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HomeMy WebLinkAbout0094 CARLOTTA AVENUE - Health 94 CARLOTTA AVENUE,HYANNIS A= r v TOWN OF BARNSTABLE D r LOCATION SEWAGE D VILLAGE Y(�4AA t. ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. W nn SEPTIC TANK CAPACITY l515 LEACHING FACILITY.(type) ��l�r.� /CcL►��� J (size) NO.OF BEDROOMS 3 C�J OWNER ors PERMIT DATE: pq, COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility v�� 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 v '/r• at. ��r 3 l o . -.n ty ' P i O � J FJ a C M � e N TOWN OF BARNSTABLE LOCATTON. 'ICI CRC O® Ate, 6I PVY%cS SEWAGE # VILLA& PAV % ASSESSOR'S MAP & LOT INSTALLER'S NM& HONE NO. 90b-0501 "71S-'7gAto SEPTIC TANK CAPACITY C-Q-Gra WOCK Cezpp o is LEACHING FACELITY: (type) (size) NO.OF.BEDROOMS BUILDER.OR OWNER ReAfth— PERMTTDATE: COMPLIANCE DATE: �� Separatioxi Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Welland 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 64, O (9 11 0 �P r ter+ 4 O cs No. �s Fee THE COMMONWEALTH OF MASSACHUSETTS , Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Mioogal 6p5tem Cow6truction Permit Application for a Permit to Construct( ) Repair() Upgrade( ) Abandon( ) ❑ Complete Systemp❑In/d_ividual Components Location Address or Lot No Owner's Name_Address,and Tel.No.�J"3�E1��— qq UAA©4 4c.. Aw-li e, No v, 5 e :�0�^o s� . Assessor's Map/Parcel 1: .4 CiS' " L1 'C, —'0..4C, w%e ,,� -t> 09-_775, 77(p Designer's 3(0`4_080 � Installer's Name Address,and Tel.No. gner's Na e,Address and Tel.No. 15 h D 1 O g _ Ot t-.°t, UL-e-, -�) IL- Car, ►� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder l q Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable��5 � � q)e-1��7, tE_S 50M. _',.Date last inspected: ,Aglement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Q-003' —C3_7 (4 Date Issued o R, .---....._......• ..>.t�,.-,..�-,: '- y �.� _ ../ r++.rr�-.., -`:�..;`Wy.,,,,,_�•d"aw-'r,-,.-«. :._.di-.•..+*''^'�.c:�,;,.�r�i a.:v-,'-•.r.�.-5---t`+.-�3.«-- . r-z.�..r .. No. . / / Fee 00. 1 Entered in computer: E�COMMONWEALTH OF MASSACHUS�TJS,,�, "Yes PUBLIC HEALTH DIVISION - TOWN.OF BARNSTABLE,'MASSACHUSETTS application for �hgpo$ar *pztem Con!6tructton Permit Application for a Permit to Construct( ) Repair V) Upgrade( ) Abandon( ) ❑Complete System❑Individual Components Location Address or Lot N Owner's Name Address,and Tel.No.So - J ���`j 137 RW Ca,�o-F4c._ J -v".0-noe, °-76,o V�sq-i,.e, Assessor's Map/Parcel l' R y �� Installer's Name,Address,and Tel.No�$r L Designer's Name,Address and Tel.No.5f�&-3(oq+0 o ` k 1�i`^ l; , t�.0\oi r'S�j�rti St' S �p_ •�,� n �� "� ` Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder'(`) Other Type of Building No.of Persons Showers( ') Cafeteria( ) Other Fixtures �r Design Flow(min.required) gpd Design flow provided $ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil J Nature of Repairs or Alterations(Answer when applicable)�6?4­Q�Q_ Date last inspected: r` Agreement.: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si.ned Date Application Approved by Date �9N� Application Disapproved by: Date for the following reasons Permit No. ©dg " (n�7 L( Date Issued ,_�I9 0 l THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance 4 THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (,O Upgraded ( ) t Abandoned,( )`by M Ci 1 fISG`n S1' �o�lL atgL( c Ifs _ Alyl f11l e f VA-uax\%\k 5 . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "d� L dated Installer Designer ., #bedrooms Approved design flow d The issuance of this P,e i shall/oaf be constru�er)drasguardritee that the syste _2il'1 function as design Date l/ � �1Y Inspector1� a� . ��/rl r iT1 y/mil/� // V ��-pr�c�-- 7 -/—���— �=> ----------- U -- —j— —�— No. �p -Q / � Feel3 THE COMMONWEALTH OF MASSACHUSETTS S�` -e-- PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS, %t!5 pogat *pgtem Construction Permit Permission is hereby granted�to Construct ( ) °Repair (x ) Upgrade pgrade ( ) Abandon ( ) System located at �I l_ .�(7 ►\ .Inv P Cis d(�/�V1'k J i r / and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constructi n must be completed within three years of thCdateof this permitDate �)0 Appby . ... . - Town:of Barnstable _ Regulatory Services Thomas F_Geiler,Director- * MASS. - : Public Health_-Division... Tho mas 1V1cKean,IDirector :- 200 MainSireet,_HyanWs,WU-A1601- Office: 508-862 644 Fax: 508-790-6304 .. Installer&Designer Form: j SevPage.Permit# U �r . Assessor's MwParcel Pq� qS Designer.. �C C '1 nstaIler: 1( 1 Ns�, S� � ✓N' 'L Address t e_ CC,- Address:: . u��c OnN1 '' was:issued ap ernut to:.install a (date). (installer) septic system .:based on a design:drau+n by (address) dated- (designer) I certify that the septic,system referenced.above was installed substantially according to... the:design; which may include minor approved-changes-such as lateral-relocation-of the distribution box and/or;septic tank: - _ that_th tic system: -w e s referenced above as italldnse witha m or-changes. . i e I certify . - � g ( . . . . greater than 10' septic..lateral relocation of the SAS-or-any vertical-relocation.of any component of iho-septic systeiia}`but in accordance with'State,&-Lot a -Regulations: Plan:revision or . : certified as-built-by-designer to follow. : ✓0<...�i� (Installer.s.Signature). . i DER ` No. 114a IIq (Designer's Signature) (Affix Designers Stamp:FIere) GawvP C6u6Naw PLEASE. RE T© ::.�ARNSTABLE 'PUBLIC =HEALTH DIVISION. :: .:CERTIFICATE: QF+ _ . COMPLIANCE -wiLL..NOT:_BE:.ISSUlED..IINTII. BOTH-.THEM-IORNI.AND:AS-BUILT:CARD::ARE. RECEIVED:BY THE BARNSTABLE PIIBLIC.HEALTH-DIVISION:-.THANKYOII:. Q:Health/Septic/Designer Certification Form3-26 0 oc - Town of Barnstable P# Department of Regulatory Services F Public Health Division Date "Iy h 3 ?mod 200 Main Street,Hyannis MA 02601 AlY 122:Date Scheduled ® Time Fee Pd, Soil Suitability Assessment for Sewage Disposal Performed By: olsU1&t Witnessed By: WOW11k WORTYIJDI LOCATIO�& GENERAL INFORMATION Location Address q+ Cq lrt off e) J/I-Ve- Owner's Name��yl F or s Y- � e 15 Address g4 CAI lade Assessor's Map/Part e l: 5 ` Engineer's Name !/gip Ott pr iy NEW CONSTRUCTION REPAIR Telephone# Slopes(%) y Surface Stones y o7 j e Distances from: Open Water Body 6� ft Possible Wet Area 1v� t ft Drinking Water Well Cojq 4 ft` Drainage Way 50 t ft Property Line t© � ft Other ft -SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) X, . i\1m 1\A \1e `e� k GROUNDWATER ADJUSTMENT ' F EXISTING GROUNDWATER LEVEL kk BASED ON TOWN OF BARNSTABLE 1 1 GIS DEPARTMENT RECORDS. f INDICATED GW 19.00 I` INDEX WELL M1W-29 f ZONE D READING DATE JAN 2008 READING 9.5 ADJUSTMENT 6.3 i ADJUSTED GW 25.3 �\ ­274- f Parent material(geologic) �o ie v✓°!5 Depth to Bedrock Depth to Groundwater. Standing Water in Hole: N ®he Weeping from Pit Face l D K Estimated Seasonal High Groundwater DETEATION FOR SEASONAL HIGH WATER TABLE Method Used: See_ G 0 11(!_ Depth Observed standing in obs.hole: - - __in, Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustmeat ft. Index Well# Reading Date: Index Well level Adj,lhctor- Adj.droundwater Level PERCOLATION TEST betel (31 N^nme'1 O-AM Observation N/9 Hole# I Time at 4" Depth of Pero G© 1 h Time at w �'jo Start Pre-soak Time C� ' �� 'lime(9"4") End Pre-soak ^V ' 's Rate MinJlnch Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. I�l� Barnstable Conservation Division at least one(1)week prior to beginning. J Q:\SEPTICIPERCFORM.DOC I SOIL TEST LOG ' DATE OF TEST: FEBRUARY 13. 2008 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. PERC NUMBER: 12101 P i TEST PIT 1 ! NO GROUNDWATER ENCOUNTERED PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 60 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 52.55 (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING " i 0-12 FILL 12-16 Ap LOAMY SAND 10 YR 3/4 NONE FRIABLE 49.38 16-3B B LOAMY SAND 10 YR 5/6 NONE FRIABLE I j 36-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 41.55 i NO TEST PIT 2 COUNTERE PAARENOTUMAATERIA EPROGLAC ALD OUTWASH 2 MIN/INCH IN C SCILS a i ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 52.40 (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING 0-10 FILL �J� / 10-15 Ap LOAMY SAND 10 YR 3/3 NONE FR'T1 49.40 15-36 B LOAMY SAND 10 YR 5/6 NONE FR 36-132 C MEDUIM SAND 10 YR 6/4 NONE LO. 41.40 - - —- - - - - Csistency.%G vel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munselp Mottling (Structure,Stones;Boulders. Consistency, t. Flood Insurance Rate Map: / Above 500 year flood boundary No_ Yes .y__ Within 500 year boundary No S✓ Yes " Within 100 year flood boundary No! Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? `'tE S _— If not,what is the depth of naturally occurring pervious material? Certification " I certify that on��J (�R (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 310 CMR 15.017. ova zH OF Afj I 9 wo " 7 Q DAVID, Signature L� Date o� D. COUGHANOWR 190 �'CENSE1 Q Q:\.SEpTiC1PERCFORM.DOC ,� E VA L U;', Commonwealth of Massachusetts ✓q R�Cf/JF� W., N Executive Office of Environmental Affairs 19 Department of �� � 96 Environmental Protection will um vwld Trudy Coxe e. ,.,Y.EOEA David B. Struhs �Dfnmialioner - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address:Cly Crl I; T+H Av }-�yq;�n„ Address of Owner: Date of'Inspection: 14-b ctS Of different) �� KA Name of Inspector: ��,�1,gr���kc►.>>: S:�wn i :� =cii tr,?. Company Name, Address and Telephone Number: CERTIFICATION STATEMENT ��� �?��►=` I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of 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: Date:The System 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 flo%% of 10,000 god 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 appiicabie and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A] 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. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate , no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) T The septic tank is metal, 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. (revised 6/15/95) 1 One VAnter Street • Boston,Massachusetts 02108 • FAX(617)SWID49 a Tdephone(617)292-SM Panted on Recoul Paper , L, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: C+4 C,A-I t��n .Hv Owner: k,to tti i A,,A_ , Date of Inspection: i 1_L e) SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water leve rved in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven di 'Zion box. The system will pass inspection if(with approval of the Board of Health): broken pipe are replaced obstructi is removed distri tion box is levelled or replaced _ The system required pum g more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with appr al of the Board of Health): broken pipes: are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require,further evaluation by the Board ealth 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- ETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEA AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within feet of a st.rface water Cesspool or privy is w in 50 feet of a bordering vegetated wetland or a salt marsh. 1) SYSTEM WILL FAIL UN S THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FU ' ZONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT _ The cvctem has a septic tank ano soo absorption system and is within 100 feet to a wrfaLe waiel suNN;y 01 ihbutal> iu a surface water supply. _ The s%c!e ha, a septic tank and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The systen, hat a septic tank and soil absorption system and 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• D) SYSTEM FAILS: I have determined that the system violates one or more of following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board eahh should be contacted to determine what will be necessary, to correct the failure. Backup of sewage into below, r system component due to an overloaded or dogged SAS or Cesspool. Discharge or pondin effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) cf�� R�� Property Address: q�{ C� � W Ywvv� _ Owner: Date of Inspection: (�,.�—Ci5r D]SYSTEM FAILS (continued): Static liquid level in the distribution box above outlet ' vert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below i ert or available volume is less than 112 day flow. Required pumping more than 4 times in a last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorpti System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool privy is within 100 feet of a surface water supply or tributary to a surface water supply. j Any portion of a cess of or privy is within a Zone I of a public well. Any portion of esspool or privy is within 50 feet of a private water supply well. Any portion of 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: The following criteria apply to large systems in addition to the criteria above: The design flo%/becael is 10,000 gp r greater (Large System; and the system is a significant threat to public health and safety and the envirouse one o ore of the following conditions exist: the shin 0 feet of a surface drinking water supply the'shin 200 feet of a tributary to a surface drinking water supply the cated in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a publ, ply welh 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. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: C(y Owner: Date of Inspection: Check if the following have been done: Pumping.information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for.at least two weeks and the system has been receiving normal flow rates during that period Large volumes of water have not been introduced into the system recently or as pan of this inspection. ' 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. y,/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 existing information or approximated b\ non-intrusive methods. The facili;) o.,.nc- ;anal occupants, if fro!r ovine•' were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 a ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: 2 .-gal Ions Number of bedrooms:_ Number of current residents: Garbage grinder (yes or no): N,� Laundry connected to system (yes or no):. Seasonal use (yes or no): Water meter readings, if available: lk-c c q% Last date of occupancy:;; COMMERCIAUINDUSTRIAL: Type of establishment: Design flow:_gallons/day Grease trap present: (yes or., o)_ Industrial Waste Holding lank present: (yes or no)_ Non-sanitary waste d3Eharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of cupancy: OTHER Describe) Last to of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no) �jc If yes, volume pumped gallons Reason for pumping. TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool _ ( Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) LL (revised 8/15/95) S ; f k SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: q4 (A"I"{44 Iiv 0"IAnrl.s Owner: k4R Date of Inspection: SEPTIC TANK:hyv\� (locate on site plan) / Depth below grade: Material of construction: concrete_,metal _FRP—other(explain) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: Commenty, / (recomn)endation 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.) GREASE TRAP:_hLGfvc ..a (locate on site plan) Depth belo",'grade: Material of construction: —concrete,_metal _FRP —other(explain) Dimensions. Scum thickness. Distance from top of sc to top of outlet tee or baffle: Dicta^ce fro-. botto^^,,9' «i'm to hottom of outle? tee or b3ffle Comments. (recommend,aWo/n 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 8/!5/95; 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: `14 F{yP�,na Owner: It. Etlgvd Date of Inspection: TIGHT OR HOLDING TANK: c;t S (locate on site plan) Depth below grade: Material of construction: _concrete_metal FRP_other(explain) Dimensions: Capaci6% eallons Design flow:_ ¢allonVday Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: Kv:' r (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if leve! and d bue:c e, a', e. de^:e e!�o' ds �a n P�, evidence of leakage into or out of box, etc.) i PUMP CHAMBER: Cf•� C:1 �,,ic (locate on site plan) Pumps in working order.(yes or n Comments: (note condition of pu chamber, condition of pumps and appurtenances, etc.) (revised 6/15/9s) 7 _ W SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 9 y C.'O Q f+A Ave. Ny/�,�11•� Owner: jz'i ps 0-'I A'A Date of Inspection: (N_6. ti 7 SOIL ABSORPTION SYSTEM (SAS): I/ (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:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number:_ Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) , Etc &l,C1 N;:iS 41 64- LIU. L'— 1II54-J C•1 'JJirl-J A. /:lcf, � runt, OL th•a,\ �'k F.iit At Anl 4.7i CESSPOOLS: (locate on site plan) Number and configuration: I-L z a h r k gcc Depth-top of liquid to inlet invert: Z`4 f+- Depth of solids layer: to, c:, a:Z k0c.:N fc k. ,an y` •d Depth of scum layer: Dimensions of cesspool: , Materials of construction: ;.•. ,t. indication of groundwater a.oc, inflow (cesspool must be pumped as part of inspection) l Fie,.: 1'.'c I s, d:v rA� }i•l�i •hr'�.T`� L h n,.t 't i ri i P• 14<•Y\ Comments: (note condition of soil, signs of hydraulic failure; level of ponding, condition of vegetation, etc.) C [rSh)`[fc .• - r Kt:7 CC,44� ca rj} f i-ry— C+— PRIVY:_ (locate on site plan) Materials of con etion: Dimensions: Depth of solid .— its.. ote condition of soil, signs of hydraulic failure,.level of ponding, condition of vegetation, etc.) (revised 8/15/95) B l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: l{ (��^ c A.� F�►��n Own Date of of Inspection: ►a�b pis SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' L 94 C P-- r otta avc i �1T• 7L- 5) Lo5 \ DEPTH TO GROUNDWATER t Depth to groundwater: _feet method of determination or approximation: (revised 6/15/95) 9 SOIL TEST .. BOG , . DATE OF TEST: FEBRUARY 13. 2008 DESIGN CALCULATIONS APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR, #461 WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPO PERC NUMBER: 12101 SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS 1 INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) TEST PIT 1 PAARENOTUMAATERIIAL ENCOUNTERED AL OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. PERC AT 60 in - 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 33 FL x 6.5 Ft- x 2 Ft LEACHING GALLERY CAN LEACH ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER Abot, = ( 33 x 6.5 ) = 280.5 sf (INCHES) HORIZON TEXTURE (MUNSELLI MOTTLING A = ( + 33 8.5 + 8.5 l x 2 = 166 sf 52.55 AtoL = 446.6.5 sf 0-12 FILL Vt 0.74 x 446.5 = 330.41 GPD 12-16 Ap LOAMY SAND 10 YR 3/4 NONE FRIABLE USE A 33 Ft. x 8.5 Ft_ x 2 Ft GALLERY. Vt. = 330.41 GPD > 330 GPD REQUIRED 16-38 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 49.38 38-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 41.55 1500 GALLON SEPTIC TANK TO NO GROUNDWATER ENCOUNTERED LEACHING GALLER SCALE DIMENSIONS AND DETAIL NOT Y NOT USE SHOREY ST-1500-H-10 SCALE TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH CONSTRUCTION DETAIL 2 MIN/INCH IN C SOILS USE CULTEC RECHARGER 330 CHAMBERS (H-20 LOADING) ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 1 in (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING TAPER 52.40 0-10 FILL END CENTER CENTER END w 10-15 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE uNlr uNlr uNlr uNlr N m o 0 5 Ft- 15-36 B LOAMY SAND 10 YR 5/6 NONE FRIABLE , C 8 in 49.40 " 36-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 3.375 f 26.25 ft 3.375 ft 41.40 33.0 Ft 0 1� f � (� GROUNDWATER ADJUSTMENT CROSS SECTION VIEW EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS: 2 ,n 4 2,n PEAS rONE INLET CENTER OUTLET END COVER END INDICATED GW 19.00 24 i., 3/4 in TO INDEX WELL M1W-29 26 to EFFECTIVE 1-1/21n GRAVEL ZONE D DEPTH �3 IN DROP �,. READING DATE JAN 2008 —► -FLOW LINE READING 9.5 25 to 52 to 25 to FROM IB in = 14 TO ADJUSTMENT 6.3 BUILDING ADJUSTED GW 25.3 lee '^ �n D-eox INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE 48 in LIQUID GAS FABRIC IN PLACE OF THE PEASTONE LAYER SPECIFIED LEVEL BAFFLE NOTES 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. CROSS SECTION VIEW 2) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 3) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 4) EXISTING CESSPOOLS TO BE PUMPED. COLLAPSED. AND FILLED OR REMOVED. 5) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLA'CE. ` -TO SERVE EXISTING DWELLING 6) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES JOHN ❑. FORSYTHE AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. 71 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT 94 CARLOTTA AVENUE HYANNIS, MA • PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. ECO-TECH ENVIRONMENTAL 8l' SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-2657T FEBRUARY 13. 2008 212 HYANNIS. MA NOTE CONTOURS LINDA LANE ^' LEGEND EXISTING CESSPOOLS ARE TO BE PUMPED. EXISTING - - - - - '50 + ❑ 1 V COLLAPSED AND FILLED OR REMOVED. MINIMAL GRADING PROPOSED 1500 GALLON > � CARLA ROAD SEPTIC TANK � o m -+ m -+ W LOCUS Q oZr EXISTING O ? �o C1`"w CESSPOOL �� 'o� AVENUE � ow< m N .�� ` BENCH MARK 0 o v mJc3 TEST PIT® D-BOX ❑ TOP CORNER OF DECK X u DECIDUOUS CONIFEROUS AO f j��' ELEVATION = 5 3.8 2 LOCUS M A P w a J TREE q�p TREE 1��' �� LOT 44 \ BARNSTABLE GIS DATUM NOT TO SCALE ❑m U? U7 Z W d �]2-M 12-P �W�� m �Q .�C ARE/ = 10950 sf+- \ DISTANCES -NUMBER REFERS TO DIAMETER IN J W J d � W 3 INCHES. LETTER DENOTES TYPE. \� WW O C ; N� O-OAK M-MAPLE P-PINE C-CEDAR \ \6a TO LEACHING GALLERY = J I O z } w OW CD O i \6 ALL DISTANCES ARE IN DECIMAL Z< <�Z< = W W Z F_ /� `F FEET NOT IN FEET AND INCHES. .,Z > o 7= i \ NOT TO mo 4X U _j 0 J Lq 00 O \ SCALE O m F m W < W W m Q I 53 ��/ e cri N v —I (D ❑ JV O< OU W W \ \ Ui z � H (!l \ - 'Q \ ` O O� \\ A B C A T j O Z n 4 �_ _ \ \ S� v 1 28.5 17.3 31.3 C B i- U \ .a Z 2 23.7 9.0 --- W X l 2 IT O O? ❑ WW � \ 3 55.2 31.2 34.8 W Zo ❑ m m 2 `Ci e m v `\ \ k\ P`G \ 4 34.5 40.7 I W Z I W U❑ I IT m �Q \ P•� _\�� W I: LiWZ 9 I— U 0- x - Fco��mo_ O-n\ P �� 4 cn <J (n Wov = o J X'N e o ~ J Z 3�\ ` �� ' QSp D. i� moo DAVID yGs �o�' DAVID y�N z �, J N ,, J / O Z i�f� COUGHANOWR N U r WO zo m ,� \ PP/ J �3a No. 1093 COUGH/1NOW�. �W ff w m `° \\ '/ 33 f t X 8.5 f t x 2 f t �FG►STE�``� so '�Eriss°oq- e w ° —p TP-2 � 1e�� LEACHING GALLERY sq / / \\ J a � C-eb�'U,ir y 13, ZD0� 4Ln GARBAGE GRINDER SEWAGE DISPOSAL SYSTEM PLAN WZO Z IS NOT ALLOWED �� ~ �/ ��®� ��� -TO SERVE EXISTING DWELLING r-i J WITH THIS DESIGN. LL J , EST. JOHN D. FORSYTHE O0 00 U \ OWNER OF RECORD N 0 0 ` C� PLAN %I% � 94 CARLOTTA AVENUE L_L_ 1995 �' � � � � � � �` G � HYANNIS, MA � � wSCALE. lim = 20ftVARIANCE REQUESTED ®N�41 PROPERTY ADDRESS r 20 `� 0 20 40 ASSESSORS MAP 2 4 8 PARCEL 9 5 43 TRIANGLE CIRCLE MAY BE GRANTED IMMEDIATELY BY HEALTH AGENT OR HEALTH INSPECTOR. SANDWICH MA 02563 PLAN BOOK 165 PAGE 41 O0 10 20 506 364-0694p '� � 31td CMR 15.211(1) - SOIL ABSORPTION DATE: FEBRIJARY 13. 2008 J N `` SYSTEM TO SLAB FOUNDATION. JO f t woe B E T E-2 8 57 PAGE 1 OF 2 VERSION: o W U m `� MIN REQUIRED - VARIANCE TO 8.5 ft h ~ m SEPARATION REQUESTED. THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING PLACEMENT OF ADDITIONS. SHEDS, FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR.