HomeMy WebLinkAbout0070 DELTA STREET - Health (2) 70 DELTA ST.
HYAN N IS
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No. i 3 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pprication for M sposal *pstetn Construrtion permit
Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) ❑Complete System A Individual Components
Location Address or Lot No. 70 OZ( 4-4 S T W(f*Anc S Owner's Name,Address,and Tel.No.
KA.-( W-
Assessor's Map/Parcel 7-c( 2 003 P 0 2-L S*CVVLA- p k Zg 2. 37 31
Installer's Name,Address,and Tel.No.br&*E:t(t 5 Designer's Name,Address,and Tel.No.
tv tv StiN►d��cv� �� Gz,sTv �IVC.yew San S �7 36633�l
$ e Zqa� 6n Rol SaN1d a Z5"3?
Type of Building:
Dwelling No.of Bedrooms / Lot Size sq.ft. Garbage Grinder( )
Other Type of Building t 41 /ti No.of Persons Showers( ) Cafeteria( )
Other Fixtures ` `T
Design Flow(min.required) 3 3o gpd Design flow provided 310 gpd
Plan Date Number of sheets 2- Revision Date i'I,d:p+._
Title
Size of Septic Tank �eX t S (0 00 Type of S.A.S. ' oiV Q�P3J Gt!14,41 >Ps2 Q�,a c(ctif
Description of Soil F�P� jal.4-4
Nature of Repairs or Alterations(Answer when applicable) At.dZd 641.w4,L'is
Alz4, 34 x l< 3 2 r,e/d
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 Q
Signed k. 6� Date 7-17
Application Approved by Date ^�
Application Disapproved by Date
for the following reasons
Permit No. ® Date Issued
No. Vt +� '
"`� ` Fee
� '
THE COMMONWEALTH OF MASSAPHUSETTS Entered in computer:
! ' PUBLIC HEALTH DIVISION -
., TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppliCatlon f;Dr'*posal 6pstem (Construction Permit ,
Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System W Individual Components ?
}
Location Address or Lot No. '7 I I �, 5-T 6�A l n l S Owner's Name,Address,and Tel.No.
�1A,fc- N/1n so"
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Assessor's Map/Parcel a Cj Z v 2 2• - .,k, e '3j 29 Z 3?31
Installer's Name,Address,and Tel.No. Des'gner's Name,Address,and Tel.No. {
K to to GL 5Z1� u 3 3 ( I
& & 2 9 eu o f SA✓►d
o !
Type of Building:
Dwelling No.of Bedrooms Lot Size ( sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons k Showers( Cafeteria( )
Other Fixtures `
Design Flow(min.required) 3 p gpd Design flow provided gpd
i
Plan Date - L�! , �� - Number of sheets '2- Revision Date h a^j IL
Title
a
Size of Septic Tank p_X,Z t' DU Type of S.A.S. '�kn,p%i r C�j�,,1,1,6oi7 tQ k y !-P
Description of Soil 5-kJI A4
i
`f Nature of Repairs or Alterations Answer when applicable
I c
Date last inspected:
j 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 He
I Signed Date
ApplicationNA.pproved by Date
Application Disapproved by Date
for the following reasons V
Permit No. r Date Issued --
= ------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(/ Upgraded( )
Abandoned( )by�v/7f l�! S ()UN-e /t2 G1 (_,4t1,4-,47,)
at -7 D [)e L 7A An A-4 4 , has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 1 dated "� 6
Installer 8/ C t/I S Designer P-e(,t (i
#bedrooms ✓C Approved desim flow gpd
The issuance of his pel it shall not be construed as a guarantee that the system wil LCon\aas designed.
Date ( S Inspector
v
No.d10 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
3Bisposal *pstem (Construction 3permit
Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( )
System located at 0 bt 1�Q �� ✓� f % �t'+il/1/I/1 t S
I�
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.—
Date ilk ( Approved by
i
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down of Bah instable. P#
off
Department of Regtilatory Services
emB-�. -
�,,,,, �, : I?ublie'Health Division Date
t659. ems$ 200 Main Street.Hyannis MA 02601
ArfD Nli�� i.
Date Scheduled , u / ! Time Fee Pd. 40--<-/
I
,,foil Suitability Assess kent fog- Sewage Disposal
Performed By: �I1 9-421t)n Witnessed By: D
i
LOCATION & GENERAL INI+'ORMATION
Location Address 90 bEu PF I Owner's Name I I "" s e✓�
Address �f �3�� 6� 5� ✓t
Assessor's Map/P4rcel: 3,P� C7 o 3 l ZZ I Engineer's Name S
' �
NEW CONSIRU�'I;ION REPAIR i Telephone# \
i q
Land Use Nis t Oat Al4_ / Slopes(%) d rf Surface Stones r7
Distances from: Open Water Body �"C/ ft Possible Wee Area � 200 ft Drinking Water Well �� ft
brainage Way > y� ft. Property Line } J ft Other ft
SKETCH:(Street name,dimensiods'of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
PkoT - Soh
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Parent material(geologic Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:,,' 0 `O Weeping from Pit Face ,
Estimated Seasonal Iiiigh Groundwater
DI ; ATION FOR SEAS UNAL HIGH WATE�t TA LK
Method Used: L'� 444 Gam
in. Depth to salt mettles; 1n•
Depth db�served standing in obs.hole: Z , 0.
Depth toiweeping from side of obs.hole: /V in. Oroundwuter AdJustAmdJ ndrauntiwnterl ever*�
Index Well# Reading Date Index Well level Adj.factor. _
PERCOLATION TEST 'xluse
Observation Tiitte at 9" L%- - --
Hole#
Jli°qe.(Z, /9t+ Time at6" --
Depth of Perc
Tim(9"-6")
Start Pre-soak Time.@ --
End Pre-soak
Ptir 9,1e o �s
Rate MinJInch
Additional Testing Needed(Y/N)
Site Suitability Assessment: Site Passed ^ Site Failed: —
Original:.Public 1'e$lth Division Observation Hole Data To Be Completed on Back—
***If percola jipn test is to be conducted within 100' of wetland,you must first notify the
Barnstable C40servatieai Division at least one(1) week prior to beginning.
DEEP OBSERVATION HOLE LOG Hole# J.._
ail Color Soil Other
Depth from Soil Horizon Soil f e (Mansell) Mottling (Structure.Stones,Boulders.
Surface(in.) (USDA)1 Consistenc %Gravel
�lJ ' v
"- COOS& 2`
DEEP OBSERVATION HOLE LOG Hole# �
Soil Other
Depth from Soil Horizon Soil Texture Soil nose Mottling (Structure,Stones,Boulders.
Surface(in.) (USDA) ( consistency,35 Gra el
DEEP OBSERVATION HOLE LOG Hole# A
Depth from' Soil Horizon Soil Texture Soil Color Soil Other
p Surface in. (USDA) (M osell) Mottling Mottli Structure,Stones,Boulders.
u
Consistency,3'o Gravel)
DEEP OBSERVATION HOLE LOG Hole# hi LA
Depth from Soil Horizon Soil Texture Soil Color Soil ther
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders.
Consistency, _m I
Flood Insurance Rate Map:
Above 500 year flood boundary No_l Yes
Within 500 year boundary No V Yes,
Within 100 year flood boundary No v Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervio s material exist,in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pe vious material?
Certification
I certify that on C (date)I have passed the soil-evaluator examination approved by the
Department of Environ ental Protection and that the above analysis was performed by me consistent with
the required rat ' g, xpertise nd experience described in 3:10 CMR 15.017
Signature Date i
O:\.SEPTICVERCFORM.DOC
down cape engineering, Inc. SIEVE SOILS ANALYSIS 70 DELTA STREET HYANNIS, MA
DATE OF REPORT: 8/13/15
JOB : GRAIN SIZE ANALYSIS-SIEVE TEST
SITE: 70 DELTA STREET, HYANNIS
LOCATION: DARREN MEYER TEST HOLE
SIEVE ANALYSIS Weight Sample(Grams): 209.2
SIZE ;WEIGHT RETAINED % RETAINED % PASSED
(sum )
•-------------:......................................................:-------------------- .....................................
1" 0.0
3/4" 0.01 0.0%i 100.0%
-------------- ............................................................
0.0€ 0.0%E 100.0%
--------------.......................................................---------------------}------------------
3/8" 0.0 0.0% 100.0%
-------------:......................................................:----------------------------------------
#4 0.0• 0.0%i 100.0%
--------------:......................................................}---------------------,.....................................
#10 11.6; 5.5%':. 94.5%
------------ ...................................................... .....................................
#20 72.0 34.4%E 65.6%
-------------......................................................>---------------------.....................................
#40 145.2 69.4% 30.6%
------------ .......................................................---------------------............I.........I...............
#50 178.6€ 85.4%E 14.6%
-------------......................................................:-------------------- .............I.......................
#80 198.0 94.6% 5.4%
------------- ......................................................---------------------,.....................................
#100 201.2 96.2% 3.8%
--------------......................................................
.----------------------------------------
#200 204.8� 97.9% 2.1%
•------------o......................................................----------------------------------------
PAN: 206.4€ 100.0%:: 0.0%
---------------------------
,SAMPLE: 209.2
NOTE:TEST ON PASSING#4 ONLY, 5.7% RETAINED ON#4 <45% O.K.
RESULTS:
SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL&SAND)(UNCOMPACTED)
PERCENTAGE OF MATERIAL PASSING#4 SIEVE :
#4 100% (TEST ONLY MATERIAL- PASSING#4) OK
#5010%-100% OK
#100 0%-20% OK
#200 0%-5% OK
SAMPLE MEETS TITLES FILL SPECIFICATION ,ZH OFMgSSA
� c
>97%SAND o`er DANIELA. yGN
o� OJALA a
RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MIN./IN. MATERIAL (0.7 6 M/SF)vIL `n
NONCOMPACTED No.46502Q
SOIL DESCRIPTION: COARSE SAND P9*f'F rsTS�`�
�SStONAL ECG
Town of Barnstable
of1HE Regulator Services
°.� Richard V. Scali, Interim Director
BARNSTABLF. Public Health Division
y MA99. $
�p s6g9• ��� Thomas McKean,Director
TfD MAC
200 Main Street,Hyannis,MA 02601
I
Office: 508-862-4644 Fax: 508-790-6304
Homeowner Certification Form for Alternatives sterns
Property Address: ' 1
Assessor's Map\Parcel: g
Property Owners Name: _
In accordance with Massachusetts DEP alternative system approval letters, the following certification
information is required by the Owner of record. The Owner of record must place an "x" in the
applicable box next to each line certifying the information.
Yes N\A
❑ I have been provided a copy of the Title 5 I/A technology Approval letters.
(15 page Standard Conditions letter and the specific technology letter)
❑ �I have been provided with the Owner's Manual
[� I have been provided with the Operation and Maintenance Manual
❑ L 'For Systems installed under a Remedial Use Approval, I,agree to fulfill my
responsibilities to provide a Deed Notice as required by 310 CMR 15.287(l0)
and the Approval
❑ [�f For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to
provide written notification of the Approval to any new Owner, as required by
310 CMR 15.287(5)
ElIf the design does not provide for the use of garbage grinders,the restriction is understood
/ :,and accepted
L�' ❑ Whether or not covered by a warranty, I understand the requirement to repair, replace, modify
or take any other action as required by the Department or the LAA, if the Department or the
LAA determines the.System to be failing to protect public health and safety and the
environment, as defined in 310 CMR 15.303
agree to comply with all terms and conditions above.
Pro �erprinted�naame�
Propert Owners Signature Date
Note: This form must be submitted along with the septic system disposal works permit
applickion for all I\A systems including new construction re airs\u grades with and
without aggregate (stone) and with conventional design criteria or credited design
criteria.
QASeptiO[A homeowner certification.doe
S1P/29/201-/TOE 02: 12 FIB FAX No. P. 001
Town of Barnstable
Regulatory Services
a Richard V. Scali,Interim Director
* WNSTAlLZ r
Public Health Division
°i Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 ]Fax: 508-790-6304
Installer &Designer Certification Form
Date: ' )57 Sewage Permit# Assessor's MaplParcel 17 r
Designer: t4qy4 Ems Inc. Installer:
Address: P .&X 17/ Address:
On. / �� �.� ���/5 15-e--et was issued a permit to install a
(date) installer)
septic system at o D LZ � HYAWPJ1S base on a design drawn by
(address)
e- z4 dirti! dated
r designer) �r��
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.Aftift I4 601p/e'p Tb 6LIAlix", IVE o r P90. L111M
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State& Local. Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constru fiance with the terms
of the IAA approval letters(if applicable)
ARR N
(Install r s gnature) Y
(Designer's Signature (Affix tamp Her
PLEASE RETURN TO B STABLE PUBLIC HEALTH DIVISION. CERTIFICATE
011i' COMPLLANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QAScpticlDesigner Certification Form itev 8-14-13.doc
Town of Barnstable
Regulatory Services Department-•-,iz,,
Public Health Division
r it
aARxarAs� 200 Main Street, Hyannis MA 02601
MASS
Office: 508-862-4644. Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL# 7014 1200 0001 0358 3872
July 6, 2015
Mark Hansen
PO Box 534
Barnstable, MA 02630 s
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5
The septic system-located at 70 Delta Street, Hyannis, MA was last inspected on
6/20/2015 by Shawn Mcelroy, a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Fails" under the guidelines
of 1995 TITLE 5 (310 CMR 15.00) due to the following:
• Static liquid level in the distribution box above outlet invert due to an._
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system within one (1)year from the date
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH
c ean, R. ., 0
Agent of the Board of Health
Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\70 Delta St Hy Jul 2015.doc
7/1f2015 Parcel Detail
9� THE IQ
b,VL'tiSYABLE,. � �+ ."• 1r�w _
NIASS,
l `
Logged Ln As: Parcel Detail} Wednesday,July 1 2015
Parcel Lookup
Parcel Info r
Parcel ID 292-003-02-2 �l Developer Lot LOT 22
Location :70 DELTA STREET Y l Pri Frontage ',120 _ l
Sec Road � -- -^� --F-- -- l Sec Frontage
Village HYANNIS� l Fire District HYANNIS l
Town sewer exists at this address ,NO ..~� 4 l Road Index 0435 w l
Asbuilt Septic Scan: f� ,
Interactive Map
292003022_1
Owner Info
Owner HANSEN, JACQUELINE.l owner Co- HANSEN TRUSTY l
streetl ,PO BOX 534 - l streetz
city BARNSTABLE fl state }MA �- - _ l Zip 02630 l Country
Land Info
Acres 0.44 l use Single Fam MDL-01 l Zoning iRB l Nghbd ,01:)i l
Topography Level l Road 'Paved
utilities Public Water,GaS,SeptIC l Location
Construction Info
Building 1 of 1
Year 1984 Roof Gable/Hip Ext
Built Struct Wall
Vinyl Siding
;
Living+1104 _J Roof AC
Asph/F GIs/CmpJ
v 'None _
Area Cover Type _
t
Be
style Raised Ranch _ . wall Drywall J Roomds ,3 Bedrooms
Model Residential Floor;Carpet R oms 1 Full-1 Half -
Grade 'Average Type Rooms
Heat Elec Baseboard Total '5 Rooms l
'
I � ��� Found-
Stories �1 Sto
Heat ry µ J Fuel ,Electric ation POUred Conc.
Gross �2282��
Area,
Permit History
Issue Date Purpose Permit# Amount Insp Date Comments
W Visit History
Date Who Purpose
httpJfissglyntranet/propdata/ParcelDetail.aspx'?ID=22883 1/3
THE r
Town of Barnstable
• anxivsr��,
' SaRegulatory Services Department
Ar fD MA't�
Public Health Division
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Richard Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6,2007
Rev. 4/28/15
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §360-44 and Title V: 310 CMR 15.000)
An"x"marked in,the ❑ is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA
❑ Discharge or ponding of effluent to the surface of the ground
❑ Pumping more than 4 times during the last year not due to clogged or obstructed
pipe.
❑ Backup of sewage into the house due to an.overloaded or clogged SAS or cesspool
ONE 1 YEAR DEADLINE CRITERIA
Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool
❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation
❑ Any portion of the cesspool within a Zone 1 to a public well
❑ Any portion of a cesspool within 50 feet of a private water "supply well with no
acceptable water quality analysis. (This system passes if the water analysis
indicates the well is free from pollution).
TWO (2)YEAR DEADLINE CRITERIA
❑ Single Cesspool
❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation
1
of a driveway due to H-10 components,.etc)
o Leaching pit or cesspool with high liquid level, <1.2"below pit(per Town Code
§360-9.1)
OTHER
Repair deadline:
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc
f
Commonwealth of Massachusetts %/ o� I) Q
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name/
information is Hy- a/ MA 02601 6-20-15
required for every y
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not-be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector:,
Shawn Mcelroy
Name of Inspector-
Upper Cape Septic Services
Company Name .av is
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information;reported below is true, accurate and complete as of the time of the inspection.The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title's (310 CMR 15.000).The system:
❑ Passes ❑ Conditionally Passes ® Fails
❑ Ne-eds,Fu r theLFvaluation,by the Local Approving Authority
6-20-15
I 4spectorr'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
7 - -
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15'
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:
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 exriltration 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):
n
J
t5ins-3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.) 4
❑ 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):
ry
❑ 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
t5ins-3/13 . Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 3 of 17
r
Commonwealth of Massachusetts '
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r< 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.) F
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
.❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
*" This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes"or"No"to each of the following for all'inspections:
Yes No
Backup of sewage into facility or system component due to overloaded or
® El 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 1.
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than %day flow
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is
required for every Hyannis MA 02601 6-20-15-
page. Cityrrown 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
El -0., 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
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page. Cityfrown 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 NIA)
® ❑ 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?
-Z ❑ 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:
• 3 3
Number of bedrooms (design): Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203 (for example:110 gpd x#of bedrooms): 330
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
I - •
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is
required for every Hyannis P MA 02601 6-20-15 .
page. Cityrrown State Zip Code Date of Inspection
D. System Information _
Description:
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (include laundry system inspection El Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? - ❑ Yes ® No
Water meter readings, if available (last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 6-2015Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): . Gallons per day Y(9Pd)
Basis of design flow(seats/persons/sq.ft., etc.): .
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
L •
Commonwealth of Massachusetts
W Title 5 Official. Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page. Citytrown, State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
• Commonwealth of Massachusetts
Title 5 Official Inspection Form
i n s o
= p
Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name -
information is required for every Hyannis MA 02601 6-20-15
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.) - • - . .
Approximate age of all components, date installed (if known) and source of information:
2001
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan): , -
18"
Depth below grade: feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):'
Distance from private-water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank(locate on site plan):
Depth below grade: 12"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: 1000 gal
Sludge depth: 1211
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is
required for every Hyannis MA 02601 6-20-15
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
� Distance from top of sludge to bottom of outlet tee or baffle 20"
Scum thickness
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
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
r
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
70 Delta St
Property Address -
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal - ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
*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
Commonwealth of Massachusetts '
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
page_ City/Town 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.):
Good condition with water at working level.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: 0 Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3113 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
70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis _ MA 02601 6-20-15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number: 1-1000 gal
® leaching chambers number: Cultecs
❑ leaching galleries number:
i
❑ leaching trenches number, length:
❑ leaching fields number,dimensions:
� i
❑ overflow cesspool number: t
❑ 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.):
New cultec field was filled beyond capacity and backing up into d-box and spilling into old leach pit.
Old leach pit has the signs of failure from before the new field was installed.
Cesspools(cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM ` 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis ' MA 02601 6-20-15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
. F r
t5ins•3113 Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
• Commonwealth of Massachusetts
Title 5 Official. Inspection Form
0
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 70 Delta St ~, `
Property Address ,
Mark Hansen
Owner Owner's Name
information is Hyannis MA 02601 6-20-15
required for every H y •
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
r V A -
bb. �
3, -Y / - 3 c
j4 -5-.7 > IF- 6)�
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is required for every Hyannis MA 02601 6-20-15
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: 12'+
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed- Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
® Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database- explain:
You must describe how you established the high ground water elevation:
Original design plans from 2001 show no groundwater at 12'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 70 Delta St
Property Address
Mark Hansen
Owner Owner's Name
information is
required for every Hyannis MA 02601 6-20-15
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
COMMONWEALTH OF<MASSACHUSETTS
ID
= EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
350 MAIN STREET
WEST YARMOUTH,MA
Cc�"1CO 508-775-2800
TITLE 5
RECEIVED
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSME S
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM N[l�'PART ACERTIFICATION T0v,, UrBIE JI
MAP 292 PAR 003 HEAL
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner's Name: 70 DELTA STREET REAL ESTATE TRUST-FRANK SHEALEY,TRUSTEE
Owner's Address: 37 STAGE HARBOR ROAD
CHATHAM,MA 02633
Date of Inspection NOVEMBER 6,2001
Name of Inspector:(please print) JAMES D.SEARS
Company Name: A&B Canco
Mailing Address: 350 Main Street
West Yarmouth,MA 02673
Telephone Number: 508-775-2800
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information
reported below is true,accurate and complete as of the time of the inspection. The inspection was
performed based on my training and experience in the proper function and maintenance of on site sewage
disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310
CMR 15.000). The system:
X Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
ails
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 tot
he buyer,if applicable,and the approving authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at
that time. This inspection does not address how the system will perform in the future under the same
or different conditions of use.
Title 5 Inspection Form 6/1.5/2000 1
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes: X
I have not found any information which indicates that any of the failure criteria described in 310 CMR
1.5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes: N/A
One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.
The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"
please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,
exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing
tank is replaced with complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a. broken,settled or tmeven distribution box. System will pass inspection if(with approval
of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health)"
broken pipe(s)are replaced
obstruction is removed
ND explain:
Title 5 Inspection Form 6/15/2000 2
Page 3 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(CONTINUED)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
C. Further Evaluation is Required by the Board of Health: N/A
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 salt marsh
2. Svstem 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 public water supply.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
** This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility
and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided
that no other failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
I
Title 5 Inspection Form 6/15/2000 3
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(CONTINUED)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
D. System Failure Criteria applicable to all systems: N/A
You must indicate"yes" or"no"to each of the following for all inspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded
or clogged SAS or cesspool
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
X Liquid depth in leaching is less than 6"below invert or available volume is less than'/z day flow
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
X Any portion of the SAS,cesspool or privy is below high ground water elevation
N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a
surface water supply
N/A Any portion of a cesspool or privy is within a Zone 1 of a public well
N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well
N/A Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. (This system passes if the well water
analysis performed at a DEP certified laboratory,for coliform bacteria and volatile organic
compounds indicates that the well is free from pollution from that facility and the presence of
ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.)
NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact
the Board of Health to determine what will be necessary to correct the failure.
E. Large Systems: N/A
To be considered a large system the system must service a facility with a design flow of 10,000 gpd to
15,000 gpd.
You must indicate either"yes" or"no to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a
mapped Zone 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 is 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.
Title 5 Inspection Form 6/15/2000 4
Page 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
Check if the following have been done. You must indicate"yes"or"no"as to each of the following
Yes No
X Pumping information was provided by the owner;occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X Was the facility or dwelling inspected for signs of sewage back up?
X Was the site inspected for signs of break out?
X Were all system components,excluding the SAS,located on site?
X Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the
condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum
X Was the facility owner(and occupants if different from owner)provided with information on the
proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)has been determined based on:
Yes No
X Existing information. For example,a plan at the Board of Health.
X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
distance is unacceptable)[310 CMR 15.302(3xb)]
Title 5 Inspection Form 6/15/2000 5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE
Date of Inspection: NOVEMBER 6,2001
FLOW CONDITIONS
RESIDENTIAL
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: 330
Number of current residents: 2
Does residence have a garbage-finder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): YES
Seasonal use(yes or no): NO
Water meter readings,if available(last 2 years usage(gpd)):
Sump pump(yes or no) NO
Last date of occupancy: PRESENT
C OMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203):
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: N/A
Was system pumped as part of the inspection(yes or no): NO
If yes,volume pumped: gallons—How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
X Septic tank,distribution box,soil absorption 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)
Tight tank Attach copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
UNKNOWN—NEW LEACHING IN 1996,PERNUT#96-479
Were sewage odors detected when arriving at the site(yes or no): NO
Title 5 Inspection Form 6/15/2000 6
i
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
BUILDING SEWER(locate on site plan): N/A
Depth below grade:
Materials of construction: Cast iron _ 40 PVC _ other(explain)
Distance from private water supply well or suction line:
Continents(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK(locate onsite plan): X
Depth below grade: I'
Material of construction: X concrete metal fiberglass polyethylene
_ other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions: 1,000 GALLON
Sludge depth: 2"
Distance from top of sludge to the bottom of outlet tee or baffle: 28"
Scum thickness: 1"
Distance from top of scum to top of outlet tee or baffle: 11"
Distance from bottom of scum to bottom of outlet tee or baffle: 18"
How were dimensions determined: . ASBUILT AND TAPE
Continents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as
related to outlet invert,evidence of leakage,etc.):
TANK AT WORKING LEVEL.NO SIGN OF OVERLOADING SEEN IN TANK. TANK AND COVERS F
BELOW GRADE.
GREASE TRAP(located on site plan) N/A
Depth below grade:
Material of construction: _ concrete metal _ fiberglass _ polyethylene other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Continents(on pumping reconunendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as
related to outlet invert,evidence of leakage,etc.):
Title 5 Inspection Form 6/15/2000 7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: concrete metal fiberglass polyethylene other(explain)
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no)
Alarm level: Alarm in working order(yes or no):
Date of last pumping
Continents(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: X (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: 0
Comments(note if boa is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.,):
DISTRIBUTION BOX IS 16"X21",2'BELOW GRADE.ONE LINE IN,TWO LIENS OUT. ONE LINE TO OLD
PIT.ONE LINE TO NEW LEACHING.BOX IS CLEAN AND SOLID.NO SIGN OF SOLID CARRY OVER OR
OVERLOADING SEEN.
PUMP CHAMBER: N/A (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Continents(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Title 5 Inspection Form 6/15/2000 8
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
Type
X leaching pits,number: 1
leaching chambers,number:
leaching galleries,number
leaching trenches,number,length
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of
vegetation,etc.)
LEACHING IS ONE OLD PIT.PIT IS HALF FILLED IN WITH SAND.NEW LEACHING IS THREE CULTAC
10'X25'.TOP OF LEACHING IS 25"BELOW GRADE.PROBED AND DID TEST ABOVE AND ON SIDE,
NO SIGN OF OVERLOADING SEEN.
CESSPOOLS: N/A (cesspool must be pumped as part of inspectionXIocate on site plan)
Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Continents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.):
PRIVY: N/A (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.)
Title 5 Inspection Form 6/15/2000 9
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
CAI T
�s•6
o�➢ s� i
o'
Title 5 Inspection Form 6/15/2000 10
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DELTA STREET
HYANNIS,MA 02601
Owner: 70 DELTA STREET REAL ESTATE TRUST
Date of Inspection: NOVEMBER 6,2001
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to no groundwater 7 feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
X Observation 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:
TEST HOLE NOTED ON PATE 10. NO WATER AT 10'.TEST HOLE Y BELOW BOTTOM OF
LEACHING.
o aM
No wioTiA
Title 5 Inspection Form 6/1 i/2000 11
Certified Mail#7014 1200 0001 0358 4329
��t► Tati Town of Barnstable
o�
Regulatory Services
BAMAMAsB`�,g Richard Scali, Director
Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304,
Raul Fernandez
70 Delta Street
Hyannis, MA 02601
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION.
105 CMR 410.300 and 310 CMR 15.00: Sanitary Draina;;e System
The property owned by you located at 70 Delta Street Hyannis, MA was inspected on
October 6, 2016 by Timothy B. O'Connell, R.S., Health Inspector for the Town of
Barnstable. This inspection was conducted on the basis of a complaint received at The
Town of Barnstable Health Division.
The following violation(s) of the State Sanitary Code were observed:
105 CMR 410.300 and 310 CMR 15.00: Sanitary Drainalle System
There were a total of five (5) bedrooms observed on this property; three (3) on the main
floor and two (2) within the walkout basement level of the home. The existing septic
system (Permit#2015-319) was designed for three (3) bedrooms not for five (5)
You are ordered to correct the 105 CMR 410.300 and 310 CMR 15.00 violations
listed above within six (6) months of your receipt of this notice by pulling the
required building permits. You are ordered to remove two bedrooms from this
dwelling by removing entrance door(s) and by opening the door-way entrance to a
minimum opening of four-feet. This will bring the-total bedroom count down from
five (5) to the appropriate three (3). You are ordered to cease and desist within (24)
hours of your receipt of this letter the use of the rooms within the basement as
bedrooms due to the insufficient septic capacity.
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.
P + ORDER OF THE BOARD OF HEALTH
Director of Public Health
Town of Barnstable
QAOrder letters\Housing-Motel.Violations\70 delta street oct 3 2016.docx
ASSESSORSMAPNO•
t3
No. - V21 FARCM Fee$4 0 . 0 0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2(pplication for ni.5pogal *pgtem Construction Verna
Application is hereby made for a Permit to Construct( )or Repair(x )an On-site Sewage Disposal System at:
Location Address or Lot No. X e2" 2;;� Owner's Name,Address and Tel.No. 61 7-2 2 7-7 0 31
70 DRla Rd. , Hyannis, MA Karen Lynch'Property Mngr.
Assessor's ap arcel
72 Russell St. N. Quincy, MA
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.
Wm.E.Robinson, Sr. , Septic Svc.
P.O.Box 1089 , Centerville
Type of Building:
Dwelling No.of Bedrooms 3 Garbage Grinder(NO
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil San d -
Nature of Repairs or Alterations(Answer when applicable) Install t h r P P J-1,1 0 S t o n e p a c k e d
infiltrators and D-box.
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this B d of He /
Signed Date —07_3`-�
Application Approved by '�.e4 == Date
Application Disapproved for the following reasons
Permit No. Date Issued
No. Fee �$40.00
THE COMMONWEALTH`OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
{ 2pplicatton for Mtopogal 6p5tem Con.5truction Permit
Application is hereby made for a Permit to Construct( )or Repair(X)an On-site Sewage Disposal,System at:
`- Location Addressor Lot No. 14�� �� Owner's Name,Address and Tel.No. 61 7 2 2 7—7 0 31
Ass
essOor'sIv�aP7LccelRd. , Hyannis, MA Karen Lynch/.Property .Mngr.
72 Russell St. , N. Quincy, MA
Installer's Name,Address,and Tel.No. 7 7j—8 7 7 6 Designer's Name,Address and Tel.No.
Wm.E.Robinson, Sr. , Septic Svc.
P.O.Box 1089, Centerville
Type of Building:
Dwelling No.of Bedrooms 3 Garbage Grinder(NC)
Other Type of Building No.ofrPersons Showers( ) Cafeteria( )
Other Fixtures \
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil Sand
Nature of Repairs or Alterations(Answer when applicable) Install three #330 Stananarked
infiltrators and D-box.
Date last inspected: i
Agreement: '
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
�.* in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued bythis loo d of Hea tkR
Signed �J F��`''� Date `02 Rf
Application Approved by 0.. _ '�t S_—__ Date
Application Disapproved for the following reasons
Permit No. _ Tr "'" ^� Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
K. Lynch BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
t
THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(g )on
r Sr. tic
Wm.E.Robinson Se Svc.
by Installer P ;
at 7U Delta Rd. , Hyannis, MA has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction .ermit No. - dated
Pate / `l Inspector
w THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS-
TEM WILL FUNCTION SATISFACTORY.
No. L,/ -7 9 Fee 4 0.0 0
r
K. Lynch THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
ligozar *pgtem Construction Permit
Permission is hereby granted to Wm. E. Robinson, Sr. , Septic Ser*tee
to construct( )repair( X)an On-site Sewage System located at No.# 70 Delta Rd. , Hyannis, MA
Street
and as described in the above Application for Disposal System Construction Permit.
y No. Date
The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions.
All construction must be completed within three years of the date below.
Date: C7- I ?i- 2/_ Approved by
Board of Health
fy
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
I, William E. Robinson, iefeby certify that the application for disposal works
construction permit signed by me dated , concerning the
property located at 70 Delta Road, Hyannis , MA meets all of the
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED
-✓ DATE:
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
Attach a sketch plan of the proposed stem.Also if the licensed installer posesses a certified plot plan,
[ P P Po system.
this plan should be submitted].
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THE COMMONWEALTH�OF MASSACHUSETTS
BOAR® OF HEALTH
RPA ER
Town Bar:. nstable MICHNIEVY CA
-•----.._.._....._.. ....................OF.........................................-----------------.................------......... ea No.30420
.p CIVIL Q
Applira too for Eli-gVviial Tgorkg Tomitrur#iun trout
Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewag ID)is
System at:
Delta Street Lot 22
................_................................................................................ ........._........_...•--••-•-----------------•---•--•--.....-----------...----------•---.....----
Location-Address or Lot No.
Owner Address
a G�.iF --7 ..±�.s Qr �v.f��lt !_.I .: .. 1R�3. of_,..f�l. �........
Installer Address 19,076
Q Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.............3................_------------Expansion Attic ( ) Garbage Grinder (no)
aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ----------------------------
Design Flow.......... 5..............................gallons per person per day. Total daily flow..........330...........................gallons.
WSeptic Tank—Liquid capacity._1000gallons Length_$�_6�I...._ Width.4'10"-- Diameter________________ Depth_5 4"
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
_ Seepage Pit No----------l---------- Diameter-__.-.14. ....... Depth below inlet.... ...... Total leaching area... 7........sq. ft.
Z Other Distribution box ( x) Dosing tank ( ) TP#1 7/7/83
Y J. Monahan Jr. Date---TP#.2 7/5/83-----•----
a Percolation Test Results Performed b ________ _________-----__.-2...._
Test Pit No. 1.......2-------minutes per inch Depth of Test Pit------I ......... Depth to ground water------- 0--_--_-----
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------9.............
a •-••----•---...••---•---••----•-•-•-•-•••-•-•-••------•..................•---------.......-•----•--•.........................................................
0 Description of Soil....TPtU__0"--12......
_coarse _sand_ &...
gravel...
fill ...l2"-120"_coarse sand and.............
x gravel.; TP#2••0"--24" coarse--sand-•&__grayed •_fill,---24" 108", coarse-_sand-_and__g}ravel
U
W
x •••-•--•••••-----•------•-----------------------•-----------.............---•------- --•••-•-•--••-•----•••-••----------------------•-••---••••-----••••--•--•--•••--•-••--•-•-•-•------•..............
0 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to Y place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed. Vrc% . . ...dY? .......
•-• •• .„ O__
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons:---------------------------------------------------------------------------------------------------------------
--......•-•-••••-••---•----•---•-•--•-•--••-••----------•-•-•--•----•-••--....•-•--------...-•--•••-----....••••••••----••---••••-•--••••---------------- ...............................................
Date
PermitNo.......................................................... Issued-.......................................................
Date
0 OF
FE:B.... .. ..........
0.GG ER yG
THE COMMONWEALTH OF MASSACHUSETTS PAUL
0 MICHNIEWICZ
BOARD OF HEALTH No-3C1 AA
0420
-A CIVIL
.......................To ..............OF..........:..B...a........rns........tab.....le..................................................Appliration for Works Tiamitrurtion Prrmit
V -.1 o - 3
/OF.
Application is hereby made for a Permit to Construct (x ) or Repair an Individual Sewage Disposal
System at:
Delta Street Lot 22
.................................................................................................. .....................,.........................................................................
Location-Address Vie..------ Lot NO.
. &9....... ,V.W- 4,
Owner Address
.....................................&exw.aww Rp ....HA.R.W.. &ywl ........
Installer Address
-19,076
Type of Building Size Lot............................Sq. feet
U 3
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder (ae)
a
Othef—Type of Building ............................ No. of persons............................ Showers CafeteriaOther fixtures ............................................................................... --------------------------
W Design Flow.........55 3�6--------------------- ----------------
....................................gallons per person Per day. Total daily flow......... eallons.
9 Septic Tank—Liquid' capacity.-pg90 ..... Width.4
---gallons, Length.§.r�... ...► ....... Diameter---------------- Depth..............
Disposal Trench—No..................... Width_._.'.............. Total Length_.__................ Total leaching area.....................sq. f t.
Seepage Pit No---------I---------- Diameter.......14. ------- Depth below inlet....1_,. 7....... Total.leaching a 227 sq. .t.
Z Other Distribution7/7/83
J. Mfta�an, Jr. 1 T rP2 7,5,83
P
box lk Dosing tank TP
Percolation Test Results Performed by,........................................................................ Date.........................................
Test Pit No. I------ _______minutes per inch Depth of Test Pit___-_--1.0 Depth to ground water......10----------I
9.....-----
Test Pit No. 2................minutes per inch Depth of TeS\ Pit._._____............ Depth to ground water___........9
.............
...........................................................................................ff.........11..................... ----
0 Description of Soil....T!#1 0"-12" coarse...sand ravel fill, 12 1.120 Coarse iiiiia""ifia...........!�..S
----------------------- ......................................... ........ ........ ..................
�4 gravel; TP#2 coarse sand & iyj!�...f4�.; 24"-108" coarse audd and gravel
U .........gravel;......................................................._.Sjf� ....................................................................................
-----------------------------------------------------------------------------...........................................................................................................................
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'TTIE 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.
Signed-.. .... 4VqR41,L 91-3
Date
ApplicationApproved By............................................................................................... ...........I.............................
Date
Application Disapproved for the following reasons:................................................................................................................
.........................................................................................................................................................................................................
Date
PermitNo......................................................... Issued......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF,,HEALTH
i
.............OF.......... ................ ' ..........................z
...............................
THIS IS.TO CE IFY, hat the Individual Sewage Disposal System constructed ( —r`o`r Repaired
p by....... el'—*-& ------ .....
.. ............... --------- ...................................................
---------- ---- ...........taller
at....... .......... r
.........;......................................................................................................................
has been instilled in accordance with the provisio of T IT 1 5 of The State &Initary Code as desgribe4 in the
application for Disposal Works Construction Permit No------- 0........
Y3 m-141.......... , dated-----------------1 41
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WIL FUN BON SATISFACTORY.
DATE......Z/2-. f l -------•---.......•........................... Inspector--- ..... .....................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF,,)IEALTH
rfa
.............. .. .. ........OF............... .................................................................
No.... .... FEE..................
Disposal Wor4ii 'up n!q�wtiva panfit
Permission is h b nted..............X—.._�W;e y gra ............. .............................................................
to Construct or R s S
epair _)-an I S Di pe
atNo.. ------ �/..... .......................................................................................
Street
as shown on the ica for Disposal Works Construction Permit No....fa .OF/ gl--fo-
tedw.....g---............. .........
.............................. ----------------------------------- - --- ---------------
Board of Health
DATE--- ... . ............................................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
EXISTING BENCHMARK:
LEGEND ' HYANNIS
TOP PLATFORM
LEACHING EL=40.00 (GIS±) - PROPOSED CONTOUR
(SEE NOTE 10) PARCEL ID: ® PROPOSED SPOT GRADE
292/087 I —_98 __ EXISTING CONTOUR OvjE 28
N + 96.52 EXISTING SPOT GRADE
$74 35 11 W— EXISTING WATER SERVICE
Grr E TEST PIT y LOCUS
� to
1�
'
� G cP
' o G ► ' 20
8
r .00
XIST. 1000G r p
A SEPTIC TANK G
Q rr LOCUS MAP
r PARCEL ID: I' LOCUS INFORMATION
' t;
0 i # 0 PLAN REF: 342/56
7
/ r 292/003-022 TITLE REF: 28153/243
AREA=19,076tS.F. PARCEL ID: MAP 292 PAR. 003-022
W ' ZONING: "RB"
r TOF=39.42 0o FLOOD ZONE: "X"
COMMUNITY PANEL: 25001CO566J DATED:07/16/14
W R�soh SEPTIC SYSTEM
v.m( : OHW _ _ PECK REPAIR PLAN
co
" ------__ _ � LOCATED AT:
GENERAL NOTES: 70 DELTA STREET
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL HYANNIS, M A.
/ ——_— BOARD OF HEALTH AND THE DESIGN ENGINEER.
' `--- 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS PREPARED FOR
GRg DEL I OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE
r pRl � - �, o
LOCAL RULES AND REGULATIONS. J A C Q U E L I N E & MARK
TWA Y ,1 TP 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR H A N S E N
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
i o C\l - 36 --_ h DESIGN ENGINEER.
0 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING AUGUST 24, 2015
�tl
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
'IV J ENGINEER BEFORE CONSTRUCTION CONTINUES.
5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
35 Z �` 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF �� OF MAS
' 4! THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF t��� s9e,
$74 3 Jr,,, HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. D RREN M. y✓'
'j1 E 99 Q V 7. WATER SUPPLY PROVIDED BY TOWN WATER. (SLEEVE W/ 6" AS SHOWN.) _
t 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED —'
1 J9 65 PROP. 5 FT ti o TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 14
CONVENTIONAL 3BR SOIL REMOVAL (note 17) 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
3O X 1 5 FOOTPRINT THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING STERE�
CONSTRUCTION. �4NITAR\A� /
PARCEL ID: 40 mI POLY N89`10'16"W 10. EXISTING LEACHING TO BE CRUSHED, PUMPED AND FILLED. �(
292/003-020 LINER (note 18) 28.22 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION VVV
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
6 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING
14. ALL PIPE TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) MEYER & SONS, INC.
15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW
GRAPHIC SCALE FOR THE USE OF A GARBAGE GRINDER P.O. B 0 X 981
16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING
20 0 10 20 40 s0 17. REMOVE UNSUITABLE SOILS 5 FEET AROUND LEACHING TO EAST SANDWICH, ' M A. 02537
EL. 30.45 OR TOP OF C LAYER AND REPLACE WITH CLEAN
MEDIUM SAND PER TITLE 5. PH: (508)360-3311
18. PLACE 40m1 POLY LINER AROND ENTIRE EDGE OF SOIL REMOVAL FAX: (774)413-9468
IN FEET ) FROM ELEV. 36.30 TO 32.30 TO PREVENT BREAKOUT. m e ye r CI n d S O n S I n C @g m a I I.C O m
1 inch = 20 ft. 19. EXISTING SHED TO BE RELOCATED.
SHEET 1 OF 2 J 1771
HE
NOTE: MAGNETIC TAPE TO•BE PLACED OVER ALL COVERS NOTE: FINISH GRAD BREAKOUT,
NOT BEP<OEL::3629 DESIGN CRITERIA
i FOR A DISTANCE OF 15' AROUND THE
PERIMETER OF THE S.A.S.
TOP OF FND NUMBER OF BEDROOMS: 3 BEDROOM DESIGN
-EL.=39.42t SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. SOIL TEXTURAL CLASS: CLASS I" DESIGN PERCOLATION RATE: <2 MIN/IN
INSTALL RISERS .;& COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER
OUTLET AND SET TO 6' OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. DAILY FLOW: 330 G.P.D. DESIGN FLOW: 330 G.P.D.
F.G. EL.=39.0t F.G. EL.=39.5f F.G. EL: 37.50f F.G. EL: 37.50(MAX.) GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER)
► PROPOSED SEPTIC TANK:
• COS MIN COVER/ 330gpd x 200% = 660 gpd (USE EXIST. 1,000G TANK)
9" 0,
36' MAX COVER L = 55' L = 1O'(MAx) INSTALL'TWO INSPECTION PORTS (MIN.) LEACHING AREA REQUIRED: (330)/0.74 = 445.95 S.F.
® S=1% (MIN.) EL = 38.06 ® S=1% (MIN.) ® S=1% (MIN.)
4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC DISTRIBUTION BOX: (4 OUTLETS (MINIMUM))
LLL . PRIMARY S.A.S.
10'
14" 6 IN3.VERT
USE 4 ROWS OF 9 - INFILTRATOR QUICK 4 STD LP (3.3" INVERT)
INV.=37.0 �'unuro INV.=36.75
LEWL UNITS WITH NO STONE
GAS BAFFLE PROPOSED INV.=36.00 4 R 9 UNITS AT 4.0'/UNIT = 36.0'/ROW
D BOX
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF OF CHAMBER)
INV. 36.2 DB-5 INV.= 35.90 SOIL ABSORPTION SYSTEM (PROFILE) (CHAMBER UNITS) 36 UNITS x 4.00 LF x 4.73 SF/LF = 681.12 SF
EXIST, 1.000 GALLON SEPTIC TANK TOTAL AREA = 681.12 SF
RESTORE VEGETATIVE COVER DESIGN FLOW PROVIDED: 0.74GPD/SF(681.12SF) = 504 GPD>330 GPD req'd
EXISTING OUTLET
BACKFILL WITH CLEAN PERC SAND
TO TOP OF CHAMBERS 11.32 x 36 = 407.5 SF > 400 SF REQUIREMENT
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING BREAKOUT=TOP ELEV.=36.29 - 48"
PIPE INVERTS PRIOR TO CONSTRUCTION INV. ELEV.= 35.90
2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.= 35.62
GRADE ON A MECHANICALLY COMPACTED SIX EXISTING SUITABLE
INCH CRUSHED STONE BASE, AS SPECIFIED IN 2.83' MATERIAL
310 CMR 15.221(2) 5' MIN. ABOVE BOTTOM OF -
3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 4 x 2.83' = 11.32
WITH 1500 GALLON SEPTIC TANK IF FAILED, (5.09' PROVIDED) USE 4 ROWS OF 9 INFILTRATOR QUICK 4 PLUS 34"
DAMAGED, NOT H2O LOADING, OR UNDERSIZED. ADJ. GROUNDWATER EL.=30.53 = STD LP (3.3" INVERT) UNITS-NO STONE
4) INSTALL INLET & OUTLET TEES W/
GAS BAFFLE AS REQUIRED SEPTIC SYSTEM PROFILE
TYPICAL SECTION
N.T.S. N.T. PROFILE
SOIL LOG i-- 48" -I
P#: 14758 DATE: JULY 20, 2015 �Q��� OF SS�� J.3" MR222MIUM
8
SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE #1614
WITNESS: DONALD DESMARAIS, BARNSTABLE HEALTH I � SECTION
END CAP
TESTHOLE # 2: (HIGHER LEVEL) o. 11 o INFILTRATOR QUICK 4 PLUS STD LP (3.3" INVERT) UNITS
Elev. TP-1 Depth Bev. TP-2 Depth WELL: AIW-230 ZONE: D
" MODEL QUICK4 LP
36.55 0" 36.40 0 �/s(E
LEVEL: 22.6 ADJ: 2.8' j �¢�� LENGTH 48"
Flu nLL OBS GW ® EL. 27.73' I `�A►ITAR NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT
EFFECTIVE LENGTH 48" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
ADJ. GW ® EL. 30.53' DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
32.55 C1 48" 30.45 C1 72" 1- L ) SIDE WALL HEIGHT 3.3"
OVERALL HEIGHT "
� VE 8
SIEVE SAM
COARSE SAND COARSE SANG
OVERALL WIDTH 34"
• EL 30..0 2.5Y 6/6 2.SY 6/6
CAPACITY
26.55 120" 26.45 120" PROPOSED SEPTIC SYSTEM/SITE PLAN
PERC RATE <2 MIN/IN. (-Cl- HORIZON) PER SIEVE SAMPLE 70 DELTA STREET, HYANNIS, MA
G.W. OBS. AT 106' EL 27.72 G.W. OBS. AT 104' EL. 27.73 Prepared for: Hansen
Design and Site Plan by: SCALE DRAWN
MEYER&SONS,INC. NTS D.M.M.
• I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX981
to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANOWICH,MA02537 DATE: CHECKED SHEET N0.
requirements of 310 CMR 15.017. 1 further certify that�I have passed the Soil Evol. Exam in October, 1999. 508 22922 08/24/15 D.M.M. 2 Of 2
a
i
C
Certified Plot Plan in Barnstable, MA
Address 70 DELTA STREET Prepared For . RAUL .FERNANDEZ
Assessor's Map: 292 Lot: 003-022 Baxter Nye . Engineering & Surveying
Community Panel Number 250001 0566 J, Effective Date 07/16/14 Registered Professional
F.I.R.M. Map Zones: X (un—shaded) Engineers and Land Surveyors
Plan Reference: Plan Book 342 Page 56 Lot 22 78 North Street, 3rd Floor
Deed Reference: Deed Book 29328 Page 102 Hyannis, MA 02601
Phone — (508) 771-7502 Fax — (508)-771-7622
Owner: Raul Fernandez & Laura Duy Job Number. 2016-083 Scale : 1" = 30' Date : 11-23-2016
` ►� 4t t , 48 GARDEN 14NE
.0o,
NOV 29 1 r>}PN 6:21
� 7
qO
�RS'PS S9,
01
co N.01.
ROOF OVERHANG N
4�, 10.07' �RaA
38.5' roLLSrr
srAW SET
fir, F EXISTING
8 Wo STRUCTURE
N ARJUN & SHUBHADRA GIRT PARCEL 292-003-022
F 075t S. . so
DEED BK. 29815 PG, 66 19, of
PARCEL 292-087 F
N DECK 3
21'
W IA
;7
EXISTING
DWELLING
ruj #70 z N/F PHILLIP P. & ANNA COHEN, TRUSTEES
UNCLE AL'S REALTY TRUST
(n LGASJ 51.1' DEED BK. 12519 PG. 190
PARCEL 292-003-020
0 I 0
EXISTING I
- DRIVE
4 APPROXIMATE
— — — EXISTING SEPTIC
N 11*54*19" E 120.00'
DELTA STREET z
NOTES:
1. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE. THERE MAY BE RIGHTS BY OTHERS, EASEMENT, TAKINGS, MORTGAGES, RIGHT OF WAYS ETC. NOT
DEPICTED. IF DETERMINED TO BE NECESSARY, A TITLE SEARCH SHALL BE PERFORMED BY OTHERS AND SUPPLIED TO BAXTER NYE ENGINEERING & SURVEYING.
2. THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE RECORD INFORMATION CONSISTING OF PLANS AND DEEDS. THE EXISTING FEATURES
SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY PERFORMED BY BAXTER NYE ENGINEERING & SURVEYING ON OCTOBER 26, 2016.
I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON IS
LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT LOCATED WITHIN A SPECIAL jNOFR*
FLOOD HAZARD AREA. �``
per' SHANEM.
tiN
THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY LINES. o AAALLON
V -4
No.48687
REGISTERED PROFESSIONAL LAND SURVEYOR N BAXTER NYE ENGINEERING & SURVEYING DATE
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FT
- TP-/ 7/7f 8 3 REVISIONS:
TEST PIT DA TA DATE OF TESTING: TP-2 7 1s3 PERC. TEST DA TA : SEPTIC TANK DETAIL * /000 G DIST. BOX -DETAIL: LEACHING FACILITY DETA I L: NO. DATE
TEST BY: - T04 100N.'4 AN„ r.e _
T, P. DATE OF TEST/NGJP / r/�183 Tf-2 7/5Jfi TANK TO CONFORM TO r/TLE 5 REOUIREMENTS. TO CONFORM TO T/rLE5RE04#REMENTS
_ W/TNESSED BYE J. 7�A C D B/
r-p*� ELIEv. TF' &FV. TEST By, TOE �fa*4,4/fl}� . ja NO. OF OUTLETS�
--- W/MESSED BY: J. TA C D 8• IL
CG6Ft5 `}A,%6`v � t � REMOVEABLE COVER
c>ttavE Fi[.G 1 C'�4/{ E &44';? r� �/Z,,, rim ii� �� `,--,_ C\� y
MANHO BROUGHT TO ,
^At j r �.�. Y. ��:..�...;, �;•;.��, rr FINISH GRADE. • _ �. .� .•. PNPE L44MB P"AL4X 7,p_I .
-CLEAR EAR •LT .": ASTONE _ ��FILL /
6,.M/N. 2r`M/N. �i' �j' OUTLET PIPES 's `••"' '_ �-- •-- -r
DEPTH OF TEST 6"MIN. I AS REOVIRED
RATEr �•• .�?N T T ce
/ - k INLET + 1
L G J� /�iI /LI/11f/( ��/LN 0„MIN, t
r 'f /NLE EE ,' OUTLET TEE BOX '
:,F °� a• •'. it \ / / w 4NG.4 /000- GAL. i I/I -
i INLET AND OUTLET `a 4'Or`MIN/MUM i OUTLET TEE DEPTH:r * ' • �'
SEPTV TAMP -= .
TEES TO BE CAST L IOUID DEPTH 14 `Ar LIDUID DEPTH OF 4J o' £a 6 r �. / �s t• PRECAST OR BLOCK '�' t
IRON, SCH£D.40 19° •• 5' /' COJVO4ETE SEEPAW PIT
j " CONSTRUCTIGYV /O�
DEPTH OF TE$T° P,V,C, OR CAST IN 24 b
RATE L E, SS T iqN lYllh'/` JlV' PLACE CONCRETE 29 „ •• 7 •'. , a^ •..;r.• .. �:,
CONCRETE . N ANN.
-- CONSTRUCT/ON '�41 B BOTTOM ON LEVEL STABLE 84,5>f � ,
(iYArERTIGHTI
.. 'S"! f"ti"e :•,`;t �.;,. .:'-tyf",,� ,� ,�i•"i:�•*j�_.. :..,�,,-.f: ', .r.•o� PROVIDED WHERE S PE FOUNDATION !•• __----_____ •I
INLET TEE PRO. £ a1
- '"'�' TANK TO B£ABLE TO WITHSTAND
OF jNLET PIPE EXCEEDS O.Ot9 ,
Ca•`i0(j W T%. BOTTOM OF TANK ON LEVEL STABLE BASE H-10LOADING UNLESS UNDER IN A PUMPED SYSTEM. 20�MIN. I j
PAVEMENT OR/N pR/VE.H-20 i I/WASHED srmE i ---
LOADING UNDER PAVEMENT AR
DRIVE. !'g�
RECOMMENDED MANUFACTURER III-IllAd Lf-5 RECO,IMSENDrE'D MANUFACTt�ER:
(OR APPROVED EOUAL) ( OR APPROVED EOIAL)
NOTES INVERT ELEVA TIONS:
PLAN VIEW
/. THIS PLAN IS FOR THE DESIGN AND CONSTRUCT/ON OF THE SEWAGE 11
DISPOSAL FACILITY ONLY. SCALE : / �D,
INV. AT BUILDING 8�1 . as
2 ALL CONSTRUCT/ON METHODS AND MATERIALS SHALL coNFORM TO '
4Xs t
INV. AT S£PT/C TANK(IN) �a30
' MASS. D.E.O.E. T/TLE 5 AND THE BAi?1V5T4 PLE BOARD OF
,
INV AT SEPTIC TANK(our) R�.'55 !
HEALTH REGUL A TlONS. '
r
sue, �`^ •�• t •' F J rr1
/NV. AT DIST, 80X(IN) �•35
INV. AT DIST• BOVO//TI
AT LEACHING FACILITY
BOSTON, MASS. WORCESTER, K"s
HALIFAX, MASS. NORWELL, MASS.
s�T TT�7M DF P/T: 31 BEDFORD, MASS. LEXINGTON, MASS.
HYANNIS, MASS. MANSFIELD, MASS.
CA 1_=Uz_A7"r_ D P/G/-/ CRANSTON, A.I. DERRY, N.H.
SRO L)h✓L)wArF_ R,
PROFILE' SCALE: I fix
,
DESIGN FLOW
��i ��-� ST _3___ few x ►�v GPI - 330Pp-=
3
IV G ER
,
tJ G/ 1 } REOUIRED SEPTIC TANK
GAL.
SEPTIC TANK PROVIDED : I00 GAL. CAPE COD SURVEY'
4�T�u �o ti• CONSULTANTS
i n C?O GAl- �,>`�.v•($g�5 ` \ REWIRED SIZE LEACHING FACILITY: p p BOX 5fi
-- ---- -
_ �
7! / 5�P tc — -- G P U _ __- H YA NN IS, MASS. 02601
617 775-7165
AR`E A Y — -- ------- DIVISION OF
f l -r zr2 Q BOSTON SURVEY CONSULTANTS INC.
SIZE OF LEACHING FAC/L/TY PROVIDED: ENGINEERING • SURVEYING • PLMVMWO
},. TYPE OF SYSTEM TITLE:
SEC T/ON• SCALE: I = _—
c l J_0 I
�
/0�-lln &Qss-0A -� t_t�_-_ 54 1Z— SEWAGE DISPOSAL SYSTEM
�. _ — — �•Ilk-IV DESIGN a
F -
LOCUS PLAN
Nk� �.
FOR:
BERTHA,
r _
pp
r ruts HYANI
SCALE: AS SHOWN � a
METERS
07,2
„i� �•,�*�++ FEET 0
♦ �� ,. Cat _
•' L GtrUS
Y j
DATE:
COMP./DESIGN:
..
Vf=x �. CHECK: '. !�1
•
,
DA MM
DRAWN
FIELD: F ;}_FILE NO:
"7 all
�, • % _ ..,. DWG. NO: S 9 J08 NQ A
r. SHEET: 1 OF: I
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