HomeMy WebLinkAbout0152 BRISTOL AVENUE - Health 152-Bristol Ave
Hyannis
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No. �� Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
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PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ZippliLatlon for MispoBal 6pstem Construction j3erinit
Application for a Permit to Construct( ) Repair( ) Upgrade(+t() Abandon( ) [:]Complete System ❑Individual Components
Location Address or Lot No. iSoZ 1(16}01 iaVenv@ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel a9,1 097, 9-1 1 k 7 M-r"C% �'� 1 Q Sev&t f P65 7 76-j
Installer's Name,Address,and Tel.No. SO$-q77-$Q 7 Designer's Name,Address,and Tel.No.
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Robe-t 6 our 363 cilh:�os 1��►,.S Yu.med>�, VhA Te 1✓IeQ� y el�n6er � l�G�`e tw,
Type of Building:
Dwelling No.of Bedrooms Lot Size a, I S sq.ft. Garbage Grinder( )
Other Type of Building Re.Sm 14�'IVI; No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 330 gpd Design flow provided u/ gpd
Plan Date n y l Ao;w Number of sheets l Revision Date e
Title VW ur<J o e-Z
Size of Septic Tank LS-00 Type of S.A.S. pr oc.-' -
Description of Soil C504,SF_ s4 ad I a Dlen)
Nature of Repairs or Alterations(Answer when applicable) btjQ orA CK p s
Se .¢v -ow Soo Ar V
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 o He t .
Signed Date (� Q O
Application Approved by Date
14aApplication Disapproved by Date
'for the following reasons
Permit No. (� Date Issued
------------------------------
_1
- i- ti a
No. d )' ,Fie,:1
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Ye
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Misposar,&.pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade'(x) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 1 _ Owner's Name,Address,and Tel.No.
sa 11,641 Avenue { �
Assessor's Map/Parcel a Grc l Scr M L Cis' -�( } '`•.,
Installer's Name,Address,and tel.No. (�'�_gs 77 Designer's Name,Addre s, d Tel.No. 03-a73'6377
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Rpbo(4 B Ova 363 W*hi f5 PPc.i Y6,1"011Ph- Opp R E
Type of Building:
Dwelling No.of Bedrooms Lot Size g5� sq.ft. Garbage Grinder( )
Other Type of Building (2 os,Ll� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) f ZZ gpd Design flow provided#7 -A 4/Q' 49 gpd
Plan Date rl u 1.aoao Number of sheets ' Revision Date
. Title
0
Size of Septic Tank_�70,0 Type of S.A.S. CC.4 Y'
Description of Soil r36 ( r
r '
nCl�l�7 r �
Nature of Repairs or Alterations(Answer,when applicable) PA'vs
Date last-inspected: -
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
t 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 He4lth.
Signed Date
Application Approved by L Date
Application Disapproved by Z Date
for the following reasons F
Permit No. -� ��� /� Date Issued
s THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(,,c)
Abandoned( )by
at I �. — - - 1.-���Tg,a���_ry c� has been constructed in dance >�
with the provisions of Title 5 and the for Disposal System Construction Permit No.30.)-n— 1 dated
Installer cup,-- Designer Te �r,_/—
#bedrooms Z Approved design flow gpd
V
The issuance of this permi6hall not b cons% d as a guarantee that the system will function as designed.
Date /C. Inspector )
- ------------------------------------------------------ ---------- --------------------------- - - - --.-
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstrm Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade Abandon( )
System located at r, 4-" 1 � f.�
Y
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 Q' Approved by
Town of Barnstable
•BIKE Regulatory Services
Richard V. Scali, Interim Director
MAn� snatvs�nsi.e.
Public Health Division
i639. �0
�f1639. Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 6-5-20 Sewage Permit# 2-02-0 13( Assessor's Map\Parcel 291/97
Designer: SC. Errgtme.eri05, 'xvic-. Installer: Robert B. Our Co.,Inc. (RBO)
Address: 2$54 Crm perry Oj j1 c%y_ Address: 363 Whites Path
I IfSouth Yarmouth,MA
rn54 ware-r%avn N 02_538
On S S' 2 o 2,) RBO was issued a permit to install a
(da ) (installer)
septic system at_ 152 Bristol Ave. based on a design drawn by
(address)
f✓ En 5ir1e�C�O 9 aTr1c._ dated May 4. 2020
(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. Strip out (if required) was inspected and the
soils were found satisfactory.
_X_ I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed i iance with the terms
of the AA approval letters (if applicable) zw Or,M,4,1.4o
r JO N L.
CHURCHILL&
;(Dner
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CML
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(Affix De t p Here)
�LLIC HEALTH D SION. 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:\SepticTesigner Certification Form Rev 8-14-13.doc
Certified Mail#7015 1520 0000 1967 7665
,�T►,E ,,,� Town of Barnstable
Inspectional Services
BARNSTAISM
v� MAS& `0g
�f039. 6. Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
November 20, 2019
Marcia Gayle
152 Bristol Avenue
Hyannis, MA 02601
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION.
The property owned by you located at 152 Bristol Avenue, Hyannis, MA was inspected
on November 20, 2019 by Timothy B. O'Connell, R.S., Health Inspector for the Town of
Barnstable. This inspection was conducted on the basis of complaint received from
Barnstable Police Department.
The following violation(s) of the State Sanitary Code were observed:
105 CMR 410.300 and 310 CMR 15.00: Sanitary Drainage System
There were a total of six (6) bedrooms observed on this property; three (3) on the main
floor and three (3) within the basement level of the home. The existing septic system
(Permit# 82-450) was designed for three (3) bedrooms not for six (6) bedrooms.
105 CMR 410.450—Means of Egress:
Observed three.(3) rooms within the basement being used for sleeping purposes and
lacks adequate secondary egress.
You are ordered to correct the 105 CMR 410.300 and 310 CMR 15.00 violations
listed above within thirty (30) days of your receipt of this notice by pulling the
required building permits. You are ordered to remove three (3) bedrooms from the
lower level of this dwelling by removing entrance door(s) and by opening the door-
way entrance to a minimum opening of four feet. This will bring the total bedroom
count down from six (6) to the appropriate three (3). You are ordered to cease and
desist within (24) hours of your receipt of this letter the use of the rooms within
basement a's bedrooms due to lack of proper egress and insufficient septic capacity.
4
QAOrdei letterMousing-Motel Violations\152 bristol I I-20-19.docx
You may request a hearing before the Board of Health if written petition requesting same
is received within ten (10) days after the date the order is served.
Non-compliance will result in a fine of $100.00 per violation. Each day's failure to
comply with an order shall constitute a separate violation.
PER ORDER OF THE BOARD OF HEALTH
,r
5 A. McKean, . ,-CHO
Director of Public Health
Town of Barnstable
Cc: Barnstable Police Department.
Q:\Order letters\Housing-Motel Violations\l52 bristol 11-20-19.docx
.:.Health Master Detail Page I of I
�' '. Health Master Parcels Search Selections JFIT Applications Logoff oconnelt
IParcel I septic I Perc I well I Fuel Tank
Parcel: 291-097 Location: 152 BRISTOL AVENUE,Hyannis Owner: GAYLE,MARCIA E
Business name: i Business phone:
Rental property: ❑ Deed restricted:❑ Number of bedrooms
i
Contaminant released: ❑ Fuel storage tank permit: ❑
Save Parcel Changes I Return to Lookup
Parcel Info Parcel ID: 291-097 Developer lot:LOT 3
Location:152 BRISTOL AVENUE Primary frontage:111
Secondary road: Secondary frontage:
Village:Hyannis Fire district:Hyannis
Town sewer exists at this address: No Road Index:0186
Asbuilt Septic Scan: 291097_1 Interactive map:
„V
Town zone of contribution:AP(Aquifer Protection Overlay District) State zone of contribution:OUT
Owner Info Owner:GAYLE, MARCIA E Co-Owner:
Streetl:152 BRISTOL AVENUE Street2:
City:HYANNIS State:MA zip: 02601 Country:
Deed date:5/29/2009 Deed reference:C188654
Land Info Acres: 0.29 use: Single Fam MDL-01 zoning:RB Neighborhood: 0104
Topography:Level Road:Paved
Utilities:Public Water,Gas,Septic Location:
Construction Info&:"tlm ry Year Bwl 'Loss Vez Ivin a e bedrooms Eachrooms
1 1961 340 1104 3 Bedroom 1 Full-1 Half
Buildings value:$110,300.00 Extra features: $35,400.00 Land value: $86,000.00
https:Hitsgldb.town.bamstable.fna.us:8431/HealthMasterDetail.aspx?ID=22652&mp=291... 11/20/2019
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3 :'T01WN OF BARNSTABLE
.00ATION- ISM �(�S"TO Ave, SEWAGE#.
nUAGE . t/Q✓I'T S. ASSESSOR'S MAP&LOT---.:--
L.NSTA .ER:S.NA7E M �&PHONE NO. " �5
;EP71C TANK CAPACTT.'Y, X e5 S o� i
.EACU NG FACIY I M (type) �• (sizc) ' IC 6- 0 ,.
40.OF•BEDROOMS 3
JUII.DER OR OWNER :"r,nvrt
• 'ERMITDA7E:- _.__,__.....,.._ .__,..__ _(-,OMPLIANCE DATE,
loparation Distance Between tW:
vlaximum Adjusted Groundwater Table to the Botiotn of I.eaching Facility eet
'eivate Water Supply Well and Leaching Pacility (If my wells exist
on site or within 200 feet of leaching facility) .
'Age of Wedand and Leaching Facility(if any wetlan �exist
wlthln 300 feetpf leaching facility)
'uraishcd b �Sa� M .5 �
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every 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.
A. General Information I In
1. Inspector:
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
29 Atwater Dr
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
508-495-0905 S13971
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
3-12-09
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 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.
"""`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.
System has 2 cesspools overflowing into a leach pit. All were empty and in good condition.
t5insp official document-03N8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15
10 1 31�I
Ic
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town 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 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:
System has two cesspools that overflow into a leach pit. All are in good condition and empty at
inspection.
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
t5insp official document•03108 Title 5 Official Inspecton Form:Subsurface Sewage Disposal System•Page 2 of 15
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle(Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally.Passes (cont.):
❑ 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:
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.
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15
F
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 152 Bristol Ave
Property Address
Barbara Earle_(Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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 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
❑ ® 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 'A 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.
t5insp official document•03/08 TrUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® 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 CM 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 CM 15.304. The system owner should contact the appropriate
regional office of the Department.
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
µ 152 Bristol Ave
Property Address
Barbara Earle(Perego)
Owner Owner's Name
information is H
required for y annis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate "yes" or"no" as to eac:.h 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 f,arge 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 CM 15.302(5)]
t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 152 Bristol Ave
Property Address
Barbara Earle(Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
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
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available (last 2 years usage (gpd)):
Sump pump? ❑ Yes ® No
Last date of occupancy: 12-08
D ate
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CM 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:
Last date of occupancy/use: Date
Other(describe):
t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is H
required for -y
annis MA 02601 3-12-09
—
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
General Information
Pumping Records: t
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
❑ Septic tank, distribution box, soil absorption system
❑ Single cesspool
® Overflow cesspool
❑ Privy
I
❑ 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):
With leach pit.
Approximate age of all components, date installed (if known) and source of information:
1964 and 1980's
Were sewage odors detected when arriving at the site? ❑ Yes ® No
t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
Depth below grade: 30"
feet
Material of construction:
❑ cast iron ❑ 40 PVC ❑ other(explain): Iron and orangeberg
Distance from private water supply well or suction line: feet
Comments (on condition of joints,venting, evidence of leakage, etc.):
Good condition
Septic Tank (locate on site plan):
Depth below grade: 24'
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:
6x8 cesspool
Sludge depth: 0
Distance from top of sludge to bottom of outlet tee or baffle 0
Scum thickness 0
Distance from top of scum to top of outlet tee or baffle 0
Distance from bottom of scum to bottom of outlet tee or baffle 0
How were dimensions determined? Tape
t5lnsp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town 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.):
6x8 cesspool is in good condition and empty at inspection.
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
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):
t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is Hyannis MA 02601 3-12-09
required for y
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) t
Tight or Holding Tank (cont.)
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.):
I
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert N/A
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.):
I
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 152 Bristol Ave
Property Address
Barbara Earle(Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
® leaching pits number:
1
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
® overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
System has two cesspools overflowing into a leach pit and empty at inspection. Stain line in leach pit
is at 24"off bottom of pit.
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15
I
Commonwealth of Massachusetts -
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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.):
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.):
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
--
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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.
Deck
O
o v �
CAW �'Pe�l Lgao
�-D-SI'd" 6-Q- 18
A-F_- b�
i
t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments-
152 Bristol Ave
Property Address
Barbara Earle (Perego)
Owner Owner's Name
information is required for Hyannis MA 02601 3-12-09
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope r
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 20'
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:
You must describe how you established the high ground water elevation:
USGS maps show groundwater at 20'.
t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15
,LOCATION SEWAGE PERMIT NO.
VILLAGE
INSTA4L yR'S NAM i ADDRESS
SUIL'DER OR OWNER
DATE PERMIT ISSUED gz
DATE COMPLIANCE ISSUED ,���_�z
1 \\II
q\ I l
N,L.�
\�
a'
r
No82-• VSv---• Fxs$....I.QQ............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
............................T own.--.OF..........Barnstable.....
Applira#ion for Disposal Works Cnomitrurtion .ermit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
-� �...U2...BrIzt.Q1...AY.Q.#, Jlyann.,�.s.,...M.....A26Q1........................•--........---•---••-•-------•----....................---
Location-Address or Lot No.
Charles Earle.. ...................................•--•.._ -.Aa Hyannis 1----•.......--
.............---- _....... i . HynA
Owner Address
a A & B Cess ......................ol Srice �25...Bi`sh-ogs-.Tsrrace.,...Hy-anni.s....MA.....D2601.......
......................... ----------..........-----••...................._
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms................3 .Expansion Attic ( ) Garbage Grinder ( )
'_l Other—Type T e of Building .... No. of persons.............2
G.� yP g P Showers ( ) — Cafeteria ( )
Q' Other fixtures --------------------------------- -
W Design Flow..................................:.........gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 ...--•.....................•-•-----.......-•-•---•---•--•-•-•---•-•--------------.................._..............----••----------------------•-......---•--
Descriptionof Soil Sand----------------------------------------------------------•--------------------------.....--------•---------------------....
x
c,
x --------------------------------•------------------------------------------------------•--------------------------------------------------------------------------------------..._......._...---•-------
U Nature of Repairs or Alterations—Answer when applicable.Arlatallati-on---Qf-._a..]..QQQ_.-gall-Qn.,._.pxe-naat,
stonepacked-leach pit (overtl.go'--------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not tg place the system in
operation until a Certificate of Compliance has been iss»ed by the bo tad o ie I .
..... ............
/ 2
.......�--Signet�
ate
Application Approved By.................................... _- _ .d....------•--................ ...............
...........--8/17/"82........
Date
Application Disapproved for the following reasons---------------•---------------------------------------------------------------------------------------.........
....................•-------•--------.....---......-----•--•----•-------.....--._--•--•.--•-----------•------------------•-----------------------------•-----------------------------------------------
Date
PermitNo. 82-...............•------------•....... Issued_.......81171?..-----....-•------•--•--•-•---
Date
Nogg:....ysV... FE$$....5!�?p............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�a.Kn...OF...........
�'arri3table
......................... .............
Appliration for Diopusal Works Tonstrur#inn Vrruti#
Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal
System at:
................tIr'. iA 52 'L�rirt of Ave= yaxin i A,..l A.....0260 ................... ......
- --.........-............-_...
Location-Address or Lot No.
C1arles ' arle 15? x stol Ave.,---'-{Yannis,...MA 42601.............
- -... -.. •-._---•-----------------••----•--. ---
Owner Address
� A..&1' Cess-Dool_Serv'Service 128 Eis_hocs_.?exrace,-..;iannis-=-..k-A 02601
Installer Address
VType of Building Size Lot............................Sq. feet
.-, Dwelling—No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder ( )
`4 Other—T e of Building No. of persons.............2............ Showers —
a YP g ---------------•-----------• P (..--)-------Cafeteria ( )
Otherfixtures ----------------•--------------------------•-•--------.------••---------•-----•-----•--------•-----•--••-----. ----------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter-------_........ Depth................
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
D Description of Soil.............................-----5�-......................................................................__._....._.....-•--------••-•---..._._......---......
x -----------------•------........----------•----------------------------------------•-----------------------------•-------------------
U .........---•.............•--••-•-----------•---....-----------------------•--.....---------•--------------•--•-••----------------•......-•--...........................................................
E4
UNature of Repairs or Alterations—Answer hen applicable...insta11at1.on_.of_.a_1t 000 pallor., pre—cast,
stone packed leach pit (overflo�t.
----------------•------------------------•--------------------------------.....-•-•--•----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE; 5 of the State Sanitary Code— The undersigned further agrees not t place the system in
operation until a Certificate of Compliance has been issued by the boarld of.he It .
Signed�.G_�GGGyt.-ss�.�_.-.... ------7� V 17�82
-------------------------------
Application Approved BY................................. �••!�---455-•1------•..................... ................. .�
fk�82
Date
Application Disapproved for the following reasons:................................................................................................................
------------------•-------------------------•---....-•-------.......------------•........------•...-----..__....-••--•-•-------------•---------••---•----------------•--••-----•--------•--••------------
D
Permit No.............82-..................----------••••.... Issued_........8/17/E2-----------------•Date.......
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......................... own......O F.......Bam statle
...................••-...............................
Cnrdif irate of (Soutpliam
THI I CERTIP Y Tha the In� i 1 Sewa Di osal S7 stem onst cted 1� l or Repaired
r
�esspool Sery ca, TC ishopsglerrpace, i�yannis, P c) A P ( )
by•-••••.................•- -------•--•--•-•-.............•-------------••-........--------•••-------•-•-----------................----------------.......-•---------.........._......_------_..._
152 nristol Ave., Hyannis, FA 02,j0fnL1al1.ajSrles Earle
at......................................................................................................................................................................................................
has been installed in accordance with the provisions of T F f 5 of The State Sanitary described in the�
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................................. ���� -�--•-----... Inspector........ � ")...................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town "'a.rnstable
.........................................OF.................._.............-----•--.......---•--................................
No.........................`�Sd 5.00
FEE.......................
Dispoul Vorkg Tono#rudion Errant
A B Cesspool Service= 12� I31shops rerrace, Hyannj s, ;"A 02601
Permission is hereby granted-- -- -- ---------•--•----..........--.•. •---• ----- ----•--•-•-•-• . .--•--..... . -•-•------•-....._...... ......
to Constr1c 2( r'i irtolepgve., RYn�d 'dua SeMIDispMrses arle
atNo...............................................................................................................................................................................................
Street
as shown on the application for Disposal Works Construction Permit No..................... Doed......Q__ 7� .....................
DATE health
� 'J Board f
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
T.O.F. EL. 36.25'± FINISH GRADE OVER D-BOX= 34.74 PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE p
FINISH GRADE OVER CHAMBERS= 34.5, - 35.0, GENERAL NOTES
PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED
F_�lWITH COVER OVER INLET& REMOVABLE WATER-TIGHT COVER OVER
STONE TO CROWN OF PIPE
FINISH GRADE OVER TANK EL.= 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
RISER TO WITHIN 6"OF FINISHED GRADE
OUTLET TO WITHIN 6"OF F.G. 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS BOX
fFINISHED GRADE � � �� 11 ,1 METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
FOUNDATION = 35.5 35.0 ± MIN SLOPE 1% 2 OF 1/8 TO X DOUBLE WASHED
_ 5" DfA. OUTLET(S) TO F.G. (SEE GENERAL NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES.'
@ STONE OR GEOTEXTILE FILTER FABRIC
24"MIN.ACCESS 4.0' MAX. _ , 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
TOP OF SAS - 30.00 PLACE RISERS ON ALL DESIGN ENGINEER.
.COVER(3 TYP.) SEE NOTE 23
PROP. SCH. 40 AS-BUILT 4.3' MAX: 5.0' MAX. /32.29' CHAMBERS WITH
PROP.SCH. 40 , ` „ 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
PVC SEWER 4 PVC TEE SEE NOTE 23 29.00 SEE NOTE 23 BREAKOUT EL = 29.50' INLET PIPES TO 6, OF
PVC SEWER SYSTEM UNLESS OTHERWISE NOTED.
V6'
2" DROP MIN. 31.29'1) 31 .791 FINISHED GRADE117 3'� g�' L_7�� 4. TO PREVENTBREAKOUT, THE PROPOSED FINISHEDGRADESHALL NOT BE LESS THAN
Marv,sLOPe t�i3" DROP MAX. MiN.s�oPe ^i GHT ELEVATION =29.50' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
4" PVC IN FROM JOINTS TYP. o( ) Sw 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
* ' 14" 1134.0 ± 29.50 SEPTIC TANK 4 PVC OUT TO O °° O THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
LEACHING FACILITY 0 00SID 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
(33.Oo ) 0 � 00 � 0 0 00 0 00 0 � q TEE
29.75 1211 6" �'o 00 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL:
1 4811 OUTLET TEE 29.37 MIN. 29.20 (32.15 2 0 0 0 00
(33.35 ) / � � � � � � � � � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK.
TEES TO BE CENTERED (32.39'} 6"CRUSHED STONE o 0 0 0 00 FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. Y
GAS BAFFLE o 0 � 0 0 0 0 0 0 0 0 0 0 0 � 0 0 � o SYSTEM IS
DIRECTLY UNDER RISERS OVER MECHANICALLY o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
14.8'OFFSET TO FND COMPACTED BASE
4.0' 8.5' (TYP) -( 4.0' 4.0' AND DESIGN ENGINEER.
HED TO E 5OUTLET DISTRIBUTION BOX1 -4.0'- 4.83' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 35.00,
6 CRUSHED I N TO BE INSTALLED ON A LEVEL STABLE 25.0' (TYP') ESTABLISHED ON TOP OF NAIL SET IN DRIVEWAY AS SHOWN ON PLAN.
OVER MECHANICALLY
BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 22.00'
COMPACTED BASE C C C 27,00 12.g31 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1 ,500 GALLON H-10 CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
�� � �►� � �� /29.29' 2 - 500 GALLON CHAMBERS s' MIN.
10 -6 5 -g 5 -g ( 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES.` REPORT ANY DISCREPANCIES
LENGTH WIDTH DEPTH (Dimensions per CROSS SECTION VIEW CHAMBER END VIEW
CONTRACTOR TO VERIFY EXISTING TYPICAL CHAMBER PROFILE / TO THE DESIGN ENGINEER.
IO PRIOR TO ANY WORK& ACME/Shorey) \/
ELEVATION H-1O SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL H 20 CHAMBER DETAILS
NOTIFY ENGINEER IF DIFFERENT: NOT TO SCALE NOT TO SCALE
NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS COMIC. STRUCTURES SHALL BE MADE WATERTIGHT.
11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
. ,; ;'.' K * • ,,;�, - - APPROPRIATE AUTHORITY.
!M► PERC NO. TPT 20 77
ZONE II
{ % K $ INSPECT R• Donald Desmarais 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-1 LOADING,,. O 0 OAD G UNLESS LOCATED
<; UNDER MORE THAN 3 FEET F OVER R r ,, ,. �j r.,� ,� � O C O LOCATED UNDER PAVEMENT, DRIVES, OR
MAP 291 � - �" .' EVALUATOR. Michael Pimentet, EIT, CSE
,3r �.�4- r,. , .�.,, �, 5_,, TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
MAP 291 ; > �. �. ;,:
LOT 87 ;re .0 . _ „
s C.S.E. APPROVAL DATE: Oct. 27, 1999
<„
AS-BUILT TWO 2 500 GALLON LOT 88
O 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND FINES.
bx ,. r,,, - DATE: April 27, 2020
H-20 LEACHING CHAMBERS W/ AS-BUILT H-20 .
SURROUNDING AGGREGATE r :.: :,.,: ;. ;, .,F. ... y l 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM SUBSOIL AND UNSUITABLE
DISTRIBUTION BOX N ,. X X� .:a ,:�:�„ ��.0 � k' : �� tt z.:, ,a TEST PIT#: 1 '
FEW X a MATERIAL IN AREA BENEATH EAT AND FOR S FT. ON ALL SIDES OF LEACHING FACILITY:
- w= ; .
34x8 ` _ _.._ X X X ,��, � ,., ,. . ,: ,. �. . .., _ . � b;. ..:.. : _, ELEV TOP - 34.50 REPLACE ALL UNSUITABLE MATERIAL WITH LEAN
X X X X I C COARSE SAND FREE FROM CLAY,
MAP 291 _ x X X is
PORT - X ? + FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
AS BUILT INSPECTION _ -: X X �! ELEV WATER= < 22.00
- LOT 89
-s ,,. � � � :, ",�. �, ;; �,: ;: ,�� -• - 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN -
„ ..-X o0
E w .. ".� PERC RATE 2 min./inch
84 25 30 / �, SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
N t' i 3
10.001 / ,
34x4 I z _ " - 16.J , DEPTH OF PERC- 36 54 PROPOSED PROJECT IS LOCATED WITHIN:
n w 1 -
h STONE WALL 1 I '� d f �
M - \ ASSESSORS MAP 291 LOT 97
J i W " _ ;• TEXTURAL CLASS: 1 - -
\ ► at3 4 .x
Q V OWNER OF RECORD: M RCIA E. GAY
LE
2 \ a ,� w S , ,k +�"' �, >� � „�1 A G LE
/ TP 1 34x5' ` � .,
/ 34x5�" \ _
- r• �y�° � �.; � �, >z,.,� ; � ADDRESS: 152 BRISTOL AVENUE
X / 1 AS BUILT 1,500 GALLON o , .a 1
FIRE PIT � \ c� >- ., ,<,., � °; ,..,y�., „., ,,�, � 34.50
( EXIST. ., H 10 SEPTIC TANK
0 HYANNIS MA 02601
X \ Loam Sand
\ o
Sty ?FY {., ,{',
SHED K. �°�" ,
\
S .� _�
O 10Yr 3/1
X • . " : \.: -,.. .. . . .: . . . .. EXISTING CESSPOOL TO BE .,,, , � ... ,.. �>... - .�.,. � �� ..�. ,.� ,, X
w 11 m ? ,.; 11 FEMA FLOOD ZONE
� � 12 N `
X O PUMPED, FILLED w/CLEAN Z . .
.: 1 "-; - �.�.; +, , , COMMUNITY PANEL# 25001C0568J
I \ -SAND&ABANDONED TYP OF 2 LOCUS #
x \ ZONE I I Loam Sand
(6 \ 1 a s. ,, � g Y 17. DEED REFERENCE. L.C.C. #188654
fi4 10Yr 5/6
r
1 a1 s n.
" „",. if �, ,;; ,;�,; " 18. PLAN REFERENCE: L.C. PLAN NO. 1403 E
y y
\ 4 ,.;:4 4 x k." 36 31.50
/5 ) �+. I ,�.. ,. ..,•.: � ��,.�,,, ;� 19• ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
Perc
1 \ I k yy
�� 1 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
1 Yt ,; FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
3 / RI
FOR E US S OF THIS PLAN OTHER THAN ITS
N ,:. , s" ;; • ,:, 4, ,, r '�.,, .. ,:. r,.,<, INTENDED PURPOSE.LP
....
y ,,5,-. . �+ . ,: ., .. : rE v. m a ... -:..., 6r... . ".,;. it
. -._ ,,,
DEC ;„, $- „�. � � K,,, , , „ �::.., A 4 PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
" � � �� r °- z �� Coarse Sand
X � \ � I N
\ - I
C o DEPTH OF THE BOTTOM ,1
x
" (10-20/o gravel OM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A
o :.fs: „ u t *'+ REMOVABLE_THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
2 ", w
. .F <x &cobbles
x / I oo cr_ 2.5Y 6/6
f / o- o 22. CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL REQUIRED PERMITS AND
APPROVALS FOR THIS PROJECT.
HC-2 LOCUS PLAN
LAN 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE
v APPROVALS ARE REQUESTED FROM 310 CMR 15.221(7):
EXISTING LEACHING PIT TO �- I r'� SCALE: 1" 1000' (1.) A 1.0'WAIVER(3.0' -4.0') FOR THE MAXIMUM COVER OVER THE H-20 SEPTIC TANK.
150" 22.00' 2. A 1.3'WAIVER 3.0'-4.3' FOR THE MAXIMUM COVER OVER THE H-20 DISTRIB. BOX.
BE PUMPED, FILLED w/ x \ / TOF=36.25' ( ) ( )
CLEAN SAND &ABANDONED 1 "? (3.) A 2.0'WAIVER (3.0' -5.0') FOR THE MAXIMUM COVER OVER THE H-20 SAS.
X I HC-1 SLAB-35.12' / No Mottling, Standing or Weeping Observed
/ e
/ DESIGN DATA
TEST PIT DATA LEGEND
Benchmark >c /
Nail Set in Drive \ o \ GAR. SLAB #152 / 1 PERC NO.
, I ( p z 1 a, TPT-20-77 '
Elevation=35.00 \ ' \ uy o\ = 35.17 EXISTING co ` NUMBER OF BEDROOMS (EXISTING) 3 INSPECTOR: Donald Desmarais
50x0' EXISTING SPOT GRADE
Approx. M.S.L. 3-BEDROOM /
\ � � �L � � EVALUATOR: Michael Pimente, - - - 50 - - - EXISTING CONTOUR
p DWELLING / NUMBER OF BEDROOMS (DESIGN) 3 ` EIT, CSE
1
/ MAP 291 DESIGN FLOW 110 GAL/DAY/BEDROOM C.S.E. APPROVAL DATE: ° Oct'27, 1999 50 PROPOSED CONTOUR
LOT 98 Aril 27 2020
DATE. p ,
\ O \ / ' TOTAL DESIGN FLOW 330 GAL/DAY 50 PROPOSED SPOT GRADE
/ O \ o = 660 TEST PIT#: 2
co \ N DESIGN FLOW x 200 /o GAL/DAY
M \ GAS EXISTING UNDERGROUND GAS
'\ ELEV TOP _ 34.50'
USE PROPOSED 1,500 GALLON SEPTIC TANK
/ 34x5' \ \ ' \ ELEV WATER = < 22.00'
O�H�W EXISTING OVER HEAD WIRES
EXISTING LEACHING
CATCH-BASIN / o\ \ " 06 I PERC RATE = W W EXISTING WATER LINE
INSTALL 2 - 500 GAL. CHAMBERS w/AGGREGATE
/ M O N \ MAP 291 `0� , DEPTH OF PERC= TEST PIT LOCATION
®� 4 / . \
' 3 Q c� �� LOT 97 \� SIDEWALL CAPACITY TEXTURAL CLASS: 1
12,485t S.F. \ LENGTH + WIDTH 2 SIDES 2' HIGH 0.74 GPD/S.F. GAL/DAY O O O AS-BUILT 1,500 GALLON H-10 SEPTIC TANK
(25.0 + 12,83) (2 ) (2 ) (0.74 GPD/S.F.) - 112.0 GAL/DAY
AS-BUILT 4"SOLID SCHEDULE 40 PVC PIPE
Off 34.50
N J a \ BOTTOM CAPACITY A Loamy Sand a AS-BUILT H-20 DISTRIBUTION BOX
'o \ = 611 10Yr 3i1
a / z (LENGTH x WIDTH) (0.74 GPD/S.F.) GAL/DAY
MAP 291 <,, / o (25.0 x 12.83) (0.74 GPD/S.F.) 237.4 GAL/DAY x AS BUILT 500 GALLON H-20 LEACHING CHAMBER
LOT 96 o / Loam Sand
cr► B Y k 1 ACTUAL ELEVATION "AS-BUILT"
1 / 10Yr 5/6 (6.$7
TOTALS:
TOTAL NUMBER OF CHAMBERS 2 36" 31.50'
/ `� 3� \ REV. DATE BY APP D. DESCRIPTION
c� TOTAL LEACHING AREA 472.2 SQ.FT
TOTAL LEACHING CAPACITY 349.4 GAL./DAY n _ "
- SEPTIC SYSTEM AS BUILT PLAN
t{ OF
,� �'''`� cyc PREPARED FOR:
J Q3 50 -N r NOTES: Coarse sand CHURCHLY JR. -4 ROBERT B. OUR INC.
/ 1.,1A0 6 . - p V��� C (10-20% ravel " CIv4L _ CO.,
/ .20�5 8 /EpG�G OF &cobbles) No. 41807
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE )
. - TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. 2.5Y 6/6 �� LOCATED AT
AS-BUILT SWING-TIES �. 2. CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE 152 BRISTOL AVENUE
LOCATION OF THE PROPOSED LEACHING FACILITY TO
HC-1 HC-2 OL AV HYANNIS, MA 02601
DESCRIPTION � / R��jT AYpUT� ENSURE CONSISTENCY WITH TEST PIT'DATA SHOWN ON THIS
WIDE L PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH
(40 150" 22.00' SCALE: 1 INCH = 10 FT. DATE: JUNE 5, 2020
SEPTIC COVER IN (1) 23.8' 35.4' - IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 0 5 10 20 40 FEET
SEPTIC COVER OUT 2 20.0' 42.6' No Mottling, Standing or Weeping Observed
O 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A MASS. DEP
r APPROVED ZONE II. PREPARED BY:
DISTRIBUTION BOX(3) 23.6 49.6 RESERVED FOR BOARD OF HEALTH USE 11 11 JC ENGINEERING, INC.
AS-BUILT
CHAMBER COVER(4) 32.6 51.4 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY 2854. CRANBERRY HIGHWAY
AS A COURTESY FOR THE INSTALLER. INSTALLER SHALL A
CHAMBER COVER (5) 31.6' 57.8' VERIFY SWING TIE MEASUREMENTS IN THE FIELD PRIOR TO PLAN EAST WAREHAM, MA 02538
SITE PLAN- INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY 508.273.0377
INSPECTION PORT (6) 37.1' 65.3' • ' „ ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT.
SCALE. 1 10 Drawn By: BJW Designed By:MCP Checked By:JLC JOB No.5115
7- ........ .........
NOTES:
1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS
& DIMENSIONS IN THE FIELD z
0
2.) CONTRACTOR TO VERIFY ALL INTERIOR & EXTERIOR MATERIALS,
w cl
DETAILS, & FINISHES IN THE FIELD WITH OWNER I 0')
T
3.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO. 2 GRADE lij0 C\l< (o
n (o
4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS � o(o
STATE BUILDING CODE, 9TH EDITION AMENDEMENT & IRC2015
QW24
34'-6" 5.) 110 MPH EXPOSURE B WIND ZONE co I--
U) W 04
6.) VERIFY ALL PLUMBING & ELECTRICAL DETAILS W/ OWNERS ON THE SITE 3: ui
00
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46'-0" SCALE
1/41f = 1 1-011
UPPER LEVEL PLAN-
DATE :
AREA CALCULATIONS 12/19/2019
UPPER LEVEL 1104 S.F. LEGEND:
® SMOKE DETECTOR
UPPER LEVEL 1104 S.F.
LOWER LEVEL (FAMILY APARTMENT) 795 S.F. 0 EXISTING WALLS
CARBON MONOXIDE DETECTOR
CONSTRUCTION TO BE REMOVED
NEW CONSTRUCTION Al
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BEDROOM #3
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SCALE :
46--0" 1/411 = 1 1-011
DATE :
LOWER LEVEL P LAN- 12/19/2019
(FAMILY APARTMENT)
A2