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0005 HAMDEN CIRCLE - Health
5 Hamden Circle Hyannis P — A = 291 190 �i a F e 4. s, d� I a a No. �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: j Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0ppYication for Oigoi[ *p!tem Con4truction Permit Application for a Permit to Construct( )Repair( )Upgrade(t/ )Abandon( ) ❑Complete System k Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. VQV4 V➢L M ILV i p �y I O LoulS �. '� itT i I{o; A�N1S MIA Assessor's Map/Parcel ��'� � �9 0 Installer's Name,Address,and Tel.No. PAST006 e4CftVA ➢ Designer's Name,Address and Tel.No. F_N d 1 N NI�M W RG C. lZ�� . ➢=©dam®A L� N1 iZ my Ct�oSS t �dI? 'Tf) �SDB 47,0. -g30c) S o � Lm - S ' Type of Building: 2 Dwelling No.of Bedrooms y Lot Size Jl23& sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 33) 9 gallons. Plan Date 1`15- 04 Number of sheets ? Revision Date Title Size of Septic Tank l X 1—) t #J$ 1 Ott 0 91 Type of S.A.S. C VAAM FRS Description of Soil Nature of Repairs or Alterations(Answer when applicable) 42.tPLA( -1a i/ 2_ �a) a H Ammon c —H TTO,�J$ ors) ,AtA- S 1 OMS- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been' s e thi do Health. ;< Signed YY�I 1 Date 5 Application Approved by _ Datele-lag Application Disapproved f t e following reasons Permit No. Date Issued-- No. * 1 . Fee D� THE COMMONWEALTH OF MASSACHUSETTS r• Entered in computer: PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS Yes 0 Ytcation for �c� aal Stem Construction ermit Application for a Permit to Construct( )Repair( )Upgrade(✓ )Abandon( ) ❑Complete System k Individual Components Location Address or Lot 1Vo. .}�A N`,�ANN IS Owner's Name,Address and Tel.No. VQ Y% V 1 L Dus iw 1p + 1 10 LOuIS Si. vNrc Hy'atuNlS Mv\ Assessor's Map/Parcel Z�j� 1 Installer's Name,Address,and Tel.No. 7A5709'6 e4CAV16TI Designer's Name;Address and Tel.No. Cti 6 t ?Qri C2 (luck@ P,G B C4 I7-$9 F=aft-'S-t p.A a M W I-L w• (.G 20SS f:1SL_JD -F0 2b:;�TO r%L-G (SaB� 44Z; -9100 ( Scep Lj71 " S3t3 ,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 37o gallons per day. Calculated daily flow 331 •Z gallons. Plan Date f '15- 01 Number of sheets '�- Revision Date Title Size of Septic Tank Cx iS i'1 +J b 1000 91 Type of S.A.S. C H AM9£2--, Z 500 01 ` Description of Soil S't VLAt,.NS Nature of Repairs or Alterations(Answer when applicable) 2£PLA6Z SAS W/ Z. 500 Q) C Nf tAQ!Gf v►.I 4f STq'Ns otv At—(.. S 1 nT 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 bee ss �thi rd of Health. SignedPA XcC—A 'A f'1 J Date 1 7 Application Approved by V / Date v Application Disapproved f a fol't lowing reasons Permit No. Date Issued ; ———————— ---- =-- -----------�— ----- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate-of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired ( )Upgraded O Ct Abandoned( )by PPS b Q:S 'FX ,,0,VA-1 101-) at 9 H f1 MOBt,", G t RCLZ as% constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N . i U '%dated Installer PrgTafLT. Dt�.A��`i 11T� Designer G IN ke (fie mszs The issuance of this permit shall�jott-be domtrued as a guarantee that the sys If tem w'1'1,urn yti�n as designed. Date �Y C3 r.l Inspector F .�.C�J --- No. _`VI Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS nigpogar *pgtem Construction permit Permission is hereby granted to Construct( �R air( t Upgr 9c d�bn�(-, ) System located at 5 Wfl MORN I � � Y 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:Constr ctio .iist be mpleted within three years of the date of this erilriit. Date:_-_�� j� Approved by / 7 f Town of Barnstable Regulatory Services Thomas F.Geller, Director NAM Public Health Division_ 3Y 'Tbomas McKean, Director 200 Main Street,Hyena* 02601 Office: 508.-962-4644 Fax: 508-794-6304 I��l� near�er��c�tioao T`or , Date- _ _. Sewage Permit# a��� Assessor's NZaplPasacei__-._-�..� a Designer; ����rVtL,��in�Mt��v� Installer: Address: �a C S S$-.`z. c m Address: L:d Oct .__.w .. .._...,. ��cssued as pennit to install (date) (installer). septic system at 5G1Y►'LG�G►!� �e rC� I- GlriVltb�sed on a design drawn by adsiJress) MC�i/l�e RL dated____1 (designer) - - _ _ I certi6, that the septic systern referenced above was installed substantially asccc�adizag to tl a design, which may include minar approved changes such as lateral relocati:n of the distribution box;anal./or septic tank, 1. certify that the septic system referenced above was instilled with major changes (i.e. greater-than 10' Weraal relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State dt Local Regulations. Plan revision or certified as-built by designir to follow. - (Insta�er's Signature) ��P` 9�yG o PETER T. F, iA McENTEE CIVIL No. 35109 _�. (Designer's Signature) (Affix Desi °'�Fssraty E��� Q:m4towsepticiocoper cctcirisaliion Fom 3.26-04.dm I Town of Ba ble Department of Re$ta3atory�egvne� a ' ,►�,s Public flea th Divisi®n Date a ..p�. � aoo Main street,Hyannis In1A ozfso I Date Schedulc4 Tirtte Fee Pd ,Foil Suitability Assess ie)?t f or Sewage osa1 Witnessed oy: . P4rfortned By: Loc— x. qy 9ryy ./Yp /per ps .VirqO ppp ON Owner's defame vqh�+U' 1 ; D q Sa I vC1 I aeattion Address 5, H am 0[e'n ecru w i�t'S ' address l o Lov�"s 5t, —Un t+ �� I AV".s opt 0-U00) Asac�sor's A�Iap/P'�rcel: 2 Per;011 — l °I b Ettgineer'o Narest A?e.£hfeC NI;W rnNSLtMN TR RF.PAtia — Telephone! 1, � � A N/A- Land Use 1 A '(;,� Slopes{fir)— !'_ �-- Surface Stones c i ft Drinking Water Well J Distaees front: Opens Water Body�--ft Possihlc k°ct,,0.rc 71GC �' ____ft Odsea'_._._--- -- ----_ft Drainage Way ft Property Ling f SKI.'TCH-.Meet name,dimensions of lot,exact locations of test holes Data tests,Ittr ,vedaU&in paoxitWty to 1 ) - i i i �-4-5 � � K n > C> � M —�� U) !r��!{.Gi' / O✓�-pnl� } �l Depth to 043drae& �.. . w M povaat Material(gamlogic) /4 weeping from Pit Depth to Groundwater Standing l ater in Hole;> _ .. - -- ii3tirraated Scssottmi tvgh(iroundwsta' _..._._. { L��_--_-._._. D �TION FOR SEASONAL HIGH WATER TABLE LE Method Used: ---- _in. Depth. o wil tnaatbw Depth moved str ndirrg in alas.hole - - -Clrottnsiwrite!AdJUMUMOt Depth loiweeping Frans side of abs.hole _ --• 1 dj,faCtSat'...,,,. - ,ttmad"W t Iteadi-0 Date:.- ladex Weil level�...,«,-.. Index Well it tow PER OLATION TEST 171sservatiota Tlow at 9 �`✓1 .w. 11 BYr��t Vµ .r....wuo""' �wrwdar+ag, f)epth of Pero Ltl�,=,k ao.� — �,t M r of Sits Suitability Asseitisluent: Site Passed -- 5itc Fiailed: Additional Testing Needed(YIN)--.-.--- (observation 1401e Data To Be CortaplEte d on Back Original: Public}1eKih yhvisian 0� an ***If pereotagon test is to be conducted within 10€9 �' You mast n rst notify the d et 9 ion Division at lust one(1) weli&priori to b Barnstable trb4serva e�a�lslia�g° t - t DEEP OBSERVATION HOLE LOG Hole# Dep*ftm Soil Hodzut Soil T"ture Soil Color $011 ± Debar Su fxoe CIO.) (USDA) (Metnsell) Mottling ( ,StoBea.Boulders. 0 . �� Via.11Z, 313 SL 3 `=j zee ��h 2. s :DEEP OBSERVATION HOLE LOG Mole# Depth facet Sg11 f tzPti - Soil Texture SoiI Color Soil (alter Surface(in.) a (USDA) (Mussel!) Molding (Strttotitre,Slow.Boulders. i -ssiA YXS 3 z—I t _c�s,:� Z..5—f s,-y r1J��►- zc> DEEP OBSERVATION HOLE LOG Hole# Depdt from So11 horizon Soil Texture Soil Color -Soil 0dw Surface(in) (USDA) a (Muriel!) Mottling (Shucture,stizes,eoulrs. jDEEP OBSERVATION HOLE LOG Hole# depth from Soil Horimn Soil Texture _ Sail Color Soil ' `. odw- Sauface(in.) (USDA) (Munsell) Mvttilas (Sowtum stones.sooku". f wd Insurante l Above V0,year flood bMadmi No— Yes w1tW2 S00'year boundary No Yes..�..: Mthin IW year flood bouadery. No Yes . of leant Iper A0 tr a Dow at least t . feet of naturally occurring pervious material exist in all areas observed throughout tlla ate,proPosed Of the anil,a*Tdon system? ..=C.J 3.f not,what is the depth of naturally occurring.pervious material? , Y.t .� I t rtify that on. Id L t (date)I have passed the sailevaluator examination approved by the Departmntof]env !(testat protection and that the above analysis_was perfarrmed by-�;corlaistent with the required traWng,experdse and experience described in 310 CMR 13.017. ` Date 6-7 Signature -cam Z Town of Barnstable K" o� Regulatory Services BMxxsrnsie Thomas-F. Geiler,Director 9w MASS. Public Health Division prFD A Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 January 10 2007 Mr Vantuil DaSilva 5 Hamden Circle Hyannis,MA 01601 ORDER-TO COMPLY WITH STATE ENVIRONMENTAL CODE;Title 5 The septic system owned by you located at 5 Hamden Circle, -MA was Oast inspected November 20th 2006 by Robert a. Paolini, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system"Fails"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: System is in hydraulic failure You have 2 years from the date of the system failure to bring the system'into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HE TH DEPARTMENT Thom s McKean,R.S., C.H.O. Agent of the Board of Health l DATE 11 /20/06 PROPERTY ADDRESS 5 Hamden circle Hyannis MA 02601 On the above date, the septic system at the address above was Inspected. 0 This system consists of the following: f l000 ui10r1 Gep�1 C � l — D i GtR I bib On BOX - I c�©© gd 610n )ieaci c na Pc L Based on inspection, I certify the following conditions: SIGNATURE _ Name: Robert A. Paolini Company: Joseph P. Macomber & Son Inc Address: P. 0. Box 66 ~` Centerville. Mass 02632 ' Phone: 508-775-3338 or 508-775-6412 JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachfields Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 026.32-0066. 775-3338 775-6412 / • COMMONWEALTH OF MASSACHUSETTS ExECUTIVE OFFICE'OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION r �y TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: .. 5 Hamden Circle Hyannis MA 02601 Owner's Name: Vantuil DaSilva Owner's Address: Same Date of Inspection: 1 1 /2.n f n 6 Name of Inspector: (please print) Robert ,A F .o.lini Company Name: 2, l.Aacomae2 � Son Inc. Mailing Address: Pox 66 Cen e2 v t e, a.s.s.'026 32 Telephone Number: 5 0 8-7 7 5-3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the.sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15:340 of Title 5(310 C-MR M000). .The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority F ils Inspector's Signature: Date: ao The system inspector shall submit a copy of this inspection report to the.Approving Authority(Board of Health or DEP)within 36 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 r Page 2 of 11 ' OFFICIAL INSPECTION,FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 5 Hamden Circle Hyannis YM Owner: VaniEui 1 Dasi Iva Date of Inspection: 1 1 /2 0 j O b Inspection Summary: Check A,B,C,D or,E/ALWAYS complete ali of Section:D A. System Passes: I have-not found any information which indiCateslhat any of the failure criteria described rin..31'0 CMR 15.303.or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: 114 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. -I(jp 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: Yam_ 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 inspectionlif(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution boat is leveled or replaced ND explain: The system required pumpingg 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: 5 Hamden, Circle Hyannis MA 02601 Owner: Vantuil DaSilya Date of Inspection: 1 1 /20/0 6 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(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: tt' Cesspool or privy is within 50 feet of a surface water 11A 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 an determines that the y ( PP Y) system is functioning in a manner that protects the public health,safety and environment: 9(� 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. l� The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. V ,o The system has aseptic tank and.SAS and the SAS is within 50 feet of a private water supply well. YYO The system has aseptic tank and SAS and the SAS is less than 100 feet but 5Q_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: 5 Hamden Circle Hyannis MA 02601 Owner: Vantuil Dasilva Date of Inspection: 1 1 /2 0/0 6 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the followingfor 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'A•day flow 1 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 J 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 fornp.] (Yes/No)'The system fails.I have determined that one ormore�::of the above failure criteria exist as 7 described in 310 CMR 15.303,therefore the system fails.The system owner.shovld 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 1.0;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 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 largc system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5,of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE-SEWAGE DISPOSAL-SYSTEM 1NSPECTION FORM PART B CHECKLIST. Property Address: 5 Hamderi . Circle Hyannis MA 02601 Owner: Vantuil DaSilva Date of Inspection: 1 1 / o n F Check if the following have been done.You must indicate"}yes"or"no"as to each of the following: `es 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 . P P P 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) f _ 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 n _ Existing information.For example,a plan at Oe Board of.Healih. _ 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)] 5 I Page 6 of l I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE-SEWAGE DISPOSAL SYSTEM:INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 5 Hartiden, Circle Hyannis MA' 02601 Owner: Vantuil DaSilva Date of Inspection: 1 1 /2 0/0 6 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 _ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): _- 0 ?d.' Number of current residents'.. r-,^ Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system()es or no): [if yes separate inspection required] Laundry system inspected(yes or no):j�S ���15D6 a �r;6--�q,3a �p Seasonal use: (yes or no): 1'UO Water meter readings,if available(last 2 years usage(gpd)): Cq -UU aOO6 z •4� cr- Sump pump(yes or no): Last date of occupancy: COMMERCIALMMUSTRIAL Type of establishment: o� Design flow(based on 310 CMR 15.203): Qpd 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: . ��,6tr o Was system pumped as-part of the inspection(yes or no):_ If yes,volume pumped: Q 4 OOgallons--How was quantity pumped determined? Reason for pumping: 4 .� T7E 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 e of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site.(yes or no): 6 Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 5 Hamden 'Circle Hyannis MA 02601 Owner: Vantui.l DaSilva Date of Inspection: 11 2 0/0 6 BUILDING SEWER(locate on site plan) Depth below grade: 1 6%' Materials of construction:_cast iron _40 PVC�L other(explain): Distance from private water supply well arsuction line: 10} Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) /1 Depth below grade:,20 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: i( 10 'w Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: _ Scum thickness: Distance from top of scum to top of outlet tee or baffler • kN Distance from bottom of scum to bottom of outlet ee or baffle: How were dimensions determined: t) 4)joon ✓.P `1 1) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of.leakage,etc.): L.Onage GREASE TRAP:'&(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 leaks ,etc.): 7 Page$of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE"SEWAGE DISPOSAL SYSTEM INSPECTION FORM !� PART C SYSTEM INFORMATION(continued) Property Address: 5 Hamden •Circle Hyannis MA 02601 Owner: Vant ui 1 nAgi l va Date of Inspection: 1 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 U.olyethylene -other(explain): . . Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes.or no): Date of last pumping: Continents(condition.of larm and float switche ,etc.): T �1a 1 �, . J DISTRIBUTION BOX:Ye3if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distriblition to outlets equal,any evidence of solids carryover,any evidence of leakage into 9or out of box,et .): , cA J v U` PUMP CHAMBER: -r7,rj(locate on site plan) �.. Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of rump chamber,Condition of pdmp§and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 5 Hamden, . _i r c-1 P Hyanni c MA ' Q21;01 Owner: Vant-iii 1 rl.asi 1 Va Date of Inspection: 11 12 c-)6 SOIL ABSORPTION SYSTEM-(SAS)W (locate on site plan,excavation not required) If SAS not to ted xplain why: iq Type t�leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil,condition of vegetation, etc.): • Pull CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes'or no): Comments(note conditi n of soil,sigps of hydraulic fail e,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note cond�iti_o{�o oil,signs ofoydiaulic failure,level of ponding,condition of vegetation,etc.): �( T�T�t.Ql r��,5 PJl'11� 9 • Page IO,of I I . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGEDISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued)' Property Address: 5 ' Hamden Circle Hyannis MA 02ED1 Owner: Vantuil DaSi va Date of Inspection: 1 1 2 0/0 6 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent refeteticeaandmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters_the building: tj •. r O Cip. �LG 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.(continued) Property Address: 5 Hamden 'Circle Hyannis MA '02601 Owner: Vantuil Dasilva Date of Inspection: 1 112 0 f 6 SITE EXAM . Slope Surface water Check cellar Shallow wells Estimated depth to ground water SO feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: u e,3 Observed site(abutting property/observation hole within 150,feet of SAS) N e,s Checked with local Board of Health-explain:a s p u P c a 2 d no Checked with local excavators,installers-(attach documentation) Ye ®ccessedUSGSdatabase-explainAt;6/?:;town.,9a2n3; a&2e.,ma.-uz /— You must describe how you established the high ground water elevation: llsed r Cape Cod Commzzzon Nate2 7aa.2e Cori.tou2a 4.nd 1 ugti.c Oaten Sul?122y Neii head /22oteet.io-n aszeah map.- Sept 1995 Wate2 2e,6ou2ee.6 ollice ease cod comm.izion., Top of Ground Leaching Pit feet Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method �f r Therefore,the vertical separation distance between the bottom of the leaching pit and the adjusted groundwater table is r , feet. 11 r •►.11►{lAlrwP/R111+7�Mtq.tw.A+.w. A�v . DOAIiU QF Ii$A�,�'ll ' 'TOWN OF BA�tNSTABLE •y ..9UIlSURRACR 89NAG1R nl8l'OSAI, AYS'CRM IUSPECTON PERM - PART FYI D. CErtr�PlcA�'tON w- "Y•1M N,/7 I" Nn-r lR11�►7HM I It qvh N III.--1 -TYPE 01 PIUNT.01,34Rty- """►'-• PRQPERTY r"PSCTRJ2 STREET ADDkESS 5 Hamden Circle Hyannis 02601 ASSESSORS MAP, DLWK''ANU 'PARCEL I / .j am OWNER's NAME Vantuil DaSilva PART'D ORRI'IFICAT3pN NAME 'OF INSPECTOR Rebert: A ':Paoliri ' COMPANY NAME r. COMPANY AVDAFSS ;r:. 4 Sox""'E �'p:� r •x�il�. • Str• k: :. Totim•or ty.. .8ta��• L P COMPANY TELZPNONE ( 508• Q7.5 3338 #SAX 508-1190 + f 578 CF,R71.FICATION. STATEMENT I certiSy that I have pereoriai,lY .jnspeoted ..the sewage 'digp094 $ygtem at this address -and that• -.the' information reported .is true,. aooUrate-, and omplete as of the time .-oif', inspection..• The r inepeotlOn was per•tormed and any're ard.ing upgrade•, .ma•intennnce,'. and xepaAr ,are• eot,Qis'tent wits my trains;ig and experience in th@ ppoper fun'cti'on• and maintenance of on..- site sewage disposal systems, Cheek one; ' Systeoi PAS92D - t The inspection which J. have .•conduoteO has .,n•oct o0bd gny information. . which indicates that .the sytem Pails to ' ade, uate,ly.: protect •public health or the env i.ro Amen t as defined its' .31'0 CMR. 1 g 30.3 lltre criteria r�bt .•evaluated' are as stated in the FAILUR, .CRI Any fs ati this form. r ' RSA .e+eation of System FAZL•ED* ' I The ingpec•tioh wild). I have '00" dtr6ted -hag found that 'the' System fails to protect the public 1ie61 th 9knd the engronm' en•t ' in acoord•anee with Tit'e 6 , 310 CMR 16 . 3QS, and as • speeitioaliy noted -on .PAR FAILURE CRITERIA of this inspection -.f rm, , Inspector Signature, `� _vosae ,�� _Q�o ne� copy of this certi,f ioatl4b must where a li.aabl• a A be rovi'ded to the .pWM R.� �h� BUYER-• PP ) and hp 13 ARD OV HEA -'ll, * If the inspection FAZL•Eb•, 'thb .OWnefi' y within o'ne year of the da't•e of the n oection, un e.hala • uowad' 'the °Yetem. i. ap i n, unless. ai'laasd ar regji�,red . n h.hArw{se. ae urovided i» $al{j CMR ld , 306 ,, .. I . 1 Date: Saturday May 12, 2007 8 AM Locations: 64 Walnut Street, Hyannis 78 Mulberry Street,Hyannis 85 Spruce Street, Hyannis 6 Bristol Ave, Hyannis 43 Eldridge Street, Hyannis 89 Kilkore Drive, Hyannis 17 Uncle Al's Way, Hyannis 45 Uncle Al's Way, Hyannis 112 Spring Street, Hyannis 5 Hamden Circle, Hyannis Inspectors: Donald Desmarais, Health, Jeff Lauzon, Building & Robin Giangregorio, Zoning Fire Dept: No Representative Police: Officer Mark Delaney 112 Spring Street • Property for sale. • Two bedroom bungalow • Partially finished basement—with laundry area, storage, closets and office space. • Son, Jeff reported his parents live here but will be moving in with at 64 Walnut in the primary dwelling. • Observed that 2 bedrooms are used. Clothing in storage appeared typical of a younger man. • Did not see evidence of female resident. • Needs additional smoke detectors and batteries in basement unit 64 Walnut Street • Met Jeff(see above) at 64 Walnut Street 2 legal bedrooms & loft& 1 bed accessory unit • Found owner to be remodeling bathroom—replacing fixtures—no permit. • Deck& railing needs attention. • Former attic space has been converted and counted as a third bedroom. • This room does not have adequate ceiling height. • Advised Jeff that this is not for sleeping but for storage or family room/office space. I 1 • Jeff informed us that he resides in basement apartment but unable to open the door in the primary structure to access the apartment. • He was also unable to easily identify the key to the outside apartment door. • While we were walking around Jeff turned down a picture of a man in the living room. • Found female clothing, cosmetics and prescriptions were in the single bedroom. • Ultimately, Jeff admitted that he does not reside here but he intends to move here in 2 weeks. • He keeps his belongings at his parent's home and stays in Yarmouth with his girlfriend. • He advised he can't afford the mortgage so his parent will sell their house and move in with him and his girlfriend in the primary dwelling. • He will rent the apartment under the Amnesty program pending approval. • Found interior stairway from apartment to house to be blocked with personal belongs of tenant who was using area as a closet. • An exit order was issued for the loft area and the apartment bedroom. • Tenant can sleep upstairs for now. • Advised Jeff to come in on Monday and talk to Jeff to review requirements. • Must obtain building and plumbing permits. • Must register with BOH as a rental. Bonus 78 Mulberry Street • No one home. • A stop work order was posted on front of house. • Car frame on front lawn. • Multiple dogs inside (advised very large ones averaging 180 lbs) • PD reported owner to be Robert Dunlop. • Neighbor advised he just left for an auction. • Best to reach him around 5 pm. • He works on these cars for himself. 85 Spruce Street - notation • Neighbor complained about 85 Spruce Street. • Team was there recently. • He's complaining about 10 cars there at night and cars being offered for sale. • I've not seen any evidence of that this year. • Will make a point of checking. • Resident made an appointment with me for Wednesday. • Will call Pd to check responses as neighbor complains the I'd is there quite often. 2 a Update: Inspected intended family apartment week of 5/14/07. Need some work to bring up to code. Daughter& grandson live downstairs with another son. Saw no evidence of Class II use here. Have been doing early AM drive by—no activity. Found 4 cars on site 7:15AM 5/21/07. Owner is working on title issue to allow for damily apartment application. Owner will advise of status within next month. Bonus 6 Bristol Ave • Found basement apartment. • Door swings in over stairway. • No railing. • Steps are too steep. • Tenant let us in—language barrier. • Exit ordered issued 2 bedroom unit. • Sign language, dictionary and cheat sheet used to convey message. • Cards left with telephone numbers for landlord. • 5 or 6 vents were noted on the apartment side of the house. Update: • Owner came in 5/14/07. She is attempting to evict downstairs tenant. • Owner moved here in Jan or Feb of 2007. Ma License reflected that change. • She wants to create a family apartment for her sister. • Owner expressed disgust over number of cars on site—attributed to downstairs tenant. • Property was pristine and well maintained outside. • We discussed options and code issues. • She must maintain communication we this office during eviction process in order to avoid citations. 43 Eldridge Street • No one home. • Found 2-story garage to be converted to an apartment. (Possibly 2) • Primary structure also has an apartment on the side. • Rear bulkhead was a skylight installed—finished like a roof. • 2 Cars were in the secondary driveway. 3 �. 5 Hamden Circle • 8 people live here with as many cars & trucks. • Owner is a landscaper who works for tow companies. • There are 5 adults and 3 young children. • An exit order was issued for the "TV"room that had a pull-out couch and closet? • Owner and teenage niece insist the sleeping arrangements are as follows: o Mother& father-in law sleep in-first bedroom(door was locked but key accessible, occupants of this room smoked- lock maybe to keep kids from lighters)? o Owner, wife and baby sleep in 2nd room. o Third room - mother, teen, and baby sleep in bunk beds. • It is more likely that teen (who admits she is downstairs watching TV) is living there. " • Advised owner to refrain from parking over septic and keep in driveway, neaten up property to keep neighbors at bay.' He replied that he intends to landscape area in 1 -2 months as soon as he earns some money. 89 Kilkore Dr • Property divided into a quad. • Landlord picks up rent in person. • First floor is rented to one couple—they are moving in June. • Basement is a one bedroom apartment. • Second story is divided into 2 studio units. • Obtained cell number of landlord. • 508-360-1186 • First floor tenants believe owner lives off Cape. • Owner also has illegal quad on Beth Lane. • Basement tenant would not admit us. • First floor tenants work at the 99 (closing shift). 17 Uncle Al's Way • No one home but confirmed basement apartment. • Found recent deck—less than a year old. • Span too wide, railing pulls away from deck. • Property has doghouse entrance in place of bulkhead. • Door swings over stairs. • Saw kitchen and bedrooms thru windows. • Christine Palkoski sent letter to owner on 4/18/06. 4 45 Uncle Al's Way • Owner was driving by as we exited the car. • He let us in the basement. • Two bedrooms remained but it obvious that no one was sleeping here or otherwise using this area. • The kitchen was gone but the walls remained unfinished. • Owner will obtain permit and open walls to eliminate bedrooms. • He does not want an overcrowding situation here as he replaced the septic system once already. 5 r . COMMONWEALTH OF EXECEMVE SE'1Tq ()FFICE OF ��'r�as or O��T� 'P' s osAF P� , RECEIVE® JUN 2 9 2004 '�+�.�� TOWN OF BARNSTABLE OFFjCTAT+INSP ij�s+L' S HEALTH DEPT. S NACRM-NOT FOR VOL. SE'WAGX DISPOSAL�AI�cY A PARTA TEM FORM Cie"IQy Owaer', MAP OWE"' PARCEL Date of od 601 iA Name ate; Compaq Name:' ) r� Maliep Addrem d E G y Telepbe Mmbw.- U" that I TION 3TATE j►,med the sewa� amq and -. aPp ed� kmeoe r-Parsaa t to and=dmm ooe atom dit sewa�� u qasbft ned based a, °�TH1e3 piA yj000X � Ia n a DEp c% -# � �- - I CD Paste � =N pd'48Cj Fads Eya[mtaa by tht Low! 8 hapemes Signature; Dates S 30 T7ie t �within�shag submit a copy��mvection��� �or t theme `uLVm lam,M the sy�m 3a a sha ed 8 or has d(Board arHealtb a; DEP.The CnMnd Mild be seat to Mftthe system t the IVM to ar has a desipprop*wgn&W of 10,mo wnw and copies SM to tht bqw.if °fie of the Notes and Comments +� a{ , , - /0 ..0 8 6t ve 4- sash report 0 ett7 describes eondidons at the c�dn��W uw pectios dos not address how the�, w'ti o�0d under the condition of at 1 MII1e under the same or UW Fate 2 of 11 • OMCLlL INSPECnON FORM— S BSU"ACZ SUYAGE D]q, NOT FOR VOLWTABY PARTAS M IlY3PECTI0 '0.. ft""Addtase s /�Gr1�e✓� C�„. OwenBaft F.�.►,,� 6 0� °t _ o Sari: clock AJOAD or s A;�: `!fin�W�e Hof&Xdon D e not itiund aa� wh1� 1S.30Q oris310.tWR 11304 . Oft Az, no���� descnbedls 310� Coeise,b� ar s wed bdo w a C hormone system armed.The as descr,•6ed m U otthe r o4 abe nPived or Answer 3^�m or (YAM .will pam expo ed )m the_ for the ng �Ir. mod'phase —..__1Ls soptic iaat is metal and om2A y=s oW or unso"mq, do e'd n8twatis ikl or a ortamirm*is ('vS�or not)� *A���w a o°m�'�8�tm*as appey �,the Board ofpill pass igthe 8 dw tha taetc is k� it ld� 90=4 not and ds C � ND w#aiL. noe Boowd o b'"0 4 settled or *ilmdm box tint, naOn bot X �PKI are SYstetnwillpsi .ar ;s dskewou is kvekd or ND vqiaimL 77w Vsm mqumdPigmole 4 p ia�pectian if(with*PovW al the Board atHr�th):a year doa to> ° PiPe(s)The syskm win hralcea PiPC(s)are replace onion is r=ov d ND e d Pale 3 of 11 OFFICIAL INSPEMON FORM- S�UUACE SEWAGE D NOT FOR VOLUNTARY jr A M 1NSPEC`n6?j FOgM aminCATION PtgWq Addem S f fw m jeo CI✓ - .Date otb 5 a`� 9 bythlBaard atV jM.. e�dst w�re9odne Soihes or the MUaameat the Bwnd at> m o b e q: L s7ateaa wi�paas�g��bf 1 =91 b u�t b P �stae�oedanoe wi 31� 1' 36c )twt the �,�4 aad t11e — 1 orpdvy� sow�a r — ca"d ar privy is n ots . bOidezinBed wetland ara sah mares a 3y*=wiz fail asim tee gowd at luft syshes il thecdoubAS In a 0"0*mat P seer d aa7)"Julioes tw tee The system has a septic twit aid MEANwater suF*ar 7 to.; a'PP ( "and the& is witbia 100$et ota The system has a septic tact and US aed the —. The s3UM has a septic tact aid US aid ���a zome 1 ata pn6tic�S°PPi1 �3.43 is widda 30 feet ata prhft wow S"p wd1. — pdvaf� a� �aid the 3Ag is�than 100 feet baeft isedto d �� bat 30 f�a��a "Ibis�M passes itthe we11 4 aadvwlafc � Pc*rmpd at s �e pneseaoe att dieOY,for &&M aite aro �sm ad aft*coff is eql m °M'Wft 1 ty aid offt�ysis most be attached�this gy PM m. provided that no other A Other; Pae4ofii •_ ' _ OFFICIAL IIVSPEC'IZON FO SUBSURFACE RM NOT FOR VOLUNTARY. SWAGE DlSppgAL SY A A S�'EM RT Il�TSPEC'rION FORM CJRT"TCATION( �perty Addi,gs l�q w, �e�, C,OftOwner. 1��t oe ` JA t o/ Date of20*abie to an I 5 0 D. 3ys�eas Finn Yw 1M bd caft W or`W-1 each atom ng arAL Yes Alo� '— Dhdj eto Q pow doe to—d-.dcd ar "Sor celow ottiw gad or sum cloI.I IA.4 ar ce,� .1L is the Wa�dw to as oveed or �'6otioa boa abova t4 an d depth is Is kse two 6-below_ ° sled a clogg�gqg or dma Rwpk"�6 B%"than 4�iPmVedn the Year or waftk�M iS d*K Nkimbw �An9partiand ard°0 to or s 0esspoai ar privy}a� f okv�oa ,�Patioa of s o MWW ar>�is within a 'or uqV'or to a sort pordoa ofa cow or Ph7 in done i era per . �9Iren . ar pdy is��OO IM��atet ..o well. tbaa 30lbet hum a prty�� Wknies d w GfhVM and the 1'b°ratO+7,fer�srm back p'u'rea fd`ths we/water anai9� efivapountift to aif g.isto or" edrvua * taeft mr the Pe+eaaue aft Mpa°°dr apy a[the an**most be fo Ot ae otbw� s —f=(YO")oe system t 1 I H�m 310 t 03 narmoee(trhe ab ,a * - mine wbat wi benecewzy 10s3�em owner sad IL urp osdenad s W&e cod �e �system the jyStem most urn a fac ft with a cgs$mr of 10 (T'heYou UMS1 edr Oes"or each of the gpd to 15,000 oweng C° apply to p s3'�in tho�above) ) the system is within 400 feet of a surF�Ong w, the sysGam is within 200 feet of Ugxd ry to a su*m aging water the ZON�a located in a mtmgM��am Y Public water we (��WelDa Ptotoctron Area_IWPA)or mapper YOU but �'�"yes"to any Si er in �� °SI tbg N TEheawWor is�Mftr &Sig 13.304 Zbe s Sft 0*.w shotildorbiledumd D sW nP& the sy A d a ma the aPPopnate re'g�al o�Of the with 310 C'11R L1 • . Page s of 11 OFFICIAL]NSPF FORM—NOT FOR vOL UXURSUBSORFACE�VAGZ DEPOSAL S rgrIM p EY'lTON PART g FORM CRBCK gT Pnp"Addmm #a w 4 , til. C/ r oww.F vt✓1 D'a-C O/ Date of L oz Chit if the � baps bees dog Yas moat or`bor'�a,�yd� ✓— — P oab&=IdOa WUPW ded by the _ awaM oowipao��g��� _ W : aq�atttte sys� °gmp°°edsPmped an bate two Wcax _ /�s the sysr��e�edmra�Boars�S the P�rlods i��p�. / hopecam WeMas Mccody or as Put afthis�plans°Etbe s9�obta+aed and ��►�e�ie ✓ was the '�no*as WA) 0r dfr sips af wwaBabecklip was the die bgw ftdfw si Ps otbreat oat Were all sysmm the SA,%bcsteacssh, wentlii 72fflortw4mdmWQtco=ftcdM 4mmd604• depthof �ots� tTcrtra a w7���4 Darner(a�doao � � �°f� saaa�d sydem °�)Pra+idedaritb o°on they 'ire aims aad Of thO SON - - Y m Absogdoia Syst.(�an the sits has be=wed band oic E*dpB ce•FarMmpq apiaa 32 the Bond orne d Dettminedim stmw E�the Ad u3(Many of the� Pait Cis >ssne criteria related to �. ��� Y Poe 6 dll OF SUM"A�ON FORM-NOT Fob VOLUNTAR SEWAGE D Y pAR,p�'e STEM INSpEcrrox FORM Ownet -vt a w l Date d:: 7 o� 1�fimbei 9NUMW .�' df bead ow 33l(dodo* C1141t13►30c� �_ N%Mbw d (ft esampt%110 k 3�,v �t arsideahc O mod:d cf Dices reaidmm Joe s D Uhl," a bps grmk, ' 6=_" fay" l.a�p®p�Qmk: 3�,��k date day; CDC DUS 3'ypede 8n a►(base -00.310 CMR lax_ cidesige Sow Game Bats ar nok Aftk IndaiMd�reno>ataa p Wwrit°aw b the ras s sy it'ava 6►a ark Last date otocaop�y�—_ OTHIM(aSctbe) 1 GZMtRAL="aA1To,, Was; AwQfthe- TV 914;vwn �asos t — �soy — cmwd 9Ysteaa _..MWW system(yes o:no)Cd �attach fim�)iIoBf:J►tbdi aroPy a —risk tank _Attach a copy of the DEp app mW °0e contra(to be —Odw(gibe): Approldm*agre of all �date d(¢1�,n) Were / i 9 - /s'o,S,C sewa0e odors dew ►+hen * g at the site(yes ar no .� • Page7atil OFFICIAL] NSPECTION FORM-NOT FOg VOLUNTARY SUBSMACE SEWAGE DISPOSAL;Sys ASSES PART C EON FORM r STEM INBORMATION(oonta„e� Fperty Addmm J tq�irl J vt 61 ' owner. �t v►cc, o— "` of Bob of �'4 -Onm]Ncuwm 00caml on ter=) Dhbdowgraaec �km / :/JOPVC cdmc Cam(Via[ k arsacdmlimo j01k VMI evidenceaf alr; dm) sic TA111� qq�a*&l�) Dq&below Va& / Maoariat o[oa ! xn at 0"or no):_(attach a copy of Dish=&a�at to atoodet o Dista fmm atom sum tat IOP ataati "tee a bad �_ /(/O— Sc-•. tobou I'mamq�det r'`le pW°fir m COMManpmp ev�c as ta� x ontkt tee or i � �strn �/ 1 dmal integrity f� •M r�G 610 � T rll S r'✓►'fP G •liqgdd ICVCl/ GRE a AR Mh. J�( abe on silo pion) ugft"at �� _ i tex�amy: concxft— _p*ethylens other sameimess: Distancefmm top swan to tWofmrtlet tee ar bf l ati�bona®of scum to bottom of oatt tee 07— (on pm"n= meud�Ink mdouft as elated to outlet hmaj,evidence a�f lealm W;ft}: tee Of ba ft cane sbucdua!laLat�,Apd levels ;. . Pa�e8d11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY A&SUBSURFACE SEWAGE DUPOSAL,WSMd INSPEC opg PART C RM SYSTEM INFORMATION(c=gum4 A+oPert7 Addrmumc C �¢h Cr✓� Owner. Date of Inspect, a o TIM ar HOLDING TANFs=(tacit aft be Pmood at time of )(IoCape cs site �) bGIO'w grdc 11�6adai doa�ocliiosr_�,� mNal �Lack d Ab=is wading Qfdw&W ar no). Comments(Comm at n=df1 t s.whM eta` ; DisoD .ao]G_.._(�PKssntmnst be opened( on si�spbm) Deg*a(BW"kvd above owa&Mt dl Ors Commeob ftm it m is teed=a >��r oroata k an7►evideooe d//so8ids My"4 my awu of O SOI.c/j p'uWmom�'=(Tocaoe an site p Ptunps is wmkbg=W(yes or noX & �Omme (Aft �amok nts - .coodbion otpnmps md appfftcm=cc4 etc): „• Pw9of11 ' OFFICIAL WSPECnON FORM-NOT FOR VOLUNTARY SUBSMACL SEWAGE DISPOSAL SynM INSP ASS pAgT ECTION FOS SYsTM INFORMATION(e ntime4 riggv Aaa:�: �W, denVol C +w l Ow'x+: l✓lo. Daft dhopecdor d p SOIL ABSORPTION"STM Aaaf os site plan,"mad=not MVUe tisasaotl« =*Inwir. R6x f o to . m+�mbnr:— �rmave a�f (note Coin arm,Ops ofh `&m ft&%M kVE1 d is 1C or Sic p00�&`o"'-SQL,Op�of CBS►MOM'!L.(,w, 4 d now be pamsped as part of' e an silo ptaaj ?Aw* r and caned; DajA_ *� of Materials dooms hxvcadm°dam es(yes as no): . Comments(sole cofica SA sism ahJ c fa7m%level apoa 6qL atveget ear ------------------- PRlvlt:,�(locaoe on site� CDM� (none waft Cf �; ' is of hy&m&c kvel aipon f won of vegeta�ia�styes): 9 • c 1 P88p l0 o[I1 OFFICIAL RVSPECITON FORM—NOT FOR VOLUNTARY SUBBURFACR SEWAGE DISPOSAL,SYSTJ2A INSPECTION FORM PAR?C SYSTEM IlOORMATION(oo oed� PrqpdyAddmm A44�,�Q� n t oa-6 o/ o.•.ei:_ A / Dated e SAKWTCS OF SWAGE DRWWAL SYSTM Provide a dmkb cabs sewage diapood syalea sties to at two p or bcndbmad�1.ocaEe aD aregt writltiw i00 ftef.Locale Whete poblic�valer supply�the bmldins Q ,. A2 - 3A Q C _ r u" OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSIMENU 'F . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECnON FOBM PART C SYSTEM DWORMATION(con meo rnP Addrum t/f Cr r ann�t Od�GO/ Dsledb vecdm 0 S=1!gAM Scope Swrboe wales Cbedcodlor sh!dbW sWd t d 35 ` € ,Womd clo„ tim �faiaed$as s1►a�m desigp puns aei mcaed•1[checbo�dale ddedgie p1aQ nevieared__ Qbe<v+ed site(abnitius bole wigs 15016et of SAS) C3ecbed wilti kcal Bom+da�Healfc Aooested ilb (atmci�docamentatios) � . To F You Mfg bow established blO s+mnd water elevadom: r 3 /o e cc /.o.,» TO i 77-�. I goo, "I* , f t� a � � 1 t: TOWN OF BARNSTABLE L'LOt'ATION,� d CA SEWAGE # VIILAGE /'t' ASSESSOR'SQMAP�& LOT /- /�lO ��D G�11.0"CJ�J'C-tr T1 T2]iiJi i TDI( AT - fL A�� /'1 D SEPTIC TANK CAPACITY - t LEACHING FACILITY; (type) f \' (size) NO.OF BEDROOMS c BUILDER OR OWNER �Q ) PERMITDATE: e`+ 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 �n.ause �5 ( LOCATION SEWAGE PERMIT NO. VILLAGE r HY,�/v/-o s ALL ER'S NAME & ADDRESS B U I'L D E R OR OWNER v a 7f /4 ��'�19-X f DATE PERMIT ISSUED DAT E C0-MPLIANCE ISSUED _ Cam• CTA 7Z f/ G 7, o �qA h� I 9°qZl al fi( C ' nZ- � d YYY TOWN OF BARNSTABLE i()ATION NA IQ N* IS SEWAGE # Z®o7), 0i' ASSESSOR'S MAP & LOT 1N,' 'ALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) _ A M b(L (size) 13' ?5 NO.OF BEDROOMS 3, / BUILDER OR OWNER V QAY14 U 11 Q4P- i 1%f12 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 facility) Feet Furnished by f ' LEGEND p R0. p 78 PROPOSED CONTOUR pU o BRISTOL RD v� �� CHESTNUT ST 79 PROPOSED SPOT GRADE i o r` EXISTING CONTOUR couNrr SEAT sT Q CHERRY ST + 9-1.22 EXISTING SPOT GRADE a 19 TEST PIT LOCUS W EXISTING WATER SERVICE CIR G EXISTING GAS SERVICE �o --0tiVV— EXISTING OVERHEAD WIRES �J $ BENCHMARK ...._.._._._...... 581 e2G'55%V LOCUS MAP N.T.S. t 137.70' O ;l AN291 - 190 CONC, O 10.23G±5F PATIO 4 _ � TC)NI~ I LG�/M / ;No. 5DIEV,A //'"/1STY. / ! , GENERAL NOTES: I / . F . aALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL IT.O.P. IQ4.63 / BOARD OF HEALTH AND THE DESIGN ENGINEER. 0 jJ W 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS t fr Q d OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Z lr T ^ ^ LOCALRULES AND REGULATIONS. ES O I �'i 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR i �1 _- TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 5 * � / DESIGN ENGINEER. it }I �• , '4.S _-- 03 3 EXISTING SEPTIC TANK } / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ! TOP OF TANK, EL.=101.81 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN INV.(OUT)=100.48t ENGINEER BEFORE CONSTRUCTION CONTINUES. _ $ ;' 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. } i " 1012 �� % 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF TPM -fi EXISTING S.A.S. THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF a 1t TO BE PUMPED & FILLED WITH SAND HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. , " 3 - T1:LEPHONE 7. WATER SUPPLY PROVIDED BY TOWN WATER. STANCFilON �, dr•: i 86 I '. - D. 8. THERE ARE NO ABUTTING WELLS LOCATED WITHIN 150' OF THE S.A.S. y ' � I� _N8•'1`2655"E '. _ - 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED �� — -- `� 11 t -( TO A CONDITION A GREED UPON 6E TWEEN OWNER AND CONTRACTOR. ``••• % s .. ". -_ .• `- -- 10, IT SHALL BE THE RESPONSIBILITYOF THE CONTRACTOR TO VERIFY DG;E OF PAVEMF�� 96 ! THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 00 x b CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. hAMDEN C RC�LE AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). BENCHMARK: MAG NAIL ELEVATION = �,100.00 (A55UMED DATUM) o PETER T• �, McENTEE PROPOSED SEPTIC SYSTEM UPGRADE g ICIVIL No. 35109 5 HAMDEN CIRCLE, HYANNIS, MA R£CISlER�� FPrepared for: Vantuil DaSilva, 10 Louis St.-Unit 1, Hyannis, MA 02601 S N Surveying b : - . S I n ineerin b . Su a AWN JOB. NO. 9 9 Y Y 9 Y SCALE. DRHOOD SURVEY - P.T.M. -- n neer�n Works CROU 59 06 P 22 West Crossfield Road P.O. Box 1724 orestdale, MA 02644 Mashpee, MA 02649 DATE CHECKED SHEET NO. 508) 477-5313 (508) 539-7799 1/15/07 P.T.M. 1 of 2 � - -�_ .,..•+...,...•yam w � .� ,� _ � v ._ ow I NOTE: TO PREVENT BREAKOUT, THE PROPOSED y TOP OF FOUNDATION G PROVIDE RISER OVER D-BOX F.G. EL: 102.5t FINISH GRADE SHALL NOT BE < EL:100.0 To wrrHIN 6" of FINISH GRADE FOR A DISTANCE OF 15' AROUND THE EXISTING F.G. EL: 103.0± F.G. EL: 102.6t PERIMETER OF THE S.A.S. MAINTAIN 2% MIN SLOPE OVER S.A.S. =RE PVC PERFORATED PIPE WITH SET TO WITHIN 3" OF FINISH INSTALL RISERS W/COVERS OVER INLET - - 2-500 GALLON LEACHING CHAMBER SERVE AS INSPECTION PORT. & OUTLET TO WITHIN 6" OF FINISH GRADE IN SERIES WITH STONE ALL SIDES INSTALL RISER OVER CHAMBER L =46' L =4.(MAX) SHOWN ON PLAN AND SET COVER WITHIN 6" OF FINISH GRADE s" 4' SCH 40 PVC 4" SCH 40 PVC i0" ®B ®® 2" LAYER OF 1/8" TO 1/2" ia" ® S= 1% (MIN.) 6" CAD S= 1% (MIN.) ®aa�®®a DOUBLE WASHED STONE ®B ®®®� OR APPROVED FILTER FABRIC a ae" uouio t 2' EFF. DEPTH ®®�®®®® ( ) EXISTING BEVEL G S INV.=100.01 INV,=99.84 4' 5.2' 4' 3/4'1 1/2" BALE PROPOSED ID—'BOX DOUBLE WASHED INV.=100.48 EFFECTIVE WIDTH = 13.2' STONE i EXISTING 1000 GALLON SEPTIC TANK ? ! INV.=99.50 TOP CONIC. ELEV.=100.3 —BREAKOUT ELEV.-100.0 gleam INV. ELEV.=99.50 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING BOTTOM ELEV.=97.50 PIPE INVERTS PRIOR TO CONSTRUCTION. 3' 2 x 8.5' = 17.0' j3' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 23.'0' GRADE ON A MECHANICALLY COMPACTED SIX T.P. EXCAVATION OR G.W. (3) 5" DIA.OUTLETS INCH CRUSHED STONE BASE, AS SPECIFIED 15.5' 161, 2" NO G.W. AT EL.=92.0 (TP-1) IN 310 CMR 15.221(2). LEACHING SYSTEM SECTION I�-----�I -"I 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. ,5,5" -� `; 6 SEPTIC SYSTEM PROFILE " s D-Box 2„ N.T.S. DESIGN CRITERIA x T.a SOIL LOG NUMBER OF BEDROOMS: 3 BEDROOMS SOIL TYPE , CLASS I DATE: JANUARY 12, 2007 (P-1 1577) DESIGN PERCOLATION RATE: 2 MIN./IN. DAILY FLOW: 330 G.P.D. SOIL EVALUATOR: PETER T. MCENTEE P.E. _17 > '!G. DESIGN FLOW: 330 G.P.D INVERT �®®® ® ®®®® PATIO WITNESS: DON DESMARAIS—HEALTH AGENT GARBAGE GRINDER: NO � ®®®®®®®®®®® Elev, TP— 1 Depth Elegy. TP-2 Depth LEACHING AREA REQUIRED: (330) = 445.9 S.F. 24" ®�®®®®E3®®® —� --� 102.5 A SAND LOAM 0 102.4 A SANDY LOAM 0 .74 102" ji :�/ �V%' ! 10YR13/3 1r�YR 3/3 EXISTING SEPTIC TANK: 1000 GALLON CAPACITY SECTION / �'/j // JT�f/ 102.0 B 6" 101.9 B 6" Fw. SANDY LOAM SANDY LOAM USE 2-500 GALLON LEACHING CHAMBERS IN SERIES TQ:P 104:3' 10YR 5/8 10YR 5/8 SIDEWALL AREA: 2(13.2'+23.0') X 2 = 144.8 S.F. 4" KNOCKOUT ;�j i f zz_ 99.5 C1 36" 99.7 C1 32" 20" DIA. COVER 38 BOTTOM AREA: 13.2' x 23.0' = 303.6.0 S.F. TOTAL AREA: 448.4 S.F. 4" KNOCKOUT O/4" KNOCKOUT 62" N \ '. F/ PERC ^,�� ��\ � 50" DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. 4" KNOCKOUT �/ AiQpA rp M—C SAND M—C SAND `� `S �� 20% GRAVEL 20%GRAVEL PLAN �, PROPOSED SEPTIC SYSTEM UPGRADE 23. 5 HAMDEN CIRCLE, HYANNIS, MA 500 GALLON CAPACITY, H-10 LOADING Prepared for: Vantuil DoSilva, 10 Louis St.—Unit 1 , Hyannis, MA 02601 CHAMBERS Engineering by: Surveying by: SCALE DRAWN JOB. NO. S.A.S. LAYOUT 92.0 s ? 126" 92.4 132" EngineedngWorks HOOD SURVEY GROUP N.T.S. PTM 259-06 12 West Crossfield Road P.O. Box 1724 NO GROUNDWATER OBSERVED Forestdale, MA 02644 Mashpee, MA 02649 DATE CHECKED SHEET NO. PERC RATE <2 MIN/IN. (508) 477-5313 (508) 539-7799 1/15/07 P.T.M. 2 of 2