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Home My WebLink About0030 CHESTNUT STREET - Health 30 Chestnut Street Hyannis P. A 309 056 ,1 Town of Barnstable Health Inspector Office Hours oFt"E r�� Regulatory Services 8:30-9:30 Thomas F.Geiler,Director 1:00—2:00 M e ' ' ' 9B Public Health Division ' Thomas McKean,Director 200 Main Street,Hyannis,MW660'1 J ' C ` Office: 508-862-4644 508-790-6304 ..,n.✓tV Si01 AMNESTY PROGRAM APPLICANT - SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: a3 Address: 3 U-� YLt/4- Map" Parcel�� Name: Phone#: 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? �0 If yes,how many? bedrooms total are proposed at this property (including the amnesty unit), 2c. How many p p 2d. Please include a copy of the floor plans for the entire property - showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or �NO) = sIft`he�dwelhngis�connected�to�~p� lsewe,�slcip qugstionsa#4�through�#9below � .�.,.��, ,.��, �,�,�� 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 5: Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO --------------------------------------------------------------------------- 7X'p / FOR OFFICE USE ONLY The Public Health Division no objection t bedrooms at this prope Special Conditions: Q;1health/wpfiles/amnestyapp arc ' l t p i � 9 CA- a� (fib 6 �"�' Do 6 • I � I 6 l�\,AJ �i I�� v'V �� `� �`� �k \� �� a�" I COMMONWEALTH OF MASSACHUSETTS x f EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS q d DEPARTMENT OF ENVIRONMENTAL PRAT ASSES��ft� �� W PARCELNO:_�-- �!�'M �Jeyv :ON 130Rdd ON&IN SHOSS3SSd TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 30 Chestnut Street Hyannis MA 02601 RECEIVED Owner's Name: Lawrence J. Morash Owner's Address: Same Date of Inspection: June21,2004 JUL U 7 2004 TOWN OF BARNS IABLE Name of Inspector: PATRICK M.O'CONNELL HEALTH DEPT. Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information 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 D �1ltlttlp approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _XX_Passes Conditionally Passes °• G' • T K :cn Needs Further Evaluation by the Local Approving Authority Fails co 'Ins ectors Si nature:�-'-! P g Date: 6/21/2004 s INSPEs�`�� The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or lia I DEP)within 30 days of completing this inspection. if the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable.,and the approving authority. Notes and Comments: No evidence of backup in perf pipe inside rechargers. ****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. Title 5 inspection Form 6/15/2000 page I Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 30 Chestnut Street, Hyannis Owner: Lawrence.1. Morash Date of Inspection:June2l,2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: XX_ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old' or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a.Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced _ obstruction is removed distribution box is leveled or replaced ND explain: _ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 1 I OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 30 Chestnut Street,Hyannis Owner: Lawrence.1. Morash Date of Inspection: June 21,2004 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. __ The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 30 Chestnut Street, Hyannis. Owner: Lawrence J. Morash Bate of Inspection: ,tune 21,2004 D. System Failure Criteria applicable to all systems: You must indicate"yes" or"no"to each of the following for all inspections: Yes No _X_ B ackup of sewage into facility or syste component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X Liquid depth in cesspool is less than 6"below invert or available volume is less than %z day flow — _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy'is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. —X— Any portion of a cesspool or privy is within a Zone I of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma _No-(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR.15.303,therefore the system fails. The system owner should contact the Board of. Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no — _ the system is within 400 feet of a surface drinking water supply — ` the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone ll of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 30 Chestnut Street,Hyannis Owner: Lawrence J. Morash Date of Inspection: June 21,2004 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _X_ — Pumping information was provided by the owner, occupant, or Board of Health _X_ Were any of the system components pumped out in the previous two weeks? _X_ — Has the system received normal flows in the previous two week period _X_ Have large volumes of water been introduced to the system recently or as part of this inspection `? _X_ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? _X_ _ Was the site inspected for signs of break out 9 _X_ Were all system components, excluding the SAS, located on site'? _X_ _ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? _X_ — Was the facility owner(and occupants if different from owner)provided with infonnation on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ — Existing infonnation. For example,a plan at the Board of Health. _X_ ^ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 30 Chestnut Street H annis � � Y Owner: Lawrence J. Morash Date of Inspection: June 21,2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x 4 of bedrooms):330 Number of current residents:5 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Two years usage: 155,500 gal. = 158 gpd. Sump pump(yes or no): No Last date of occupancy: Currently Occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): and Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings, if available: Last date of occupancy/use: _ OTHER(describe): GENERAL INFORMATION Pumping Records: Last pumped two years ago. Source of information: Owner Was system pumped as part of the inspection(yes or no): No If yes, volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X Septic tank,distribution box, soil absorption systern Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval M _ Other(describe): Approximate age of all components, date installed(if known)and source of information: Compliance date: 11/19/96 Were sewage odors detected when arriving at the site(yes or no): No Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 30 Chestnut Street, Hyannis Owner: Lawrence J. Morash Date of Inspection: June 21,2004 BUILDING SEWER: X (locate on site plan) Depth below grade: I' Materials of construction:_X_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: 20' Comments(on condition of joints, venting,evidence of leakage, etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 10" Material of construction:_X__concrete_metal_fiberglass__polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 10.5' long x 5.8'wide—1500 gal. U Sludge depth: 6 Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 4" 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: I I" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees intact and clear, liquid level at bottom of outlet pipe Recommend pumping tank GREASE TRAP: No (locate on site plan) Depth below grade:_ Material of construction:__concrete_metal,fiberglass_polyethylene`other (explain): Dimensions: Scum thickness: _ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: ` Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 30 Chestnut Street, Hyannis Owner: Lawrence J. Morash Date of Inspection: June 21,2004 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade:_ Material of construction: concrete metal__fiberglass polyethylene other(explain): Dimensions: Capacity:_ � gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping:__ Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): No high stains or solids present,liquid level at bottom of outlet pipe PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): n Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 30 Chestnut Street, Hyannis Owner: Lawrence J. Morash Date of Inspection: June 21,2004 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: __X_leaching chambers,number: Three Rechargers. leaching galleries,number: _ leaching trenches,number, length: leaching fields,number,dimensions overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): No excessive ve etation.Checked interior Dipe through leaching units with camera, found no evidence of backup. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): n Page 10 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) !Property Address: 30 Chestnut Street,Hyannis Owner: Lawrence J. Mlorash Date of Inspection: June 21,2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Chestnut Street �3c, Z 1500 gal tank 3 rechargers with inspection port in center Page I 1 of I l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 30 Chestnut Street, Hyannis Owner: Lawrence J.Morash Date of Inspection: June 21,2004 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells- None Estimated depth to ground water: More than 20 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) _X_Accessed USGS database-explain: USGS topo map and town GIS You must describe ho w you establishe d the high Y g ground water elevation. i Town groundwater contour map shows water below el.20 and topo map shows property at or above et. 40. Bottom of SAS less than 5' below grade. I TOWN OF BARNSTABLE LOCATION .3 ® Clve 5l-Ala r Sef SEWAGE # VILLAGE. .y.y1 S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. A4,4 C 6 Al /.?@2¢2 0,V SEPTIC TANK CAPACITY � 6 O LEACHING FACILITY: (type) �ee�,4 R G eR`S (size) 1 X d NO.OF BEDROOMS 21 BUILDER OR OWNER 0!7 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet r,,Edge of Wetland and Leaching Facility(If any wetlands exist -,< within 300 feet of leaching facility) Feet Furnished by1,014 /2 r! r � � 4 No: 2u? t''" —�� Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplicatton for Mie;pogal 6potem Con.5truction Permit Application for a Permit to Construct( )Repair( )Upgradqn)o Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 30 Chestnut Street Owner's Name,Address and Tel.No.Jay O t B r i e n Ayeassors s,Mass ,02601 35 Trinity Place Centerville,Mass . 02632 Installer's Name,Address,and Tel.No. 5.O 8-77 5 3338 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8 J.P.Macomber & Son Inc. J.P.Maco#er• & Son Inc. Box 66 Centerville,Mass . 02632 Box 66 Centerville,Mass. 02632 Type of Building: DwellingXXXNo.of Bedrooms 2 Lot Size sq.ft. Garbage GrinderX0 ) Other Type of Building RFS No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 30 gallons per day. Calculated daily flow 2x1 10=220 gallons. Plan Date 11 /1 /96 Number of sheets Revision Date Title ?, Size of Septic Tank 1 500 Type of S.A.S. 6-High Capacity Description of Soil Medium sand Infiltrators. 4' stone Nature of Rep airs or Alterations(Answer when applicable) 1-1500 gallon tank, 1-Distribution box. 6 High Capacity Infiltrators in 41 of stone. Omit existing cesspoo s. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss ed by thi o o alth. / / Signed Date 11 1 96 Application Approved Date Application Disapprov or t e following reasons Permit No. Date Issued ..--,. .1��.+�-. +��`"r'�..-t� '.f,-�tii{ Y.e� „� J,:.rTM !h...-C/" -.,a' ... r'. �v^' _ - ,t. E.--'f....c•y•a�,a.'�� -.lr--.vs+.�;•.r+_-•� 0.00 No. Fee - ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE' MASSACHUSETTS t Application for �Digogai *potern Construction Permit Application for a Permit to Construct( )Repair.(, )UpgradeX(XX)Abandon( ) D Complete System ❑Individual Components Location Address or Lot No. 30 Chestnut 'Street Owner's Name,Address and Tel.No.Jay O'Brien Hyannis,Mass,02601 35 Trinity Place Assessor's Map/Parcel C e n t e r V i l l a,,Mass.' 02632 Installer's Name,Address,and Tel.No. 5 0 8-77 5 3338 Designer's Name,Address and Tel.No. i 508-775-3338 J:P.Macomber & Son Ihc. J.P.Maco#br & Son Inc. Box 66 Centervil.le,Maes. 02632 Box 66 Centerville,Mass. 02632 Type of Building: DwellingXXXNo.of Bedrooms 2 Lot Size sq.ft. Garbage Grinderlq 0 ) Other Type of Building RES No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 2x110=220 gallons. Plan Date 11/1 /96 Number of sheets Revision Date\ Title t' Size of Septic Tank 1500 Type of S.A.S. -High .Capacity Description of Soil Medium sand Infiltrators- ' stone ! i is l�-1500 gallon tank 1-Distribution { Nature of Re, air or aAl�teration (An we whh n a licable) g box. 6 nigh Capaci y nil ra��oxs n 4 o stone. Omitexisting ce s o la. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss=ed by tht/Bo o alth. Signed Date 11/1/96 Application Approved o Date Application Disapprove for the following reasons F Permit No. Vk2 Date Issued Pitt ———— ————— —.————————=— —-——`-—-------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of-Compliance THIS IS.TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired( ) UpgradedX(XX) Abandoned( )by J.P.Macomber & Son Inc. at30 Chestnu Street Hyannis , ass. en constructed in accordance with the r vip'o of Title and e f Dis al System Construction Pertq�t o. d ed _ Installerps'r' aeom er `�onpTncy Designer `� ' 6l aco111t7er lon ne. The issuan is permit sha 1 not be cco true as a guarantee that�tth---e� function de ned. Date ��- '-�' InspeEtor-•'^G' P � i — —— ———————— —————— ————————_ _ 13 T �(f 00<.� No. J0 q O Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migoai *pMem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(dX�Abandon( ) Systemlocatedat 30 Chestnut Street Iiyannis,Mass. 02601 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constin /coon s Abe completed within three years of the date of pe it. � 4 Date: I Approved by � �" 4 �� .may ��r�c,..� ��.� �i4�, � - CERTIFICA`i i tv vie SKE'FCII AND APPLICA-110N 1.011 A DISPOSAL WORKS CONS'I'RUCI'ION PL:IZN11'1' (1VI'I'IIOU'I' DESIGNED PLANS) I, Joseph P Macomber Tr-__, lj,�r�:by certify that the application for disposal works construction pernut signed by concerning the property located at 30 Chestnlz _� .remit_, ann-i�-TMas� -- meets all of the following criteria: • There are no Nvellands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is _4 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or clianGc in use proposed • There are no variances requested or needed. SIGNS DATE: 11 /1 /96 LICE' SEPTIC SYSTEM INSTALLER IN THE TO\VN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed s}stem. Also if the licensed installer posesses-a certified plot plan, this plan should be sJ1bnlittcd].