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HomeMy WebLinkAbout0037 HIRAMAR ROAD - Health 37 & 39 Hiramar Road Hyannis A=292-138 N j 1 d Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis,.MA Property Address Tracey Oringer Owner Owner's Name information is Hyannis MA 02601 5-10-2010 required for State Zip Code Date of Inspection every page. City/Town 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. Important: A. General Information When filling out ( /) forms on the tiff(( computer, use 1. Inspector: only the tab key to move your Darrell Stone cursor-do not Name of Inspector use the return key. Cape Cod Septic Inspection - Company Name rab PO Box 1466 Company Address Harwich MA _ 02645 enm City/Town State Zip Code 508-240-2500 S 14995 Telephone Number Liccenseense Number B. Certification - x " y Cj ewage disposal system at this address and that the -= I certify that I have personally inspected the s 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 ved system inspector pursuant to Section 15:340 ofY sewage disposal systems. I am a DEP appro Title 5 (310 CMR 15.000).The system: ® Pas ❑ Conditionally Passes ElFails i ❑ Fu her Evaluation e L al Approving Authority _ 5-11-2010 — spect s Signatur 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.. LM Title 5 Official Inspection Form:Subsurface Sewage Oispos ystem•P ge 1�f 7 t5ins•og108 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ^M 37 + 39 Hiramar Rd Hyannis MA Property Address Tracey Oringer Owner Owner's Name information is Hyannis MA 02601 5-10-2010 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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): y Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 t5ins•09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis MA Property Address Tracey Oringer Owner Owner's Name information is Hyannis MA 02601 5-10-2010 required for State Zip Code Date of Inspection every page. CityrFown B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or 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): ❑ ❑ ND (Explain below): obstruction is removed ❑ Y ❑ N 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, Msafety 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 Title 5 Offic al Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 t5ins•09108 Commonwealth of Massachusetts W Title 5 Official Inspection Form io Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis, MA -- Property Address Tracey Oringer Owner Owner's Name information is Hyannis, MA 02601 5-10-2010 required for State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is'functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: - **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other. D) System Failure Criteria Applicable to All.Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters ® due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level In the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1h day flow Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 t5ins•09/08 c Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis, MA -- Property Address Tracey Orin ecerr — Owner Owner's Name information is Hyannis, MA 02601 5-10-2010 — required for -" State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped. ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. E] ® 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 El ® 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'ofthe Department. Title 5 Off cial Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 t5ins•09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ;M 37 + 39 Hiramar Rd. Hyannis, MA Property Address _Tracey 0 inger Owner Owner's Name information is Hyannis MA 02601 _ 5-10-2010 , required for State Zip Code Date of Inspection every page. City/Town r C. Checklist i 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,nor Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ® this inspection? ® Were as built plans of the system obtained and examined? (If they were not El available note as N/A) 4 ® ❑ 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? El ® 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: Z ❑ Existing information. For example, a plan at the Board of Health. ® El approximation 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: 4 4 Number of bedrooms (design): — Number of bedrooms (actual): 440 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): - I Title 5 Official Inspection Form:Subsurface Sewage Disposal system•page 5 of 17 t5ins-09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Oringer -- Owner Owner's Name information is MA 02601 5-10-2010 required for Hyannis, State Zip Code Date of Inspection every page. CitylTown D. System Information Description: 2 family residential dwellin_c — 6 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No See Below Water meter readings, if available (last 2 years usage (gpd)): Detail: #37-2009 125,000 -2008 91,000 gal. #39 -2009 80,000-2008 65,000 gal. 2009 Total 205,000 gallons = 561 GPD 2008 Total 156,000 gallons =427 GPD Sump pump? ❑ Yes ® No 5-2010 Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gauons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): ❑ Yes ❑ No Grease trap present? I ❑ Yes El No Industrial waste holding tank present? I EJ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? Water meter readings, if available: Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 7 of 17 t5ins•09108 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 37 + 39 Hiramar Rd Hyannis MA Property Address Tracey Oringer — — -- Owner Owner's Name information is Hyan nis,is, MA 02601 — 5-10-2010 required for State Zip Code Date of Inspection every page. Cityfrown D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Unknown _ -- Source of information: 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 0 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 El Tight tank.Attach a copy of the DEP approval. Other(describe): Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 t5ins•09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ^M 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Oringer Owner Owner's Name information is H annis, MA 02601 5-10-2010 required for Hy State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 per BoH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 21 Depth below grade: feet Material of construction: ❑ cast iron Z 40 PVC ❑ other(explain): — Distance from private water supply well or suction line: feet - Comments(on condition of joints, venting, evidence of leakage, etc.): Apparent ood condition Septic Tank(locate on site plan): 16" -- Depth below grade: feet Material of construction'. ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of.certificate) ❑ Yes ❑ No 1500 gallon Dimensions: 12" - Sludge depth: Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 t5ins•09/08 c Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 37 + 39 Hiramar Rd. Hyannis, MA -- — Property Address Tracey Orin�er — - Owner Owner's Name information is Hyannis MA 02601 5-10-2010 , — required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Septic Tank(cont.) 20" - Distance from top of sludge to bottom of outlet tee or baffle -- 2" Scum thickness 5" —. Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 15" Sludge How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grade to inlet cover 3" Outlet 16" Normal liquid level SCH 40 tees No sign of leakage Recommended next pumping within 1 year Recommended maintenance pumping every 2-3 years 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 ---- I Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 t5ins•09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Oringer Owner Owner's Name information is Hyannis, MA 02601 5-10-2010 required for �— every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): l *Attach copy of current pumping contract(required). Is copy attached? El Yes ❑ No Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 t5ins•09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Oringer - — Owner Owner's Name information is H annis, _ MA 02601 — 5-10-2010 required for —y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): 01, Depth of liquid level above outlet invert - Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Grade to box 33" Cover 18" OK condition 2 Outlets with speed levelers Some scum (removed) Normal liquid level No sign of leakage No si n of failure — Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: El Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 t5ins•09108 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments "p 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Ciringer Owner Owner's Name information is Hyannis MA 02601 5-10-2010 required for every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: - 2, 36' ® 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.): 2 (36X4X2')trenches Clean and dry stone No sign of hydraulic failure .. 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 t5ins-09/08 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 37 + 39 Hiramar Rd. Hyannis MA Property Address Tracey Oringer Owner Owner's Name information is MA 02601 5-10-2010 required for Hyannis, _ — every page. CityFrown 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.): Title 5 Official Inspection Form:Subsurface sewage Disposal System•Page 14 of 17 t5ins•09108 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 37 + 39 Hiramar Rd. Hyan_nis, MA _ Property Address _Tracey Oringer Owner Owner's Name information is Hyannis, MA 02601 5-10-2010 required for �— — every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 20 � . 3 A B 1 Sr 4 - 3-0 2 -2 7- 3 4 5 6 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 37 + 39 Hiramar Rd. Hyannis, MA — Property Address Tracey Oringer _ _ Owner Owner's Name information is Hyannis, MA 02601 5-10-2010 _ required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells >5 Estimated depth to high ground water: 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: 2005Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health —explain: Plan on file ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Elevations from design plan Bottom of SAS EIV. 93.8 Bottom of test hole 83.5 NWE Separation >5' — Before filing this Inspection Report, please see Report Completeness Checklist on next page. Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 t5ins•09/08 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 37 + 39 Hiramar Rd. Hyannis, MA Property Address Tracey Oringer _ Owner Owner's Name information is MA 02601 5-10-2010 required for Hyannis, every page. Cityrfown 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 t5ins•09108 y TOWN OF BARNSTABLE �, 6� LOCATION ,37 �� rrzsW4,-- �D SEWAGE ' i/ILL'A`GE r7'�t o��1/S' ASSESSOR'S MAP & LOT -5 a INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /3W) G� L LEACHING FACILITY: (type)Tier l (size) 36 X V A-2 NO.OF BEDROOMS BUILDER O WNER tr +.. PERMI`TDATE: COMPLIANCE DATE: Id - 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 ,f'- Feet within 300 feet of leaching,facility) Furnished by t-r Zs S $ �' r � C l i r o .r.l bv`cG e0 Fee G?o-_ VH6.COMMONWEALTH OF MASSACHUSETTc; Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,L MASSACHUSETTS Application for bigozal *pgtem Con5tructiOn Permit Application for a Permit to Construct( . )Repair( )Upgrade(✓)Abandon( ) Complete System ❑Individual Components Location Address or Lot No. �Gl��r r Owner's Name,Address and Tet.No. AsZ YZ Map arl Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Mr tv/off C��s�: Type of Building: Dwelling No.of Bedrooms Lot Size�4sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i/, qz!u Design Flow ® gallons per day. Calculated daily flow C 7 i �Z gallons. Plan Date Number of sheet Revision Date Title P a/l f g C ✓` i r/ Size of Septic Tank Type of S.A.S. Description of Soil: Nature of Repairs or Alterations(Answer when applicable) 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 issued b t 's oar f H lth. Signed -__.._. Date /0/�, l Application Approved byI A) Date Application Disapproved for4re following reasons Permit No. Date Issued d loo- Fee rim COMMONWEALTH OF MASSACHuETft Entered in computer:>/_ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0[pplication for Migpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade($ )Abandon( ) U Complete System ❑Individual Components Location Address or Lot No. �.� Owner's Name,Addr9ss and Tel.No. Asses is Ma /Parcel Zz�- g Y /S Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No og- 7 7�-�3q9 Type of Building: Dwelling No.of Bedrooms Lot Size /l/i sq.ft. Garbage Grinder( ) Other Type of Building l PS/G�i.. 'ia No.of Persons Showers( ) Cafeteria( Other Fixtures a.'o Aay u�} Design Flow yP _gallons per day. Calculated daily flow y/7 �Z gallons. Plan Date L/ Number of sheet / Revision Date e9'D Title Oy` la/I/.� /� .S 7G/C St $1-sw Size of Septic Tank Type of S.A.S. Z Description of Sod; s� Nature of Repairs or Alterations(Answer when applicable) 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 issueWbt,,,s Board-of Health.SignedDate f Application Approved by ,,a t Date Application Disapproved for4re following reasons Permit No. a 0dr cv 14 Date Issued 14J u S THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS _ Certificate of Compliance THIS IS TO CERT.IR, that the n-,site Sewage Disposal System Constructed ( )Repaired ( )Upgraded Abandoned( )by at 3 7 Y-- 3 q l}/fa,ftPl� l • /17 /7S has been constructenf in accordance with the provisions of Ti;ae,5 and the{for iiDisposal System Construction Permit No. 9M 1:i <OIYdated -I 7 UT Installer 19'lIi Designer The issuance of this pe, i shall not be construed as a guarantee that th ystem ww f n do e . Date ��Y3 -5 Inspecto --- — —=' — --- ------------ =— No. �(/c�S �1(;_0 — Fee /ao - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS -Migponl *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade a,)Abandon System located at 3 /S��la�G��^ 1'yl • _7. /� 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: Construf;tion/must be completed within three years of the date of s pe ft. Date:_ 10 �� a� Approved by r' Town of Barnstable °Ft"Er°"'' Regulatory Services Thomas F. Geiler,Director •AUISTABLE, _ � HAS& Public Health Division ArEDMA�A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: C� Designer: Shay Environmental Services Inc. Installer: Address: P.O. Box 627 Address: I East Falmouth, MA 02536 On /,*1- 7-e i p"�l(installer)(IZA, (date) was issued a permit to install a 2 septic system at aJ�' 31C�1rGt` based on a design drawn by (address) Shay Environmental Services, Inc. dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified -built by designer to follow. �H of kAS S CARMEN N nstaller s Signature) o E. 0 SHAY N No. '1181 r4 nA*V A/L. �FG/STER�o SgNI TAR�PN es>gner's Signature) (Affix De i tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form ti Town of Barnstable Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. Mr. Carmen Shay, R.S. May 2, 2005 Box 627 East Falmouth, MA 02536 Dear Mr. Shay, You are granted conditional variances on behalf of your client, Howard Winer, to construct a replacement soil absorption system at 37 and 39 Hiramar Road, Hyannis. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be 5 feet away from the front property line, in lieu of the 10 feet setback separation distance required. 310 CMR 15.211: The septic tank will be 5.5 feet away from the foundation wall, in lieu of the 10 feet setback separation distance required. 310 CMR 15.211: The soil absorption system will be 5 feet away from the water supply line, in lieu of the 10 feet setback separation distance required. Section 360-1: The soil absorption system will be 93.5 feet away from the bordering vegetated wetland, in lieu of the 100 feet setback separation distance required. Section 360-1: The septic tank will be located 82 feet away from the bordering vegetated wetland, in lieu of the 100 feet setback separation distance required. - ShayWiner These variances are granted with the following conditions: No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (3) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. The septic system shall be installed in strict accordance with the engineered plans dated March 4;2005. (5) The designing sanitarian shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the plans dated March 4, 2005. These variances are granted because the physical constraints at the site severely restrict the location of the septic system due to the close proximity wetlands on two sides of the lot. The proposed soil absorption system appears to meet the maximum feasible compliance standards contained within the State Environmental Code, Title 5. Sinc ely your Wayne Piller, M.D. Chairman Shaff iner e - Doc= 1s015r318 10-07-2005 1 :31 BARNSTABLE LAND COURT REGISTRY DEED RESTRICTION WHEREAS, HOWARD A. WINER Trustee of the WINER REALTY TRUST No. 8, under a Declaration of Trust dated September 1, 1994 and recorded as Document No. 623,800 at the Barnstable County Registry of Deeds, having an address of P.O. Box 434, Harwich Port, MA 02646, is the owner of 37- 39 Hiramar Road located at Hyannis, MA and being shown as Lot 29 on Land Court Plan Number 17786-C (Sheet 2); WHEREAS, HOWARD A. WINER Trustee of the WINER REALTY TRUST No. 8, as the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board,of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Codejitle V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. NOW, THEREFORE, HOWARD A. WINER Trustee of the WINER REALTY TRUST No. 8, does hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. 37-39 Hiramar Road, Hyannis, MA may have constructed upon the lot a house containing no more than four (4) bedrooms. HOWARD A. WINER, Trustee of the WINER REALTY TRUST No. 8, agrees that this shall be permanent deed restriction affecting Lot 29 located on 37-39 Hiramar Road, Hyannis, MA, and being shown on the plan M recorded as Land Court Plan 17786-C (Sheet 2). For title of HOWARD A. WINER, Trustee of the WINER REALTY TRUST No. 8, see Land Court Certificate of Title Number 134978. Executed as a sealed instrument this of d vC , 2005 Al Howard A. Winer, Trustee COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss. On this 6 4 day of GCt- , 2005, before me, the undersigned notary public, personally appeared HOWARD A. WINER, Trustee as aforesaid, proved to me through satisfactory evidence of identification, which was gas-' j<-gu4 , to be the person whose name is ' ed on the preceding or attached document, and acknowledged to me t t he gned it voluntarily for its stated purpose. NOTARY SEAL: NOTARY PUBLIC My Commission expires: 1 b D CRDWEI'` \O-OW Pug�-IC t�O1P�Y0 t?.a sacnu ress EXpi z Nwpecem"T BARNSTABLE COUNTY REGISTRY OF DEEDS A,�TR��UE COPY,ATTEST JOHN F.MEADE,REGISTER BARNSTABLE REGISTRY OF DEEDS Health Complaints 16-Jun-05 Time: 12:55:00 PM Date: 5/23/2005 Complaint Number: 18120 Referred To: DONALD DESMARAIS Taken By: JUDITH FLYNN Complaint Type: TITLE V SEWAGE Article X Detail: ILLEGAL OPERATIONS Business Name: Number: 39 Street: HIRAMAR ROAD Village: HYANNIS Assessors Ma _Parcel: 9 p Complaint Description: CALLER SAYS THAT SEPTIC IS BEING WORKED ON - LIDS LEFT EXPOSED OVER WEEKEND CHILDREN PLAYING ON THEM - NOTICED THAT ONE OF THE LIDS HAD A CRACK IN IT-AFRAID OF CHILDREN FALLING IN. Actions Taken/Results: DD WENT AND SAW TWO CESSPOOL COVERS DUG UP. CALLED HOWARD WINER(LEFT MESSAGE)TO FIND OUT WHAT WAS DONE AND HAVE THE COMPANY THAT DUG THEM UP FILL THEM IN. I STOOD ON EACH COVER AND THERE WAS NO GIVE. I WEIGH 240 LBS. I FEEL IT IS REASONABLE THAT IF THEY HOLD MY WEIGHT, A CHILD IS SAFE. Investigation Date: 5/24/2005 Investigation Time: 3:15:00 PM �F3HE DATE: �4-Os «... '.: FEE �S * )AINSTASLE ;ti MASS. PQj t639 REC. BY Town of Barnstable SCHED. D TE: Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION 2�Q Property Address: �j}T9 wcxv - �,A Assessor's Map and Parcel Number: cA IAR Size of Lot: 1, © c�• ��- Wetlands Within 300 Ft. Yes Business Name: N No Subdivision Name: NIP —o APPLICANT'S NAME:Wnl ( (ADI"Z Phone �J '600(o Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON C D C �� Z, Name: �Ot",SaA U.)wwx, Name: r Address: Address: r Phone: Phone: 15 n—T (Mk0 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 3 L& —1 Lo-r Sing ay"'As sQ-F��c� Cti�cQlhCcY� ?i(a.e -a-1 i/ � k 5s I rota � --NCO NC-Rc t\Cta -\n �c,��F1� S HS fi' F- wv) la.ct ,a•,c�r- Rom` yGc1 oc,ae- A-ti w s \1 tt) rn r7)�cif �e� \--tnsz U74-%-, 600tOk-r- S 1-e2ATe. NATURE OF WORK House Addition 0 ????? House Renovation 0 Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. _✓ Four(4)copies of the completed variance request form _✓ Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans 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 _✓ 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) C:\Documents and Settings\decollik\Local Settings\Temporary Internet Files\OLK3\VARIREQ.DOC _ Variance request application fee collected (no fee for lifeguard modification renewals, 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 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 MAIL-IN REQUESTS NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Please mail the completed variance application form to the address below. Also include four copies of engineering plans, house plans, authorization letter, etc (see check-list below). In addition, please include the required fee amount (see fees at bottom of this page). Make $85.00 check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Checklist _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans 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 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) i Full menu submitted(for grease trap variance requests only) $85.00 variance request application fee (no fee for lifeguard modification renewals, 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 no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, you must mail the required $85.00 fee. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. In addition, please mail four copies of engineered plans, house plans, authorization letter, etc. (see check-list below): Checklist _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans 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 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) $85.00 variance request application fee (no fee for lifeguard modification renewals, 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 no expansion to the building proposed]) DATE: FEE: REC. BY SCHED. DATE: Variance request submitted at least 15 days prior to meeting date For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Paqe C:\Documents and Settings\decollik\Local Settings\Temporary Internet Files\OLK3\VARIREQ.DOC U0/� 1/[v14 V4:Jr rAA 1o001/003 CAME E.• SHAY (508)548.0796 ENVIRONMENTAI SERVICES, INC. P.O. Box 627, East Falmouth, MA 02536 May 18,2004 •� — /10t 17 Mr. Howard r P.O. Box 434 Harwichport, MA 02646-0434 RE: #37 &39 irimar Road, Hyannis, MA-310 CMR 15.00 Title 5 Design Pr posal Dear Mr. �r. Pursuant to youl request, the following is a proposal to design an upgrade to the on-site subsurface sewage disposal system located at the above referenced address. All work performed shall be at a mi imurn in accordance with the requirements set forth in the Massachusetts Environmental C de Title 5: Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,Regulation 310 CMR 15.000. As mandated by Title 5, observation and recording of Deep Observation Hole Tests, Percolation Tests and Soil Evaluation will be performed with the approving Board of Health. The soil evaluation and engineering time for a percolation test cost will be included in the design cost unless existing c nditions result in time spent over three hours. Time over three hours will be billed at an hourly'rate of$65.00/hr. If this additional time is required this cost will be billed over and above the actual system design cost and will be billed separately. The test holes will require the use of a subcontracted backhoe for excavation. The cost of a backhoe is included in this proposal. The plaits and specifications shall be prepared by a Registered Professional Engineer or Registered Sanitarian as mandated in 310 CMR 15.220. Upon completion of the sitelpecific subsurface dispo al design plan, you will be furnished with three (3) copies of the plan, Additional copies of the plan can be provided for additional cost. Upon completion of system installation, you as the property owner will be responsible for having a certified as-bui t plan prepared and submitted before the approving authority will issue a certificate of compliance. We can on behalf of the property owner perform the as-built survey and plan and ob 'n a certificate of compliance from the approving authority pursuant to the requirements set forth in 310 CMR 15.021 (2) through (6)_ The cost of the as-built plan preparation is inel ded in this design cost contract. b. Prior to the iss ce of the Certificate of Compliance, the local approving authority is also required by the regulations to make a sufficient inspection of the system to determine that all work has been completed in compliance with the applicable requirements set forth in the design plan and Title V Code. — — Soil Evaluation Percolation Test Design&Plan Preparation Backhoe for Perc Test - 2 Night Meetings (1 Health& 1 Con C Town of Barnstable (; 1 s,Inc Less Deposit of ine st Note 1: If minimum setback distances from the proposed septic system to the property lines are needed it may be necessary to set stakes on the lot comers. If important property monumentation in the area is missing or destroyed, a property line survey may be required to accomplish this. A full property line survey is not included in this design contract. If necessary we could perform the property line survey under a parate contract. Note 2: If�passing percolation test is not obtained on the day of the soil examination due to poor soil conditions, the time associated with obtaining the necessary variances from the local and state approving authorities for the system design will be billed over and above this contract. If this situation occurs we will notify you and obtain yoi ir authorization before proceeding with.any additional work, Note 3: 01 r proposal is based on the design of a conventional on-site sewage disposal sy tem. If an innovative/alternative system is required due to existing site co ditions, the design fee will be adjusted according to our standard fee schedule ov-r and above the price shown on this contract. If this situation occurs we will notify you and obtain your authorization before proceeding with any additional work. Note 4: Client is responsible for all State and local dine fees; i Note 5: If t e determination of a Resource Area, filing of a Notice of Intent or Request for De ermination of Applicability form with the Local Conservation Commission and the State D.E.P. are necessary your property must meet criteria of the Massachusetts Wetlands Protection Act. Typical criteria include being within 100' of,a wetland or a resource area. Costs associated with complying with the Wc 11ands Protection Act are charged over and above this contract. Note 6: If attendance of ADDITIONAL Board of Health or Conservation Commission me tings is required due to existing site conditions an additional fee of S20,00/mecting will be charged for each meeting, if you or the Town of Barnstable request the presence of the design engineer/registered sanitarian. One Vo/G1/GV IY VY.Jo rnll W..J VVJ/VV.J Board of Health and/or Conservation Commission Meeting is anticipated but not guaranteed and is included in this contract. Note 7: If State and/or local variances must be applied for due to existing site conditions, the time associated with these applications will be billed over and above this contract. The contract does include the cost of filing a property setback variance dule to the size of the property. Local and State Fees not included in Variance Filin . If you have any questions regarding this proposal, please do not hesitate to call me at(508)-548- 0796. Sin erely, Carmen E. Shay, R.S., C.S.E. President FOR: espo a Party Please sign for " lesponsible Party" and return original, If possible please include a copy of the deed for your property and a copy of the mortgage plot plan and any other plans of the property with this contract.(For lot size, reference and dimension data) Prior to doing any work on the property, we reserve the right to post a notice of contract. The parties to this contract specifically agree that Carmen E. Shay has no obligation to release drawings or other documents until the final bill for services has been paid. A copy of the exe uted contract will be forwarded to you for your records. #29 & #31 HIRAMAR ROAD, HYANNIS MA Floor Plan NOT TO SCALE Bathroom Bedroom Bedroom Bathroom Kitchen Dining Kitchen / Dining Living Room Living Room Bedroom Bedroom s McKean, Thomas From: Anderson, Dave Sent: Friday, April 29, 2005 8:41 AM To: McKean, Thomas Subject: Sewer on Hiramar Road Currently, sewer is NOT available on Hiramar Road, Hyannis. The Town did leave a stub at Rte 28, for Hiramar, when the vacuum sewer was installed, but I have no guess as to when ( if ever)that sewer might be extended up that road. Dave Anderson Ext 4068 B_R1GC3 Briggs Engineering & Tcsting A n/NfS1(M OF PK AIWOAMI,INC. April 7, 2005 Shay Environmental P.O. Box 627 E. Falmouth,MA 02536 Attn: Mr. Carmen Shay Title V Soil Analysis Address: 37 &39 Hirimar Rd-, Hyannis Briggs# Tested: 4-7-05 1 Lab Ref, No. Description Source M-12096 410 Fraction Site 2. Particle Size Analysis {ASTM D 4221 Sieve Size Results Standard Alternate {%Passing by Wt_1 2.0 mm #10 100 9.. 0.850 mm #20 80 0,425 nun #40 49 Sob 0.180 min #80 22 0.150 mm #100 19 0.053 nun #270 9 0.0375 mm 6 0.0242 mm 3 0.0139 nu-n l 0.0100 mm. 0 9% 0,0070 mm 0 0.0035 mm 0 0.0015 mm 0 3. The above analysis was performed in accordance with D.E.P. policy#BRP/DWM/PCP-001-1, 0% Appendix 2. Respectfully Submitted, BRIGGS ENGINEERING &TESTING A Division of PKAssociates, Inc. Mark D. Liebert Director of Testing Services Construction Technology Division enclosures: graph ._,.._.----------..___...-....._.._......._ _—.------ �vww.1>ril;I;scnl;inct�rini;.c•cam ..._..........__---...__..._.........------ — 10O Weymouth Street- Unit B-1 100 Pound Road Rockland,MA 02370 Cumberland,RI 02864 Phone (781)871-6040-Fax (781)871-7982 Phone(401)658-2990•Fax(401)658-2977 __ 20'd Z86LT2,8T82, JN8 SJJINEI 82:VT S00Z-6T—Ndd D 53Ca Project: 37 & 39 Hirimar Rd., Hyannis FF-4Rlr3C3S Briggs Engineering & Testing Date Tested: 4/7/05 � .4 Di.j.iox of PA:Jefod:urrt. Irc." Lab Ref. No.: M-12096 m m A Particle Size Analysis W i 0.0025 6 L.t _.____�T 11 b #4 301 100 , f F JI 1 1 t 90 i i (LO 8o m ' A II I ; Z M 70 E I I C �' 60� 1 ro 4-4 a s I 50 Z u, 40 U a 30 f � 20 .i I1w I i " ' a 10TI ' I I ' 0 ODD 0.00 0.01 0.10 1.00 10.00 100.00 -11 Ib Sieve Size, mm N 0 N te: Th illustrated graph represents the sa id fraction only as defined by D.E.P. olicy#BRP/DWM/PeP-POD-1,Appendix 2. -o A m 1b u 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 1515�vnes of Coil Textural 0wgRen (1) The.following soil textural classes apply to soil types ofwluch they are composed: CLASS I Sands,Loamy Sands CLASS II: :-Sandy Loams,Loams CLASS III Silty Loams CLASS IV Clays,Silty Clay Loams (2) Textural Classifications are made based on the relative pi oporuoa of sand,silt and clay in the soils and in accordance with the following textui-al.tnangle: SOIL TEXTURAL.TRIANGLE 100 .90 �o 80 70 lay 60 d4 { of 50 ,. w• Q sa 40 cl gp san cla 4_0 i 20 ° jj 10 san to I . stl to I' I1' san Sa. 311t DO lob 00 percent sand i MCC- C x 1117 07 '�)Q1 ` f-'s' C i-)S'::�T PC'CJ S 12/1/95 (Effective 11/3/95)—corrected x� I� t526 it LOCATION SEWAGE PERMIT - NO. `VILLAGE INS&-ge,T- LER'S NAME S ,ADDRESS R UI DER OR OWNER 4Ybh-Ai tiht% M&SS . DATE PERMIT ISSUED DATE COMPLIANCE ISSUED g% � � �pig&T A-To O.is-►ac-ptr A-To Id ed P i*r (� B-To tr sna& P.T To New P IT o I84DID 1112VAF�- -- _ ' �t! ALL OUTLET PIPES FROM THE „ fI" DISTRIBUTION Box SHALL BE 1 • ;� SET LEVEL FOR AT LEAST 2 FT. 2 -' CONCRETE COVER "0 10 min. from 'NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. VENT PIPE (O Least 24 inches tau) } - s' outtET Sr 40 � 2 Schedule PVC w/Charcoal Odor Filter KNaCKDVTS Y /n� NEW Foundation hones to septic tank Septic tank coven must be +\ - S.S' 12" INLET i TOF ELEV 100.00 (Assumed) OUTLET "'t QQa within 6 in. of finished grade Grade aver SeptIC Tank - 99.0C Grade ow D-Bo. - 99.00 ' (, FkNM Onade Ow 99.00 R• �. I .sue.,;.••^ I ? 7 I S C 3 HOLE H-10 TOP 0f afet«"- ELEV e6.80 4" - SCH. 40 Te t7S vs Me j a f ----- r ca.. T -- �;E� s-o.,o or cr.oter D6T. BOX s- oo,o• per foot s..00s --- - �- PLAN SECTION CROSS-SEC ION ,•/_t � ��" -�-- t ..._. EXIST. PIPE--'' 5 ��" �4• Perforated P v C T-1/e•-1/2' Wo•nea Stone ,.� j -1 1.500 GAL. OR GREATER / SEPTIC TANK ,� s t w F ; S A• FRON FOUNDATION W 32 �• invert EI•v-B5.80 a; 1 A f t 1 ur.....; ^y /1 H H-10 g 2' ,�.-,>`" waened Stan. 80"O, of Le h FacHity E;-- 9380 3 HOLE H-10 DISTRIBUTION BOX ! CONCRETE SLAB FOUNDATON--' --3 " rn rn rn I6 NOT TO SCALE Mw ! '�f'���� > II p Nob: AM lead+ �m*v to be capped at ends w/VVC cope. 8 PROVIDED • acaw"* •I'�FKfM® •we,��� SYSTEM PROFILE 6 In.of 3/4•-1 1/2• -9 " 5' STRIPOUT ALL AROUND So torn----------- Not Test �e 1 -°'�° GENERAL NOTES compacted atone y o to scale � > > w LEACH TRENCHES LEACH TRENCHES CROSS-SECTION (2 TOTAL) < < (2 TOTAL) 1. Contractor is responsible for Digsafe notification and protection of all underground utilities and pipes. NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE «�• _ 2. The septic tank and distri ution box shall be set level on 6" of 3/4"-1 1/2" stone. 2•of 1/e•-1/2'_- 3. Backfill should be clean sand or gravel with no waened Stan• stones over 3" in size. 4 Ma>a.ry' 4. This system is subject to inspection during installation NOTE: MUNICIPAL WATER LINES TO BE REMOVED AND by Carmen E. Shay - Environmental Services, Inc. REPLACED AS SHOWN. ALL WATER LINES TO BE DOUBLE 5. The contractor shall install this system in accordance 3/4'-1 •Wooed star with Title V of the Massachusetts state code, the approved plan PERCOLATION SLEEVED FROM STREET TO HOUSE. ° poct"d etwe and Local Regulations. 4'p•APr•4d P.V.G Pipe °" Date of Percolation Test: AUG. 6, 2004 Note: Remove Soil down to el. 87.00 & replace with - NOT TO SCALE 6. If, during installation the contractor encounters any soil conditions or site conditions that ore different Test Performed By. CARMEN E. SHAY, R.S., C.S.E. clean coarse sand w/perc. rate less than or from those shown on the soil log or in our design Results Witnessed By. DAVID STANTON (Barnstable B.O.H. or equal to 2 min./in. before & after placement installation must halt & immediate notification be EXCAVATOR: RODNEY FISHER (5 FOOT STRIPOUT ALL AROUND AS SHO','JN) I mode to Carmen E. Shay - Environmental Services, Inc. Percolation Rate: Less Than 2 MPI 0 120" i I 7. No vehicle or heavy machinery shall drive over the 40 POLYETHYLENE LINER FROM ELEV. I I i septic system unless noted as H-20 septic components. C i i I 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. 97.00 to 92.00 AND TO EXTEND 10 BEYOND TANK ----- -- - c I 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. Test Hole LOT #28 \ 1, , �I 10. All solid piping, tees & fittings shall be 4" diameter No. 1 PROJECT BENCH MARK 1 o', t"'\ Schedule 40 NSF PVC pipes with water tight joints. DEPTH SOILS ELEV. TOP OF FOUNDATION 1500 GALLON 3', \ e1 6 i, �1 ,` 11. Municipal Water is Connected to ALL OF The Residence and Abutting Pro 0 97.50 ELEV. (Assumed)( l SEPTIC TANK= 100.00 A p �I erties Within 150 Feet. I \ I � 1 11 FILL THE PROPERTY LINES ARE APPROXIMATE AND �O It COMPILED FROM THE SURVEY PLAN GENERATED BY 89.50 '00 t Failed c� BEARSE & KELLOG, BARNSTABLE, MA ENTITLED � \ I \ Cesspoop Loamy \ \ I \ 0 "SUBDIVISION PLAN OF LAND IN BARNSTABLE, MA" LC 17786-C Son CP \ `\ I \ \ DATED MAY 21, 1954. IT SHOULD BE USED FOR NO PURPOSE ,o YR 3/2 OTHER THAN THE SEPTIC SYSTEM INSTALLATION. 1 96"-104" A, 88.83 Loamy \ I \ 0 Sand \\ \ I ` \ 5. 0 \ `\\ \\ 1 10 YR 5/8 \\ `� \ ` EXISTING CESSPOOLS TO BE PUMPED OUT AND 04"-120" Be e�.5o rTl \ \ \\ #37 & #s9 \ \\`\4` \`� REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION Medium �o `� \\ _ < `of� It J NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE Sand I \_ EXISTING z.s e/e m �` -' �� FRAM wE� 4 BEDROOM ` u \\\ �\ V FROM THE EXISTING CESSPOOLS TO BE DISPOSED i c, (� D S \ \ OF AS PER BOARD OF HEALTH SPECIFICATIONS. I120"-168 83.5 \ HOUSE a--100 WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY LOT ;�29\�� \�� \ \�` �� ``�\ (, \\` ASSESSORS MAP 292 PARCEL 138 � � 10,00k Squarb\Feet +/- CONCRETE SLAB \�\\ \ f ? \\_ \\\�\\ \\\ LEGEND FOUNDATION \ \ Perc #1 \ \. ` 0 ` \ `\ SIEVE ANALYSIS TO FOLLOW +1 \ DENOTES PROPOSED Perc Rate= Less Than 2 MPI ` ` 0 r \ \ 104X 1 \ SPOT GRADE 00 Groundwater Not Observed EDGE DENOTES EXISTING No Observed ESHWT �, `J' �0F \ 46 SPOT GRADE WETLANDS \ \\ \ 1, `��� `� :s x 104 ADJUSTED H2O Elev. = None ,�� . EST HOLE #1 µWa,c W 1 PL PROPERTY LINE J' o �`� \ ELEV = 97.50 ' ' , r»> PROPOSED CONTOUR \ m \ 80.99 t I , , �o 11 �� - - - - - -97 EXISTING CONTOUR m \\ `11 Z I i ' i li DEEP TEST HOLE & TYPICAL 500 GALLON SEPTIC TANK 1 �, PERCOLATION TEST LOCATION NOT TO SCALE p� \� \ t9 I oJ� I fy 6 FOOT STOCKADE FENCE CIO 3-24'DIAM. ACCESS MANHOLES (H- 1 0 LOADING) �� LOT #30 ' REV.: 4/19/05 - Revised Elevations per BOH teleconference 4/19/05 t0' -6•- 'r NOTE: REPLACED DURINGURAL GAS SSEINES PTIC 0 BE REMOVED AND PLO LA INLET 1. e 0 \-` � :• OUT OF PROPOSED SEPTIC SYSTEM UPGRADE INLETr: DISTRIBUTION BOX AND FOR EACHING4. THE ACCESS COVERS THEEPTIC COMPONENT VARIANCE REQUESTED: I PREPARED FOR [� y� I� SHALL BE RAISED TO WITHIN 6' OF 1 REQUEST AVARIANCE TO INSTALL AN SAS 93.5' FROM A WETLAND. M R . H 0 WA R D W I N I \ S ',:"•:^�' f z '.. �•'"T•� „'_.;� FINISHED GRADE. STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TTTE GAS BAFFLES OR EQUALS 2. REQUEST AVARIANCE TO INSTALL AN SAS 5' FROM HIRAMAR RD ON ALL OUTLET TEE ENDS AT PLAN VIEW 3. REQUEST AVARIANCE TO INSTALL AN SEPTIC TANK 5.5' FROM �7 3-24• REMOVABLE COVERS THE HOUSE FOUNDATION - 40 MIL: RUBBER LINER PROVICED. 3 / 39 H I R A M A R ROAD + 4. REQUEST AVARIANCE TO INSTALL AN SAS WITHIN 10 FEET' OF t t A WATER LINE - WATER LINES TO BE DOUBLE SLEEVED. H A N N IS T MA J mkt. dearonu ;, I 13' PALT•P -- INLET e• mit T 1Y min xxet to outlet a. ,ti I DeSiQn Calculations NLE Ilr min. u0Id level,� OUT.ET I } PREPARED BY: Li s -r * --- t i -r Number of Bedrooms:4 Equivalent to 440 Gal./Day v �� M Try� ' ! T T �r T T T E$ Garbage Grinder No �� l/i 1/11l/JlHi 11Y/ IJ\lHl lY E awe'. uquI4 deg" Leaching Capacity Proposed: 440 Gal./Day Minimum (Min. Per Title V) RM yG Im Septic Tank - 2 x 440 Gal./Day = 880 INSTALL NEW 1,500 GAL. Septic Tank. O 20 40 50 'A E. �� ENVIRONMENTAL SERVICES, INC. j SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch U •A,o'-a• " S -e' Proposed Leaching Trench Dimensions: 2 TRENCHES -4' Wide by 36' Long by 2' Depth EACH. P.O. BOX 627 CROSS SECTION END-SECTION Bottom Area: 0.74 gal/sq. ft. x 288 sq. ft. = 213.12 EAST FALMOUTH, MA 02536 gal gallons STER Sidewall Area: 0.74 gal./sq. ft. x 320 sq. ft. = 236.80 gallons SCALE: 1 "=20' s TEL/FAX : 508-539-7966 Providing: = 449.92 gallons =20' DRAWN BY: CES DATE: MARCH 4, 2005 Use: 2 TRENCHES - 361 by 4'W x 2'D PROJECT#SD700 FILENAME: SD70OPP.DWG SHEET 1 OF 1