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0297 COMPASS CIRCLE - Health
2Comp:ass ' sre�e Hyannis P. 310 432 ,r u a 0 I� a 1 . � 9 1 0 310 1t3ol- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .297 Compass Circle v Property Address Vilma Haddad Owner Owner's Nam information is required for every Hyannis Ma 02601 10-22-2020 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 A. Inspector Information S!filling out forms # I"f / 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 Company Address Sandwich Ma 02563 City/Town State Zip Code r (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. ❑■ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Brett Hickey pae:2020.102613`19:4-0a00' 10-22-2020 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.doc•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 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 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: FM1 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 Title 5 Official Inspection Form j, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every Y page. City/Town State 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: t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form r - i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Me 02601 10-22-2020 required for every y 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 Backup of sewage into facility or stem component due to overloaded or ❑ � P 9 Y Y P clogged SAS or cesspool ❑ El 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 r/ 297 m s/ Co pass Circle , Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 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 ❑ ❑ 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 '/2 day flow ❑ ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ M 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. ❑ ❑ Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ El Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 0 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.] ❑ El The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ Q 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. 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 � I ❑ ❑ 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 t5lnsp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name i-lformation is Hyannis Ma 02601 10-22-2020 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 ❑ [E] 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? M ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ [E] Was the facility or dwelling inspected for signs of sewage back up? El ❑ Was the site inspected for signs of break out? E ❑ 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? ❑ a 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: El ❑ Existing information. For example,a plan at the Board of Health. ❑ a 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts .— - Title 5 Official Inspection' Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 3 2 Number of bedrooms(design): Number of bedrooms(actual): 348/GPD DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes 91 No Does residence have a water treatment unit? ❑ Yes Ri No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes [0 No See below Water meter readings, if available(last 2 years usage(gpd)): Detail: Only reading was for 2019/2020 per water department 68,068Gallons Sump pump? ❑■ Yes ❑ No 3 months Last date of occupancy: Date I t51nsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address . Vilma Haddad Owner Owner's Name information is required for every Hyannis Ma 02601 10-22-2020 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/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No 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): 7 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 Tide 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 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: El 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: 2017 per permit Were sewage odors detected when arriving at the site? ❑ Yes ❑■ No 5. Building Sewer(locate on site plan): 11811 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 Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 811 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 1500gallons Dimensions: 711 Sludge depth: 2911 Distance from top of sludge to bottom of outlet tee or baffle 1 Scum thickness 619 Distance from top of scum to top of outlet tee or baffle 15" 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 not in need of pumping at.this time but should be pumped every two years for maintenance. t5insp.doc•rev.7/2 612 0 1 8 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 t .. 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every Y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): NA Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): NA Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Y Dimensions: Capacity: gallons Design Flow: gallons per day t5lnsp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts - w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owners Name information is Hyannis Ma 02601 10-22-2020 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): oilDepth 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 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: (2)500 gallon chambers R leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is required for every Hyannis Ma 02601 10-22-2020 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. 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 f Commonwealth ,of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is required for every Hyannis Ma 02601 10-22-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: NA Dimensions Depth of solids Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form I" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020. 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 Assessing As-Hunk Cards MSTALL)STt s WA,NM,AA PHONE NO. V cEImMYANCt,TTtRTH B®�axati@n]CFlstan 1Betvreerx thc:. Mnxftna t Adjuswd Gv6uv%4"ftr'13sl+le.to fto Donom odLiacm i$F"jM 2 eee P0Yatw Water SiWpX9'V W1 and X eat-Fati32ty(7t shy w8its_exiat aito o€ vtt}�itt 20t1'Ceox ofia�a}ra�{5sfociJ.ity�.. ,�" Poet dand`L Faa3liq Ssuy.avattWUl[9WXj_gt,crltFAU 3PfS, c:nf tectchie i 71 • . t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 f Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every Y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑■ Check Slope P Al Surface water ❑■ Check cellar N Shallow wells Estimated depth to high ground water: No GW @ 144"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: 3-13-2017Date ❑ 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. t5lnsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts r p Title 5 Official Inspection Form p _ Subsurface Sewage Disposal System Form Not for Volunta Assessments 9 P Y rY 297 Compass Circle Property Address Vilma Haddad Owner Owner's Name information is Hyannis Ma 02601 10-22-2020 required for every 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 as completed appropriate P 4(Failure Criteria)and 6(Checklist)completed ❑M 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 LOCATION P,9 7 C@rY►J?R e '11C'9- SEWAGE# ,�61'7-6 9 VILLAGE )JQnn ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. Qw��/lSY SEPTIC TANK CAPACITY LEACHING FACILITY:(type)C (size) NO.OF BEDROOMS -9 1 It OWNER V e PERMIT DATE: q COMPLIANCE DATE: q/� 7 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) &A- Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachi f ility Feet FURNISHED BY Cco p WCUGO a > :�P* � No. O—V Fee c THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYitatiou for Disposal .6pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(v�Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No..197 Com PqsS c%ft le- ner's Name,Address,and Tel.No. Assessor's Map/Parcel 3/0 y l vjl 77 Installer's Name,Address,and Tel.No. 7 7 q 3967007rj Designer's Name,Address,and Tel.No. u-Alle, 39 BOAQ1%W 1-�f( i INeelt kl. szgq77,r31,3 Type of Building: Dwelling No.of Bedrooms 3 Lot Size /QC40 sq.ft. Garbage Grinder AIA- Other Type of Building i ` ,'J No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3.36 gpd Design flow provided 3Y8, 7 gpd Plan Date ?2k3Ii7 Number of sheets Revision Date Title Size of Septic Tank Ir0j) nn Type of S.A.S. � ��� QC/ /-�-�0 C�"be_re Description of Soil Fi<< a 8Qf%jV O aw'-, med- ( Nature of Repairs or Alterations(Answer when applicable) uPAC4d'- 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 EnvirournepkI Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board ealth. It t ned Date / 7 Application Approved by P, Date Application Disapproved by Date for the following reasons Permit No. Date Issued vim•^--"--s„ �.f j� �� �� -�Q �•- ��-"" ! f��/I� y y -�l , 1Vo. as Fee THE COMMC�Nir'VkALTH OF MASSACHUSETTS En'te ed in computer: Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS es Rpplicatlon for BispoSal 6pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(v) Abandon( ) ❑Complete System ❑Individual Components r Location Address or Lot No.�1 7 com R S C Pc 1 e- J8t AOwner's Name,Address,and Tel.No. Assessor's Map/Parcel "VA"VAma Us4ja 7' s !�(C�i a� Installer's Name,Address,and Tel.No. Dessiigner's;Name;Address,and Tel.No.80, ` V•/'i�!. C//��G't/4 f U�. K� f'�!/� /]�4s o /-f�911 i'1 ;I Lf/A1 5 �7 5"3/7 v Type of Building: Dwelling No.of Bedrooms 3 Lot Size •2# /QSN© , sq.ft. Garbage Grinder Other Type of Building ��lf s�P -�g,�11f No.of Persons` +P Showers( ) Cafeteria( ). Other Fixtures z Design Flow(min.required) 3 Q gpd Design flow provided gp Plan Date �j�/3// Number of sheets o, Revision Date i t,. Title Size of Septic Tank /5 06 Type of S.A.S. S 6A a e?l 1416 C Aa., ;erg Description of Soil f 1111 , 44n ji le a w\ . /1 44 sej Nature of Repairs or Alterations(Answer when applicable) LIPG(aje Date last inspected: j Agreement: k 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 Environme 1 Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boards ealth. c /.3ikned f / // s Date 41111/�l7 Application Approved by ��' v'L - b Jil, i'. ` Date �. 1 Application Disapproved by / ,r' � '• Date v i for the following reasons /�.. A-I' Permit No. / f r Date Issued - '/ ------ - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS [, kf -1A. Certificate of Compliance THIS IS TO CF/R�IF-Y,that the Ojn--sites S)ewage/ isposal system Constructed( ) Repaired( ) Upgraded(--f Abandone )by f�V ,l (_rP 11Y • c - Jf.a-been cons-, cted accord' '- with the provisions of Title 5 and the for Disposal System Construction Permit No. J dated j Installer Designer i' nee t O i n c Luck v #brooms Approved design flow 3 418. ? gpd l,l fhe issuance of is perrmit shall not be construed as a guarantee that the system will function as desi nevi. 'Datef Inspector ----- •-= °-- ------------------ ---- -- No. Li�(J/ lJ '. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal .pstetn Construction Permit Permission is hereby granted to Construct( ) Repair( ) Up a fe)(�)f Abandon( ) System located at W (06' c i,C le a i�l I� . sS � r 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:�Coo4s'tuctil must be completed within three years of the date of this permit. - t' Date ` / / >( Approved by i f 6// r M i T Page 1 of 1 Miorandi, Donna From: PETER MCENTEE [peter.mcentee@gmail.com] Sent: Tuesday,April 11, 2017 9:02 AM To: Miorandi, Donna Subject: Fwd: 297 Compass Circle see forwarded response from Dave ----------Forwarded message---------- From: Stanton,David<David.Stantongtown.barnstable.ma.us> Date: Wed,Mar 15,2017 at 11:29 AM Subject: RE: 297 Compass Circle To: PETER MCENTEE<peter.mcentee@gmail.com> Hi Pete, Sorry for the delay, I have been bombarded with tons of non-typical plans and permits lately. I just checked the file,the original septic 79-50 allows 3 bedrooms. Someone did some crossing off and changing on the number of bedrooms back in the day and changed it to 2 bedrooms, however,they did not cross off and change the approved daily flow of 330 GPD, so they are grandfathered in per DEP policy to allow 330 GPD at this property. Thanks, Dave -----Original Message----- From: PETER MCENTEE [mailto:i)eter.mcentee@amail.com] Sent: Monday, March 13, 2017 8:10 AM To: Stanton, David Subject: 297 Compass Circle David, The information that I have on this property indicates that it is a two bedroom house.Do you have permitting that says anything else?Just curious. Peter Peter T. McEntee PE-Principal Engineering Works,Inc. 12 West Crossfield Road Forestdale,MA 02644 Tel/fax(508)477-5313 Peter T.McEntee PE-Principal Engineering Works,Inc. 12 West Crossfield Road Forestdale,MA 02644 Tel/fax(508)477-5313 4/11/2017 Town of Barnstable ��F1NE t � Regulatory Services yP o� g Y Richard V.Scali Interim Director BARNSTABLE. ' $ MASS. $ Public Health Division 4p i63q. �0 . �Eorno,+' Thomas McKean,Director 200 Main Street,Hyannis,MA02601 1 Office: 503-862-4644 Fax: 508-790-6304 Installer, &Designer Certification Form Date: '���' Sewage Permit# Assessor's-Map\Parcel 310 - y3Z Designer: �y;rice e`,n�j Wor-ks. (r►c • Installer: Qv+ nn j(( Vq�4-ira, Address: IZ. W Cn,sS-P e P-4 Address: 3�1. ,�Oa� Q2ise• QOh01 T: -estate MA (0Z,GY1 O2.(,PH9 On `?�I�h S G--�4a440*!�yas issued a perinit to install a (date) (installer) septic system at 29 2 C M S G fr,! H 4a(. based oil a design,drawn by ei;ef ►, IMLGn:+keL� (address) Eyiy ine�zci".etc) CiJo,''LU C , dated 3 lr3 (designer) ' certify that the septic system referenced above was installed substantiatly according to the design; which may include minor approved changes'sties 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.c. greater than 10' lateral relocation.of the SAS.or'anyvertical relocation:of any component of the septic system) but in accordance Nvith State & Local Regulations. Plan revision oi- certified as-built by designer to follow. Strip out.(if, required) was inspected and the soils were found satisfactory. certify that the.system referenced.above was constrircte ncc with the terms of the I\A approval.letters (if applicable) %OF PETER T. �� MeENTEE- CIV& (Instal. s Signature) N•O.3st0,q FosTER��' (Designer's Signature) (Affix Designer tamp Here) PLEASE RETURN.TO :BARNSTAB.LE PUBLIC HEALTH. DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED. BY THE BARNSTABLE PUBLIC HEALTH.DIVISION.. TRANK YOU. Q:1ScptiCNDcsigner Certification form Rev 8-14-13.dac i Town!of Barnstable P# �{ Departmept of Regulatory Services &UtNarA8LA � public!Health,Division MAn Date 200 Main Street,Hyannis MA 02601 - � rE0 MAC M � h� Date Scheduled Time I O t d� Fee Pi.� C (U c f1c Soil Suitability Assessment for Sew e Dis osal Performed By::Fsi Witnessed By: LOCATION & GENERAL INFORMATION Location Address 2`�7 Owner's Name 9�' ,�,tt � ,{y HyC1Vl n IS' Address 13 Assessor's Map/Parcel: ! �--e� lt✓ -- A 3"Z Engineer's Name j r1k �r1 NEW CONSTRUCTION _3 REPAIR a: Telephone# 5 o _ -3 a2iL Land Use t Gil i(A {- �_� Slope](go) Surface Stones lj r"---q Distances from: Open Water Body '_ Possible Wet Area �l1 IF� ft Drinking Water Well _ ft e Way / I . g Y '�ft Property Line -� _��-ft-- Other ft SKETCH:(Street name,dimensions of lot,exact locatigns of test holes&perc tests,locate wetlands in pmxitnity to holes) j 1 i i t Parent material(geologic) �A Depth to Bedrock. Depth to Groundwater. Standing Water in Hole:�.�ti i'lg j Weeping from Pit Face Estimated Seasonal High Groundwater i I DETERAUNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth_Observedin, Depth to soli'mOttles Depth to weeping from side of obs.hole: in, Groundwater Adjustment Index Well# Reading Date; _ Index Well leyei_� � Adj,factor,,,,,-s„�._ Adj,Ovoutidwater Level Observation PERCOL4TION TEST Data Thine j�_ 1 Hole# I Time at V Z Depth of Pere Z 1 �� — l P Time at 6" � Start Pre-soak Time @ Time(9"•6") End Pre-soak 1 ' Rate Min./Inch. G " Ic Site Suitability Assessment:. Site Passed f Site Failed: Additional Testing Needed(Y/N) i Observa Original: Public Health Division g � e ;lion Hole Data To Be Completed on B�ck -,== ----- If percolation test is to be conducted within 100' of wetland,you must first)notify the Barnstable Conservation Division at least onq (1) week prior to beginning. i „ } Q:\,SEPTICtPERCFORM.DOC . ��k I DEEP.OBSERVATION HOL LOG Hole# 1 Depth from Soil Horizon Soil Texture oil Color Soil Other Surface(in.) I (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Consistency.%Gravel 1 DEEP OBSERVATION HOL LOG Hole# Depth from. Soil Horizon Soil Texture Soil Color Soil Other Surface in. (USDA) i(Munsell) Mottling (Structure,Stones,Boulders. -i Consistency.% rave ,,DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) I(Munsell) Mottling (Structure,Stones,Boulders. Consistency. 3n Gravel) I I DEEP OBSERVATION HOL!+ LOG Hole# Soil Horizon Soil Texture Soil Color Soil Other " Depth from I, Surface(in.) (USDA) I(Munsell) Mottling (Structure,Stones,Boulders, I Consistency,WOmI I - i i - i i Hood I:�,s lran'ce Rate_I+Ta -- Above 500 year flood boundary No-- Yes Within!500 year boundary No Yes Within too year flood boundary No 1�11 Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? I _— If not, what is the depth of naturally occurring pervious material? - I i Certification I I certify that of '� (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 tr'inixig,ex p ertise and experience described in 310 CMR 15.017. f Signature— Date QAS,EPTICS'ERdFO RM.DOC � 2u.;% FFC��OMMONWEALTH OF MASSACHUSETTS TiT�., 97 T.Y ,i S9Kff��E OF 9NVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTIO 7M UL 26 AM 11: 4.SMAP � 1�1(SlO PARCEL„ • �2. L-OT OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY TITLE 5 SUBSURFACE SEWAGE DEPOSAL SYSTEM F ASSESSMENTS PART A FORM CERTIFICATION Property Address: 9 D r� alss C 1 PC l e. Owner's Name: D Owner's Address: Pp Date of Inspection: 30 log Name of Inspector.(please print) Av Zr Company Name: L' _ Mailing Address: Ox Telephone Number o _ 2, , CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage di sposal below is true,accurate and complete as of the time of the ins stem at this address and that the information reported training and experience m the proper function and maintenance o on.0.�site soio was performed based on my approved system inspector pursuant to.Section 15.340 of Title 5(310 CMR a disposal systems.I am a DEP ). The system: "sses. Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: Cl �20 The system inspector shall submi a copy of this in DEP)within 30 days of completing this ins spection report to the Approving Authority(Board of Health or gpd or greater,the ins pection.If the system is a shared system or has a design flow of 10,000 inspector and the system owner shall submit the report to the appropriate DEP.The original should be sent to the system owner and copies sent to the buye ,if applicable,and the office of the authority. approving Notes and Comments ""This report only describes conditions at the time of inspection and under the condition This Inspection does not address how the under the same a different u at that time conditions in use. cord e system will perform in the future L.J i Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: � n h Owner. a�0 O 0 h Date of Inspection; o p Inspection Summary: Check A,B,C,D or E/AL�yS complete all of Section D A System Passes:. (/ I have not found any information which indicates that any of the failure criteria 15.303 or in 310 CMR 15.304 exist.An failure criteria not evaluated are indi dW=. nbed m 310 CNM y sated below. t: Comments: _. $,/System Conditionally Passes: A V One or more system components as described m' the"Conditional p repaired The system,upon completion of the ass„section need to be replaced or replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,Np)in the for the following statements If"not determined" lease explain P 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' existing tank is replaced.with a complying septic tank as a imminent. System will inspect on if the A metal approved by the Board of Health. l indicator tank w>il Pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance g that the tank is less than 20 years old is available. ND explain:. Observation of sewage backup or break out or hievel II Obstructed pipe(s)or due to a broken,settled or uneven distribution box,System wilin the l box due to broken or approval of Board of Health): pass inspection if(with 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 du to broken or obstructed Kass inspection if(with approval of the Board of Health): PiPe(s). h due system will 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: �7 (M C%ff Cl r Owner. L Date of Inon: 7C. her Evaluation is Required by the Board of Health: Conditions exist which rewire further evaluation by the Board of Health in order to de is failing to protect public health,safety or the environment determine if the system 1. System will pass unless Board of Health determines in accordance�vitl!3I8 C1i�R 13.303 1 O system is not functioning in a manner which will pest public health,safety and the (b)that 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 march 2. System will fail unless the Board of Health(and Public Water Supplier,if an system is functioning in a manner that protects the public health,safety and envi Y)determines that the ronment: 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 aseptic 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 a Tells 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 pQUutionthe presence of ammonia nitrogen and nitrate nitrogen is from that facility and failure criteria are triggered A copy of the analysis must attached lto f provided that no other 3. Other. J l Page 4 of 11 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner. orl y y Date of Inspection: 0 0 D• System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes N✓ ✓�-, nackuP of sewage into facility or system component due to overl v Dio Discharge or ponding of effluent to the surface of the ground or °ade or clogged SAS or cesspool / gged SAS or cesspool mane waters due to an overloaded or J[ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool squid depth in cesspool is less than 6"below invert or available volume is less than/:day -- --- hued Pumping more than 4 times in the last year NOT due to clogged flow /of times pumped_ gged or obstructed pipe(s).Number //ary portion of the S,cesspool or privy is below hi Any portion of cesspool �ground water elevation. or privy is within 100 feet of a surface water supply or tributary to a surface /water supply. —��Y Portion of a cesspool or privy is within a Zone 1 of a public well. Y 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 supply well with no acceptable water quality a100 feet but greater than 50 feet from a private water nalysis. [This system p if t wen waterPerformed at a DEP certified laboratory,for coliform bacteria and volatilehorganic compOundss' 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 are triggered.A copy of the analysis must be attached top his form,]Provided that no other failure criteria (Yes/No)The system fails.I have determined described in 310 CMR 15.303,therefore the systemat one f more of the above failure criteria exist as Health to determine what will be neces to ce fails.The system owner should contact the Board of nary 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 g d to 15 0 gPd P , 00 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) XSno e system is within 400 feet of a surface drinking water supply e system is within 200 feet of a tributary to a surface drinking water supply system is located in a nitrogen sensitive area(Interim Wellhead protection AreaWpA)or a mane II of a public water supply well peed you have answered"yes"to arty question in Section E the system is considered a significant "yes"in Section D above the large system has failed The owner or operator of an lae ti►reat,01 answered significant threat under Section E or failed under Section D shall u Y g system considered a 15.304. The stem owner should contact the appropriate regional officpgrae of the system Department. Page s of I I OFFIC7Ai,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Address.- oZ q7 Cart ass C� Owner: PGVri, • ` d'� Date of bspectien: k 3• O Check if the ig have been one.Yon must es'or" or as to each of the fopowin Y.es/No VV PympinB information was Pm ided by the owner,oca Or Yazd of Health Wer$any o€the system Pumped out in the pmv+iays two weeks system re o wwedAaa n a n,ws is the f"week period _ Have bw vdames Of I been b the systemMccullyor as paw of this y�spectioa Were as built plans off system obtained and examined?(If they were not.ava;aa*note as N/A) Was the facility or dwelling inspected for signs of sewage back up Was the site inspected for signs afba+eak out J`- Were all system components,cehudmg the SAS,located on site �� Were the septic tank manholes of b C or ices,material of w� 'o and the interior of the tank mVe�for the condition depth Of liquid;depth of sludge and depth of scum was the fawlty ownermwknanm of subsur{� (andWwage Occupants if differetrt fiom owner).p led with.inSormatian on the proper systems The size and location of the Soil Absorption System(SAS)on the site has been Yeses no 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 a is unacceptable)13 10 CAR 15.302(3)(b)j approximation of distance f 1 Page 6 of 11 • OFFICIALSUBSi3 INSPECTION FORM—NOT FOR VOLUNTARY ASS RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM TS PART C )q SYSTEM INFORMATION Fn)pert7 Address: C o✓q Owner. 90#1%1 a 61Cc/ Date of Inspection: .Te RESIDENTIAL FLOW CONDITIONS Nurnberof bedrooms DESIGN now based n31310 L— N��of (actual): Nub 15.203(for example: 1.10 gpd x#of oZ cam Nsidents;_� ); aZ p I residence have a garbage grim(yes or no): /YO is laundry on a separate sewage system es or no) Laundry system inspected(yes or.no): [if yes separate inspection ) Seasonal use:(yes or no): *e meter mdngk if available(last 2 years Sump Pure(yes or no)* Xld ° ( )): Last date of occupancy: !, aia a COMMERCTALIMUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats*r5ans1 and Grease trap pr+esent(y no): scpft,etc.): es or — Industrial waste holding tank present(yes or no):— _sanitary waste discharged to the Title 5 Water meter system(Yes or no);— ,if available: Last date of occ�rpancy/use: OTHER(describe): GENERAL P4FORMATION �mPhrB Records Source of information: Was system primped as part of the ' If yes,volume pumped: tioII(yes or no); / Reason for -- ° "How was quantity pumped detamiuce Pumping: Ttr��'SYSTEM —�c�,distribution box,soil absorption system —Single cesspool _Overflow cesspool —ArivY —Shared system(yes or no)(if yes,attach previous _InnavativeJAltemative technology. Attach a copy��on records,if arty) operation and rr�airrterrance contract(to be obtained from system owner) —Wight tank —Attack a copy of the DEP approval —Other(describe). Approximate age of all components,date installed if$------------ jownYand source of information: Were sewage odors detected when arriving at the site(yes or no):" Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FpRM N[E TS PART C SYSTEM FORMATION(bontim,ed) PrOIreV Addoess• a 9 '0 Owner, 01r1q Date of haspection. DUE LMG SEWER(loea0e C site per) Depth below g�:�. �� Materials of constnx�'on: =�e Distance from private wate i supply well of suction line:_other(explain): Comments(on condition of joints;venting.evidencz of ham,etc•): SEPTIC TANX- '� t _(oc ate pp site plan) olof ode: 'Material '// oonstryctian: c�ooncrebe m�_ �� —othWexplain) I _p*ethylene If tankis metal fig ccrtificato age: a Certificate of Dimensions: � � eo'��ce(yes or no):—(attach a copy of Shxkc depth x g d. 01 Distancefrom top(if sludge to bottom of outlet tee or baffle:.. o�i Scum thickness: O eaut�e Distance from bott M of scum to bottom mac orbafile j �d SG �. �-I How were teeorbA,ffie: Comments(onions o G a C, c as �,outl pumping O Ons,inlet and outlet t or Ie condition,structural inte lot evidence a, ). grtt3',liquid levels rf e� t a GREASE TRAP:A/(locate on site plan) Depth below grade: Material of constnuc�on; (explain): _concrete—metal— erglass_jolyethykne other 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 bad Date of last pumping:_ Comments(on�n�g recommendations,ndations,inlet and outlet or as related to outlet invert,evidence of leakage, baffle condition,structural etc.): mtegrih:ligtrid levels Pass 8ofll � • OFFICI AL INSPECTIONPECTION FORM_NOT FORSURFACE SEWAGE DISPOSAL VOLUNTARY ASSESSMENTS SYSTEM INSPECTION FORM PARS'C. SYSTEM INFORMATION(ccwtmued) PmPerfY. �J C� f Owner. am a�rt� V�o/ Date of bspc �� r TIGHT or HOLDING TANG; tank must be pumped at time of it VO ion)(locate o Depth below gam; site plan) Material of wftw►ctionDimensi : conaete —Polyethylene ons� othe;(exp)ain). C ►: �,� Desiga Flow: moons/ Alarm present(yes or no): Alarm Level: -""— Alarm in working order(yes cw no): Date oflast punving Comments(condttion ofof alarm and float switches,etc.): DISTRMUTIONBO x �(ifpm=t must be opened)(locate on site plan) Depth of liquid level above outlet invert:_140 I'V4 Comnnents(note ifbox is level and cffgnbudon to outlets equal;a � �.�g6 into or out of box,etc.): s0hc1s carryover,any evidence of PUMP CHAMBEX.1lL_.tote on site plan) Fcmrps in working order(yes or no): Alarms in worldng order(yes or nq Comn'ents(n(te condition of pump chamber,condition of pumps and appurtenances,etc.): O { Page 9 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY' SUBSURFACESEWAGE DISPOSAL.SYSTEM INSPECTION FORM ASSESSMENTS PART C SYSTEM FORMATION(contim edj ProPeAdds: Cows 6 Owner. O1/'1gN Oaf-G0/ Hate of Inspection: G o SOLI,assoxrTIorl SYSTEM(sAs):. (locate on site plan,exmvation not regWred) HSAS not located eq"n why: T" �eachinnumber: �t I o h $Pam, 4 �jx �G —CGS JL Q leaching member: leaching ��' umber: trenches,munber,Length: ling fields,number,dimensions: overflow cesspool,number: innovativelaltem ve system Typelname of technology: Comments(note condition of soil,signs of hydraulic failure,level of pondin dam etc.): �i $, p soil,condition of vegetation, L. CESSPOOLS: (cesspool must be pumped as part of inspecdon)(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 constnrction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ndin Po g,condition of vegetation,etc.): PRIVY:k(Oocate 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, $ n,etc.): r Page 10 of I I OMt't SUBS SL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS URFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(aontimn Property"d xm d 9 OV7 offs oww'. 90,01'.4 oaco� Dabs at S 'CH OF Spl%wit DISPOSAL.SYsum Provide a*ct&of the sewage dLVoW:system inc bem Locate an wells within 300 feeC lading ties to at least two Penmanen�refenmoe iandm,ft or I.acate where public water s„ *enters the building F 'o v,-� J10 W4�+C v IA VIA , 4` t - 1 i a - aL/ 31 C - 33 00 V Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C 1 n/� SYSTEM INFORMATION(continued) Property Address: 0� pV4, 5-f Cr✓� avivll oa 610 Owner: Oi"'tANf 0 Date of Inspection: 0 p SITE EXAM Slope Surface water Check cellar Shallow wells . Estimated depth to ground water feet Please indicate( )all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checlack date of design plan reviewed ed site(abutting propez y/observation hoMdoc��—on) fe of SAS) Checked with local Board of Health-explain:Checked with local excavators,installers=(attac Accessed USGS database-explain: TO You must be how you fished the high,end waterlevati n:�o H✓�c'it ✓ i s /l ' �.3 o f�o v�,, ow /� � oh ✓! Wv � J e- 0 � 1 o O p polo i tV C i Town of Barnstable Barnstable OF I E r\ rbn g� . LLE�m'LII�IIeaOC��it 1W- Regulatory Services Department P L D " 39 Public Health Division �O t6gq. �0 A1FOMAtA' 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO February 8, 2008 Esmael Rosa None Silva 297 Compass Circle Hyannis, MA 02601 As of October 1, 2006 a new rental registration ordinance was put into affect requiring all property owners of rental units to register their rental units with the Town of Barnstable Health Division. According to our records, you own the rental property at 297 Compass Circle. Enclosed is an application. Please use a separate application for each rental unit you own. Should you need more applications, they are available online at www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department Menu. There is a link to the Rental Registration information on the Health Division page. You may print out as many as you need, and return them to the Health Division with the appropriate 2008 fees included. Failure to comply with this ordinance may result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4644. Thank you in advance for your cooperation. CERTIFIED MAIL # 7006 2150 0002 1038 6643 JALetter to Homeowner to Register.doc - d (0- �-C1 Certified Mail#7006 0810 0000 3525 3091 (E,COPY 1 l�7 Town of Barnstable Regulatory Services 9A" UM MAST& Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 L Office: 508-862-4644 Sd Fax: 508-7 0-6304 �Z K- ��� " 1(9 3-7 VG October 1, 2007 Esmael Rosa 297 Compass Circle Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 297 Compass Circle, Hyannis, MA was inspected on October 1, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of four (4) bedrooms observed in this dwelling; two (2)were observed on the first floor, (2) two were observed within the basement. However, the existing septic system (permit # 79-50) was not designed for four(4)bedrooms. It was designed for three (3)bedrooms. 105 CMR 410.350-Plunbing Connections: Observed the toilet within basement not installed in accordance to accepted plumbing standards. 105 CMR 410.450- Means of Egress : Observed bedroom within basement without second means of egress. 105 CMR 410.482- Smoke detectors: Observed that there was not a smoke detector within basement. Also observed lack of CO detectors present within home. Q:\Order letters\Housing violations\Rental ordinance\279 compass hyannis You are ordered to correct the violations listed above within fourteen (14) days of your receipt of this notice by pulling any required building permits(if applicable); by repairing toilet mentioned above so that it meets proper plumbing standards and codes; You are ordered to remove the bedroom from the basement that does not have proper egress; by removing entrance door and by opening door- way entrance to room to a minimum of five feet wide opening. This will bring the total bedroom count down from (4) four to the appropriate (3) three as designated by your septic permit. You also have twenty four (24) hours of your receipt of this notice to install a smoke detector in bedroom within basement(area with kitchen unit) and to install a CO detector within basement and first floor. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of. $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. EPER ORDER OF THE OARD OF HEALTH h cKean, R.S., Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector QAOrder letters\Housing violations\Rental ordinance\279 compass hyannis TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date s Owner Tenant 4 Address Address a� Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities t 6. Heating Facilities 7. Lighting and Electrical Facilities — A)LO 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal `� o 17. Temporary Housing PART If 37. Placarding of Condemned Dwelling; •� �LP Removal of Occupants; Demolition Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here °a r 't'"i•rt1'i�aJe-+�.��"::Yt.,. .l ry:,�y... *�4'i'�!"�.tiJi``Y"tfrd•'}� " ''`nr Y - �',f.."^ ,y`fi.,cS.f.-aF�,,.� .,�". ..F' .A..#+.vs.f:r'_..�.1s: �•. - :.q. `� %•. ' l) TOWN OF BARNSTABLE 17)t n BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner Tenant Address _ Address 3 t U - Ll 3 �w / Com liance,, " #-? Remarks or Regulation# Yes, �No r}f . Recommendations 2. Kitchen Facilities J 3. Bathroom Facilities " d �.. 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities V 7. Lighting and Electrical Facilities — / )�O 5 5 Olt"' 011> 8. Ventilation 9. Installation and Maintenance of Facilities z 10. Curtailment of Service 11. Space and Use 12. Exits . 13. Installation and Maintenance of Structural Elements t 14. Insects and,.?pdents 15. Garbage and Rubbish Storage and Disposal r 16. Sewage Disposal 17. Temporary Housing I�-- PART II 37. Placarding of Condemned Dwelling; " Removal of Occupants; Demolition ---- rn� Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here t_ ;� r Parcel Detail Page 1 of 3 c z eta ' ' .g '� ,�. _- =✓" `�`.r' '" ry .r - s Pa rce I Detail Parcel info Parcel ID 1310-432 Developer I LOT 46-A Lot Location#297 COMPASS CIRCLE Pri Frontage:128 Sec Road, Sec Frontage Village HYANNIS Fire District HYANNIS Sewer Acct Road Index=0340 Interactive map Owner Info Owner ROSA, ESMAEL & Co-Owner SILVA, IVONE F ................................ ............... ..... . _ ........... ...._........... ......................................... Streets 297 COMPASS CIR Street2 ........ ...... ..... ...... ... city;HYANNIS State MA Zip i 02601 country 1 US Land Info_ ... ......................... Acres.0.23 Use ISingle Fam MDL-01 zoning RB Nghbd 0105 Topography Level Road Paved Utilities Public Water,Gas,Septic Location Construction Info B ri I o I& Year11979 -.._ .J Roof Gable/Hip Built �_.,,,= ,...�» Struct »� Wall all l�Woad Shingle Effect — _..._.__ _-__.__..__ Roof"_...._ . AC _...,., _........ . Area ,=1054 Cover Asph/F GIs�Cmp Type None Style Ranch Int Drywall Bed €2 Bedrooms W a l l »»�� »» Rooms Model 1 Residential Floor Rooms 1 Full Grade Average Type Heat: _ Rooms Not Water Total 4 Rooms http://lssgl/intranet/propdata/ParcelDetail.aspx?ID=25950 10/1/2007 f Parcel Detail Page 2 of 3 ---- S Heat .- ----- Found er, Stories i 1 Story Fuel OBI ation Poured Conc. , Permit History Issue Date Purpose Permit Amount Insp Sate Comments Visit History _.. .- ...... _......................................_ ....... ......... ........ .. . __._.... Date Who Purpose 10/19/2004 12:00:00 AM Paul Talbot Meas/Listed 5/13/2003 12:00:00 AM Paul Talbot Meas/Listed 3/19/2001 12:00:00 AM Paul Talbot Meas/Listed 110/15/1987 12:00:00 AM ME - Sales History Dine Sale Date Owner Book/Page Sale P 1 7/15/2004 ROSA, ESMAEL & 18830/060 2 9/19/2002 ROMANSON, WALTER A& MARY D 15614/051 3 9/3/2002 ROMANSON, WALTER A 15545/134 4 1/15/1990 ROMANSON,WALTER A& BONNIE G 7018/066 5 9/15/1983 ROMANSON, WALTER A 3853/216 Assessment History Save# Year Building Value XF Value OB Value Land`value Total Parc( 1 2007 $110,800 $8,300 $0 $161,800 ; 2 2006 $97,300 $8,300 $0 $162,000 3 2005 $93,500 $8,200 $0 $128,100 4 2004 $75,800 $8,200 $0 $96,000 5 2003 $68,500 $8,200 $0 $35,400 6 2002 $68,500 $8,200 $0 $35,400 7 2001 $67,800 $8,200 $0 $35,400 8 2000 $51,100 $7,800 $0 $21,700 9 1999 $51,100 $7,800 $0 $21,700 10 1998 $51,100 $7,800 $0 $21,700 11 1997 $60,000 $0 $0 $18,600 http://issql/intranet/propdata/ParcelDetail.aspx?ID=25950 10/1/2007 FORM30 H&W HOBBS&WARREN TI THE COMMONWEALTH OF MASSACHUSETTS BOARD , - O LTH CITY/TOWN W TA DEPART E'111T ADDRESS p,M spa JOB p� TELEPHONE Address l� Occupant_ Floor Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.Stories Name and address of owner -Ol-7 Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: C 0 Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 { Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION T IS SIGNED AND CERTIFIED UNDER T P INS AND PENALTIES OF P U " INSPECTOR ( � TITLE AM DATE b �I 0 I TIME ` A.M. THE NEXT SCHEDULED REINSPECTION P.M. l 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. J The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public ( ) P Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation,or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FoRM30. HOBBs&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS ES C�H$,W BOAFg O LTH i CITY/TOWN � r W I o DEPART ENT Y j ADDRESS G1.y SV0"`oW S ^ TELEPHONE / I Address — Occupant- Floor Apartment No. No.of Occupants { No. of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units_ No.Stories I Name and address of owner 1`7 ,. Remarks Reg. Via j A_ YARD Out Bld s.: Fences: Garbage and Rubbish j Containers: r # Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: , Roof �j Gutters, Drains: Walls: ' Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: ` Stairs: Li htin ;. STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: t QC D 4" Hall Lighting: Hall Windows: j HEATING Chimneys: { Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT i Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry I Den . 4 Living Room t" Bedroom 1 Bedroom 2 iw Bedroom 3 Bedroom 4 i Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues;Vents,Safeties: Kitchen Facilities Sink ` Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice„Roaches or Other: j Egress '' Dual and Obst'n.- General BuildingPosted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH r MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) 'i "THIS INSPECTIO kt�ORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OFPERaU INSPECTOR TITLE DATE ! `f r TIME lZ 1_� �_ _ —17 ..� A.M. THE NEXT SCHEDULED REINSPECTION'' - - ` " ` i i P.M. r 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating,gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. FORM30`CH HOBBS&WARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARwD O�F iTH CIT Y/TOWN W t� DEPARTMENT � r i ADDRESS L. r TELEPHONE Address Occupant �!�. Floor Apartment No. No. of OccupantsT No. of Habitable Rooms No.Sleeping Rooms I No. dwelling or rooming units_ No.Stories — Name and address of owner ^� 5� ^""�.... 1.* - 0+ c1 Remarks Reg. Vio. YARD Out Bld s.: Fences: ` Garbage and Rubbish Containers: `> Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation.- Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: -0 C 0 Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT 1 Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom(1). d Bedroom 2 Bedroom 3 .1 to 2- � Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other.- Egress Dual and Obst'n.- General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY. f ' INSPECTOR '"- ' TITLE ^ A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents,,insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. LOCaT 0 SEWAGE PER NO. i.: VI"LLACE INSTA LLE 'S NAME & ADDR SS L� BUILDER 0R 0 NER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED —914 �� �\ '`.J �� �'� � i a "�� �1j`I �- V �• {�� �� �� � � - Z __ . ..r N&.....---------------- THE COMMONWEALTH OF MASSACHUSETTS I BOARD ,IF HEALTH - . .................OF..... .................... ---------------- OF............. ...... ............................................. - Appliration for Dispaiial Works Tonstrurtion Frrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal SystTi at: -- ----- -------_ :.A e�74 ----------�_ 0/r ---------------- wn ca( 7 .......... ........ . ...... .. .. ........ Lon ess dr 0. . ..... . ... . ......................... .. .. . ..................... .. ............... 0 0 w.e Address ... .............. .............................. ...I ---------- ................ ---------------------*------------"....... ...... ...... Installe'r" Address Type of Building A.�..02�Size Lot..... Sq. feet Dwelling—No. of Bedrooms._.__ _____..___.._Expansion Expansiontic Garbage Grinder ( ) Other—Type of Building _X No. of.persons.______.._------------ Showers ( f ) — Cafeteria ( ) Otherfixtures ...................................................................................................................................................... Design Flow......�13.............................gallons per person per day. Total daily flow........rf.jO.........................gallons. Septic Tank—Liquid capacity.AdVagallons Length_._... Width._/........ Diameter................ Depth.............._. Disposal Trench—No. ............. Width.....__......_...... Total Length.................... Total leaching area.-In2a.1........sq. ft. . Seepage Pit No ... Diameter.................... Depth below inlet.._..............._ Total leaching area..................sq. ft. Z Other Distribution box (A ) Dosing tank V -f Percolation Test Results Performed by.,44a. ............ Date..._............... Test Pit No. I................minutes per inch Depth of Test Pit___.__............._ Depth to ground water_-_N _ _:� G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................._... -- --- 0 Description of Soil.... ....... U ........................................................................................................................................................................................................ W ........................................................................................................................................................................................................ �4 U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITLIE' 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t board of health. Signed...'05zte'.'o..... ...... .............................. Date Application Approved By.... ........... vvv Date Application Disapproved for the following reasons:............................................................................................................. ........................................................................................................................................................................................................ Date PermitNo......FP......................................... Issued_...... ------------------- Date FzB,.r1/. ............ THE COMMONWEALTH _OF MASSACHUSETTS BOARD 07F HEA ' TH OF... -------7_10e� ............... ............................................................................ Appfiration for Uhipaaal Vorkii Tonotrartion Vamit Application is hereby made for a Permit to Construct (,X or Repair ) 'an Individual Sewage Disposal System at: /" .... ................. ............ ............ ....... ... .............................. ............ Locat(ion�-9d ess ....... 7 ...........................�a------------------------------------------------------------------ ..... ................ .................. Owne Address .................................................................................... ............................................................e:.................................... Installer Address ' Type of Building Size Lot.....h?l..�`:6QSq. feet Dwelling—No. of Bedrooms....... ....................Expansion Attic Garbage Grinder Other—Type of Building No. of persons..........6"............. Showers Cafeteria aOther fixtures .........................-----_--------------__-------_---------_------------------------------------------------------------------------- <11 �r. � * Design Flow.......r:e.................................gallons per person p�day. Total daily flow......:f:70 .................gallons. * Septic Tank—Liquid*capacity../AC,�Igallons Length.__.._.........�. Width.....i�'_`f_.... Diameter---------------- Depth................ Disposal Trench—No. -r Width..................._ Total Length.................... Total leaching area..2E��&_.L._.....sq. ft. Seepage Pit No ..... Diameter.................... Depth below inlet.................._ Total leaching area..................sq. f t. 1 Z Other Distribution box O Dosing tank ............. Date...... z Percolation Test Results Performed ........Z� Test Pit No. I................minutes per inch Depth of Test Pit._____............_. Depth to ground water...... 04 Test Pit No. 2................minutes per inch Depth of Test Pit.__................. Depth to ground water..__.__._..........._... 9 v::..... .. ................................................................................. 0 Description of Soil. ... .........V ----- ----------- ---------11-11*11,11,1111"*------------- .................................... U ................ ------- ---------------"........*---------------------------*---------------------------------------*--------------- --------------- -------------------------------------- ................................................................................................................................................ -------------------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................. ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'11, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in - operation until a Certificate of Compliance has been issued by the board of health. Z Signed. 4/Z��.� .. .......................................................... ................ ....... Date ApplicationApproved By........TA................................................................................. W Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo........V------------------------------------------ Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - ......._OF.......... ............................... Tntifiratr of Tuampliaurr THI IS TQ CERTIFY, That-fthe Individual Sewage Disposal System constructed or; Repaired ................ ....................................................................................................... Installer,at.... , e,_........................................................................ has been installed in accordanfe with the provisions of 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........XZ......................... dated....... ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF... OF, HEALTH ............... .........................................No.......:x .......... FEE.. ......... Permission is hereby granied_.A/ ............................................................ to Construct or Repair Individua/Sewa _1Disposal/S;SteM at ......4/4/��.X... ...... -----------------------------------------------------------................... t St 7< -------- 5"t, as shown on the application for Disposal Works Construction P e/vnit No.....n�......... Dated....... ........... ge uct on ........................................................................................................ Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS s --99 --EXIST CONTOUR ��'� AIRPORT N x 100.98 EXISTING SPOT GRADE �aF ROTARY NI ;�)EXISTING WATER SERVICE LOCUS ROUTE 2S Ro 4 --&.H. yip-- OVERHEAD WIRES � A UrF 2a PB 273-PG 9 �' TEST PIT \A m BENCHMARK oT Ro s'o� LEGEND s W �o N m 9_ gP� w LOo TLE UOSSMAP 1062 \ 103.41 N 14°44'05" E 99,93 stockade fence T . ° 128.00' + x98, 6 I 97.6 10 �fb� Xo21.4 / 0 t GENERAL NOTES: 6 \\ / I� 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL °\ 101.21 / ! BOARD OF HEALTH AND THE DESIGN ENGINEER. PROPOSED a / x 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SEPTIC TANK / 9 ,85 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DECK EXISTING 100.55 // m1 LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: 3r HOUSE/ 297) h \ -310 CMR 15.405(1)(b): T.O.F=`107.6t 1) A 3' variance to the 3' maximum cover requirement, for up to CELLAR FL, EL.1o0.3± PAT/0 / V w 6' of max. cover. S.A.S. shall be H-20 and vented. 0 10555: ` 00 99,90 99,3 �o o 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR °O .°:a .. ` m o TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE Q.• ... \ . .: .:..<.`.':':... .` :.:.. � 0 o `n DESIGN ENGINEER. .. j 01.87 100.3900 z W._. `'.. 101.00 in 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 99,07 a FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 104.9 ;�O 0 10�33 co cn ENGINEER BEFORE CONSTRUCTION CONTINUES. 04.9 0,09 EXISTING SEPTIC TANK 0' 103.76 :: :.. ':`.: :::: .':.:":: 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. (TO BE REMOVED) :~ 1 12 .. . . . 98.46 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF TOP OF TANK, EL.=104.25 ` ,DRII�EAY THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF INV.(IN) •=1.03.05E o0 "; ..' . HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. INV.(OUT)=102.80E 1(�4,09_ tom' 0 0 s� cv / ; • � 1 ` 104 - 1 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. . `s. s. : / . 103,9 ``;,p .;.' 25,' TP-1 8. THERE ARE NO POTABLE WITHIN 150' OF THE PROPOSED S.A.S. TP- 0 101.05?: ".''`.; �p�` 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 10 37 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 103,3� 102.89 � S❑ 128.00 S 14°44'05" W DIRECTED BY THE APPROVING AUTHORITIES. x 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY EXISTING LEACH PIT__ lT f100139 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING (TO BE REMOVED) :�• '"�" _-• -' CONSTRUCTION. PK SET 100.56 9977 102.34 101,89 edge of pavement 100.14 G N 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 101.60 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND T �/ + REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). PCOMPASS C �C1JJ_/ f 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 100.00 INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL. OF Mqs BENCHMARK START MAG. NAIL SET EL.=101.60 PETER T. UP PROPOSED SEPTIC SYSTEM UPGRADE PLAN o �, M CIVIL EE y 297 COMPASS CIRCLE, HYANNIS, MA o. 35109 Prepared for: Quinn's Excavation, 39 Bog River Bend, Mashpee, MA / OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. HADDA, VILMA 1"=20' P.T.M. 129-1 7 134 ENSIGN ROAD Engineering Works, Inc. CENTERVILLE, MA 02632 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. -� (508) 477-5313 3/13/17 P.T.M. 1 of 2 t n NOTE: TO PREVENT BREAKOUT, FINAL GRADE SEPTIC TANK SHALL NOT BE AT, OR BELOW, EL.=99.50 INSTALL RISERS & COVERS OVER INLET & FOR A DISTANCE OF 15' FROM THE EDGE OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D-BOX OF THE PROPOSED S.A.S. INSTALL RISER & COVER PROPOSED S.A.S. SET TO 6" OF GRADE INSTALL RISER & COVER OVER EACH CHAMBER AND DECK EXIS17 T.O.F=107.6E SET TO 3" OF F.G. TO SERVE A�NSPECTION PORT HOUSE(�297) /� F.G. EL.=106.3t .G. EL.=103.0 to 105.5E F.G.FG EL.=106.0E F.G. EL.=105.8E T.O.F.= 07.5 0 VENT CELLAR FL, EL.100.3f PA TIO MAINTAIN 27. SLOPE OVER S.A.S. L = 6' 3'(max.) L = 7' ® S=1% (MIN.) ® S=1% (MIN. L = 13' 4"SCH40 PVC 4"SCH40 PVC) ®'SCH 0(PVC) 2" LAYER OF 1/8" TO 1/2" 6" ,/ DOUBLE WASHED STONE I� s aaaSaaa (OR APPROVED FILTER FABRIC) �j�3`• O 141, INV.=102.90 48" LIQUID aaaaaaa --3/4" TO 1-1/2" DOUBLE 0 �" LEVEL ADD PROPOSED 4' 4.8' 4' WASHED STONE r,� � GAS BAFFLE INV.=102.27 _ INV.=102.10 p T INV.=102.65 EFFECTIVE WIDTH = 12.8' N� �CO ^^j^ AM 2w," II3 OUTLETS INV.= 99.00 PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS LV PRO. S.A.S.SURROUNDED WITH STONE AS SHOWN ------ 1 CONNECT TO EXISTING SUITABLE SEWER PIPE/S - 99, -� AT HOUSE, AT OR ABOVE, INV.=103.00t verif H-10 RATED TOP CONC. ELEV.=100.1t NOTES: BREAKOUT ELEv.= 99.50 Emma SEPTIC LAYOUT HINV. ELEV.= 99.00 mama® 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & aaBaaaeaaaa INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. BOTTOM ELEV.= 97.00 4' 2 x 8.5' = 17.0' P4�' 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL ANY � ,/ 4' OF NATURALLY OCCURRING TRUE TO GRADE ON A MECHANICALLY COMPACTED -,_ EFFECTIVE LENGTH = 25.0' SIX INCH CRUSHED STONE BASE, AS SPECIFIEDU. a PERVIOUS MATERIAL IN 310 CMR 15.221(2). 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION ®®®® ® ® ®® 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTTOM OF TEST PIT, EL.=91.5 = ®®®®®® ® ®®®® „ 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE H 37 AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. W ® N Z ®�®®®® ® ®®® ® SEPTIC SYSTEM PROFILE 102" DESIGN CRITERIA SOIL LOG 4" KNOCKOUT . NUMBER OF BEDROOMS: 3 BEDROOMS DATE: MARCH 3, 2017 (REF#15,284) 20" DIA. COVER SOIL EVALUATOR: PETER McENTEE PE(SE#1542) SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) WITNESS: DAVID STANTON R.S. HEALTH AGENT DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH 4" KNOCKOUT 4" KNOCKOUT 58" DAILY FLOW: 330 GPD 103.5 0" 103:6 0„ 0 FILL FILL DESIGN FLOW: 330 GPD 101.5 A 24" 103.6 A 24" GARBAGE GRINDER: NO-not allowed with design SANDY LOAM SANDY LOAM 4" KNOCKOUT LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 101.0 B 10YR 4/2 30" 101.1 B 10YR 4/2 30' .74 GPD/SF SANDY LOAM I SANDY LOAM 500 GALLON CAPACITY, H-20 LOADING PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY 99.6 10YR 5/8 47" 99:6 10YR 5/8 48" CHAMBERS PROPOSED D-BOX: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED C PERC C N.T.S. USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 24"/42" SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES PROPOSED SEPTIC SYSTEM UPGRADE PLAN MED. SAND } MED. /6 6 SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. 2.5Y 6/6 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. FEW COBBLES FEW COBBLES Prepared for: Quinn's Excavation,. 39 Bog River Bend, Mashpee, MA TOTAL AREA:.......................................................I...... 471.2 S.F. 91.5 144' 91.6 144" Engineering by: SCALE DRAWN JOB. NO. n DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD PERC RATE <2 MIN/IN. "C Engineering Works, Inc. N.T.S. P.T.M. 129-17 HORIZON g REFERENCE PERC NOV. 11, 1978 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. NO ,GROUNDWATER ENCOUNTERED (508) 477-5313 3/13/17 P.T.M. 2 Of 2 l r ` y i 4� _ 1 f �'F�IN+_ __� %FtN�SH G'IPAa� __Q�C7 �INtSM G•QA�+� F1ti/,S'N G9TA77G" _ .._ • _ ---------- !� �Uv�R Tit NK = �. .. Ova, n�T r � :'x�7 Top IF 0mto. �`n�'�]If'►�-a`���/l�vU/�.7/,,`!i/iA'JYv. J�.t'Yl1'�allh�]!��`Tf1,-�J���ITr��w7i,�ytl���ZY77�h�i7���'v�7f'��n/ - -- - NC• ',' „ -- // tw✓/�1 At�+afDCkF/LG / CELL.A .� qy L E�f✓ s� 1Pdt IY R EAD CONC. 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