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HomeMy WebLinkAbout0059 BLUEBERRY HILL ROAD - Health 59 Blueberry Hill Rbad Hyannis A= 249 - 077 1 M r 0 0 *`,,;TOWN OF BARNnnS"���TABLE.._ II�� LOCATION I S�1 63�v e;U�s «�\` "V SEWAGE# oCo I y VILLAGE �r�n��S`, ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. S�JJTre Gn�L SEPTIC TANK CAPACITY ~1 j61f touo ,2 U O ao-x LEACHING FACILITY: (type) (gclL C�,�, ) NO.OF BEDROOMS �� ,-owe n OWNER PERMIT DATE: / ;lf / COMPLIANCE DATE: 3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility eet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) eet < :- .Edge of Wetland and Leaching Facility(If any wetlands exist within ;' -300 feet of leaching facility) Feet • �wr= w. ;:FURNISHED BY �� 1 G 0 Town Of Barnstable Regulatory � � ry Services ® a Richard V.Scali,Interim Director NAM Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Sewage Permit# 1 b ` 04� Assessor's Map\Parce6•+,;2�7 Designer: SMR 1kE1-a Al. kA",pC Installer: SC45 - lA. F4t14%1- °- Address: I> c.>. 't,60k ! Address: its O" YAWb . C7 Z fob® On ZU I�o� ►A. K was issued a permit to install a (date) (installer) septic system at � �`0<, ram( �A CZJ based on a design drawn by (address) S-T&=P dated� f�a, I I iP (designer) _ZI 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. Strip out (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. flan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed ins:;�ti Dance with the terms of the IAA approval to pplicable) g+p a 1 (Installer's Signature) r (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY IRE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU. --- QASepticlDesigner Certification Form Rev 8-14-13.doc No. /(O —0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21ppliLation for Mispo8al 6pstem Construction Permit Application for a Permit to Construct( ) Repair(/.Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. � �Ouc,/ `��\\ . Owner's Name,Address,and Tel.No. Assessor's Map/Parceoo .-7 / Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. M O Ube Type of Building:Dwelling No.of Bedrooms L� Lot Size I I sq.ft. Garbage Grinder(Alp Other Type of Building No.of Persons Showers( ) Cafeteria.( ) Other Fixtures Design Flow(min.required) SSb gpd Design flow provided ka v® gpd Plan Date � I �a l�� Number of sheets Revision Date Title Size of Septic Tank \01Q�tj ( ` Type of S.A.S. I{ SW &63,_ tea"O, Description of Soil C S &;n� C.J 0.3 rJ 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 Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si a Date pC lgu t! Application Approved by Date Application Disapproved by Date for the following reasons Permit No. )Lp Date Issued i3k t( No. Fee O 7 `f' Fee v O THE COMMONWEALTH OF MASSACHUSETTS Entered in computer::}—J,---1 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS '' Yes 21pplitation for Disposal 6pstem Construction j3ermit Application for a Permit to Construct( ) Repair(V Upgrade('�r) Abandon( ) ❑Complete System Individual Components Location Address or Lot No.,sr, �es� %\`RT Owner's Name,Address,and Tel.No. Assessors Map/Parcelc`,49 7 Ny 1 S T Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 5C.c3��ct�� `\ Okd Y,—rn -Q-\, 4� �u{ ��S �� 3�a. $13 a �bIc -' oU Type of Building: /r` Dwelling No.of Bedrooms �� Lot Size �`'I ti sq.ft. Garbage Grinder A)v Other Type of Building No.of Persons Showers( ) Cafeteria.( ) Other Fixtures Design Flow(min.required) S Sb gpd Design flow provided to,(3 gpd Plan Date .Z oZ \�y Number of sheets Revision Date Title Size of Septic Tank CX�S \Cep(`3 (��� Type of S.A.S. S`60 G.� VjZC,C�. cN=, Description of Soil (_� Y� c,r C ,3 RU Nature of Repairs or Alterations(Answer when applicable) , L rrGU/\ 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. ryry r� Si \e Date a lg Application Approved by \ Date �p Application Disapproved by Date for the following reasons Permit No. DO)LD ^(I c�(p Date Issued �{ --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS tertifitate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V) Upgraded( ) Abandoned( )by SC o H (1^ V aAj_ C at h-4 IZ,I has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.-'�C' dated Installer S CO�\ 1�rL-1111 ( Designer #bedrooms Approved design flow A gpd The issuance of t is pe it shall not be construed as a guarantee that the system will functionj�designed. Date 1 1 Inspector lI��JJ�� \j --------------------------------------------------------------------------------------------------------------------------------------- No. ;)o/b ---0 ,9G Fee too THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS disposal *pstem ConstrUttion permit Permission is hereby granted to Construct( ) Repair(1/I '1Upgrade( ) Abandon( ) System located at n 2\Q2\o,C rY yl^W' C�1G�-�^iS i 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 co hpleted **th/in three years of the date of this per,,it. Date 7 // b Approved by Town of Barnstable P# Departitnent of Regulatory Services z Public Health Division Date MAss. � ..:r.l 200 Main Street,Hyannis MA 02601 �®y 4 "I Date Scheduled � � �-d� . Time -�i-1-�•— Fee Pd._ {ease Soil Suitability Assessment for Sew ge D's osal r Performed$y: n -S �� Witnessed By: v i v- 111, P LOCATION&.GENERAL INFORMATION Location Address Owner's Name Address t \J�J�I�� LA Assessor's Map/Parcel: `� "� Engineer's Name jr S NEW CONSTRUCTION REPAIR Telephone# Land Use- X_4s, Slopes 96 L'�- p ( ) Surface Stones Distances from: Open Water Body a Possible Wet Area ft Drinking Water Well ! ft Drainage Way i ft Property Line to� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands fn proximity to holes) � V- VJ h ' Parent material(geologic) O- � �/t� Depth to Bedrock Z� J— Depth to Groundwater. Standing Water in Hole: Weeping*am Pit Face A A- Estimated Seasonal High Groundwater 4 DET RM[NATION FOR SEASONALMIGH WATER TABLE Method Used: _µ! A- Depth Observed standing in obs.hole: In. Depth to still mottled: Depth to weeping from side of obs.hole: ir., Groundwater Adjustment tt. Index Well-# Rcading Date: Index Well level „ Adj,_thctbr„7— Adj.Groundwater Level , PERCOLATION TEST bale F /� JUL Observation Hole# L Time at 9" qZ ,t , Depth of Pero Time at 6" Start Pre-soak Time @ 0 t er— 'Time(9"-6") End Pro-soak Rate Min./Inch . LZ. 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 Conseirvation Division at least one(1)week prior to beginning. Q:ISEPTICU'ERCFORM.DOC ;S(l DEEP-OBSERVATION HOLE LOG Hole# — Depth from Soil Horizon Soil Texture .Sd11 Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. o rsistency 96'aritvell e" z DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil, Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ansistency, ZZ it Y 5 L� /oI�-lb DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. Consistency,gh Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders. 0 Flood Insurance Rate MU : Above 500 year flood boundary No— Yes - Within 500 year boundary No Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material 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 o' (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training peruse and experience described in 10 CMR 15.017. Signature Date Z Zoi/a Q:6SBPTICVBRCFORM.DOC ~ 'J 1 YYY}}y Y s T to L-O z I>AT-E= JUG 30 /93, 0 is r c1 ENL: BE. r; C.> t-v . 0/V A PLAN' RECORDED ; F_ B.ARNSTAr3LE CO U/V -r- - 7F_ ( /STRY OF 2)EE.D5 PLf}N BOOK 6>` CERriFy' THAT T F REG. L"A /.'�> S ( ' 4Vi= Y NE OUIVDA7 ON C% WN ON 7- /-l /5 PL -,,N / S LOCATED O/V 6ROU D AS SHOWN HEREON AND f'� i 7 DOSS C' QN� O M 7-0 T/H E ,• 1' 4F ';... i C tit E/V 7' S O c r � s ! •(a5e � � © 70 C J '4t4 � C§ ri �i `— 154 U9 a . 55 1/2 VC03018 j Y WF3 � ]„(� �V� �/ 33 W2130 W2130 W3630`• /r U WEC1230Lm � � - _ B21 B21 EZR36SSR y' ------------ BF3 276 95 - SB3 - 33 60 e i 59 1/2 -6:; i--33 102 33 ipe Home Centers lient:HAMILTON,PAT atalog:Kraftmaid Trad, View:Plan 34 Phone: tyle:DaltonScale:Scale-to-fit inis_MA 02660 _ Design:HAMILTON,PAT(BLUEBERRY LANE).ROM ull: Date:5R7l99 - —— -- insp� aA-A TOWN OFBARNSTABLE ^ATION 6lU aG SEWAGE # �rii,LAGF ��ON 0 I ASSESSOR'S MAP & LOT 07 MEM 'S &PHE NO. i ',4L SEPTIC TANK CAPACITY /0Q0 ,'// LEACHING FACILITY: (type) Ae—c- (S (siz4�i t o r � Pi NO.OF BEDROOMS S IONEMR OR OWNER an�- .y a PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility ('.f 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 'I �-=-- .. .� ��'- � `�' `� _ ..� °� ,� � � � _ TOWN OF BARNSTABLE LOCA'ITON /3`U Ye- �/66. A. SEWAGE # V6I.LAGE )-k,,A/.u; c ASSESSOR'S MAP'& LOT - INSTALLER'S NAME&PHONE NO. • ��aCi'�nS�b r r SEPTIC TANK CAPACITY Z�v O LEACHING FACILITY: (ty r` d c-c- (size) NO. OF BEDROOMS BUILDER OR PERMITDATE: COMPLIANCE DATE: f J 6 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 s r. d— � f No. / 1 i� V V U �C 1 (J°1�J d.� Fee 50� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: p R 4 0 —7 Yes '� IC HEALTH DIVISION - TOWN.OF BARNSTABLE., MASSACHUSETTS 01ppYication for dig oga *pgtem Cone4ruction Permit Application for a Permit to Construct( )Repair( pgrade( )Abandon( ) ❑Complete System 1?5Irtdividual Components Location Address or Lot No. r Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: e n IV6 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Z Revision Date Title Size of Septic Tank 4_7 zc-, Type of S.A.S. nC� Description of Soil Te 9•J-Sv� (fO`��L S►= Si�-uW ) Nature of Repairs or Alterations(Answer when applicable) uU _ Lv PCs S 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 Certifi- cate of Compliance has been is e Signe V Date " 0` `Q Application Approved by Date Z a Application Disapproved for the following reasons Permit No. 1 Date Issued q 11-2- 9 Fee ^] THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: G1 _ r ; Yes _I P.-�B IC HEALTH DIVISION -TOWN,-,OF BARNSTABLEs MASSACHUSETTS pplication for Di�pon *pgtem Construction Permit „i.-,j pplieation fora Permit to Construct( )Repair( pgrade( )Abandon( ) ❑Complete System �"dividual Components Location Address or Lot No. V r Owner's Name,Address and Tel.No. l .. ,.Assessor's MapTarcel a�-k�q o 5T N C t... Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type df Building: "Dwelling', No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building---- No. of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow ga&gs,penday. Calculated daily flow y gallons Plan Date cr Number-of sheets Revision Date Title Size of Septic Tank Type of S.A.S. C-7k—, 1 T 1=C_ 33 C7 Description of Soil --Ta —t Sc:. cc) f r' Nature of Repairs or Alterations(Answer when applicable) V- U-J Date last inspected: . i,. Agreement: R ��> The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions offitle 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is Signe r Date ?_9 Application Approved by. Date - !5 Application Disapproved for the following reasons ; Permit No. 1,-- , Date Issued 2 L9 r: No /� t c� THE COMMONWEALTH OF MASSACHUSETTS �.---_� �1 BARNSTABLE, MASSACHUSETTS JAA Certificate of Compliance TTHIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed Re aired Upgraded g P Y ( ); P � ) (✓) Abandoned at �• ��� has been constructed in accordance with the provisions of Title 5 and the for Di osal System Construction Permit No. dated Installer Designer „� A The issuance of this pe i shal of trued as a guarantee that t r st w' fun t desi ina gr/- �/cl� Date Inspect lA - No. C? — — —— —Feet �J/.v3- � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Migogaf *pgtem Construction Permit p P Cl JJ^^S l� Permission is herebylgranted to Construct( )Repair( )Upgrade Abando ( ) System,locaied at 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:`Cohs ction must be completed within three years of the date of this perm= Date: /2- Approved by r > COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION iA t O•• In 5yey TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 59 Blueberry Hill Road Hyannis MA 02601 , Owner's Name: GRP Loan,LLC Owner's Address: Same ! �` Date of Inspection: July 18,2006 Job#06-182 Name of Inspector: PATRICK M.O'CONNELL _ Company Name: SEPTIC INSPECTION SERVICES CO. W Mailing Address: 189 CAMMETT ROAD 77 MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 777 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a ,EP oo�pp Blll I/ approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: � OF _X_ Passes ••�yG Conditionally Passes $ P TI'HIC Needs Further Evaluation by the Local Ap roving Authority = M. •; Fails ��. Inspector's Signature: tN) Date: 7/18/06 '�i �F5 DNS E�oQ•```` IIIIQ ``�` The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health I►� or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments: Leaching system has no standing water or evidence of surcharge.Recommend pumping tank every two years. ****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. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _XX_ 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: 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. Answer yes,no or not determined(Y,N,ND) in the 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. ND explain: 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 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 obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 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(l)(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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool —X— Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool —X— Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than_day flow —X— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. —X— Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ _X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _X_ Pumping information was provided by the owner,occupant,or Board of Health _X_ Were any of the system components pumped out in the previous two weeks? _X_ Has the system received normal flows in the previous two week period ? _X_ Have large volumes of water been introduced to the system recently or as part of this inspection? _X_ _ Were as built plans of the system obtained and examined?(if they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up _X_ _ Was the site inspected for signs of break out? _X_ _ Were all system components,excluding the SAS, located on site _X_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems'? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no _X_ _ Existing information.For example,a plan at the Board of Health. _X _ 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)] Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 Number of current residents:0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):No Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 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: None Source of information: Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_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) Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Compliance date for SAS expansion: 8/12/99 Were sewage odors detected when arriving at the site(yes or no): No Page 7 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 BUILDING SEWER: XX (locate on site plan) Depth below grade: l' Materials of construction:_cast iron _X_40 PVC - other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 1' Material of construction:_X_concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions:8.5'long x 5.2'wide—1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 14" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees intact and clear,liquid level at bottom of outlet invert.Recommend pumping every two years. GREASE TRAP: No (locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 TIGHT or HOLDING TANK: No (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (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.): No solids or hieh stains,equal flow to both outlets PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 11,2006 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: One 6x6 pit. _X_leaching chambers,number:Two Cultec's _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.): No standing water in either leaching system. CESSPOOLS: No (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: No (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.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.Locate where public water supply enters the building. Blueberry Hill Road Water Service Driveway 27 15 5 41 24 • Page I 1 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Lane,Hyannis Owner: GRP Loan,LLC Date of Inspection: July 18,2006 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 20 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) _X_Accessed USGS database-explain: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water at el.30 and topo map shows property at el.50. I APR. 15.2005 �10:46AM ARNSTABLE BOARD OF HEALTH NO.073 P.1i1 ' Town of Barnstable Health Inspector Office Hours; Regulatory Services 8:30—9.30 Thomas,F.Geiler,Director 1:00—2:00 aatwsTAace. � , "� �,�' Public Health 'Division . Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-962-4644 Fax: 508.790-63b4 AMESTY PROGRAM.APPLIC' —SEPTIC QUESTIONNAIRE 1. General Information: Size-of Property Addy SS: Map Parcel w m M - Nam Phone#: � 2a, H 63y many bedrooms exist at your property now? LM 2b. you planning to add any bedrooms? �d If yes,how many? . 2c. Hipw many bedrooms total are proposed at this property(including the amnesty unit)? 2d. Please include a copy of the floor plans for the entire property-showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label . each room cldarly on the plans. 3• Is the dwelling connected to public sewer? YES or NO ,t�e�uve��ia •'is', tt�io' 'r.;�,�vei'�,sleip:�ues"I�ii'. �:? �•`I � :i...- .,, ,.; •. •. 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6�Y 5. Is the dwelling connected to, ONSITE WELL or to UBLIC WATER? 6. Is a disposal works conmuction permit on file? YES or NO 6a. IfY�yes, many bedrooms were approved according to this petmi? 13e oms. - 7. Were nay building permits obtained for construction of additional bedrooms? ea Y 04.;ti NO A Is there an engineered septic system plan on file at the Health Division? � W o YES o�'y�, 1V0 9:-Has the septic system been inspected by a.DU certified inspector within the last two ye s? _rrtL -orb; NO FOR OFFICE USE ONLY -- _ � - ;�P The Public Health Division has no objection to bedrooms at.this property, 5 'gym' Special conditions: _ V° q 1 90d, Signed: Date: ' Q;�healthfwpftles/amnesdyapP ' 1 M i—rr-0 9d0MS MAXI. 7Uw1 'J rn , A.A (I N 4� c a C' 1C t Y d � i I v Y I I i III 1 i� �.► r Ta I. I - ' I .. I f I I ' I i ; I ' ' i it yx� i I I i i i i i I � s t 1 � 4 Dillen, Elizabeth. From: Dillen, Elizabeth Sent: Tuesday, April 19, 2005 10:55 AM To: McKean, Thomas Cc: Barry, Lois Subject: 59 Blueberry Hill Road, Hyannis Hi Tom - Thanks for your quick response on these applications. I reviewed the family apartment permit decision for 59 Blueberry Hill Road,which allowed the prior owner to convert one of the bedrooms into a family room to comply with the Title 5 requirements. However, because of the room configurations, it is not feasible to widen any of the bedrooms' doors to 5 feet. The current owner is willing to remove the door and agree to a deed restriction limiting the total number of bedrooms to five. Would that be acceptable in this case? -----Original Message----- From: McKean,Thomas Sent: Friday,April 15,2005 12:01 PM To: Dillen,Elizabeth Subject: Septic Questionnaires/New Amnesty Applications 20 Lantern Lane/Applicant- Eric Hubler This application is approved. The dwelling is connected to public sewer. 59 Blueberry Hill Road/Applicant- Faythe Collins-Azevedo This application is disapproved. The dwelling is limited to 5 bedrooms per the 1999 permit#99-501. Six bedrooms would violate 310 CMR 15.214, State Environmental Code, Title 5. 96 Camp Opechee Road/Applicant-Joshua Leonard We do not have any septic system records on file for this address. Please require the applicant to hire a certified septic inspector to fill-out a 16 page septic system inspection report. 1 COMMONWEALTH OF MASSACHUSETTS'-C)ia/' x W EXECUTIVE OFFICE OF ENVIRONMEN;',4L AFPAA Ar p,�eLF DEPARTMENT OF ENVIRONMENTAL PR)C4k;qTI0N w , -� O1 VO4 �., TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 59 Blueberry Hill Road Hyannis MA 02601 ASSESSORS MAP N0: Owner's Name: Ocwen Federal Bank F.S.B.C/O Steve Higgins PARCEL N0: « �- Owner's Address: Same Date of Inspection: ,July 12,2004 Name of Inspector: PATRiCK M. O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT i certify that I have personally inspected the sewage disposal system at this address and that the information repotted 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 D 11111pt/lp��� approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). Tile system: ������,It1OFY4 _X� Passeszz Conditionally Passes _ 1C m= Needs Further Evaluation by the Local Approving Authority Fails LL Inspector's Signature: �'� - X. Date: _7/12/04_ ���`�� fill 1111,�` 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 is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments: Leaching pit and Cultec chambers empty at time of inspection. Leaching pit may have been half full at one time. ****Tbis 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 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 59 Blueberry Hill Road,Hyannis Owner: Oewen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 inspection Summary: Cheek A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _XX_ 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: 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. Answer yes, no or not determined(Y,N,ND) in the _for the following statements. If"not determined"please explain. _ "Fhe 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. ND explain: __ 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 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 obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 59 Blueberry Hill Road, Hyannis Owner: Ocwen Fed. Banlc C/O Steve Higgins Date of Inspection: July 12,2004 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 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: __ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM. INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 59 Blueberry Hill Road, Hyannis Owner: Oewen Fed.Bank C/O Steve Higgins Date of Inspection: July 12,2004 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool __X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in cesspool is less than b"below invert or available volume is less than day flow _ __X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of tirnes pumped _ X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X Any portion of cesspool or privy is within 100 feet of a surface.water supply or tributary to a surface water supply. X_ Any portion of a cesspool or privy is within a Zone I of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma ___�No__(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ 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—1WPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 7 Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 59 Blueberry Hill Road, Hyannis Owner: Oewen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 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 _ X_ Were any of the system components pumped out in the previous two weeks ? X_ Has the system received normal flows in the previous two week period? _X_ Have large volumes of water been introduced to the system recently or as part of this inspection'? _X_ Were as built plans of the system obtained and examined?(If they were not available note as N/A) __X Was the facility or dwelling inspected for signs of sewage back up ? _X_ _ Was the site inspected for signs of break out'? X_ __ Were all system components,excluding the SAS, located on site _X _ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum '? X _ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no X__ _ Existing information. For example,a plan at the Board of Health. _X_ _ 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)] Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 59 Blueberry Hill Road, Hyannis Owner: Ocwen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x#of bedrooms): 550 Number of current residents:0 Does residence have a garbage grinder(yes or no): unknown Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2002—128,000 gal./2003—112,000 gal.=329 gpd. Sump pump(yes or no): No Last date of occupancy: 6 Months+ COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 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: Last pumped on 6/10/03 Source of information: Barnstable WPC Was system pumped as part of the inspection(yes or no): No If yes, volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_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) _Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Tank and pit original to house,Cultec chambers compliance date: 8/12/99 Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 1 I OFFICIAL. INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Road,Hyannis Owner: Ocwen Fed.Bank C/O Steve Higgins Date of Inspection: July 12,2004 BUILDING SEWER: X (locate on site plan) Depth below grade: V Materials of construction: _cast iron X_40 PVC_other(explain): Distance from private water supply well or suction line: unknown Comments(on condition of joints, venting,evidence of leakage, etc.): SEPTIC TANK: X (locate on site plan) Depth below grade: I' Material of construction:—X—concrete_metal—fiberglass_polyethylene —other(explain) — If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 8.5' long x 5.2' wide— 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness: trace Distance from top of scum to top of outlet tee or baffle: - Distance from bottom of scum to bottom of outlet tee or baffle: - How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Liquid level at bottom of outlet pipe. Tees intact and clear. Recommend pumping tank every 2-3 years.. GREASE TRAP: No (locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Road, Hyannis Owner: Oewen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 TIGHT or HOLDING TANK: No (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/day Alarm present(yes or no): Alarm level: _ Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: X (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.): Liquid level equal to both outlets.No high stains or solids present PUMP CHAMBER: No locate on site plan) ( P ) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): Page 9 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Road,Hyannis Owner: Oewen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type _X leaching pits,number: One 6x6(1000 gal.)pit. T_X leaching chambers,number: Two eultec units w/stone around 11 x 12.3 — leaching galleries, number: . leashing 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.): Leaching pit empty,never more than half full. Checked interior of cultecs with camera found no standing_water. CESSPOOLS: No (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: No (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.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 59 Blueberry Hill Road,Hyannis Owner: Ocwen Fed.Bank C/O Steve Higgins Date of Inspection: July 12,2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Blueberry Hill Road t5 1000 gal tank 1000 gal pit I 1 x 12.3 cultec leaching bed I I Page 1 1 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION("continued) Property Address: 59 Blueberry Hill Road,Hyannis Owner: Oewen Fed. Bank C/O Steve Higgins Date of Inspection: July 12,2004 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 20 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) _X__Accessed USGS database-explain: USGS topo map and town GIS You must describe how you established the high ground water elevation: Town groundwater contour map shows water below el.30 and topo map shows property above el.50. TOWN OF BARNSTABLE LOCATION / C • SEWAGE # VILLAG ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 10:5PidC11ir�c�_ Sc6 r r .SEPTIC TANK CAPACITY _ /e'o c1 LEACHING FACILITY: (size) NO. OF BEDROOMS BUILDER OR � PERMTTDATE: I.�-. I COMPLIANCE DATE: t f i - 91 /3 it t t Separation Distance Between the: i 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 1 1 of Z4,G•- o-7- :. .1 AT-IeN� 6� � S r ' AGE PERMIT N0. V I I L A G E SY a IyA (� vuI !S� � s I N S T A LLER`S_NAME & ADDRESS _ 3 h tu " � 0U1LDEIT OR OWpER If7-S .( I h !U Li P)<C PC---)f('so av DATE PElIMIT ISSUED 7 �� DATE C 0 M P L I A N C E ISSUED .22_ C Ti u �. cl F�. S .3/7 ".� �- = • r Fes$. ........... � No _ .............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH o,�. Appliratiou for Biipoiial Works Toogtrurtion permit Application is hereby m(ade for a Permit to Construct (><) or Repair ( ) an Individual Sewage Disposal System at: 1 u� � ...�..11 ..................•.--..-..--......... j/ ................................................... �7 L�at�n �re s.................................... Lot I�jo.��E/�4r/ �.�l..I.�LL .r Owner ( , Address �Wl ..........2 E_.---------------•-•---....------.........._.....-•----------.. Installer ft-------- Address dType of Building Size Lot--- ....Sq. feet aDwelling—No. of Bedrooms.................._.............___..._Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- --------------- •-------------- W Design Flow.....____.6",<........................gallons per person per day. Total daily flow............3t ...................gallons. WSeptic Tank—Liquid capacity-1P.,2°.gallons Length._.._g.._____ Width__...J`�.'.... Diameter________________ Depth... x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--___-J.,.......... Diameter___-__e.i____..... Depth below inlet................... Total leaching area_7-0-0_......sq. ft. Z Other Distribution box (x) Dosing tank ( ) '-' Percolation Test Results Performed by.4U_e-G ____Lew... ?..:............ Date..:3__.....Z.4................... Test Pit No. 1.:!5_Z-----minutes per inch Depth of Test Pit.... 4 ..... Depth to ground water."_o%_--- 'N— (i, Test Pit No. 2_ _ -__minutes per inch Depth of Test Depth to ground water_�°_ .4t� .E O Description of Soil_-j1 -/ y= �� �# j h-"/ �� FjcJD - Z� G0 �Sv S¢/L . V - ` .......... '! ��j ' �°fit✓y1 � s��_a�a�4--7_..�� W ------------•--------------------------•---•-----•---------------- ---------•---------•--------•- •--------•--.....•------••------......--------•---•------.......-••------------------------ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•-----------------•--------------------------------------------------------------------------•--••--------•------------------------------------------•---------------------------------------•._...--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T p ' -` S of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. Se --••• -• --•-• --------------•-_ •••. -------•---•---- •• -_-.......... ----_----•---•-•--•--•-•--- ,n Application Approved BY----•- F -- ----- ----- --- - - --- -...r---------------------- __1_��-3_�t'---1 f M. Date Application Disapproved for the following reasons----------------------------------------------------------------------------•--•---------------------•--•--•-••- ................--------------------------------------------------------•=----•----....---••-•.....----•----••-•-•--•--••----•---•- ......----••---•••-•-•--------•------••-•---•-•-•----•-•...._.._. Permit No......................................................... Issued_.......................................................Date -�`t/ Date r � ' ra No. �' .. 1 Fss '..... .'. .. ^� V. . THE COMMONWEALTH OF MASSACHUSETTS J' r BOARD OF HEALTH ti .-.................OF......... :'�-;Z a}S.7.......r`- ............................ Appliration for Disposal Works Tonstxn.rtinn rrntit Application is hereby made for a Permit to Construct (}C) or Repair ( ) an Individual Sewage Disposal System at: ................ 'W .[�f1............................................................... ...................................... 3................................................... Location-Address or Lot No. , Z. -1i1 Owner l l 1 Address a ......................................... ...1..l-T-.... l . ............................................................. Installer Address Type of Building Size Lot...4 'r..q.t..z_...Sq. feet , Dwelling—No. of Bedrooms.................. .....................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .................................. ... ... W Design Flow............ .......................gallons per person per day. Total daily flow............. .;zJ......_...._....._gallons. WSeptic Tank—Liquid capacity&U g __.. ___allons Length__ .'..... Width _._a..... Diameter________________ Depth_¢`....... x Disposal Trench—No. .................... Width.................... Total Length......................... Total leaching area....................sq. ft. Seepage Pit No �_..--..----- Diameter......4;2_......... Depth below inlet..:14._......... Total leaching area. JLi_-_--sq. ft. Z Other Distribution box (X) Dosing tank ( , a Percolation Test Results Performed by__�- 42_ 5;A ........ ...__.// �"•--��--�''-------------- Date.. - �f b.. Test Pit No. 1................minutes per inch Depth of Test Pit....k9.4...... Depth to ground water_ fs, Test Pit No. 2_.'<'._--^'-•...minutes per inch Depth of Test Pit----�.`.�f___. Depth to ground water �_st l c c� a ----------------- 4--------------------------------------------------- .--------------------------------------------- ----------------------- --- ----- O Description of Soil. �`4-- a � -- Gaflr??.... ... ......................Sr}f r-�f ''_•-.f• � W ••--•••--•-•----------------•-----••......••--------------------------•--••--......-••----•---••-•------••••-•••------•--•--••-•-------•----•--•--••••--••••••--••-•••--------•-•-•............------... UNature of Repairs or Alterations—Answer when applicable- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f-1T�'1-'.7 the provisions of 1 - 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. x Sig;ed - ---•--j .Date Application Approved B .t --''ye/ _ { '=== # :^!•��` . *r..................... . ell, Date Application Disapproved for the following reasons:............................................. ..._ ---------------------------------------------•-----------------------------------------•-•••-----••-•------ Date PermitNo......................................................... Issued ....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .............OF.......... .^'Crk.s.... .....�#...................................... yTrrtifiratr of Toutpliattrr THIS IS TO CER T the tindividual Sewage Disposal System constructed ( ) or Repaired ( ) by.......... ------• -- •-- R1 ---------------- nstal at- - 1t.e ! +4,i { `� _ I E# 1 /.i .............................................. ' x ` f.The ate Sanitary Co e a escr' in the has been Installed In accordance wrtn the provisions of TI " > o••�� S S y application for Disposal Works Construction Permit No--- .. �._..___e.a_, ....... dated--...- "--- ............. THE .ISSUANCE OF THIS CERTIFICATE SHALL NOT B.E CONSTRUED AS A GUARANTEE THAT THE SYSTERAI+/ILL;.FUNCTIOMSATISFACTORY. DATE.... :..................... ---------------- Inspector -•----------------------•----------.-................................... THE COMMONWEALTH OF WIA$SACHUSETTS- BOARD OF HEALTH •� - ..-.OF...:........... .. ' No... FEE ......... ....... Disposal orkn V!nPtr inn Vprrmit Permission is hereby granted. ----------------•-- •.... t ........................... to Constrict L. Repair an I iv ual . ra e I osa(l/f/]S stemy%' [J�{/ at No..-• ah "i =t J<+i°1 d � .6 .---- At .T.....'; kf f` 7 r -- .............. Street as shown on the application for Disposal Works Construction Perm' o _ ated..... ............................... 4 .. u v Board of Health 7 DATE---------- 1._ ,9 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS a -4 A A NOW" X ll 0 102, 3 a SUBSOIL SugSDi /00.S Z4 ' toe lut, /00.0 0- 7- 1.4 4.51f__j. to — -- , "1 -)Of 'Al \9 L 10 0 6,J,49 71F2 6U Co1 AJ Ij )oil TESF A710LE _ AE!E %5 u L. T ---------- 14 7 ' PEA T-0 W/V RECORDS 1_07- Z),,49 7-E .- M F�e 24, / 980._, sct,9LE : P, Tow/ / WATER 1 -5 V,,Q L ,,9 3 ,L E IA/SP. A// M ;5u1LL) 1A-1G SETBACK ,2EQU/,eE/"lENTS $Qp FRONT R c- 0 P Os E Z) 23 E Z:>,e 0 A./0 -r TO E L-0 7-E D a 3 0 VE 'e SE 61/le 1-:9 S'Y5 7-E 117 U/V 1-,ES 5 DES/GA/ Z)"gy Ar J4- 00 DESIGN LO ,19D /A./G 1S USE .D - tL p SEP7-10 ,;eoPO5,ED O /V SHALL -5­/,c,7fZ- 077 r-E_q 7,'17 4-0.0 0 ;e -f -r a Mfg S S. E A.1 V/R 0 AJ/tl E- AJ 7-,,9 ,4- p (c 0 t!9rr/0 -X_ DATE Z:> 7-UZ-Y 6, /'?7 7 Iq^JZ) 7-oA//V OF leESUL77-6 Z5,,9eAJ5 7-ig,6 4L C_ EL E V TO 8,E > FT i48OVE RDA -rop OF b L E 1-flA FO U A/2)oq7-/0N 03, S I-EOQ(2", A/ 0 1,-7,Pl',EeV10US OOVE� /0 t-lP,,NJ/4O1_ coviff)e 7-0 E)<7_EA./j) TO WITHIN /' O,'=- G)e,,,qr 7-0 PREVEA1-r )-1^.1E:S /0',,O-1 1A.11M U^-f -S7-0,Aj-- .2,, 0,,_ /0 24"OovE2 DIS77 4 k1,,,9_s14Ez) 0 L 4"cRswl SOX1,9R0(1AJZ) AImac . � T 4 /A//,Al HUM'Al ZV /0 Foor /0"M/A/. 14" \�/f_1F0 07- 1441AJ. /7r 2>1A -�Ll� /000 Af/Al "IF or, X4 0 Q 4 -e WRS9 E 2) /00 G,4,4-L'O� " IAI WE A-r (�a 4> lqi_4� IAIVER�r otq P14)C/7-Y /9AFOU/,/r� 5 E p-r,/(2 -rpvv K (c� Cw ATE e 4-1 6-1'4 7-) La ,;1V4--IX2 `, cv_e�j I Al VEST Z_ E .90 H-1 /2 " z0v VEer LO%Re- 48"Mfg x- /V 0 2 0" 1­7 A-1 ^I U/%-I a )..4 > 4' 1,-71AI D15 A-7,q)(. GR0lUA_1Z) P�..0 7` iQ Al OF A. 1A OF& r- q . 0 H Y,-q"AJ CRAIG r.i� 4YMOND 2 SHORT T C /19 Z- E (�Y D,-9 7-,E-: 7-C,' 0 Q. SHORT No. 27483 E- ,l=E R ENJO E 5E IAJ(g LOT' 1310� com P/_ AN ;e Z) E 23,-R;e AJ- 4, OIST 57;q254E 004/A/7-,v 0)=' Z> _= dEz)_s NAIL, 0 Re Lj 40' 10="e(oZ)/-I 4='o UAj n 9:�C_,� U Af e c?r e� Cow c). 0 Aj 14? 1011./D E 19 a H /C> E/Q CAI/Al,,g P/7-,S. To. . BE ,c? 1-71AI- 1,A-7'U /-1 0,-- • :r _CE1e V 7 L / A-1 EE 5 -9 /5 �.V W OF AJ Z) CD' R 40/-1 0 0 A-1 M),Q 7-/0/,/ CA./ R co U A./ r.> _-5 S A4,(o i-./A./ 14 ER ff C>,&j OWNS, k 1Q,Z) 7"H,449 7- /'7- z,>0 <20A/FQ M 4 GEOR Ge E sN — — DATE _rl 7-/- �E 07WE l3U`11._'D1^jc� 'SE-r8 ,-qcg gE<pu1;er LOW,JR. 4i ,6 ,AJ7-s _41Z�7- 11V^J �yO� GIST 09 D x?7 sul*v F n q ff 7.9 4 7W 0�8 ACCESS COVERS MUST BE WITHIN 9" MINIMUM. INVERT ELEVATIONS : DES l GN CR l TER l A : GENERAL NO TES : 6" OF FINISH GRADE 3' MAXIMUM COVER INVERT OUT SEPTIC TANK: 99.5 FIRST 2' TO DESIGN FLOW: BE LEVEL MIN 2' OF PEASTONE INVERT IN DIST. BOX: 98.77 5 BEDROOMS AT 1/0 G.P.D. PER I. THIS PLAN 1S FOR THE DESIGN AND CONSTRUCTION OR F 1 L TER FABRIC INVERT OUT DIST. BOX: 98.6 BEDROOM EQUALS 550 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. 4' DIAM PIPE 3/4" - 1 I/2" DIA. INVERT IN LEACH CHAMBER: 98.5 � NO GARBAGE GRINDER 2 VERTICAL DATUM 15 ASSUMED, FOR BENCH MARKS S 99.5 98.6 $� T2 �o DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 96.5 . SET. SEE $I TE PLAN. BAFFFLE A 98.77 � � 98.5 2, 96.5 ADJUSTED GROUND WATER: N/A SEPTIC TANK REQUIRED: B 3 OUTLET 4-500 GAL LEACHING CHAMBERS OBSERVED GROUND WATER: N/A 550 GPD x /OOX - 550 GAL - 15.404:(2 lo) J. ALL CONSTRUCT/ON METHODS AND MATERIALS AND EXISTING 0-BOX W12' STONE ENDS. 4' STONE SIDES BOTTOM OF TEST HOLE *1: 91.3 SEPTIC TANK PROVIDED: 1000 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1000 GAL H-20 CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL SEPTIC TANK 6" CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. j COMPACTED BASE DESIGN PERC RATE ! 5 MIN/INCH \VI PROF l L E : NOT TO SCALE SOIL TEXTURAL CLASS - 1 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 550 GPD / 0.74 GPD/SF - 744 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WI TH- STANDING H-20 WHEEL LOAD$. PROVIDED: 4-500 GAL LEACHING CHAMBERS W/2' STONE ENDS. 4' SIDES. A-825 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR 825 S.F. x 0.74 - 610 G.P.D. APPROVED EQUAL. L RO 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED SOIL TEST P l T DA TAB 82 INDICATES / PRECAST CONCRETE OR APPROVED POLYETHYLENE. PERCOLATION OBSERVED L BSER VED D BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER .r 1 � ._ Y fr TEST ' GROUNDWATER TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE R 6. 7P •1 Po,14920 7P #2 OUTLET. 0, HORIZON TEXTURE COLOR 101.3 0' HORIZON TEXTURE COLOR 101.3 7 BEFORE CONSTRUCTION CALL 'DIG-SAFE'. j L ---__. l-z.__� LOAMY IOYR LOAMY IOYR v FLAG`POLE6 A SAND 212 A SAND 212 1-888-DIG-5AFE AND THE LOCAL WATER DEPT. 91 - - - - - - - - - - - - - - - 100.6 /0' - - - - - - - - - - - - - - - 100.5 FOR LOCATION OF UNDERGROUND UTILITIES. \ B LOAMY IOYR B LOAMY IOYR i' \ SAND 316 SAND 316 24" - - - - - - - - - - - - - - - 99.3 22' - - - - - - - - - - - - - - - 99.5 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE r m \ MEDIUM IOYR MEDIuv IOYR\ C l SAND AND 516 G l SAND AND 516 DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION r r \ GRAVEL GRAVEL OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE r r r \\ CONSTRUCTION I NSPECT l ONS. 42- r \ 9. EXISTING SEPTIC TANK TO BE PUMPED AND CLEANED. INSPECT AND REPLACE INLET TEE IF REQUIRED. G� LOT / 3A r/ i l NO WATER NO WATER 91.3 l 7. 9/2 f S.F.�- DATE: JANUARY 5. 2016 i�6j r TEST 8Y: STEPNEN HAAS WITNESSED BY: DAVE STANTON l.1`Ij JJ oZ� r GARAGE a PERC RATE: ! 2 MIN/INCH / 1 40' 1 O / Sq\ O / \ / �-�.�Ow0 \ EXISTING-- PAT10 SEPTIC TANK 101.6 �. •ma14 c' I �p1 101,7 ;a OB�� T .2 _-.• ,�10 IO I.4 ae c POOL �p0� C ; D-BOX 4-500 GALLON LEACHING CHAMBERS 101,2 m , �: �(� W/?' ' /45 STOC K�DE' � 'C�aO JS� N8/'S/ 'SO W ,27 4' STONE SIDES S E7 P T C S Y S T EM I E S (3 N _ 59 BLUI7BERRY HILL ROAD . MAP .249 . PARCEL 77 8M. CORNER POOL APRON 100.7 EL-101.66 BARNS TABLE . PREPARED FOR LEGEND J p H N H,A R © Y ROUTE 2 e C8 CONCRETE BOUND LOCUS -w WATER LINE SCALE : I �' 20 FEBR UAR Y 22 . 2016 A O HYDRANT a GAS LINE STEPHEN A . HAAS OHW- OVER HEAD W l RES sr -0 LIGHT POST ENGINEERING , INC -E- UNDERGROUND ELECTRIC L 1 NE + P . O . E3 a x 16 SrAF -T- UNDERGROUND TELEPHONE LINE / i�� I V �� S o u t h D e n n i s MA 02660 } --CTV- UNDERGROUND CABLEVISION LINE � � /j ����'< ( 508 ) 362-8 1 32 J +40.4 SPOT ELEVATION / ­­--40------- EXISTING CONTOUR LOCUS MAP 0 IO 20 40 40I PROPOSED CONTOUR JOB NO: 15-074