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HomeMy WebLinkAbout0027 CONNEMARA CIRCLE - Health 2°7�Connemara :Circle t H anrus -- A 292 s o o 'I o h �L f c Commonwealth of Massachusetts ���✓�l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every H annis MA 02601 04/20/2021 y page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information ! # 15-3 I on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key•..... 52 Rivers End Road Company Address Teaticket Ma. 02536 Citylrown State Zip Code 508-280-3356 S13938 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 1/ 04/20/2021___. 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 r - Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3i or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This 3 bedroom home has an H-10 1500 gallon septic tank with a H-10 D-Box feeding 2 leaching chambers with stone. At the time of the inspection there was apx 1 foot of ponding water in the leaching and no visible failure criteria was found. NOTE: Rooms are finished in the basement. None of them qualify as a bedroom under Title 5. There is a sewage ejector in the basement. 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 _ ter. ♦,J ' .. _ �, . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I (� 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Citylrown 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): N ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: , ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form v J., Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS'is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No El ® Backup of sewage into facility or system component due to overloaded or 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 l5insp.doc•rev.7/26/2o18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 t. Commonwealth of Massachusetts U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown 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: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply, ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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. I Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑, - ❑ the system is within 200 feet of a tributary to a surface drinking water supply El the system is located in a nitrogen sensitive area (Interim Wellhead Protection ` Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc rev.7/26/2018 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ve Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA , 02601 04/20/2021 page. Cityrrown 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 ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from-owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at.the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 .t c Commonwealth of Massachusetts Title 5 Official Inspection Form Y Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara'Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): GPD lus Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d town water 9 ( Y 9 (gP ))� Detail: In 2020- 126,412 gallons were used and in 2019- 151,844 gallons were used. Sump pump? ❑ Yes ® No Last date of occupancy: 8 days ago Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts urTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) . Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No 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 i Water meter readings, if available: I Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes:volume pumped: gallons How was quantity pumped determined? Reason for pumping: ..,,. e t5insp.doc rev.7/26/2018 .' �,^. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 } Commonwealth of Massachusetts U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Comp Date 1/25/2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 32"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: town water feet Comments(on condition of joints, venting, evidence of leakage, etc.): Water was flushed and came freely. 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 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 24" 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 • Dimensions: H-10 1500 gallon Sludge depth: 4" • Distance from top of sludge to bottom of outlet tee or baffle 32" •Scum thickness 3,. Distance from top,of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge Comments (on pumping recommendations,,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use,of the home. At the time of inspection the liquid level was at working level and the tee's were in place. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form t i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is Hyannis MA 02601 04/20/2021 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction:' ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: ' Scum thickness r Distance from top of scum to top of outlet tee or baffle • r Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)'(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: . gallons Design Flow: gallons per day t5insp.doc•rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is Hyannis MA 02601 04/20/2021 required for every page. Citylrown 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): , Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At the time of the inspection the liquid level was at working level and there were no visible signs of leakage or solids carryover. l5ins•.doc-rev.7/26/2018 +.• + o P Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 12 of 18 , Commonwealth of Massachusetts Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown 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.): *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: ® leaching chambers number: Two _ ❑ leaching galleries number: • ❑ leaching trenches number, length: Elleaching fields number, dimensions: ❑ overflow cesspool ' number: ❑ innovative/alternative system Type/name of techriology: L 't5insp.doc•,rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 t i Commonwealth of Massachusetts U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page. Cityrrown 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.): At the time of the inspection there was apx 1 foot of ponding water and no visible failure criteria was found. 1 I r . I 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration I Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction i Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i k i 4 1• r r t5insp.doc•rev.7/26/2018 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA • 02601 04/20/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 1 , t5insp.doc•rev.•7.126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 1 f j. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for•Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 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 tt�ll-g, IOs Zt,i IF,`ZZ"$� 6 I �Ys IAr b c . 2A•3 g'-o� '� a A aD.3�_'� 1 5'+4rCCG+ (Cehn16Wer4 Ct'ccle t5insp:doc•rev.726/2018. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every Hyannis MA 02601 04/20/2021 page, Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10 plus feet feet i Please indicate all methods used to determine the high ground water elevation: i ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show 4 plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 i f Commonwealth of Massachusetts Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Cir Property Address Everton Grant Owner Owner's Name information is required for every 02 Hyannis MA 601 04/20/2021 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate _ 4 (Failure Criteria)and 6 (Checklist)completed ® 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 i • F . f i • 4 t5insp.doc•rev.7/26/2018 + Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Pd Sr, I L?�Z3 a9I-a y� I Commonwealth of Massachusetts Ok Title 5 Official Inspection Form Subsurface Sewage'Disposal System Form - Not for Voluntary Assessments : °M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is �/ u required for every Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection �y Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brett Hickey use the return Name of Inspector key. Excavation Company Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113747 Telephone Number License Number B. Certification certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5-18-17 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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal)System•Page 1 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System was in working order at time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis annis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) 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. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins-31113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is Hyannis Ma 02601 5-18-17 required for every y page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"*. Method used to determine distance: "* This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: i Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w. 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form _ a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? I ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3-Number of bedrooms (Actual) 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 339gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See below 9 ( Y 9 (gP ))� Detail i 2016- 53,856gallons 2015-63,580gallons Sump pump? ❑ Yes ® No Last date of occupancy: CurrentDate Commercial/Industrial Flow Conditions: Type of Establishment: NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner-not pumped since new Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool, ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3'6" feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. Town feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2 6 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 Dimensions: 1500gallons Sludge depth: 6 i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required forevery Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 30 Scum thickness 4 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is in need ` of pumping at this time and should be pumped every two years for maintenance. Grease Trap (locate on site plan): Depth below grade: NA feet I Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is Hyannis Ma 02601 5-18-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: i ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level.' Alarm in working order: ❑ Yes ❑ No Date of last um in p p g: Date Comments,(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up. 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: (2) 500 gallon ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Chambers had 6" of standing water when viewed. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is Hyannis Ma 02601 5-18-17 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i 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.): l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is Hyannis Ma 02601 5-18-17 required for every Y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately Al-15'6" A2.35' 61.13' 62.28'4" C1.177' C2.28'9" D1.22'3" D2.347" El-228" E2-284" F1.201" F2.38'8" 2 DECK E IC D � 1 F J,,�'���DRIVEWAY t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is Hyannis Ma 02601 5-18-17 requirey d for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10-31-06 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: Observed at 91" (5' separation perplan) ❑ 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: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w„ 27 Connemara Circle Property Address Deanne Maraj Owner Owner's Name information is required for every Hyannis Ma 02601 5-18-17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN O�/F� BARNSTABLE LOCATION 0 � �0hrXjk'�r� ( I'CC.fe SEWAGE # r96Q2— 3`�0 VILLAGE lrl ,nail ASSESSOR'S MAP & LOT 2 / - J-- INSTALLER''S_NAME&PHONE NO. f j'dv� A - S�u SEPTIC TANK CAPACITY 16-6ra 6-a&as. }f l® LEACHING FACILITY: (type) �/2 [ (size) /4 NO.OF BEDROOMS 3 BUILDER OR OWNER f6ln PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of 1 bins facility) Feet Furnished by �r r� ry a W t1 \o QI N IS" It I � IZ s:S .re n n � No. — / l/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for 3i6pont i§p!5tem Construction- j3ermit Application for a Permit to Construct kl' Repair( Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components (0AA)EMAYA C/I'�je Owner's Name,Address;and Tel.No.Location Address or Lot No. 2 7 j��, y S'/vcrr Assessor's Map/Parcel Z9! S"U, — 7 234S Installer's Name,Address,and Tel.No. JAS OA) JOV l,4 Desi ner's Name Address and Tel.No. 7C'�'I'CccA�R s �A 77 q7b Type of Building: C Dwelling No.of Bedrooms 3 Lot Size J / b �� sq. ft. Garbage Grinder ( Other Type of Building No.of Persons — Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re wired) 33o gpd Design flow provided 352- gpd Plan Date /0 6 • 8 0 7 Number of sheets / Revision Date 8 0 Title r JO !U t' 2 7 CU M / ' !S Size of Septic Tank 15610 614 1 Type of S.A.S. 2--00 bA GueG! W ,v& Description of Soil �O Z s Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Ith. Sign Date I2 Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 7�L,J fTl Date Issued V:7— •THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewa a Disposal System Constructed (i�) Repaired ( ) UpgradedAbandoned( )by d�� A- - ey—T� �— at 1-�1 C-csh �j�v e� has been constructed in accordance 7 with the provisions of Title 5 and the for Disposal System Construction Permit*No. 3 dated o - Installer Designer #bedrooms Approved d&Tfllow gpd The issuance o his pe its all not be construed as a guarantee that the systems design d. 0 Date Inspector I "_ � _ .rv��y,., .p y- 'r'n^ti� - �,-r.,. ...+MVrv`•_-•�r."V,.nM,�},t `ti„L'_"�s. ..... � _.�.-., � w- • y _ T No. r N ,,,_ .;, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: }P_ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes AbOtWirdtion-for dig o9al 6p.4tem �lConviucttott,Verintt A•pplicition for a Permit to.Construct Repair( ) Upgrade O Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. 2 ? l '�N �fl rA l ,r(�P Owner's Name,Address;and Tel.No. Skee—* Assessor's Map/Parcel 2Cf Z�Z� SU - 7 /— 2 S i r Installer's Name,Address,and Tel.No%Jf)S r)Au J,9 tl Sig Desi ner's Name Address and Tel.No. Uri . J. s0 7' - 976 ---'-Type of'Buil'ding-~•A...�.•----••-,--.-....---�' . 4 `" Dwelling` No.of Bedrooms Lot Size �(' S0S sq. ft. Garbage Grinder (/�} Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33o gpd Design flow provided 352- gpd Plan Date /O , k G 2 . 612416 7 Number of sheets / Revision Date I Title _ �� Jr �r/U�,�G< �i^y C/ : 2 7 ( C� .l _ /" vim) / Size of Septic Tank 41 Type of S.A.S. 2-SOO. 15 A)F i Description of Soil �G/iv�� /ZLPA • 2. 6 h'IP//. 2`St 6 Nature of Repairs or Alterations(Answer when appli able) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental-Code and not to place the system in operation until a Certificate of Compliance has been issued by,this Po' alth. I\ + _ Sign e a � �� Date _ i 1 � Application Approved by �/ Date Application Disapproved by: r Date for the following reasons Permit No. Date Issued ' ----------------- /// -- ——————————_ .THE COMMONWEALTH OF MASSACHUSETTTS �. BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS'IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )<paired ( ) Upgraded ( ) Abandoned;( )by J dU Z- at C-11.,` VA.-e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. _ 3 dated 0� Installer �, `�- Designer - #bedrooms Approved design flow , gpd The issuance o this pe it shall not be construed as a guarantee that the systems I fu c on as designed. Date Inspector . '� - -==---------.------------._=~.=�,'�———— ' I No. THE COMMONWEALTH OF MASSACHUSETTS Fee PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS &.5pogar Item Construction Vermtt Permission is hereby granted to Construct (\ ) Repair ( ) Upgrade ( ) Abandon ( ) System located at -Q K)k_)IlQ M 12 1/a I V L7'da AJA2 �x /"//1 OU11D,91 and as described in the above Application for Disposal System Construction Permii.The applicant recognizes'his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: onstruc ion must be completed within three years of the date of this Date Approved by Town.of Barnstable ,Regulatory Services Thomas F.Geller,Director . e Public Health Division 11omas Mclitean,Director 1 200 Main Street,Hyannis,MA 02601 Office: 509462-4644 Fax: 50&790.6304 Installer&Designer Certilkadon Form Date: 3 26 d or Sewage Permit## .} ?O Assessor's MapTarcel+9/ -a9Z Designer: Zw Installer: A 07 A_ Sary za, Address: 1�D8 Address: �? � Yjgam6yM�1?2/3-6 lice . .A,- - %Z(V � 73 On ,r ,j__*-- was issued a permit to install a (date) (installer) septic system at ob"Ae bWr, f j,' -e e- based on a design drawn by(AlAr- le dated QG'�41v/ ; (designer) i I certify that Me septic system referenced above was installed,substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stroll (if required) was inspected and the soils were found satisfactory. I certify that the septic system reference above was installed with maj'ar oranges (i.e. greater than 10" lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State dt Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)w� inspected and the soils were fund satisfactory. 1-YC-: • 1, ler's Signatures4,t (Designer's Sigma (AMt Designer's Stamp Here) �LF"E RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CEMMICATE F COMPLIANCE MIL NO BE ISSUED UNTIL BOTH TMS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. !HAWK YOU. gAft t Mesiper CeMfica6on Fenn Rev 03.09.06.doa sw G7 11:50a 3 y f Z4 f ur-O yr RL moo ' • ' 1 i 1 � i G S-6 w '� � ► I2 ' i i 1 � 1 1 , W ..,5 f s r 0z 1 � Hill, � . Aug 27 07 11:49a p.4 k, .s v Rw i �'e 2-s � r mme - NB�IItE 04. VN cm f -pt sovum �— :.�IfRS - t g As . � y � r � t O memo r TR Z41 ~° i O'll.. 9 a m 5 1 -1 1 11 ' Hu ®r-h! t t I I r� RONALD J. CADILLAC, PLS, RS, P.C. Professional Land Surveyor&Registered Sanitarian P.O. Box 258, West Yarmouth,MA 02673 (508) 775-9700 (800) 520-5591 TRANSMITTAL FORM To: Board of Health&Conservation Staff Re: 27 Connemara Circle—AM 291-292 Date: 10/27/06 Certified : ❑ No. Fax ❑ Enclosed: Copy working plan—no stamp, not final checked Copy Town GIS Message: Question I have is concerning the Isolated Wetland and how it relates to this proposed project. This Isolated Wetland is smaller than the state regulated size. (Barn. ConCom Bylaw defines regulated Isolated Wetland as anything over 500 s.f.) Is the BOH Reg. requiring 100' separation from tanks and leaching to wetland from State definition of Isolated Wetland, or more stringent Town reg. Which was created first? Thanks for you help. n o N -� o ca l P 291 AP 291 284 131 - _ 1. 14 1 P 291 MA 2 2 - -MAP S',Y, 2� M _P 41. 1 6 ' 35, � 1 37.5 ,0 -- 291 i � I 1 11 1 291. �- --� 9 - 3 2 1 ,1 M W 1 M P 91 �-- � 3 C 8 4 I MAP 2- ' McKean, Thomas Subject: RE: 27 Connemara Circle ' This site is partially within a ZONE II and is only 10,508 square feet in size. Please deny the application at this time due to the following; The plan is deficient as follows: - Part of the septic tank is in the zone II (limits home to one bedroom). - Sewer pipe is totally inside the zone II a wetla T - No floor plans of the proposed house received I also understand that there is question of whether three bedrooms could be approved due to it's location partially within a zone, a DEP policy. I have not seen a copy of the partial zone policy but this needs to be examined. -----Original Message----- From: Morgan, Meredith Sent: Friday,August 24, 2007 4:05 PM To: McKean,Thomas Subject: 27 Connemara Circle Tom, 27 Connemara Circle needs to be reviewed. I put the plans on your desk. Thanks Meredith E. Morgan Health Inspector, Public Health Division ' Town of Barnstable 200 Main Street, Hyannis, MA 02601 Tel: (508)862-4644 Fax: (508) 790-6304 r I ------------ ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE. JOB No. B-06-10 m NOTES SILVERA.dwg rUCIA £SZONING DISTRICTS: RB & GP INSPECTION- SCHEDULE 1. LOCUS. IS A.M. 291, PARCEL.. 292.. wqr- FRONT YARD: 20' CALL R.J. CADILLAC TO 2. ELEVATIONS SHOWN ARE TOWN GIS t0.4'.C14SIDE YARD: 1O' INSPECT PRIOR TO BACKFILL BENCH MARK--MAG. NAIL SET IN 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATEfl AUGUST 19, 1985.PAVEMENT=36.34 TOWN G.I.S.f0.4' 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) J REAR YARD: 10' (28'-7" OFF CENTER OF UTILITY POLE) 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. o_ 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. RA CIR. v 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". N-/F 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW NEPHEW D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. NOT TO N/ F RAISE COVERS TO WITHIN 6" OF GRADE: 2 ON TANK, 1 ON D-BOX, AND 1 ON LEACHING. SCALE LEAF = 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LOCATION MAP 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, r N /F 3' DEEP IMPERVIOUS CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. BARRIER--32 L.F. GF 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING JOHNSON V11 40 MIL POLYETHYLENE IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). TEST HOLE 2 ® 36.34 (MILLER BREAKOUT**) 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN - set TOP BARRIER=TOP LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. PEASTONE=32.6,GRADE 14. ALL 'CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS: DEPTH (inches). ELEV.(feet) 36,4 ABOVE BARRIER=33.0 MIN 0 A layer 10yr 3/4 35.1 BARRIER IS STIFF sandy loam x 6 & OBTAINABLE FROM TEST HOLE DATE: September 6, 2006 10 MILLER ENVIRONMENTAL PERFORMED BY: Ron Cadillac, Soil Evaluator B layer 10yr 5/6 x 37.3 508-697-3710. WITNESSED BY: Donald Desmarais RS sandy loam ,RAA- 3 _ _ _ ---�-36T 73 � PERC- RATE: <2'-00"/inch (C player) 24„ (gravel 10%) 33.1 NEM CON _ -�6 37.0 SOIL SURVEY(1993): Carver coarse sand a avement 36.6 Prop. Top Found. GEOLOGIC MAP 1986 : Barnstable lain deposits a� edge -p --"-'3 - --E E ( ) P P Q C1 layer 2.5y 6/4 __ -�I E___I/ E� 36,8 Invert 33.25 54�� loam med. sand -�7 ---_E___ - E 82 rj 40'x St7.4 TAKE & // 33.2 min.** Invert 32.45 (gravel 30%) 37 8 00 D TACK SET Prop. Top Slab Proposed 2 DRY WELLS TEST HOLE i 8Z r___ 5.6 Proposed prorosed 20 0 ��" r. H-10 Use Gas Baffle H-10 54" 30..6. STAKE & N i braX 1 O 1 I p� S=3�8„/ft 9 min. cover H-10 P 32.9=Top Conc. C2 layer 2.5y 6/3 TACK SET OP. „ ...� 32.6=Top Peastone .. - med. fine sand DEPTH (inches) ELEV.(feet) _ PR �o Proposed S-1/4"/ft 0 35a p ARK 6 t f:.E._:a **Top slab to be 1500 Gal. A layer 10yr 3/4 TH 1 35. T, { P above to eastone Invert 32.70 1 '. , t Q p p Septic Tank sandy loam 6.1 N O U0 I Proposed p „ 15' 11 _>._- I::;::::: 1. . : 538 " no water Il © x 3 \ / I 24 120 25.1 B layer 10yr 5/6 N/F / 36 11 R: } t:•:�:.. N F I sandy loam POSED2,9 [:-: :: 3 ; 27" (gravel 107.) DURAO I PRO 11 :._:::.{ I 30.1 33.3 33 SOUSE 11 �D T-. \ SILVERA I Invert 32.37 Invert 32.10 t x X o '� 5 TEST HOLE 3 tom' 21.* * *; ;•.. -, 11 I 6 Stone or CompaCt Proposed Proposed I Bottom 34,0 P -5 } ... : C1 layer 2.5y 6/6 I asement -11 ' x 31. ��� ►� p �s I 1 ' 1 I N I 8' W 18 3 I Hi h Groundwater=25.1 DEPTH inches med. fine sand 11, i 32 11�' �� 132 N"'�.0� �� sr: 1 J t I 1 - I- ' (inches) ELEV.(feet) TH 4 ��- Fn N 7 2.9' USGS Adjustment 0 29.7 „�._E,� :30 7 4 < A layer 10yr 3/4 z _ 30 I o ,s cu Using Barn230-August 06 9.7 29.7 1 rn , �- 30l :.. tiTti DESIGN DATA - Zane D 14" sandy loam TH 3 9 0 0 C Observed Water=22.2 �_ '4 y BEDROOMS: B layer 10yr 5/6 � W PROP. W K LIMIT . � u� OG 3 sandy loam N 2 <z9.o s S LEACH AREA t� GARBAGE GRINDER: No z. 27.2 i' :. REQUIRED CAPACITY: 330 GPD USE 2 DRY WELLS SET 1' APART WITH o .'.'.'.'.'.'...'.'.'.'.'..REMO FLOWE S 0) i C layer 2..5y 6/5 . .'''' _' 2 u z91 SEPTIC TANK: 1500 GAL. 3� 1/2 OF STONE ON THE SIDES AND no water /' -'° - INSTALL KNEE HIGH BOTTOM LEACHING AREA: 307.E SF " , 120' 25.6 .1 t� -i- 8 4 ON THE ENDS TO MAKE A 26 X loamy med. sand �, -.FES E GRASS ....... �� RAIL FENCE TO WALL 30.3 11 -10 X 2 DEEP LEACH AREA. 72° 23.7 INSTALL KNEE' 29.5 2 x. .5.7.'N.'..... .............. [(26 X 11.83')] TEST HOLE 4 HIGH RAIL FENCE �.'.'.'.'. 39 SIDE LEACHING AREA: 151.3 SF PARTIAL 5' REMOVAL ALONG HAYBALES x ...\.. 1 ''� '... ''' '' �- ' [2(11.83'+26') X 2' DEEP)] " C2 layer 2.5y 6/4 3 Town _ * . �4 .. 6,85 EXIST. GRASS DO PARTIAL 5 REMOVAL DOWN 30 f DEPTH (inches) ELEV.(feet) \NE nd •••••-• med. fine sand J Isolated ---26'-'•' '.S. K SET DESIGN CAPACITY: 339 GPD TO LOAMY MEDIUM SAND, AS SHOWN. 0 00 A layer 10yr 3/4 30.5 25,3 + 4,2 LO 8 \ [(307.6 SF + 151.3 SF) X .74 GPD/SF] 91" observed water- 22.1 10" loamy sand <v w3,5 I (�' O • �. .. RAISE HEIGHT OF "I 0 BLOCK WALL HERE 120" 19.7 B layer 10yr 5/8 2 Ot : ::.:::.: LANDSCAPING & FENCE IN PLACE BY MEMORIAL DAY loamy sand x 24.7 aoe er 2 5 .-:-."`�`�`:`; 27,4 e 9 06 06 �"':� 2T 28 2 _-.:: ; ;�' :. OWNER TO MOVE FLOWERS, STONES, BLOCKS AND PLANT FESCUE WETLAND DELINEATED 23,5 �.� SHE GRASS (CAPE COD MIX) AS SHOWN. INSTALL A KNEE HIGH C1 layer 2.5y 6/4 BY WAYNE TAVARES ISOLATED WETLAND �A <"- (g ) (PER TOWN REG. NOT STATE �_ =` RAIL FENCE ALONG HAYBALE WORK LIMIT EXTENDING EAST OF , Q ravel 30% " LOT 98 TO THE BLOCK WALL. CALL R.J. CADILLAC AFTER 50 ) . loamy med. sand *NOT BORDERING VEGETATED WETLAND , MEMORIAL DAY TO INSPECT AND TO CONTACT CONSERVATION 60" 25.5 85.p0 STAKE & BENCH MARK--TOP OF STAKE SET DEPT. FOR THEIR INSPECTION. STAKE & , » TACK SET DOWN 1 =26.85 TOWN G.I.S.f0.4 C2 layer 2.5y 6/5 TACK SET S 82.55 40 vv (OFFSETS ARE TO HOUSE CORNERBOARDS) med. fine sand N/F observed water N/F REMOVE BLOCKS, STONES, FLOWERS, 100" - 22 2 PERRY MORSE HYDRANGEAS, AND SEED WITH SITE PLAN 120" 20.5 FESCUE GRASS (CAPE; COD'MIX). *ISOLATED WETLAND NOTE: TOWN CONSERVATION BYLAW FOR REGULATES ISOLATED WETLANDS OVER 500 S.F. IN SIZE, WHICH IS A 22' X 23' RECTANGLE, AS A MINIMUM SIZE. THIS PLAN IS A VALID COPY ONLY IF IT BEARS 310 CMR 10.57(b) (1) DEFINES AN ISOLATED WETLAND AN ORIGINAL RED STAMP AND SIGNATURE. JOAN Y. SILVERA AS AN AREA OF 1/4 ACRE (10,890 S.F.) WHICH FLOODS ONCE A YEAR TO A DEPTH OF 6" AS A MINIMUM SIZE.LEGEND BOARD OF HEALTH REGULATIONS FOLLOW THE STATE DEFINITION OF A WETLAND. L' e LOT J Q Q V 27 CON N EM AR A CIRCLE H YAN N I S MA. N OF MASSY ` I �y�N OF Mq S ! , TH 1 TEST HOLE LOCATION, NUMBER c ° R° f L NA G OCTOBER 31 , 2006 SCALE. 1 "=20' _ �✓ PROPOSED WATER �-_ , o JA " S , � A � - E OVERHEAD ELECTRIC WIRES (IF SHOWN) 1�11.83' 1 #35 9 x 9.5 x 8•7 EXISTING & PROPOSED ELEVATIONS ( X # 10 MARKS POINT) RESERVE IU, I EXISTING CONTOUR Bot. area=311.6 s.f. tv I Fo�sT�R�c �y �Fss�° oe 8-- PROPOSED CONTOUR GPimeter=75.8 I S�R�SANITAR�PN f "'Q �y RONALD J. CADILLAC, PLS, RS, P.C. 0UTILITY POLE (IF SHOWN) i '� i 8 (2� 10 7 PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN 0 TREE (IF SHOWN, NOT ALL SHOWN) 1 13, 1 P.O. BOX 258 REV. 08/27/07--CHANGE HOUSE FOOTPRINT WEST YARMOUTH, MA O2F)73 REV. 08/24/07--MOVE LEACH, TANK, SEWER OUT OF ZONE II, CHANGE HOUSE FOOTPRINT REV. 08/24/07--MOVE LEACHING OUT OF STATE ZONE 11, HOUSE MOVED 5' (508) 775-9700 REV. 07/03/07--NOT BVW NOTE ADDED 0 BOH REQUEST HEALTH AGENT APPROVAL DATE � REV. 12/29/06--HAYBALE LINE, KNEE HEIGHT RAIL FENCE & LANDSCAPING 2006 BY R.J. CADILLAC PAGE 1 OF 1 ALWAYS DIG SAFE PRIOR TO CONSTRUCTION--UTILITY LOCATIONS SHOWN INCOMPLETE. ti JOB -NO, B-06-10 1 NOTES SILVERA.dwg CfA R� eF9�p SE' , 0) ZONING DISTRICTS: RB & GP 1. Locus Is A.M. 291, PARCEL 292. s wqr r- FRONT YARD: 20' 2. ELEVATIONS SHOWN ARE ASSIGNED. ir N SIDE YARD: 1O' BENCH MARK--MAG. NAIL SET IN 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. z PAVEMENT=36.34 TOWN G.I.S.f0.4' 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) J REAR YARD: 1 Q'. (2s'-Y OFF CENTER of anon POLE) 5. MUNICIPAL WATER tS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. 0 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. (3 ' 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". CONNEMARA CIR. N/F 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW. NEPHEW D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. NOT TO N/F 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. SCALE RAISE COVERS TO WITHIN 6" OF GRADE: 2 ON TANK, AND 1 ON D-BOX LEAF 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LOCATION MAP 11. IF UNSUITABLE SOILS, OR SOILS-DIFFERING FROM THE SOIL LOG ARE FOUND, N/F CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. S 83•22 00 W 12. IF AN OVERDID IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING JOHNSON1 310 CMR 15.255(3). TEST HOLE 2 • 36,34 EXISTING CESSPOOLS.616 13. PUMP AND FILL ANY MN set 140. LEACH AREA AND DISPOSE OF AS DIRECTED RBY HEALTH AGENT. CLOGGED SOIL, BLOCK, AND STONE IN IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF DEPTH (inches) ELEV.(feet) Lj 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. 0 A layer 10yr 3/4 35.1 C � RC � TEST HOLE DATE: September 6 2006 10" sandy loam PERFORMED BY: Ron Cadillac, Soil Evaluator B layer 10yr 5/6 - WITNESSED BY: Donald DeSmafais, RS (gavel loam -CONNEM _ _ _R' A PERC RATE: <2'-00"/inch (C. layer) 24' _ 33.1 __ - - 5,�1 SOIL SURVEY(1993): Carver coarse sand 1 "-`3TI3 E__E � '�.� �. Prop., Top Found. GEOLOGIC �MAP(1986): Barnstable plain deposits � C1 layer 2:5 6 4 �,�E E_E_55,40 E 36.8 g6 v i Invert 33.50 54"a loamy med. sand �--3�5 ' / - Invert 32.8S y Fy-E x 37 8 N x ,85-00 _ 7_5 Proposed fUse oposed LEACH TRENCH (gravel 30%) TEST HOLE 1 N T 7'S _---_- / Gas Baffle Invert 32.30 54" 30.6 ��Z--_--- - _-� 10 f 9" min. cover Proposed 32.8 (inches) ELEV.(feet) x 37,1 W - --_ sER _-_ --- / S=3/8"/ft C2 layer 2.5y 6/3 DEPTH inches C3? ---- R --- , Pro osed TOP PEA STONE- P /4"/ft med. fine sand 0 A layer 10yr 3/4 TH 1 ` 35.6 O O / In=33.10 1500 Gal. 15" sandy loam be - �� Proposed Septic Tank B layer 10yr 5/6 NSF 111 40'x � ��� N F �> 120" no water 25.1 sandy loam 32.9 325 - - 27" (gravel107) DURAO slab 35. ��` SILVERA ' 30.1 33.3 x 33,2 _ " Invert 32.47 invert 32.30 5' Bottom TEST HOLE 3 N____- �1 i� \ vv� i 6 Stone or compact Proposed Proposed C1 layer 2.5y 6/6 �34.0 --fig i x \�. �6 I i t N 1 i Basement C,i 30 F, - ;� 13 i 18'--a -�-0� Hi h Groundwater=25.1 DEPTH (inches) ELEV. feet med. fine sand TH 4 0' 2.9' USGS Adjustment 0 (29.7 PROHOUSDE �--- - 3 ------ TH 3 �_ ' +S DESIGN DATA Using Barn23Q-August 06 layer 10yr 3/4 30 1 Zone D 14" A sandy loam 0� ` . y Observed Water=22.2 B layer 10yr 5/6 O C °°°° _ -„ l :.. �S��S BEDROOMS: 3 sandy loam f_� - 1 O� °° °°.°° 8 -- J . 0 F GARBAGE GRINDER: No 30" 27.2 i o' w ° w ,��` o ! :.... - LEACH AREA L~0 T Cal REQUIRED CAPACITY: 330 GPD M W O� 8 u'`. i USE 63' X 3' X 2' TRENCH C layer 2.5y 6/5 120" no water 25.6 27.7 2 : SEPTIC TANK. 1500 GAL. �C 1 0 2 5 0 8± S.F. N I `j� 3BOTTOM LEACHING AREA: 189 SF loamy med. sand x. 29.5 26 - 25.7 V! O: , / 3c�', [(63' X 3')] 72' 23.7 TEST HOLE 2�' I SIDE 3LEACHI XG2A DEEP 264 SF C2 toyer 2.5y 6 f4 DEPTH inches ELEV. feet Ede oT Wetland r6'85 (inches) ( j g 26 SPIK SET DESIGN'CAPACITY- 226 GPD med. fine sand ,�� 2 189 SF + 264 SF X .74 GPD SF 91" _observed water _ , 22.1 0 A layer 10yr 3/4 30.5 25,3 4.2 [( ) / ] loamy sand sr - ------- 10", � 120" '� 19.7 B layer 10yr 5/8 2 loamy sand x 24.7 27 4 27" 2&2 23.5 IN.) C1 layer 2.5y 6/4 ISOLATED WETLAND50* (gravel 30%) (PER TOWN REG. NOT STATE) Loamy'med: sand 60" 25.5 85.00' „ W BENCH MARK--TOP OF SPIKE SET C2 layer 2.5y 6/5 S 82'5540 DOWN 1"=26.85 TOWN G.I.S.t0.4 med. fine sand N/F (OFFSETS ARE TO HOUSE CORNERBOARDS) - 100" -observed water _ 2 2 PERRY N/F SITE PLAN 120" 20.5 M ORSE FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN ORIGINAL RED STAMP -AND SIGNATURE. JOAN Y. SILVERA LOT 98, 27 .CONNEMARA CIRCLE, HYANNIS, MA. LEGEND SEPTEM BER 15, 2006 SCALE: 1 "=20' TH 1 TEST HOLE LOCATION, NUMBER W PROPOSED WATER E OVERHEAD ELECTRIC WIRES (IF SHOWN) RONALD J. CADILLAC, PLS, RS x 9.5 x 8.7 EXISTING & PROPOSED ELEVATIONS ( X MARKS POINT) PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN 6-� EXISTING CONTOUR $--- PROPOSED 'CONTOUR P.O. BOX 258 E UTILITY POLE (IF SHOWN) WEST YARMOUTH, MA- 02673 508 775-9700 ;.. HEALTH AGENT APPROVAL DATE ©2006 BY R.J. CADILLAC PAGE 1 OF 1