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Home My WebLink About0168 FAWCETT LANE - Health 168 Fawcett Lane Hyannis A 270 141 r �l _ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 168 Fawcett Lane Property Address Indy Mac Bank ! ' Owner Owner's Name information is Y required for Hyannis MA 02601 05/10/2010 every page. Cityrrown State Zip Code Date of Inspection Inspection results must ble,subfnitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: When filling out A. General Information When forms on the computer,use 1. Inspector: 4 (o. only the tab key to move your A.RIKER cursor-do not Name of Inspector use the return , ; key. R.L.C. ;; t Company Name P.O. BOX 726 # - Company Address SOUTH YARMOUTH MA 02664 City/Town State Zip Code 508-776-6460 SI 4590 Telephone Number License Number �r B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 05/10/2010 Inspec or's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage jispystem•Pa e 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: INSPECTION OF SEPTIC TANK AND DISTRIBUTION BOX HAD NO INDICATION OF FAILURE OBSERVED. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board-of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is Y required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or laced re p ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title .5 Official Inspection Form rd Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is Hyannis MA 02601 05/10/2010 required for y every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is Hyannis MA 02601 05/10/2010 required for State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] El ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ E the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): THREE Number of bedrooms (actual): THREE DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 GPD t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is H annis MA 02601 05/10/2010 required for y State Zip Code Date of Inspection every page. Cityrrown D. System Information Description: PROPERTY WAS INSPECTED AFTER PROPERTY WAS VACANT FOR AN UNKNOWN PERIOD OF TIME. THERE WAS NO INDICATION OF FAILURE PRESENT. unk. Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Zoos= )q 1 y rd 2008= T5Sj,2j Detail: Sump pump? ❑ Yes ® No N/A Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 t every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: BARNSTABLE TREATMENT PLANT Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts L r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ® cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 18 feet Comments (on condition of joints, venting, evidence of leakage, etc.): NO LEAKS . INTERIOR SEWAGE EJECTION PUMP VENT REPAIRED . Septic Tank(locate on site plan): Depth below grade: 1.8 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) PRECAST CONCRETE 1000 GALLON TANK If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5'H X 5'W X91 Sludge depth: 11" t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of-17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is Hyannis MA 02601 05/10/2010 required for y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 22" 81 Scum thickness 6„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? SLUDGE JUDGE/STICK Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANK HAD NO OBVIOUS STRUCTURAL DAMAGE . REGULAR PUMPING FOR MAINTENCE IS RECOMMENDED. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness' Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date l5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping` Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 168-Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert EQUAL AT SPEED LEVELERS INVERT Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): BOX HAD TWO OUTLET LINES WITH SPEEDLEVELERS ADJUSTED CORRECTLY. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances; etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 INFILTRATORS ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): SOILS ABOVE S.A.S. HAD NO INDICATIONS OF FAILURE OR INCREASED VEGETATION. Cesspools (cesspool must be pumped as part of inspection) (locate on site.plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 168 Fawcett Lane Property Address Indy Mac Bank Owner Owners Name information is required for Hyannis MA 02601 05/01/2001 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately t Rear 3 A 0 )9 l O 0 i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 9 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2/22/2004 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Test hole on record 2/22/2004 ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Plan and soil test hole on file at board of health dated 02/22/2004. Certificated of compliance confirms system was installed per plan . No water encountered at 144"on test hole data. Applied adjustment with seperation applied. f : Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09108 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 168 Fawcett Lane Property Address Indy Mac Bank Owner Owner's Name information is required for Hyannis MA 02601 05/10/2010 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage.Disposal System either drawn on page 15 or attached in separate file t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form ', _ o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important:When A. General Information filling out forms on the computer, 51 use only the tab 1. Inspector: key to move your a �, cursor-do not Brian K. Tilton I f use the return key. Name of Inspector - The Building Inspector of Cape Cod �a Company Name Z7 i T4 PO Box 307 I � ' .d T Company Address Eastham MA 62642 City[Town State Zip Code `. 508-255-9343 S14392 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection Was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6/10/2009 spectoASignatUn Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. - ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 RAJ Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ® broken pipe(s)are replaced ❑ obstruction is removed 168 Fawcett Ln T5 insp.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 168 Fawcett Ln T5 insp.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: The inlet cover is under a wooden deck, the outlet baffle is deteriorated but still in place, it needs to be replaced with a TEE. The riser on outlet is not level and the cover is damaged and will fall through and needs to be replaced. The vent is clogged and needs to be cleaned and the stand pipe and filter needs to be replaced. The line to the D-Box is settled and 1/2 full of effluent and should be corrected. There is a garbage grinder that needs to be removed as it is not allowed in design. System is functional as it is now. D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 U tq (�z V,-0,W 7/4 2007 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,.you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ E the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. City)town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 331.8 Number of current residents: 4 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 358.5 GPD 9 ( Y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A canons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): N/A Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N/A Last date of occupancy/use: N/A Date Other(describe): N/A 168 Fawcett Ln T5 insp.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Tenant Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Repairs made to leach system 2/22/2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Sewer line is under deck with inlet cover to tank not accessible, tank needs to be pumped. Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 5,8"x 9'6"x 4'10" Sludge depth: 11" Distance from top of sludge to bottom of outlet tee or baffle 19" 6" Scum thickness Distance from top of scum to top of outlet tee or baffle 4"to damaged baffle Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? Accu-Sludge, Baffle Stick and Tape measure 168 Fawcett Ln T5 insp.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts L u Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Outlet baffle is deteriorated and needs to be replaced, it is still intact and functioning but will not last. Outlet cover and riser are not level and cover is damaged and in need of being replaced to avoid falling into tank. Grease Trap (locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 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 Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): N/A 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 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments(condition of alarm and float switches, etc.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): 0" 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 leakage into or out of box, etc.): Box is level with speed levelers to two outlets, light solids carryover possibly due to garbage grinder installed. Line from tank to D-box is settled slightly holding effluent in line approximately 2" mid way. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 5 high capacity Infiltrators in series with stone to a field of 10' x 37.25', no evidence of break out or hydraulic failure, < 1" ponding when viewed wit Mytanna Video inspection camera from D-Box. Lawn overtop. 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 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 ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: 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 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is Hyannis MA 02601 6/10/2009 required for every y page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. yr 3 EL LINO A1=1i' }31=141' A A2-->;' B"---i' 1 I,Q(IO gst Aim 3781 B3~28' O � 3 'N i P NO�T'TO 5[.AT E 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 168 Fawcett Lane Property Address Marcio DosSantos Owner Owner's Name information is required for every Hyannis MA 02601 6/10/2009 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 12'Estimated depth to high ground water: feeetet No water encountered Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2/22/2004 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: System design plans and certification form on file with the BOH. 168 Fawcett Ln T5 insp.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 ompteted by: HjGH LEVEL CO L� Lot No. Site Location: / � L va Owner: xv CO Contractor: he - f. Notes: STEP ; treasure depth to rvate table 'or -es ......................__....._. _.............._.. _ ..._. - OnihitisYtY r i W { • 3 STEF atS:rR4 anu lnd-ex VoCA_i Ml'a9 1C.c'a i site and detern:ne- M W I O Atfffrae,Fate i<nrlex eve1t..................... .... - _........,.-....... t ! ✓^ *fi<^:•€ ; e��P i2't2 _K—te------_----------- »..,.....-'-_•__._ t_--.� F �� STEEP 2 -Us_inr,m ont,111V FepGrt"Cu,rent Ll?2tVr esi5ur es".t792di—Oohs' / { Z to �?iet?rift 82aE d� 'if s3 ®� h ' e t ° 1 i' tamer ievey tcT index vVell--- _ i 1 1 STEP 4- Using Tahfe of ester-leuel Qdafsifnents a i for index well ;S7c=P 2A),current aePth � ; to war ei ar 1e 54rinden wall (87-:7 f �:>tvQ�-lesz? zone i4, of j 2 i86ew[`�'ei`.. al 7itsE:" at� ..'•..............•___••_•__••-_•_--__-• { i1 ^ 1 f STEP 5 Estis:.-aue demil M:tigh v to 1 by subtrac?ing the vvcter. s ierel a-diusts-retie V f EP r} •szc-.-.*..ter r� .a a of '� ,; 0 level a`site fS: P ._........._.,........_..._,.a.,=.__.,,,.R, .................... i M t� Capq Cod Commission: USGS Well Data- May 2009 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties,the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey (USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001: Estimation of High Groundwater Levels for Construction and Land use Planning to predict high groundwater levels. For your convenience, we've also provided links to USGS national and state data. Seethe last column in the table and the footnotes below. To see what's happening in real time at a separate well in Brewster, visit the USGS site: USGS 414630070014901 MA- BMW 22 BREWSTER, M.A. For further information about any of the data or links on this page, please contact Hydrologist Gabrielle Belfit at the Commission offices (508-362-3828). May 2009 Departure from USGS Site Number**** Location Well No. Water Record Record ( Average" links to USGS national Level* High* Low* Monthly g Overall water-level database) Barnstable 230 22.4 20.5 26.6 0.3 1.2 413956070164301 Barnstable 24w 22.6 20.5 28.6 0.9 1.8 414154070165001 Brewster BMW 21 9.6 6.9 13.61 0.0 0.5 414518070020301 Chatham CGW138 23.2 20:9 26.6 -0.2 0.7 4141,00070011101 ® Mashpee MIW 29 7.4 5.6 10.0 0.1 1.0 413525070291904 Sandwich ZDw 46.8 45.8 48.2 0.0 0.4 414418070241601 Sandwich SDW 49.3 45.8 55.1 0.2 0.7 414124070265901 Truro TSW 89 11.6 10.2 13.0 0.1 0.4 420206070045901 Wellfleet WNW 17 10.1 7.3 12.8 -0.3 0.4 415353069585401 BOLD New Monthly High * Measurements are in feet below land surface. ** Measurements are in feet above mean sea level. **** USGS national water-level database provides historic data, hydrographs, and site maps. http://www.capecodcommission.org/wells.htm 6/15/2009 Nlw l * - -_. _ �'"eegar,,,cHw - r w:. r/ ♦ S qe Neck B ch �, r .'r-,saa,aaU„, „�+'>r�+�,. $t a✓t#, 61 � ,. 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' wL"�' `;'`+�a" >tN'" �,�" `,3"k �'"a'ex`�k "!�4�y,'�= a... r. �'� - ,,�J ��f f ,t s Y � �' � i•F��yi�, y � ,} m�'YF «l �� w.{ ""°'• �� t.'�� ti '� ,, ,i•,�u.:` �,r :b "s A+"' a ' �', a'r,� 'r �* '�'.Y:. t e 1 •'4 : ",,� At ' ` � .j Cy�.it "•,.!► r i `s. `4 '-� ° '�"�' �!'�`' x •st �',.. � �`�4` '�'� if�r' Y � d"', s#', '°rtst.}" �" .y s �,`�j, t fit '. # ,tg} �54`� '�A4 '1, ;.�` �,A t•. °+ }� 'am '�' .` �7 '•i .��f z F¢. 1� ,Fs'b r, 7 �`• A F ,i el P� +F I 168 Fawceit Lin Barnstable Town*iMA 02601r r� �.1 3 # f C;` ti.4 ; +tt. :r }r• c ti s,N i,� S:•:'9+r+ � +t i�. tifiw 4"#gs��'�+'�k �$�� t ., w+�' � r1 ��' 1=a d',F �' $N� s .i +��' .-Sty • � ��"��"L « N i11r f e / ..5+ a x�,�. 5 "« •f� � i Nit✓;� £ 7'� fy� tk • #, tt�t • �� , • ® 009cT,eleFtfas ., ..., � f,. # r sibtl� t st 4, USn'sua Bureau �',� .� � �`� • � i • } e.� , � � .-• FrI81ONSt t V - � tf��sftSPwI r � OT �., .. Imagaty Date:Jul 2-; 007 it at R rei{lt' 41 39'QO Oi#N *70'18'23°87' elev�*`28,ft r 12' ENW,PVC tot+CAL nW111Tsaa m SEPTIC TANK u i p H-10 a o. c CONCRETE FULL SYSTEM PROFlLE s ttiat 31r 1 Iff Not to scow OO�OGbe dww NOTE ALL COMPONENTS MUST HAVE RISERS TO WITHIN fi I PERCOLATION TEST Date of Percolation Test FEBRUARY 22. 2004 Test Performed By. CARMEN E. SHAY. R.S., C.S.E. Results Witnessed By WAIVER (per BARNSTABLE B.O.H.) Excavated By.ROBERTS SEPTIC SERVICES. INC. Percolation Rate: Less Than C2 MPI Test Hole No. 1 DEPTH SOILS ELEV. 0 99.00 i Sandy Loam to rR s/r � s 0"-6" A, 9&50 Loamy F� Sand l to rR 31% 6"— 30" Ba 96.50 MOCL I Sand j 2.3 Y 7/4 i30"— 14-C C, 87.00 L� j { Depth to Perc. 30 to 48" Perc Rate= Less Than 2 MPI ` Observed ESHWT6 — NONE OBS.— 144` Assumed ADJUSTED H2O Elev. NONE OBS. — 144` Assumed g 2-4jr[Iflil. AmtSC6.6atammm.¢c. ., . .., «.. . L OE /07/2014 20:37 FAX 002/002 Town-9f Barnstable Ttse r Regulif Services II Thomas F. Geiler,Director • BAR.\$'j'ABLL. KA & Public health Division ib39 �� Thomas McKean, Director 200 Main Street,Hyannis,NIL4 02601 Office. 508-862-4644 Fax: 508-790-6304 Installer&: Designer Certification Form Date: 3/10/04 Designer: Shay Environmental Services Installer: _Roberts Septic Service Address: 34 Thatchers Lane Address: 5 Trenton Street East Falmouth, MA 02536 Yarmouth. MA On 3/8/04 Roberts Septic Service was issued a permit to install a (date) (installer) septic system at 168 Faucett Lane.Hyannis based on a design drawn by (address) Shay Environmental Services dated 3/5/04 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify.that the septic. system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance.with State & Local Regulations. Plan revision or certified as-built by designer to follow_ s 1 44 (Testa er's Signature).* y.t ` A h4 y ri U to NW 11 Designer's Signature) (AM i re) " '��vrTaRlh� PLEASE RETURN TO BARNSTABLE PUBLIC HEAL I CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Hcafth/ScVtic/Dcsigncr Ccnifica:ion Forte MAR-11-2004 THU 08: 12AM ID: PAGE:2 TOWN OF BARNSTABLE eL LOCATION 149 t RQc e&. (-one- SEWAGE # 200 f VILLAGE 4 4 an n i S ASSESSOR'S MAP & LOT 2?OINST,WmEW S NAME&PHONE NO. �r�a� •T:IEun �o$ -2S�- 43y3 SEPTIC.TANK CAPACITY 1)oOn Cj a/ i LEACHING FACILITY: (type) NO.OF BEDROOMS 3 BUILDER OR OWNER MQ fct Jo 5 ��nI-o 5 PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility ' 2 f Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) �' Feet Edge of Wetland and Leaching Facility(If any wetlands exist / within 300 feet of leaching facility) - / Feet Furnished by r A n k ��+n 1 TOWN OF BARNSTABLE LOCATION (0 " SEWAGE # ' VII,LAG /ASSESSO x-�& LOT�7o / 14/ .INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Sa' G7/ ) 61 LEACHING FACILITY: (type) tt� 4�c�(—Irma ' (size) NO.OF BEDROOMS BUU-DER OR OWNER PERMIT DATE: aS 0 COMPLIANCE DATE: Iv U Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet I Furnished by �``�^^ v, r. 's � �`,�� - y ct - o �� _��JJ C�I �_' ,� c� � � � - _ No. FEE CU 16WEA]LTH OF MASSACHUS ETTS Board of Health, � $ ,�p MA. APPLICATION FOP DISPOSAL SYSTEM'][ CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - ❑Complete System dividual Components Location Owner's Name ° I IQ Map/Parcel# fl Address t46 Lot# Telephone# Installer's Name ' Designer's Name Address p._.. rl tii Address--30 t F. etm S'VC5, Telephone# (_p 6--ssibTelephone# �• �(o �� Type of Building .�'slLl't1CA 1 Lot Size '51D& sq.ft. Dwelling-No.of Bedrooms `'�►C'� C � Garbage grinder Other-Type of Building SVA?f\ No.of persons Q Showers Cafeteria (fy Other Fixtures kC&PA Design Flow(min.required) i J c7U gpd Calculated design flow L7 Design flow provided s a _gpd Plan: Date a s'4 6% Number of sheets ` Revision Date Title Description of Soils) rr�� Soil Evaluator Form No. Name of Soil Evaluator Comyn Date of Evaluation D! DESCRIPTION OF REPAIRS OR ALTERATIONS ` The under ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree to nof to place tem' eration until a Certificate of o smp�linee has been issued by the Board of Health. Sign d Date V Inspections —'7-Y"`✓`-,.--f':�..x-,:,-,��u ` � �..,�,r*� 1, :.rr.,•.n-Eat .'1 �'�:,'«,....,,,^J �.::`f"�`'�"y5'� '*'t*`'"'!"'y'��.a�v€ No. <` ''t t. x� a� a i FEE -R. Board of Health, � S� t4'�� MA. ` APPLICATION,,FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair Upgrade( ) Abandon( ❑Complete System dividual Components Location +( c&.1C '& LAtA ANrU1S Owner's Name Map/Parcel# Q 'to HttO, -' 4A Address Is�ME t -- Lot# - Telephone# tt Installer's Name 1 Designer's Name CAQ�z� •CNAI ?'/)✓1 t'tX�n.cP' -A S VCS. Address e� e,�� _ Address-3U ems_-_ . LP-4 F 4Z(rna*i1.Mtn Telephone# a �(� (-3- 3i r Telephone# v ` /. Type of Building �S k6RO/; Lot Size sq.ft. Dwelling-No. of Bedrooms G rbage grinder Other-Type of Building SVVk1 No.of persons Q, Showers Cafeteria Other Fixtures IC a"t C%•P11 w k, UU _ Design Flow (min.required) 7 s C) gpd Calculated design flow 3 2>0 Design flow provided ._� (d� gpd Plan: Date Number of sheets t Revision Date ....� Title a " (�L� � cy��'1C -S-,sAem (.) )q"Ka C�0 'r Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator 1�t nC(V\Qh J Date of Evaluation ID1119104 DESCRIPTION OF REPAIRS OR ALTERATIONS The underg! ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree's to not to place th system'in operation until a Certificate of ompli ce has been issued by the Board of Health. Signe�� Date/�✓ a 41 Inspections - 1 1 � :•..,.'e.::_. �=:.<....-__-�.«_.•rr-=_�....��..at.�-�=`==-..T --Y::'-*:ram^:-._-"��g�..�'_�. 1..._.:-�3—.-=.'.1:�u;;•-;r:--`-:-.�=--.z tir..:ss-a*.�=., -_t�. .3s=.r- + -�� •---t-.'-:•-v,.+>-<:_�:-ate'-�-:.._::. No. 1 �-O� ¶ ALTH OF FEE Board of Health, !�J to 5 11J-b I��MA. CERTIFICATE OF COMPLIANCE Description of Work: L :Individual Component(s) ❑Complete System The undersigned hereli/y`certify that the Sewage Disposal System; Constructed ( ),Repaired X Upgraded ( ) Abandonedby: PO6.45 �V�L at to -Gml H re— f 11 nt? �- S has been installed in accordant with the provision M s of 310 CR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. QU � 0 7 S , dated �l2(n��1jl`!/ Approved De ign F ow (gpd) Installer /-� I (� Designer: Inspector: I Vim ��))• A� IC V, Date: 3 110 1 Qq The issuance of this permit shall not be construed as a guarantee that the system will function as designed. t may,, No. v"'"-'7 '-�C'�� 5 FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, �. rn5Ja'J/1 _, MA. DISPOSAL SYSTEMS[ �� INSTRUCTION PERMIT t4 �� Permission is hereby granted to;,�Construct( ) Repair( Upgrade( ) Abandon( ) an individual sewage disposal system at O lit/l `h� <r'> !c�f')lI/-s / as described in the application for r Disposal System Construction Permit 41lo.":�4/ 07`3 , dated ��tl IUD-{ Provided: Construction shall be comple ted within three years of the date of•this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Dat'A,-�L � �/ ✓7 Board of Health _ -.. Health Complaints 26-Jan-05 Time: 1:10:00 PM Date: 1/14/2005 Complaint Number: 17893 Referred To: DAVID STANTON Taken By: Linda Edson Complaint Type: CHAPTER II HOUSING Article X Detail: ILLEGAL OPERATIONS Business Name: Number: 168 Street: Fawcett Lane Village: HYANNIS Assessors Map_Parcel: 270-141 Health Complaints 26-Jan-05 ONLY HOUSE. SEPTIC 2004-075 WAS ALSO FOR 3 BEDROOMS. NO FURTHER ACTION REQUIRED. Investigation Date: 1/14/2005 Investigation Time: 3:45:00 PM 2 I /� are: ��' � �.rir��.9�✓'rkbuf.� q e~—yw > � �..�� i s - W1pME i Mr Home: Departments: n:Assessors Division :N Property Assessment Search Results 168 FAWC Al®TE Owner: CASS, ROBERTA L property Sketch Legend Map/Parcel/Parcel Extension 270 /141/ Mailing Address w CASS, ROBERTA L 9�r %NGUYEN,TRANG �(Giv 168 FAWCETT LN �v r HYANNIS, MA. 02601 �d5 ,h 2005 Assessed Values: Appraised Value Assessed Value Building Value: $ 124,900 $ 124,900 Extra Features: $2,500 $2,500 Outbuildings: $600 $600 Land Value: $ 135,700 $ 135,700 Interactive Property Map: ap re, uires Plug in: Totals:$263,700 $263,700 I have visited the maps befores f� First time users Show Me The Map Click Here April 2001 photos available .,.? Sales History: Owner: Sale Date Book/Page: Sale Price: CASS, ROBERTA L 2/15/1985 C42400 $0 NGUYEN,TRANG 3/18/2004 C172391 $279,000 2005 REAL ESTATE Tax Information: Tax Rates: (per$1;000 of valuation) Land Bank Tax $47.86 Town Fire District Rates Other Rates $6.05 Barnstable-Residential $2.12 Land Bank 3%of Town Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $400.82 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,595.39 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,044.07 Due to rounding differences these values may vary I Land and Building Information Land Building Lot Size(Acres) 0.35 Year Built 1967 Appraised Value $ 135,700 Living Area 1578 'Assessed Value $ 135,700 Replacement Cost$ 150,423 Depreciation 17 Building Value 124,900 Construction Detain Style Cape Cod Interior Floors CarpetHardwood Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Air Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 6 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,500 $2,500 SHED Shed 80 $600 $600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) No. @� FEE ` COMMONWEALTH Of,MASSACHUSETTS cc� Board of Health, '?jC D\--e MA. APPLICATION F®I, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - ❑Complete Systemdividual Components Location Owner's Name �R&Qurko, Coss Map/Parcel# Address K Lot# Telephone# Installer's Name Designer's Name t ZjAAA Address 7 ' Address�0, Y im Val Telephone# (p 6.. c v Telephone# -L� 11(p 6aS t. Type of Building Lot Size 1#4 Etc& sq.ft. Dwelling-No.of Bedrooms jn 4&— Garbage grinder Other-Type of Building rS) No.of persons_�Showers V,Cafeteria( Iy Other Fixtures L6i�►S� �j(' y �1C1 , Design Flow(min.required) c"�O gpd Calculated design flow Design flow provided '331sh gpd Plan: Date o� �'b� Number of sheets Revision Date Title u Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator o Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS —\T—, qnm- The under ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree to nof to lacePr a tem' eration until a Certificate of om$li ce has been issued by the Board of Health. Sign d10 Date t� Inspections z. No. ;L1 / FEE COMMONWEALTH OF MASSACHUSETTS .F Board of Health, �.�Individual CERTIFICATE ®F COMP .IANCE Description of Work: Component(s) ❑Complete System The undersigne hereertify that the Sewage Disposal System; Constructed ( ),Repaired ,Upgraded( ),Abandoned ( ) by: �' S S� �' at 4 8 P e i has been installed in accordan5with the rovi ions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 11 " il7. dated v ? Approved D 1gn ow (gpd) Installer t Designer: Inspector: Date: d �q l — The issuance of this permit shall not be construed as a guarante that the system will function as designed. No. �"'�y FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, &05LQ6J6f-, MA. �o DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereb granted to; Construct( ) Repair( /) Upgrade( ) Abandon( ) an individual sewage disposal system at R,"� / as described in the application for Disposal System Construction Permit No.�101/ G' ,dated zo,), Uq Provided: Construction shall be completed within three years of the d�-Eh's pg.>< 1 local conditions must be met. Form 1266 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Sc�c�/�7 Board of Health-�- -j �� Edson, Linda From: Lt. Don Chase [dchase@hyannisfire.org] Sent: Friday, November 19, 2004 1:27 PM To: Edson, Linda Subject: Apartments Hi, I found one at 168 Fawcett Ln, Hyannis the other day during a resale inspection. The listing sheet claimed 5 bedrooms but I only counted 3 (not including the 2 in the basement) map/parcel: 270/141 Thanks Don e PC--Yvt 'S D S C UJ& 1 I TOWN OF BARNSTABLE (p SEWAGE # LOCATION r VII,LAGE_. �L' '�J ASSESSO /pp & LOT INSTALLER'S NAME&PHONE NO.• . SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) o NO.OF BEDROOMS BUMDER OR OWNER PERMITDATE: a3 0 COMPLIANCE DATE: /U U t'1 Separation Distance Between the: r Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by r l is 4 Qo 10 Sloe 1 a 4 6d, 2-L3� 06/07/2014 20:37 FAX Z 002/002 . i Town o#'Barnstable Regular ry Services Thomas F. Geiler,Director • aA WWASM MASS. Public Health Division 6D MAC Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3/10/04 Designer: Shay Environmental Services Installer: _Roberts Septic Service Address: 34 Thatchers Lane Address: 5 Trenton Street East Falmouth, MA 02536 Yarmouth MA On 3/8/04 Roberts Septic Service was issued a permit to install a (date) (installer) septic system.at 168 Faucett Lane, Hyannis based on a design drawn by (address) Shav Environmental Services dated 3/5/04 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changcs (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance.with State & Local Regulations. Plan revision or certified as-built by designer to follow. J 4, (1n.sta er s Signature) A M l N 11 Designer's Signature) (AM • N►TAR1a� PLEASE RETURN TO BARNSTABLE PUBLIC HEAL I CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU, Q:Heahh/Septic/Dcsigner Cenifieaiion Form MAR-11-2004 THU 08: 12AM ID: PACE:2 Et- 20 O1 13 : b2 BARNSTABLE HEALTH DEPT 50879063U4 :�C)TTCE: This Form is To Be Used For the Repair Of Failed .Septic Systems Only. PEKCOL-kTI.ON TEST AN` D SOIL EVALUATION EXENIPTIOl� FORM c��rA4� hereby certify that the engineered plan sip ed by me 4-1 concerning the property located at —1-4 meets all of the —F-ice•---- T�LT— ict:ow ng c�teria. This failed system,is connected to a residential dwelling only. There are no :omm:trzial or business uses associated with the dwelling. r,�e soil is ciass:;ted as CLASS I and the percolation rase is less than or equai to ri:�utes der rich. The applicant may use histoncal data to conclude this f3c: Ur may .:�rduct are:tm,:,ar% tests at the site without a health agent present here :s no increlse to flow and/or change in use proposed i here are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than fourteen 3onve the maximum adjusted groundwater table elevation. f Adiust the ;:..)unt!water table using the FHmptor method when applicable) Please complete the following: 2 fop of Ground Surface Elevation (using GIs informvlon) 5, �(D_ adluscment for high G.w. 3.,� 1�+ EET`N'EEiq and B VED DATE: ,22 NOTICE 3asec ,^tin t^e above ir.fo.rmation, a repair permit wil! be issued for ozdr^oms bedrooms are authorized to the future without en,tncerec :ept c system plans. --- — �r un:r,:au �ucc.m9 168 Fawccet Lane hyannis Look inside of 1°nd Floor(exist) -------------------------------------------------------------------------------------------------- O Kitchen II Bedroom I � I i Dinner room Living Rom —' Exist step Down/Basement steps Up 2od Floor steps } r ors,. 168 Fawccet Lane hyannis Look inside of 2°nd Floor -------------------------------------------------------------------------------------------------------------------=------ � I 1 ----7 ' 1 1 I 1 _______________T__--__-__-__-______-_-______-� / _Kai- , / 1 1 , i I 1 / 1 1 / 1 1 � 1 / O � 1 Bedroom 2 Bedroom 3 1 1 1 1 1 4 I 1 Y 1 / \ Ixist step UP a1 1 1 168 Fawccet Lane hyannis Look inside of Basement Floor(exist) -------------------------------------------------------------------------------------------------; O Living space 01 II II storage S' II I I Play room Living Rom I.I II i —�— Exist step _-- Down/Basement steps Up 1°d Floor steps f - Permit Number: Date: Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: I (o`LS Fc�..%G�"� L�� Y�a� Lot No, Owner: � ��G�-(�L Address: 1"7�C0 imcE Contractor: Address: Notes: STEP 1 Measure depth to water table 0-1 o tonearest 1/10 ft. .............................................................................. .Date r mo th/day year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: t,) OA Appropriate index well.................................................... U OBWater level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to �L water level for index well "........................... mo th/Year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment .......................................................................................... STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to,water 1939 level at site (STEP 1) ..................................................;........................................................ .. I; Figure 13.--Reproduclble computation form. 15 SECTION A -A46= *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. VENT PIPE (O Least _4 Inches tall) ALL OUTLET PIPES FROM THE '' S [house 10' min. from--{ 40 PROFILE VIEAStbp FoLerwatlon to septic tank schedule PVC wj Charcoal odor Futer VIEW OF ADDITION TO LEACHING SYSTEM SETLEVEL DISTRIBUTION sox LEAS: 2 12. TE CO� Tap of Foundation =ELEV. 100.00 (Assn ed) - Septic tank town must be 3- of 1/8" - 1/2' Washed Peastone �T tEVEt FOR AT(EAST 2 FT. c within 6 In. of finished grade " trr3 3 4 to 1 1 2 '.Washed Crushed Stone �`"' Grade over Septic Tank - 91L50 Grade o+er D-Box- 9t1.50 over SAS-.99.00 to 97.50 / / - ,, 3-5.OUTLET .�-?.'•- KNOCKOUTS A\ e PVC(CAPPED)MVSPECTO)N PORT TO BE - - 5.5- , ''< •...;:': ,.. ... _ INSTALLED AND TO 8E 1N1tif11 6.OF GRADE r - OUTLET '1 - 72' NtLET S 0.02 3 DIST. BOX 0 3' Maximum Cover Top Load - Elev. a95 95 Q IY ;�"C'' S-0.01 or Greater Top of SAS•-EWv. -95.5013 .EXIST. PIPE t!•) dt SAL. S� 0.01• - - - _ .;.- ` .,�.�,. .. t` t` o 1T per foot • t5 4" - SCH. 40 T FROM EXIST. FOUNDATION rn SEPTIC TANK N 0 Elf«five Depth 1.7s' u al H-10 M 5 Units a 6.25' = 30' PLAN SECTION CROSS-SECTION °I cneak ,x ; CONCRETE FULL FOUNOA a'> n (d � ui 0.83' (10 inches) 3' 3 rn 31.25' ( Ra -6 d 3 HOLE H-10 DISTRIBUTION BOX SYSTEM PROFILE 6 inaf a/4'-t 1/Y II 37.25 compacted atone o 0 o A rn Effective Length NOT TO SCALE r �R R � 'y YI Not to Scale c c o R 4' 4' a SOIL ABSORPTION SYSTEM (SAS) ED2004 :waoosr+.,"�M �*=�M-y� •t�Yr i. t a 05, INFILTA:ROR HIGH CAPACITY (H-10 LOADING)/ GEORGE O'BRIEN GENERAL NOTES compacted atone Effective Nldtfi NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE m m (OR EQUIVALENT) Not to Stole 1. Contractor is responsible for Digsafe notification Bottom of Teet Hole 1 Oev.-87.00 NOTE. OVERALL HEIGHT OF INFILTRATOR IS 18- /EFFECTIVE HEIGHT IS 10- and protection of all underground utilities and pipes: vObs. Groundwater - Test Hole 1 Elev.= NONE OBSERVED 2. The septic tank and distribution box shall be set level on 6 of 3/4 -1 1/2" stone. 3. Backfill should be clean sand or gravel with no stones over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance PERCOLATION TEST with Title V of the Massachusetts state code, the approved plan and Local Regulations. Date of Percolation Test; FEBRUARY 22, 2004 6. If, during installation the contractor encounters any Test Performed By CARMEN E. SHAY, R.S., C.S.E. soil conditions or site conditions that are different Results Witnessed By WAIVER (per BARNSTABLE B.O.H.) LOT #84 from those shown on the soil log or in our design Excavated By.ROBERTS SEPTIC SERVICES, INC. installation must halt & immediate notification be Percolation Rate: Less Than <2 MPI �� rr made to Carmen E. Shay Environmental Services, Inc.. 7. No vehicle or heavy machinery shall drive over the septic system unless noted as H-20. septic components. LOT #85 �J ° 05„ E �' i� 8. Install Tuf-Tate gas baffles or equals on all outlet tee ends. Test Hole r� ; 'N 2d 28 5.32 i� i 9. All Distribution Lines shall be 4` diameter Schedule 40 NSF PVC pipes. No. 1 , 12 , -- -- ----- / r 10. All solid piping, tees & fittings shall be 4" diameter I DEPTH SOILS ELEV. 0 99.00 i ,J� Schedule 40 NSF PVC pipes with water tight joints. Sandy 11. Municipal Water is Connected to ALL OF The Residence and Abutting ILoom Properties Within 150 Feet. 10 TR 3/2 / r SHED � 0--6- A, 9a5o THE PROPERTY LINES ARE APPROXIMATE AND Loamy 3 r TEST` HOLE #1 ,i (��r�'Failed -. COMPILED FROM THE SURVEY PLAN GENERATED BY Sand ELEV.= 99.00 Leach/Pit w NELSON BEARSE, R.L.S. of HYANNIS, MA 10 rR 5/e :� ENTITLED - SUBDIVISION PLAN OF LAND IN BARNSTABLE, MA DATED MARCH 20, 1964, CERT #22825-P SHEET 1 s 30.1Be ss.so / / 7.25'--�---) �\ AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN Med. • ! I Sand 4" PVC ti..t >, - zs r 7/4 Vent Pipe '> " \\ \� \ IT SHOULD BE USED FOR NO PURPOSE OTHER THAN `t'C•'�. `•.'' ti, LOT 76��L~`�''4-' •��,�sy-; � ` # THE SEPTIC SYSTEM INSTALLATION. 130"- 144 7.00 +► ff ' y • �� I is t• �- -= ''�- EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE. EXIST. 1000 gaT., I D-Box O Septic Tank �\ �. NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE f i / 20I PROJECT BENCH MARK FROM THE EXISTING LEACH PIT TO BE DISPOSED TOP OF FOUNDATION OF AS PER BOARD OF HEALTH SPECIFICATIONS. r . _./. r-LGV. = It/V.VV m5J17TT1L i - l } 'NO WETLANDS ARE PRESENT WITHTN"ZU0" OF THE PROPERTY - O i �/ � ` DECK it ASSESSORS MAP 270, PARCEL 141 LOT #74 I, ,t Perc #1 i / \ \\ t I vl 1 Depth to Perc: 30" to 48" I ,/ �� \� i .Z t L_EG E N D Perc Rate= Less Than 2 MPI t to HOUSE #168 1 ¢ Observed ESHWTO - NONE OBS.- 144" Assumed 00 ► r �� I p i -DENOTES PROPOSED ADJUSTED H2O Elev. = NONE 08S. - 144" Assumed �� EXISTING JAI I 104X 1 SPOT GRADE I �\ GRAVEL I - 3 BEDROOM I I CIS I DRIVEWAY , o W , I , I HOUSE , o DENOTES EXISTING r , I ► , X 104.46 SPOT GRADE PL PROPERTY LINE ,�� J LOT #75.- 96P PROPOSED CONTOUR -- ------------ 14,586 Square Feet +/ - - - -- -97 EXISTING CONTOUR r� DEEP TEST HOLE & - 2-18•OIAM. ACCESS MANHOLES - /I , , �� B 110.00' /J ; PERCOLATION TEST LOCATION N 12d 33' 25" E e 6 FOOT STOCKADE FENCE "IT -- -ouT ET\ :i FA TYCE T T LIA NE Y f- THE CMS COVERS F10R 'lHE SEPTIC TANK P LOT P LAN COMPONENT GRADE '""" '"`HES TO "TDISTRIBUTION BOX AND HIN6NtOF OF PROPOSED SEPTIC SYSTEM UPGRADE GRADE SHALL BE RAISED TO BELOW FINISHED OF (40 FOOT RIGHT OF WAY) STEEL REINFORCED PRECAST CONCRETE FINISHED MADE PLAN VIE INSTALL TUF-IITE GAS BAFFLES OR EQUALS PREPARED FOR 3-24• REM MS. R O B E RTA CAS S AT 3-m►,. dance # 168 FAW C ETT LANE INLET B- mini 2-min. Inlet to outlet 1S wET- 10`mh�-__llqu�l Tevel-... •Tin. OUTLET �Tr HYAN N I S, MA 4'-0-depth Design Calculations f . PREPARED BY: J c v ew e.r.. Lklutd depthOF 1 3 ` � u J r _ Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. p8r Title V) e� Garbage Grinder: No � I :la. AR H.�T E. ,SHA Y ;, - •.� - '�' =::'*: • � " . J Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) _ ��` �', , 4'-10• Septic Tank - 3 x 330 Gal./Day _,660 USE EXIST.'1,000 GAL. Septic Tank. ' f_',a, ENVIRONMENTAL SERVICES, INC. CROSS SECTION END-SECTION SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch 0 20 40 50 " , I Bottom Area: .'0.74 of/sq. ft. x 370 s . ft.'_ 273.8 gallons , �F c P.O. Sidewall Area: . 0.74 gal./sq. ft. x 78 sq. ft. 58 gallonsn CfSTFF BOX 627 TYPICAL 1000 GALLON SEPTIC TANK Providing: 331.80 gallons, w A, EAST, AtMOUTH, MA 02536 r r �^ �AnrlT��y�' NOT TO SCALE .k,. a TEL/FAX : 508-�548--0796 Use: (5) INFILTRATOR HIGH CAPACITY H-10 UNITS, HAVING A 0.83 (10 INCHES) EFFECTIVE DEPTH SCALE: 1 r=20 m TO,BE USED WITH 4.0' OF WASHED STONE ON THE SIDES AND 3.5'.OF WASHED STONE A SCALE:.1 =2O :` DRAWN 'BY: CES ` DATE: FEB. '22, 2004 ON THE ENDS. NO STONE UNDER. PROJECT#SD529, FILENAME. ,SD529PP.DWVG SHEET 1 OF 1