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Home My WebLink About0031 KENT LANE - Health 31 Kent Lane,Hyannis A= a�.q/ O ooS- I a 0 0 To WTi OF BA,� STABLE Lt.iCA i 10N "JLK=&h7'' /_c�..� � SEWAGE # VII,LAGE /�i��• ASSESSOR'S MAP & LOT � INSTALLER'S NAME&PHONE NO. /077 i7 CIV-� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /,y (size) NO.-OF BEDROOMS _ BUILDER OR OWNER PERMITDATE:_/f ( COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any.wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist 1. within 300 feet of leaching facility) Feet Furnished by L� �.� �� r .,J r �� . .,. A� G No. ' G �✓ SS Fee 57�1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _k_11V Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYication for Miopoar *pztem Construction Permit 7Applicationfor a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Ycomplete System O Indivii ual Components Location Address or Lot No. 3 Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �� , Ov�� ✓Tc l r 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 gallons per day. Calculated daily flow kk�j gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank ;7o_( Type of S.A.S. e Description of Soil Nature of Repairs or Alterations(Answer when applicable) A � f L Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 o t e nviro ode and not to place the system in operation until a Certifi- cate of Compliance ha en issued by this ea th. Signed 64 Date _mX`!� Application Approved b Date zor— Application Disapproved for the following reasons Permit No. Date Issued °' '� CA No. Zf Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 41-111 d Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Xigpogaf *pgtem Congtruction Permit 1 ' Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) `Complete System ❑Individual Components Location Address or Lot No. 3` '� C t�,—Q.� r-,..._ Owner's Name,Address and Tel.No. Assessor's Map/Parcel � _0 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. (A(Za-S-C(/T,4C 1 Type of Building: Dwelling No.of Bedrooms hot`Sfze sq. ft. Garbage Grinder( ) i Other Type of Building No.of Persons .^ +� Showers( ) Cafeteria-(-- ) Other Fixtures t Design Flow gallons per day. Calculated daily flow %-( G! gallons. Plan Date Number of sheets Revision Date Title S s Size of Septic Tank Type of�S.A.S. T C cE / C-r � r� Description of Soil `A Nature of Repairs or Alterations(Answer when applicable)I S c L- c S, . .f .G L, µ j i .L i�r L� ,V W R.L i Date last inspected: 4� k4""k 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 o t e n ' Code and not to place the system in operation until a Certifi- cate of Compliance ha e ssue'- d by tt s ealth. Signed �""� Date Application Approved b Date Application Disapproved for the following reasons Permit No. Date Issued ✓ - - ------------------- _---------- -------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS f` Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by i —G' at 2� f NE ry C-: 1� v�VaA-V-,0 S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No� dated /�OK:: 07 45;'. Installer Designer The issuance of i pe t sh 1 of be construed as a guarantee that the system will unction as designed. Date Ins vector �1 P --------------------------------------- No. v Fee �./� ) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS =igpogaf *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(t/1'Abandon( ) System located at 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 thisp3trmt. Date: � Approved by E r rf J 1/6i99 • NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT CWTTHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated (—��5 concerning the property located at 31 V` meets all of the following criteria: ��/• The failed stem is connected to a residential we system dwelling only. There are no commercial or business es associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. ere are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the macimurn adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] If S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the ma.-dmurn adjusted groundwater table elevation, Please complete the following: J(.� A) Top of Ground Surface Elevation(using GIS information) 6 / B) G.W. Elevation (:�IU _the High G.W. Adjustmend-/ - D T ERENCE B ETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back]. j q:health folder.cct a a " -t> 00 G i TOWN OF BARNSTABLE c7q' ; LOCATION �J SEWAGE # ASSESSOR'S MAP & LOT 22 VILLAGE INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ' 7`i J`"r�fl (size) NO.OF BEDROOMS BUILDER OR OWNER ` v COMPLIANCE DATE: 1 t PERMITDATE: I f �f -yy separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) exist Edge of Wetland and LeachingFacility(If any Feet within 300 feet of leaching facility) Furnished by a Lr I " f 9 ' V COMnXx veo#h of Massachusetts ExecuWe Office of ErMormantai Affcdrs John Grad D.E.P. Title V Septic Inspector Department of P.O. Box 2119 Environmental Protection Teaticket,MA 02536 50 564-6813 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION 14 f0 PART A Lro CERTIFICATION har/ MAY 2 2 Property Address: 31 Kent Lane Hyannis Address of Owner: 15 to 1997 Date of Inspection:5119197 (If different) yy OFBMNST Name of Inspector:John Gracl McGowan �CryofPTAtf Company Name,Address and Telephone Number: lure Z 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: % Passes This Inspection Is based on criteria defined In Title V Conditionally Passes code 310 CMR 15.303.My findings are of how the system is _ Needs F he Evaluation By the Local Approving Authority performinq at the time of the Inspection.My Inspection does Falls not Imply any warranty or quarantee of the longevity of the septic system and any of its components useful life. Inspector's Signature: 4( Date: 5119197 The System Inspector shall submit a Y p copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B,C,or D: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: _One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined", explain why not.) _ The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 1 U151951 One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 9 Telephone(617)292-5500 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 _ Sewage backup or breakout or high static water level observed in the distribution box is due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm. 3) OTHER D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage in facility or system component due to an 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 cesspool. SAS is in hydraulic failure. (revised 11115195) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 D]SYSTEM FAILS(continued) ) _ 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further Information. I (revised 11/15195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 Check if the following have been done: X Pumping information was requested of the owner,occupant, and Board of Health. X None of the system components have been pumped for at least two weeks and the and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. n►aAs built plans have been obtained and examined. Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow.' X The site was inspected for signs of breakout. X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened, and the Interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge, depth of scum. X The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. X The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11115195) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of inspection:5119197 FLOW CONDITIONS RESIDENTIAL: Design flow: o gallons Number of bedrooms: 3 Number of current residents: 2 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available: Na Last date of occupancy: n1a COMMERCIAL/INDUSTRIAL: Type of establishment. nla Design flow:0 gallons/day Grease trap present:(yes or no) No Industrial Waste Holding Tank present: (yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings,if available: nla Last date of occupancy: nla OTHER:(Describe) nla Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System was last pumped two years ago by MacComber System pumped as part of inspection: (yes or no)Yes If yes,volume pumped: 1200 gallons Reason for pumping: Maintenance. TYPE OF SYSTEM Septic tankldistribution box/soil absorptions system X Single cesspool x Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source information: 1907 Sewage odors detected when arriving at the site:(yes-or no) No (revised 11115195) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 Kent Lane Hyannis Owner. McGowan Date of Inspection:5119197 SEPTIC TANK: (locate on site plan) Depth below grade: Na Material of construction:X concreate_meta l_FRP_other(explain) Dimensions: n1a Sludge depth:rya Distance from top of sludge to bottom of outlet tee or baffle: 21a Scum thickness:n1a Distance from top of scum to top of outlet tee or baffle:_n1a Distance form bottom of scum to bottom of outlet tee or baffle:n1a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) nla GREASE TRAP: (locate on site plan) Depth below grade:Ma Material of construction: _concrete_metal_FRP_other(explain) Dimensions: n1a Scum thickness:Iva Distance from top of scum to top of outlet tee or baffle:n1a Distance from bottom of scum to bottom of outlet tee or baffle:n1a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) n1a (revised 11115195) G SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: n1a Material of construction:_concrete_metal_FRP_other(explain) Dimensions: n1a Capacity: n1a gallons Design flow: n1a gallons/day Alarm level: n1a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n1a DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: n1a Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.) nla PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) n1a (revised 11115195) ' 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 SOIL ABSORPTION SYSTEM (SAS):X (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: n1a Type: leaching pits,number: n1a leaching chambers,number:n1a leaching galleries,number: n1a leaching trenches,number,length: n1a leaching fields,number,dimensions:n1a overflow cesspool,number:TO'block Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.) The overflow is structurally sound and functioning properly it was 112 full.Shows signs of being 314 full. CESSPOOLS:X (locate on site plan) Number and configuration: one Depth-top of liquid to inlet invert: V Depth of solids layer: 1' Depth of scum layer: 2" Dimensions of cesspool: 7'x6' Materials of construction: block Indication of groundwater: none inflow(cesspool must be pumped as part of inspection) n1a Comments:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.) Main cesspool and all components are structurally sound.Recommend pumping system every year for maintenance. PRIVY:_ (locate on site plan) Materials of construction: n1a Dimensions: n1a Depth of solids: n1a Comments:(note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation,etc.) n1a (revised 11115195) 8 J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 Kent Lane Hyannis Owner: McGowan Date of Inspection:5119197 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' N P6 5� DEPTH TO GROUNDWATER Depth to groundwater:12 feet method of determination or approximation: USGS Maps and Charts (revised 11115195) 9