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HomeMy WebLinkAbout0137 BUCKWOOD DRIVE - Health 137 Buckwood Drive,Hyannis r k B 0 i No. i Fee t,00 / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_l.Z PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pfication for Vsposar'�6pstrm Construction i3ermit Application for a Permit to Construct( ) Repair(k Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3 b uci,Lv Z)7Z, Owner's Name,Address,and Tel.No. t+y K&CILEY Assessor'sMap/Parcel , 1 131 (b0CKtlul(polo CAL HYlkAItjI Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 50$-,).73-03'7'7 �C.. �1�CLN�Z�Q1lVCa ANC:. 28S Type of Building: Dwelling No.of Bedrooms Lot Size I 010 —sq.ft. Garbage Grinder( ) Other Type of Building (ZC-:&(1)CVT[4-CA No.of Persons Showers( ) Cafeteria( ) Other Fixtures , / Design Flow(min.required). gpd Design flow provided 3 �f gpd Plan Date I V " I 1 - Xo t`7 Number of sheets Revision Date Title B u Gte-000 7 n N U ie [a T"YA_0V(s Size of Septic Tank I ( 000 Gp6fC-OFJ Type of S.A.S. (—A) 3-00 CZAL C4Adj&f9g Description of Soil M ey i y m " (304e2S c S'6A/b � � �r Z SEE PL.A Z Nature of Repairs or Alterations(Answer when applicable) L,S4a C;X(S 7'lAAts ( 1 0 OCR Q,-gkLLp I j 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. f Signed Date 1 O a O" 10(' Application Approved by Date f O C)r Q Application Disapproved by Date for the following reasons Permit No. Date Issued sir- i•�a�f �i;-� ,'.ArcY'��..r,� �"�'��.r•^r+T�'.n.-s h+.Arc-r •r,py J`" '+{.:XrF+) .:,�.p'��*'�..'—°' ""1 -y+ '�"3'.t��.r•r�..' .fF':-,e..'". [-' .w __ r.. No.• -)(' Fee (0991--�� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes l�l�ILatIDTC for I8�lD8aiYm�pstPM �"onstruitiDYY30ermit Application for a Permit to Construct( ) Repair( ) Upgrade'( ) Abandon( ) []Complete System . ❑Individual Components Location Address or Lot No. '3 8 d GK W Owner's Name,Address,and Tel.No.odic. Assessor's Map/Parcel �!7 0�, 131 t3uc.KwCkgV DR— HYAt"JL Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. - Lulu C IAJe W NGr Type of Building: >.. Dwelling No.of Bedrooms Lot Size 1 01 — sq.ft. Garbage Grinder( ) Other Type of Building RGS 1 a C1JTI 4-(.- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)' gpd Design flow provided ,3 q C1 gpd Plan Date ( V " t Z ' A 0 01 "Number of sheets / Revision Date Title l?j B ucte- 000 ulpl V ie Size of Septic Tank ! OOp Cr4GG.OrJ Type of S.A.S. _ (;Q J-®O "C/FL C4A&k&tL2S Description of Soil M&V f U M " (204 S E 57hN"b —c�P) yr(E P(4J ~, Nature of Repairs or Alterations(Answer when applicable) L.)SG C5?C 15- rI AJ C- U OU C-zjk ,3 N Date last inspected: Agreement: The undersigned agrees to erisure 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 a Compliance has been issued by this Board of Health. Signed Date d r { Application Approved by oN 0,(�� 2- .- Date_ .- Application Disapproved by Date for the following reasons Permit No. Date Issued ` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(A) Upgraded( ) Abandoned( )by C APe ci t DC Ei1JT&4 O-465 at 13"1 3tJ e-�[_u!O b �}y has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated r Installer QA&C0Cbi5E'07dARAJL G& Designer -1 4— —C kXX QJC_ #bedrooms �-� Approved design flow gpd The issuance of this permit shall l^n�ot be construed as a guarantee that the system w'11l film ttibn ass da,ign r Date 1 t t i Inspector _ . . No. '� / r ->� Fee too 6.�• THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS �i8�JD8ar �p$tetn �0tt8trULti01t �erlllit Permission is hereby granted to Construct( ) Repair(A Upgrade( ) Abandon( ) System located at 1:3`Z AL)C14 w U o a nA us- qyA u l s , 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 i� Approved by 11/22/2017 14:08 5082730367 95770 P. 001/002 Town of Barnstable t Regulatory Services Richard V. Seal!,Interim Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: $08-790.6304 Installer& Designer Certification Form Date: 111-27-1? Sewage Permit# JL0ill -3,' Assessor's Map\Parcel 2121 67 Designer: G Ln�t.naut �C_ Installer: QaeZ4,14e. &I4-e.cPct5eS Address; 2951 Cranberry Ili hWa Address: 153 Coonme-re(ol 5.4f C,i 1505k W01f6 POI� HA 62538 HOSIAPae, H- 0 2 (o ll i On CueWic cM14eclw was issued a permit to install a 1. (date) (installer) Y septic system at 13-7 4uckwood Dci ye_ based on a design drawn by (address) �`G Ern lrlet:,ci,� Oc.,.. dated �k0 Z017 (designer) 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. 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 construe nce with the terms _of the 1�.A_approv41 letter, (if applicable) JOHN L CMUR iI1.1R. (I stalle ' Signat e) vn. k .dt r A signer's Sigtta (Affix igne s St mp Here) EASE N TO BARNSTABLE PUBLIC HEA H D S N. CERTIFICATE OF C MPLL&NCE WILL NOT BE ISSUED UNTIL HOTJJ IS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. ` THANK YOU. QASeptic\Designer Certification Form Rev 8-14.13.dao TOWN OF BARNSTABLE LOCATION ��j Z3L;a<(J SEWAGE# '20 r? 34o4 VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.�&W cbi MsgS a (�E�7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type)MUnn C..}L C.16W S (size) ( [ NO.OF BEDROOMS OWNER Diaisjtifs ecc— 144-Lz PERMIT DATE: JO—a43 - (I COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility hI 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 CAQEj.-Aye E-a.d Rl—ges Nul 6- (N VIQ' - _ _ ell � N ^' 00 W >w , TOWN OF BARNSTABLE LOCATION 13 7 1�a k- t-J o Iqu SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY CU U 2 C- /1�0 i, ' LEACHING FACII.ITY: (type) (size) NO.OF BEDROOMS O BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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:::7--. (.J •��-, s o7 /`/ /�SS _ -�+ i�l U � CN � i t:� f� C Jri (f �! U � � \ �\ s .i Town of Barnstable . P 11514i�p Departiment of Regulatory Services I mwaMi, F Public Health Division Date 2 - MAM r�fbMOK1 200 Main Street,Hyannis MA 02601 i 4 i Pe'I d` iQ /�Zz Date Scheduled a - � Time Fee Pd._ v v X Soil Suitability Assessment for Se e Disposal Performed-By:_ M l(�AGP.� �i vv►�l{�TEI j� GSC Witnessed By: P—s LOCATION&.GENERAL M1 ORMATION Location Address Owner's Name t S + 7 Ir'rt: f kE f La � Q�UCteJoO� ()cpitt)IS p V to Address 37 l ` 7 <Z!Ap& Jtp(g Assessor'sMep/Parce /��7 -Engineer°e Name �` NEW CONSTRUCTION REPAIR Tele hone# Q Q--X73-- 17 _ Land Use 1 slopes M- —CY fo Surfhco Stones �M I I Distances from: Open Water Body �� ft Posslblc WotAnn �� ft Drinking Water ell ft /p, I Drulhage Way ft Property Llne 7 tU ft Other l� $ SIMMIC(Street name,dimensions of lot,exact locationof test holes&pora tests,loeato wetlands•t'n proximity to holes) 5 e' a id (Octo I. Parent material(geologic) DuAWA den Depth to Bedrock >I C�� Depth to Groundwater. Standing Water In Hole: Weeping iYolrt Pit Pace Estimated Seasonal High Oroundwatcr 0 4 P,ETEPJ ATION FOR SEASONALMIGH WATER TABLE Method Used: U t1 Depth Observed standing in obs.hole: In. Depth to 5011 mottles., Doilth to weeping from side of obs.hole: I IML r In, amundwater Ad usltasnt Index Well•# Reading Date: Index Wall]oval Adj facibr. ;,_. _Adj.diun'dwntor•Leval,,,_ PERCOLATION TEST Datel(, la TIMI II_ ( Observation _ Hole# _ �_ Time at 9" � I Depth of Poro S01 Mine at 6" Start Pro-soak Time @ 11 Q 4 _ 'Time(9"-611) 4 . Had Pro-soak l tU 1 Rate Mfn./Inch SIto Suitability Assessment: Slto Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed an, ack— ' • I ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(i)week prior to beginning. Q:ISEPTICU'ERCFORM.DOC i VS DEEPABSERVATION HOLE LOG Hole# I Depth from Sall Horizon Sol Texture Shcl Color Sall. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,Boulders, • rsistency.96'Oravoll LA - 5a Lava m t7A ICE r 5t4 ; DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Sall Color Soil Other Surface(in.) (USDA) (Munsell) Mottling ,(Structure,Stones,Boulders. �0;� "a L W-'XA 954r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sall Texture Sall Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders., Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon SoR Texture Soli Color Roil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stow',Boulders, Flood Insurance Rate Man: / Above 500 year Mood boundary No— Yea Within 500 year boundary No—V Yes Within 100 year flood•boundary No., YEs . _Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material?,.___.__�...... Certifleation I certify that on I th' "�(date)I havapassed 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,expertise an perlence described in 10 CMR-15.017. Signature104 Date Qs1S8PTl0PgI1CPORM.DOC r V TROY WILLIAMS SEPTIC INSPECTIONS - X0 Certified by MA Department of Environmental Protection 199g(50� 385-1300 TOWNOF g m RNS 19 Hummel Drive ®f HEgf NDEPJ�� South Dettn�MA 02660 �i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS g (� DEPARTMENT OF ENVIRONMENTAL PROTECTION T ONE WINTER STREET. BOSTON, MA 02108 617.20-5500 WILLIAM F.WELD TRUDY CORE Govcmor Sccretwy ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner ` PART A CERTIFICATION Property Address: /3 7 u k Wov c� ��. 14y c ,r, s Address of Owner: Date of Inspection: �/ �99� (If different) IRo Name of Inspector: Troy Williams o2 9 d I / I am a DEP approved system inspector pursuant to Section 1S.340 of Title 5 (310 CMR 1S.000) ~ G��r Company Name: Troy .Wi 11 iams Septic Inspections 0, ( w, ; ,,� �`, � /4 Mailing Address: 19 HUmmpl Drivp - cotith DpnniS MA 02660 Telephone Number: (_P_3 8 5-130 0 / 7 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection: The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: S 'l , Ppv Date: d y 198 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: ` AI SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: 81 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. Indicate yes, no,or not determined (Y, N,or ND). Describe basis of determination in all instances. If'not determined',explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (r iv.d 04/1S/97) a P.Q. 1 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Robert Regan Date of Inspection:February 4, 1998 BJ SYSTEM CONDITIONALLY PASSES (continued) A1119 Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 q FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: N11 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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, IT APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Robert Regan Date of Inspection: February 4, 1998 Dj SYSTEM FAILS: /VII� You must indicate ei-o.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (ravlaad 0�/25/97) Page 3 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 137 Buckwood Avenue,Hyannis,MA Property Address: Robert Regan Owner. Date of Inspection: February 4, 1998 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes, No ` Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receivi g normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. A(�A As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components—excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material-of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: ✓_ _ The facility owner(arid occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. — Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) 115.302(3)(b)1 (raviaad 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Robert Regan Date of Inspection: February 4, 1998 RESIDENTIAL: FLOW CONDITIONS Design flow:�yO p.d./bedroom for S.A.S. Number of bedrooms: 9 Number of current residents: o2 Garbage grinder (yes or no): NO Laundry connected to system (yes or no): Seasonal use (yes or no): YES Water meter readings, if available (last two (2) year usage (gpd): 96 �y 7 = /.Z, 600j Sump Pump (yes or no): No Last date of occupancy: 'S e 9 7 a „( ,,e e-r e- c/u y o { COMMERCIAUINDUSTRIAL• Jl/I/9 Type of establishment: Design flow: I allons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pv�A-.,<�4 AI/a..I f 9c --"1) `p 1 C/1 Cn U Y' h ✓-)'t C- /] ✓7 7�1� I�•4 � f [ N Lh L<. System pumped as part of inspection: (yes o(no)�E S If yes, volume pumped: /ao0 eallons Reason for pumping: M , �— TYPE 9F SYSTEM Septic tan k/di9t6bvtkm-b0*js0iI absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sys s s e Sewage odors detected when arriving at the site: (yes or no) NU (revix•d 04/25/97) Page 5 0! 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Robert Regan Date of Inspection: February 4, 1998 BUILDING SEWER: 1,//19 (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site plan) Depth below grade: / Material of construction: /Concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions:_ S X ' x Sludge depth:_ y , Distance from top of sludge to bottom of outlet tee or baffle: o? Scum thickness: I �.y e�- 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: / How dimensions were determined: T'ro S c Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Co i- ,. e-4 -7��<- '�, �h f{ 4 c— ,,, J o o-I- ✓ou� �ork,�. o o� �� o av+ GREASE TRAP: /Vl� (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: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) ' (revised 04/25/97) a Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Robert Regan Date of Inspection:February 4, 1998 TIGHT OR HOLDING TANK:N//9 (Tank must be pumped prior to, or 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 level: Alarm in working order_ Yes;_ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:.'�Y///� (locate on site plan) Depth of liquid level above outlet invert: Comments: . (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER:V�/,9 (locate on site plan) Pumps in working order: (Yes or No) Alamo in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (reviaad 04/25/97) a Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: 137 Buckwood Avenue,Hyannis,MA Date of Inspection:RObert Regan February 4, 1998 SOIL ABSORPTION SYSTEM (SAS):, (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits, number. Uh �X L c� �, ✓J w �, o? - leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, s' ns o 6 hf hydraulic failure, level of ponding, condition of vegetation, etc.) / cA 6 G �f L U t o - o✓ ra C c c>. ow CESSPOOLS: _Y1/9 (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(cesspool must be pumped as part of inspection) 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.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Buckwood Avenue,Hyannis,MA Owner: Date of Inspection: Robert Regan February 4, 1998 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) Ij 01 fir L.r c T fact oZ2 �6 , l_...\ o�5 3y ' 31216 " I (revised 04/25/97) ry Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C /. 0 SYSTEM INFORMATION (continued) ty Address: 137 Buckwood Avenue,Hyannis,MA { wner: Robert Regan Date of Inspection: February 4, 1998 Depth to Groundwater Feet _ adjusted high groundwater level Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) dc%,,,d 0.,�er4,-d y ' 6�/b s6 h � (revised 04/25/97) Page 10 of 10 L T.O.F. EL.= 62.4+± FINISH GRADE OVER D-BOX= 60.5'± FINISH GRADE OVER CHAMBERS - 61 .1' - 60.5+ 3/4"TO 1-1/2" DOUBLE WASHED GENERAL NOTES PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM STONE TO CROWN OF PIPE f WITH COVER OVER INLET& i 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WI O RISER TO WITHIN 6"OF FINISHED GRADE 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE + OUTLET TO WITHIN 6"OF F G. + MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2"OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL, 60•7 ± F.G. OVER TANK EL_ = 60,5 ± 5 DIA. OUTLET(S) STONE OR GEOTEXTILE FILTER FABRIC -- -- - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE ., I I TOP OF SAS - 58.33+ PLACE RISERS ON ALL DESIGN ENGINEER. /--EXISTING 4" PROPOSED 4" 9 MIN. - CHAMBERS WITH " 9"MIN. � 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL 36" MAX. + iivLcT PIPES T G�' yr SEWER PIPE SCH. 40 PVC i f 57.5D 36"MAX. BREAKOUT EL= 58.00 \ 1 d f FINISHED GRADE SYSTEM UNLESS OTHERWISE NOTED. SEWER PIPE + 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" 2" DROP MAXI 3„ 9„ L 28 ± PROVIDE WATERTIGHT o o ELEVATION = 58.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN SLOPE @ 1/ I ' f I r�_\ 4" PVC IN FROM JOINTS (TYP.) �w� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 10 SEPTIC TANK 4" PVC OUT TO 0 00 0oTHE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14' � fl �CONTRACTOR TO PROVIDE ! - --- i LEACHING FACILITY oo , ,-- oo rI j� j� j o 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECfF1ED DROP BETWEEN �� L -� `-' I-� `-J 12" ) 00 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALOUTLET TEE 58.00+ M1 5j7.83+ 2 o 0 0 SHALL VERIFY SIZE 48' VERIFY CONDITION O \ o0 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE 00001 0 C 0 CD FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY o0 0 0 0NOT TO BE BACK FILLED TANK NECESSARY COMPACTED BASE 4.0' 4.0' ( I AND DESIGN ENGINEER. WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 5 � 8.5 (TYP) -I l, 4.0 -4.83' ---�+ 4.U OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 61.34, - --- TO BE INSTALLED ON A LEVEL STABLE i 25.0' (TYP.) ESTABLISHED ON THE FENCE POST AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 55.50' GROUND WATER ELEV= < 50.20+ J 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS 5 MIN` CHAMBER END ViEVV 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES GONT,, ERIFY EXISTIN, CROSS SECTION VIEW TYPICAL CHAMBER PROFILE (''` p � p �+ i TO THE DESIGN ENGINEER. ' ELEVATION PRIOR TO ANY WORK& ' .rIC ANK I Di6 i RIk�°�O I !(.)NH(.,,)X LSE I.AIL CHAMBER DETAILS NOT TO SCALE � _ NOT TO SCALE NOT TO SCALE � 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING --- ' - - + ! TI-ST P I T n AT!A REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM SWING-TIES - ' f �° ,o �. - PERC NO. 15496 APPROPRIATE AUTHORITY. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED DESCRIPTION HC-1 HC-2 j INSPECTOR: Donald Desmarais, R.S. �' , i, 0 UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR :' l' • , EVALUATOR: Michael Pimentel, E.I.T. TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING, CORNER OF STONE (1) 55.T 30.3' } . , • " ' . ;• •\ �+J C.S.E. APPROVAL DATE: OCt. 1999 CORNER OF STONE (2) 45.3' 25.9' • • '<;" f ! �"ll • :' -/ • DATE: October 12, 2017 13 DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. CORNER OF STONE (3} 64.4' S0.8° • � • �rl "�`°«� j/ • „ � •� r�,_-....+i TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. •g'• •�, ELEV TOP = 60.7U REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, MAP 272 CORNER OF STONE (4) 72.0 53.2' �• • f: l� f/ FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). llllll • • • . • ,V 10 . j d i, C, ELEV WATER= < 50.20 MAP 272 LOT 88 Benchmark •. // .�f! 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN ..,��� ,• . I! ll' `- PERC RATE _ <2 MIN/IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. Nail Set in Fence „ • U : \\\ LOT 69 `� "' ' DEPTH OF PERC = 30"-48" 16. PROPOSED PROJECT IS LOCATED WITHIN: �. Elev. =61.34' a J� Q! �. Approx. M.S.L. l/. 3 LOCUS is f ., j ' ASSESSORS MAP 2, �O, 8, .ti „ �, ) ,�. \ TEXTURAL CLASS:_! 1 �� + T ce) ; • � ` •g ` �' S$YV OWNER OF RECORD: DENNIS T. & HELEN R. KELLEY , �' �� oo x__. �� a !t t.i'•'r `' '�" 011 60.70 ADDRESS �'�.. •,'� ' ' • a '• 5� 137 BUCKWOOD DRIVE ©© t• t4• _ N • A Loamy Sand HYANNIu, MA 02601 ©� 1 Jt• } l ..•■ 10Yr 312 j } ! 4„ 60.3T FEMA FLOOD ZONE x �m�..,� 147 g J • • -EXISTING LEACHING PIT 0 9' • /�aJ • ' , • COMMUNITY PANEL# 25001 CO566J PUMPED AND FILLED S:'"- Nag 34'40 J •' ( ;<' Loam Sand y 17. DEED REFERENCE: BOOK 19083, PAGE 115 SHED CLEAN, COARSE SANi / 11 qP l�• it • B 10Yr 5/6 • ��,,._� 6„ 60xV 60xt3' ' , , 18. PLAN REFERENCE: PLAN BOOK 35404, PAGE A . . . r EXISTING 1000 GALLON x ' •� •{ ' ' _. 30" 58.20 ( % ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. SEPTIC TANK TO BE USED IN s' TW; DESIGN 1 J 1 3 Perc 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY r /� ry. i 48" 56.70' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY r' 11 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 14" MAP 272 12" 16 ° '` f yi '` 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A r• �' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A LOT 67 UJ 1 PROPOSED / / C Medium REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. DISTRIBUTION BOX / x � J Coarse 2 5Y 616nd 60x6 / �� J LOCUS PLAN TREE (TYP.) 14„ 15" l.11 60x3' X--- #137 EXISTING 2 „ 19' 2-BEDROOM / W I Uj SCALE: 1" = 1000' 126" 50.20' 10 DWELLING � TOF =62.4'± ' 4Q No Mottling, Standing or Weeping Observed PROPOSED 60x9' (3) 25Q• N � DESIGN DATA ST PIT A LEGEND' INSPECTION 8" • ^ N' J PERC NO. 15496 PORT -- -- (2) MAP 272 W EXISTING SPOT GRADE HC 2 "' INSPECTOR: Donald Desmarais, R.S. x 50 B.H. GAS METER LOT 87 co, NUMBER OF BEDROOMS (DESIGN) 2 (3 MIN. DESIGN PER TITLE 5) TP1 25.9' / E EVALUATOR: Michael Pimentel, E.L.T. - 50 - - EXISTING CONTOUR O 60x6' ' 11,070± S.F. DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 1999 + 50 PROPOSED CONTOUR 12' 60x7' TOTAL DESIGN FLOW 220 GAUDAY i3�" 61 � w � / DATE: October 12, 2017 1 _ (4) Hl i✓ J J DESIGN FLOW x 200 % = 440 GAUDAY 50 PROPOSED SPOT GRADE `, - i TEST PIT#:t-j> 2 i o v J o_ / w_'-�' ✓ USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 61.00' - ^` EXISTING GAS LINE 61x1' � ✓ 12"' DECK y� ELEV WATER = <50.50' EXISTING OVERHEAD UTILITIES 61x1' ` / (1) PERC RATE = �l � p � � -- W----1� EXISTING WATER LINE Ljj 60x6 ti INSTALL 2 - 500 GAL. CHAMBERS w/ AGGREGATE DEPTH OF PERC - PROPOSED TWO ( 60 GAS 500-GALLON LEACHING ? SIDEWALL CAPACITY TEST PIT LOCATION _'`�- GAS --, ,� / � Q. .� TEXTURAL CLASS: 1 CHAMBERS w/AGGREGATE G y_ ' G,as--______-_ u � �( QQ �O (25 0' + 83 WIDTH) (� SIDES)0.74 GPD/IS.F.)(O 112.0 GAUDAY AL/DAY - Q EXISTING 1,000 GALLON SEPTIC TANK N76°4,z1 BIT. DRIVE '� f O 011 61.00 40"w k I �\ V O BOTTOM CAPACITY Loam Sand 1 - PROPOSED 4 SOLID SCHEDULE 40 PVC PIPE (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY A y 10Yr 3/2 d PROPOSED DISTRIBUTION BOX (25.0' x 12.83'} (0.74 GPD/S.F.) = 237.4 GAUDAY 4, 60.6T PROPOSED 500 GALLON LEACHING CHAMBER MAP 272 , ( TOTALS: Loamy sand B 10Yr 516 LOT 86 �� I TOTAL NUMBER OF CHAMBERS 2 REV. DATE BY APP'D. DESCRIPTION TOTAL LEACHING AREA 472.2 sQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE TOTAL LEACHING CAPACITY 349.4 GAL./DAY 30" 58.50 WPREPARED FOR: J j CAPEWIDE ENTERPRISES J C Medium LOCATED AT o Coarse Sand 137 BUCKWOOD DRIVE 2.5Y 6/6 NOTES: " w HYAN N I S, MA 02601 SCALE: 1 INCH = 10 FT. DATE. OCTOBER 17, 2016 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 126" 50.50' o s io 20 ao FEET EACH SEPTIC SYSTEM COMPONENT. No Mottling, Standing or Weeping Observed ' ZN of i , 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF _- - _+ PREPARED BY: THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST RESERVFD FOR BOARD OF HEALTH USE JOHNL JC ENGINEERING, INC. CHUB ILL JR. �++ PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL 2854 CRANBERRY HIGHWAY BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. fsT� EAST WAREHAM, MA 02538 3.) PROPERTY IS LOCATED WITHIN THE GROUNDWATER PROTECTION SITE PLAN 508.273.0377 OVERLAY DISTRICT SCALE: 1" = 10' - _�_ i✓ a Drawn By AMC Designed By:MCP Checked By: JLC JOB No.3967