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HomeMy WebLinkAbout0085 KENNEDY CIRCLE - Health 85-Kennedy Circle Hyannis F/R . A = 268 058 i ( I Ir P I I I 'r „ o TOWN OF BARNSTABLE /&0 LOCATION A&dSEWAGE # p, VILLAGE ASSESSOR'S MAP & LOT1 0 5-& INSTALLER'S N��E&PHONE NO. ' t SEPTIC TANK CAPACITY LEACHING FACILITY: (type)t (size)" No. OF BEDROOMS BUII DER OR OWNER -'PERMITDATE: 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 -_ _ _ 1 j � - �I :.+ �`� , ��- O ,� �� r , F � P j Y Y � � n T ~ M. Tf2 .i � ��W. d�u� TOWN OF:BARNSTABLE �- s LOCATIONAS' 1<(50 Cl ~ >.: SEWAGE # O®`�-b�l� VILLAGE 0 O ASSESSOR'S,-MAP & LOT Xjr vsy INSTALLER'S NAME&PHONE NO. f C l+tX& SEPTIC TANK CAPACITY LEACHING FACILITY: (type) r size NO.OF BEDROOMS �' -J' T/W d origi�,�c,Il y�, 3 ged 1BUILDER OR OWNS .. LC � ERMITDATE: 6 a 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 7:r-> � t - �_ ..�� � �_ - _ . No. 70`s i ( ) V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Miopool bpztem Conotruction Permit Application for a Permit to Construct( . )Repair(.1 6`grade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. _n�S Owner's Name,Address and Tel.No.ehn2cQy /�. ' 'A��n e �JA J�j AIV Assessor's Map/Parcel '1(�'1 — O:5-19 Installer's Name,Addres s.*ANCO Designer's Name,Address and Tel.No. 350 Main Street �'Ao F q(F , W. Yarmouth, MA 02673 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 qq0 gallons per day. Calculated daily flow 17/59 gallons. Plan Date (9`i • .3 Number of sheets Revision Date V/A Title lei-c- i ;c ki Size of Septic Tank /r0- nn Type of S.A.S. 13 X �.7 Description of Soil Ge r- /"� 0_7 Nature of Repairs or Alterations(Answer when applicable) Pe r /)1'A-7 a Date last inspected: Agreement: f 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 by this Board o,fKHeal rjoL�� SignedDate / /k i-/ Application Approved by Date l Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------•— No. �l�tJ T �i Fee y / +� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplicattou for Mopoot *pgtem Cou.!tructtott Permit Application for a Permit to Construct( )Repair( v)-gpgrade( )Abandon( ) ❑Complete System 0 Individual Components Location Address or Lot No. J/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel" Q&J - U S6 Y +. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: / Dwelling No.of Bedrooms �f Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow y U gallons per day. Calculated daily flow �S gallons. Plan Date �a 'o�S Number of sheets Revision Date IV 114 Title 5-ed/,c. 1,f,•c r► Size of Septic Tank y (� T Type of S.A.S. nn �3 X 3y•>x a Description of Soil l e r A14� Nature of Repairs or Alterations(Answer when applicable) ate" 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 by this Board o�ealthl—) Signed 1 \ G'2_R.� t.ev t_�^ Date �l /,141 Application Approved by �I ',-�_ Date f A Application Disapproved for the following reasons � I 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(1,1�pgraded( ) Abando ed( )by r,-- C C) at � e��P Y C- i`/ . / Yg�''�' i S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. u U 4 b a dated � U t Installer Designer The issuance of this uermit shall not be construed as a guarantee that the sy�s e_ a ill f@�.ction as dp-siigned Date �'.,7 i J t Inspector ---�+—, ----------------------------------- No. 2L ) 7�/- o 2& Fee �G c I THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Zigotal bpg;tem Con.5tructiou Permit Permission is hereby granted to Construct( )Repair( pgrade( )Abandon( ) System located at R.5 '� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of.this_per-nut. Date: Approved by TOWN OF BARNS.TABLE �- - 12 � LOCATION }`� SEWAGE # l VILLAGE O ASSESSOR'S MAP & LOT 6jr- 5Y INSTALLER'S NAME&PHONE NO. i7f COX6 . "?7S7-d9_66 SEPTIC TANK CAPACITY - LEACHING FACILrrY:-(type) (size) NO.OF BEDROOMS TM-0P'�9�'na��y.e1 3 tS BUILDER OR OWNS °PERMITDATE: I 6Ld 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 - . %♦ ;O \ a P 3arnstable Assessing Search Results Page 1 of CE dome: Departments:Assessors Division: Property Assessment Search Results 85 NE CIRCLE 7wner: GIOFFRE,VINCENT A& DOLORES D Property Sketch Legend Map/Parcel/Parcel Extension 268 /058/ Mailing Address t GIOFFRE,VINCENT A&DOLORES D 95 GREEN ST " 11fix,.333nfl �, - WOODBRIDGE, NJ.07095 ` 3 t004 Assessed Values: Appraised Value Assessed Value 3uilding Value: $69,000 $69,000 -xtra Features: $2,400 $2,400 Outbuildings: $0 $0 Land Value: $ 139,600 $ 139,600 Interactive Property Map: ap requires Plug in: Totals:$211,000 $211,000 1 have visited the maps before � � ,' First time users Show Me The Map Click Here April 2001 photos available Sales History: Dwner: Sale Date Book/Page: Sale Price: 31OFFRE,VINCENT A&DOLORES D 1365/893 $0 2004 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $ 1,394.71 Town Fire District Rates Other Rates 6.61 Barnstable 2.01 Land Bank 3% of Town Tax Hyannis FD Tax $428.33 C.O.M.M. 1.10 Cotuit 1.52 Land Bank Tax $41.84 Hyannis 2.03 West Barnstable 1.36 Total: $ 1,864.88 Due to rounding differences these values may vary Land and Building Information Land Building ittp://www.town.bamstable.ma.us/tobO2/Depts/AdministrativeServices/Finance/Assessing/AssessO3/displa... 2/18/200, 3arnstable Assessing Search Results Page 2 of Lot Size(Acres) 0.41 Year Built 1960 Appraised Value $ 139,600 Living Area 1004 Assessed Value $ 139,600 Replacement Cost$85,229 Depreciation 19 Building Value 69,000 Construction Details Style Ranch Interior Floors CarpetHardwood Model Residential Interior Walls Drywall Grade Average Minus Heat Fuel Gas Stories 1 Story Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 5 Rooms Extra Building Features Code Description Units/SO ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch .PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) ittp://www.town.barnstable.ma.us/tobO2/Depts/AdministrativeServices/Finance/Assessing/AssessO3/displa... 2/18/200, 12-05—003 04:�34PPI FROt,I SWEETSER ENGINEERING TO 15187979541 P.02 235•Great W$stetn Reed P.O. Box 1044 Tslsphoni�(508)396-8311 South Denis, MA QM0 Fax (50)398-M PROFESSIONAL CIVIL ENGINEER, SOIL.EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL.&.BUILDING DESIGNS SEPTIC DESIGN PROPOSAL PAGE 2 PROPERTY SURVEY AND FLOOR PLAN SKETCH Please Ci l l Out this form,inciydlizg_the floor glaa skeXcAz, and return to us with the signed lsrapasa3 and retainer. This irfformAtiOrl is fk"WAry t0 prOlVerly prepare your Septie System Design. -• IF YOU ARE PLANNING AN ADDITION PLEASE INCLUDE THAT INFORMATION ALONG WITH THE = _ FE3t7;MAITON FIM_ _IONS AND LOCATION FOR THE NEW ADDITION. Tafa3#of RobmS -, ---Year Found.Home Seasonal Home _ Owner Occupied _ Re -,ZL#Be druoms Family Roam/Den Living Room Dining Room #13fit Washec/Dryer Dishwashor Garbage Disposal Gas Service To -In_ground Ele=ic Wises" In-Ground Oil Tank* In-ground Sprinkler* In-ground Cse _— * Please note on 9.k.t. cis wbere loented. Craig R Short, P.E. assumes no responsibility if in-ground components dam4ed-5-duri4 Sb-x .Tekings, Inspections, Locations of and/or Installation of New Septic System. = - CQl1ar: Y Partial(Crawl) Saab _ _. Wells; main Use Irrigation Only (please provide location of all)veils) PLEASE.USE THE SPACE BELOW AND THE BACK OF T141S SHEET TO PROVIDE US WITH A R,0Ii SKE - THE_E TlNG PLO.O PLAN('ALL FLOORS). Also include any items that should be avoided,IF FEA 'IBLE,ram; tr€eQ pAAos,eleetrk. %iLtanks,etc. IF YOUARE PLAIVAINGANADD.ITION,PLEASEPdd()T1DETHELOCATIONANDFOUNDATIONDI11dENSd�1N je, C LW. (-I Ly�n --.. .—. ... - - :.: - 71 - - 1 -- -.. __ TOTAL P.02 .,. 1 Ca FAILED INSPECTION COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS � Y d DEPARTMENT OF ENVIRONMENTAL PROTECTION q v ' �l� MAP .� 350 MAIN STREET WEST YARMOUTH,MA PARCEL qb �..�.�0 508-775-2800 LOT TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMLJAN -�+ ' SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM � PART A CERTIFICATION 2004Property Address: 85 KENNEDY CIRCLE C3AR`iS AT'-EWEST HYANNISPORT,MA 02672 TH D'-- r Owner's Name: GIOFFRE,DOLORES Owner's Address: 44 CR 1 WATERLO,NY 12193 Date of Inspection DECEMBER 2,2003 Name of Inspector:(please print) JAMES D.SEARS Company Name: A&B Canco Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 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 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority ./ Fails Inspector's Signature: Date: The system inspector shall sPmit 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 tot he buyer,if applicable,and the approving authority. Notes and Comments FAILED SINGLE CESSPOOL ****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 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 2,2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: N/A 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: N/A One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or extiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health)" broken pipe(s)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 2,2003 C. Further Evaluation is Required by the Board of Health: N/A Conditions exist which require further evaluation by the Board of Health in order to detenrine if the system is failing to protect public health,safety,or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of 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 detennine 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: Title 5 Inspection Form 6/15/2000 3 Page 4 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE, DOLORES Date of Inspection: DECEMBER 212003 D. System Failure Criteria applicable to all systems: ✓ (SEE ATTACHED LETTER) 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 N/A Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) YES (Yes/No)The system fails. I have detennined that one or more of the above failure criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to detennine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 85 KENNEDY CIRCE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 2,2003 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No ✓ Pumping infonnation was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS,located on site? ✓ Were the manholes uncovered,opened,and the interior inspected for the condition of the 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 infonnation on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No N/A Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CM 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE, DOLORES Date of Inspection: DECEMBER 21 20003 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: 330 Number of current residents: N/A Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): YES Water meter readings,if available(last 2 years usage(gpd)): N/A Sump pump(yes or no) NO Last date of occupancy: UNKNOWN COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sqft,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 infonmation: N/A Was system pumped as part of the inspection(yes or no): If yes,volume pumped: gallons—How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system ./ Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: UNKNOWN Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 2,2003 BUILDING SEWER(locate on site plan): ./ Depth below grade: 24' Materials of construction: Cast iron 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): N/A Depth below grade: Material of construction: concrete metal fiberglass polyethylene _ other(explain) If tank is metal list age: Is age contnned by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to the bottom of outlet tee or baffle: 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: How were dimensions detennined: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP(located on site plan) N/A Depth below grade: Material of construction: concrete metal fiberglass _ polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): I Title 5 Inspection Form 6/15/2000 7 I Page 8 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 'PART C SYSTEM INFORMATION(continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 212003 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alann present(yes or no) Alann level: Alann in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: N/A (if present must be opened)(locate on site plan) 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.,): PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I Title 5 Inspection Form 6/15/2000 8 Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE,DOLORES Date of Inspection: DECEMBER 2,2003 SOIL ABSORPTION SYSTEM(SAS): N/A (locate on site plan,excavation not required) If SAS not located explain why: Type 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.) SINGLE CESSPOOLS: .( (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: ONE Depth—top of liquid to inlet invert: 55" Depth of solids layer: 2" Depth of scum layer: 0" Dimensions of cesspool: 5'DEEP Materials of construction: BLOCK Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): SINGLE BLOCK POOL.ONE LINE IN NO TEE,NO OUTLETS.5"WATER.COVER AT 22".WALLS ARE LOADED WITH ROOTS. BLOCK UNSTABLE. SEE ATTACHED LETTER. PRIVY: N/A (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 Inspection Form 6/15/2000 9 r Page 9 of'I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIOFFRE, DOLORES Date of Inspection: DECEMBER 2,2003 SKETCH OF SEWAGE DISPOSAL,SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i i �f Title 5 Inspection Form 6/15/2000 10 Page I 1 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 KENNEDY CIRCLE WEST HYANNISPORT,MA 02672 Owner: GIO FRE. DOLORES Date of Inspection: DECEM BER 2,2003 SITE EXAM Slope Surface water Check cellar Shallow wells N� Estimated depth trroundwater feet Please indicate(check)all methods used to detennine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: J-- Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: 17 i Title 5 Inspection Form 6/15/2000 11 Notes: 1.All work to be performed in accordance with Massachusetts State Building Cede 780 CMR,Seventh Edition,or as directed by authorities having local jurisdiction. 2.Contractor to secure all permits,and to arrange for all required inspections on iw.. site- LOT3.All debris to be disposed of legally off site.Completed work to be in usable and clean condition. ASSMORS LOT 57 ' 50•0r �`• EDrARD d &ANNS DONBRTY b 4.Patch and repair all areas of the existing building where affecte 9d by new work. ate' 'Am t722Bf1tl Replace all components where temporarily removed during work Refinish areas as_ rB� �y C � required to match existing. MAR BOUND .,, �•8•-�^e m To • 5.Contractor to coordinate his work with utility companies and other third parties .� LOT.B i " trrA � which may need to become involved in the completion of the work a .(7,_ w ( a �`'�YJB�6 1� !"pyQp• 6.Cost of all permits and utility company back charges to be by the Owner,unless otherwise specified in the Owner-Contractor agreement r. ' NEW ADDITION MA O�BrwuMIS iron AMMMY usJi' LWtW AUP - Z , 16 LOT SO u LOT 7 3 �� RBB aASSESSORS LOT !93 AE � c AREA Jy31s S4 FA ryh WNW �a6o AK PLAN REFERENCES` t '4 v1A1>rW A A 001DR6S Lt•GR7FFRB. .�'"�: COXMMATION . DFSIt l3Bd/tl8t4 --_ `s PLAN 11990 A r � ��''�`n � 1Bl/129 • • •LOT 29 --•ors& i eu 139/1! ASSESSORS LOT 47 _'- ®r`-°�- 3 oe a�� �7 �=� RAPS 58 A�• Y.. LL�10 J. & LOUlSE E. LOT 7A _ FZNr$ �--- LOT BA w FLOOD ZONE' C. t.- PO BELL ARsa $64 SQ. o N Dr•Q. •12q� AREA 6Bs SQ FT isr r . MN gti � b t'G RES ZONE• 'W •'� APPROVAL NOT RM67RsD PD'E o`er a 11�s ties rA?�B '>8 ' t+7 imv Ln1 gf]7 J/ UNDER THE BAAAZ9ABLE SUBDIVISION CONTROL LAZY 11i835 40 � p8 b 4$J60 SF ?O roe LOT 5 4setsiso� min S�raAa ASSESSORS 53 NOWT E A d► ° ---w o - N EE"BOFJVUB � =xse i s=� ��r � �+ GROUNDIYATER PROTECTION 11se/2io :u _'ila�vnsor _ _= oYm? r DISTRICT "NP" List of Drawings: LOT 6 _== t Site 1 Site Plan ASS�ORS 54 PLAN OF LAND Al Plans and Elevations AREA JO,00 SQ. Y? A2 - Sections,Details,Framing Plans BRADLEY G A LOCATED IN RamrNARD 1aa JMW 411A. BARNSTABLE, Jf - (WEST NrANNISFORT) JW D6 EWINAMS AS IVCONPLGNC6 T7(E 4•�QO E 8¢8B PREPARED FOR 7ONDW ORDR"WE Ai817r/DPEiYJCM MAS BZMV AMW OR fiWMW BY 7W AWW A ROMAvJt M (1d' &s DOLORES & PMENT GIOFFRE & TERRA BRAD &'.POSE NAM CE' Addition to Residence NNF'ODE-PRy�r�� DAr JAN11AItY 1� 1Jf99 of (40' I CERTIFY TVAT TIIJS PLAN JUS BBF.N PREPARED LOT eA IS 7i1 BE ANNEXED To LOT 8 Mr- and Mrs. Daniel Bandlerl IN CONJR"ffY M H W R{D=AND AWLUMVW LOT 7A & TO BE ANNE9YE'D W LOT 7 GRAPmc SCAM Y 85 Kennedy Circle OF=REICISTRY OF Ob'BQS OF "M CO1P1fONs6A M to G o of JVAssACIIusETJ^.r BOTH Lars BA �41i►D 7A•AJ46 NOT TO BE � - : �°-'. � � . YANXl�SURVEY CONSULMAW Hyannis, MA CONSIDEW AS SEPMUP1 BUILDING LOTS I W UNIT 1,.448�IN�DUSTRYROAD C s WWII P.O. I.GS 285 PAUL A XF.NDMIr, P.LS DA77; l�s ZO: ` YARS717XS XI AM= OPB48 h t(aM-iM K n•r 4a-aw JAY' 4W_WW t p JOW:tinn PA. 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E:�4Fi;-.?'.65YAr!i?_:_ .... .. �'--- _ :0•^,K J_ .. +. _ -. _..I-. ..._ i �_Tct._Irri=.ya,k3 'PkP-ffl..-p ac -K5.----J '-J Sai"}.J. lyQr.S�'r'QNUGZC y _ +e,:F4vH+.9 Sa C lNs. I:.. _ _..__. --.-.—._ _�_._.../ i 10• _TxQ..Baa2:= . : ,� 'L4'=' `— tt�� ,,tt t �} —,AR 1i ._�_G'£f:ww_YtBGCL'.an3.D,.PA�a•7 z-7.:,c^,y:s._.�.<e:+=a_.. I . hI EL .. 4 ! - �rAf✓ :±a i Su!F.ham;•.':�r�:LF?fl.2£a.;-;arrs[P::f.`_.NaJFd�\ � r~ I _ llfu I.• �L.;.,.. ._. .-...._... .-..... I � GIs. . - •i 1 -4i"AY4`;i..c' i � � I � i �-�'Q�• - _ .-I-� J !:'j' :Z�s7-=<�*•_+' P;.kTE PT 1w_SHc_L�7L.:Tfi t.i.P.Wt.w • I I .._ I I , - --fN?tK!�.-f.�&S41T4 Sll<ELts:.. GsT�i.7c - .......... .. I j,. -�:b->_^u. i 0, �Yli -62zoR lfA.SW-4-14AT_S91F, .EAG' --- — —L--------� -- i .- • a Y e, - r-1:a.:y.:_yyK�.- - I =t I ! i l) ( coteiSVsJt,x _scar x- - !Wc - .� 1 �y..iLWti;..YrAE_ : I I !1`6cx.�Y.'r I + ' I i I � �'�— . I E I I � � I � � � -...::.:. .-.- .3•-.__.15i%-:—;_:..<h�_:�z�'ts:- - �'-� � `'__ ¢ r t i �_—_—t N `I •oI � j -.F#1s'G I. Y.,''•.i?/^ ' — __ y\ It. I — S \ ' I •s,. 2'��5 �n' • I 1 I I I �c _ I I i 3at:wmztu�z.1N Kum-, rE i!Ei(a':.�4i?J'YEf sue. I , •��'— 1! •I =4 -::�,�t:-:p�sr..-. _- _,. I 1 � __. .__. _. _. i;,'� _ �-_.Es�:- rca-rw:: _ _ II : ' I ! s•��_� � c Hof, g �i i•o,�-,K�: - -C71f= -- r/ . �hiK'� _.�?!A@I_��.'iSs"To✓ p�l�i '.�+�ri`-FI ��•���*btl��-'i°`Rt�i'�)- . -."lX�i��� �:�-il_C.�L- r • � --�"C.k;;,��";--;t�-t".N :II^U�'.. .•3eISLs5'-��,fs.�.r���._ .._.. _. � ...SG13t,6?-� 1`:=1':p....--- I Andrejs R. $trikis Arch(tecY fly River Yew fine,—'Cenlwille,Masauhua<tJi,nb32. •TdepN..e(5o8T79(Y'9 - i Sections,Retails,Framing Plans AA ��yy Addition to 85 Kennedy Circle 1�G I Hyannis, MA a. C BEN - I S�?IL; TEST TOP -0F FOUNDATION > -2a FT. MINIMUM. OM'CELLAR U FR LLAR b . TEST OF 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE ., _._-�CLEANSANDEEV. i0 FT. MINIMUM SOIL 7E5TDONE BY .. .. WITNESSED BY ASSUMED r t ) CONCR ETE .,. , , A AN SEED - �. LOAM D ;COVERS -. L ; 4 PVC PIPE �BSRVATIDN .HOLE 4 SCHEDULE o Q_y c, R T. PERCOLATION ATE 4 c MIN, INCH.AT INCHES MIN. PITCH:1/8 PER f R F . / _ 2 LA tE 0 : I RE OOR � 0 BOTHER ., . I I : � ' DEPTH HOR Z _TEXTU C L M TT N WASHED STONE ♦. I :. -' .. .' �. '.:, ..,: .. _ .. ..... _ PS VENT ,. ,. 23� �x . , . .4 ,CAST IRON PIPE. � �C � NOT REQUIRED OR EQUAL)'MINIMUM R.I _L PITCH 1 4 PER T. , ,. .. FLOW 'LINE 10 ❑C73 ©�I0LOC3 ELE s c 4�.2 a : ._..,. LE ... ....,. C! C3 L7�D C7 C3 CI f��❑ . L�VEL� ,; ' n UMP S 7 _. GAS ELEs.i�-ram _. BAFFLE o d t3 C t3 C]f_7 Cl GI C0 ir3 G� 2 DIST RIBUTION a a a a EL �._ LIQUID OUTLET - DEPTH A TEEBASE) �' fl M B SE T EPLACEDON R 4 FEETBOX 14 INCHES ( _ TO BE wA IER TESTED -. el �' GALLAN`-DRY [LS iM1H FEET 19 ..INCHES IF MORE THAN :ONE OUTLET t 1500 GALLUN ;i.'9 8,FEET 24 INCHES. i I AN X..'�3. X 1 7RENGW fTA+f�A 3'ldV WELL O WATER 'ENCOUNTERED AT _ ELEV.. PLACED ON BASE _ `7.� N -------"- 7 .FEET 29INCHES (TO BE ) . 34INCHES SEPTIC TANK " ZONE ; . 5 FEET 3 4 TO 1 1 2" CLEAN INDEX I ! SOIL ABSORPTION F . TONADJUST_ DOUBLE WASHED STONE CALCULATION TIONS . DESIGN ' A - FREE OF FINES & SILT _ SYSTEM SAS ,. ::.NUMBER OF' B£DROOMS .3tt7 A' ARBA DISPOSAL UNIT NO OWED ,. �USGS PROBABLE WATER<TAB..E ELEV. _....�� G G£ DI . �I_�t1r �. . SEWAGE-.flISPC�SAL SYSTEM PROFILE WATER TABLE ELEV. TOTAL:£517MA TFD FLOW M, - 1iDCAL ' R, AYX: BR :.. .:CAL AY - , NOT � � BOTTOM O>=-:TEST HOLE ELEV. � �,.;�. < r'� � � .�. _ o TT PA CI ✓ GAL. t. �. ;REQUIREt? SEP17C _TANK.CA AC TY _. _ : C T NK PACITY GAL. AC7UAL-'SEPI7 A CA Lam. 1F A ON:SOIL:CLASS IC 77 ...._.!.-_;. lN.' NCH DESIGN t'£RCOLA TION'RA T£ • ... �`i..,.._�U /l - EfFLU£NT LOADING RA Tr GAL./bAY/ f: �- XZl.'� LEACHING AREA 1 x . t 9 HING CAP C/TY tCAL. AY. L£AC A �, 4 z.. .S 7-f R£S£RVE'LEACHING CAPACITY O S: - 1. ALL WORKMANSHIP AND MATERIALS SHALL CONF`OR1vV TO I .E.P. TITLE S AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6 OF FINISHED GRADE: J. ALL COMPONENTS OF THE SANITARY SYSTEM 'SHALL.BE CAPABLE OF . WITHSTANDING H-�10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF' DRIVES OR PARKING_:AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO`GRADE:SHALL'BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR 98.7 ZONING.REGULATIONS. OWNER / APPLICANT IS TO OBTAIN- SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 98.4 6. U7(UTIt=S SHOVv I ARE APPFCv^XIh�nTE< "3LY. EvCAVP,nr�nl CONTRACTOR IS TO �99A + CALL DIG-SAFE" AT 1-888-344-7233 AT I FAST 72,HOURS PRIOR TO 98:6 98.b �\ COMMENCING WORK ON SITE. 13Q.39 98.4 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS..AS WELL AS SITE \. CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE 98.4 BROUGHT TO THE ATTENTION OF `THE DESIGN ENGINEER IMMEDIATELY. j 98.8 \ 8. PARCEL IS IN 'FLOOD ZONE C „- LOT 7 ! 9. LOT IS 'SHOWN `ON ASSESSORS MAP 268 AS PARCELg . 98.4 la ALL UNSUITABLE MATERIAL SHALL BE REMOVED.FROM-UNDER, AND FOR A S.F. �' 0,1_ MINIMUM OF FEET FROM ,AROUND THE SOIL ABSORPTION SYSTEM, AND BE �s REPLACED WITH SAND AS SPECIFIED 1N 310 CMR 15.255: (3) (I.E. TITLE'5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT., 71, EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND OR .REMOVED, 12. A ZABEL A1800 FILTER IS .TO BE INSTALLED, r 1 \ 99.4 99.a cn x 98.3 1.1 CONTRACTOR TO PROVIDE SHORING AS NEEDED TO PROTECT BUILDING AND o 9A.1 � r F PROPERTY LINE. a a G j 99.4 38,4 ! , 4 . FIT d G G'RA VEL 3 (+�i s cis b �, ' D, OARD . CIF HEALTH APPROVED.'' " 97.7 G /v !o. 2743 9897.3 : D w,EG L t�/G. ��, 1 \ M. 7,8 gg AGENT '-, 98.7 � � 9$.3 29��3 J#2571 DATE � f 8$,4 99.0 �� `9$.5 PROPOSED SEPTIC DESIGN ' " 97.4 /5.A• _., DECK FOR t �. .._ 5 " n�k a C Ri!'^rL 5 NDPIPER LN. ALINE G�ALGAV 99.0 KENNEDY LOC. 85 xENNED Y �cr.�. 9$.5 sI Y RD. BARNS TABLE, MASS. SHARE ,. f!YAIVNIS�'C1R T .----J J2.00, 0 58 85 ;y CRAIGOLLE BEACH FENCE CRAIG R. SHORT, P.E. 235 GREAT WESTERN ROAD P. 0. BOX "1044 98.3 -, 5083 SOUTH DENNIS, MASS. MAPL 398-8311 02660 LEGEND: EXISTING SPOT ELEVATION 00,0 PIN£ DATE DEC.:. 29, 2003 F571 � „ = 2C}' EXISTING CONTOUR -- 00--- FINAL SPOT ELEVATION 00. - FINAL CONTOUR REV. JOB N0. SOIL TEST LOCATION O1 1 UO UTILITY POLE -b TOWN WATER -WSW- CATCH BASIN ® .____. .,_....r.:._.._._._ ..... (_; LOCATION MAP REV. I SHEET 1 OF `1 GAS LINE CLEAN OUT C.8 CESSPOOL C.P. 0 ' C:\SB\PROJ\2571-00\dwg\2571-SAS.DWG 02003 CRAIG R. ,SHORT, P.E.