HomeMy WebLinkAbout0013 FRESH HOLES ROAD - Health 13-15 Fresh Holes Rd., Hyannis
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TOWN OF BARNSTABLE
LOCATION ,�/3 —15 ��e-. V7 liS !/LA" SEWAGE#-
VlI:LAGE �y�h n`S. ASSESSOR'S N#AF LOT
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NO.OF BEDROOMS
UILDER'UR OWi�tER
pERRRFT MPLfANCl DA'I
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Separation Distance 8etrreeti fhe :� .: .
Maximum Facifity Feet
Pnvate dater Supply�deti and I.eacluag Facility (€f auy wtlls exist
on seta urthin,2t�feet of leecliag facilccy)
Edgeo€V�Metland and Leactung F�ac�ity(if any wetlands exist
wittun.3(#0€eel of'teaehing facility) JJ beef
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
, 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector:
L �-
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 y the Local Approving Authority
11-17-14
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•3/13 i Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cant.)
Inspection Summary: Check A,B,C,D or E!always complete all of Section D
A) System Passes:
Z+ 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:
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):
i
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
1
Commonwealth of Massachusetts
O
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
G M . 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Citylrown 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:
❑ 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection - Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
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:
I
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
dogged 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 'h day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. CityrTown 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 II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,. 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
El ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes'uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
t5ins-3/13 Tide 5 Official Inspection Forth: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
4M , 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner. Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: Varies
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: 11-2014Date
I
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): canons per day(gpd)
Basis of,design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? El Yes ❑ No
Non-sanitary waste discharged to the Title 5 system?, ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3113 + Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
a
. t
Commonwealth of Massachusetts
Title 5 Official Inspection Farm
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M s 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
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:
2001
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade:
24"
feet
Material of construction:
f
❑ 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: 18"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500 gal
Sludge depth:
12"
t5ins-3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System form -Not for Voluntary Assessments
M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.) t '
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
20"
Scum thickness
x
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)-
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is
required for every Hyannis MA 02601 11-17-14
page. City(rown 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.):
I
"Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 11 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. CityfTown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box.is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Good condition with water at working level and no sign of back-up from field.
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 ar9 not in working order, system is a.conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number:
6-Infiltrators.
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Infitrator field in good working order with no sign of back-up into d-box or surrounding stone.
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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
a
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is y required for every Hyannis MA 02601 11-17-14
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
F Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
C::7
t5ins-3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis- MA 02601 11-17-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 12'+
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13-15 Fresh Holes Rd
Property Address
Murphy Realty Trust
Owner Owner's Name
information is required for every Hyannis MA 02601 11-17-14
page. Cityfrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
�QfIKE
Town of Barnstable
i
U�X'MAS& Aegulatory Services
9`h iesv .0
Thomas F. Geiler, Director
Public Health Division
Thomas McKean, Director
200.Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 14, 2008
Murphy Family Real Estate Legacy LLC
25 Pierrepont Rd.
Winchester, MA. 01890
Dear Mr. Murphy(s), Mr. Campbell
I inspected 15 Fresh Holes Rd. Hyannis, MA on January 112008 because of a police call
to the residence. There are housing violations that I'must discuss with someone as soon
as possible.
I can be reached at 508-862-4740 between 8-9:30 AM and 3:30-4:30 PM. My E-Mail is
donald.desmarais@town.bamstable.ma.us.
Sincerely,
Donald Desmarais R.S.
Health Inspector
Town of Barnstable
I
Q:Heal th/orderl etters/refu se/2 74 South.doc
.�`"E'°�, Town of Barnstable
Public Health Division
NAS& 200 Main Street
CFO ru.+� Hyannis, MA 02601
Murphy Family Real Estate Legacy LLC
25 Pierrepont Rd.
Winchester, MA. 01890
TOWN OF-BARNSTABLE
BOARD OF HEALTH
ARTICLE If:MINIMUM STANDARDS FOR HUMAN HABITATION
Date
Owner Tenant
Address �� Address
Compliance Remarks or
Regulation# Yes No Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities V00,
7. Lighting and Electrical Facilities Pn�
8. Ventilation ��.
9. Installation and Maintenance of Facilities -Rip
_
10. Curtailment of Service
11. Space and Use
12. Exits
13. Installation and Maintenance of Structural -
Elements IM
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal k . ko laj")nO j
17. Temporary Housing
PART IIC9 ►'v��
37. Plocarding of Condemned Dwelling; "<`� V �' / 3
Removal of Occupants; Demolition
Person(s) Interviewed Insp ctor
If Public Building such as Store or Hotel/Motel specify here
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Town of Barnstable
y��pFTHE Tp���
Regulatory Services
BARNSrABLE. = Thomas F. Geiler, Director
�e MASS. g
Public Health Division
i
�tFO MA'S A
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
January 14, 2008
Attn: Hyannis Fire
Health Inspector Donald Desmarais conducted a housing inspection in accordance with
the State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify
the F ire D epartment i f t here i s a s moke d etector v iolation, o r p ossible s moke d etector
violation.
The following property had possible smoke detector(and\or CO detector) violation(s):
15 Fresh Holes Road, Hyannis Parcel ID 292-154
Smoke detector not operable. Also trash is being stored by gas furnace and water heater.
Donald Desmarais RS -Health Inspector
QAOrder letters\Housing viol ations\Rental ordinanceUire ViolationsTIRE TEMPLATE.doc
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TOWN OF BARNSTABLE
CF TH E T0�
OFFICE OF
i MUST BOARD OF HEALTH
i Ilse&
0o i639• �� 367 MAIN STREET
DJul HYANNIS,MASS.02601
October 24, 2001
Eric Weiner
P. O. Box
Harwichport, MA 02646
Dear Mr. Weiner:
You are granted multiple variances to replace an onsite sewage disposal system at 13-
15 Fresh Holes Road, Hyannis.
The variances granted are as follows:
• 15.211 Septic tank less than 10' from dwelling (5' variance requested)
• 15.211 Septic tank less than 10' from lot line. (7' variance requested)
• 15.211 S.A.S. less than 10' from lot line (variance of 6.7' & 7.9" requested)
• 15.248 No reserve area provided
• 15.255(5) Less than 5' overdig around S.A.S. (variance of 1.7' & 2.9' requested
These variances are granted with the following conditions:
(1) The septic system shall be installed in strict conformance with the revised plans
designed by Sweetser Engineering Company.
(2) The designing engineer shall supervise the installation of the septic system and
shall certify in writing to the Board that the system was installed in strict
conformance with the revised plans.
The variances are granted because the existing system failed and the proposed
replacement system meets the maximum feasible compliance standards contained,
within the State Environmental Code, Title V.
Sincerely yours,
Susan G. Rask, R.S.
Chairperson
Board of Health
Town of Barnstable
SGR/bcs
weiner
-� TOWN OF BARNSTABLE
-qesh HdeS �Unf `LOC TICN ��.
SEWAGE # o?dU
VII LAGE n f ASSESSOR'S MAP & LOT
INSTALLER'S NAME& PHONE NO.hcvl , e r
i
SEPTIC TANK CAPACITY /
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS a
BUILDER OR OWNER +i'WJ Hdr0h(4 / /,
PERMITDATE: COMPL DATE: 0/
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 leachi]g faci • ) N I 1r Feet
Furnished by
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
TOWN F BARNSTABLE MASSACHUSETTS Ye
o PU LIC HEALTH DIVISION TO O s
plitation for Mio7Upgrade(
Y 6pgtem Conotruction Permit 0\ r 7,0
Apph ation for a Permit to Construct( )Repair( )Abandon( ) El Complete System O Individual Components
Location Address or Lot No. ( C Owner's Name,Address and Tel.No.
1715)
r
Assessor's Map/Parce , 1 v /."/ i G� 'z G �.i' l._ i? „Y� �
Ins alle's Name,Ad ss,anQ Tel. o. Designer's Name,Address and e).No.
30,E 1S5 r
Ll S AnP 021o01
Type of Building:
Dwelling No.of Bedrooms- H Lot Size sq.ft. Garbage Grinder
Other TY a of Building w�'►-'��— No.of Persons Showers((.) Cafeteria( )
Other Fixtures v b 1.b
Design Flow gallons per day. Calculated daily flow 'y L2 gallons.
Plan Date Number of sheets Revision Date _
Title PERNE,t"
Size of Septic Tank er ���— Type of-S�A�9411 10'��
IN3TP&I-Ai iv, p U.-
Description of Soil. 6�"�>3� �ryE SYSTEM WAS 1NS,�1
CCORD
Nature of Repairs or Alterations(Answer when applicable) e P ) fed__2 Mrs=jey_�
Date last inspected: ti' � N., /6
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 Env'/ nmental Code nd t to the sy tern i erati nn until a Certifi-
cate of Compliance has been issued b oar eal
Si i b� Date Z I
Application Approved by 4 Date 0
Application Disapproved for the following easons
Permit No. Date Issued
W_-rrw
Is
_ L . ._lee'.
a` htered in computer:
THE COMMONWEALTH OF MASSACHUSETTS .
_ _.. ..�• { pf a Yes I \
PUBLIC HEALTH-DIVISION -TOWN"OF BARNSTABLE., MASSACH (SETTS (o
Ytcatior� fosrigogaY �pgtern 0t�gtructtoriern�ft ,\�' '
Appli ation foi a Permit to Construct(`. )Repair( Upgrae( )Abandon( .) 7(Complete System`�O Individual Components lam; II A,
Location Address or Lot No. i Owner's Name;Address and Tel.No.
Assessor's Map/Pazce 'V ! G 1— J b �
AA. � � � ,
1 r�
Installer's Name,Ad ss,and.Tel. o. Designer's Nam ddrpess-and e�.No�.
Ob2rl'S p� 1L.. f 4' t �.d8 ,�;� VS1Y Ay
Ct ) S . �'1 P•�(00 1 ��M• .10S tt> V
Ty RPe of Building: f .. p j'
Dwelling No.of Bedroom Lot Sizes'q+(ft! f Ga�rbag"e Grinder( )/
>_
Other a of Buildin VS)LT No.of PersonsP. owers00 Cafeteria Y, `
a�S Other Fixtures W b2_M641_ Ile
.� ' •r �r � v 4Z
x Design Flow J4 4"V N-- gallons per day. Calculated dailyrflow �' 1 gallons'
Plan Date Number of sheets Revision Date
Title " N
rSize of Septic Tank I J�; )52) 4•Q 7. . •"4 Type of S.A.S. °1-7,02
Description of Soil; zf� p-vb - �� y��'�' • ti
Nature of Repairs or Alterations(Answer when ap licable) e_P I_f�a.-�M�o✓�''�-' / �yJ'p �'�3'�
NT
z- Date last inspected: `v
- , Agreement:
` n Tye undersigned agrees to ensure•'the construction and maintenance of the afore described on-site sewage dis osal system
y,i�Y g � .y g P, Y
ry,:- • in accordance with the provisions of'fitle� of the Env gdnmental Code nd t to pl the system in o eration until a Certifi-
t cate of Compliance has been issued b`' o PIealt� 'r 1`� � ��
11
Si „ _ f Date .0
y Application Approved by _ "'� ', x r` Date D _
/11 Application Disapproved for the following easons l . .� �� .;'
Permit No. -�`�- --'"� Date Issued
THE COMMONWE<JH OF MASSACHUSETTS
BARNSTA'BLE, MASSACHUSETTS
n Certificate of Compliance—
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( )
----Abandon s
at,. has constructed in accordance
with the p •visi ns of T��i>>tl�e 5 and the for Disposal Sy tem'Cons ctio ermit N dated
,.Installer YZ ,u 1 a�t4 (0) !�S �XA C—�Designer
f�+'r The issuance f Vpermit shall not be construed asla guarantee that the system will function as designed.
Date �•��� 1 �. Inspector ���/•
� J
' No. ——— -- .�r` U�•� `� � �..n �—f j—y—•T——--—'————Fee C,��/+
THE COMMONWEALTH OF MASSACHUSETTS
P_ U.BL'ICE HEALT (DIVISION 6"BARKSTAB LE., MASSACHUSETTS r,
gtenx_&arigtruc 'o�m P rrnit -
Permission is hereby granEed�Co'`n"structl�'�'LRepair,`�� Tpgrade( 1 ,�'andon( ) =I
�- System located at �ff�'f�j/`> l?'SYI 8 ,PDCt/;L 0� .
�� Y•1�Li►° W 1 f 1 -
and as desd 'bed in the above Application-for Disposal'System Construction Permit:� e,applicant recognizes'his/her duty-to
comply with Title 5 and the following local provisions or.special c nditiQns.
Provided:C ns tion must a co pleted within three years of the date of thi
r O .
Approved byAk
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t7 P5
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41.
November 09, 2001
1345 Fresh Holes Road
Hyannis,AM
Mr. Thomas McKean
This is to certify that the septic system installed at the above mentioned property has been
installed in substantial compliance with the plans drawn by Sweetser Engineering.
Sincerely,
9
Thomas Marcell A .
���ZN OF Itilgss9c
cz THOMAS yG
MARCELLO
c� CIVIL
o.24421
�o RE o
11 Lila Circle
Wellesley, Mass, 02482
August 30, 2001
Thomas McKean, Director
Board of Health
Town of Barnstable
367 Main Street
Hyannis, Mass. 02601
Re: Plan Required for Septic System Permit No. 2001-548
13 - 15 Fresh Holes Road, Hyannis
Dear Mr. McKean:
Enclosed please find Two (2) copies of a plan titled
"Proposed Septic Disposal System" for 13 and 15 Fresh Holes
Road, Hyannis.
The proposed system will replace the existing cesspool
system serving the building that has failed. I believe the
plans describe fully the system we propose to install to
replace the failed present system. Your review and favor-
able approval of the proposal will allow us to move with
dispatch to instill the replacement system.
We would appreciate it; upon approval of the plans for
the replacement system, your reinstatement of the above cited
permit . This will allow us to install the replacement system
expeditiously.
Very truly yo s:
RECEIVED
Rober Murphy. P.
SEP 5` 2001 address as abov
tel. 1-781-23 676,V
TOWN OF BARNSTABLE
HEALTH DEPT. 1
l
I
Dp qqy�ggAAIMVETp.�� DATE: L! ^ G -
FEE:
• aARNsrABLB.
MASS.
1639. `0� REC. BY aivo
Town of Barnstable SCHED. DATE;/A!�Z )
Board of Health C
367 Main Street, Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,R.S.
FAX: 508-790-6304 Sumner Kaufman,M.S.P.H.
Ralph A.Murphy,M.D.
VARIANCE REQUEST FORM
LOCATION
Property Address: 13-15 Fresh Holes Road, Hyannis
Assessor's Map and Parcel Number: 292/154 Size of Lot: 6252 sf
Wetlands Within 300 Ft. Yes Business Name:
No x Subdivision Name: L.C. Plan 17786E
APPLICANT'S NAME: Sweetser Engineering Phone 508-398-3922
Did the owner of the property authorize you to represent him or her? Yes X No
PROPERTY OWNER'S NAME CONTACT PERSON
Richard T. Murphy, et al
Name: MR & R Realty, LLC. . Attn: Campbell Name: Eric Witter, Co—Owner
122 Chestnut Street
Address: E. CBridgewater, MA 02113-2119 Address: P.O. Box 566, Harwich Port, MA
Phone: Phone: 508-430-4308
MAXIMUM FEASIBLE COMPLIANCE FOR THE REPAIR OF A FAILED SEPTIC SYSTEM
VARIANCE FROM REGULATION(List Res.) REASON FOR VARIANCE(May attach if more space needed)
15.211 Septic tank less than 10' from dwelling (5' variance requested)
15.211 Septic tank less than 10' from lot line. (7' variance requested)
15.211 S.A.S. less than 10' from lot line (variance of 6.7' & 7.9' requested)
15.248 No reserve area provided
15.255(5) Less than 5' overdig around S.A.S. (variance of 1.7' & 2.9' requested
if permission of abutters not obtainable
Variances requested for most feasible compliance due to shape and size of lot
Checklist(to be completed.by office staff-person receiving variance request application)
X Four 4 copies of engineered plan submitted e.g.septic stem plans)
O P � P ( � p Y P )
Four-(4)copies of floor plan submitted(e.g. house plans or restaurant kitchen plans)
Signed letter stating that the property owner authorized you to represent him/her for this request
X Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
N/A Variance request application fee collected(no Pee for lifeguard modification renewals.grease trap variance renewals(same owner/leasee only).outside
dining variance renewals(same owneuleasee only),and variances to repair failed sewage disposal systems(only if no expansion to the building proposed))
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Susan G. Rask, R.S:, Chairman
NOT APPROVED Sumner Kaufman, M.S.P.H.
REASON FOR DISAPPROVAL Ralph A.Murphy, M.D.
Q:/WP/VARIREQ
I
S WEET SER ENGINEERING
P.O. BOX 713-SOUTH DENNIS—MASSACHUSETTS 02660
TEL (508) 398-3922 FAX(508) 398-3063
LAND SURVEYING—ENGINEERING—TITLE 5 SEPTIC SYSTEMS
October.5,2001
NOTIFICATION TO ABUTTERS OF;
Qwner; Richard T. Murphy, et- CERTIFIED MAIL
MR&R Realty, LLC RETURN RECEIPT REQUESTED
122 Chestnut Street
E. Bridgewater, MA 02333-2119
Re: Septic System at 13-15 Fresh Holes Road, Hyannis
Dear Abutter,
This letter is to serve as off6ial notification to abutxer(s) that a public hearing has begin s h-edulw for the
Barnstable Board of Health to take action on an application for variances from the Regulations of the
Mass. Department of Environmental Protection, Title 5, and/or the Town of Barnstable Regulations for
Subsurface Disposal of Sewage, as follows:
Title 5 Section: 15.211
Septic tank less than 10' from dwelling (variance of 5')
Septic tank less than 10' from lot line (variance of T)
Soil absorption system less than 10' from lot line (variance of 6.7' &7.9')
Title 5 Section: 15.245
No reserve area provided
Title 5 Section: 152,55(5)
Request for less than 5' overdig around soil absorption system if permission of abutters not
obtainable (variance of 1.7' &2.9')
Said hearing will be held at the Second Floor Conference Room, New Town Hall, 367 Main Street,
Hyannis, Ma on Tuesday October 16, 2001 at 7:00 PM or as soon thereafter as practicable.
Sincerely, ,
Robin W.Wilcox,PLS
Representative
r,
ABUTTERS OF MR&, R REALTY
AM 292/154 13-15 Fresh Holes Rd, Hyannis
Locus Hilo # 252
Bd of Health
Richard T. Murphy, et al
AM 292/154 MR 8s R Realty, Attn Campbell
Owners 122 Chestnut:Sli eet
E. Bridgewater, MA 02333-2119
Howard Winer, Trustee
AM 292/152 Winer Realty Trust
P.D. Box 434
Harwich Port, MA 02646
Charles E. Mason
AM 292/155 C/o Howard A. Winer, Trustee
P.D. Box 434
Harwich Port, MA 02646
Richard P. Fennucio, Jr.
AM 292/159 Jeffrey P: Fennucio
1 Wachusett Drive
Sutton, MA 01590
WINER REALTY TRUST
P.O. BOX 434
HARWICH PORT MA, 02646
PHONE 508 432-8005
FAX 508 432-8006
10/08/01
To Whom It May Concern,
Please let this letter serve as permission for Sweetser Engineering as well as
the septic installation company to travel over our property while installing a
new system for 13-15 Fresh Holes Road Hyannis;MA. They will also have
permission to use a small portion of our land for overdig. The property must
be returned to a hazard free condition.
At this point in time we do not give permission for any parts of the septic
system for 13-15 Fresh Holes Road Hyannis to be located on the adjacent
properties 9-11, and 17-19 Fresh.Holes Road.
N
ely,
rd A. Winer
Trustee
r
Eric J. Winer
Trustee WRT 14
MR&R REALTY TRUST
40 WILLARD STREET
SUITE 105
Q UINCY MA, 02169
10/08/01
To Whoin It May Concern,
Please allow this letter to give Sweetser Engineering full permission to
represent MR&R Realty Trust at all Public Hearings in an effort to replace
the septic system at 13-15 Fresh Holes Road Hyannis, MA.
Thank you for your Cooperation.
Sincerely,
Eric J. Winer
Sep-06-01 09:48 BARNSTABLE HEALTH DEPT S087906304 P-02
BIKE r, DATIR:
• y FEE:
RAIW91PAVUL
MASS.
�y sbgg. �� REC. BY
.
ff°"tea Town ®f Barnstable
SCHED. DATE:
Board ®f Health
367 Main Street,Hyannis MA 02601
Office: 508.862 4644 Susan G_Rask,R.S.
FAX: 508-790-6304 Sumner Kaufman,M.S.P.H.
Ralph A.Murphy,M-D.
VARIAiNCE gLQUEST1i' FORM
LOCATION
Property Address: 13 and 15 Fresh Holes .Road, Hyannis
Assessor's Map and Parcel Number: z_`— 1 �j y Size of Lot: C/ . I
Wetlands Within 300 Ft. Yes _ Business Name: _
No XX Subdivision Name: Captain S QUar ers
APPLICANT'S NAME:Robert H. Murphy Phone 1-781-237-6761
Did the owner of the property authorize you to represent him or her? Yes XX No
PROPERTY OWNER'S NAME CONTACT PERSON
Name. Robert H. Murphy and others_ Name: Robert H. Murphy
1 02�82 Wellesley 02482
Address: 1 Lilac Circle, Wellesley Address: 11 Lilac Circle, y
Phone: 1-781-237-6761 Phone: 1-781-237-6761
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(Maya ach if more s ace need )
10 foot setback from e s e, shape and confM-uration
property line - for of the lot does not allow a re-
septic tank and soil placement septic system to meet
absorption__system the setback requirements.
NATURE OF WORK: House Addition O House Renovation O Repair of Failed Septic System
Cberklisl(to he completed by office staff-person receiving variance,equev application)
Four(4)copies ofthe completed valiance request t'nrm
_ Four(4)copies ofenginecred plan submitted(e.g.septic system plans)
Foul(4)copies of labeled dimensional fluor plans submitted(e.g.house plans or restaurant kitchen plans)
_ Signed later stating that the property owner authnrized you to represent him/her for this request
_ Applicant understands that the abutters must be noti lied by certified mail at least ten days print to meeting date at applicant's expense
(for Title V and/or local sewage regulation variances only)
_ Full menu submitted(for grease trap variance requests only)
_ Variance request application fee collected(no fee for lifeguard modification tencwals.grease trap variance renewals[same
owner/leasee only),outside dining variance renewals[same owner/leasee only),and variances to repair failed sewage disposal systems
(only if nn expansion ro the building prnposedl)
i Variarce request submitted at least i5 days prior to meeting date j
VARIAM I'APPROVED Susan t1 Rask,R.S.,Chairman .
NOT APPROVED Sumner Kaufman,M.S.P.H.
REASON FOR❑ISAPPROVAi. Ralph A.Murphy.M.D.
Q:/i9P/VAR:REQ _
No.. Fxs..................-?:.......
THE COMMONWEALTH.OF MASSACHUSETTS
BOARD f E HEALTH
v'Ns . .
'S
ApplirFa#ion for Disposal Works Tonstrurtiun Fautit
Application is hereby made for a Permit to Construct ( ) or Repair (X an Individual Sewage Disposal
System at:
................__...... ._.........
..__----•--•- --•-_____... . -•-••- ••-••••- ...........
Location-AddreJJs/� or I,ot
............... ....�!_�. L..f..�r........ ............. ../�fr l.S.....__•__',.ai _f &IE/O
a .................
Installer Address
Type of Building Size Lot............................Sq. feet
�. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
'k Other—T e of Building No. of persons............................ Showers — Cafeteria
Other fixtures .
-----...-------•---- ---•----------------•---•-----------.
WDesign Flow...........................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.....................Total Length.....................Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
t Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-._._-_____-_-__---___--
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
------------------ .....................
....-•.................................................................................................
Descriptionof Soil--------------------------------------•-----------------•------------------._...------------------------------...-----------------------------••-•-••--•---------------.
x
x ----------------------------••••••-•---•----------------------------------------------------••-•--•------•-•--------------- - =- -----------
---------- -
U Nat of Re airs or Alterations— er when ap licapl / .................................... .....�.._._�. .........
..
� r ----••-•-------• iLtit--=-` C c +....4a�.,
O ...............................................................
Agreemen
The undersigned agrees to install the aforedesc d Individual Sewa Disposal System in accordance with
the provisions of TITLL 5 of the State Sanitary Co — The undersigned rt er agrees t to place the system in
operation until a Certificate of Compliance has been ' ued by the bpard li -th. r
gned- -•
...
-- .
/ i Date
Application Approved By.................... ........... •. . •........... .lQ�.i��d......
Application Disapproved for the f ollowt easons:---•---•----------- -----------------------------------------------------------••-----.---••-•----------
••.............••---••••-----------------•--------------•-•....------------------••.........-------•••-••--------------=-------------------------------.--------------•-••-----------------•--.........
Date
PermitNo......................................................... Issued-.......................................................
Date
�f
FEB.-....d d•_......_.
i THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE -TH
OF..... ..........
. ---------•..................................
Appliration for Disposal Works Tontrn.rtion 1hrutit
Application is hereby made for a Permit'to Construct ( ) or Repair ()< an Individual Sewage Disposal
System at: .
................-....... ....._....•--..................................... .......•-----------------•----------------•------1..�:'-------••-•------•----.-------.-•----•--
L cation-Addr s
...............
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M Installer Address
Q7i Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building No. of persons............................ Showers
YP g --------•------------------- P ( )--- Cafeteria (---->-
Otherfixtures ----------------------- _... --------.•••-•---•----•--•••-•--••••-•--------••-••--•----••-••••••••..
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal-Trench—No..................... Width.....................Total Length.................... Total leaching area.................:.-sq. ft.
Seepage Pit No--------------------- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank•( )
Percolation Test Results Performed by........................................................................... Date........................................ .
,.� Test Pit No. I................minutes per inch Depth of Test Pit..................... Depth to ground water.........................
G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 ••-•-•-•-•-•••----••-••••••••••-•-•-•••---•-••••-••-••=•---.......•---------•.................................................................................
0 Description of Soil..........................................................................................................................................................................
---------------------•--•-----------•-------------------------------------------------------------------------- ------• - .
U Natur o Repairs or erations— wren ap 1'c � '� �r ���-------.Ge/ )I.Fer
.. `------------------------�------------•-----•--.............
A eemen f:
The undersigned agrees to install the aforedesci ed Individual Sewa Disposal System in accordance with
the provisions of TIT Li 5 of the Statt'Santary Cod — The undersigned r er agrees t to place the system in
operation until a Certificate of Compliance has been' ued by the kDard o h th.
,Sign
Application Approved BY --------------�.--• ........ '° to G..-
ate
Application Disapproved for the follow easons:_ =^�='s....
---------------------•-------------------------------------...--------•--••----...........................:........................ °................................................................
Date
e
Permit No......................................................... ' Issued---'
..................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T rt'
.................... ............. ....OF....... ..................:..........................................
�er#if irate of Tontplionre
THIS IS CE TIF That the Lndividual Sewage Disposal System constructed ( ) or Repaired ( )
---' ---------------
has been installed in accordan�_�t provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No----- 56_7................ dated................................................
THE ISSUANCE 6f THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
l
DATE............... ...........ld 1.�? gr� Inspector -------•--•---.------
f t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF .H•EA-L:•TH
r ...........!!.............................O F....._...:............ ...........................................
No... G...56.7 FEE........................
�ioriottl rko �on #rttrio rani
Permission is hereby granted. 4'►-•. Ce,
------•----------------------------------•. ••-••-•••----••••----••-•••-•••••••••-•-•.......-•--••-•................
to Construct ( or epair ) an divi ual , ew� agge Disposal System.,
i
iv /�
at No............ ..................................•---•-••-•••---- •----•--------------•------------•••......--.........
--------------
Street
as shown on the application for Disposal Works Constructio p-Perp rt No.................... at _......:._....__.....____..._.....__.
-----------------------------------------••••-•--••••. --•••--•-•--....•-----....••--.......-----••-
/ •
DATE------.... Boar Health� �t�
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS. 4•
Aj ION Z;S'E W A G E PE RMIT NO.
:-, VULAGE ma 's- :�
I N S T A LLER'S NAME i ADDRESS
• CJ¢�r`� Co.
3 UILDE R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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SEPTIC SYSTEM CALCULATIONS
_ 11 a bed room 440 als da total u.,
Bed-Rooms at 0 g 1/ g . / y
Percolation Rate - Less than 2 min/inch.
Area,Required/Gallon - 1 .35 sq. ft.
Leaching Area Required 440 gals/day `x 1 .35 sq. ft./gal. = 594 sq. ft.
" " "Infiltrator" roe, tUse a single row with 9 Infiltrator chambers. Each Infiltrator 3 ft. wide x �u��=E ��JA� �-��D
2 ft. high x 6 ft.-3 in. long, set in a stone bed 59 ft. long x 2 ft.-4 in. deep
x it ft. wide as per plan and cross sections. - -d" 3'-D" oil
Determine Determine Adequacy of Area of Stone Bed - S94 sq. ft. ; 56.25 (length of 9 "In- '
j filtrators") = 10.56 ft. width required. 11 ft. width proposed.
Determine Adequacy of Leaching Area - 9 "Infiltrator" units x 66 gals/unit = 660 _
gallons. In excess of the 440 gallon requirement.
Provide 1500 gallon septic tank as required.
Provide 1 standard distribution box as required.
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B�rtCBwR SOIL TEST P 10 084
TOP OF SLAB 20 FT. MINIMUM FROM CELLAR
00- 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE ES SOIL TEST �� X01
ELEV. = 100.
_ CLEAN SAND SOit TEST DONE BY F3._1d11.Q_4X_ -
(ASSUMED) CONCRETE WITNESSED BY _L McCQNNELL
COVERS LOAM AND SEED z ' 1" 4`
4" SCHEDULE 40 PVC PIPE. ��. �' �«• � ELEV.- 98.80
OBSERVATION HOLE
MIN. PITCH 1/8" PER FL 2" LAYER OF ` PERCOLATION RATE < 2 MIN:/INCH AT 59 INCHES
1/8" TO 1/2" x' `= DEPTH HORIZ TEXTURE COLOR MOTT. OTHER
LEGEND:
„ 98�0 MAX. WASHED STONE VENT EXISTING SPOT ELEVATION 00,�0 0-22 FILL
VARIES 4" CAST IRON PIPE 9076 MIN. REQUIRED EXISTING CONTOUR ----00----
(OR EQUAL) MINIMUM FINAL SPOT ELEVATION F- 22-27 AfE LOAMY SAND 10YR3/1 NO ROOTS
PITCH 1/4" PER FT. 1 CU. FT. OF CONCRETE FINAL CONTOUR -
ANCHOR
' 9�,� � 27-42 B LOAMY SANG 10YR7/6 ROOTS
FLOW LINE ? �, ANCHORS SOIL TEST LOCATION UTILITY POLE -0--
ELEV. VARI TOWN WATER =W -W= 42-66 Cl MEDIUM SAND 2.5Y8/6 SLIGHTLY LOAMY
10"
-�- Tl� " o o J 10% GRAVELS
o CATCH BASINELEV. _ _ � L o d ��G Y, � 0 10� o ELEV. -4 Li GAS LINE C94 4 1ELEV. _ _ � GAS ELEV. _ _ � t` 6" SUMP . = _�5�r* o _ _ _ 04 �� a a - CLEAN OUT V v 66-120 C2 MEDIUM
BAFFLE ° o 0 o a o 0 0 0 0 0 o c o o COARS�SAND
DIS 1 RIvUTfON ° o ° o a o o o g 8 ELEV. = 9 D L CESSPOOL C.P. O
ELEV. _
LIQUID OUTLET, 6 HIGH CAPACITY INFILTRATORS WITH
BOX -l&3A0- STONE IN ANDEPTH TEE VI�JYL
4 FEET 14 INCHES (TO BE PLACED ON FIRM BASE) TO BE WATER TESTED
5 FEET 14 INCHES IF MORE THAN ONE OUTLET 11' X 42' X llr TRENCH FORMATION 5
6 FEET 24 INCHES 500 GALLON SViL ABSORPTION l0N �' NO WATER ENCOUNTERED AT 170" ELEV.
7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) 'SOIL G7 VOR Vial WELL N A
ZONE
8 FEET 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" CLEAN INDEXDOUBLE WASHED STONE SYSTEM {SAS) ADJUST i L y2Sv
FREE OF FINES & SILT DESIGN CAL.CiULA 11ONS '
ELEV. = NUMBER
SEWAGE DISPOSAL SYSTEM PROFILE OBSERVEDUSGS WATERRTABLELE( WA�R /BL) ELEV. _ __ .___ GARBAGEODISPOSAOLOMS UNIT NQ
NOT TO SCALE BOTTOM OF TEST HOLE ELEV. - 8&K- TOTAL ESTIMATED FLOW
( 110 GAL./BR./0AY X 4_ SR.) -MO- GAL./DAY
REQUIRED SEPTIC TANK CAPACITY _J4 GAL.
ACTUAL SIZE OF SEPTIC TANK Z GAL
SOIL CLASSIFICATION
DESIGN PERCOLATION RATE Ste__ MIN./IN.
EFFLUENT LOADING RATE Dj4_ GAL./DAY/S.F.
LEACHING AREA 821.00 SQ. FT.
(11 X42)+(53X2X1.5)
LEACHING CAPACITY (AREA -X RATE) 4 9-H GAL/DAY
- 821.00 X 0.74
RESERVE LEACHING CAPACITY NONE GAL./DAY
NOTES:
1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
BARNSTA@LF
14. VARIANCES TO TITLE 5 AND BAR B ---- RULES AND
E REGULATIONS: TITLE 5 AND THE TOWN OF REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.
A. SEPTIC TANK LESS THAN 10' FROMM BUILDING.B. SEPTIC TANK LESS THAN 10' FROM LOT LINE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
C. SOIL ABSORPTION SYSTEM LESS. THAN 10' FROM LOT LINE. WITHIN 6" OF FINISHED GRADE.
OL 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL 8E CAPABLE OF
D. LESS THAN THE 5' OVERDIG AROUND SOIL ABSORPTION SYSTEM. WITHSTANDING H-10 LOADING UNLESS. THEY ARE UNDER OR WITHIN
E. NO RESERVE AREA. 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
X 9'8.8 USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. '
r 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL
BE MORTARED IN PLACE.
5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH
(DEEDED OR'ZONING REGULATIONS.'OWNER / ArPLICANT IS TO
LOT SO LOT 80A OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR
6 IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS
X 99.1 23 8 �� PRIOR TO COMMENCING WORK ON SITE.
7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION
IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
' �4, IMMEDIATELY.
6� �Q W X-98 18 S. PARCEL IS IN FLOOD ZONE _ C
T 9. "LOT `IS`'SHOWN ON ASSESSORS_MAP- 292 AS PARCEL: 154
L 10. PIPING MAY NEED TO BE RAISED TO EXIT AS SHOWN.
0.2 ARE 6252 S.F.f W _x 98.3 -�� `� 11. EXISTING CESSPOOLS ARE TO BE PUMPED AND REMOVED.
12. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER AND FOR
f A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE REPLACED
9$.7 `�� ` j WITH SAND AS SPECIFIED IN 310 CMR 15.255:(3).
` kt• 13. PERMISSION TO. DO THE OVERDIG SPECIFIED IN 12 ABOVE ON ABUTTING
141
EXISTING DUPLEX , �r OF 4460�.
vNMc 2 BEDROOMS EACH SIDE Bye X 6 t S�`S LOTS IS BEING SOUGHT, A VARIANCE IS REQUESTED IF UNABLE TO OBTAIN.
INV. = 98.65 4 BEDROOMS TOTAL �0 98. T. A. APPROVED: BOARD OF HEALTH
o DUMA
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a C.O. INV. .= 97.50 c, ., K, No. 61
O 1 INV. = 97.15
C.O. .
E� D. BOX . N
.0. p gNITAR�P
DATE AGENT
8
o PROPOSED SEPTIC DESIGN
00' FOR
!�
42• 2 21 1500 GALLON LOT 82 �
3¢06 SEPTIC TANK ERIC 1�I11��R
SOILS /�
TEST LIMIT OF ROUTE 2B LOC. IAT 819 LC. PL. 17786E
5' OVERDIG Loc'Us 13-15 FRESH HOLES RD. BAMMLE MA.
�.�Ov SwAWISRR ANGLNEUNG
u' 235 GREAT WESTERN ROAD
508- P. 0. BOX 713
398-3922 SOUTH DENNIS, MASS. 02660
['DATE OCT 3, 2001 SCALE .� �, _ 20'
REVISEDocs, 17 Z / 1011 No. 5252-00
REVISED a0 1
. LOCATION MAP �al/ /!�2 SHEET 1 OF
C: S8 PROJ 5252-00 dw 5252-OO.DWG '0 2001 SWEETSER ENGINEERING