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Home My WebLink About0156 FAWCETT LANE - Health 156 Fawcett Lane �,� Hyannis IR V� A = 269 165 P I� T i u. 17 � ve fi U s oFt"E r Town of Barnstable Regulatory Services i J� ;+ P` � 9 BARNSTABM $ Thomas F. Geiler,Director OR 44t,5" J'^MASS ^ b�� A i639• �0 Public Health Division rip- Thomas McKean, Director C!'Q c t o maz_ 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Valdenir Barboza March 1, 2005 156 Fawcett Lane Hyannis, Ma. 02601 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. The septic system owned by you located at 156 Fawcett Lane Hyannis was inspected on, 11/13/2002 by Robert J. Bortolotti 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: Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. Our records show that the system has been in a failed state for more than.two years. You are ordered to hire a professional engineer or registered :sanitarian to prepare• a plan of .proposed replacement septic system component(s). This plan is to be submitted to the Town of Barnstable Public Health Division Office (Regulatory Services, 200 Main Street,Hyannis), within (90) days receipt of this letter. The plan will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title V. You are a lso o rdered t o u pgrade o r r eplace t he s eptic s ystem w ithin s ix months (180) days o f y our receipt of this letter. Any person aggrieved by any order issued by the local approval authority may appeal to any c ourt o f competent jurisdiction as provided for by the laws of the Commonwealth. You have the option of requesting an adjudicatory hearing pursuant to 310 CMR 15.422 Failure to comply with this order will automatically result in a public hearing scheduled before the Board of Health. �nVER O THE h BOARD OF HEALTH Tomas A. McKean,R.S., C.H.O. Agent of the Board of Health CC: Board of Health 1/failed—septic letters ! , BY STREET 3/30/2005 ID Permlt,# Date „ _, Hauler Owner _ Hse;# Street;y, Utlla e> Source 33676 20031982.1 10/30/2003 Robinson Phillips 180 Fawcett Lane Hyannis Septic 261 989070.2 1/19/1998 A& B Canco Larsson, Eric 153 Fawcett Lane Hyannis 262 988944.1 1/8/1998 Robinson Cahoon, Arthur 200 Fawcett Lane Hyannis 263 988942.1 1/8/1998 Robinson Stansfer, Re,`,be 200 Fawcett Lane Hyannis 2293 980948.1 7/13/1998 A& B Canco Pissimissis ` 59 Fawcett Lane Hyannis Septic 2294 980949.1 7/13/1998 A& B Canco Pissimissis 59 Fawcett Lane Hyannis Septic 3280 981662.1 9/12/1998 Ace Chretien 220 Fawcett Lane Hyannis Septic 4790 992711.1 1/7/1999 A& B Canco Pissimissis,'.^Ch 59 Fawcett Lane Hyannis Septic 5008 980053.1 12/9/1998 A& B Canco Viera 233 Fawcett Lane Hyannis Septic 6557 993992.1 5/24/1999 A& B Canco Gomes 250 Fawcett Lane Hyannis Septic 6733 994109.1 6/4/1999 A& B Canco Pissimissis 59 Fawcett Lane Hyannis Septic 6767 990086.2 6/1/1999 Sep tech Griffen, Dorpth 47 Fawcett Lane Hyannis Septic 7067 994254.1 6/22/1999 A& B Canco Pissimissis ' 59 Fawcett Lane Hyannis Septic 7284 994432.1 7/6/1999 A& B Canco Pissimissis jCh 59 Fawcett Lane Hyannis Septic 9293 995841.1 10/29/1999 A& B Canco Phillips, Ber.mic 180 Fawcett Lane Hyannis Septic 9294 995842.1 10/29/1999 A& B Canco Phillips, Bernic 180 Fawcett Lane Hyannis Septic 9689 996155.1 11/24/1999 Robinson Hatch 38 Fawcett Lane Hyannis Septic 10106 996448.1 12/29/1999 Midcape Cristo ` '' 59 Fawcett Lane Hyannis Septic 11460 20007515.1 4/14/2000 Abco Larson, Eric:. 153 Fawcett Lane Hyannis Septic/Cesspo 11714 20007688.1 4/27/2000 Midcape Christo 59 Fawcett Lane Hyannis Septic 12283 20008063.1 6/1/2000 A& B Canco Zicko 193 Fawcett Lane Hyannis Septic 14944 20009815.1 10/20/2000 Robinson Pinney 200 Fawcett Lane Hyannis Septic 15599 20009783.2 11/29/2000 Wind River/Mid Chretein, Hazel 220 Fawcett Lane Hyannis Cesspool 16525 20010954.2 2/23/2001 A& B Canco McCarthy 180 Fawcett Lane Hyannis Cesspool 17082 20011263.1 4/10/2001 Robinson Heroian 173 Fawcett Lane Hyannis Septic 18289 20011973.1 6/8/2001 Wind River Miranda, RuO 103 Fawcett Lane Hyannis Cesspool 18590 20011948.1 6/27/2001 A& B Canco Hardy, John3': 153 Fawcett Lane Hyannis Septic 23292 20023913.1 4/12/2002 Wind River Griffen, Doroth 47 Fawcett Lane Hyannis Septic/Cesspo 24062 20025108.4 5/21/2002 Wind River Miranda, Rul` 103 Fawcett.Lane Hyannis Cesspool 26490 20026788.1 9/21/2002 Macomber Marsh 193 Fawcett Lane Hyannis Septic 27316 20027216.1 11/5/2002 Robinson Phillips 180 Fawcett Lane Hyannis Septic 275661 20027360.2 11/18/2002 Bortolotti Koch 143 Fawcett Lane Hyannis Septic/Cesspo -- "-------1-56 Fawcett Lane-H annis- -_ a tic • --- 28341 �--20020053 9 --1 4/25/2002 1Nind:River_----Pierce;Shaun=� ..�__ y S__p , Pagel s BY STREET 3/30/2005 ID Permit# -' Date.. Hau erOwner ;. Hse,# Street .,., Villa a S91urce 28409 20037907.1 1/25/2003 A& B Canco Phillips 180 Fawcett Lane Hyannis Septic _._ 30747 20039320.1 6/18/2003 Macomber Penny 200 Fawcett Lane Hyannis Septic �34307 --20032384.1 --_ .12/1.1/2003 Macomber Barbosa °' 156 Fawcett Lane_-Hyannis TGessp_ool/s—epti :— 34394 20032470.2 12/17/2003 LeBoeuf Septic 163 Fawcett Lane Hyannis Septic 34525 20032508.2 12/31/2003 A& B Canco Barnstable Hou 190 Fawcett Lane Hyannis Septic 36570 20043746.1 5/28/2004 Macomber Phinney 200 Fawcett Lane Hyannis Septic 36875 20043961.2 6/16/2004 A& B Canco Pilo 250 Fawcett Lane Hyannis Septic 37202 20044238.1 7/3/2004 A& B Canco Bryan 113 Fawcett Lane Hyannis Septic 383521 20044779.3 9/2/2004 A& B Canco Phillips 180 Fawcett Lane jHyannis Septic 398881 20045428.1 1 1/22/2004 LeBoeuf Septic Hardy;Teresa 153 Fawcett Lane jHyannis Septic Page 3 No. O'�� S U _ Fee /—v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYication for Miopaaf *p5tem Congtruction Permit Application for a Permit to Construct(ARepair(W Upgrade( )Abandon( ) �Complete System D Individual Components Location Address or Lot No. IS(, FA UJ C.6 'LN Owner's Name,Address and Tel.No. V lQ 1..0)1J j&R. - 131;Q,6 Assessor's Map/Parcel 2 &q / 1tR 6 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. P. 0 it 12.99 F0ZE i c7A Zr to +;• CRO&S Al UZ P a RZST Dil LF. Type of Building: -� Dwelling No.of Bedrooms J Lot Size�sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ?Li?- • 3 gallons per day. Calculated daily flow 3.30 gallons. Plan Date 9—'L— OS Number of sheets Revision Date Title Size of Septic Tank Qa CM Type of S.A.S. 1Z.5 Description of Soi11A lJ — L 3 (�)� — 3 II S �'� :3(_0 1 e _ q G t' Nature of Repairs or Alterations(Answer when applicable) N 7P 0 IGI-o 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' s b and of Health. igned Date ®" Application Approve Date N-411S Application Disapproved for the following reasons Permit No. C'�O 5 3 Date Issued 5 No. Fee THE COMMONWEALTH OFWASSACHUSETTS Entered in computer: Yes PUBLIC-HEALTH DIVISION -TOWN OF BARNSTABLE.,MASSACHUSETTS 01pprication for 30i5pozar *p!tem dCon!5truction Permit V ,r Application for a Permit to Construct(a)Repair(D)Upgrade( )Abandon( ) ]Complete System ❑Individual Components Location Address or Lot No. 15(o Fi9 w`C)T L.N Owner's Name,Address and Tel.No. V fA L_011V Q;(L fSV41160-Zil yam�S Assessor's Map/Parcel 2(.� / I V 5 (� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. PAsrott6 EX GA v AT)Ofi� L�6t NT;�,st�r>b W ORIC.S P• o 9 CP-*, Q-9 9 PoRzs VA LB IZ- w. C(tOSS P i r,L.O F()2ZST DJ9 tS Type of Building: ? Dwelling No.of Bedrooms J Lot Size ,_ 7 sq.ft. Garbage Grinder( ) + Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3LiZ- 3 gallons per day. Calculated daily flow 3.3 O gallons. Plan Date q-Z- O S Number of sheets 3 Revision Date Title Size of Septic Tank IS oa 1 S 00 Type of S.A.S. MALIA El GO VK lZ A I Description.of Soi1A ® - G a U (�� ' 3 L It LS C, 3 Co 1" Q(+h t Nature of Repairs or Alterations(Answer when applicable) NCB Tn NK /1 A!D Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system i in accordance with the provisions of Title'5 of the Environmental Code and not to place the system in operation until a Ceh.ifi i cate of Compliance has been 'ss b -: and of Health. igned Date Ap plication Approve 4�24 11 Date /0 AVL Z/ M„ Application Disapproved for the following reasons 1 Permit No. �'�5 S�� Date Issued 1'0 5 y S THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance R a THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired ( )Upgraded( ) =?%Abandoned.( )by PAST0Q-r= O(C.A V6 C71�-� at 15 6 F-A WGETt- L•,N H YA NN e S . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer I7/J"S1 Deb CAVA"T(?31J Designer E.Nb 1N4AE&M b 4t 'R The issuance of this permit shall n t be cyssttrued as a guarantee that tl syste un tion as designed. Date l.� � 5 Inspec r ✓✓��t.J�� V No. (7� Q 5 �� Fee </o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 1wigw6al *pztem QCon!5truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at I5.Co nW -TT- 1--.M oyl j� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction m sst2t be c mpleted within three years of the at:of his Date:_ O- Approved by Town of Barnstable Regulatory Services Thomas F.Geller,Director sxsrsr�ar, � Public, Division. Thomas McK-Oan,Director �-- 200 Main Street;Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form . Date: 4 Z oj— Sewage Permit# " 53Y Assessor's 1VIap\Parcel Z�9 ' &S� Designer: F-va i/_7 wor- .S Installer: Address: 1 Z � �S S�-i"e4 /"t/ 1� .Address: o &L,)c On U� I J re CX CA004i�;i was issued a permit to install a (date) (installer) "fit septic system at. ✓ Go Cf#' (Rn4Pf YlVi d rbased on a design drawn by (address) Mc & eE .._ f � /r --- dated q 1 7�J&T � :ry (designer) I.certify that the septic system referenced above was insfalled substant4ily•according to the design,which may include minor approved changes such as lateral relocation of the distribution bon and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. flan revision or certified as-built by designer to follow. p H 1 PETER T. � l yCAv1mJ WENTEE 1 (Installers ignature) CIVIL y ,� N0,93109 (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN IQ BARNSTABLE PUBL f— HEALTH DIVISION. CERTIFICATE OF ('O1dgPLI&NCE WILL NOT BE ISSUED Uld'TIE >3iOTH THIS FORM AND AS&UT CARID ARE FcEYVEDflY THE BARNSTABLE I'UBLJQJJEALTH DIVISION. THAtIK YOU. t : Q:Health/Septic/Designer Certification Form 3-26-04.doc rY f: 14 � ^ a 911 NO3 Notice: This Vorm Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, R ✓ �U 1 C��-2-P hereby certify that the engineered plan sib by lie dated Z 1,0 conceming the property located at 15(v 1:�tcnj cc �f LA v%e H i �`g,v1.�f S meets all of the, following criteria: • This failed system is connected to a residential dwelling only. There are no.conitnemial or business uses associated with the dwelling. 0 The soil is.classified as.CLASS I and the percolation rate is less than or equal to S minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation tests at the site'without a health agent present. s 'there is no increase in flow and/or change in use proposed r • There are no variances requested or needed. • The bottom of the proposed leaching facility-sill be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Erimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) f'Ce—cZse 6•LU E) G.W. Elevation ZI +adjustment for high G.W. 3� = Z�' M.2ajQMM4A>�' MT'ERENCE.BETWEEN A and B SIGnD : DATE: Z�,U� -L�,r►e r2-ucj) r NOTICE 14 Eased upon the above information;a repair permit will be issued for_ bedrooms m-aximum... No additional bedrooms are authorized in the future-without engineered septic system plans. q:'Svoc�woexeM.doc t"E Teti Town of Barnstable Regulatory Services BARNgrABLE, * Thomas F. Geiler,Director 9 MASS. �o i639• &�e Public Health Division rEc n�a'� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Valdenir Barboza March 1, 2005 156 Fawcett Lane Hyannis, Ma. 02601 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. The septic system owned by you located at 156 Fawcett Lane Hyannis was inspected on, 11/13/2002 by Robert J. Bortolotti 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: Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. Our records show that the system has been in a failed state for more than:two years. You are ordered to hire a professional engineer or registered sanitarian to prepare' a plan of proposed.,replacement septic system component(s). This plan is to be submitted to the Town of Barnstable Public Health Division Office (Regulatory Services,.200 Main Street,Hyannis), within (90) days receipt of this letter. The plan will bring the septic system into compliance with 310 CMR 15.00,The State Environmental Code, Title V. You are a lso o rdered t o u pgrade o r r eplace t he s eptic s ystem w ithin s ix months (180) days o f y our receipt of this letter. Any person aggrieved by any order issued by the local approval authority may appeal to any c ourt o f competent jurisdiction as provided for by the laws of the Commonwealth. You have the option of requesting an adjudicatory hearing pursuant to 310 CMR 15.422 Failure to comply with this order will automatically result in a public hearing scheduled before the Board of Health. ER O THE BOARD OF HEALTH Thomas A. McKean,R.S., C.H.O. Agent of the Board of Health CC: Board of Health 1/failed—septic—letters i Barnstable Assessing Search Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results 56 FAVVVV CETT ANTE. Owner: BARBOZA,VALDENIR S& Property Sketch Legend Map/Parcel/Parcel Extension , 269 /165/ �i Mailing Address BARBOZA,VALDENIR S& „ f j 'rv! BARBOZA, RENATA S � 0 156 FAWCETT LANE HYANNIS, MA.02601 2005 Assessed Values: Appraised Value Assessed Value Building Value: $ 108,600 $ 108,600 Extra Features: $ 10,800 $ 10,800 Outbuildings: $500 $500 Land Value: $ 139,600 $ 139,600 Interactive Property Map: ap requires-Plug in: Totals:$259,500 $259,500 1 have visited the maps before Show Me The Map '_ April 2001 photos available _..__..,. Sales History: Owner: Sale Date Book/Page: Sale Price: FIRMIN, MICHAEL S&ANITA 1 12/15/1992 C128587 $90,000 KEARNS, ROBERT J&DEBORAH 8/15/1988 C115112 $ 120,000 LANGLOIS,CYNTHIA J 10/15/1985 C103767 $67,500 ZICKO, PETER C83844 $0 PIERCE,SHAUN 8/18/2000 C158747 $ 146,000 BARBOZA,VALDENIR S& 5/2/2003 C169057 $271,000 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $47.10 Town Fire District Rates Other I $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $394.44 C.O.M.M.-All Classes . $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,569.98 Hyannis-Residential $1.52 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing/... 2/17/2005 Barnstable Assessing Search Results Page 2 of 2 a Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,011.52 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.41 Year Built 1968 Appraised Value $ 139,600 Living Area 1004 Assessed Value $ 139,600 Replacement Cost$ 130,788 Depreciation 17 Building Value 108,600 Construction Details Style Ranch Interior Floors Hardwood Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 1 Story Heat Type Hot Air Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 5 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,500 $2,500 SHED Shed 96 $500 $500 BLA Bsmt Liv-Aver 400 $8,300 $8,300 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 2/17/2005 I +J Septic Inspection Information DatantyDate;; 11/19/2002 6 Sevin"spot No` 913 ssessors MaP 1269 mot 76 ' ess �t+lu b r'. � . 00 156 _uAdd des Fawc t Lane V�I jHyannis Sao Robert J. Bortolotti 1nspecEate 1/13/2002 S�ystem�St��u � � omment Backup of sewage into facility or system component due to ovberloaded or clogged SAS or cesspool 'Pem1�4�'# Re�a�r Dai �"NottficaUon Dates �— � En�ilristall �Repa�r Deadline Date COMMONWEALTH OF 1VIASSACHUSETTS 3 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION FAILED INSPECTION MAP 2' � PARCEL LOT � (P TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: /Vim` �GCCI A � 9 � � Owner's Name: Owner's Address: RECEIVED Date of Inspection: l/ DUB Name of Inspecto (please��,r-i�jn��t��p d-U. I 0 NOV 15 2002 Company.Name. Z,(J LG(� tC TOWN OF BARNSTABLE Mailing Address: .0 c Co) HEALTH DEPT. 7 Telephone Number:SQaC' 1-7_ � CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.,I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMRr 15.000), The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority i✓ 'Fails Inspector's Signature: l 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. Notes.and Comments ""This report only describes conditions at-.the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of i 1 OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A •.w.� CERTfFICATION'(continued) -` ""'*^-+...•+ �.1.--A��--r I Property-,Address:./1 Q.CQ9C¢ Owner:. i`` 1 ..� Date of Inspection: a0w Inspection Summary: Check A;B,C,D or E/ALWAYS comple'te.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: 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 exfiltratiori or tank failure is imminent.Systern 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 T— distribution box is leveled or replaced ND explain: The system required pumping more than 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: 2 Page 3 of I I OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARY;ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: A Owner: Date of Inspection: 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 aseptic tank and soil absorption system(SAS)and the SAS is within.100,feet of a, surface water supply or tributary to a surface water supply. — The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. _ The system has a septic tank and SAS.and the SAS is.within 50 feet of a private water supply we1L _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a, private water supply well".Method used to determine distance "This,system passes if the well water analysis,performed.at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from`that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are.triggered..A copy of the analysis must be attached.to'this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property p y Address: /SCp Owner: Date of Inspection: '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 orsystem component due to overloaded or clogged SAS or cesspool _ -IL Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ._A/ 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''/z day flow Required:pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number ' of times pumped ___IL Any portion of the SAS,cesspool or privy is below high ground water elevation. _✓ Any portion of cesspool or privy is within 100 feet of-a surface water supply or tributary to a surface Vwater supply. Any portion of a cesspool or privy is within a Zone I 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence.of ammonia nitrogen.and nitrate nitrogen is equal to or less than 5 ppm,.provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in.310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a.facilitywith a design flow of.10,000 gpd to 15,000 gPd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes - no T _ the system is within 400 feet of a.surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is:located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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. 4 Page 5 of 1.1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: � � C A,14 UaCoo/ Owner: Date of Inspection: ! p Check if the following have been done. You must indicate."yes"or"no"as to each of the following: Yes No Pumping.information.was provided by the owner,occupant, or Board of Health Were.any of the system components pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period ? Have large.volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) i/ _ Was the facility or dwelling inspected for signs of sewage back up ✓ _ Was the site inspected for signs of break.out? Were all system components, excluding the SAS, located on site _✓_ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? _✓_ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no / 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 15302(3)(b)] 5 Page 6 of 11 , OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM APART C SYSTEM INFORMATION Property Address: % Q, 64! Owner: Date of Inspection: dU c� FLOW CONDITIONS RESIDENTIAL Number.of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 11:0 gpd x#of bedrooms): Number of current residents Does residence have a garbage grinder(yes or no)- Is laundry on a separate sewage system(yes or noL_A� if yes separate inspection required] Laundry system inspected(yes or no)� Seasonal use: (yes or not/X t Water meter readings, if available(last 2 years usage(gpd)):QC"- ro dZ—5/,em Sump pump(yes or no Last date of occupancy: ✓%� (� ✓L - ` COMMERCIAL/INDUSTRIAL,✓� Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap.present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): J GENERAL INFORMATION Pumping Records • RG � Source of information: 11 IMVIYA A( Was system pumped as part of the inspec •on(yes or no):. If yes, volume pumped: gallons How was quantitypumped determined? Reason for pumping: TYPE F SYSTEM eptic tank, distribution box,soil absorption system _Single cesspool _Overflow cesspool _.Privy Shared system (yes or no)(if yes, attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other'(describe): e�jroximate age of all'components, date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no 6 Page 7 of I I OFFICIAL INSPECTION FORM L NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:LIZ pL Owner: < Date of Inspection: . / Z BUILDING SEWER(locate on site plann, ) Depth below.grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting, evidence of leakage,etc.): SEPTIC TANK:V(locate:on site plan) Depth below grade- !r Material of construction: concrete_metal_fiberglass_polyethylene _other(explain). If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth:1z, Distance from top of sludge to bottom of outlet tee.or baffle: ?3 Scum thickness: Distance from top of scum to top of outlet tee or baffle: / Distance from"bottom of scum to bottom f outlet tee or baffle: 7 How were dimensions determined:,! Q� � �1J71, Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels related to outlet invert,evidence of leakage,etc.): Ck. /O >Zei1c rc ��e2 GREASE TR6PIocate on site plan) Depth below grade:— Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION(continued) Property Address: 154 Owner: P Date of Inspection: l cxvc? TIGHT or HOLDING TANIL,/�&(tank must be pumped at time of inspection)(locate on site plan) Depth below-grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions:' Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: k (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of eakaae into or out of box, ete.): �� PUMP CHAMBER:{ -(locate on site plan) Pumps in working order(yes or no): 4 Alarms in working order(.yes or no): Comments(note condition of pump chamber., condition of pumps and appurtenances, etc.): 8 Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: � ' Date of Inspection: � ecl SOIL ABSORPTION SYSTEM (SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ Teaching chambers,number: leaching galleries,number: leaching trenches, number, length: leaching fields,number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, e c.): 11 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'or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): PRIV,Y�(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.): 9 I Page 10 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM`.INSPECTION FORM PART C SYSTEM INFORMATION(continued) `Property Address: / Zo ."v -V Owner: Date of Inspection: iL//iC�)06 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. L ' o O 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:1 o�ClP9f'n � � Owner: Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated.depth to ground water ` feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with.local excavators, installers-(attach documentation) ✓Accessed USGS database-explain: You must describe how you established the high ground water elevation: �- 7 �o �r 5 � s, ell I1 c.rii i Nu'il toe cLe ]r`_ is :O.L.' I L E V,E i 1�..o 1V1 'A .. Jit.. LOCa:.O::: r y�f � LO: No.. . Contr ctor: d.otes:. Measure cePt^ao.w•a•e tsbly momtn/day&ear } S••1. u L Usine,VViater-Le:va1. 'anoe Z07e i • `� .ti}^.'�'1-io.�ifc_a.ii)l3EX\Nc!'I_._...•.................__....�./.�...__ I{ (// } f. � I -- Sa _ ;,�.. Jsine��,tly.�:Evar.:t;'.'Gu,�ra.,� ! - .. �- • ! ��/ESEi ;ncC!U i.C_S-Conditions'' d.etenminl_ curre,-it'de th`tC water Eve; i0i'(I1 dcX Vl cll __. ' 'I � I'• month/yea, f ! S�•.-p. � Usire.Ts�ie.o:;.t^;•at=�-;Isvel ,�cJUS'�msn.Zs j� � �. _ _ I •. - ;'or inde„'well (S!tc 7_';,' curr.e 1t de_J h' I' ! :o water Ie.vel for.i•ndiex wei.l (•S11EP 31, I IF cad•wa-:Br-i2A1.Et ZOFIw (S J =P.213) i VUcT:,;-)EV.2} aGfUs.a.'tER: ................. ..... ..... ..................... __..._.. -: t f S.I D __7 1li:8ic .e t 0.:ifQi Wa?ei by Sub.t-ac:i'1C_ level ad u5L—ma __(S:! c°i-) 1 'nepas ' • __ c i•c_ -~'zip ?,--'l� `�:ifi�`��ivly•.iii l:�ia•L'tl7ii Ivif.(i: .. a 1, r m m j� ! .r . � Z J27 /per BY STREET 27-Feb-03 Hse# Street Village Prop Owner Date Hauler Source 38 Fawcett Lane Hyannis Hatch 11/24/99 Robinson Septic 47 Fawcett Lane Hyannis Griffen,Dorothy 6/l/99 Sep tech Septic 47 Fawcett Lane Hyannis Griffen,Dorothy 4/12/02 Wind River Septic/Ce 59 Fawcett Lane Hyannis Pissimissis 7/13/98 A&B Canco Septic 59 Fawcett Lane Hyannis Pissimissis 7/13/98 A&B Canco Septic 59 Fawcett Lane Hyannis Pissimissis,Christo 1/7/99 A&B Canco Septic 59 Fawcett Lane Hyannis Pissimissis 6/4/99 A&B.Canco Septic 59 Fawcett Lane Hyannis Pissimissis 6/22/99 A&B Canco Septic 59 Fawcett Lane Hyannis Pissimissis,Christo 7/6/99 A&B Canco Septic 59 Fawcett Lane Hyannis Cristo 12/29/99 Midcape Septic 59 Fawcett Lane Hyannis Christo 4/27/00 Midcape Septic 103 Fawcett Lane Hyannis Miranda,Rue 6/8/01 Wind River Cesspool 103 Fawcett Lane Hyannis Miranda,Rui 5/21/02 Wind River Cesspool 143 Fawcett Lane Hyannis Koch 11/18/02 Bortolotti Septic/Ce 153 Fawcett Lane Hyannis Larsson, Eric 1/19/98 A&B Canco 153 Fawcett Lane Hyannis Larson,Eric 4/14/00 Abco Septic/Ce 153 Fawcett Lane Hyannis Hardy,John 6/27/01 A&B Canco Septic TE Fawcc . ane_� : - _ IlyannisPicrcc;Sh'aun= ^—' 1:1-/ 5/_02 V�7uid.Fivecphc �""` 173 Fawcett Lane Hyannis Heroian 4/10/01 Robinson Septic 180 Fawcett Lane Hyannis Phillips,Bernice 10/29/99 A&B Canco Septic 180 Fawcett Lane Hyannis Phillips,Bernice 10/29/99 A&B Canco Septic 180 Fawcett Lane Hyannis McCarthy 2/23/01 A&B Canco Cesspool 180 Fawcett Lane Hyannis Phillips 11/5/02 Robinson Septic 1 Hse# Street Village Prop Owner Date Hauler Source Septic Hyannis Phillips 1/25/03 A&B Canco Se 180 Fawcett Lane y p p 193 Fawcett Lane Hyannis Zicko 6/1/00 A&B Canco Septic 193 Fawcett Lane Hyannis Marsh 9/21/02 Macomber Septic 200 Fawcett Lane Hyannis Stansfer,Rebecca 1/8/98 Robinson 200 Fawcett Lane Hyannis Cahoon,Arthur H.,Jr 1/8/98 Robinson 200 Fawcett Lane Hyannis Pinney 10/20/00 Robinson Septic 220 Fawcett Lane Hyannis Chretien 9/12/98 Ace Septic 220 Fawcett Lane Hyannis Chretein,Hazel 11/29/00 Wind River/Midc Cesspool 233 Fawcett Lane Hyannis Viera 12/9/98 A&B Canco Septic 250 Fawcett Lane Hyannis Gomes 5/24/99 A&B.Canco Septic � Y 2 S.J o COMMONWEALTH OF 1VMASSACHUSI_i:TTS L' XECU I'IVIJ OFFICE ICL Or ENVIItONML,NTAL AFFAi 16 DEPARTMENT OF ENVIRONMENTAL PROTECTION Z L EDB 2 5 2003 N OF BARNSTABLE HEALTH DEPT. ' ITLE 5 OFFICIAL IN,'WECTION FORM— NOT FOR VOLUNTAR. ASSESSMENTS SU USURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP Property Address: 156 FANVCETT LANE HYANNIS 02601 M269 P165 L76 PARCEL. A �� Owner's Name: PIERCE Owner's Address: 156 i�AWCETT LANE HYANNIS 02601 LOT �p Date of Inspection: 2/12/03 Name of Inspector: (please print) JOHN GRACI, INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET, MA. 02536 Telephone Number: 508-56' 6813TAX 508-564-7270 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 Os of the time of the inspection. The inspection was performed based on my training and experience in the proper funs Lion and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X I'fsses _ C mid itiona I IL Passes _ Needs Fu r Evaluation by the Local Approving Authority Fails I' Inspector's Signature: �� Date: 2/12/03 The system inspector shall submS a copy of this inspection report to the Approving Authority(Board of Health or DI i')within 30 days of completing this inspe lion. I f the system is a shared system or has a design flow of 10,000 gpd or greater, tllc inspector and the system owner hall submit the report to the appropriate regional office of the DEP. The original should be sent to the-system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG P13- - SYSTEM'S USEFUL LIFE. .......... ****This report only describes conditions at the time of inspection and under the conditions of use at that i!i ofe.This inspection does not address how the system will perform in the future under the same or different conditiui: of use. I II Ins n^rfi.m Form ("1 S!1000 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. 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. n/a 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: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a 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: n/a r Pagd 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 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. _ 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 n/a "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped nLa. X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be nv attached to this form.] N�(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes" or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no 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 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. a Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems`? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X _ Existing information. For example, a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 1 I 5 f Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)):ga Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a 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/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a 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) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components, date installed(if known)and source of information: NEW FIELD IN 1992 Were sewage odors detected when arriving at the site(yes or no): NO C, r Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 BUILDING SEWER(locate on site plan) Depth below grade: 9" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN SEPTIC TANK: X(locate on site plan) Depth below grade: 3" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: L 8' 6" H 5' 7" W 4' 10"' Sludge depth: 0" Distance from top of sludge to bottom of outlet tee or baffle: n/a Scum thicknes'--` Y 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 were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL 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(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): n/a I 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 TIGHT or HOLDING TANK: (tank must be pumped 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(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX IS STRUCTURALLY SOUND. 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 u Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: 0 INFILTRATORS leaching chambers, number: 3 n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THE LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY. THE FIELD SHOWS NO SIGNS OF FAILURE. THE BOTTOM IS AT 4' THE FIELD HAS APPROXIMATELY 3' OF STONE. CESSPOOLS: (cesspool must be pumped as part of inspection)(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 inflow(yes or no): 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: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a 9 .............. Page 10 of I I OFFICIAL INSPUICTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 P165 L76 Owner: PIERCE Date of Inspection: 2/12/03 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. 0,04 ap IZ-mil Ell 9 in OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 156 FAWCETT LANE HYANNIS 02601 M269 1"165 L76 Owner: PIERCE Date of Inspection: 2/12/03 SITE EV,iM Slope Surface water _Check .ellar Shallop.• wells Estimate l depth to ground water 10+ feet P.lease',i idicate(check)-'all methods used-to determine the high ground water elevation: NO Obtained from system design plans on record- if checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER DETERMINED FROM HAND AUGER- NO WATER AT 10' a Barnstable Assessing Search Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results 156 F Owner: Property Sketch L gend BARBOZA,VALDENIR S& Map/Parcel/Parcel Extension 269 /165/ y} Mailing Address y BARBOZA,VALDENIR S& BARBOZA, RENATA S 156 FAWCETT LANE HYANNIS, MA. 02601 2005 Assessed Values: Appraised Value Assessed Value Building Value: $ 108,600 $ 108,600 Extra Features: $ 10,800 $ 10,800 Outbuildings: $500 $500 Land Value: $ 139,600 $ 139,600 Interactive Property Map: ap requires Plug in: Totals:$259,500 $259,500 1 have visited the maps before ,F Show Me The Mao April2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: FIRMIN, MICHAEL S&ANITA 1 12/15/1992 C128587 $90,000 KEARNS, ROBERT J&DEBORAH 8/15/1988 C115112 $ 120,000 LANGLOIS,CYNTHIA J 10/15/1985 C103767 $67,500 ZICKO, PETER C83844 $0 PIERCE, SHAUN 8/18/2000 C158747 $ 146,000 BARBOZA, VALDENIR S& 5/2/2003 C169057 $271,000 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $47.10 Town Fire District Rates Other f $6.05 Barnstable-Residential $2.12 Land B. Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $394.44 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,569.98 Hyannis-Residential $1.52 http:Hwww.town.bamstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessing/A... 3/3/2005 Barnstable Assessing Search Results Page 2 of 2 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,011.52 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.41 Year Built 1968 Appraised Value $ 139,600 Living Area 1004 Assessed Value $ 139,600 Replacement Cost$ 130,788 Depreciation 17 Building Value 108,600 Construction Details Style Ranch Interior Floors Hardwood Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 1 Story Heat Type Hot Air Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 5 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,500 $2,500 SHED Shed 96 $500 $500 BLA Bsmt Liv-Aver 400 $8,300 $8,300 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/Administrative Services/Finance/Assessing/A... 3/3/2005 Se rchfo Map/Par a 269165 onrnf fi'40amsta fieemz mow9 /r-' I � low � �. a x x BMW" ' or 1arcefNurr►ber 269165 .'', ... , .3u w' , sttlPraperi(Y{ i u ,l a��BLLSItleS�a eomwezu e 'Co I LL�I1 area Nu r%b � y Corita � a et(Y/N)M \1 P✓/ i Pl'orte 000 0000000 y, Fuel Storag ank Pe t . mwm �' Gardbn Ie�ii o f % DISI7oSalWD1C iia air ri'i% ` r Per��eS� INeIItlt «GCi1lStruCtlOn IN . ISSuanceDa�e;y � 11/24/1992 �f/� a,/ram Completio a 11/24/1992 �F' �" t n„„ >.: Size ofkSe�c y 7ypelSize of -Tank r � � � w „• REPAIR failed septic 11/29/02 ' mapPar 269165 G1wr►sr PIERCE SHAUN o oc 15 FFAWCETT LANE ('e.� .h cK � c«�fi'••�K�� .c ;,.;;laic. M.�c.... >.�e ,.3� ��fK��y ,uF. "�f�c E InnoVativ fAtte'rnatnre Tech oiog Septrc Systemsbr�� Sin to r y�/ add records� � � delete�records�� ,�/�j Barnstable Assessing Search Results Page 1 of 2 TAB ,Ae Home: Departments:Assessors Division: Property Assessment Search Results ' <<back to search 156 FAWCETT LANE Owner: Property Sketch Legend PIERCE,SHAUN Map/Parcel/Parcel Extension k 269 /165/ .... .ry Mailing Address f ~ PIERCE,SHAUN 156 FAWCETT LN HYANNIS, MA. 02601 pc - Assessed Values: Appraised Value Assessed Value Building Value: $79,400 $.79,400 Extra Features: $ 10,800 $ 10,800 Outbuildings: $.500 $500 Land Value:- $.32,100 $32,100 Interactive Property Map: Ma requires Plugin: p Y Totals:$ 122,800 $ 122,800 1 have visited the maps before Show Me The Maps + :�' ° April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: FIRMIN, MICHAEL S&ANITA 1 12/15/1992 C128587 $90,000 KEARNS, ROBERT J &DEBORAH 8/15/1988 C115112 $ 120,000 LANGLOIS, CYNTHIA J 10/15/1985 C103767 $67,500 ZICKO, PETER C83844 $0 PIERCE, SHAUN 8/18/2000 C158747 $ 146,000 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $ 1,154.32 Town Fire District Rates Other Rates 9.40 Barnstable 2.88 Land Bank 3%of Town Tax Hyannis FD Tax $354.89 C.O.M.M. 1.54 http://www.town.bamstable.ma.us/tob02/Depts/Administr.../displayparce103.asp?mappar=26916 3/4/03 Barnstable Assessing Search Results Page 2 of 2 Cotuit- 1.88 Land Bank Tax $34.63 Hyannis ' 2.89 West Barnstable 1.96 Total: $ 1,543.84 Due to rounding differences these values.may vary Land and Building Information Land Building Lot Size(Acres) 0.41 Year Built 1968 Appraised Value $32,100 Living.Area 1004 Assessed.Value $.32,100 Replacement Cost$.95,645 Depreciation 17 Building.Value 79,400 Construction Details Style Ranch Interior Floors Hardwood Model Residential Interior Walls Drywall Grade Average Grade Heat Fuel Gas Stories 1 Story Heat Type Hot Air Exterior Walls Wood.Shingle AC Type None Roof Structure Gable/Hip Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 5.Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BLA Bsmt Liv-Aver 400 $8,300 $8,300 FPL1 Fireplace 1 $2,500 $2,500 SHED Shed 96 $500 $500 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living.Area (Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/Administr.../displayparce103.asp?mappar=26916 3/4/03 f J ,per rA ", 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: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Address of Owner: 166 FAWCETT LANE HYANNIS,MA 02601 Date of Inspection: 8/7100 Name of Inspector: JOHN GRACI ' I am a DEP approved system inspector pursuant to Section 15.340 of Tide 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 , 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: c X Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date:8/7/00 The System Inspector shall su I 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 th 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. 4 T�k s o � �F revised 9/2/98 ,� Page 1`of 11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 817/00 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. n/a 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. n[a 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 nla 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 .�l 4i 9i revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7/00 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 IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE ENVIRONMENT: ry 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 soil absorption system and the SAS Is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, k.,L The system has a septic tank and soil absorption system and the SAS 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,Method used to determine distance n&(approximation not valid). 3) OTHER n/a r, s ,t revised 9/2/98 Page 3 of 11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8R/00 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"below 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 Il. 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. revised 9/2/98 Page 4 of 11 a., f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner: FIRMIN Date of Inspection: 817100 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No t"Ft X - Pumping information was provided by the owner,occupant,or Board of Health. X - 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)] i; X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. Yr revised 9/2198 Page 5 of 11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7/00 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual): Total DESIGN flow: 330 gpd Number of current residents:0 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): YES If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): YES 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) F. Basis of design flow:n/a =_ 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 GE NERAL 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: ORIGINAL 1968 WITH A NEW FIELD IN 92 Sewage odors detected when arriving at the site:(yes or no) NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8l7/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 10" 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.) THE SYSTEM HAS TOWN WATER. SEPTIC TANK: X (locate on site plan) Depth below grade: 2" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: Na If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 8'6"H 6'7"W 4'10"" 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: n/a 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.) 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 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7/00 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 gallonstday 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: LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. 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 revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7100 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: (3)INFULTRATORS W/3'OF STONE leaching galleries,number: (n/a)n/a 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 LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY,THE SYSTEM SHOWS NO SIGNS OF FAILURE.SOIL PROBED DRY. 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 Ix Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a r; PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a s Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a 4 ,KI revised 9/2198 Page 9 of 11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7/00 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) GC- C 6 AC a7 aG revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 156 FAWCETT LANE HYANNIS, MA 02601 M269 P165 Name of Owner FIRMIN Date of Inspection: 8/7/00 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 revised 9/2/98 Page 11 of 11 ti _No..� ..— I � �� Fim.....�Pi ►i�EA � 8W6g2=3t:t= ntTHE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE , ppliration. for Elispvaal Workii Tomitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( -Zan Individual Sewage Disposal System at: ............. ........ ..�4:5N..rn -- ------ ------------------------------•-•-•------•-•----------............------........-•---............. Lo tion-Address or t No. Owner Addressto Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms__ . ....................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------•-•----••---•-----•---------------•-•-------•---•••••--•-•--•..........•......--•-•-••-••-•--- Design Flow............�_'S...................gallons per person per day. Total daily flow____---7��_?>.C�)_...........__.....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----ho........ Depth below inlet....�+. ......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) lPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0-4 PLI Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ 9 ---•-•-•••---•-•-----------------------------------------------------------------•--------------............................................................. 0 Description of Soil------------------------------------------------------------------------------- ------------------------------------------------------------------------------------•--- x U Nature of Repairs or Alterations—Answer when applicable____ _f!L_r�T .�� etw�. -.._.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the-board-of h Ith. Signed\,.J --- ---------- -- .: ..1. Dace Application Approved By ......... J L� ------"''_-------------------------------------------------------------------- ��• '�� Dare Application Disapproved for the following reasons: ............................................................................................................. --------------- --------------------------------------------- ------------------------ ---- ---- --------------------- ------------------------------------- ---------------------------------------------- ------------------------- ----- Dace PermitNo. ------ -..-... ��.. ................ Issued .............................. Dare Nod.-.:spa C-(,2 q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstr ion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: .............. - - ....... =..l.......c`--L--------- ......................__......................-...... ....___........�__._........_._. Location-Address or Lot No. ........--... ..........--....... ��£r��-r�..�,►._� ----------------_----..__......__.. Owner Address Installer Address Type of Building Size Lot•_--------------------------Sq. feet �-, Dwelling—No. of Bedrooms----3�-------------------------------------Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T ype of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 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----/..0........ 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--_____-_--_-._------__. 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water---_--__----____----_.-- 0 a ---------------------------------------------------------------------------------------------------------------------------------------------------------- Description of Soil--------------------------------------------------------------------------------------------------------------------------- U --------------------------------------------------------------------------------- -----------------------•-------------------------------------------------------------------------- - - - W V Nature of Repairs or Alterations—Answer when applicable____=' -_S ' _I. ___Y f7j_____. a�_-(-__,/J-t-__- -----------------9..... °....---•-•��, -----E'�`�`� '�J.......r:��.� --------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by theboard>ofh• lth. Signe -: ------r p ` -z� ------ k Daze`--'---- -- Ap�lication Approved BY ;,�v .�f: = ------- ----------'�---------------------------....................... ------ Application Dare Disapprovedfor the ollowing reasons• -------------_-_---------------------_-------------------_------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------=- D. Permit No. ---------"?'1 `r,- Issued re C� Dace r � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 01ertiftcate of (gantyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired Y - -- ---- --- -- ------------------------- Installer atS-CQ `mac" ...................................-T- 1•-'�`-- ----------- ----------A . `' ----------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......V? _ _0............. dated ____--._--...-.._.------..----..--..--..--..-_-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �__i DATE - / ---�� - ------- --- -- Inspector ------- _--a � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No._._.. _._. TOWN OF BARNSTABLE ��, FEE------................. Disposal Works Tonstrurtiun Ilermit Permission is hereby granted..................... ` � i�1 -----•-------------•----........------..........----.. to Construct ( ) or Repair ( �n"'Individual Sewage Disposal System at No..............................�_ � C"'W(--e- r L-V� . - ---------------------------- -- ------ Street op rr as shown on the application for Disposal Works Construction Permit No.__-J 2-.?_K_Gated.......................................... ................................fr-� a-------------------------------------•--------------— (� Board of Health DATE. t 1! ^��------------------------•------------ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS w LCGEND • \ PROPOSED CONTOUR O :. . RDBERTA L. CASS Y TRANG NCUYEN 102 rc° ol ?� X 105 ( • 168 FAWC£TT.LANE 1FO21 PROPOSED SPOT GRADE 101-tey C' C)_ (MAP 279, PARCEL 145) - — !10!` " — EXISTING CONTOUR >? 114,09 RIT P[1UT a x s,l;'' EXISTING SPOT GRADE Rd tI , ---, /Y SEE NOTE 11 LOCUS ry �f c 1„0 v TEST PIT $ o y A ��EA : S' J 79 ADO 40`MIL PUL Y LINER W EXISTING WATER SERVICE �i Pirte Rd = q y \ `� 44 TD SURROUND S.A.S. Rdrn 1 r�; 4g E ' { EL 105.3 TD 103,8 — oHW. - z I� 5' �y J — EXISTING OVERHEAD WIRE a s u Rd h T � p a W a {J G � ,;f CB/SEAL BENCHMARK a w { - , �`0;� 9 (t{ WEST MAIN STREET j — r -�` W 7�lt al^3Tf.D-BDX '�P 2 JOS£PH M. 8 MAR A GEMME W¢Aj -�1L_— EXISTING P a ' 431 PITCHERS WAY a Q ;f Q .DWELL ING 10' SEED S;"'-�- 1 _,. - 1`J; NAP 270, PARCEL 146) if CHDUSE #15b� ,„ LOCUS MAP N.T.S. 104 TDF= .1 10:.9 - , 8 f IF GENERAL NOTES; o trlw't..k 104 LIMI T OF WORK & 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL PRDPOS TANK/ BOARD OF HEALTH AND THE DESIGN ENGINEER. 1.Or�• 0 ! SPTIC TANK/ � 1 � LDCATIDN OF PUMP CHAMBER- � � SIL TATION FENCE 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 9 9 :4 i 9 .� i OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE \ 7 0C LOCAL RULES AND REGULATIONS. 1 ) e 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR }x{ U� TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ''`�•_\., 8.96 Q O DESIGN ENGINEER. r, _._. .44� 7 ' 4 � � :, •... e. ; <F,ci pE` s •� +y rj o �,. ANY CONDITIONS ENCOUNTERED DURING .CONSTRUCTION DIFFERING .58,f O FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN O F r SA,S. / f�, 3 1 �' (U X )00 = ENGINEER BEFORE CONSTRUCTION CONTINUES. � � . Ct✓E'Cd r 9t :;SAS 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. x.• ('I 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF pp `�3'�,�_ - �_ 1 LOT 76 � THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. £LIIABETH WALKER R 1 r ` •w • ' ` � r S 417 PITCHERS WAY 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVIVE. It f 178�7t S.F CMAP 269, AR fL 66) a f1 r ;K a�i: i xi 0.41 t AC, �- x, 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. i ; 'ir - ��tNOFMASy, G 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE LOAMED w r{ 9892 ,:< - Map 26 9 moo? TERRY sF� AND SEEDED UPON COMPLETION OF CONSTRUCTION, y oc 1 n 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE q I if € IBC STIN4 SEPTIC TA • ' Parcel 16 5 WARNER N THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING ;i TO BE COMPLETELY PUMPED o.38721CONSTRUCTION. 1 r \ i t 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Q a r 1 AND FILLED W/ SAND, �-- a�� 1t SP ,S� 1�o IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE PROPOSED a r j �JSSTI CL SAS, S•A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). TO BE ABANDONED x 1 1i 1. 0 {i+ 0 , 12. SUBJECT SITE LIES ABOVE THE 500 YEAR FLOOD PLAIN. 1� WETLAND DEUNEATION BY: FLOOD ZONE DESIGNATIONS FROM ��.9�7 �' — 9t;?---- •�y-� w 06,3c��----� W�:4 i7 W Sabatio, Inc. COMMUNITY PANEL NO.250001 0005 C T'--I l(a` — . 985 t 30 21 Observato Lane 96a _fa � 82 41`48' W �••••,,,, S 79�— Pocasset, MA 02559 Revised August on C X 96:08 ^)iy� J. QF Mq 508 563-5349 Site lies within Zone C �.;t�:0; / v ,t J rj.. �{� � `� HAROLD H. & ALICE BASscrr �� q�yG ✓ .1 © PETER T. W ,: 20 CHECKERBERRY LANE McENTEE PROPOSED SEPTIC SYSTEM UPGRADE n{' i. (MAP 269, PARCEL 083) o H DRAINAGE EASEMENT' � ;; CIVIL TOWN OF BARNSTABLE `� No. 35109 156 FAWC ETT ., LANE; NYAN N I S, MA 94 140 FAWC£TT LANE �� 97 64 � �E� � r: V rbvza 156 Fawcett Lane, Hyannis, MA 02601 (MAP 269, PARCEL 164) 9� e F 7 Benchmark 2 set FSFCISIA. G\ Prepared for: aldenlr- Bo Y Q S EN Engineering by: Surveying by: SCALE DRAWN JOB. NO. Top o f' conce to support Benchmark 1 Set En �ringR'or*s Terry A. Warner PLS 1"=20' P.T.M. 1$5-05 PK Nail in driveway block at Left front i Y corner of shed �j 1�6 Fo W. Cle. MA Rood H Long Road E1.=100.00 (Assumed) E1,=99.3c' CAssurled) w �a Forestdale, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 9/2/05 P.T.M. I Of 3 ELEV. TOP NOTE: TO PRE\AZNT BREAKOUT, A COMBINATION OF RETAINING WALL AND 40 MIL POLY FOUNDATION LINER SHALL BE PLACED AROUND THE k (Existing) =104,19 � F.G.EL: 101.Ot F.G,EL:104.Ot F.G. EL: 106.5� FINISH GRADE RANGES FROM 106.1. TO 106.5 PROPOSED S.A.S. AS SHOWN ON PLAN. a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER S.A.S, = 36" ;. INSTALL RISERS OVER INLET & OUTLET PROVIDE 20" RISER W/COVER OVER OUTLET PIPES SET LEVEL 12.5' x 37.0' LEACHING FIELD W/3-4" Li=3o' TO WITHIN 6" OF FINISH GRADE PUMP TO WITHIN 6" OF FINISH GRADE OVER FIRST 2 FEET SCH 40 PERF. PVC DISTRIBUTION LINES L =7'(MAX) ENDS TO BE CAPPED L2=50' 4" SCH 40 PVC a 4" SCH 40 PVC 2" SCH 40 PVC 6 @ S= 1% (MIN. 6' ET""F9' • 6. OF RCE N DEPT @ S= 2% (MIN.) Io. Io I V. EL.=104.35 END 14• OUTLET SHALL BE ( ) INLET SHALL BETEE'S ARE TO BE 24' WATER TIGHT INV.=104.77 D BOX " WATER TIGHT 4" SCH 40 PVC 16' INV.=99.75t (MIN) INV.ELEV.=104,54 GAS BAFFLE $, INV,=100.00 INV.=104.60 SOIL ABSORPTION SYSTEM (PROFILE) PROVIDE COUPLINGJ ML TEE SHALL NOT EXTEND KM TIE IN TO EXISTING 4" SEWER BELOW FLOW LINE 1 FT. OUTSIDE CELLAR WALL INV.=99.75 SEWER INV.EL.=100,5t (See Pump Detail, Sheet 3 of 3) 1 LAYER OF /8"-1/21 DOUBLE BREAKOUT ELEV.=105.04— WASHED STONE 1500/500 GAJ.LON COMBINATION SEPTIC TANKZRUMP CHAMFER BOTTOM ELEV.=103.85 3/4'-1 1/2' DOUBLE 2' 4,25' 4,25' 21, WASHED STONE 5' MIN. ABOVE BOTTOM OF T,P, EXCAVATION OR G,W, 12,5' EFFECTIVE WIDTH NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING SEPTIC SYSTEM PROFILE ADJUSTED HIGH G,W, EL1 98,85 SOIL ABSORPTION SYSTEM (SECTION) PIPE INVERTS PRIOR TO CONSTRUCTION, 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND N.T.S. TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN `� dG 310 CMR 15.221(2). o PETER T. 3) INSTALL INLET & OUTLET TEES AS SHOWN. = McENTEE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE O IIL LOG- .I CIVIL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. y No, 35109 DESIGN CRITERIA FSS ECG DATE: AUGUST 2, ,2005 FER cENTEE NUMBER OF. BEDROOMS: 3 BEDROOMS 1" X 1" X 3' BEAN POLE NOT WITNESSED BY TOWN SOIL TEXTURAL CLASS: CLASS I ` DESIGN PERCOLATION RATE: 5 MIN/IN Elev. TP- 1 Depth Elev.� TP-2 Depth DAILY FLOW: 330 G.P.D. 98.85 A 0" 101,52 A 0" DESIGN FLOW: 330 G.P,D. SILTATION FENCE LOAMY SAND LOAMY SAND GARBAGE GRINDER: NO 10YR 3/3 10YR 3/3 BINDING WIRE 98.35 a 6" 101.02 a 6" PROPOSED SEPTIC TANK/PUMP CHAMBER: 1500/500 GALLON CAPACITY OR TWINE LOAMY SAND LOAMY SAND LEACHING AREA REQUIRED: (330) = 445.9 S.F. 10YR 4/6 10YR 4/6 .74 FILTERED 96.85 PE" 18"/30' g8.85 ADJUSTED G.W. RUNOFF FLOW 98.52 C 36" 12 5' x 37 0' LEACHING FIELD Wf3-4" F W 95.85 STANDING G.W. .— 36" PERC 40"/52" SQH 40 PERF PVC DISTRIBUTION LINES M-C SAND BOTTOM AREA = TOTAL AREA: 12.5' x 37' = 462.5 S.F. - M-C SAND 10YR 5/6 DESIGN FLOW PROVIDED: 0.74(462,5) = 342.3 G.P,D. II 10YR 5/6 SEDIMENT LADEN 95.85 STANDING G,W. -_ 68" PROPOSED SEPTIC SYSTEM UPGRADE RUNOFF SILTATION FENCE SHALL BE g3,52 96" 93,52 96" 156 FAWC ETT LANE, HYAN N I S, MA TRENCHED IN AND BACKFILLED I Prepared for: Voldenir Borbo2a, 156 Fawcett Lane, Hyannis, MA 02601 STANDINGIING G.W. @ 68" P PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering by: Surveying by: SCALE DRAWN JOB. N0, S I LTATI 0 N FENCE I Engineering Works Terry A. Warner PLS N.T.S. P.T.M. 185-05 INDEX WELL: MIW 292-JULY 2005 12 W. Crossfield Road 22 Long Road G.W.'ADJUSTMENT 3.0' (ZONE D) Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET N0. (508) 477-5313 (508) 432-8309 9/2/05 P.T.M. 2 Of 3 I TM F ALL 1' PVC CONDUIT T❑ H❑USE FOR WIRING PROVIDE WATERTIGHT CONCRETE RISER H WATERTIGHT JOINTS. WIRE HIGH WATER ALARMWITH SECURED COVER TO GRADEAT TO GP 2000 HIGH WATER ALARM PANAL ❑N NEMA 4 JUNCTI❑N BOX CORR❑SION RESISTANT 1/2' UIT SEPARATE FROM CIRCUIT TO THE PUMP, & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 3-5' DIA, INLET �5-5' DIA. OUTLETS BY 1-1/4' PVC CONDUIT, JOINTS T❑ BE MADE 2" FORCED INLET HOISTING CABLE 7x19 STAINLESS STEEL WATERTIGHT W/ VERTICAL TEE 15 1/2• 1/8' DIAMETER, / 1,760 LB. STRENGT 2" _R 4" GRAVITY 2'BALL VALVE w/ UNIONS SCH, 80 PVC OUTLET(TYP.) -- GEORGE FISHER CO, MODEL NO. 560 �_: 1I5" INV. IN -99.75 .E`'r_,.- 2'SCH, 40 DISCHARGE Hw RGE TO D❑BOXCAP �_l ( )- R6. 30 1/2' ALARM ON EL: 97,75 2 FILL SIDE KNOCK-OUTS PUMP ON EL: 97,09 PROVIDE 1/4' WEEP HOLE IN DISCHARGE Section WITH MORTAR Top View PUMP OFF EL: 96.42 24' PIPE FOR SELF-DRAINING FORCE MAIN BOTTOM OF 16°e, 2' BALL CHECK VALVE SCH, 80 PVC ' DISTRIBUTION BOX aF PUMP CHAMBER 100 P.S.I. FLOWMATIC MODEL No, 208S 9 ELEV.= 95.42 --- PROVIDE 2 WIDE ANGLE FLOATS --- 2° SCH, 40 PVC DISCHARGE PIPE < N,T.S. c� PETER T. "✓ FLOAT NO,1: PUMP ON/OFF (BARNES 073618) BARNES SEV412 PUMP .5 M.P. 115 V MCENTEE r FLOAT NOZ ALARM ACTIVATION (BARNES 073612) 2' DISCHARGE PASSING 2' SOLIDS CIVIL No. 35109 PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT THROUGH WIGGEN PRECAST CORP., BOURNE MA. (800) 564-6774 PUMP & ACCESSORIES AVAILABLE THROUGH WILLIAMSON ELECTRIC (781) 444-6800 SS10 ENG PUMP DETAIL N.T.S. BUOYANCY CALCULATIONS Septic- Tank/Pump C_,hbamber Unit EXISTING BOTTOM OF PUMP CHAMBER EL.= 95.42 " DWELLING HIGH GROUNDWATER EL.=98,85 20' Dia. Covers (Typ.) (HOUSE #156) BUOYANCY FORCE PER FOOT OF DEPTH: 4" Dia. Inlets 4' 4" Dio. Outlets TOF=104,19 6,67' x 12.17' x 1.0' x 62.4 Ibs/cu.ft. = 5,065.3 Ibs/ft Brh (ASSumed) MAXIMUM DISPLACEMENT = 98.85--95.42= 3.43' wk f,�Ld$ MAX. UPLIFT PRESSURE = 3.43' X 5,065.3 Ibs/ft = 16,715.5 lbs. 0 iGarage WEIGHT OF EMPTY PUMP CHAMBER = 20,088 lbs. 4„ 20,088 LBS. > 16,716 LBS. O.K. 5'-8" 4'-7' 48" Liquid Level 4'-4" j �G"c 11 `• 5" s g- DOSING & STORAGE REQUIREMENTS SECIION DESIGN FLOW: 330 GPD 12'-2" �I DOSING REQUIRED: 4 CYCLES/DAY (SAND) T a, 330 1 4=82,5 GALLLONS/CYCLE o DISTANCE REQUIRED BETWEEN PUMP 3 — 20" Dio. Covers I 1 1 ' i 1 3�,3' ` ON AND PUMP OFF FLOATS: i I O 82.5 GAL/CYCLE 125 GAL/FT = 0.66 FT/CYCLE i..! I 6'-e" O l..1 ' I � STORAGE REQUIRED ABOVE WORKING LEVEL: 330 GALLONS 0 STORAGE PROVIDED: I I I- .----- INV.(IN) EL:99.75 - PUMP ON EL:97.09 = 2.66' I I Q61 I STORAGE PROVIDED = 2.66' X 125 GAL/FT = 332.5 GALLONS s�- �� 4" Dio. Outlets N I PROPOSED SEPTIC SYSTEM UPGRADE NOTES: I 1. UNIT SHALL BE SEALED, WRAPPED & MADE WATERTIGHT. 156 FAWC ETT LANE, HYAN N I S, MA 2. ALL PIPING JOINTS SHALL BE MADE WATERTIGHT. r-12.5'-�I 19'- Prepared for: Valdenir 8arboza, 156 Fawcett Lane, Hyannis, MA 02601 1500/500 GALLON CAPACITIES (H—1 0) Engineering by: Surveying by: SCALE DRAWN ' JOB. NO. SEPTIC TANK PUMP CHAMBER S•A•;S. LAYOUT 2 W. Ceringworkd Terry A. Warner PLS N.T.S. P.T.M. 185-OS CB/SEAL 12 W. ole, A Rood H Long Rood DATE CHECKED SHEET N0. Forestdale, MA 02644 Harwich, MA 02645 N.T.S. (508) 477-5313 (508) 432-8309 9/2/05 P.T.M. 3 o 3 i I