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Home My WebLink About0112 DUMONT DRIVE - Health 112 DUMONT DRIVE A = 307—093 Hyanns .l No. Feet2l; THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Misposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(X [:]Complete System ❑Individual Components Location Address or Lot No. 3®,7 /093 wner's Name,Address,and Tel.No. MAWA M0VW 5_ObYLC Assessor's Map/Parcel i r a, D VOL-16V r D U 45 C.A cA&�c m i -Fa" H4 Installer's Name,Address,and Tel.No. O$s41 -$$ 7l Designer's Name,Address,and Tel.No. c 40Ewto G. &&A9eM6QS LA � Type of Building: II Dwelling No.of Bedrooms /V� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) A)W gpd Design flow provided MA gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �73�n�lJ �uc�S�-c e��- S �.. s Y.S��► Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of f Compliance has been issued by this Board of Hea Sig Date I. L - [a - 14 Application Approved by Date_ /v Application Disapproved Date for the following reasons Permit No. 2oi 4—f.:2?-�, Date Issued i No. � ' __ � - Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF-ErARNSTABLE, MASSACHUSETTS 1pplication for -MisposaY *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(X ❑Complete System ❑Individual Components Location Address or Lot No. wner's Name,Address,and Tel.No. 30'7 /093 MAWA Assessor's Map/Parcel ' tD U Wt(woc) mA Installer's Name,Address,and Tel.No. Sob•qj-j-gg-4� Designer's Name,Address,and Tel.No. . G4 0 E w(D 6 Wlee A"(1S 4s Type of Building: •• ,,'A . Dwelling No.of Bedrooms /Vl� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided &14 gpd Plan Date Number of sheets Revision Date J Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. . A Sign Date I D- - 10 - 14 -y< Application Approved by Date o _ '' Application Disapproved5im Date 'Y for the following reasons + Permit No. 2bI 3 Date Issued t 2T�o 20/ ----------------- -------------------------- ---- -------------------------------- - - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned(X)by e A p 6(t iiDi;: xjm*4� l l at ( �� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 4 dated IZ��(L/ Installer��I� R- � '� Designer /\ #bedrooms Approved design flow ! n/ A gpd The issuance of it h be construed as a guarantee that the system wilk-Onctidh as designed.t s �� f'1C Date Inspector V � l L' v pv /rrV " of ' ---- ---- - ---- -=----- --_- ---- No. 3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction j3ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(N) System located at f ` DLja40jL= b4t()j=- j,/Atj A] / 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 (��to Approved by try Town ®f Barnstable Barnstable rkzftld Regulatory Services Department A&Am eficaC j IIARNSCA$LE. MASS. Public Health Division fD NrP't 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1289 January 13, 2014 Maria Morris Doyle 15 Lantern Lane IMPORTANT NOTICE Milford MA 01757 Map & Parcel 307-093 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 112 Dumont Drive, Hyannis, MA, • to public sewer on or before 9/30/2016. • The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis.. Failure to comply with this Board of Health Order may result in a complaint against you, j in a court of law. For additional information pertaining to the sewer connection, please see enclosure. PER ORDER OF BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. I Agent of the Board of Health i • Enc. • Q:\SEWER connect\Sample order letters for sewer connection\l 12 Dumont Dr Hy Jan 2014.doc Parcel Detail http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=24636 t i�. ts�nkK� rtt �> � ll , -ti.Qp tixC,:e �43j , ad �. twe'?7�44 47", Logged In As: Parcel Detail Monday, January 13 2014 Parcel Lookup Parcel Info ..... Parcel 307-093 I Developer LOT 6 ID Lot Location r112 DUMONT DRIVE 106 ) n Frontage Sec _._ _-- .._,___ _ ...... _..__m_ Sec Road ! Frontage I Fire r�-- Village HYANNIS I District IHYANNIS Town sewer exists at this Road _ address No Index Asbuilt Septic Scan: Interactive 307093_1 Map Owner Info { ._-_ __ __ Co- Owner Owner DOYLE MARIA MO_R RIS- Owner Streetl j15 LANTERN LANE Street2 City MILFORD State MA Zip�01757 Country Land Info Acres€0.27 Use'Single Fa MDL-01 Zoning JRB � Nghbd 0105 Topography Above Street Road Unpaved Utilities{Public Water,Gas,Septic ! Location F Construction Info Building 1 of 1 Year 196C -- Roof Gable/Hip Ext Vinyl Siding Built Struct Wall Living 1768 Roof AC GIs/Cmp AC Area Cover I'" Type In — _ Bed ___._.__ _ w Style IRanch I ;Drywall 3 Bedrooms _._ '. Wall Rooms . efar� : _ _. Int .n Bath _ _ Model;Residential Floor Viyl/Asphalt Rooms,1 Full a Grade Average Minus�� Heat Hot Air Total�5 Rooms �� war Type Rooms '70 Heat _._ ___.. . Found . _ • Stories�1 Story Fuel Gas ation iconc. Block Gross http://issg12/intranet/propdataiParcelDetai1.aspx?ID=24636 1/13/2014 t. Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr " Property Address Fannie Mae Owner Owner's Name information is Hyannis MA 02601 3-18-09 required for —� every 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. A. General Information, 1. Inspector: :!!51�'M 7 D Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E.Falmouth MA 02536 City/Town State Zip Code 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 5 (310 CMR 15.000).The system: _ ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evalu lion by the Local Approving Authority 3-20-09 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. o n /V 112 Dumont Dr Hyannis•03l08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr ' Property Address P Y Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined,"please explain. ❑ The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 112 Dumont Dr Hyannis 03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �,M y 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): , ❑ 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: 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 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. 112 Dumont Dr Hyannis•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments- ^M 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure'criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each.of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ®{ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool R a ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow ❑ ® Required pumping more than 4 times in.the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. 11 ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 112 Dumont Dr Hyannis•03/08 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 112 Dumont Dr Property Address Fannie Mae _ Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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- I0,000gpd. ❑ ® 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 7 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. 112 Dumont Dr Hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 112 Dumont Dr M Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been`done. You must indicate "yes" or"no" as to each of the following: Yes No El ® Pumping information was provided by the owner, occupant, or Board of Health ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ❑ ®, this inspection? Were as built plans of the system obtained and examined? (If they were not ® ` available note as N/A) . rt ® " ❑ Was the facilityor dwelling-inspected for signs of sewage back u ? 9 P 9 9 p ® ❑ Was the site inspected for signs of break out? ®. ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: - ® ❑ Existing information. For example, a plan at the Board of Health. ❑, Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 112 Dumont Dr Hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 16 Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings,if available (last 2 years usage (gpd)): 73gpd/2 yrs Sump pump? ❑ Yes ® No Last date of occupancy: 10-08 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on.310 CMR 15.203): canons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 112 Dumont Dr Hyannis-03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 16 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address ' Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: • - Source of information: NIA 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): Approximate age of all components, date installed (if known) and source of information: 1996 Were sewage odors detected when arriving at the site? ❑ Yes ® No 112 Dumont Dr Hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments + 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 22 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: 16" feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, Iist age: ' ' years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1500 Gal Sludge depth: 101, Distance.from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 0 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 16" How were dimensions determined? Tape 112 Dumont Dr Hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 - every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): t Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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): 112 Dumont Dr Hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) , Tight or Holding Tank (cont.) 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 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. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes . ❑ No Alarms in working order: ❑ Yes ❑ No 112 Dumont Dr Hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town, State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 6-Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach field in good condition with no sign of failure or backup into surrounding stone. 112 Dumont Dr Hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): 112 Dumont Dr Hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is 1 required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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. 18QC C- B-6 , A -F 3 l` - I { 112 Dumont Dr Hyannis•03108 r Title 5 Official,Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 112 Dumont Dr Property Address Fannie Mae Owner Owner's Name information is required for Hyannis MA 02601 3-18-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 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 show no groundwater at 12'. 112 Dumont Dr Hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 307 093- - Account No: 217866 Parent : Location: 112 DUMONT DR Neighborhood: 61AC Fire Dist : HY Devel Lot : Lot Size : . 27 Acres .Current Own: WILSON, CLEVE A State Class : 101 PO BOX 2464 No. Bldgs : 1 Area: 768 Year Added: HYANNIS MA 2601 Deed Date : 080196 Reference : 10343185 January 1st : WILSON, CLEVE A Deed MMDD: 0896 Deed Ref : 10343185 Comments : Values : Land: 22400 Buildings : 33500 Extra Features : Road System: 112 Index: 455 (DUMONT DRIVE ) Frntg: 106 Index: ( ) Frntg: Control Info: Last Auto Upd: 020997 Status : C Last TACS Update : 092596 Land Reviewed By: Date : 0000 Bldgs Reviewed By: ML Date : 0488 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ J Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [307] [094] [ ] [ ] [ ] HM ] 61 H E A L T H M A S T E R ] HELP [ ] R E C O R D ] ACTION I] For Parcel Number 3071 0931 ] ] Rental Property (Y/N) [ ] Owner Name WILSON, CLEVE A ] Zone of Contrib (Y/N) [ ] Location 112 DUMONT DR ] Contaminant Rel (Y/N) [ ] Business Name [ ] Area Number Contact Person [ ] Phone [000] [ ] Fuel Storage Tank Permit [ ] Card on File [ ] Perc Test Well Septic File/Permit No. [ ] [ ] [96-364 ] Issuance Date [ ] [0802961 Completion Date [ ] [0828961 Last Communications [ ] (MMDDYY) Comments [NEW TITLE 5 ] Cancel [ ] NEXT SCREEN [HM ] ACTION [ ] PARCEL NBR [ ] [ ] [ ] TANK NBR [ ] ] [ ] COMMONWEALTH OF MASACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 112 DUMONT DR HYANNIS, MA 02601 60') — V_`� Name of Owner CLEVE WILLSON Address of Owner: BOX 2464 HYANNIS MA.02601 Date of Inspection: 8/31/00 Name of Inspector: JOHN GRACI 1 am a DEP approved system inspector pursuant to Section 15.340 of T►ffe 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 608-664-6813 FAX 608-664-7270 CERTIFICATION STATEMENT ,y,).? 1 certify that I have personally Inspected the'sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes Conditionally Passes _ Needs Further EvaluatiQn By the Local Approving Authority Fails lit Inspector's Signature: Date:9/3/00 The System Inspector shall su it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If t e system is a shared system or has a design flow of 10,000 gpd or greater,the Inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.My inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life:" THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE.RECOMMEND RAISING COVERS TO DISTRIBUTION BOX AND LEACH FIELD.THE DEPTH TO THE COVER OF D-BOX IS 7' ='F ' .' ...1 revised 9/2198 Page 1 of I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination In all instances.If"not determined",explain why not. nLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled oruneven distribution box.The system will pass Inspection if(with approval of the Board of Health). _broken pipe(s)are replaced _obstruction is removed _distribution box is levelled or replaced nLa The system required pumping more than four times a year due to bro.;zn 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 r, revised 9/2198 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31100 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No - X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet Invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"bellow invert or available volume is less than 1%2 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 nla. - X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. - X Any portion of a cesspool or privy is within a Zone I of a public well. - X Any portion of a cesspool or privy is within 50 feet of a private water supply well, - X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No - X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. F K. afi rf Y. 1. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B �.. CHECKLIST Property Address: 112 DUMONT'DR HYANNIS, MA 02601 Name of Owner: CLEVE WILLSON Date of Inspection: 8/31100 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health. _ None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ X As built plans have been obtained and examined.Note if they are not available with N/A. X _ The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. X _ The site was inspected for signs of breakout. X All system components,excluding the.Soil Absorption System,have been located on the site. X _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X _ Existing information,For example,Plan at B4O,H, X _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)] X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal Systems. N if 11 revised 9/2198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31/00 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual):n/a Total DESIGN flow: 364 gpd Number of current residents:3 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a is<; Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a ; OTHER: (Describe) n/a GENERAL INFORMATION PUMPING RECORDS and source of information: n/a System pumped as part of inspection:(yes or no):NO If yes,volume pumped n/a gallons Reason for pumping:n/a 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) _ I/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval Other:n/a APPROXIMATE AGE of all components,date installed(if known)and source of information: 1996 Sewage odors detected when arriving at the site:Ores of no): NO revised 9/2198 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8131/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 22" Material of construction: _ cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of joints,venting,evidence of leakage,etc.) THERE IS TOWN WATER SEPTIC TANK: X (locate on site plan) Depth below grade: 16" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 160OG L 10'6"H 6'6"W 6'8"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32 Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 18" How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) 1 THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. >+', GREASE TRAP: _ (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n/a revised 9/2198 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31100 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:N/A Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a DISTRIBUTION BOX:X (locate on site plan) Depth of liquid level above outlet invert: n/a Comments: f (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) RECOMMEDN RAISING COVER TO DISTRIBUTION BOX PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a .t. revised 9/2198 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31100 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(n/a)n/a leaching chambers,number: (6)INFULRTRATORS leaching galleries,number: (n/a)n/w leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE INFULTRATORS APPPEAR TO BE FUNCTIONING PROPERLY.THE SOIL PROBED DRY IN LEACH FIELD.THE SYSTEM SHOWS NO SIGNS OF FAILURE:RECOMMEND RAISING COVERS TO LEACH FIELD. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO Comments: ; (note condition of soil,signs of hydraulic failure'level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: nla Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) s AIL � n o � �wt c Ag S Ar, 1� Ab 1R�rvX cc F90 revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 112 DUMONT DR HYANNIS, MA 02601 Name of Owner CLEVE WILLSON Date of Inspection: 8/31/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions Checked with local Board of health _ Checked FEMA Maps _ Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET I revised 9/2/98 Page 1.1 of 11 TOWN OF EARNSTABLI Loa-moRl I an v�P . SEWAGE #" �IIlL Cs "___.M_ v d1✓1 r S _ ASSESSOR'S MAP,&L OT IN$TAL E R'$NAME&l'HC1NE NO. ,. . . . WnC TANK-CAPACITY LEACHING FAC[Lrff- (type) NO,OF'BEDROOMS.�. �. .. BUILDER OR OAP Separation Distance Betweep the: Maximum AdjusW,Groundwater Fable to the Bottom of Leaching,pa6lity fee Private Water Supply Well and L.eacWng Facility (If any wells exist on site or.widtin 200 feet of leaching Facility) fet Edge of Wedand and LeacWng Facility(If any well 5 e St v✓iP�ailb C3 t feet of lc tic k�In k`acilsty� 4�. Furnished by G�w� =�� Li/,0j°t� �a 4J gy UI O tN -n = r Tri �, N-� I" TOWN OF BARNSTABLE LOrATI(IN / QJVu SEWAGE # lal.I^.GE-AWaNIS ASSESSOR'S MAP& LOT-?,a 67,0.�7 PISTALLER'S NAME&PHONE NO. A.8r*k d --�&Z PO4W O SEPTIC TANK CAPACITY ISM G iql LEACHING FACILITY: (type) (size) �3 r>0 X 7 e NO.OF BEDROOMS ,` BUILDER OR OWNER �/,0119P O PERMITDATE: _ '` -7 f COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet 'Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of eaching facility) Feet Furnished by r— W n Y Q iq '^ � ��I� �` o '� Q r _ V ; . •�� ;^ r� �� J I^+, VJ ., o � C W N '),r n�i y��- �'-1 � N . .� � r y .�- >P_ ,_ )� Q �� `� � � .. TOWN OF BARNSTABLE LOCATION SEWAGE VII„ .AGB_-_G 11-' ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. A & B CANC'O 775-6264 SEPTIC TANK CAPACITY Z d DD LEACHING FACILITY:(type) ,�fa� ,� �s (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER rBUILDER OR OWNER �� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ✓' wl r .f C� 4 d � r r No. . Par' �J Fee ® THE COMMONWEALTH OF MAS ACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplication for Mig;po.5al 6potem Construction permit Application is hereby made for a Permit to Construct( )or Repair(g..Kn On-site Sewage Disposal System at: Location Ad ess or Lot No. r Owner's Name,Ajdress and Tel.No. Installer's Name,Addres signer's Name,Address and Tel.No. ,.A� ��vC 360 Main Street arsf - me Yarmgpth, MA Oa'f 3V- )7/0 Type of Building: Dwelling No.of Bedrooms _ Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3SY gallons per day. Calculated daily flow lgO gallons. Plan Date 7-dl-9 6 Number of sheets ! Revision Date Title 07 tQ GgAk,-Q -- 1,641/AnS Description of Soil p #&a n Nature of Repairs or Alterations(Answer when applicable) p 1 140 i 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 Board of H alth. Signed Date Application Approved by o• Application Disapproved for the following reasons Permit No. Date Issued ' 6.. { ` No. �' / Fee 'T i ~ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS.. 2ppfi�cation for )Digpoga[ *pgtemc Congtruction Permit Application is hereby made for a Permit to Construct( )or Repair((,man On-site Sewage Disposal System at: Location Add'jess or Lot No. Owner's Name,Address and Tel.No. ` .. SArj2i2 Installer's Name,Address signer's Name,Address and Tel.No. *9e0NCAN(;G 350 Main Street signer hA a r 5 Inc t c m4,t) W.Yarmouth MA.0267 Type of Building: f / Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow gallons per day. Calculated daily flow 390 gallons. Plan Date 7-d9.9 6 Number of sheets / Revision Date Title /9 Y_Q rlo"y — /;/a//A»4 Description of Soil �d /r >7(1 ,n well Nature of Repairs or Alterations(Answer when applicable) 1Jv r D V Date last inspected: Agreement:-7-7 - 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 Board of H alth. Signed Date Application Approved by . = Application Disapproved for the following reasons t _.Permit No. Z Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repa ed/replaced(.--)on by C'AiUGd for � as i/ 0--a-7 0 0 4`' h� en constr fed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No _ dated Use of this system is conditioned on compliance with the provisions set f r4h below: -No. "A + Fee 7Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migpogar *pgtem Congtruction Permit Permission is hereby granted to .(JC to construct( )repair( *.�-an On-site Sewage System located at / l i17e and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. ;5,0 Date: Approved y°°^ • 1 b Town of Barnstable ' • Department of Health, Safety, and Environmental Services BAMANe Public Health Division 1, Ec 367 Main Street, Hyannis MA 02601 'Office: 509-790-6265 Thomas A.McKean FAX: 508-775-3344 Director of Public Health May 8, 1996 Susan Holland 21 St. Anton's Way Marstons Mills, MA 02648 RE: 112 Dumont Drive, Hyannis ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL a CODE, TITLE 5. The septic system owned by you located at 112 Dumont Drive was inspected on April 30, 1996 by James Sears a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • The cesspool is sitting in the groundwater table. i You are directed to hire a licensed professional engineer (PE) to design a system that will bring the septic system in compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within twenty-one (21) days of your receipt of this letter. You are also directed to hire a licensed septic system installer to install the system components within forty-five (45) days of your receipt of this order. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. pE E BOARD OF HEALTH omas A. McKean, R.S., C.H.O. Agent of the Board of Health Town of Barnstable Department of Health, Safety, and Environmental Services Health Division 367 Main Street, Hyannis MA 02601 Office: 308-790-6263 71romea A.McKean FAX: 309-775-3344,. DLector of Public HeaM tN! 1,A1tliBUlll. 11A� [ENG ER LETT TO: �t,n (Date) onS Wn ORDER TO COMPLY WITH 310 C 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at , ( Z LC)kp- was inspected on by� yl.�� S�Tfs a Massachusetts licensed septic inspector. 3g The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 MR 15;00)due o the followi <, �,,• � You are Irected to hire a licensed professional engineer (PE) to design a system that will bring the septic system in compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within twenty-one (21) days of your receipt of this letter. You are also directed to hire a licensed septic system installer to install the system components within forty- five (45) days of your receipt of this order. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Town of Barnstable Commonwealth of Massachusetts Executive Office of Environmental Affairsl- ®epartment of Environmental Protection William F.Weld Governor Trud Coxe $earetary,EOEA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM MAP#_g,;�07' PART A PAR#_0q,y CERTIFICATION Property Address: /� 2 AJ/�o�7`' Z)r 1Lj �nn�S �e��yr td �.�e�f►5 Q D� P Y e Address of Owner: or-orr+� Date of Inspection: y-3O- 9(0 (If different) Name of Inspector: :)4Ac5 j�, 8e,4/ZS Company Name, Address and Telephone Number: A & B Canco 350 Main Street West Yarmouth, MA 02673 (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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes _ Conditionally Passes Needs Further Evaluation By the Local Appro"ng Authority Fails Inspector's Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system ov:ner and copies A•:',, to rile Uu)ei, if app cable and tl e aprto.ing authority. INSPECTION SUMMARY: Check A. B, C, or D A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is ` imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 One IMnter Street • Boston, Massachusetts 02108 • FAX(617)556-1049 • Telephone (617)292-5500 i, Primed on Recycled Paper Y i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A 7� " '\ CERTIFICATION (continued) Property Address: /la �[Jv!»do Uri U� 1�yHn n iS Owner: Zoro -t-4- .Z2e.c.AA-b Date of Inspection: 7-3o-4i/0 e) SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: is within 50 feet of a surface water �is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system-has a Septic tank dn6 SUIT dUSUIpUUIl sybteni and is within 'CV feE', to a surfaCE water supp!', or tr{.butarj t0 a surface water supply. _ The systen, has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. D) SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS of cesspool. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Dvrnv n-f— v e_ A n"S Owner: —T)a C 0-rt R =tee (a ri Date of Inspection: j4- D]SYSTEM FAILS (continued): Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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/Zoneepublic well. Any portion of a cesspool or privy is withinrivate water supply well. Any portion of a cesspool or privy islesstht greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the ell has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic com unds, ammonia nitrogen and nitrate nitrogen. E]LARGE SYSTEM FAILS: The following criteria apply to large sy ems in addition to the criteria above. The design flow of system is 10,00 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because on or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is wi in 200 feet of a tributary to a surface drinking water supply the system is ocated in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a public wat supply well) The owner or operator of y such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CM 5.00 and 6.00. Please consult the local regional office of the Department for further information. I (revised 8/15/95) 3 r - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1 I a_j)u nr,o r'-� Owner: Date of Inspection: 4-30-9 Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ZAs built plans have been obtained and examined. Note if they are not available with N/A. ZThe facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow ✓The site was inspected for signs of breakout. v/AII system components, lxcluding the Soil Absorption System, have been located on the site. vl The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or / tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. v The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. The facilii� o;;rc; iarid uccupa;,t,, if dlffere;-.; fro-.-. c„nr; ; ere provided ;;ith information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: n r%i S Owner: 00 C 0-r-4 1 c e l P cC\ Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: �,?D gallons Number of bedrooms: Number of current residents: a Garbage grinder(yes or no):�1 _ Laundry connected to system (yes or no): 1� Seasonal use (yes or no):_LQ Water meter readings, if available: / Q 9 S /'fDD Gl'L L fee-i- per bun reTG2 S o u rc2 6 R r n gT--A s3i-e_ L0,9 re r 'Co r^ tNn ., Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: aallons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: (1 l)a 2\0-c0(Z�S System pumped as part of inspection: (yes or no)_&(U If yes, volume pumped gallons Reason for pumping: TYPE QF SYSTEM Septic tan soil absorption system Single cesspool Overflow cesspool. Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: ACC C 0 p11' UW'f C)W IV �i �-�IC, (nsT�IlecQ 5�- 87 Sewage odors detected when arriving at the site: (yes or no) Per M i J" 8`J- a 9 4 (revised 8/15/95) S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION (continued) Property Address: >Vrr� n`i �r'v � Owner: Dp r 0%N 4 re ArJ Date of Inspection: _ - Cho SEPTIC TANK: f (locate on site plan) " n Depth below grade: Material of construction: concrete _metal _FRP—other(explain) Dimensions: 1600 (0Aw6 r l Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: 33 Scum thickness: a „ rt Distance from top of scum to top of outlet tee or baffle: .5 Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) -7-20V its HT 0 o r-ki J C- SUP-L- • t N I<-eT ' O JT LET Tees . Comer is con«ere_ A%3 lt�, et_oW Grf1� GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP _other(e ain) Dimensions: Scum thickness: Distance from top of scum to tor) of outlet tee affle: Dlsta^ce from bottom r,( c ii M hnttnm o' lltlet tee or baffle- Comments: (recommendation for pumping, o�dition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakae , etc.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: enc)S-t Zr i v Owner: —�Do(F-OTN Date of Inspection: 3 D-cl TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete_metal _FRP—other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert. Comments: (note if level and distribceic- i, e:; ', e"idcnc of salad- ca ^.r .e . evidence of leakage into or out of box, etc.) PUMP CHAMBER:_ (locate on site plan) Pumps in working orde/hamber, Comments: (note condition of pumtion of pumps and appurtenances, etc.) M1 (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: w rr,on t �rr u� i+y A r-, Owner: �prUTN =Ye PtY�GQ Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) l 4 r Pre c A ST -10 11 t )Al^e—C 1 r o iT F&Tror% o f 42L as " CESSPOOLS: _ (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 (cesspool must be pumped as part of in lion) Comments: (note condition of soil, sign/oydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_ (locate on sit/* signs Materials of Dimensions: Depth of soli Comments: ( of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 8/15/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: _ -3 u — Q SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' y� yo' �y 0 p 7£5 r /,4c£ A °T L ,r74 vLS DEPTH TO GROUNDWATER a Depth to groundwater: Y'O feet method of determination or approximation: f�,1 r' u F �Es i °L£ /�i T wgT,Z �i ro £ST ffo L i N°Tcb: ov �i�Bv �I/fcJF�i (revised 8/15/95) 9 HIGH GROUNDWATER LEVEL COMPUTATION Site Location: I a ✓V r�or�"1 f i UP— Pi`aAnn�-_1 Lot No. Owner: tt _Tq-p__�(At�_L> Address: Contractor: t— 6 fl Address: 3S0 0-)6� 12i WeS' Notes: STEP 1 Measure depth to water table 3a 56 8'� J i to nearest 1/10 ft. .............................................................................. Date month/day/year STEP 2 Using Water-Level Range Zone S. and Index Well Map locate site and determine: / OA Appropriate index well..........................•......................... oZ9 UB Water level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... month/year STEP 4 Using Table of Water level Adjustments ` for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment .......................................................................................... STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) < from measured depth to water p levelat site (STEP 1) ............................................................................................................. Figure 13.--Reproducible computation form. 15 r ' ' r �� C✓ to Fi — r7 ♦: u�?t�'fFt, _ � yG+4 i�.'� � �� _.,r� •.o„ d^i1 l .:1��jC',' � '"' �`� tn'1 ."'; Ole IN g ilk I Ip e �, .� 1 ,'j� � 1 •'� s r r :s . F Z 348 6.S1 073 Receipt for Certified Mail No Insurance Coverage Provided � UNRED STATES Do not use for International Mail VOSTIIL SERVICE 1 e Reverse),-, M Seni to L Street nd No. J to e e O Go�cstfg/ $ ch a E Certified Fee `p r LL Special Delivery Fee d fies`tricYe`dn DAVeT'y Fee'' J !R'etuKi Rec"e`ipttSliowrig"" 1 to Whom&Date Delivered Return Receipt Showing to Q Date,and Addressee's Ad r s -� TOTAL Postage =, I ter"---- &Fees Postmark or Date �Uslp i STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). ar 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no-extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return M address of the article,date,detach and retain the receipt,and mail the article. rn 3. If you want'a return receipt,write the certified mail number and your name and address on a 2 return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ro ends if space permits.Otherwise,affix to back of article.Endorse front of.article RETURN RECEIPT - REQUESTED adjacent to the number. C 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, 0 endorse RESTRICTED DELIVERY on the front of the article. E l o 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Sase this receipt and-pr^sgw it-if you make inquiry. 105603-93-D-0218 , AA6Fe i AIA t�f�n�srz��t� l�Bc�rcQ �" r /S _Sre s Commonwealth of Massachusetts - ��; S Executive Office of Environmental Affairs Department ofR . Mq � Environmental Protection Y s William F.Weld '19�6' � Caownnor Trudy Coxe (7AY!�a Secrotery,EOEA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM MAP# J?_?0 7' PART A PAR#0-,y CERTIFICATION Property Address: Address of Owner: �o��N y A�►d Pe`AfA_5 � Date of Inspection: y—30- 9(, (If different) Name of Inspector: :7�4n-e_S �- ?04/z S Company Name, Address and Telephone Number: A & B Canco 350 Main Street West Yarmouth, MA '02673 (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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes _ Conditionally Passes �/Needs Further Evaluation By the Local Appro�ing Authority Fails Inspector's Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection The original should be sent to the system ov;ner and copies x: t to the buyer, if app;icabic and the appro,ing authority. INSPECTION SUMMARY: Check A. B, C, or D. A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 One Winter Street • Boston, Massachusetts 02108 • FAX(617)556-1049 • Telephone (617)292-5500 Printed on Recycled Paper _ 3 12.E L 6 Af 10N SEWAGE PERMIT NO. Oz/ -*?- Z2 - VILLAGE I N S T LLER'S 01AME i ADDRESS l_Z BUILDER ' OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED I _ 1 (` 1 V� . \ �� rA �..rS0 nr r +'t� r _ Fy- TOWN OF BARPISTABLE LOCATION a Oe SEWAGE # f VILLAGE ASSESSOR'S MAP & LOT 'INSTALLER'S NAME & PHONE NO. ,SEPTIC TANK CAPACITY / o 0 o F9 L LEACHING FACILITY:(type) awP£ CYST (size) / NO.OF BEDROOMS v2 PRIVATE WELL OR PUBLIC WATER' BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ..::- �; ..,. s. � c �� y � � �. i� .�'�- o �( -, �- � �, �,, � .�.- y a �� , � 1 � P ) • 7 _ _.. __ -� r FEim.....$...5.:.22....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ........ ....T.own.......OF.........BArnstable.. -----------------.._..---......._......-•------- Appliratiou for E igvati al Works Tontitrurtion Vvrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: .....---•...... .................................................................................................. i Location.Address or Lot No. .Mc�.e... 1zs�.X1..1tS2l1.axld---- ------------------------------------------------ 172..Dumnrit.�xa,..liyal�xlisr D26D]. - -- Owner Address a A & B Cessp.00l__Service............................................ 12.8..Bishops..T.erra.re,.._Hyannia,_..MA.....D26D1...... Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms......................... .................Expansion Attic ( ) Garbage Grinder ( ) .� `., Other—T e of Buildill No. of persons---------- ________________ Showers — Cafeteria Q' Other fixtures ________________________ ........ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_----------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY-------------------------------------------------------------------------- Date........................................ aTest Pit No. 1----------------minutes per inch Depth of Test Pit__-___-_---_-______- Depth to ground water_-___-_-________._------ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' --•---•-•--------------------•----•••-••-•--•---••-------•-------••-•••-••••-•••........-•-••••....•......................................................... 0 Description of Soil----------Sard--------------•----------------------•------••-------------------------------------...--------•----•-------------------------------...........---- W -----------------------------------------------------------------------------------------=------------------------------------........................................................................ U Nature of Repairs or Alterations—Answer when applicable---installation,.--of--a-6_-X..6----gxencaS.t..l.a-ch _pit with extra stone- overflow) Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with provisions of �.�the p E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in 'TT LE operation until a Certificate of Compliance has been issued by the bo r of alth.' Sig d. �.} . .. .......7/?3/80......... Date 31 8Q...........Application Approved By...... ---•- 4- •-------------7 Date Application Disapproved for the following reasons:....... . �{� . _�l�-!! .................................... .............. ---------------------------------------------•----•------------------------------------•--•----•••------- / Date PermitNo....-•-•-.80-.............................................. Issued-........!`- V3 0.............................. Date No. -. � ... FEs....$...1.00 � .:.:. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............ T.own..........OF......... .......................------------------------- ,��lirtt#lien Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 112..Autoamt..�r�. Hyanniaa .....02.601................ -----------------------------••-----•----------............-----.....................------------. Location-Address or Lot No. t3..... ........................................................ 112..D.=C t..-Dr. ...H,Y.annis¢..YA....W601.................. Owner Address aA••....B_C..... s9 ............................................. ....02601...... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms........................3.__..___..._...._Expansion Attic ( . ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons.._._...2_-_•_-•_--__-___- Showers ( ) — Cafeteria ( ) Q' Other fixtures __________________________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width---_--------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_--------------_ Diameter.-_-___--______-___- Depth below inlet.......`;........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Perfd , b ----- --------------------------------•----------------.----------------- Date......................................... ,aa Test Pit No. 1----------------min s per inch Depth of Test Pit................. Depth to ground water-----------------_____-. ;3, Test Pit No. 2................-nu�tes per inch Depth of Test Pit.................I ___- Depth to ground water.._.................__ t O Description of Soil.._�,;f '5 ................ W --------------------------------------------------x ----------------------------------------------------------- ------------------------------------------------------------------------------ Z Nature of Repairs or Alterpti ns—Answer when applicable...installation--of-a-_6.X 6 pTe-Cast-_IeB,Ch pit with extra, stone k overflow) Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T i i'L.: p 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 theeofF11 alth: S*Fjd. -3/8 Application Approved By.... 64L .... --- .... 7/iJ780 Date Application Disapproved for the following reasons ................................................................................................................ ....-----•------------------------------------------------------------•••.• -= --- ------------------------------------------------------------------------------------- *; =k ,�� Date 80- ,., 7/23/80 Permit No. =----------- - Issued ........................................ 2 � Date THE COMMO NWiEALTH . MASSACHUSETTS 139A.FZD``00P%HEALTH T own ` Barnstable o F..r a................................................................................ Cwrrtifir atr of TompliFanrr b A IS IS TO Cesspool CERTIFY, Th�atthee Individual Sewage Disposal System constructed ( ) or Repaired (X ) Y ishops•Terraces nip.... MA:-•--Q26Q .....--....:7.� �626 _..__.._. +° installer at.•••Z12_Dumgnt_•Dr..,..Hyannis.: . 02601 ~.. Susan Holland has been installed in accordance with t`li provisions of DTI j of The State Sanitary Code a described in the application for Disposal Works Corlis"tructlon Permit No.86__._:,;.. _____..__. ` .da.ted_....712� $Q THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATIS+�FACTORY �k, ,�,� �.; � • �,,. W �' DATE . ?� 0 Inspector rf. w '"a ►L l:�F; +'�. ". " aSf'f3^ c �' r-�a 4 �t''`,} .. r }�`" "i�Wn.fGx w � FHE COMMLTt IF MASSACHUSETTS t" BQARD ®F \HEALTH ,�- ........... own........®F........Baxnstable 50.00 No................. ...... ___.. FEE...--...50........... Biov'ns al nrkvATUTmAr ion prrmit Permission is hereby granted_A & B Cesspool Service, 128 Bishops Terrace, Hyannis 02601 to Const c ( or Re air ( X an Ind•v 1 Sew e Disposal System ffi Uu 00A D�., s, 0 �1 -- wean Holland atNo.•••--••••••--•-••-••••....--•••-•••=--=•••••...--•-----•--••-•-•••--••-----•----•-----•...--••.--•--••----------------•••••-••--•----•----•-•-•-•-•••-••-••••••••......---•••......---........ - Street as shown on the application for Disposal Works Construction P rmit $�_`........... Dated..7�z3�80....................... v w� qO Board of I e th DATE ----------------------------------------- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS '� ASSEMORS W III ;Z PARCEL FIO: Fz$..... a•.:............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c>Wn...............O F....fJ.firh Sq.c1j.e.....---- Appliratiun for Biipuaa1 Workii Tonutrnrtiun Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal System at: 72.4 ...,: lr�ts�er 4xlYi h�-----•--•---------- -------•-----•--------................------.................---•--.........................-•---- Loc tion-Address or Lot No. d- -- - ------------------------------------------------ ll.Z.. mon_ _.�?L�Ne �r_S-•-----•........---••------•-•-- C ner �Addr s � Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...........................= ............Expansion Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ . W Design Flow............................................gallons per person .per day. Total daily flow....................._......................gallons. 9 Septic Tank—Liquid capacity............gallons Length..,.........*... Width................ Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-----------.........sq. ft. Seepage Pit No--------------------- Diameter____________________ Depth below inlet.....:.............. Total leaching area...........-----..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by--- ----------•.._....--------.....-----------•-------------•------------- Date........................................ . Test Pit No. I.............................minutes per inch Depth of Test Pit.................... Depth to ground water...................... (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•-•-•-----------------------•---------------------------------------.................-•----•--•----......................................................... 0 Description of Soil.......................................................................................................................................................................... x U ----------------------------------------- ----------------------------------------------------- •-------------------------------------------------- •------------------------------- •--•------------ W ------------------------------------------------------------------------------------------------------------------------------------•--------------•-•---•-•----------------•--------•--- ............. UNature of Repairs or Alterations /—/ Answer when applicable_ n b 47W-----too _g Dx_._S ? 4t._;� ............. LflA7t�h c.�- ei..QaCka t---N pk�--------------•------•--------•-------------•-..................----------------------•-. ......------....---•--....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT=_E 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,_ !- { D ". �6 ----••-- ----------------$7........ y 5-D/' ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ----•--•--•---------...•---------•----•-.....-••-------------------------••-•--------....-----•--------•---•---•-------------•-----------------------•------------•-----------------------••-•--------- �+ Date Permit No.....0. "'...s .��l. Issued_..--•-----•-------------------•---•----•------•-------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 n•t, �OF. eril 44 P ....... .......c....'...................__.... ---•-------------•--••-----•-----•-•--- Appliratiou for Disposal Worko Toustrurtiou Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (W.) an Individual Sewage Disposal System at: ) ��.. f w� Location!Address[ t ( ^y or Lot.No. ......................L tZ r:I_¢..,.t_C+ 1';r,o-n''i-1,.� _/t 7 J)[J))wjr -' l ior4?A--' A•f.,4-w."(.s 1�! �ff............ . Owner ...- a �)l n%�LF lil y>*tie'f Ad rt'ss 9 �...�frl'r!t>t.Et7 fi -.......... ............... i.. Installer Address ll d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) PA Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. GG Septic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter.-.--.-..----.-. Depth................ Disposal Trench—No. .................... Width....--.--....--.--.. Total Length----................ Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter--.-.--.------.----- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-----------------------------•--.....:------------•----................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --•--------------------- ---------------------------- ------------------------------------------- ---------------------------------------------------- ••-•-- 0 Description of Soil........................................................................................................................................................................ x W -------------------------•----------------- !---•---------•--••--•-----••--••--••--••-•---•••-••--•--•-•--•••-•-••-••••-•-••-••••-•---•--•-•-•••••--••-----••----••-•••----••---•.......•...-----•---•- U Nature of Repairs or Alterations—Answer when applicable —r90-_---t-nor.-�......... _ --- .......... ................................... rn . � - 1 t Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T T'I l ;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. l ,hr!�•C----�r----------------'---•--------•-----•--------- ------ Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons---------------••------•---------------------•-•----•---•----•---------------•-......--•------------------._...._ ---------------------------------•--------------------------....-•------•-•-------------•--•--.........---•--•------•-----------•--------••---•-•••--•---•-----••------•-------------•--•---•--••------- QQ Date Permit No...�Cl.�'... .�� -. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.....t`aItrIl e t � ?�,0.................................................. Tntif irate of Tuutpltuttrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by................. +._ ........i --e—...-•-----•-•-•--...-----•-•----•--•--------•---•-....•......................•---------•--------------•-•--....----- Installer at - ..=" ----�•'�- ------•------•----------------------------••-------------•----------------------•------------- has been installed in accordance with the provisions of TITIE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No---- ��__......... dated..................._-... ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................................................................•••-.....-•-- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4-11 9-7 ....,.f.v�:,r?. OF.. 1 01"r)J�yt r,r y - NO. ^..._.....1-... FEE...F? .. ............ Disposal Works Tuustrurtiou rrutit Permissionis hereby granted............................................................................................................................................. to Construct ( ) o Repair anKndividual Sewage Disposal System atNo.. /Z ° -, ...........:r-............................---.....---------------•--................---------------------------------------.........----- Street as shown on the application for Disposal Works Construction Permit No .... Dated.......................................... -•----•--••••-• H -------- ahBoard o -------------- DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ASSESSORS MAP: 307 TEST ST HOLE LOGS NOTES.- FLOOD t F sTREaT PARCEL: �_ 1. VERTICAL DATUM: ASSUMED FROM QUAD (NGVD +f ) ZONE: � ENGINEER: THOMAS M----- N,_P.E. 2, MUNICAPAL WATER IS AVAILABLE. WITNESS: EDWARDBARRY +,3. SCHEDULE 40 - 4 PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. DATE 7-25-96 Lows �a 1 - 4. ALL PRECAST UNITS TO CONFORM WITH AASKTO H-10 1 V PERCOLATION RATE: � 2 MIN/IN LOADING SPECIFICATIONS. On TH-1 TH-2 5. PIPE PITCH = 1 4" PER FOOT, (UNLESS NOTED OTHERWISE). 3s.o 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE SET LEVEL, A HORIZON ELE' 7, THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE LOAMY SAND USE OF A GARBAGE DISPOSAL, foYR s/s 35.5 8, ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE B 90RAMY SAN STATE OF MASS. ENVIRONMENTAL CODE TITLE FIVE AND LOCAL LOCATION MAP LOAMY SAND , ( ) 18" 10YR 618 34.5 HEALTH REGULATIONS. LOT 6 C HoRIzoN 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 12,092 t S.F. MEP-COARSE SAND z.5Y 618 TO CONSTRUCTION. (0,28 ± AC.) , 10. GROUND COVER_ OVER ALL SEPTIC SYSTEM COMPONENTS NOT TO 20.�21 EXCEED 3.0. f3z" z5.0 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND. NO GROUNDWATER ENCOUNTERED / 4 / I I 22 y , f9. 9 I S:� PT IC SYSTEM DESIGN 4 / / _ - -23 =24 FLOW ESTIMATE: (3 BEDROOM DESIGN MINIMUN) _ 25 ; `� ' / i/ / / _ - _ .8 BEDROOMS A?' 110 GAL/DAY/BEDROOM = 330 GALEDAY 4 , - ' _ 26 STAKE ELEY= 322 / i I SEPTIG' TANK; ' 1 330 GAL/DAY x 2 DAYS = 660 GAL /� i �, � 1'7 USE 1500 GALLON SEPTIC TANK zo. O 20. s LEACH,�NG AREA:. (BARNSTABLE REG. # 1.14, NO SIDE AREA TO BE USED) 4- / / \ l -29, 30 ' 18. 6 ' ' / / I 3233 USE 6 STANDARD INFILTRATORS WITH 4' OF STONE ' AROUND SIDES AND 3' AT ENDS 43.5' x 11' x,.7„ EFFECTIVE DEPTH SIDE' AREA.- NIA ( ).- GAL/DAY ` 19. 9 �,, \ / /SIN 37 BOTTgM AREA. 43.5' x 11' = 478 SF (.74) = 354 GAL/DAY a I / I / � TOTAL..CAPACITY = 354 GAL/DAY SEE NOTE 11 S 'PT I C SYSTEM SECTION 17. 4 I \ \\ \ t / / / �a�jN / f; TH-1 / BENCHMARK AT C91C. BOUND / ilk, ELEY.=`209' ( { 1 1 \ \ / k / / : 1 . ay COMERS'iIITHIN 12" OF I / / I / FINISHED.GRADE 2» PEASTONE I l \ / i i / h. ONE INSPECTION COMER 33.,8 fi0 BE WITHIN 6" OF GRADE) RST FLOOR 314" -_1 1/ 9'FI WASHED STONE ELEV.= 29.5 29,8 ELEV. 29,55 a e I ' o ELEV. D-BOX 29.16 28.5 20 t t e I / 1500 GAL ELEY. 29.1 ,E-} F ELEV. / / 1 I I I i l i SEPTIC TANK 29,33- (6 OFOF ELEV. '�,,4, 3'-4, 17. 3 \ ti t I / (6 OF STONE UNDER OR ELEV. STONE 43.5 11' r / I USE 6 STANDARD INFILTRATORS I ► 30,.0 MECHANICALLY COMPACTED) UNDER � ) ) WITH 4 OF STONE AROUND SIDES ` \ ELEV. TEE SIZES: GAS BAFFLE ( ) AND 3' AT ENDS 43.5' x 11' x 7" DEEP ts\ \ �� 34 3586 �Oy, 2;{• i INLET: 6" UP, 18" DOWN (T0 BE VENTED) ze29 so sr s2 33.. _. i OUTLET: 6" UP, 14" DOWN . 20 24 2526 27 19 ELEVATION OF WETLAND 17.3 37 as KEY: TL � SITE AND SEWAGE PLAN EXISTING CONTOUR: APPROVED BY: DATE: PROPOSED CONTOUR: ............................. LOCATION. EXISTING SPOT ELEVATION: 25.5 I r PROPOSED SPOT ELEY TIO 112 DUMONT DRIVE TEST HOLE: - � € �� F >� �� `�� HYANNIS MA. UTILITY POLE: ! 01 IL ,4 a 1 FENCE LINE: ,, �� PREPARED FOR: HYDRANT; - ? ; � M t _ `I w � h ,, a V: A & B CANCO H LLA D RETAINING WALL: �M . " . O N TREE: � DEMAREST MCLELLAN ENGINEERING � 1,�. � SCALE; 1 = 20. DATE: 7-29-96 24 SCHOOL STREET P.O. ;BOX 463 } WEST DENNIS, MASSACHUSETTS 02670 REFERENCE: PLAN_BOOS" 49 PAGE 133 DM # _96_090 (D19F20) ffH:OMAS :McLELLAI , P,E. JOHN Z. DEMAREST JR., P.L.S.