HomeMy WebLinkAbout0001 FRESH HOLES ROAD - Health 1 3 Fresh Toles`Road
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Commonwealth of Massachusetts U
�;. Title 5 Official Inspection Form
i' Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address K
Anthony Aliberti �
Owner Owner's Nam
information is
required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information S/-*
1. Inspector:
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
8-1-17
spector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
vs
Commonwealth of Massachusetts r
ta=i Title 5 Official Inspection Form
,pi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. Cityrrown. State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes: ,
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
System is in good working order with no sign of failure.
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
• Commonwealth of Massachusetts
,I = Title 5 Official Inspection Form
N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
i ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑' Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
I
I
• Commonwealth of Massachusetts
x+ r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
`- 1-3 Fresh Holes Rd
v.o.cfy.
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment: ;
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and,the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:,
** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
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 Y2 day flow
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' ill Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory, for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area— IWPA) or a mapped Zone 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.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
Commonwealth of Massachusetts
to=1 Title 5 Official Inspection Form
I Subsurface Sewage Disposal System Form -Not for Vol u nta ry'Assessments
-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. Cityfrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate "yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
N . ❑ 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): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):
440
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t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
; Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: Unknown
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 8-2017Date
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
i
, Commonwealth of Massachusetts
Title 5 Official Inspection Form
A Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface-Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
:a Title 5 Official Inspection Form
rl
rd Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is Hyannis MA 02601 8-1-17
required for every y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
2009
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 30"feet
I
Material of construction:
® cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank(locate on site plan):
'
Depth below grade: 24"feet
Material of construction:
I
® 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: 1500 gal
Sludge depth:
12"
[Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
Pill 4: Title 5 Official Inspection Form
G
0I Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is Hyannis MA 02601 8-1-17
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
20"
lit.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
15.1
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
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Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
a Title 5 Official., Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 111 of 17
Commonwealth of Massachusetts
aI Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
.:
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Mspection .
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Good condition with water at working level and no sign of back-up from chambers. Recommend
lowering the d-box cover to grade to keep plow trucks from hitting it.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' �r4 Subsurface Sewage Disposal System Form -Not for Vol untary'Assessments
r'
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is
required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 3-500's
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach chambers in good condition and holding water at 6" off bottom of chamber with no other visible
stain lines.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow - ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
1
Commonwealth of Massachusetts
(IF Title 5 Official Inspection Form
�
"1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, cr
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
a Title 5 Official Inspection Form
I.�
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
art
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is
required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.).
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
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313 o
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3,5
4/9
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
21 6f Title 5 Official Inspection Form
.'II Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
i
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: 1 feeett
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked,date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health - explain:
I
® Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database- explain:
You must describe how you established the high ground water elevation:
Original design plans show no groundwater at 12'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
I
Commonwealth of Massachusetts
;+ Title 5 Official Inspection Form
' Il-I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1-3 Fresh Holes Rd
Property Address
Anthony Aliberti
Owner Owner's Name
information is required for every Hyannis MA 02601 8-1-17
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist {
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
9 ,
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t5ins-3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 j
Town of Barnstable
P�°FTr+�'ao Regulatory Services
.n
Thomas F. Geiler,Director
• u�wsreHt.e. •
9�A i6 9. ►`0� Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: `zS zio0
Designer: (��' _��_C_h_-_-- -- �e Installer: �(/�. �; ;?60 &:(617 4 (1
Address: / `I'IAr741e C, re/i Address:
�en, r l/i
On 0,Ly- PAn&IL- S/Q was issued a permit to install a
(date) (installer)
septic system at 1 43 &e,,s 'alxs flO I&MA-IS based on a design drawn by
(address)
�G o - dated 3
(designer)
Z. , ertify 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.
N,pf MAS
s a ler's Signature) � V;A o
P
CyC . �• �j `pANIT�P�
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. 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:Health/Septic/Designer Certification Form
TOWN OF BARNSTABLE
LOCATION "3 Eras i, 1-1 Pi SEWAGE# .2007 - .)3 i
VILLAGE_ 'A ASSESSOR'S MAP&PARCEL -29,2 , !S 7
INSTALLER'S NAME&PHONE NO. �.�.w.•c.?ab��.su.t S.pfs, Stm„d nr77S-g)7C,
SEPTIC TANK CAPACITY I Sbo
LEACHING FACILITY:(type) 3 x STD 4ry -c1h(size) v 3•S Xlo;XSX,
NO. OF BEDROOMS q
OWNER
PERMIT DATE: 30 l-.1—q COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet
Private Water Supply Well and Leaching Facility(if any wells exist
on site or within 200 feet of leaching facility) feet
Edge of Wetland and Leaching Facility(if any wetlands exist
within 300 feet of leaching facility). feet
FURNISHED BY bts.s,
r;
No. Fee#
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftpliLafion for Mispo8aY 6pstrm Construction VPrmit
lication for a Permit to Construct( ) Repair Y) Upgrade( ) Abandon( ) []Complete System ❑Individual Components
Lo do ddress I,�t N Owner's N e Address,and Tel.No',J0g-''J�j -
- 125h lQS`► t�C , A�''�r, S. •-j—�„ i t �jec
essor's Map/Parcel p�at
Installer's N e,Address,and Te No.,50 -77 - 77, Designer's Name Address,and Tel.No.SD:9—3(oq-D 9'j,9
1koi n& e2 Se f+ c_ t 60
Q 1 8 2,til U 1 l 3`i f i 0� CA,-cde. ,ICI
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(f�g
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures �"
Design Flow(min.required) �r gpd Design flow provided gpd
Plan Date .. Number of sheets Z Revision Date
Title
Size of Septic Tank'' 1;5-6 O X Type of S.A.S. 3 �00 44e-. (fM4-"75e2S �v S7m�•
Description of Soil
Nature of Repairs orAlterations(Answer when applicable)1r05VD_Qk_ Q OeAJ
P�MnS 6 l�icp.—T2C,�nTL 31��
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by p , S Date -7^ ^®G(
Application Disapproved by Date
for the following reasons
Permit No. ��®�^ 2 3 I Date Issued Jv
,►: `3[�.A',:nr&r:irr.�rmn-.}a-.. �.r --:^... `.nan•-,.p.+.-.r�wc+.io.s,. a�--'+�`:rrwF^-eAi-�" iar-H+orairor-'.tee. .r,n. .�-;.v.«;r:..-:.. .;,-..�e.w;.r'..
No. 20®-1 ' ..^� -^w_.. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
i PUBLIC HEALTH DIVISION -TOWN�OF BARNSTABLe, MASSACHUSETTS Yes
9ppfication for MisposaY-Opstem Construction Permit
plication for a Permit to Construct( ) Repair Yj Upgrade( .). Abandon( ) ❑Complete System ❑Individual Components
oNor's
on eddshes ao fN1 1 Owner's
er'sy NW,,
ddere.s�s-,h4 nd Tel.No5Og-3(,o -
MapP0 � bLA arcel 0-)qa cJ
Installer's Name,Address,and TeLNo.50�-7�5- 77�o Designer's Name Address,and Tel.No.SD8-3(oq-C> jj4
E �p t o C.�� S21 n r�-s'I iL
1 9 _g)4 .r U t I I c I 3-r(10-Y)c4le. Ci JGIe
Type of Building:
Dwelling No.of Bedrooms Lot'Size sq.ft. Garbage Grinder 04
Other Type of Building .-No.of Persons Showers( ) Cafeteria( ) e,
Other Fixtures
'Design Flow(min.required) N 0 gpd Design flow provided q6 gpd
Plan Date -7 Number of sheets Z Revision Date
Title
Size of Septic Tank 45-6 0 )( Type of S.A.S. 3 _00 Ci 4 C• C'/'9.A-7/s t2.S
Description of Soil
i •
-' Nature of Repairs or Alterations(Answer when applicable) 0 J T A-�e_ t
CLInS C Co. `Tech - �t Est�1
f
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance'of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation;until a Certificate of
Compliance'has been issued by this Board of Health. - V
Signed A Date ��3 d•"!� 9
Application Approved by r . .; � rj Date ^GOB
Application Disapproved by Date
for the following reasons .
Permit No. ?_00 c"t- Date Issued 2 3 -
! '�' so"
--- --------- - - --.---J�`- - - =- _ = = _ - = =------------- --�-
THE COMMONWEALTH OF MASSACHUSETTS
( I BARNSTABLE,MASSACHUSETTS
Certificate of Compuance
TIES IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( )
Abandoned( )by 1.t7M E: 'r o U`n.S0,1 �� �I.C_
at KfQS�\ u01 t?S V_Or, has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit NoZ�f'Z31 dated 7- 30-06
Installer 0 11,a SOS Designer f-GO— -T e L K
#bedrooms Approved design ow gpd The issuance of this permit hall not be construed as a guarantee that the system!' l fimc iI n as designed.-
Date Inspector
-------------------------------------------------------
No.Z-OO-^ 2 3 �. Fee /00.
THE COMMONWEALTH OF MASSACHUSETTS
A PUBLIC HEALTH DIVISION--BARNSTABLE, MASSACHUSETTS
misposal 6pstem Construction 3permit
Permission is hereby granted to Construct( ) Repair(x) .Upgrade( ) Abandon( )
System located at 1-3 -re5l� Np1eS 5�-pc,.d, t ,lQ�ti s
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
i
Provided:Construction must be completed within three years of the date of this permit.
n
Date / " 3a - Zz>QGI Approved by
v
r
TRANS. NO.:
CITY/TOWN: g�*-wc T A i�LC
APPLICANT:
ADDRESS: 1-3
DESIGN FLOW: 40 gpd
REVIEWED BY: DATE:
i
N/A OK NO
AM,;
GEjERAL �
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot,tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)]
Locus Provided [310 CMR 15.2204(t)] ✓
Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for ✓
components) [310 CMR 15.220(4)]
Easements shown [310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- i not,-a variance is required [310 CMR 15.412(4)]
Location of impervious surfaces (driveways,parking areas etc.) /
[310 CMR 15.220(4)(d)] ✓
Location all buildings existing and proposed 310 CMR
15.220(4)(c)]
Location and dimensions of system components and reserve areas. /
[310 CMR 15.220(4)(e)] V
System Calculations [310 CMR 15.220(4)(01
daily flow ✓
septic tank capacity(required and rovided) ✓
soil absorption system (required andprovided) ✓
whether system designed for garbage grinder ✓
North arrow [310 CMR 15.220(4)(g)] ✓
Existing and proposed contours [310 CMR 15.220(4)(g)]
Location and log of deep observation holes (existing grade el. on
each test) [310 CMR 15.220(4)(h)] ✓
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and (i)]
Location and date of percolation tests (performed at proper /
elevation? [310 CMR 15.220(4)(i)] V
Percolation test results match loading rate? [310 CMR 15.242
Certification statement by Soil Evaluator [310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)]
Address 1-3 Ffes h Hole 5 Pool el Sheet 1 of 7
N/A OK NO
Location of every water supply,public and private, [310 CMR
r
15.220(4)(k)] - V
within 400 feet of the proposed system location in the case
of surface water supplies and gravel packed public water sup ly V t
within 250 feet of the proposed system location in the ca.-,(-
within 150 feet of the proposed system location in the case /
of private water supply wells /
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins /
located within 50 ft. 310 CMR 15.220(4)(1)]
Water lines and other subsurface utilities located [310 CMR
15.220(4)(m)] (if water line cross see 310 CMR 15.211 1 [1])
Profile of system showing invert elevations of all system /
components and the bottom of the SAS [310 CMR15.220(4)(o)] V
Stamp of designer [310 CMR 15.220(l) and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction I /
activities within 5 ft. of lot line) [310 CMR 15.220(3)]
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 310 CMR 15.405(1)(k)]
Test hole adequate to demonstrate four feet of suitable material? /
310 CMR 15.103(4)]
Test Holes adequate to confirm adequate groundwater separation? /
[310 CMR 15.103(3)] ✓
Benchmark within 50-75' of system [310 CMR 15.220(4)(g)]
Materials specifications noted? [various sections of 310 CMR
15.000
System components not> 36" deep (unless Local Upgrade /
Approval or LUA requested) [310 CMR 15.405 l(b
Address
t -3 �-BPS ti N aI F5 'C D�7 Gr Sheet 2 of 7
r t
N/A OK NO
Located at least ten feet from any water line? [310 CMR /
15.222(2)]
Disposal piping at least 18" below water line(when water and
sewer cross, see 310 CMR 15.211 1 1 ) ✓
Cleanouts required/provided ? 310 CMR 15.222(8)] , r/
Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] ,/
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable /
[310 CMR 15.222(6)] t/
Proper pitch on all runs? (.005 within gravity-distributed trenches
and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)]
Siphonproblem/(leachfield below pump chamber) ✓
Endca s or vent manifoldspecified?V
Size and orientation of discharge holes specified? (not smaller
than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 /
CMR 15.252(2)(h)] V
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed)
rt
z- 9 '"�„ 73.ri.++�"^ v.4` v �,14r'"�"•" ,'�" �rF III
DISTRIBIIT O'1�B® s � � y"
Stable compacted base [310 CMR 15.221(2) and 310.CMR
15.232(2)(a)]
Splash plate or baffle tee required on inlet/provided? (when
pressure sewer to d-box or steeppitch of gravity sewer) [310
CMR 15.323(3)(a)]
Riser if deeper than 9" [310 CMR 15.232 3 ]
Inside minimum dimension 12" 310 CMR 15,.232 2
Minimum sum 6" [310 CMR15.232 3 (e
Watertight cover if<2000gpd); waterproof manhole if>2000gpd
[310 CMR 15.232(3)(d)]
a. ME
Capacity(emergency storage above working--design flow)? [310
CMR 231(2)]
Proper setbacks [310 CMR 15.211 (same as septic tanks))
Watertight 20-in minium access manhole at least 20" MUST BE
V
TO GRADE [310 CMR 15.231(5 ]
Service components accessible (not too deep with piping,
disconnects accessible) V
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. [310 CMR 15.231(6) and(8)]
Stable Compacted Base 310 CMR 15.221(2)]
Buoyancy calculations needed ? Provided? [310 CMR 15.221(8)]
rr
Address I Gl�J Sheet 4 of 7
l '�j f'1�F�7� �'�U'PS
N/A OK NO
SEI'TICTANK ' �� � i " " IWW9 ;` . �..nr
Size OK? [310 CMR 15.223(1)
Inlet tee located ten inches below flow line 310 CMR 15.227(6)] ✓
Outlet tee"14" or 14" + 5" per foot for increase fft depth [310 CMR /
15.227(6)] -
Outlet tee with gas baffle or approved flter[310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)]
Separation between inlet and outlet tees (no less than liquid /
depth) [310 CMR 15.227(2)]
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5)) or permitted for
upgrades under LUA 310 CMR 15.405 1 k V
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310 /
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (by 7/07) [310 CMR 15.228(2)]
Access to within 6 " of grade -'one port for systems<1000gpd, /
two fors stems>1000 d'[310 CMR 15.228(2)]
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done [310 CMR 15.221(8)]
H-20 Where appropriate? [310 CMR,15.226(3)] ✓
Setbacks from resources [3-10 CMR 15.2111
ij a'7" �.���f�`t;Y ° '?�e' '�Ls#` .y {�� „�. •. � ty a"+'fin ��' ,tea "7
�1Vlulh�C,�ompartment „�,a �� �F,
Required when other than single-family dwelling or flow>1000
d [310 CMR 15.223(1 )] t/
M
First compartment 200%daily flow; Second compartment 100%
daily flow [310 CMR 15.224(2) and 3)]
"U" pipe through or over baffle, outlet of each compartment with /
gas baffle or approved filter [310 CMR 15.224(4)] V
Address _"J r�E�s"� �y��� Py64 Sheet 3 of 7
f
N/A OK NO
AU
Pressure Dosed System ? Provided pump and piping
calculations as required [310 CMR 15.220(4)(r)]
Pressure dosing required on all systems>2000gpd or alternative
systems under remedial approval [310 CMR 15.254(2) and UA
Remedial Use Approvals]
If used in gravelless system -make sure jet is directed as not to
scour soil interface [Guidance Document
Inspections once per year(systems<2000 gpd) or quarterly
(>2000 dgood to note on plan 310 CMR 15.254(2)(d)]
Construction in fill -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ?
Impervious barrier and/or retaining wall ? [Guidance Document]
Impervious barrier installation must be supervised by ✓ i
designer [310 CMR 15.255(2)(b)]
Retaining wall must be designed by Registered Professional
Engineer [310 CMR 15.255(2)(a)]
Side slope not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document]
At least 5 ft. from impervious barrier to edge of SAS (10 ft. /
recommended) [310 CMR 15.255 2 e
.���43��
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure.discharge
to scour soil interface
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions? ✓ `
Is there a note on the plan regarding the requirement for
e etual maintenance agreement?
Any alarms involved on se irate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a cou of a maintenance
ax#s � ° , ,.a'�` 3:e: �• „�,i.w g' `
1Are the variances listed on the plan ? [310 CMR 15.220 '
(4)(q)] ✓ ;•
RLS Stamp necessary on plan if a component is within five
feet of property line 310 CMR 15.412(4)] f
New construction or increased flow proposed= [Refer to 310 /
CMR 15.414
Address l 3 �-�P5 ti 0 fPs ��� Sheet 6 of 7
N/A. OK NO
4.
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)] ✓
Required separation to groundwater? [310 CMR 15.212 ✓
Aggregatespecified as double washed [310 CMR 15.247(2)] ✓
System Venting required/provided? (system under driveway or
>3 6" deep) [310 CMR 15.241]
Inspection ports specified and within 3"final grade? [310 CMR /
15.240(13)] v
Breakout'requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and /
Guidance Document] �/
F <a.F.a•wm «.ui+x a,.:w..n3lu,� sn.luw dd..u.r�c..r., z 1..':�.ni' ,may h'1 s52 m wi 2h n �.3 4` 153 YI.. .f: h<
Chambers and Gal. in trench configuration supplied with inlet .
every 20 ft. [310 CMR 15.253(6)] ✓
Each structure with one inspection manhole(if>2000 gpd must
be to grade) [310 CMR 15:253(2
Aggregate 1'minimum-`°4' maximum. [310 CMR 15.253(1)(b)]
2' sidewall credit maximum [310 CMR 15.253 1 a)]
In bed configuration, inlet every 40 s . ft. [310 CMR 15.25 6)]
Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)].
100 feet-maximum length [310 CMR 15.251(1)(a)] ✓.
Minimum separation 2x effective'depth or width whichever
greater 3x if reserve between,trenches) [310 CMR 251(1)(d)] . f
Situated along contours 310 CMR 15.251(2) 7t
Breakout OK? [310 CMR 15.211 1 4] and Guidance Document]minimum 2 distribution lines [310 CMR 15.252(2)(a)] ✓
Maximum separation between lines 6' [310 CM R15.252(2)(d)] _ ✓ ;
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)•
Aggregate depth below discharge pipes 6"minimum, 12"
maximum. 310 CMR 15.252(2)(g)] ✓ s
Separation between beds 10'minimum [310 CMR 15.252(2)(0] ✓
Bottom area used in calculations'onl [310CMR 15.252(2)(i
• 4
I
Address _� f�eS g0l&S V 004 Sheet 5 of 7
f
I'.
N/A. OK NO
Is the system in a Designated Nitrogen Sensitive Area(Zone*H for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such
existing systems]
Is the system proposed on the same lot as served by private well ?. /
[310 CMR 15.2142
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1)]
1¢`t�"2hC'�. i""v-v ":.��„x
Pumping to septic tank ? 310 CMR 15.229]
Shared System [310 CMR 15.290]
f
Address 1 C71C-- A�'/U' Sheet 7 of 7
Town of Barnstable P#_ 1 ;2�(,d
gyp' Department of Regulatory Services
Public Health Division aearr t$ ' OIl MAM Date /lsr B /
1639. ,6� 200 Main Street,Hyannis MA 02601
lFC MA't�
Date Scheduled Time �M Fee Pd.-
Soil Suitt ability Assessment for-Sew ge Disposal
Perfored.By:-r� V1l) 'J (foQC1 �} (/✓�2
Witnessed By: Jv
m ,r
LOCATION & GENERAL INFORMATION `
Location Address Owner's Name Q ,d
�� Flre5�l �tala} R�. ,T -t his 14 �l� hF/�/i
Yl7/l N I S Address .
Assessor's Map/Parcel: `) 2-r l 5 7 Engineer's Name Dr u D' ' CG�G1u4 ta--,Y
NEW CONSTRUCTION REPAIR ° Telephone# �Io� _` �qu
Land Use ��S)d�vl /Gl Slopes
Surface Stones i
Distances from: Open Water Body Io 't ft possible Wet Area 60 f ft Drinking Water Well (y± I ft
( d
- Drainage Way S0 -t ft Property Line tft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
ZW
W J J 4
0 >0
JWW t9 m
z0< m
rP-1 i j W O O N W
If O AMU 03 Za)NN i
Ic f < 3LI N<O N M M I
>I I W zzz o-1 zo
00Z GJ 0 Wo I
I < OBI— WW C7COzW-
1 3 zQ zzcntn
O Zo< OXWE053
z oW 005wwoo
00 �W0 zZNCY fY<<
1 X<U)
0 WMCD
Parent material(geologic) (AG' i Vvfs Depth to Bedrock n D 4 e
Depth to Groundwater. Standing Water in Hole: in D Vt Weeping from Pit FQce
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE -
T Method Used: _`?e'C Ct 10 6 v(l
Depth Observed standing in obs.hole: In. Depth to soil mottles: In.
Depth to weeping from side of obs.hole: In. Groundwater Adjustment I.
Index Well# Reading Date: Index Well level Adj,factor Adj.Groundwater level
PERCOLATION TEST bate Z/U O*hne it 14 Wl
Observation f
Hole# I' Time at 9"
Depth of Pero 0 n Time at 6"
Start,Pre-soak Time @ I S4 Time(9"•6") �l G f )
_ End Pre-soak ,Z'
Rate MinJInch 2 rn p i
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) _
„ Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
': ***If percolation test is to be conducted within 100' of wetland,you must first notify the.
a Barnstable Conservation Division at least one (1) week prior to beginning.
Q:\S EPTICIPERCFORM.DOC
DATE
F S O IL TEST LOG PROV DFSOIL EVALUATOR: DAVID D. COUGHANOWR. #461 ^
j
WITNESSED BY: DAVID STANTON. HEALTH DEPT.
1 U PERC NUMBER: 12616
1TER TEST PIT PAARENTMAATER AL E D
PROGLAC AL OUTWASH
PERC AT 68 rn - 2 MIN/INCH IN C SOILS
ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER
52.75 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING
i 0-24 FILL
24-30 O LOAMY SAND 10 YR 2/1 NONE FRIABLE
+ 30-36 A LOAMY SAND 10 YR 3/4 NONE FRIABLE
48.58 '36-50 B LOAtiY SAND 10 YR 5/4 NONE FRIABLE
50-138- C MEDIUM SAND 10 YR 6/4 NONE LOOSE
i 41.25
M
TEST PIT I NO GROUNDWATER ENCOUNTERED
PARENT MATERIAL: PROGLACIAL OUTWASH
PERC AT 68 rn — 2 MIN/INCH IN C SOILS
ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER
- 52.65
(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING
0-20 FILL _
20-24 O LOAMY SAND 10 YR 2/1 NONE FRIABLE
24-30 A LOAMY SAND 10 YR 3/4 NONE FRIABLE
48.65 30-48 B LOAMY SAND 10 YR 5/4 NONE FRIABLE
41.65
48-132 C MEDIUM SAND 10 YR 6/4 NONE LOOSE
'
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency. o Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil"exture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
Flood Insurance Rate•Map:
Above 500 year flood boundary No:_ Yes
Within 500 year boundary No—Z Yes
Within 100 year flood boundary No Yes •
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? eS
If not,what is the depth of naturally occurring pervious material? -
Certification Q DV (��s T
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required training,expertise and ex erience described in 3IQ CMR 15.017.
• c r, tH OF MgSS
Signature �J Date `j yl y Z Z�a"I �o DAVID
D.
COUGHANOWR y
Q:\S•BPTICIPERCFORM.DOC ���EN SEA
' % EVALUP�O
Town of Barnstable Barnstable
Regulatory Services Department O'"'e9Ce "
BARNSTAS F. , ' r
6 9 �� Public Health Division .
AlfD"" e 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
03/26/09
Anthony Alberti
11 Rainbow Pond Drive
Walpole, MA 02081
FINAL ORDER
i
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at, 1-3 Fresh Holes Road, Hyannis was last inspected on
10/01/2004,by James M. Ford, a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Failed" under the guidelines
of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"System is in Hydraulic Failure-Backup of sewage into facility or system
component due to overloaded or clogged SAS"
The deadline for repair has past. We, The Department of the Board of Health, have not
been informed that you have taken any steps to bring your failed system into compliance.
Therefore, you are ordered to repair or replace the septic system within 60 days from the
date you receive this notification.
You may request a hearing before the Board of Health, a written petition requesting a
hearing on the matter, within seven (7) days after the day this order was received.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH
Thomas McKean, R.S., CHO {
Agent of the Board of Health
Town of Barnstable Barn
. Regulatory Services Department NfteftM
BAMSTABLE, 1111.,
MASS
Public ea vson blic Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Ceiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
May 8, 2009 r;'
c �
Anthony Aliberti
11 Rainbow Pond Drive
Walpole, MA 02081
Re: 1 Fresh Holes Road
You are scheduled to appear before the Board of Health at their public
meeting scheduled on June 16, 2009 at 3:00, to show-cause why your
property or dwelling should not be condemned to continued use of a failed
septic system. According to our records, your septic system failed on
October 1, 2004 and you were notified by certified mail to repair or replace
your failed septic system on 2/7/2008, 3/26/09. However, to date, the
system has not been repaired or replaced. The purpose of the hearing is to
provide you the opportunity to provide testimony, documentary evidence,
and/or witnesses pertaining to the repair or replacement of your septic
system.
The meeting will be held on June 16, 2009 at 3:00 PM at the Town Hall,
367Main Street, Hyannis in the second floor conference room. ,
PER ORDER OF THE BOARD OF HEALTH
r
Thomas McKean, R.S., CHO
Agent of the Board of Health
r
Town of Barnstable Barn
: . Regulatory Services Department MAMOM
BAMSUBLE. I
`"A Public Health Division
200 Main Street, Hyannis MA 02601 2007 '
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
May 6, 2009
Anthony Aliberti
O
11 Rainbow Pond Drive
p
Walpole, MA 02081
Re: 1 Fresh Holes Road
You are scheduled to appear before the Board of Health at their public
meeting scheduled on June 16, 2009 at 3:00, to show-cause why your
property or dwelling should not be condemned to continued use of a failed
septic system. According to our records, your septic system failed on
October 1, 2004 and you were notified by certified mail to repair or replace
your failed septic system on 2/7/2008, 3/26/09. However, to date, the
system has not been repaired or replaced. The purpose of the hearing is to ,
provide you the opportunity to provide testimony, documentary evidence,
and/or witnesses pertaining to the repair or replacement of your septic
system.
The meeting will be held on June 16, 2009 at 3:00 PM at the Town Hall,
367Main Street, Hyannis in the second floor conference room.
PER ORDER OF THE BOARD OF HEALTH
Thomas McKean, R.S., CHO
Agent of the Board of Health
i
°fSNE Tp�
Town of Barnstable Barnstable
Regulatory Services Department j edcaviv
flARN8TABLE. I
A 6 9 ,0� Public Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-8624644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
03/26/09
Anthony Alberti
11 Rainbow Pond Drive
Walpole, MA 02081
FINAL ORDER
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at, 1-3 Fresh Holes Road, Hyannis was last inspected on
10/01/2004,by James M. Ford, a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Failed" under the guidelines
of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"System is in Hydraulic Failure-Backup of sewage into facility or system
component due to overloaded or clogged SAS"
The deadline for repair has past. We, The Department of the Board of Health, have not
been informed that you have taken any steps to bring your failed system into compliance.
Therefore, you are ordered to repair or replace the septic system within 60 days from the
date you receive this notification.
You may request a hearing before the Board of Health, a written petition requesting a
hearing on the matter, within seven(7) days after the day this order was received.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH
Thomas McKean, R.S., CHO
Agent of the Board of Health
Jun 15 09 11 : 53a Rnthony Rliberti 5000608600 p. 2
Proposal
?� Wm. E. Robinson, Sr. Septic Service Noe
P.O.Boa 1089
Centerville,MA 02632
Phone#(508)775-9776 Fax#(508)790-1694
SUBMITTED TO:Tony Ahbetti PHONB:509-369-1861 DATE:05-29-09
STREET:I 1 Raiabow Ptmd Drive JOB NAME:Tide 5 leach system
CITY,ST.ZIP:Walpole,MA 02081 JOB LOCATION.1,3 Frestioles Road;Hyannis.
ARCHITECT: DATE OF PLAINS: JOB PHONE:face 561-747-7408 f
! Description:
1:We will pump and remove the existing plastic system and install a stone-packed concrete leach system for
2: 4 bedrooms to design engineer plans.
3: We will remove necessary bushes for access to installation.
4: Includes all labor and materials.
5: Includes all fees and permits.
6:Includes design engineer test holes and plans.
7: We will rake,clean, loam and seed the work area.
8:Inspection by the design engineer.
9:Inspection by the Town of Barnstable Board of Health.
10:
11:
'Not responsible jot utilities not nta*Cd by Dig Safe *Grass seed is complimentary,cot responsible for results.
"Riot responsible for repairs to irrigation system or other underground devices
Fee is based on normal suitable sight conditions. Unsuitable soil,high ground water,varienoes,and/or
required overdig are considered additional and will be renegotiated.
We Propose hereby to furnish material and labor-complete in accordance with the above specifications for the
SUM OF:S6,900.00 Six thousand nine hundred dollars.
PAYMENT METHOD,Deposit of$4,140.00 with signed contract.
Balance Dui Balance or2,760.00 is due upon the day of completion.
All®reiditgmmudtppenaytsiEed Nlwatisa�,r,•,�:•worlmmy>a
na�n aoxe�to spudaatiom s�emrted,ye pmdud Pmiors, 9/
Arp aitrntioo ar devilian flan tdto.e:ped5caom aroo`viig eon caste �'
rx meoaeo ady npcn wacG+ardtw,aia wip daooee m even dargc AUt
over=d.b&n the—i— Au Aff—en t—.pw vmjkM Sign�'�/. l`/• (,
&=AmA or de4ys bq-d as word.OcrtKr to ar7&L wratdo ndabv
m Pwy;—'U e. Note:This proposal maybe withdrawn
•Oa►worlcen are firl!(y corewd iy Peerteas rasmance.Company by us if not sot:eptod within days.
Acceptance of Proposal: Theaboveprioes,
speeifksdons and conditions are satisfactory and are
hereby acoepted.You are authorized to do the uork as
speci&A Payment wdl be trade.as outlined above. SiglletBr \
DsteofAeetptaoee• C� t� Signature
� r
Town of Barnstable Barnstable
rl11Iw °� Regulatory Services Department caCft
I,l RARNSTAnLE,
MASS. Public Health Division
pTfO MAt A. 200 Main Street, Hyannis MA 02601 2007
i
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
February 7, 2008
Anthony Aliberti
11 Rainbow Pond Drive
Walpole, MA 02081
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 1-3 Fresh Holes Road, Hyannis MA was inspected on
October 1, 2004, by James M. Ford, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system FAILED under the
guidelines of 1995 TITLE V (310 CMR 15.00) due to the following:
• Backup of sewage into facility or system component due to overloaded or clogged
SAS or cesspool
You are ordered to repair or replace the septic system within Sixty (60) days from the
date of this notification, or provide a more recent Title V Inspection Report with a .
Passing status.
Failure to repair/replace the septic system within the deadline period will-result in future
- enforcement action.
.� PER ORDER OF THE BO RD OF HEALTH
Thomas McKean;R.S., CHO
Agent of the Board of Health
GER- %,F%1M MAIL w '100ko 101s% lol,-v'e
Q:\SEPTIC\Letters Septic Inspection Failures\1-3 Fresh Holes Road.doc
.. 1
PILED INSPECTION -sl 2�7
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ED
"AAP 2
ARCEL NOV 0 8 2004
O „`tv__ TOWN OF BAZNSTABLE
TITLE 5 HEALTH DEPT.
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 1-3 Fresh Hole Road
Hyannis MA 02601
Owner's Name: Anthony Aliberti
Owner's Address:
Date of Inspection: October 1 2004 j
Name of Inspector: (Please Print) James M. Ford
Company Name: James M. Ford
Mailing Address: P.O.Box 49
Osterville,MA 02655-0049
Telephone Number: (508)862-9400 '
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.t� I am a`DEP : >
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: "
..
Passes r
Conditionally Passes
Needs urther Evaluation by the Local Approving Authority
✓ Fails
Inspector's Signature: Date::` . October 6, 2004
The system inspector shall sub 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 1
Page 2 bf 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, AM
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004
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:
1
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
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:
2
,Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 1-3 Fresh Hole Road
Hyannis,MA
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004
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
"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 Address: 1-3 Fresh Hole Road
Hyannis,MA
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004
D. System Failure Criteria applicable to all systems:
You must indicate either"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.
✓ 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 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 (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 System:
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
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 CUR
15.304. The system owner should contact the appropriate regional office of the Department.
4
Page 5 of 11
i
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 1-3 Fresh Hole Road
Hyannis, AM
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004
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 i
✓ 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?
i
✓ _ 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`.
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 15.302(3)(b)].
i
I
5
I
Page 6 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthony Aliberti
Date of Inspection: October 1. 2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
Number of current residents: 4
Does residence have a garbage grinder(yes or no): n/a
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)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Currently occuvied
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):
GENERAL INFORMATION
Pumping Records
Source of information: Unavailable
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: _gallons--How was quantity pumped determined?
Reason for pumping:
I
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)
Tight Tank Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Installed 3113100-per as built card
Were sewage odors detected when arriving at the site(yes or no): No
6
Page 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004
BUILDING SEWER(locate on site plan)
i
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: ✓ (locate on site plan)
Depth below grade: 2'
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: 1500 gal.
Sludge depth: 4"
Distance from top of sludge to bottom of outlet tee or baffle: 28"
Scum thickness: 12"
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: 8"
How were dimensions determined: Measuring 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.): .
_Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage. The inlet
cover was to grade.
GREASE TRAP: None (locate 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
i
Page 8 of 11
i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthony Aliberti
Date of Inspection: October 1. 2004
TIGHT or HOLDING TANK: None (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):
I Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
I
DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Above
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.):
The D-box was level Liquid was up to the inlet pipe backing up from the leach field
PUMP CHAMBER: None (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
8
?age 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthonv Aliberti
Date of Inspection: October 1, 2004
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
✓ leaching chambers,number: S 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.):
The infiltrators were in failure and liquid was backing up into the D-box.
CESSPOOLS: None (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.):
PRIVY: None (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
'Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthony Aliberti
Date of Inspection: October 1. 2004
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.
1
A
3 a
O OA f3
38` 3(o
y aq 4/
3 a'R 15a
�r 37 Ce I
10
i
'Page 11 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1-3 Fresh Hole Road
Hyannis, MA
Owner: Anthony Aliberti
Date of Inspection: October 1, 2004 ,
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 25 +/- feet
Please indicate(check)all methods used to determine the high ground water elevation:
i
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain: Topographic and water contours maps
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation: 6
Using Barnstable topographic maps and water contours maps the maps were showing approximately 25'+/-to ground water
at this site.
I
This report has been prepared and the system inspected and failed as of the date of inspection. This report is
not a warranty or guarantee that the system will function properly in the future. There have been no warranties
or guarantees,either expressed,written or implied, relating to the system, the inspection and/or this report.
11
TOWN OF BARNSTABLE s`
LOCATION L t i %eCf ch SEWAGE #
VILLAGE ,,.'e. ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY o �u
. LEACHING FACILITY:
(type)�4;., nu r0g.5 (size) J
NO.OF BEDROOMS
BUILDER OR OWNS
PERMTTDATE: D COMPLIANCE DATE:
Separation Distance etween the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
f Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 20O feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility)
Feet
Furnished by
I
_ ..
__.
i
I
•.. L ` L•�
i
L '
1
1 i
1
i
No. 2' " d P --' Fee 6-1 1_/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplication for ]Dioponl *potem Construction Vermit
Application for a Permit to Construct( )Repair( )Upgrade V-)Abandon( ) El Complete System N rndividual Components
Location Address or Lot No. VgF(,'Sh 02 Owner's Name,Address and Tel.No.
Assessor's Map/Parcel �c�a_ 1 �Q�\` 0, vrer
Installer's Name,Address,and Tel.No. ` Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 1' gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 5N• Type of S.A.S. t C;--k `��-t
Description of Soil: n S-Aufl
Nature of Rep 'rs or Alterations(Answer when applicable)
Cc aC$ -( c, l
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 d of Hea
Signed Date
I Application Approved by r Date Tid?0
Application Disapproved for the following reasons
Permit No. ZZ00 / y Date Issued 3
.y No. W " // ' � � Fee J " d•S
V
A - - THE COMMONWEALTH OF MASSACHUSETTS Entered:in computer: ✓✓
k Yes,
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS .a _
Application for Mqual *pgtem Comaruction Vermit
Application for a Permit to Construct( )Repair( )Upgrade V Abandon( ) O Complete System 54ndividual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
f' Installer's Name,Address,and Tel.No. ` Designer's Name,Address and Tel.No.
\ 5 pu\s 5 �`1t cnv`vla S
Type of Building:
Dwelling No.of Bedrooms T Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow g P Y Y �
� � gallons per day. Calculated daily flow gallons. li
Plan Date, Number of sheets Revision Date
r '
Title I,,",'
Size of Septic Tank Y&i I'SQ %T. Type of S.A.S. 0 t_tV C G Oe�C'c'
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Z-7-v-51 i0A Kre-C, D - aor
I�tA i\ c r.� c.r r't L
�► r� C V1c.�� f�4t� Vk��r rt-ec�l�
Date last inspected:
Agreement:
Ttie 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 bpza4med-b ard of Heal
Signed Date -3- -'Of)
Application Approved by Date 31/wZd010.
Application Disapproved for the following reasons
k '
Permit No. Zl G �/ y I Date Issued 3
--- -------------------------------',
THE COMMONWEALTH OF MASSACHUSETTS
A,
BARNSTABLE, MASSACHUSETTS
Certificate of CompriAnce
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded(Y-)
Abandoned( )by - SF a
at c— has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 'U_RT)-/9/ dated 3/Z/Zav-->
Installer ix- - Designer _ A a � p t(5'
u
The issuance of this permit shrill not b/re"co ed as a guarantee that the system w.11-fu cGion�,tdtesigned. � �
Date < Inspector ~' V J!/ill �`�0, !% lOr
--------------------------- ------------
No. ( — L Fee
THE COMMONWEALTH OF MASSACHUSETTS
Z z /S"� PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
lwiopofW *pgtem Conotructiott Vermtt
Permission is hereby granted to Construct( )Repair( )Upgrade( Abandon( )
System located at c 4 t,Ccti�o
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 must be completed within three years of the date of this et t.
Date: ��/7.d7l7� Approved by
J T w:y
1/6/99
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.-
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
hereby certify that the application for disposal works
construction permit signed by me dated —v' "� , concerning the
. property located at 1" > 7-e8;:r\ meets all of the
following criteria:
V• This failed system is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
4 /There are no wetlands within 100 feet of the proposed septic system
(There are no private wells within 150 feet of the proposed septic system
There is no increase in flow and/or change in use proposed I
*XThere are no variances requested or needed.
The bottom of the proposed leaching facility will not be located less than five feet above the maximum
adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when
applicable]
(//• If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed
leaching facility will not be located less than fourteen(14)feet above the maximum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
B) G.W. Elevation D�- +the MAX. High G.W. Adjustment l y
DIFFERENCE BETWEEN A and B C
SIGNED: DATE: v_"�^��
[Please Sketch propo d plan of sys o back].
NOTICE
Based upon the above information,a repair permit will be issued for bedrooms maximum. No
additional bedrooms are authorized in the future without engineered septic system plans.
q:health folder:cert
i
,, ;
` :�
�.
_ � __ _ _ ��
- _ -
t
Town of Barnstable
{ I Health Department
OU" 367 Main Street, Hyannis, MA 02601
9 - /s1
Office 309-790.6265 Thomas A. McKean
FAX 308-775-3344 Director of Public Health
May, 6,.1996
Anthony Aliberti Anthony Aliberti
18 Dunster Lane 11 Rainbow Pond Dr.
Scituate, MA 02066 Walpole, MA 02081
1 i
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY
CODE H, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51
The property owned by you located at 4 Fresh Holes Road, Hyannis was inspected on '
May 16, 1996 by Christina Kuchinski, R.S. Health Inspector for the Town of Barnstable
because of a complaint. The following violations of the Town of Barnstable Rental
Ordinance Article 51 and the Sanitary Code H were observed:
410.550 B : Areas of the kitchen specifically under the sink and stove area were
infested with cockroaches.
You are directed to correct the above listed violation within forty-eight (48) days of
receipt of this notice.
You may request a hearing if written petition requesting same is received by the Board of
Health within seven (7) days after the date.order is received. However, this violation
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of not more
than $500. Each separate day's failure to comply with an order shall constitute a separate
violation.
You are also subject to non criminal citations of$40.00 for the first violation and $15.00
for each additional violation. Tickets will be issued daily until the violations are corrected.
PER ORDER O T BOARD OF HEALTH
T omas A. McKean
Director of Public Health
cc: Cynthia Lombard
M
I
14t Cox
f 9 i P61i
Mr./IV v wys Lance
fva l�olp Vw� aI���
lx
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00. STATE kSANCi'ARY
CODE 11 MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOW 4 OIL IIARNSTABLE RENTAL ORDINANCE ARTICLE 51
The property owned by you located at Y F-&sX / 4�as inspected on
p9" by 6A,W 4,P health Agent for the Town of Barnstable because of a
complaint. The following violations of the Town of Barnstable Rental Ordinance
Article 51.and the Sanitnry Code 11 were observed:
L11 s o CB)
54
• f'
l
r
y
rict d to rect levio 'on oft ' 2 f receipt this
ice b '
You are4a directed to correct the remaining above listed violations within seven
(7)days of receipt of this notice.
You may request a hearing if written petition requesting some is received by the Board of
I lealth within seven (7) days Acr the date order is received. However, these violations
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of hot more
than $500. Each separate (lay's failure to comply with an order shall constitute a separate
violation.
.
You are also subject to non criminal citations of$40.00 for the first violation and $15.00
for each additional violation. 'Tickets will be issued daily until the violations are corrected.
Enclosed are citation numbers due to violations
observed on
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
Town of Barnstable
• l
i
FORM3o HOBBSB WARREN,INC.NOV.19M1983 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY/TOWN
o DEPARTMENT
36 Y142-1/iy C/� >�CL-01-t
w ADDRESS .
/TELEPHONE
Address y S� � I !�, /7�/ �Occupan Ci ��► /� ���G,ci
Floor Apartment No,Inf-ek/ No.of Occupants �5 �'` �y�6j c—� 00
No.of Habitable Rooms No.Sleeping Rooms / G/� \ ���` �'` �/
No.dwelling or roomingunits (No.Stories J
Name and address of owner 4-f, A az4 ,Cl / <.�, /
l Pa '1D,3t"D r--�5 viv-cu-C 0,; l D��YJ, I IIM Remarks Reg. Vlo.
YARD Out Bld s.: Fences: ` /
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress:and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
i H.W.Tanks Safety and Vents
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facll. Sup.Ten.,Gas,Oil, Elect.:
Stacks Flues,Vents Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent.,Plumb.,Sanit'n.:
Wash Basin Shower or Tub: n n r
Infestation Rats Mice Roaches or Other: L4-W--AW r-z
Egress Dual and Obst'n: ,keW „p o.
General Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF PERJURY."
INSPECTOR TI LILT
r
DATE -� �9 TIME (P:MI)
A.M.
THE NEXT SCHEDULED REINSPECTION P.M.
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions, when found to exist in residential premises,
shall be deemed conditions which may.endanger or impair the health, or safety
and well-being of a person or persons occupying the premises. This listing
is composed of these items which are deemed to always have the potential to
endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499
state minimum requirements of fitness for human habitation, any violation has
the potential to fall within this category in any given situation but may not
do so in every case and therefore cannot be included in this listing. Failure
to include shall in no way be construed as.a determination that other
violations may not be found to fall within this category. Nor shall failure
to include affect the duty of the local health official to order repair or
correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833
nor shall it affect the legal obligation of the person to whom the order is
issued to comply with such order.
(A) Failure to provide a supply of water sufficient in quantity, pressure
and temperature, both hot and cold, to meet the ordinary needs of the occupant
in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or
longer.
(B) Failure to provide heat as required by 105 CMR 410.201 or. improper
venting or use of a space heater or water heater as prohibited by 105 CMR
410.200(B) and 410.202.
(C) Shut-off and/or failure to restore electricity or gas.
(D) Failure to supply the electrical facilities required by 105 CMR 410.250(B);
410.251(A), 410.253(A), 410.253(B) and the lighting in common area required
by 105 CMR 410.254.
(E) Failure to provide a safe supply of water.
.(F) Failure to provide a toilet and maintain a sewage system in operable
condition as required by 105 CMR 410.150(A)(1) and 410.300.
(GI Failure to provide adequate exits, or the obstruction of any exit,
passageway or common area caused by an object, including garbage or trash,
which prevents egress in case of an emergency 105 CMR 410.450 and 410.451.
(H) Failure to comply with the security requirements of 105 CMR 4110.480(D).
(I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602
which results in any accumulation of garbage, rubbish, filth or other causes
of sickness which may provide a food source or harborage for rodents, insects
or other pests or otherwise contribute to accidents or to the creation or
.. spread of disease.
(J) The presence of lead-based paint on a dwelling or dwelling unit in
violation of the Massachusetts Department of Public Health Regualtions for
Lead Poisoning Prevention and Control 105 CMR 460.000.
(K) Roof, foundation, or other structural defects that may expose the
occupant or anyone else to fire, burns, shock, accident or other dangers or
impairment to health or dafety.
W Failure to. install electrical, plumbing, heating and gas-burning
facilities in accordance with accepted .plumbing, heating, gas-fitting and
electrical wiring standards or failure to maintain such facilities as
are required by 105 CMR 410.351 and 410.352 so as to expose the occupant
or anyone else to fire, burns, shock, accident or other danger or impairment
to health or safety.
(M) Any of the following conditions which remain uncorrected for a period
of five or more days following- the notice to or knowledge of the owner
of said condition or conditions:
(1) lack of a kitchen sink of sufficient size and capacity for
washing dishes and kitchen utensils or lack of a stove and oven
or any defect that renders either operable.
(2) failure to provide a washbasin and a shower or bathtub as required
in 105 CMR 410.150(A)(2) and '410.150(A)(3) and any defect which
renders them inoperable.
(3) any defect in the electrical, plumbing, or heating system which makes
such system or any part thereof in violation of generally accepted
plumbing heating,• gas-fitting, or electrical wiring standards
that do not create an immediate hazard.
.W failure to maintain a safe handrail or .protective railing for every
stairway, porch balcony, roof or similar place as required by
105 CMR 410.503(A) and 410.503(B).
(5) failure to eliminate rodents, cockroaches, insect infestations and
other pests as required by 105 CMR 410.550.
(N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A)
through (M) shall be deemed to be a condition which may endanger or materially
impair the health or safety and well-being of an occupant upon the failure of
the owner to remedy said condition within the time so ordered by the board
of health.
Town of Barnstable
Health Department
367 Main Street, Hyannis, MA 0 �0
t639. '}
r
Office 508-790-6265Thom a' McKean
FAX 508-775-33" ap �eVirector of Public Health
6., May 16, 1996
Ali b rti Anthony Aliberti
st a 1 1 Rainbow Pond Dr.
�e a 66 Walpole, MA 02081
NOTICE TO ABATE VIOLATIONS OF 105 CMR 41.0.00, STATE SANITARY
CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51
The property owned by you located at 4 Fresh Holes Road, Hyannis was inspected on
May 16, 1996 by Christina Kuchinski, R.S. Health Inspector for the Town of Barnstable
because of a complaint. The following violations of the Town of Barnstable Rental
Ordinance Article 51 and the Sanitary Code II were observed:
410.550 B : Areas of the kitchen specifically under the sink and-stove area were
infested with cockroaches.
You are directed to correct the above listed violation within forty-eight (48) days of
receipt of this notice.
You may request a hearing if written petition requesting same is received by the Board of
Health within seven (7) days after the date order is received. However, this violation
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of not more
than $500. Each separate day's failure to comply with an order shall constitute a separate
violation.
You are also subject to non criminal citations of$40.00 for the first violation and $15.00
for each additional violation. Tickets will be issued daily.until the violations are corrected.
PER ORDER OF TH, BOARD OF HEALTH
TTiomas A. McKean
Director of Public Health
cc: Cynthia Lombard
SENDER:). —
HOW 88141669.- f— S, the
I
.4'.ComplOO It6i6ii446i il�iliddl y',',I; ':-,
tolio-WI-nid 96M86ii 06rAii 6�ftg
Print�6iir AiM6 iii 6d- n d 6#this ior�i fi&ilik�k6 bdi : I X
etum this card to OU.'VVPT",Y
4 Atisch this fir-M.-to thb'fi84t 6h the bi�bk If ioe-6i 1. 0 Addiaad-661ih Address
d6es not lidiljnIt. number.
4 Write Return Ci6lpt AiQieittid'!66 thb,Mallplec�below the article ber.
1"-1.1 , '. 9 El hebtricit6d D 011yiiv
A'Th6 Ffettirri Aeclllilt'will 6-h-bWt-o'W'h'6M the arti.16 Wdal dilhiwd dhd the data
dOilver6d: .. d ca fit}:?id se ;,f{.. ` . « e,' I \v v f I I i
Consult p6atmastir for fed.
ti 4a. Afflcle Number T,ArticlgAdldrilgded�tq!4m
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F
RIGGS & BROWN
TERMITE / PEST CONTROL
HOME INSPECTION
ESTABLISHED 1910
June 3, 1996
Tony Aliberti
11 Rainbow Pond Drive
Walpole, Ma 02081
RE : Duplex at : 2-4 Fresh Holes Pond Road
Hyannis, Ma
Dear Mr. Aliberti :
At your request we responded on Saturday June 1, 1996 to a roach
extermination at the above named address . On arrival the
technician found that the tenant at #4 Fresh Holes Pond Road,
Cynthia Lombard, was not prepared for treatment and was in an
apparent intoxicated state .
I
The roach extermination therefore was not performed. Please advise
.lam if you would like to reschedule the treatment .
0incerely,
Ed Brush
Manger
Griggs & Browne Pest Control, Inc .
Massachusetts: Cape Cod: Rhode Island: Connecticut:
140 Brockton Avenue 203 Main Street 175 Niantic Avenue 1020 Hanford Turnpike(Ri.85)
Abington,MA 02351 Buzzards Bay,MA 02532 Providence,RI 02907 Waterford.CT 06385
617-871-0015 508-759-2200 401-944-3400 203-444-1388
(MA) 1-800-244-1012 508-457-9444 (RI) 1-800-924-8886 1-800-962-3296
Fax 617-871-5584 Fax 508-759-5284 Fax 401-043-8083 Fax 203-447-9063
TOWN OF BARNSTABLE
WCATION \ 3 r Inds SEWAGE # 0 — O jD
VILLAGE I� i ASSESSOR'S MAP 6i LOT
INSTALLER'S NAME & PHONE N4M I
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) ' (SL1 J (size) x S
NO. OF BEDROOMS 1 PRIVATE ELL OR PUBLIC WATER
BUILDER OR OWNER 1
DATE PERMIT ISSUED: i '-! 91a
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No c�
J
r
No.. FimB
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH ,
TOWN OF BARNSTABLE
Appliratinn for 11ispuml Works Cnnnitrnr#inn rrmit
Application is hereby made for a Permit to Construct ( ) .or Repair ( - an Indi"d` -Sewage Disposal
System at:
-------------- .....................tlf.. ...............................................
I J� Location-Address � �1 �,,, por Lot No.
---•---•--- ......... ..`r_.\..L1x?.✓ -0.............................. ........................5.V3'lv..1.......................................................
Owner Address
......---G o r__._ ------��.. P���.... 4 .. .................................
Installer Address
Type of Building Size Lot----------------------------Sq. feet
U Dwelling—No. of Bedrooms....... ................................Expansion Attic ( ) Garbage Grinder ( )
p-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P4 Other fixtures -------------------------------- --
w Design Flow....... -........... .....gallons per person per day. Total daily flow.......... .......................gallons.
W Septic Tank—Liquid capacity n.gallons Length----1_6...... Width..s_._..... Diameter................ Depth................
x Lav
Disposal Trench—No.3t4 "11."Width_.. .._..._._._ Total Length... . ......... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..........................
f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 ----------------------------------------------------------------
-...
-----------
----------------
-----
------
...--...
----........
--------------------------
..._.
0 Description of Soil........................................................................................................................................................................
x
c,
w _
U Nature of Repairs or Alterations—Answer when applicable � rSt_ �_ �T ---.
tuys
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 t�rdlth.
Signed . . ------ - ------------- ------3..`. -a`..�.--a--
Dare
Application Approved By -----------------� --�. ........---...-------------------------------------------- ��..—.1.. ..x..�f�
Date
Application Disapproved for the following reasons: .................................................................................................................I—....--........
-------------------------------------------------- .........-......................----...----......------------------....----------------------------------------------........---...----............. ----------------------------------------
Dace
Permit No. ?tom.. t ..................... Issued --------------......... --...
Dace
_T
'No.... - �hf y FEE............ ...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
- TOWN OF BARNSTABLE
Appliration for Disposal.Works Tnn,strnrtion umit
Application is hereby made for a Permit to Construct ( ) or Repair ( 14 Individual Sewage Disposal
System at:
Location\-Address or Lot No.
QuJC. ..� L..Y1 �............................. ......................C.f/�.tnt P._....................................................
W Owner Address
Installer Address
Type of Building b �i �� Size Lot............................Sq. feet
.—I Dwelling—No. of Bedrooms....... ................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of ersons............................ Showers
a —Type g --•---•--------------------- P ---(----)--- Cafeteria ( )
Otherfixtures..............................................-----•-•-••-••----•----------•----•------•---•••---•••--•--- -----•--•-
W Design Flow....... ...........................gallons per person per day. Total daily flow---------� D.....................--gallons.
1:4 Septic Tank—Liquid'capacity- .��gallons Length----/?)...... Width.... ........ Diameter..........—-'Depth................
W Disposal Trench—No. J, 5Width....9,�............. Total Length.._f. ......... Total leaching area....................sq. ft.
x
Seepage Pit No--------------------- Diameter-.-----.----.----.-- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
." Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit...---.............. Depth to ground water........................
Test Pit No. 2......... .....minutes per inch Depth of Test Pit.................... Depth to ground water.....---.--..--.........
a =----------------------------------
•------------
------------
Descriptionof Soil............................................................................................
-----..;. •-;.....-•----•--•-•-•---••••-••------•--•--••---•-•-•--------.........•---
.
UNature of Repairs or Alterations—Answer when applicable=_vt_2;.1_L.\-\.....L ...... e� ..'.y—\tA4._.....
¢ Yauu _.[? �t[�.r--"- ----..ccfL.�-Z.�.STr+v-Q: d.,+..... Y?�.....-... :............
- cS
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the"pi, visions 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 bo rd of health.
$f ned
--- -- g �.... ------- ....
_ - -- -- ---- ...... .. -- ........
. �
Application Approved B :•-
Application Disapproved for the following reasons: ..........----------------------------- --==--------------------------------------------------------------------------
. . ..................................................................................................................:........................................................... .......................................
Permit No. ...........?Z2-...:.... - Issued
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(11Prtifi ate of (11ampliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �)�
by .................. `P.. .. .--...----------....------------------.......------.....---------------------------------.......-------------------"----------------
I.smll rr
at .................. - ...��. 5. -......
............\0.........................................................................................................................
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ....... ..-..�Q.t�............. dated.................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUI NC ON'$�ATISFACTORY.� i
DATE........................................................................................................ Inspector ...................... e...:......................----------------------..................
' THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH i
)
No... TOWN OF BARNSTABLE
. •_../_�.. FEE.. .................
Disposal Works 0-5onstrnrtion Vvtrmit
Permission is hereby granted............G l4A 2.C7 . 4,)..—<—Ag K1.C._.............
to Construct ( ) or Repair (L—)an Individual Sewage Disposal System
-----• ....... ----•--- ---
...•---•••-•-•----•------•------•--- -----------
---
Street /
as shown on the application for Disposal Works Construction Permit NQ.r01 1 .. Dated..........................................
�j v � ------------------------------•--------••-•---........_
(� % Board of Health
'DATE. .........................................................
FORM 36508 HOBBS A WARREN.INC..PUBLISHERS
TOWN O�1g. RAi&TAB E /-/
/ A "
LOca'FtOl�t`: 3 Desk vies . G`� SEWAGE#
VILI.AG Gh/! . ASSESSOR'S 14iQ*L(Yr .
INSTALI.ER'.�.lYAi1rIB&PI-tO1dE ATO .
SEPTIC TANK CAFAQI'X
LF.ACfIING:FACII:I'I'1�'.( ) � � {sue) .
N0:`OFBED�OONiS
B=.-' BR OR O triER
COMPIiANCE DATE:
Se ualon.Distance`Between the
Max tumAdjnstedCrroand w k T' 1 1 the$ottoiridLkachtngFad ty � t
Pmate WaterSupply;Weli aridLeac3ung Facility {If aay v�rcIis'ext
anaita or'wl�n ZQt)fit of leaciung f )
t.
Edgeo£Wetland and Leaching i"aa�ty(If any wetiaads exist -
wittun 3Q0`feet of:1 hipg ttU�� � Feet.:iz
'.
i+uriushed by: '� �L
_ —
W
qj
�t S ! `
� ^ I
G:j
f
' TOWN OF BARNSTABLE
L AbON / 7' T'�LSh 1:kk �� SEWAGE #
V41.LAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. 1
/� �
SEPTIC TANK CAPACITY U-
LEACHING FACILITY: (type) /^ I /m D/J (size)
NO.OF BEDROOMS
^ I
BUILDER OR OWNER /"1. /�I► •/^�
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching acility) Feet
Furnished by
' 'M
38` 3��.
y P9 ys
3 2� Sa
O OF BARNSTABLE "C
I,OCA C== �' %r^4.4 �Z a LQ ( SEWAGE #A00—/A
VILLAGE ASSESSOR'S MAP & LOT �`J
LNSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) .v !/r-1f —045 (size) _"
NO. OF BEDROOMS tI
BUILDER OR OWNE _
PERMTTDATE: D COMPLIANCE DATE: ' (3//-1
Separation Distance etween the: .
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility__. Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
w
�^
�J
HYANNIS. MA
.e CONTOURS NO TES
.a.s Awl, �-% ROP°
EXISTING - - - - - - - 50 EXISTING LEACHING GALLERY IS TO BE FP�MO��H
MINIMAL GRADING PROPOSED PUMPED AND REMOVED. EXCAVATE ALL p
ASSOCIATED CONTAMINATED SOILS FOR m ROP iN
FIVE LATERAL FEET AND REPLACE WITH F_7p. H1R100S
j LC33L11EACCN MEDIUM SAND PER TITLE 5 S'F LOCUS
` INRTALL(�R�7`�TAY3MOVE VENT PIPE TO A FRESRpPp
OZ� DIFFERENT LOCATION. rs Np�ES
o�J INSTALLER TO VERIFY LOCATION OF ALL
wa J� m m S�2 33.5 Ft ix 12.5 Ft x 2 Ft EX�A�A��NG U UTILITIES NDERGROUND
SYS TEM.
BEFORE
LEACHING GALLERY
PAVED EXISTING LEACHING LOCUS M A P
ti d
GALLERY NOT TO SCALE
l9=m <11 </
Z ';i ;; z �m
~ wb.
J ,, >}.}} ' N Q3 Ln
P COMMON PARKING.-* RAISE COVER HERE
0- EW o y.,.,.y..y. 0 W N� / ��a \ LEGEND
~z �u°m F-J Z 3 Ld wo / O
>_o <W< m<I j = W w z ,, c~n / O•', VENT ���3 EXISTING
wU NU3 > o �_ ` PIPET 56� 1500 GALLON ®'
L w y- U J AREA B f
O <can m x =a O O N o= SEPTIC TANK
\ O
0? Ln m W < W w ~ ` TEST PIT H-20 0
W w z � (� v o 4`\ 0 fe ® D-BOX
J U o Lux T m w �� p0� p . E / HYDRANT
� LID
o CD Qo / UTILITY POLE
z fY CDm /53 TP-1
�J ti
w wZ m Lq
IT
O LD LID \ /
I- U tr O / + ��
U Lil z M jN OF i44 �'.ZH OF AfgSSy
W W zw `�/ Q a \ GARBAGE GRINDER 2� cti o` �y
x a W z m / / h �v WATER / o DAVID DAVID �s
e O UU IW- C o / D` O 'Q ii �TFA GATE / IS NOT ALLOWED off` D. U D.
z z z wZ m m �� <r\ / WITH THIS DESIGN. COUGHANOWR N COUGHANOWR
w �_ �m �� tiF / No. 1093
WZ3 zz / O 'f'FG/ Ea�O �O /CENSE��p�
J`' O w= L9 \ \ / ST V L\j
W O ~ z I m \\ AFi�P
W 4wi (n O 3 +ff
W
m ~ N �\
it g W ��\ LOT 84 2Qc
e W Ill �',�\AREA 78z1 _- +- .\Jjy 1
W E \\ 4w J ®� �� SEWAGE DISPOSAL SYSTEM PLAN
w w z z �.\ j Q �� �iy -TO SERVE EXISTING DWELLING
Z RL A N It x- Z EST. ANTHONY & ELAINE ALBERTI
lL a 3 <m ~ ~ Q O OWNERS OF RECORD
0 of ~ < (� SCALE: 1 I n = 20 F f-
/��
O Z IL (� 1-3 FRESH HOLES ROAD
ry o ° li m W ED 20 0 20 40 �' 2�i 1995 ���- HYANNIS. MA
(l l + IS) � 0 10 20 �ON�� PROPERTY ADDRESS
LL m L BENCH MARK
43 TRIANGLE CIRCLE
ASSESSORS MAP 2g2 PARCEL 1�J�
ILL SANDWICH MA 02563 LAND COURT PLAN 17786-E
TOP OF FOUNDATION 5�8 364-D8J4
O 0 " z ELEVATION = 54.08 DATE: JUI-Y 13. 2009
-1 U)i `n 1 JOB #E T E-318 2 PAGE 1 OF 2
W VERSION:
J O w w m BARNSTABLE GIS DATUM THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE
LL PROPOSED SEPTIC SYSTEM DEPICTED HEREON, FOR ANY OTHER
CHANGES TO PROPERTY INCLUDING PLACEMENT OF ADDITIONS.
SHEDS. FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT
WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR.
SOIL TEST L O G DATE OF TEST: DAVI 2. 2009
APROVED SOIL WITNEST t7D BY VALUATOR: DAVID STANTON.DOHEOALRTH DEPT. DESIGN C A L C U L A T I 0
PERC NUMBER: 12616
TEST PIT 1 NO GROUNDWATER ENCOUNTERED DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD
PARENT MATERIAL: PROGLACIAL OUTWASH SEPTIC TANK: 440 GPD X 2 DAYS = 860 GALLONS
PERC AT 68 in - 2 MIN/INCH IN C SOILS USE EXISTING 1500 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL
ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED)
(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING DISTRIBUTION BOX: USE 3 OUTLET H-20 D-BOX.
52.75
0-24 FILL SOIL ABSORBTION SYSTEM: A 33.5 FL x 12.5 FL x 2 FL LEACHING GALLERY CAN LEACH
24-30 O LOAMY SAND 10 YR 2/1 NONE FRIABLE A s d w A = (33.5 x 133 ) = 418.75= ( 33.5 + 33..5 + 12.5 + 12.5 ) x 2 = 18 4.0 sf
30-36 A LOAMY SAND 10 YR 3/4 NONE FRIABLE ALoL = 602.75 sf
36-50 B LOAMY SAND 10 YR 5/4 NONE FRIABLE VL 0.74 x 602.75 = 446.03 GPD
48.58 USE A 33.5 FL x 12.5 FL x 2 f L GALLERY. VL = 446.03 GPD > 440 GPD REOUIRED
50-13B C MEDIUM SAND 10 YR 6/4 NONE LOOSE
41.25
TEST PIT l NO GROUNDWATER ENCOUNTERED LEACHING GALLERY DETAILCONSTRUCTION
PARENT MATERIAL: PROGLACIAL OUTWASH SHOREY PRECAST CONCRETE
PERC AT 68 in - 2 MIN/INCH IN C SOILS 500 GALLON DRYWELL 1500 GALLON SEPTIC TANK
LEACHING UNIT OR STON DIMENSIONS AND DETAIL NOT TO
ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER EQUIVALENT
(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING USE SHOREY ST-1500-H-10 SCALE
52.65 3 3.5 F L
0-20 FILL m � 1 1n
20-24 O LOAMY SAND 10 YR 2/1 NONE FRIABLE 41
m TAPER
24-30 A LOAMY SAND 10 YR 3/4 NONE FRIABLELo
Ln O O O c�i �f•-
48.65 30-4B B LOAMY SAND 10 YR 5/4 NONE FRIABLE N m o
46-132 C MEDIUM SAND 10 YR 6/4 NONE LOOSE I O 5 Ff--
41.65 0 8 1n
4.0* 8.5' 8.5' � 8.5' I�.O �
rROUNDWATER ADJUSTMENT DISTRIBUTION BOX 33.5 FL
EXISTING GROUNDWATER LEVEL DIMENSIONS AND DETAIL USE StiOREY GiB-3 H-20 LEACHING GALLERY
BASEDr.ON-TO.WN OF BARNSTABLE CROSS SECTION VIEW
GIS DEPARTMENT. RECORDS. n
�MIIN%jt'i
USE SHOREY PRECAST 5HH GALLON LEACHING DRYWELL (H-2D LOADING)DICATED GW27.00;INDEX WELL � ' A1W-230 S�CALT� 2 fn PEASTOf�E 2 In PEASTOAE INLET CENTER OUTLET
�tEND COVER END
Y _ ( ZONE D -•
'1 READINGiD'ATE`JUNE. 2009 FRDM [ -► o a
1 READING 22.9 O TANK S i TO 2 3/4 In T 24 In _ 3 IN DROP
ti yi ADJUSTMENT 3.2 m A SAS In -1 2 /n G?AVEL EFFECTIVE 3/4 In TO 26 �( FLOW LINE
-ADJUSTMENT
K;r,:, nac a ,yt ir,;.gr; " DEPTH 1-1 2 m GRA In FROM
10 ir, 14 TO
nl ® BUILDING �� a D-BOX
r. ✓x;° 6 in STONE BASE
;, , 46 in 58 in 46 in
vo CROSS SECTION VIEW LIDUID GAS
21 1ij 2 15fd In LEVEL BAFFLE
NOTE.S \ ~ INSTALLER MAY SUBSTITUTE AN APPROVED G D
FABRIC IN PLACE OF THE PEASTONE LAYER SPECIFIED
1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 500 GALLON DRYWELL
2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED DIMENSIONS AND DETAIL CROSS SECTION VIEW
FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. USE H-20 UNIT INSTALL ONE INSPECTION
TO WITHIN THREE
3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS �^ INICHES OF FINAL GRADE
OF MASSACHUSETTS TITLE 5 SEPTIC CODE 1310 CMR 15). AND INDICATE LOCATION
ON AS-BUILT CARD.
4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES
BEFORE EXCAVATING FOR SYSTEM.
5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND REMOVED. SEWAGE DISPOSAL SYSTEM PLAN
6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. 00 36
oo�� o OO�p lr' -TO SERVE EXISTING DWELLING
7) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES oao�000�oa 0000
AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. o
000
0 00 00
ccz] 00o ANTHONY & ELAINE ALBERTI
8) SEPTIC TANK IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT �o�a 0 8 1� 1-3 FRESH HOLES ROAD HYANNIS• MA
PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. Gj
1021n 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL
STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH ECO-TECH ENVIRONMENTAL
SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. 43 TRIANGLE CIRCLE SANDWICH MA 02563
10) SEPARATION OF TEES IN SEPTIC TANK SHALL BE NO LESS THAN LIQUID DEPTH. ETE-3192 JULY 13. 2009 212