HomeMy WebLinkAbout0349 BISHOPS TERRACE - Health 349 BISHOP TERRACE
Hyannis
A = 250 - 077
TOWN OF BARNSTABLE
LOCATION_3 q 9 1ks'b,p5 SEWAGE#
VILLAGE T� �Lt t ASSESSOR'S MAPr&PARCEL O•°— tD y_
INSTALLER'S NAME&PHONE NO. I S� (o -2
SEPTIC TANK CAPACITY /0 0 0
LEACHING FACILITY.(type) ,y Q U o K y S'Ta n og Sze) /I-r X 2
NO.OF BEDROOM
OWNER / Z
PERMIT DATE: 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 ori`
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
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Commonwealth of Massachusetts a ��-
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
. 349 Bishops Terrace r ,
Property Address —
Fablo Hauch 8t Christiane Resende
Owner Owner's Name
information is
required for every Hyannis Ma 02601
— 10/8/2020
page. City/Town
State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.Please see completeness checklist at the end of the form.
Important:When filling out forms A. Inspector Information
.
on the computer,
use only the tab Sean M. Jones
key to move your Name of Inspector
cursor-do not S.M.Jone_s Title V Septic Inspection
use the return key. Company Name
74 Beldan Lane
Company Address
Centerville Ma 02632
City own State Zip Code
774-248-4850 smjonestitle5 c@gmail.com, S14522
sean@smjonestitle5.com License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address
listed above;the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined
that the system:
1. ® Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approvin thority
4. ❑ Fails
10/8/2020
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to
the buyer, if applicable, and the approving authority.
Please note: 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.
t5insp.doc•rev.72wo18 Title 5 Official Inspection Form:Subsurface sewage oisposai System.page 1 of 18
Commonwealth of Massachusetts '
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiania Resende
Owner Owner's Name
information is required for every Hyannis Ma 02601 10/8/2020
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
The property located at 349 Bishops Terrace Hyannis is served by a Title V septic system consisting
of a 1000 gallon septic tank, distribution box and 24 Quick 4 chambers in a 24'x11.5'field. Although
9
the system was found to be In proper working condition at the time of inspection this report does not
guarantee future performance under similar or increased usage.
2) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5insp.doc•rev.MW018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
Commonwealth of Massachusetts
Title 5 official Inspection form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
information is Hyannis required for every Y Ma 02601 10/8/2020
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
2) System Conditionally Passes (cont.):
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
❑ 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 ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ 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 ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
I
3) 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.
a. 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:
t5insp.doc-rev.726/2018 Idle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
information is required for every Hyannis Ma 02601 10/8/2020
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
t ❑ 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
b. 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 e Y g p the public health,
safety and environment:
T❑ he 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.
❑ 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 fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
c. Other:
4) 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
t5msp.doc're.7JY8MS Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
information is Hyannis required for every Y _ Ma 02601 10/8/2020
page. 6ty/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less `
than %day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or,
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply
well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd-
10,000 gpd.
❑ ® 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.
5) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section C.4_
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
t5lnsp.doc•rev.7J2UMS Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18
1
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch &Christiane Resende
Owner Owner's Name
information is
required for every Hyannis Ma 02601 10/8/2020
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cunt.)
If you have answered"yes" to any question in Section C.5 the system is considered a significant
threat, or answered"yes"to any question in Section CA above the large system has failed.The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner
should contact the appropriate regional office of the Department.
6. You must indicate"yes"or"no"for each of the following for all inspections:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of I
this inspection? 1
® ❑ Were as ibuilt plans of the system obtained and examined?(If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner)provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable)[310 CMR 15.302(5)]
t5insp.doo•rev.7126=18 Tdle 5 Official Inspection Forth:Subsurface Sewage Disposal System•page 6 of 18
4.++✓
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
r
349 Bishops Terrace
Property Address
Fablo Hauch 8t Christiane Resende
Owner Owner's Name
information is
required for every Hyannis Ma 02601 10/8/2020
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 gpd
Description:
Number of current residents: 4
Does residence have a garbage grinder? ❑ Yes ❑ No
Does residence have a water treatment unit? ❑ Yes 0 No
If yes, discharges to:
Is laundry on a separate sewage system?(Include laundry system inspection
information in this report.) ❑ Yes 0 No
Laundry system inspected? ❑ Yes ® No
Seasonal use?
❑ Yes .® No
Water meter readings, if available (last 2 years usage(gpd)):
Detail:
Sump pump?
❑ Yes No
Last date of occupancy: current
Date
t5msp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fabio Hauch&Christiane Resende
Owner Owner's Name
information is required for every Hyannis Ma 02601 10/8/2020
page. Citylrown State Zip Code f Date• Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq_ft., etc.):
Grease trap present? ❑ Yes ❑ No
Water treatment unit present? ❑ Yes ❑ No
If yes, discharges to:
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe below):
3. Pumping Records:
Source of information: tank pumped after inspection
Was system pumped as part of the inspection? ® Yes ❑ No
If yes, volume pumped: 1000
gallons
How was quantity size of tank
q ty pumped determined?
Reason for pumping: overdue maintenance
t5hrsp.doe•rev.7rMM18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 349 Bishops Terrace
Property Address
Fablo Hauch&Christiania Resende
Owner Owner's Name
information is I-I anniS
required for every Ma 02601 10/8/2020
page. Ctty/town State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system(yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed(if known)and source of information:
s stem repaired 6/28/2013. Tank original for house built 1972
Were sewage odors detected when arriving at the site? ❑ Yes Z No
5. Building Sewer(locate on site plan).-
Depth below grade: 2
feet
Material of construction:
❑cast iron ®40 PVC ❑other(explain):
Distance from private water supply well or suction line:
feet -
Comments(on condition of joints, venting, evidence of leakage, etc.):
Joints in good condition, no leakage, vented through roof.
t5fnsp.doc•rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
information is required for every Hyannis Ma 02601 10/8/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 1
feet
Material of construction:
® concrete ❑ meal ❑fiberglass ❑polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gallons
Sludge depth:
5"
Distance from top of sludge to bottom of outlet tee or baffle
3'
Scum thickness
2e
Distance from top of scum to top of outlet tee or baffle
7"
Distance from bottom of scum to bottom of outlet tee or baffle
10"
How were dimensions determined? Opened covers and took
measurements
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank was pumped after inspection and should be done again every 2 years for proper maintenance.
water level was even with outlet,tank was not leaking and was structurally sound.
t5kisp.doc•rev.70612018 Title 5 Official lrugX4 =Forth:Subsurface Sewage Disposal System•Page 10 of 18
.m
Commonwealth of Massachusetts r
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
„i
349 Bishops Terrace
r. Prope►ty Address
Fablo Hauch&Christiane Resende °-
Owner Owner's Name
tnfortnation is
*Wredlor every Hyannis Ma 02601 10/8/2020
,s
i
page: Cltyfrown State Zip Code Date of,in r.
D. System Information (coat:) ~
7.- Grease Trap(locate on site plan):
Depth below grade:
feet
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene
❑other(explain) t
a
Dimensions:
Scum thickness m
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
Date
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural'integrit11
liquid levels as related to outlet invert, evidence of leakage, etc.):
" rya
nA
i
8 Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan)-
Depth below grade:
Material of construction:
❑concrete ❑ metal ❑fiberglass E polyethylene
y ❑-other(explain).,F{
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
t5'rnsp.doc-rev.MA1Z018; TRIe 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18.
4K
'1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
Information Is Hyannis Ma 02601 10/8/2020
required for every y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank(cont.)
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order. ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
9. Distribution Box(if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert
0"
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any
evidence of leakage into or out of box, etc.):
Distribution box was video inspected and found level and in good condition with no rot.Water level
was even with outlet invert with no signs of past backup.
t5 nsp.dm•rev.7/260118 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 42 0118
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349"Bishops Terrace '
Property Address
Fablo Hauch&Christiane Resende ` w'
owner. owner's Name
information is
required forever Hyannis Ma 02601 10/8/2020
page. cftylrown,
State Zip Code Date of Inspection
} D. System Information (cont.) _.
10. Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in.working order. El Yes ❑ ,No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
. b
*If pumps or alarms are not in working order, system is a conditional pass.
11. Soil Absorption System(SAS)(locate on site plan, excavation not required): ,
ff SAS not located,explain why:
Type: t .
leaching pits number: H
leachingchambers 24 Quick 4
number: • ;'-
leaching galleries number
i
leaching trenches number, length:
E leaching fields number, dimensions:
overflow cesspool number
❑' innovativelalternative system
Type/name of technology:
t5rnsp:doa•rev:7/29r2018 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 13 of 18 ,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal!System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
information is required for every Y Hyannis Ma 02601 10/8/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cost.)
11. Soil Absorption System(SAS)(cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of
vegetation, etc.):
s.a.s consists of 24 Quick 4 chambers in a 24'xl 1.5'field. Leaching area was proc=bed in various
locations with no signs of dampness or previous saturation. No lush vegetation
12. Cesspools(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 ❑ No
Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,
etc.):
t5insp.doc•rev.7l WD18 Title 5 Official Ins
pection Form:Subsuface Sewage Disposal System*Page 14 of 18
Commonwealth of Massachusetts
Title S'Official inspection Form
Subsurface,Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
h
Fablo Hauch&Christiane Resende a
owner Owner's Name.'
information is Hyannis
required for,every Ma 02601 1018/2020
page, Gtty/Ttswn State Zip Code Date of Inspection
D. System Information (cunt.)
13. Privy(locate on site plan):
Materials of construction:
Dimensions
Depthbf.solids
t..:.
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation
etc:):
"
"
"
t5insp.doc•rev.7rzamib Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 16
F' x
Commonwealth of Massachusetts
Title 5 Official' Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch&Christiane Resende
Owner Owner's Name
lnkrmatlon is Hyannis requin30 for every y Ma 02601 10/812020
page; HCityfrown State Zip Code Date of Inspection
D. System Information (cont.)
14. Sketch Of Sewage Disposal System:
Provide a view 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. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
0
ai
o
A"1 2
trL 3 y`6
U2 7
A3 s$
�33 33'6
r
t5insp.doc•rev.7/26=8 Title 5 Official Inspection Forth:Subsudace Sewage Disposal System•Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form _
Subsurface Sewage Disposal System Farm-Not for Voluntary Assessments .
•yF 4 F E�5P..
349 Bishops Terrace v
' Property Address
Fablo,Hauch&Christiane Resende
Owner Owner's Name
information is
Hyannis Ma 02601 10/8/2020
required for every y _
page• ` ° State Zip Code Date of Inspection ,
System information (cunt.)
15 Site Exam
❑ Check Slope
❑ Surface water ''
,
;t
❑' Check cellar
Shallow wells n
Estimated depth to high ground water: 12'+
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: pate. °
❑ 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:
Groundwater was established by accessing town of Barnstable groundwater contour maps.
Before filing this Inspection Report, please see Report Completeness.Checklist on next page:,
, .
t5msp.616•'rev.7/26=18, l"iNe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17:of'1e
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Fablo Hauch &Christiane Resende
Owner Owner's Name
information Is Hyannis required for every Ma 02601 10/8/2020
pap. CdyRown State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
® A. Inspector Information: Complete all fields in this section.
® B. Certification: Signed & Dated and 1, 2, 3, or checked
® C. Inspection Summary:
1, 2, 3, or 5 completed as appropriate
4 (Failure Criteria)and 6 (Checklist)completed
® D. System Information:
For 8:Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
t5insp.doc!rev.7IAW18 Title 5 official Ins
pection Form:Subsurface Sewage Disposal System•page 18 of IS
Commonwealth of Massachusetts
a50- a��
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 349 Bishops Terrace
dProperty Address
Cassidy, Jennifer ~
Owner Owner's Name
information is
required for every Hyannis Ma 8/23116 $r
page. Citylrown State Zip Code Date of Inspection IV
W
Inspection results must be submitted on this form. Inspection forms may not be altered in any CT1
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. General Information
on the computer, SI 11 6-33
use only the tab 1. Inspector: 1
key to move your
cursor-do not Chad Hathaway
use the return 'Name of Inspector
key.
H.P.S.
r� Company Name ICI
P.O.Box151
Company Address
Forestdale Ma 02644
Citylrown State Zip Code
774-274-2581 12866
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
8/23/16
I ector's=inspector
Date
The systshall su a co of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 aynit
of mpleting this inspection. If the system is a shared system or
has a design flow of 10,000 or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
;M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
i
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
tank in good condition tees in place no visable leaks or cracks. tank was pumped during inspection
process Dbox and leaching is in new condition and is 3 years old
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ 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 ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ 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 ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a 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
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every Y
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
' 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
a 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 fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ z Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ❑ The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA) or a mapped Zone II of a.public water supply well
If you have'answered "yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of.the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
°M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ❑ No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: emty 3 months
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owners Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: owner
Was system pumped as part of the inspection? ® Yes ❑ No
If yes, volume pumped: 1000 gal
gallons
How was quantity pumped determined?
tank size
Reason for pumping: maintenance
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
unknown tank dbox and leaching 2013
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 1'8"feet
Material of construction:
® cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line. 25+
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 1'6"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gal
Sludge depth:
5"
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 34
Scum thickness
3"
Distance from top of scum to top of outlet tee or baffle
4"
Distance from bottom of scum to bottom of outlet tee or baffle
191,
How were dimensions determined? tape and sludge judge
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
pump every 2-3 years as maint. to protect leaching
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
"Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every _Y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
good condition no cracks or leaks.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
inspected through 4" port system was dry at time of inspection.
I
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 24 quick 4 panals11.5'x 24'
❑ 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.):
Cesspools (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 ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
i
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every Y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(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.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
W
9Dr.
C) ►n
2
30
3� '
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
® Accessed USGS database-explain:
town_gis maps
You must describe how you established the high ground water elevation:
yard is at el. 70' no G/W on test logs
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
;M 349 Bishops Terrace
Property Address
Cassidy, Jennifer
Owner Owner's Name
information is Hyannis Ma 8/23/16
required for every y
page. Citylrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
No. '22- (3— 037 Fee bo THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftplitation for bisposar 6pstem Construction Vrrmit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3Y? fjrAvPS 1-d.0-M/ COwner's Name,Address,and Tel.No.
Assessor's Map/Parcel SO / J&46
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
--7q --Ad&9 s sukzv
Type of Bu'ding: 2
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33® gpd Design flow provided 336 gpd
Plan Date Number of sheets Revision Date
Title ^�
Size of Septic Tank J[,{ ,� Type of S.A.S. glel GLIIC(L 14 N
Description of Soil T_
Nature of Repairs or Alterations(Answer when applicable) 4,
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 Co and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Hea /
Signed Date Application Approved by11-2.511-.?-
Application Disapproved by Date
for the following reasons
Permit No. 2�(� 2�� Date Issued 1 4-60013
r
e
Fee No.
THE COMMONWEALTH`OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es
4plication for Disposal *pstem Construction 3permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
�f
Location Address or Lot No. y Owner's Name,Address,and Tel.No.
3yq B�fti°p� rt�z� _
Assessor's Map/Parcel O
Installer's Name,Address,and Tel No. Designer's Name,Addre s,and Tel.No.
S
Type o•Bu'ding:
i
Dwelling No.of Bedrooms :3 Lot Size sq.ft. Garbage Grinder( )
m
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) :33O gpd Design flow provided :33 6 gpd
\Plan Date Number of sheets Revision Date
., Title
Size of Septic Tank� � Type of S.A.S. 2 4 }Ul (e C L4 S-fly"�
Descripti no of-Soil ;
Nature of Repairs or Alterations(Answer when applicable)
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 Co/�and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Healy /
i
Signed Date
Application Approved by Date b m
Application Disapproved by Date
for the following reasons ^'
Permit No. _��jiT�2 Date Issued Z-.13
------------------------------------ ----------------------------------------------------------------------------------------------
TH E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(( Upgraded( )
Abandoned( )by 6�(�eu rL.r..t_
at has been constructed in accordance
with the provisions of Title land the for Disposal System Construction Permit No. dated
Installer Designer
#bedrooms ) Approved design flowgpd
The issuance of this pe i shall not be construed as a guarantee that the system ill f1 ction as designed. 0
Date Inspector • Coon A i
-------------- - - -----------------------------------------------------
No.
�Q�(?}-7 3 7 Fee C(7
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal &pstem -oustruction permit
Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( )
System located at :j yq Z cL S t::c fie,,
T
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date 4 /2 n 6 Approved by
ViE Town of Barnstable P#
'. Department of Regulatory Services
Public Health Division mate
MASS.
�p i6J9 200 Main Street,Hyannis MA 0260
Date Scheduled _ Time Fee Pd. 10 0.0
Soil uitab'lity Assessment for Sewage Disposal
Performed By: � Witnessed By: � f
LOCATION& GENERAL INFORMATION
Location Address Q
�?J�' '✓C�J�J QS �is f�:I�G� Owner's NameA+I2
`jstin, 0, .v z&a i 34g2ts4oV'STe 2aAC�4
r Address
c 5 5J(2-Je--(T ��( sh�v
Assessor's Map/Parcel: j� Q Z Sp F4,(L —1 Engineer's Name o'b� C29SM�JpcJlc� Jw} T``5�"'����
NEW CONSTRUCTION REPAIR _ Telepho e
n
Land Use %es Slopes( ) ( &1119 Surface Stones b�Z _
Distances from: Open Water Body OJ ft Possible Wet Area A ft Drinking Water Well
Drainage Way G� ft Pr
g Y- Property Line Other ` tF
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests locate wetlands in proximity to holes)
LF
Fv � s (fps �G
-0f 5A9 1 i
o _
W "
Parent material(geologic) Depth t4 Bedrock
Depth to Groundwater. Standing Water m Hole: Weeping from Pit Face O,
U
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE n� C"
r--
Method Used: a M
Depth Observed standing in obs.hole:
.0
P g in. Depth to soil mottles:
Depth to weeping from side of obs.hole: �ln, t3rvundwater Ad ustment ft. -
Index Well# Rza'ding Date: Index Well levct_� � dJ,flactar Adj.Grour, water;level r
PERCOLATION TEST Dal Thne
erva Hole
�
Hole#, V Time at 9"
Z//
Depth of Percy Time at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak
G• r
Rate Min./Inch
Site Suitability Assessment: Site Passed_ Site Failed: Additional Testing Needed(Y/N)
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 Conseirvation Division at least one(1) week prior to beginning.
Q:4SEPTICIPERCFORM.DOC ` "
DEEP.OESERVATION HOLE LOG Dole#
Depth from Soil Horizon Soil Texture .Soil Color Soil. Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,Boulders.
onsistency.%oravel)
DEEP OBSERVATION HOLE LOG Dole l- k '�9,3
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,% rav
55-e
DEEP OIBSERVATION BOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%O e
DEEP OBSERVATION DOLE LOG hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Consistency.
t
L.
.; Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes
Within 500 year boundary No= Yes _
Within 100 year flood boundary No. Yes
Death of Naturally Occurring Pervious.Material
Does at least four feet of naturally occurring pervious m tenal exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on i (date)I have passed the soil evaluator examination approved by the
Department of-E nmental Protection and that the above analysis was performed by me consistent with .
the reqM7xper1 >��
e ' e xperience described in 10 CMR 15.017.
Signat Datel9
Q:WEPTiCVERCFORM.DOC
Town of Barnstable
�tK Regulatory Services
ti
Thomas F. Geiler,Director
BAMSTABLE, - Public Health Division
1 63 - A`�� Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: 13 Sewage Permit#6�o 3 3 2 Assessor's Map/Parcel
Installer & Designer Certification Form
Designer: C— S 609-✓k:5- � Tom- Installer: --2,j l �cS k.9✓
Address: ( -7 2.9 Address:
►JrJ t,,) C 1 1 , MbG�-
On 7� -2, F--�ke i,- was issued a permit to install a
(date) (i staller)
septic system at 3&q [3 c S 4otac T-tv V2!,cc based on a design drawn by
(addr s)
dated
(designer)
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. Stripout (if required) was inspected and the soils
were found satisfactory.
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-buill,,4
y designer to follow. Stripout (if required) was inspected and the soils
w and s actory.
H of M4ss9c
DAVID yGN
_. D.
/(thstaillerIg Wign—ature) FLAHERTY, JR. N
No. 1211
Z-4
9�Gisie O
(Designer's Signature) (Affix Des 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.
THANK YOU.
q:\office forms\designercertitication form.doc
No.... _"Z' .... Fix.. :. .......
THE COMMONWEALTH OF MASSACHUSETTS
ROAD® O HEALTH
L._...--.....OF............ ... �l� ---------- --_----_--_------_--
g� O"n Appliration for Disposal Worko Tonfitrurti n rprmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
SyrkeWa7 `
2 �
•---.- ..... �-------------------------•------
� � Locatl6n-Address wr Lot No.
12
7::7 ddress
W
Installer Address
UType of Building _ Size Lot../S� __S__G:_/__Sq. feet
Dwelling—No. of Bedrooms..._--__..--- _________________Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building No. of persons............................ Showers
YP g ------•--------•-----------• P ( ) — Cafeteria ( )
Otherfixtures ........ ---•---•---------------•-•--•-----•-•----------------------------••-------•--------•------•------------------- ....
W Design Flow__________________________ ____., gallons per person per day. Total daily flow____.._.........__.__gallons.
WSeptic Tank—Liquid capacity- -_jJ-gallons Length................ Width---------------- Diameter................ Depth----------------
x Disposal Trench—No. .................... Width....... Total Length.___________ Total leaching area....................sq.'ft.
Seepage Pit No..../_______________ Diameter-_--.--... ..epth below ---------
g q.�_._____ Total leaching area___3�.�s 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___-__-____-__________-
w Test Pit No. 2...............:minutes per i ch Depth of Test Pit.................. Depth to ground water____-___-____-_-_..._.-.
0 --
Descriptionof Soil � 2 ` •• ••-----'•-'•---•.••--•-------------••------•---••---------------------------------------------------
x
W
V Nature of Repairs or Alterations—Answer when applicable.___________________________________•-_________-_------______________________-__-._--__-__-__--.
------•----------------•---------------------------------•-•------•---------•-----------------------•--•--------------_------------------------------------•----------------------•----•---------------
Agreement:
The undersigned agrees to install the afore scribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanit de— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha bee issued by the bo ea .
_. ------•---•-•--.•----.. --------•-__ -�/ �
tgne = " ri R'G
Vate
Application Approved BY----• -- --
Application Disapproved for the following reasons-------------------•----•---•-----•-•-•------•-------------•-----------•---•-----------..._......•-----------...
--••--•------•----
Date
PermitNo......................................................... Issued........................................................
Date
No....i",................. Fmc../..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Pyl
............OF............ .... ..................................................
Appliration for Uiiipaoal Worko Tonotrurtion Vamit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
Systenvat:
7 2
----------.................. ......
:,!,V`.........._--------------- ....................................................................
),Locat�gn•Address
) , or Lot No.
-------------------------------------------o
A
......... A-t
'0 1,n ddres,
...... 4Z 1=� ........... ................... ..................................................................................................
Installer Address
< Type of Building Size Lot.J 4'1��' /--Sq. feet
U 7'
DwellingZNo. of Bedrooms..._..__._..';)... ......................Expansion Attic Garbage Grinder
Other—Type of Building ---------------------------- No. of persons.._.__........_...._.__._.__ Showers Cafeteria
P4 Other fixtures ------------------------------------------------------Desi n Flow............................�; _4!..,gallons per person per day. Total daily flow................L ..........gallons.
1:4 Septic Tank—Liquid capaclty//h� Ilons Length................ Width__....--_-.-.-__ Diameter-.---.-----_____ Depth----------------
Disposal Trench—No..................... Width........ Total Length__........____..__.. Total leaching area--------------------sq. f t.
Seepage Pit No.._/............... Diameter//-M...I-)" Depth below inlet.......sa_........ Total leaching area_-- -.sq. ft.
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------------------------
Test Pit No. 2................minutes per inch De th of Test Pit- 7---------------- Depth to ground water---._.-______________---
.................. Xit�_71
0 .... ----------------------------------------------------------------------------------
Descriptionof Soil-.--------- - ----------------------------------------------------------------------------------------
U --------------------------------------------- ..........................................................................*-------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------........I---------------------------------------------
----------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------------- ---------- --------------_-
-------------------------................................................................................... --------------------------------------------------------of-Agreement:
The undersigned agrees to install the afore scribed Individual Sewage Disposal System in accordance with
.the provisions of Article XI of the State Sanitary de--The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee issued by the board-o�" ea .
/�igneld------ ...................... ................ ................
Application.Approved By---,r... ;;�V/11,e�t,t h 1 A..
ate
Application Disapproved for the following reasons.Z ....................................... --------------
.......................................................................................................................................................................................
Date
PermitNo........................................................ Issued...................... ................................
ate
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF,) HEALTH
...OF............
............
..............I................
T rtifiratr of amphaurr
T-
TOhERT1,Fy�, Thatt. e Individual Sewage Disposal System constructed H YSIS or Repaired
by.....
....... . . ................... .�:,...................................................................................................................
Installer
---------------------------------------------------------o.........................................
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No--------------------j.. dated-Ar"' '/2 `2. . .........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON'FRUED AS A,5UARANTEE THAT THE
SYSTEM WILL FUCTIO NN SATISFACTORY.
DATE.......14-0 .............................. Inspector—,e/-�4/"`--`0-"�--"./"4"�" - `--`44
7-------------
THE COMMONWEALTH OF MASSACHUSETTS
BARD F HE
OF...............
NO. .............
Permission is hereby granted---- ----------------- .............................................................
to Constr t or Repair .(,.. ),/an lndividua�,_�,Iwage Disposal System
atNo.- �.2.........& --------------------------------------
Street
as shown on the application for-Disposal Works Construction ........
y,P,erm�N ............... Dated..4V/'_1
1.......................................
DATE_./�✓.X---/_ ...................................... --- Board(f Ith
FORM 1255 HoBSs &'WARREN. INC.. PUBLISHERS
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349
Bishods Terrace
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Bedroom 2,
II IPI II 11
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911 X118
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Bedroom 3
1 I'll" X 1 1 �
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349 Mishl o - ' Terrace
LOCUS DATA
to PLASTIC PIPE BENCHMARK
FOUND ON CORNER CORNER OF CONCRETE
CURRENT OWNER SETH CASSIDY
\ ' BULKHEAD ELEV.=70.4
JEN CASSIDY 1
PLAN REFERENCE LCP 25306-6-2 ' t
DEED REFERENCE CTF. 166815 69.6 GA\ f. LOT 70
�� os zo„ 152.42
ZONING DISTRICT RC-1 GAc GAS 70 LOT 71
OVERLAY DISTRICT GP Q / / AS
i
PARTIAL ZONE II BITUMINOUS
DRIVEWAY c
FLOOD ZONE "C" 250001 GARAGE
ASSESSORS MAP 250 69.3 x
PARCEL 077Lo
LOT AREA 18,562t S.F. v J W ._.WATT SERVI E C ; Q �v�
L - , Qo ` 69.8
SITE & SEWAGE ^ \
REPAIR PLAN Z \ #349 27.6` Z
349 � l I EXISTING
)4'
3 BEDROOM
ISHOPS TERRA CE 69.4 LOT 72 RANCH O
B
{' v
D.T.H. #2N 18,562t S.F. W
HYANNIS, BARNSTABLE _ 36.6, 69.5 x
to
DATE: 6-14-2013 I w►RE '''3
OVERFIEAD N
} in D.T.H. #1
APPLICANT: UTILITY o z
A S S I D Y POLE �I 70:4 x
S ETH C �-
349 BISHOPS TERRACE SHED LOT 73
HYANNIS, MA 02601 L70
69.3 x 69.1_ _/ 69.4 x JOB #13-0121
o
U �
SHEET 1 OF 2 W N 77'06'20'� W FfNcf
N .
LOT 74 144. N
PREPARED BY: `� ' s� Locus }
EAS SURVEY, INC. x 69.5 = N
1 R T. 6 A 2 2� ��of�ss9cti m
14 o EDWARD n
P. O. B 0/� 1729 CONCRETE BOUND 0 20 30 40 �g STONE-10 Nm o
FOUND AND HELD LOT
T
SANDWICH MA 0256389 R°UTE za
� GRAPHIC SCALE: �Fs i3 s � ``
) 888-3619 1 INCH -— 20 FEET LAND �Uf ��PH.. 508 LOCUS MAP
CELL )508) 527-3600 NOT TO SCALE:
SYSTEM DESIGN
RAISE COVERS TO WITHIN 6" OF FINISH GRADE
OBSERVATION DESIGN FLOW
SILL ELEV. 71.00 FINISH GRADE PORT TO GRADE 3 BEDROOMS AT 110 GPB/D IM GPD
ELEV. 70.2 ELEV. 69.9 FINISH !GRADE
ELEV. 69.7 ELEV. 69.6 REQUIRED SEPTIC TANK
GROUND ELEVATION 69.4
/� �� / -,
�2.5'®S=0.025 GAL.
�� �� /lam
2.6' OF COVER �O __330 x 2__ _ _ ___660_
5.0'®S4" PVC =0.02 2.4' OF COVER
21'®S=0.02 6.5'@S=0.015 tTOP ELEV 67.00 SEPTIC TANK REQUIRED = 1L500__GAL.
SCH 40 2 MI-' 3'rMgX 4" PVC SCH 40 10' ®S=0.01 EXISTING S.T. TO REMAIN = _1 00_0__GAL.
INV.=
EXISTING 67.53 10"TEE 14"TEE INV.= R iv SIZE OF LEACHING FACILITY REQUIRED
TO REMAIN 67.3671NV.=66.94
00 DESIGN PERC RATE -�__-MIN./INCH
GAS BAFFLE DB3 SET "QUIK-4" STANDARD PLUS LEVEL LONG TERM APPL. RATE 0.74_GPD/S.F.
t? 4'-1" LIQUID LEVEL X
INV.=66.67 o pi SIZE OF LEACHING SYSTEM PROVIDED:
X. "T" REQ. INV.= 66.77 y; i
.f: 24.0' - N o 66.00 330 _ 0.74 SF/GPD = -446 S.F. MIN. REQ.
° 0. % 0. USE (24) QUIK 4 STANDARD PLUS
EXISTING 1,000 GAL TANK TO REMAIN CHAMBERS TOTALING 96 LINEAR FEET 57.3 USING STONELESS UNITS
DATUM: i NO GROUNDWATER TPIT#1 INFILTRATOR
OR - 24 QUIK "4" STANDARD PLUS
48"x34 x12" STONELESS BED FORMATION 4.73 SF / LF X (4' x 24) = 453.74 S.F
VERTICAL DATUM: BARN. GIS - MSL± CONSTRUCTION NOTES: ( FOUR ROW OF SIX PANELS )
BENCH MARK USED: CORNER OF CONCRETE OBSERVATION PORT(S) 453.74 x 0.74 G/SF = 336 GPD
BULKHEAD ELEVATION 71.00 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND / SCREW CAP TO GRADE
ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING ' 336 GPD PROV > 330 GPD REQ. = 6 GPD RES.
WORK ON THE SITE. SAND FILL
SITE 8c SEWAGE 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE NO (GARBAGE DISPOSAL / GRINDER ALLOWED)
WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT
IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
REPAIR PLAN 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING o
MATERIALS OVER THE SEPTIC TANK IS PROHIBITED.
349 GENERAL NOTES: �2.83' - - ---2.83'--�--2.83=--I P 14031
BISHOPS TERRA CE 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. D.T.H. #1 91 D.T.H. #2 1b
TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 11.5' DATE: 6-13-13 DATE: 6-13-13
N FOR SUBSURFACE DISPOSAL OF SEWERAGE. j END VIEW GROUND ELEV. 69.3 GROUND ELEV. 69.3
H YA N N I S, B A R N S TA B L E 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE l NO GROUNDWATER NO GROUNDWATER
ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING I CERTIFY THAT I AM CURRENTLY APPROVED BY THE
ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT
DATE: 6-14-2013 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL A
CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE EVALUATION ARE ACCURATE AV IN ACCORDANCE WITH 310 LOAMY SAND
APPLICANT: - UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEY ,CMR 15 OUG 1 7 10YR 4/3 6" FILL 10
MUST WITHSTAND H-20 LOADING. B B „
S E TH C A S S I D Y 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION _- _ ----
OF ALL UTILITIES PRIOR TO ANY EXCAVATION. EDWOD A. STONE, CERTIFIED SOIL EVALUATOR LOAMY SAND LOAMY SAND
349 BISHOPS TERRACE 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 1 1 7.5 YR jL6j
26„ 7.5 YR 5 6
OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. GROUNDWATER ADJUSTMENT ELEV =67.1 ELEV =67.5 22'
H YA N N I S, MA 02601 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER
FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. J NO OBSERVED GROUNDWATER
7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF DEPTH TO BOTTOM OF HOLE 12.0' C 52" C
SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE COARSE SAND COARSE SAND
THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND VARIANCES REQUESTED 2.5Y 7/6 2.5Y 7/6
LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. ! NONE
SHEET 2 OF 2 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN
2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT N��Mq
. S
ELEVATION OF THE OUTLET PIPE. �! 2� ctiG
i 1D �r NO G. WATER
PREPARED BY: 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES .� r,, 144 NO G. WATER 144"
E A S SURVEY, INC.
10 BAFFLETHE OUTu 4LENCHESITA INRDIAMETER RAND CO STLL BE IRUCTED PPED ITH OF 4"GPVC H AS ELEV =57.3 ELEV =57.3
11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND I 21� INDICATES DEEP B.O.H.
141 R T. 6 A SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE F �� DTH #1 TEST HOLE DON DESMARAIS
FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL t sqISTS SOIL EVALUATOR
P. O. B O X 1729 BE LEVEL INDICATES ED. STONE
M A O 2 5 6 3 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION � 1� P-1 52" PERC TEST BACKHOE OPERATOR.
SANDWICH
TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW / JIM WALKER
AND APPROVAL. NO MOTTLING SOIL TYPE: L
PH. (508) 888-3619 13. MAGNETIC TAPE OVER ALL COMPONENTS. NO WEEPING PERC RATE: : 2 MIN. PER INCH
LOADING RATE: 0_74 GAL/SF/MIN
CELL (508) 527-3600 ..► 144" INDICATES ADJ. GROUNDWATER
I