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Home My WebLink About0260 CASTLEWOOD CIRCLE - Health E= 273 LEWOOD CIRCLE, HYANNIS 27 I's I TC)WNOF.BARN xABLE A.'ss8Sat?R'S MA:I'&1LQ: 3INSTAr LRR'S NAME BPZ'C xANK;CAPAC Y �C ..�--_---- .� _..;:. f A I> tC PACILTry, No OF ISSPRIP ITDIIAPa 'N:,._._ Cd1b� TCE .Sopration DMIlwace.T3 Weett tkie Mrlxiin tm Adjusted.Gi pbWwKtev Uble;ta the Bottom of X�;ac;h{zip ?su lUty ..... �.---. ret 1'dlvatv'R�Jnt�r:age{ply . lc l Asir�;Y.c��.6lIng l�acsliry �E•19s ex(si �pti9 y air seta os ev thin�Qa ge t o 1�ac68 ACII00, }�) V'Vodind and lt:eac6u6g:Fa duty(1(r ratty a�ci�atti�5 ex�54. xv�@.Kilt_d11t1 fee,tp 1Filral3hod by u A\N 1 b n o o w �' TOWN OF BARNSTA.BLE LOCATION 2G O 4isde-,,,ayd 6ii-d e SEWAGE# ;201 j 16?1 VILLAGE y s ASSESSOR'S MAP&PARCEL ZZ _7 INSTALLER'S NAME&PHONE NO: b �� A -R)na1ri T"C- SEPTIC TANK CAPACITY F—ryt,�Q,,js LEACHING FACILITY:(type) L c.Co -C Jj c m, 0'P r,5 (size) PJ NO.OF BEDROOMS OWNER Cc.,%,A PERMIT DATE: 6-2-- I Cv COMPLIANCE DATE: .�-,C,-I G Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S,reTc,^J 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 BYE e 9 I -i^ � r � 1 0 � � t er► � ` I %on Q M1S IE w ; C ' Q 1 l i - - TOWN OF BARNSTABLE _ - - LOCATION 2 60 t�PJA W0°C(- 64 SEWAGE # VILLAGE �c.vt w" ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. R SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER O Og PERMIT DATE: DATE: -��—) 2) 0',,, 6; Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leachin facility) Feet Furnished b -, ey A . _ .R_ �.� T \ � . . . ` b f\ m 0 �1 �. r ^. .� . .�, ,�� .�. �. �;, Q. .�. � .. J ' a :�3-. oa 3- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t • 260 Castlewood Circle u— Property Address Kathryn Gill Owner Owner's Name/ information is Hyannis t/ Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 6 P !q gU")'9 on the computer, Brett Hickey use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name key. 374 Route 130 VIC] Company Address Sandwich Ma 02563 City/Town State Zip Code rare (508)477-0653 S113747 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. M Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Brett Hicke Digitally signed by Bren Hickey . y „ Date:2020.09.25 14:57:27-04'001 9-24-2020 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.cloc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts --- - - Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments z� 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1,2, 3,or 5 and all of 4 and 6. 1) System Passes: ❑■ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The system was in working order at the time of inspection. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts P Title 5 Official Inspection Form �} Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y St page. City/Town ate Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board.of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Tl6e 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ El clogged of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts :. Title 5 Official Inspection Form - - Subsurface Sewage Disposal System Form Not for Voluntary Assessments . „J 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ El 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 1/z day flow ❑ 0 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ 0 Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Q Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Q Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ E Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑ The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ 0 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts 1n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No El ❑ Pumping information was provided by the owner,occupant, or Board of Health ❑ El Were any of the system components pumped out in the previous two weeks? El ❑ Has the system received normal flows in the previous two week period? ❑ O Have large volumes of water been introduced to the system recently or as part of this inspection? O ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ 0 Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ 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? ❑ 0 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: E ❑ Existing information. For example,a plan at the Board of Health. ❑ ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Wage 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form t � Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 2 2 Number of bedrooms(design): Number of bedrooms(actual): 337/GPD DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Description: 1 Number of current residents: Does residence have a garbage grinder? ❑ Yes 0 No Does residence have a water treatment unit? ❑ Yes ❑. No If yes, discharges to: I Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes No See below Water meter readings, if available(last 2 years usage(gpd)): Detail: 2019 are only records on file 68,000gallons Sump pump? ❑ Yes ❑■ No current Last date of occupancy: Date I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 i Commonwealth of Massachusetts h - Title 5 OfficialInspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: NA Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow seats/ ersons/s .ft. etc.): 9 ( P q ) Grease trap present? ❑ Yes ❑ No Water treatment unit resent? Yes No P ❑ ❑ If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- last pumped 2017 Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments <, 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: 0 Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 2016 per plans Were sewage odors detected when arriving at the site? ❑ Yes No 5. Building Sewer(locate on site plan): 1'6" � Depth below grade: feet Material of construction: ❑ cast iron 40 PVC ❑other(explain): Town water Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Y Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 611 Depth below grade: 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 1 Dimensions: 000gallons 9„ Sludge depth: 2711 Distance from top of sludge to bottom of outlet tee or baffle n 2 Scum thickness 611 Distance from top of scum to top of outlet tee or baffle 1491 Distance from bottom of scum to bottom of outlet tee or baffle measured How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was in working order at the time of inspection. The tank is in need of pumping at this time and should be pumped every two years for maintenance. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is required for every Hyannis Ma 02601 9-24-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: NAfeet 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.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: NA Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t51nsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches,etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Orr Depth of liquid level above outlet invert 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.): The d-box was in working order at the time of inspection. 15insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts n. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: (6)LC6 chambers F leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology; t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts = -- Inspection Form� Title 5 Official Ins p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS)(cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was in working order at the time of inspection. Leaching was dry when viewed with no evidence of past back up. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form !, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): NA Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle w Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑■ hand-sketch in the area below ❑ drawing attached separately TOWN OF RAJ*MrAvouz 1VCAW" d " VUAA(M � �iklwm�TaIE 1as 1b�lr: aaiR` V, post aaHt t `?wctadmen aorl+writes f:i�s��l: ' /fit* ' AWO t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 1 Commonwealth of Massachusetts =_ Title 5 Official Inspection Form I� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every Y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' 15. Site Exam: ❑■ Check Slope ❑■ Surface water ❑■ Check cellar ❑■ Shallow wells Estimated depth to high ground water: No GW @ 120" feet Please indicate all methods used to determine the high ground water elevation: El Obtained from system design plans on record 4-29-2016 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: A plan on file at the local Board of Health was used to determine high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts -3F Title 5 Official Inspection Form - a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Circle Property Address Kathryn Gill Owner Owner's Name information is Hyannis Ma 02601 9-24-2020 required for every y page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: �■ A. Inspector Information: Complete all fields in this section. �■ B. Certification: Signed& Dated and 1, 2, 3,or 4 checked ❑■ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed 0■ D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Town of Barnstable Regulatory Services Richard V. Scali,Interim Director MAW • ,Ntxsrn�[,e. pQ 1639. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601. Office: 508-862-4644 Fax: 508-790-6304 ( JJ Installer&Designer Certification Form Date: . ! Jf Sewage Permit# Zo 1 tG- 1 Assessor's MaplPareel 27Z✓ -4 Z7 Designer: v,�a v,�' t-Oc;-Lg 1,,, ` Installer: lam. >Q►- w o-%_ k to c_ Address: ► Z W, KCA Address: MA- o70-1` On ( 2-t V A, 3 ry.,J q �K L was issued a permit to install a (date) (installer) septic system at 2-44a CAS VJQ,- 10 }used on a design drawn by (address) WV 0 L i;,f-��C. f dated 4"1 zq I ( (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. 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 certi led 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 in co fiance with the terms of the T\A approval letters (if applicable) c PETER T. MGENIEE nsta er's Signature) civic No. 35109 (Designer's Signature) (Affix Desi Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION, CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BAi2NSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Desi8ner Certification Fonn Rev&14-13.doe r No. —V '� I/Z/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Disposal 6pstem Construction 3pPrmit Application for a Permit to Construct( ) Repair(P<1U"pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C.I eG Owner's Name,Address,and Tel.No. Assess6r's Map/Parcel 02 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms oZ\\ Lot Size b4T L[ sq.ft. Garbage Grinder( ) Other Type of Building if C S t VpN V fCr 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ;L 2-0 gpd Design flow provided 2 3 7. c gpd Plan Date IV—2,9 —1 C. Number of sheets 2-._ Revision Date Title " Size of Septic Tank 8 Y- �S�'�S Type of S.A.S. �L (` F-I ' 2-© C V1Gti/vt10e,r Description of Soil Nature of Repairs or Alterations(Answer when applicable) i n1, 4 1 A ^3 k) C)-,\00 "C) C 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. d Date Application Approved Date Application Disapproved by Date for the following reasons Permit No.�� 6 (46 Date Issued 12 No. � �J� ,- M9 R Fee �V THE COMMONWEALTH OF MASSACHUSETTS Entered incomputer: t; Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for Disposal �&pstrm Constructions Vermit Application for a Permit to,Construct( ) Repair(11�upgrade( ) Abandon( ) ❑Complete System ❑Individual Components r. Location Address or Lot No. Owner's Name,Address,and Tel.No. Assess6r's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. v as A 134c>voni Toc �nf3-`�'�O-yS�y N iNrtrrti 1AA01le-s Type of Building: Dwelling No.of Bedrooms o2\\ Lot Size lbc(Li& sq.ft. Garbage Grinder( ) Other Type of Building V C S CI t k-N F tG 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) A.ZQ gpd Design flow provided 2 3 `], t j gpd Plan Date q- 2.9 -1 C. Number of sheets 2-. Revision Date Title " Size of Septic Tank t°X 51"y s Type of S.A.S. G 14 - 20 C Y1C�M�OPf Description of Soil Nature of Repairs or Alterations(Answer when applicable) t^3 1 GL t'to C)- w C) L C �/1GMiC)W/S G, 0AA S+ON r- CAS S 60%_v4 0,0 1Q 1 Gnu e Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described bn-site sewage dis osal system in g g g P Y accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of tn Compliance has been issued by this Board of Health. S.i ed Date Application I Approved Date pp _ Application Disapproved by Date for the following reasons Permit No. ' 6 Date Issued --------------------- ----------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned b nJ _T �`C S� I J[r��..� L n]C T at i _ �,s� I, we ar/ C %,(c JA V I�A,,.,; has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. /dated 66//6r Installer\ij e l c,% A (awN Svc Designer "� .� �/ #bedrooms �v Approved design fl w__ —-4 ('� gpd The issuance oftL is permit shall not be construed as a guarantee that the system w fun io) as desi ed. Q Date Inspector --------------------------------------- / ----------------------------------------------------------------------------------- No. ir I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposaf *pstem onstrUction i3ermit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at Z 1Z p Ile, r'f r...v©d Circe' 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 w'hin three years of the date of this pxjnit. Date Approve 'y'-' 27 o ro'S ;s I �oJ Cz"e, u it l - C\��k c wv v CSC l:( � y(/L+v/✓! M�v V �JM V�J-nb' R +Lf � L _ _ No. � ( .4 — ` I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes J 01pplitation for t1 6a' 6pstem Construction 30Prmit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location AdIps or Lot-No,-Z C4.5 t_� C!/'c- Owner's Name,Address,and Tel.No. Ci Y4niN/cj Z B Assessor's Map/Parcel Z,73 - ® Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: , Dwelling No.of Bedrooms `rL Lot Size C r' 4 sq.ft. Garbage Grinder( ) Other Type of Building feS 1� }-ICA, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2-2-0 gpd Design w provide�Rsion � gpd Plan Date 4-2 A -►G Number of sheets ate Title Size of Septic Tank �CfS�!^� ype o .A.S. ��© G 1 1J Description of Soil Nature of Repairs or Alterations(Ans when app i e) PCB OCR O C.� V� r W a Date last inspected: Agreement: The undersigned a ees to ensure the construction and m ntenance of the afore described on-site sewage disposal system in accordance with the provisio s of Title 5 of he Environmental Co e and not to place the system in operation until a Certificate of Compliance has been issued this Board o Health. geed Date -Z7 — �• Application A roved by Date Application Disap oved by Date for the following reas s Permit No. ® ( Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS CErtif irate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(l�Upgraded( ) Abandoned( )by A ,1.�a s C0"Ai N at _ weru has been constructed in accordance with the provisions of Title 5 and the for Disposaf System Construction Permit No. dated Installer�o �A ac�� (�C Designer tni;\ty<_t'�o^►S W a, ✓k S #bedrooms �3AC- g='^.) Approved design flow and The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector No. �'' l r. -. Fee D� l ` THE COMM`ONWE-ALTH OF MASSACHUSETTS Entered in computer: PUBLICi�pliration HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes for re- Umad,sa' *pstrm Construction Permit IS F,4r �,etCApplication'for*-Pehnit to Construct( ) Repa (p) Abandon( ) ❑Complete System ❑Individual Components 'l - r�t� 1�tVr �,., Location AdJgvss or Lot No. '2 Cu 5 I+e Z- Cove- Owner's Name,Address,and Tel.No. ,� r 2 c.d Gc g h i,.c, As'sessor s.Mapmarce'1°V ZI 3 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ` G'0J1r-%Pt iS(owtiTrie � .1n1' )r,N " UpG TICS Type of Building: 1 r ,( } r G Dwelling No.of Bedrooms 2 Lot Size I'{(9 sq.ft. Garbage Grinder( ) Other Type'bf Buifding 0 c�S i�PN C� No.of Persons t . 'S'howers( ) Cafeteria( ) Other Fixri�ares _ a ' Design Flow(min.required) 2 2 V gpd Design w provided 4 15, gpd Plan Da Number of sheets Re 'sion Date ' Title # ` Size of Septic Tank X/q F �n►� Ve o .A.S. Gc �f° Description of Soil Nature of Repairs or Alterations(Answerwe wh e) 10,3 e,1-C. 2 500 CJ GJ C\,A0A1J0r65 Li Date last inspected: Agreement: The undersigned agrees to ensure he construction and m _ntenance of the afore described on-site sewage disposal system in t accordance with the provisions of Title 5 of he Environmental Co and not to place the system in operation until a Certificate of Compliance has been issuedjbthis Board o Health.ned Date Application Ap roved by flr� Date Application Disap owed by Date for the following reas s Permit No. o �. Date Issued i (4 --------------------- - ------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(11_�Upgraded( ) Abandoned( )byQ0,a,1& s T7:2 co lj N T rJC at l . ', �, / wcoje) r has been constructed in accordance with the provisions of Title 5 and the for Disposaf System Construction Permit No.' dated "?f Installer; o c- �L��_2?In,��J- 'S M Designer �n,��iv�tP� ��v ca W m S #bedrooms - `� �'�t' S e_� Approved design,,flow '2. Z—C-2 gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed..,- #r Date z Inspector €, ' ----------------------------------(------------------------------------------------------------------------------------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Vsposal *pstem -onstrurtion Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon(- ) System located at yti 1 5 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 tcompleted within three years of the date of this permit. Date T I// Approved by � I 9/17/2020 ShowAsbuilt(2338X1653) } TOWN OFBARNSSOLE L06Arl*N Gho �.� SFMAOFik VILI.AGR, ry -_ASSESSOR'S hL4 '&PARCEL 2.t3=WQ 7 �I INSTALLER'S NAME&PHONE NO.'i]v�a .-- SEPTIC TAI:iLWACrrY - LFACFI4JOFA&Lil --6pe) Lcc-+��.�.,b NO=QF BEDROOMS 2 _ § PERMTf DATE G-2-ILL COD-IPLIANCE D.11'E:('G')G j S pOtnti Di.mn H nv en tUe No,c G F pea-, M Adjt dCn dv.nw Tabi ro h FJn f1 huSi F'a Lry c..�,11..,s_Fct: P to W. 5 pply 0.1 end'-Le chmS F 1 ty(If-) ik exist on 1 sita ar wi h 2Q0 C t of lea h g il,ry) -.... Feti' Fdp,e JfyVetland and l'nc{up&F ditJ llfaaY wetlands czln wl0in' 700 Feei'ofl A Gfsrility) _,,,,_ __Feat FIR2NISHEUB!ZDbl - k EtI !!p F kI 38�6 a-33:1 JSeer d GvT•&S Pit-30 6 C �2�D.II1' ff COJT-251 �n Sufi WcuO rror+r�ji i https://itsgldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=273027&sq=2 1l1 Town of Barnstable x Regulatory Services Department Agftlftft Q p EMARR ST" . 0 D Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Certified Mail# 7015 1520 0001 2273 3319 May 3, 2016 Today Real Estate c/o David Holt 1533 Falmouth Road Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 260.Castlewood Dr,Hyannis,MA was inspected on 2/29/2016 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts.. The inspection of the septic system showed that the system"failed" under the guidelines of the 1995 TITLE 5(310 CMR 15.00) due to the following:. • Leaching pit or cesspool with high liquid level,<12" below inlet(per Town Code 360-9.1) . You are required to repair or replace the septic system within two (2)years from the date you receive this notification. You may request a hearing before the Board of Health if written petition requesting same is received within 10 days. Failure to repair/replace the.septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH • omas McKean,R.S., CH Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\260 castlewood Dr Hy May 2016.doc I e Town of Barnstable Barnstable Regulatory Services Department M ' Public Health Division Q D 200 Main Street, Hyannis MA 02601 zoos Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7015 1730 00012 4990 4841 Apr 27, 2016 Marilyn Moran PO Box 1120 Cotuit, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 274 Mariner Circle, MA was last inspected on 4/09/2016 by Sean M Jones, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: Leaching pit or cesspool with high liquid level, <12" below inlet (per Town Code 360.9.1) You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO • Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\274 Mariner Cir Cot Apr2016.doc Town of Barnstable Barnstable Regulatory Services Department Q p iANUMMM 0DAl Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1520 0001 2273 3319 5/03/2016 Today Real Estate c/o David Holt nQj 1533 Falmouth Road Centerville, MA 02632 ,tR/ d RE: 260 Castlewood Cir, Hyannis, MA ORDER TO COMPLY WITH ST E ENVIRONM NTAL CODE, TITLE 5 The septic system located at 260 astlewood Circle, Hyannis MA was last inspected on � May 19, 2010,by Shawn Mce oy, a certified septic inspector for the State of C Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: .• Leaching pitf or cesspool with high liquid level,<12" below inlet(per Town Code 360-9.1 You are ordered,--to repair or replace the septic system within two.(2)years from the date you receive this"notification'. F You may request a hearing before the Board of Health if written petition requesting same is received 'thin 10 days. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health �Tr�r Town of Barnstable n�xrraraeLr' p ,b$ Regulatory Services Department rfD MA{� Public Health Division 200 Main Street;Hyannis MA 02601 Office: 508-862-4644 Richard Scab,Director FAX 508-790-6304 Thomas A McKean,CHO Feb 6,•2007 - Rev. 7/6/15 DEADLINES TO REPAIRTAMED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the o is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA. ❑Discharge or ponding of effluent to the surface of the ground ❑Pumping more than 4 times during the last yea-r not due to clogged or obstructed pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA. ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or.cesspool o Any portion of the SAS, cesspool, or privy,below high groundwater elevation o Aty portion of-the cesspool withi d'a Zone 1 to a public welI ❑Any.portion of a cesspool within 50 feet of a private water supply well with no acceptable.water.quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components; etc) Leaching pit or cesspool with high liquid level,<12"below inlet(per Town Code §360-9.1) OTHER ❑ S464 I I 66 14) Repair deadline: QAISEPTIMDEADLINES TO REPAIR FAILED SYSTEMS.doc Parcel Detail Page 1 of tic Pat7N,I eta � � Logged In As: Parcel Detail Tuesday,April 19 2016 Parcel Lookup Parcel Info # Parcel ID Developer°273-027 Lot�LGT Location°'260 CASTLEWOOD CIRCLE Pri Frontage . Sec Road Sec Frontage�s.�• ,�.�..�.akin, ,w,,�...��.� �,.�,.��.,�,� �� Village;HYANNIS Fire Distract rHYANNIS Town sewer exists at this address�NG Road Index+0253 Asbuilt Septic Scan: Interactive ' I 2730271 Ma I p ni & =W4 am - Owner Info _ . ...._. . Owner CASH,SHARON A � ��- •�� Co-owner �� ••�� Streetl260 CASTLEWOOD CIR Streetz City!HYANNIS M � 0 State JMA zip 02601 Country - Land Info _ _ Acres 0.21 �I use Single FammMDL-01 ry .�µ zoning IRC-1 Nghbd y0105rn I - Topography Road B Utilities t � �U Location te Construction Info Building 1 of 1 .Year 1967 -� Roof Gable/Hip Ext Wood Shingle Built Struct Wall _p +•, Living 3942 �� a...,- Roof 3As h/F GIs/Cmp � AC None �� Area Cover Type Int Style Ranch wall Drywall I Rooms 2 Bedrooms Model Residential Int$Carpet Bath FuIIO Half w Floor Rooms _ t,4 „ - Grade=Average Minus "eat Type Ro Hot Air Total 4 Rooms oms, Stories 1,Story Heat GaS 'Found #Poured Conc. Fuel ation Gross Area 12094 Permit History Issue Date_ Purpose Permit# Amount Insp Date Comments 12/18/2003 New Windows 173686 $4,700 1/6/2004 12:00:00 AM http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=20902 4/19/2016 i; Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s f 260 Castlewood Cir GSM �i' Property Address CIA Bank Owned (Contact David Holt Ldi Today Real Estate 1-800-966-2448) - Owner Owner's Name gn information is required for every Hyannis MA 02601 2-29-16e page. City/Town State Zip Code Date of Inspection i.,. R�1 S71 Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S 13971 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 2-29-16 n or'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 god or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions.at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 40 ffa Vs v Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments fi b Mom; M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @Today Real Estate 1-800-966-2448) ,Vwner Owner's Name information is,L�quired for every y H annis MA 02601 2-29-16 .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: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) - Owner Owner's Name information is required for every Hyannis annis MA 02601 2-29-16 page. City(Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C),-FurtherEvaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑' ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well-water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. The system fails. I have determined that one or more of the above failure ® ❑ criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner should contact the Board of Health to determine what will be y necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner-or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. . t5ins•3/13 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 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 each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 t5ins-3113 Title 5 Official Inspeclion Forth:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official, Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every y H annis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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 ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16, page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Approximate age of all components, date installed (if known) and source of information: 1980's Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: ,16"feet Material of construction: +° ® cast iron ❑ 40 PVC ® other(explain): Orangeburg 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): 8" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) a - If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 2° Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 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.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: ` gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): - b *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes �❑ No t5ins•3M3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 gal ❑ 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.): Leach pit was holding water at 20" below inlet invert with stain lines above invert and into riser. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments note condition of soil, signs of hydraulic failure, level of ondin , condition of vegetation, ( 9 Y P 9 9 etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments �M s 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately C€ D 'C tJ Q • . t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 260 Castlewood Cir Property Address Bank Owned (Contact David Holt C Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 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 and town maps show groundwater at greater than 20'. Before filing this Inspection Report, Please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 260 Castlewood Cir Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 2-29-16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Town of Barnstable P#_ ls-D i Departmexi t of Regulatory Services 1 s MUMSTABIA Public Health Division Date ?' 'd �� MA89 p 2639. ,b� 200 MainlStreet,Hyannis MA 02601 Ip0 IAAy A i jab Date Scheduled— I 01 6 Time IM !gee Pd�� '� -a x Soil Suitability Ass-essment for Sewl"ge Disposal Performed I y, d e ke.r 2. S�:— S�r ( 2. Witnessed By: G-U — LOCATION & G1 NERAL INFORMATION Location Address Z,�U , Owner's Name C.r.�S•1—1 e wcrac� C� t `P�V\VI-S. Address ZG Q Ct1SE-�-btu cT<'�C� )'� Yctt� `s VM4 _Gol Assessor's Map/Parcel: 2`7'_7.—.0 'Z 7 j Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use Sloper,(30) Z—. Surface Stones Distances from: Open Water Body �( ft Possible Wet Area r�'4` ft Drinking Water Well t5 ft Drainage Way /J/J.. ft Property Line Lq r ft Other_ ft SKETCH:(Street name,dimensions of lot,exact locaticins of test holes&perc tests,locate wetlands In proximity to holes) j G) 13- 1 - - I Aojl� Parent material(geologic) Depth to Bedrock. Depth to Groundwater. Standing Water in Hole: A)j_A .; Weeping from Pit Foce Estimated Seasonal High Groundwater DETERAHNATION FOR SEX SONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: —In,In, Depth to soil tnottlus; „in. Depth to weeping from side of obs,hole: in, Groundwater Adjustment Index Well# Reading Date: Index Well level Adj,fActor,w,,,,,,,4 Adj,Groundwater Itvel PERCOLi�TION TEST brae 'dime Observation Hole# 7r' Time at V Depth of Perc Time at d" Start Pre-soak Time @ V' Time(9"•6") - i End Pre-soak Rate Min,/Inch. -z-'" Site Suitability Assessment: Site Passed L__/ Site Failed: Additional Testing Needed(Y/N)_. Original: Public Health Division Observ<}tion Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the, Barnstable Conservation Division at least one, (1) week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP-OBSERVATION HOLIa,LOG Hole Depth from Soil Horizon Soil Texture ShcI Color Soil Other Surface(in.) (USDA) ;(Munsell) Mottling Structure,Stones;Boulders, Consistency,%Gravel) DEEP OBSERVATION HOL11T,LOG Hole# —Z-- Depth from Soil Horizon Soil Texture !foil Color Soil Other Surface(in.) (USDA) i(Munsell) Mottling (Structure,Stones,Boulders. Consistency.% ravel . i DEEP OBSERVATION HOLY,LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Qonsictency,To Ciraye- i. DEEP OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon Soil Texture 'Soil Color Soil Other Surface(in,) (USDA) (Munsell) Mottling (Structure,Stones Boulders, Consistency,2 Oravell Flood Insurance Rate Map: 4 Above Soo year flood boundary No® Yes ., Within 500 year boundary No Yes i Within 100 year flood boundary, No Yes Depth of Naturally OccurrinQ Pervious Material Does at least four feet of naturally occurring pervious�tnaterial exist in all areas obs served throughout the area proposed for the soil absorption system? - ""> -- If not, what is the depth of naturally occurring pervious material? Certification I certify that on (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. J Signature_ Date (cr. l Q:\.SEPTI(1PBRCPORM.DOC i } Town of Barnstable P# oil Department of Regulatory Services RAMEMABLK : Public Health Division Date MASS. 200 Main Street,Hyannis MA 02601 Date Scheduled L do, C U7' �CJ Time t� ee Pd. 1 Soil Suitability Assessment for Sewe Disposal H. Performed By: IDe k'_ 1 , �'� Witnessedy B �U W- G� •n Location Address" LOCATION & GENERAL INFORMATION 2(ZLG ,,,,;,Owner's Name �S w crag. M ra Address .. ��a�tut�S rNtl4 02.Go� Assessor's Map/Parcel: 2-7-51 17 Engineer's Name NEW CONSTRUCTION REPAIR Telephone# S($ 7 37 I Land Use �S i� �1�t� Slopes(3$) Z_ Surface Stones Distances from: Open Water Body �(� ft Possible Wet Area A VA--ft Drinking Water Well �!_ts's ft Drainage Way �l ft Property Line �� )' ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) [54 ` I 2 j F • Ci12__ Parent material(geologic) L)�c15 Depth to Bedrock �d/ls1 _ Depth to Groundwater. Standing Water in Hole:—A)JA Weeping from Pit Face �AJ Estimated Seasonal High Groundwater -e> (?87 DETERMINATION FOR SEASONAL HIGH WATER'TABLE Method Used: Depth Observed standing in obs.hole: _ in, Depth to soil mottles: Depth to weeping from side of obs..hole. = m,in, Groundwater Adjustment Index Well# Reading Date: Index Well level .. Adj.factor Adj.Oroutndwater level n PERCOLATION TEST We Time�m Observation Hole# `' I' '7r— t y Time at 4" Depth of Peres Z Z t Time at 6" CA4 ' ✓� . Start Pre-soak Time @ _ Time(9"-6") End Pre-soak ! J Rate Min'/Inch, r r Site Suitability Assessment: Site Passed / Site Failed: Additional Testing Needed(Y/N)_ Original:;Public Health Division'; Observtition.Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTIC\PERCFORM.DOC /,0 Vs DEEP.OBSERVATION HOLE:LOG Hole#�.._ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,%Gravel) S-I -j DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Colcr Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% rave .6 T- �� 5L 1oy(Lyt DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi to t Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No`� Yes o 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? -�S If not, what is the depth of naturally occurring pervious material? Certification I certify that on (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. Signature Date 4 1 Iq ' ( Q:\,SEFT1CVERCFORM.DOC TIGER ENVIRONMENTAL 9 ENGINEERING 713 969 WASHINGTON STREET BRAINTREE, MA 02184 V0 617-849-0088 No 1 6 1998 fits N SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO M ft PART A CERTIFICATION S % Owner's Name: Ci l C We C- `I Address of Owner(if different): T� Property Address: O �4S GL,1Dv� y&&t 4ij aZ 6 O( Company Name: S G 4 o vG Date of Inspection: Mailing Address: Name of Inspector: J@ f P,4 f t f I am a DEP approved system inspector pursuant Telephone Number: It f! to Section 15.340 of Title 5(310 CMR 15.000) ❑ Voluntary Assessment(Not Reported) CERTIFICATION STATEMENT: Name 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: �i� !l�i'L Date: l l L 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 A] XI PASSES: 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: B] SYSTEM C NALLY PASSES: One or more s components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion replacement or repair, as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND). Describe i f determination in all instances. If"not determined",explain why not. The septic tank is metal, unless the owner or operator ha ided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within 20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows s ntial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replace a conforming septic tank as approved by the Board of Health. 1 of 10 TIMER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address.:�1 2.4 ® 64j4k 40' Owner: M Date of Inspection: l �" B] SYSTEM CON TIONALLY PASSES (continued) Sewage bac or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to roken, settled, or uneven distribution box.The system will pass inspection if(with approval of the Board of Health): Des 'be observations broken pipe(s) a eplaced obstruction is remov distribution box is levelle replaced The system required pumping more than times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Hea broken pipe(s) are replaced obstruction is removed 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 prot t the public health,safety and the environment. 1) SYSTEM L PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNE WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool rivy is within 50 feet of a surface water Cesspool or p ' is within 50 feet of a bordering vegetated wetland or a salt marsh 2) SYSTEM WILL FAIL UNLE THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SY M IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRO ENT: The system has a septic tank a soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surfa water supply. The system has a septic tank and soi bsorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil abso tion system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption stem and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water alysis for coliform bacteria and volatile organic com- pounds indicates that the well is free from pollution from at 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: 2of10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 2-6 40 - Owner: D w"s/L /°1 e/llce`y Date of Inspection: 5 D] SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: 1 have determined that the system violates one or more of the following failure criteria as defined in 310 CM 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 up of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharg r ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS esspool. Static liquid level in t istribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is le han 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 time ' the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspo or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a s ce water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public we . Any portion of a cesspool or privy is within 50 feet of a private water supp ell. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from rivate 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 cool^liform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: �/✓t Yo ust indicate either"Yes"or"No"as to each of the following: The follows iteria apply to large systems in addition to the criteria above: The sys erves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public h and safety and the environment because one or more of the following conditions exist: Yes No The system is within 400 feet of a s ce drinking water supply. The system is within 200 feet of a tributary to a ace drinking water supply. The system is located in a nitrogen sensitive area(Interim Ilhead 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 co ance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the De artment for further information. 3 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: �O C4 S Owner: P&Otd M G Date of Inspection: t VI 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. V 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 part 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. 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(and occupants, if different from owner)were provided with information on the proper L/ 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)[15.302(3)(b)] 4 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1. 0 C/' Owner: Me-W,:�41 Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: I-rO g.p.d./bedroom for S.A.S. Number of bedrooms: 2— Number of current residents: 21 Garbage grinder: (yes oro "V Laundry connected to s stem: e or no) GS Seasonal use: (yes or / O L �! ? CU Water meter readings if available[last two(2)year usage (gpd)]: Per n t T y Sump Pump(yes or io : .VCR L/ Last date of occupancy: COMMERCIALIINDUSTRIAL: Type of estab ent: Design flow: gallons/day Grease trap present: (ye no) Industrial Waste,Holding Tank sent: (yes or no) Non-sanitary waste discharged to th e 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: System pumped as part of inspection: (yes o no 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) I/A Technology etc. Copy of up o date contract? L Other(explain) se- K f t H Z 7�y le-4Ck P!T APPROXIMATE AGE of all components,date installed(if known)and source of information: 4- Sewage odors detected when arriving at the site: (yes orlo 5 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 2— �OG�- Owner. Date of Inspection: BUILDING SEWER: (Lo''cPPate on site plan) Depth below grade: � Material of construction: cast iron 40 PVC other(explain) Distance from private water supply well or suction line: %V A Diameter: /L Comments: (condition of joints,venting,evidence of leakage, etc.) '4/0/1 Pig q SEPTIC TANK: (Locate on site plan) Depth below grade: /2 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: 91LX S[/7X Y[ �✓ Sludge depth: 3[[ 11 Distance from top of sludge to bottom of outlet tee or baffle: Y Scum thickness: Y 4(l �[ Distance from top of scum to top of outlet tee or baffle: ,V Distance from bottom of scum to bottom of outlet tee or baffle: [` How dimensions were determined: fiicl� Hc�s�rnc�i 1 Comments: (recommendation for pumping, condition of inlet and outlet teesG or baffles, depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) SNSTza► �ocf /IDry /�cc� �G O�•�DcaL pwnci` {,� /cGIcD f o °��'o 9n 7-3 fJf �&o4 ~ rr / 11 / K ova'/'f40rg I c /-CA( �l 74"1 Q L0iG -l�IeklJ G A D L�/c C�1lG DT�Zci S//G In77, O/ DuTD '�R/I K GREA AP: (Locate on site plan) Depth below gra Material of construction: ncrete 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 leve ' elation to outlet invert, structural integrity,evidence of leakage,etc.) 6 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 20 CkSI��-✓�o� Owner: 12,L tee Date of Inspection: TIGHT OR HOLDING TANK: "�°� (Tank must be pumped prior to,or at time,of inspection) (Locate o site plan) Depth below gr Material of constructs concrete metal Fiberglass Polyethylene other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Alarm in working order es; no Date of previous pumping: Comments: (c ion of inlet tee, condition of alarm and float swi es, etc.) DISTRIBUTION BOX: (Locate on site plan) Depth of liquid level above tlet invert: Comments: (note if level and distrib n is equal evidence of solids carry over, evide a of leakage into or out of box, etc.) PUMP CHAMBER: -44 (Locate on site p Pumps in working order: (yes or _ Alarms in working order: (yes or no) Comments: (note condition of pump chamber,condition umps and appur tenances,etc.) 7 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: &611d G Date of Inspection: l✓�^�� 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: 4e-a.c4 Pi 6 _C, o/«V� Leaching chambers, number: Leaching galleries, number: Leaching trenches, number, length: Leaching fields, number, dimensions: Overflow cesspool, number: Alternative system: Name of Technology: d Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) 5,u7,-e1C ✓,-.o 5 yns of- h lv A, 1wy-, WV mue ycyc��mdl CESSPOOLS: (Locate on site Ian) Number a configuration: Depth-top o uid to inlet in, Depth of solids er: Depth of scum laye Dimensions of cesspo Materials of construction: Indication of groundwater: Inflow(cesspool must bXpued as part of inspection) Comments: (note condition of soil, signs of hydrauli ilure, level of ponding,condition of vegetation, etc.) PRIVY: ,�//4— (Locate on site plan) Materials of construction: Dimensions: _ Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, le�fponding, condition of vegetation,etc.) 8 of 10 TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 24, - Owner: e t Me Wee-I Date of Inspection: .5=�� DEPTH TO GROUNDWATER: Depth to groundwater: 3 0 feet 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) l�� p 2 7j Rkrcd 027 Graulize 6`e aell l®'4bo'l ®g /` k W -y 2-S J The intent of 310 CMR 15.302 is to provide reasonable guidelines for the inspection of existing systems in as non-intrusive a manner as is possible to avoid damage to the system and any unnecessary disturbance of the surrounding soil area which is related to the treatment process.The inspection is not designed to provide information to demonstrate that the system will adequately serve the use to be placed upon it by the new owner.The inspection criteria are intended to allow for timely inspection to avoid undue delay in the transfer of property. I understand that this report does not constitute arranty or guarantee of future operation. Client or Representative Date 10 of 10 e TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 26 Cr— Owner: Niid Mr— lVeej!� Date of Inspection: 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A . 20161( Por� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ® o . A" L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 of 10 F TIGER ENVIRONMENTAL ENGINEERING 969 WASHINGTON STREET BRAINTREE, MA 02184 617-849-0088 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 26 Owner: ite- /ECG Date of Inspection: 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Ck r . . porgy . . . . . . . . . . . . . . . . . . . . . . 6 . D F . . . . . . . . . . . . . ® 0 d• *31 F. �. .� .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 of 10 • u� 11 -—100——EXISTING CONTOUR N x 100.98 EXISTING SPOT GRADE LOCUS 4 W EXISTING WATER SERVICE I' G EXISTING GAS SERVICE U UNDERGROUND WIRES o PC 10g $,H. W.—OVERHEAD WIRES v N O ow 0 PB 2p8- TEST PIT 8 BENCHMARK BENCHMARK CORNER OF AC PAD EXISTING S.A.S. LEGEND EL.=101.61 PUMP, FILL WITH SAND & ABANDON r m m EXISTING SEPTIC TANK ', o TOP OF TANK, EL.=100.89 CC BB IN V.(OUT)=99.56f(VERIFY) ' I 101125 S 12'54'10" W IP o x 97.30' l00,96 r o m c c a 100,37 101.09 �i �` / R0 TIJTE 8 TP-2 LOCUS MAP 100,71 100.99 � � � / - x 1 f NOT TO SCALE 101,48 SH x 101,38 i GENERAL NOTES: D D101 BM 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 101,61 BOARD OF HEALTH AND THE DESIGN ENGINEER. 9 r: 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 101,22 x x x 101.0� OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE (n (n LOCAL RULES AND REGULATIONS. 0 ; v I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR PORCH�p v TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 1 w p) `"•0•,:� EXISTING � (_4 DESIGN ENGINEER. p W �N 0.9 +7& HOUSE(#260) N p 1 ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o O T.O.F.=101.9t ENGINEER BEFORE CONSTRUCTION CONTINUES. M 0O 1""I \1OL35 M I 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. 10' �O 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ;� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �a 0:,; 28 PORCH I f HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 101,18 x 00.7 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. C: 10114 i 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS ` .. W LOT 127 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE �.: :.• 100,93 8946 fSF DIRECTED BY THE APPROVING AUTHORITIES. C) ::... / 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY AP ID: Z 3-OZ7 — J H OF k4ss THE CONSTRUCTIO LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING �G 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS PETENTEE IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND McE 97.30 / o REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). xr100,o2 12.22 00 E er CIVIL _ , " 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 99,75 9.62 f No. 35109 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. o G/SSF� U' 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND SIDEWALK �' NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 99.71 99,62 edge of pavement 99.40 99.20 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC r_f`I� 4p V SYSTEM COMPONENTS NOT SHOWN ON THE PLAN PALN REVISION — 6/1/16 PROPOSED SEPTIC SYSTEM UPGRADE PLAN _ � REVISE S.A.S. CASTLEWOOD CIRCLE, HYANNIS, MA CASTLEWOOD CIRCLE Prepa ed for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. CASH, SHARON A 1"=20' P.T.M. 136-16 260 CASTLEWOOD CIRCLE Engineering Works, Inc. 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. HYANNIS, MA 02601 (508) 477-5313 4/29/16 P.T.M. 1 Of 2 { q I NOTE: T0IPREVENT BREAKOUT, FINAL GRADE SEPTIC TANK SHALL NOT BE AT, OR BELOW, E'=98.0 FOR A DISrTANCE OF 15' FROM THE EDGE INSTALL RISERS & COVERS OVER INLET & OFITHE PROPOSED S.A.S. OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D—BOX PROPOSED S.A.S. INSTALL RISER & COVER INSTALL RISER & COVERI OVER ONE CHAMBER(MIN.) SET TO 6" OF GRADE AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE T.O.F=101.9t AS AN INSPECTION MANHOLE. SHED F.G. EL.=101.0t F.G. EL.=101.3f F.G. EL.=101.1f F.G. EL.=1i00.2t f 36.1' f a 28.2' 3'(max.) L = 53' L = 27' PORCH © SCH4 (MIN.) ® SCH4 (MIN.) Sts S0 EXISTING -•� •' 4'SCH40 PVC 4"SCH40 PVC „ 6' 2" LAYER OF 1/8 '6'' • HOUSE 260 io"t 6 E3 O® TO 1/2 DOUBLE �� 4'lu 12" WASHED STONE T.O.F.=101.9f' EXISTING 48" LIQUID (OR APPROVED FILTER FABRIC) �� W LEVEL ADD INV.=98.17 PROPOSED 2.5' 3' 2.5' w GAS BAFFLE _ INV.=98.00 3/4"-1. 1/2" o INV.=99.56 �� EFFECTIVE WIDTH 8 DOUBLE WWASHED DB-6 SHOWN INV.=97.50 STONE 0- PORCH EXISTING SEPTIC TANK 3 OUTH-10ETS (MIN.) USE 6 LC-6 LEACHING CHAMBERS IN SERIES I a 1 �$Lt 1 WITH 2.5 OF DOUBLE WASHED STONE-ALL SIDES ' 4' OF DOUBLE WASHED STONE ON BOTH ENDS H-20 RATED ~$� NOTES: TOP CONC. ELEV.=98.3 —— _— —BREAKOUT SEPTIC LAYOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=97.50 ®®®®®®® ELEV.=98.0 INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=96.50 W�l 2) D—BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' 6 x 6' = 36' 4' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 4' OF NATURALLY OCCURRING STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). PERVIOUS MATERIAL EFFECTIVE LENGTH = 44' -———'—-- ------ 5' (MIN.) ABOVE G.W. I 4 KNOCKOUT 20"DW COVER 3) INSTALL INLET & OUTLET TEES AS REQUIRED. LEACHING SYSTEM SECTION 4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON NO G.W., EL.=90.8 ( _ I THE OUTLET TEE. I4'KNOCKOUT 4' KNOCKOUTI n I I SEPTIC SYSTEM PROFILE IL----- •"KNOCKOUT ——_I 72" DESIGN CRITERIA SOIL LOG PLAN VIEW 17-1 NUMBER OF BEDROOMS: 2 DATE: APRIL 19, 2016 (REF#15,011) _——— ———— SOIL EVALUATOR: PETER McENTEE PE(SE#1542) SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVID STANTON R'S. HEALTH AGENT ® ® ® ® ® ® ® 22» ® ® DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEy: TP-2 DEPTH INVERT I ® ® ® ® ® ® ® I I I .(0.74 GPD/SF LOADING RATE) 100.8 A 0" 100.6 A 0" DAILY FLOW: 220 GPD SANDY LOAM SANDY LOAM i— 72" 1 r 36" DESIGN FLOW: 330 GPD 100.3 10YR 4/2 6.. 100.1 10YR 4/2 6„ SIDE VIEW END VIEW GARBAGE GRINDER: NO BSANDY LOAM 1II1. BSANDY LOAM LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 10YR 5/8 1 10YR 5/8 WIGGIN LC-6, H-20 LOADING .74 GPD/SF 98.3 Cl 30" 97.9 Cl32" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PERC LEACHING CHAMBER PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 34 /52 N.T.S. USE 6 ' OF LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN WITH 2.5' OF DOUBLE WASHED STONE—ALL SIDES COARSE SAND � COARSE 6/6 D 260 CASTLEWOOD CIRCLE, HYANNIS, MA 4 OF DOUBLE WASHED STONE—ON BOTH ENDS {` SIDEWALL AREA: (8.0' + 44.0') x 2 x 1' = 104.0 SF 4 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: 8.0' x 44.0' = 352.0 SF Engineering by: SCALE DRAWN JOB. NO. I' N.T.S. P.T.M. 138-16 TOTAL AREA:............................................................ 456.0 SF 90.8 120" 90.8 120" Engineering Works, Inc. i 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(456.0 SF) = 337.4 GPD NO GROUNDWATER, PERC !RATE: <2 MIN./IN. (508) 477-5313 4/29/16 P.T.M. 2 of 2 t