �' ---- -————— —————— — ——— ——————— ——— — —— ————— $100.00 Fee Sark A THE COMMONWEALTH OF MASSACHUSETTS 'PrNLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS ;w5pont *v!aem COtt$truction Permit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at 205 Bishops Terrace, Hyannis 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 mustlbe com/jlete •within three years of the date of this perm t./ Date s�l Approved by (/� , ev .�� v Town of Barnstable Regulatory.Services . • Thomag F, Geller,Director * �rrsrasLe. *' p Mass. 1 g, 163q. ��� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790=6304 Installer&Designer Certification Form F..� Sewn Permit# e �� � . Date: v g Assessor's MapTarcel Designer: Eco-Tech Installer: Wm E Robinson Sr Septic .. Address: 43 .Triangle Circle Address: PO Box 1 089 Sandwich Centerville On -d C, Wm E Robinson s.r Sept s issued a permit to install a (date) (installer) septic system at 205 Bishops, Terr, Hyannis based on a design drawn by (address) Eco-Tech.. dated (designer). 1° I certify that the septic:.system referenced above was installed substantially according to the design, which may include minor approved:changes such.as lateral relocation of the distribution box and/or septic tank: . . 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}biit in accordarnce with State&Local R tions. ?la revision or: certified as-built by designer to ollow. OF MAssq o� DAVfD cti� o� D. .._. COUGHANOWR Cl) sta le s Sign e) No. 1093 c1sT>`���. SgNlT 1P+N (De signer s Signature). (Affix Designer's Stamp Here) LEASE ..RETYTRN. 76 BARNSTABLE PUBLIC HEALTH DIVISION... CERTIFICATE OF. COMPLIANCE .WILL.NOT..BE ISSUEDNTIL U BOTH TIIIS FORM AND AS BUILT CARD AIR RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3=26-04.doc Department of Regulatory Services -- a i Public Health Division Date bec U Zoo,' .679. 200 Main Street,Hyannis MA 02601 ArFO fMA't A l ' Date Scheduled_ , � / �' Time Fee Pd. Soil Suitability Assessment for S wage Dis o jV Performed By: Witnessed By% Location Address LOCATION& GENERAL INFORMATION 2I1; 61sK01 1 , CL Owner's Name Cc` N U sl>!21�1 A 140-lout Address 20S I�/SNO,P TGiZRl�-CC Assessor's Map/Parcel: H yR W M S R,,I Engineer's Name D 4 U1 U 6 cove,to P 1�z,o2- NEW CONSTRUCT-YpON 1 REPAIR Telephone# Land Use 4s,1 )tl l'Icj I p ( ) D ;n Slopes 90 PP 01, Surface Stones V Distances from: Open Water Body 100 t ft Possible Wet Area t�Q+ ft Drinking Water Well t 60 ft Drainage Way (/ t ft Property Line to y + (3 Other ft SKETCH:(Street name,'dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) L58Z Ft GRDUNDWATER ADJUSTMENT I I ! EXISTING GROUNDWATER LEVEL I� BASED ON TOWN OR BARNSTABLE GIS DEPARTMENT RECORDS.,- _4 INDICATED GW 32.00 I INDEX WELL A1W-247 ZONE D I N READING DATE NOVEMBER. 2006 READING J23.3 4.3 ADJUSTMENT 4.3 ADJUSTED GW 35.3 Parent material(geologic)ltoplqel,01' 00 5 Depth to Bedrock 1 L O� I. Depth to Groundwater: Standing Water in Hole: ►��nry o if 0 Weeping from Pit Face 140 n Estimated Seasonal High Groundwater Sege above DETEW AB ATION FOR SEASONAL HIGH WATER T Method Used: S��° yj 4t/e �" ' Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: R o in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level— A41,factor— Adj.Groundwater level Observation PERCOLATION TEST nutp , Time,, Hole# Time at 9" ©`L Depth of Perc 72i 1 m Time at 6" — + Start Pre-soak Time @ to" ) Time(9"-6")._4 End Pre-soak (P: i� Rate MinJInch 2 m p Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) . Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Consefvation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC SOIL TEST LOG DATE OF TEST: DECEMBER 12, 2006 SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONALD DrSMARAIS. HEALTH DEPT. NO ED TEST PIT I PAAREN,TUNDWATE MATERIAL: PROGLACA L OUTWASH ELEVATION = 67.72 +- PERC AT 72 in 2 MIN/INCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING i 0-9 Ap LOAM 10 YR 3/2 NONE FRIABLE 9-42 B LOAMY SAND 10 YR 4/4 NONE FRIABLE 64.22 42-134 C MEDIUM SAND 10 YR 5/6 NONE FRIABLE W/ LOAMY POCKETS 56.55 NO R TEST PIT 2 PAARENOTUNDWATEMAATERIAL:ENCOUNTE PROGLACALD OUTWASH ELEVATION = 66.09 +- 2 MIN/INCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELLI MOTTLING 68.09 0-6 Ap LOAM 10 YR 3/2 NONE FRIABLE B-44 B LOAMY SAND 10 YR 4/4 NONE FRIABLE 64.42 44-120 C MEDIUM SAND 10 YR 5/4 NONE LOOSE W/ LOAMY POCKETS 58.09 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. 1 Flood Insurance Rate Man: Above 500 year flood boundary No _ 'yes -z Within 500 year boundary No Yes Within 100 year flood boundary No yes Depth of Natural) Pervious Material Does at least fo curring pervious material exist in all areas observed throughout the area proposed sgjhgto ystem? UeS If not,what i epth o6natura Q, curring pervious material? `) COUGHANOWR Certification I certify that o e)I have passed the sot)evaluator examination approv ed by the Department of n tion and that the above analysis was performed by me consistent with . the required training, d xperience described in 10 CUR 15.017. Sig Date Sig--- f�s �C 1 Z, 2OOC \L i o r 9 p V S 1 Q -S5 v Town of Barnstable o�,tHE 1qy, o Regulatory Services STAB Thomas F. Geiler, Director MAW. �•� Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 3, 2006 Lee Sarkinen 210 Buckwood Drive Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located at 205 Bishops Terrace,Hyannis,MA was last inspected November 17`h 2006 by, William E. Robinson Septic Service, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system"Fails"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Pit was dry; although stain line shows that it has been full at one time. You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. Z L9, LT PARTMENT S., C. . . - Agent of the Board of Health Cc: Michael J. Gill, Esq I r COMMONWEALTH OF MASSA CHUSETTS ExECUTNE 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: 205 Bishops Terrace Hyannis Owner's Name:_Lee Sarkinen Owner's Address: 1 0 Bn c-kc3ood Drive r C�j/ " P7 � Date of Inspection: Name of inspector:(please print) Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 _Centerville MA Telephone Number:_t S O g l 7 7 5-R 7 7 F CERTIFICATION STATEMENT _ d 1 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 may training and experience in the proper function and maintenance of on site sewage disposal systems:l�a m a DIi approved system inspector pursuant to Section 15340 of Title 5(310 CMR 15.000). The system: � Passes Cj , Conditionally Passes _5Y = Needs F Evaluation by the Local Approving Autho 4 Fails - cD r- -.� fro Inspector's Signature: Dute• The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatth 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 authority. the buyer,if applicable,and the approxing Notes and Comments P l+ wGs t7��ti r�.�r d 4- 4-- ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I I r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:__ 205 Bishops Terrace _ HYann' S Owner. Date or Inspection: 1 1 (p tom_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes' // )�- i have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CUR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: /u I/+ 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'%at determined"please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound not 1 indicating that the tank is less than 20 years old is available. leaking and if a Certificate of Compliance ND explain: Observation of sewage backup or break out or high static water level in the distribution box due twbroken 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): brokedpipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obsowed pipe(s).T7te system will Pass inspection if(with approval of the Board of Health): broken pipes)arc replaced obstruction is rrJaotrod ND explain: vPage 3 of I 1 OFFICIAL INSPECTION FORM=.NOT FOR VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner. Lee Sarkinen Date of Inspection:. ti i 17 f Ob C Further Evaluation Is Required by the Board of Health: /V Conditions-exist which require further evaluation.by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety.and the environment:. Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 NO feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone.1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a-septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a: private water supply well** Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliforrn -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. Other. 3 Page 4 of 1 i OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner- Lee Sarkinen Date of Inspection: t t 7 Ob D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for_all inspections: Yes Nay ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above.oudd invert due to an overloaded or clogged SAS or cesspool i^c Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Numbcr / of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100-feet of a surface water supply or tributary to a surface water supply. _ Any portion ofa cesspool or.privy is within a Zone 1 of a-public well. _ Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 f et from a private water asses if the well water anal sis w' o accep table water quality analysis. This system y supply well with n p q ry y ( P for coliform bacteria and volatile or organic compounds ounds performed a!a DEP certified laboratory., g. P 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.] ` t (Yes/No)The system fails.l have determined that one or more ofthe 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: w '?, 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 _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a sraface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E dz system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of airy large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 3I0 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:205 Bishops Terrace ff-yanni Owner: Lee Sar inen Date of Inspection: I 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 01�' Were any of the system components pumped out in the previous two weeks 7 Z 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 7 r Were as built plans of the system obtained and examined?(If they were not available note as N/A) _ Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? '✓ Were all system components,excluding the SAS,located on site? _� _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of thh baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum 7 _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? Ile 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. 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 � r Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 205 Bishops Terrace Hyannis Owner: Lee Sarkinen Date of Inspection: It in 1 o to 'LOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x N of bedrooms): 330 U"� Number of current residents: C' Does residence have a garbage grinder(yes or no):., Is laundry on a separate sewage system(yes or no):f,.,o [if yes separate inspection required) Laundry system inspected(yes or no): Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)): 7/0 4 to 10 0 6 9 5,2 5 0` Sump pump(yes or no): !�O Last date of occupancy: i o .fib COMMERCIALMIDUSTRIAL /V +.R . Type of establishment: Design flow(based on 310 CUR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):— Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): Iv - If yes,volume pumped:_gallons--Hbw was quantity pumped determined? Reason for pumping: TYPE S OF SYSTEM eptic tank,Aisbibution-bet,soil absorption system _Single cesspool _Overflow cesspool _Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology.Attach a copy of the ctarent 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: or" I Were sewage odors detected when arriving at the site(yes or no): /1-/0 6 I'agc 7 of I I OFFICIAL INSPECTION FORAM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR11I PART C SYSTEM INFORMATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner: Lee Sarkinen Date of Inspection: k)b BUILDING SOUR(locate on site plan) Depot below grade: a t / Materials of construction: , cast irun ✓ 0 I'VC_other(explain): Distance ff0111 private water supply well or suction lute:_ Cununenls(Oil condition of juWs,venting,evidence of leakage,etc.): o•�a- �U� �v_ Italtnye SEPTIC TANK: t9 (locate on site plan) Dcpth below grade: `6` Material of construction:____cuncrctc—n►ctal—fiberglass Jw1yedlylcne _uthcr(cxplain) If tank is n►etal list age:_ Is age cunfirmed-by a Certificate of Compliance(yes or nu):_(attach a copy of ceriificatc) Dimensions: NO p (-4 f(o, Sludge deptl►: } Distance fton►top of sludge to buttum of outlet ice or baflle: I Sewn thickness: e _ Distance front lull of scum to 101,of outlet tee or banle: 3` Distance from button,of scum to button of outlet tee or battle: I low were dimensions deientincd: Q Comments(oil pumping rec jr utune►►datiuns,inlet and outlet ice or baflle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): l�� tc v►r�cri �v ht C- A y GREASE TRAP:N (locate on site plan) Depth below grade:— Maletial of construction:_cuncrctc Inetal fiberglass liolyciltylatc__other (caplaut): _ Dimensions: Scum tltickncs Distance from lop of scull,to lop of outlet Ice or baflle:_ Distance front buttum of`scun►to butlun►of outlet tee or bank: Dale of last pumping: Cununenls(on pumping Iccununc lid atlulls,inlet and uullct ice or baflle cunditiu:t,struclural inkpily,liquid levels as rclalcd 10 oullel inval,n-ldencc of leakage,cle.): "age 8 of I 1 OFFICIAL INSPECTION FORM"NOT F01t VOLUNTARY AS • •' SUUSUIWACE SEIVAGL; DISPOSAL SYSTL111 INSPECTION 1 NI.01( l S PART C SYSTEM INFORMATION(continued) PropertyAddress: 205 Bishops Terrace Hyannis Owner: r_oo --�.�.�. nen little of Inspection: 1 t 7 0 71GIIT or IIOLUING TANK: N P' (tank must be pun►ped at time of in spection)(locate un site plan) Depth below grade: Matctial of construction:__concrete_meta)_fiberglass_Jrulyethylerte oiltn(explain): Dimensions Capacity Ucsign Flow:present, (yes or no): ^allures Alarm gallons/day a /Harm level: Alarm in wurkin der Uatc of last purnping:_ 6 or ()cs w nu): Cununcnts(condition of alarm and float s►►•itchcs,cit.): DISTRIBUTION UOX: N (if p►csent must be opcucd)(locate on site plan) Depth of liquid level above oulle, iuv • C crt. onuna►ts(note if box is Icvcl and distribution tv ou►Icrs equal,any evidence of;ulids cam'over.any eviJcuce of leakage into or out of box,etc.): 1'UAIP CIIAMULK: (lucale on site plan) Pumps in working order O•cs or mo):_ Alarms in working order(yes of no): _ Comments(note comdition of puugr clranrbcr,t:onditiun of pumps and appurtcnanccs,ctc.): • Page 9 of 11 OFFICIAL INSPECTION-FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner: Lee Sarkinen Date of Inspection: b/ SOIL ABSORPTION SYSTEM(SAS): y (locate on site plan,excavation not required) If SAS not located explain why: Typo leaching pits,number. 1 leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): d`Y •e-► k,.s her.. �11 + CESSPOOLS:oLx�(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer. Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow.(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: �I(locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 I • OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner. Lee Sarkinen Date of Inspection: 1 ►7 u10 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 were public water supply enters the building. �yR2 oC G p� it j3 . C� O 3 T3-a ,4-37 " 10 Page 11 of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 205 Bishops Terrace Hyannis Owner. Lee Sarkinen Date of Inspection: tit 7 04 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_ feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: I1 TOWN OF BARNSTABLE LOCATION AO S 13 15� SEWAGE# ;;O 3-3 VILLAGE. 14 y14 1VJ ASSESSOR'S MAP&PARCEL Q 51 �9 p INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY ► 060 LEACHING FACILITY:(type) PIZ4 0E (size) 2 X 13 NO.OF BEDROOMS 2— OWNER 1 E C 2k i1%JEIN PERMIT DATE: 1 Z.// / COMPLIANCE DATE: _ / Z I 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 \j3 � c 1 =: � c c n l 1 EL_O W PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS EXPRESSED IN DECIMAL FEET NOT FEET AND INCHES. TOP OF FOUNDATION RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE EL = 68.98 +- ONE INSPECTION RISER FOR LEACHING GALLERY 6P.95 z D—BOX a Ft 3" DROP MAX 4 FLOW LINEFLI 64.95 10" = II 14 .......... 48" GAs� PRECAST BAFFLE DRYWELL _ 6 in BOTTOM OF EX STTI�NG STONE 64.33 LEACHING SYSTEMSOIL BSORPTION EXISTING BASE EXISTING 64.50 64.20 GALLERY 62.20 5.00 ft EXISTING (END VIEW) 1000 GALLON SEE DETAIL ON REVERSE EXISTING SEPTIC TANK 33.3 Ft. o) 5 Ft 12.5 f t b) 12 ft ADJUSTED 36.30 SEASONAL HIGH GROUNDWATER N�mcDN IaiUIt�WN -m j nZ Z 3= _< a rn ~WczN0)MM-4(A)N m� � �� mNWm-q(ID N'"WUl^`1N C'' rnp O co m II /R, �e\ Zs 01 � m � Como / n ONE 3 m z c 'A / I i � z cn 0 G) o z / Cl j 3� n 9 �zo � -on / A /� �Z O C� ' sli�`'� O I O _ y Zcb Z7 co I ^ ; o _ \ Q O uZ, DEC \�� / 0� O z v1 mop ,a�� 131e ��� y / O Slid r-m m N oil ���� �� W N �� n rl 00 m Zm-0 CD o mr oz > w �z ® O oo �0 0<0 oom0z 1 0� 20 W 0) d 0) y -I� �- ~ Zx z>0 > -q r I I am a-� 4DOZ� N 13 m cn v oy m G)� m0 PrD CO ITI �0Z�u�) UI CD mnN;Q "!� co N w 'ice *� CD =ooro C CT'O rno �Q CD � cn z� r'X _ z0 (nm 3 yczDDo Wrn murniZ rN =z orn� 3 z rn CTl acn� a a ° a can(f) 0 N 0 � m °° n ma ,� 3cn a E z 0 :2:: �-M�� O o oril � F m G-) °Z r l rn r Wiz==3 n _ � frnTl < o �� m = rX m CD ��m OD m _ cr) � � AU)oIn CD Z fV ZO > XO n IZ0173 Z��oo N o ;� 0mrn� � n r rn Hlzdd s doNSle 3o wU) z N r y O m r��mz 3 rn O �Z T 0 z m� a,0 z o k n- Z N r > T z m f l N �I F) 3 m Z 1 1IN �aa3eMd�15 F 3 ` ►. O F Z c 6d02i U'`I'z(nz � (D - <0cccnm 0) c) Z w � O ® ❑ m > _ <Mzmo m G7 y T a 0 4 c�3 rn Z V a o 0 r SOIL TEST LOG DESIGN CALCULATIONS DESIGN FLOW: 2 BEDROOMS X HO GPD = 220 GPD DATE OF TEST: DECEMBER 12, 2006 SEPTIC TANK: 220 GPD X 2 DAYS = 440 GALLONS SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) OAREN GROUNDWATER AL:ENCOUNTERED OUTWfiSH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT 1 PARENT AT Z2 In 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 24 f t x 12.5 FE x 2 f t LEACHING GALLERY CAN LEACH ELEVATION = 67.72 +- Abot. = ( 24 x 12.5 ) = 300 sf Asdw = ( 24 + 24 + 12.5 + 12.5 ) x 2 = 146 sF Atot = 446 sF DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER Vt 0.74 x 446 = 330.04 GPD (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING USE A 24 Ft x 12.5 Ft x 2 Ft. GALLERY. Vt = 330.04 GPD > 220 GPD REQUIRED 67.72 0-9 Ap LOAM 10 YR 3/2 NONE FRIABLE 9-42 B LOAMY SAND 10 YR 4/4 NONE FRIABLE 64.22 42-134 C MEDIUM SAND 10 YR 5/6 NONE FRIABLE W/ LOAMY POCKETS NOT TO 56.55 LLEA C H I N G G A L L E R Y SCALE USE SHOREY PRECAST 500 GALLON LEACHING DRYWELL (H-10 LOADING) NO GROUNDWATER ENCOUNTERED TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH CONSTRUCTION DETAIL 500 GALLON DRYWELL ELEVATION = 66.09 +- 2 MIN/INCH IN C SOILS DIMENSIONS AND DETAIL DRYWELL UNIT STON USE H-10 UNIT INSTALL ONE INSPECTION RISER TO WITHIN SIX DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 24.0 FL INCHES OF FINAL GRADE (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING AND INDICATE LOCATION �,, ON AS-BUILT PLAN 66.09 "4 0-6 Ap LOAM 10 YR 3./2 NONE FRTARI F in � OD N —C� � 8-44 B LOAMY SAND 10 YR 4/4 NONE FRIABLE N `) "oo uUp In 64.42 a0000000000 000�� 44-120 C MEDIUM SAND 10 YR 5/4 NONE LOOSE s 5 Ft es Ft 6.5 F' s Ft �0000000000 00� 58.09 W/ LOAMY POCKETS 24 0 Ft 102 In NOTES CROSS SECTION VIEW 2 Wr PEASTONE 2 In PEASTONE 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 0 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 28 24 in EFFECTIVE3/4 in TO6 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS InDEPTH 1-1/2 in GRAVEL In OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES MINOR BEFORE EXCAVATING FOR SYSTEM. 46 in 58 in 46 in 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED, AND FILLED. OR REMOVED 150 1n 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON, FINES AND DUST IN PLACE Z) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0" BEFORE PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES GROUNDWATER ADJUSTMENT SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK EXISTING GROUNDWATER LEVEL 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT BASED ON TOWN OF BARNSTABLE -TO SERVE EXISTING DWELLING PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 1J GIS DEPARTMENT RECORDS. 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. , INDICATED GW 32.00 LEE A. SARKINEN INDEX WELL A1W-247 205 BISHOPS TERRACE HYANNIS, MA 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL ZONE D STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH READING DATE NOVEMBER. 2006 ECO-TECH ENVIRONMENTAL SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING READING 23.3 12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED ADJUSTMENT .6 FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH- GAS BAFFLE. ADJUSTED GW 33 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-2521 DECEMBER 13. 2006 2/2