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Home My WebLink About0055 LAKE AVENUE - Health Kew A.ve Hyannis A=287-023-001. 0 o` '1 I� } �1 ene =om3uugtmjo Else aanMaoows AM=nx= .. x5� dsn ui open . woa•peews CVW Odn MOOS*ON 7 ®W:3 w s i J'IV Corrtmonwealth of Pilassachusettg li , y Title 5 ,Official Inspection Forte t ��, Subsurfac:. Se,jlage.03isposal system Form -Not'for Voluntary Ass.,ssments. . 1` 55 LAKE AVE Property Address TATE ISENSTADT Owner Owners Name information is HYANNIS PORT MA 02647 8/19/2009' required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspe"ctooi Irms may-not be altered in any way. Important:When A. General information . filling out forms on the computer, use only thetab 1 Inspector key to move your: -cursor-'do not--- r -use the return JAMES D SEARS key. Name of Inspector - BLUEWATER i Company Name 350 MAIN ST Company Address ' W. YARMOUTH MA City/Town State 02673 Zip Code " 508-775-2800 S-1623 Telephone Number License Number B. Certification I,certify.that I have personally inspected the sewage,disposal system at this address and that:the , information reported below is true, accurate and complete as of the time of the inspection. The inspection" was performed based on.my training and experience in the proper functionr and maintenance of on site sewage disposal systems.1 am a DEP approved system inspector pursuant to Section 15.340 of Title-5-(3:10 Chill?1-5:000)—T-he system: ® Passes ❑ Conditionally Passes .Faits I? • ;�y �° -JAMES ❑ Needs Further Evaluation by the Local Approving Authority =ff: - .M o �. SEARS 4.4 °FR rI .2/20/09 '.,��F s 1 N • ,,.. _ /ur nntwlnni\�\Cry:. , 4 pector's Signature. Date The system inspector shallaubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection..lf the system is a shared system or " has a design flow of`10,000 god or greater, the inspector and the system owner,shall submit the. report to the appropriate regional office of the DER 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. LID Ll .Tile 5 Official Insnection Form-Subsurface wane DisoosalSvstem•Paae 1 Of 16: J ., Coronwealth of.Masacse"t Me offid Hnspection Form i i Subsa:rface SewageDisposal SystQM 1=orrn - Not for Voluntary Assessments f✓ 55 LAKE AVE ` Property Address TATE ISENSTADT Owner Owner's Name information i e required for every HYANNIS PORT MA 02647 8/19/2009 . page. City/Town State Zip Code Date of Inspection B.. Certification (Pont.) r Inspection Summary: Check A,B,C,D or E ahmays complete,.all;of Section D A) 'System Passes: X ❑ I have not found any information which indicates that any of the failure criteria described - in 310 CMR 15.303 or in310 CIVIR 15.304 exist. Any failure criteria not evaluated are. indicated below. Comments: - > 8) System Conditionally.Passes: • ❑ One or tore system cbrnpcnents'as described in the"Conditional Pass"section need tote 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. e . ❑ The septic tank fis 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 wll._pass_nspection 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: ❑ .:Observationof sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipes) or due to a broken, settled or uneven distribution box. System Will `. pass inspection if(with approval of Board of Health); Q broken pipe(s) are replaced Q obstruction is,removed THA 5 Official 1--finn Fnm,R,,h.urfnra sp..AnA..nisnneal.q sta •Pane 7 of tri 1 Commonwealth of Massa6husetts 1_lriy I .� Y1; Subsurface Sewage Disposal System: Form - Not for Voluntary Assessments f i 55 LAKE.AVE Property,Address TATE ISENSTADT Owner Owner's Name information i e required for every HYANNIS PORT MA - 02647 8/1.9/2009 _ - page. City/Town State Zip Code. Date of Inspection B. Clertfioation" (coat.) E) System Cor3diitionally Passes(cont.): ❑ distribution box'is leveled or,replaced ND Explain: ❑ The`systerri required pumping more than 4 times a..year due to broken or-obstructed pipe(s). TJ e system will pass inspection if(with approval,of the Board Qf Health) ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: e C) Further Evaluation is'Rerluired.by the Board of Health: . F ❑ -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 9. System will pass unless Board of Health determines in accordance,with 310.CiMR 1.5.303(1)(b)that the system is not functioning'in a manner which will protect public •t` health; safety,and_the environment: ❑ .', .: Cesspool or privy is within:50 feet of a.surface water ❑--Cesspool_or_privy_is_within 5.0..feet of a'bordering.vegetated-wetland_or a-salt marsh-..--_.._ Y: 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 e water supply: The system has a septic tank and SAS and the SAS is within 50 feet of a private water'supplywell. 45 i awr mx WYAMNIBPORT MA Hi .f19/f1A - - - Title 5 Official Insnectinn Fnrm Suhsurface Sewage Oisnnsal.Svstem•Pane 3 of 19 - �� Commonwealth of.Massachusetts Title °° l.'; 'Subsurface Sewage Disposal System Forma - Not for Voluntary Assessments u/ 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name information is HYANNIS PORT MA 02647 8/19/2009 required for every page. City/Town State Zip Code Date of Inspection B. Certification .(cont.) C)_ Further Evaluation is Required by the Board of Health:(cont.): ❑ 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 systempasses 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: Yoga"rnri�st indicate "Yes or"No"to each of the follo�idng fog a_Il inspections. Yes No � Bac.kup of_sewagej.nto_facility or system component due to overloaded or clogged SAS.or cesspool ❑ Discharge or ponding of effluent_to the surface oftli6 ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to.an.overloaded ❑., ' or clogged SAS or cesspool Liquid depth in leaching is less than 6" below invert or available volume is less than Y2 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. sa(nu❑Awr uvanu iIcanRr nnn H.coma.' Title 5 Official Inseection Forth:Subsurface Sewaee Disposal Svstem'•Pace 4 of 16 PIN .� Commonwealth of Massachusetts ,;J Tit] Official Isctib Forte ,UI Subsurface Sewage,Disposal System corm - Not for Voluntary Assessments MET; �; 55 LACE AVE Property Address TATE ISENSTADT Owner Owners Name information is HYANNIS PORT ., - MA 02647 8/19/2009 required for every page. City/Town State Zip Code `Date of Inspection , Bo Cep ficatio `(cont.) D) System Failura Criteria Applicable to Ail-Systems(cont.); Yes .No ❑. �, 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. ❑ 0 Any portion of a cesspool or privy is less than.100 feet but greater than 50 feet. from.a private water supplymell with no acceptable water quality analysis. [This , system passes if the well•wiater analysis, performed at a DEP certified laboratory,for fecal col'aform bacteria indicates absent and-the presence - of ammonia nitrogen and nitrate nitrogen is equal to or less thaa.5 ppm, provided that no`other.failure criteria are triggered. A copy of the analysis and chain of custody must<be attached to this forma ❑' 0 The system is a cesspool serving a facility with a design flow of 2000gpd 10,000gpd. ❑ The system falls..l have determined that one or more of the above failure criteria exist is described in 31.0 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. S E). Large Systems: To be considered a large system the,system must serve a facility;.with a design flow of 109000.gpd to 15;000 gpd; - o 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 0 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. -__.—_-55I A VP AVP HYANNLSPCIRT MA don•03/08 - - - - Title 5 official Insoection Form:Subsurface Sewage Disbosal Svstem-Page 5 of 16. Commonwealth of Massachusetts i'S Ici Subsurface Sewage Dssposal System.1=orrra -Not for Voluntary Assessments . cam; 55 LAKE AVE u Property Address.. TATE ISENSTADT Owner Owner's Name information is HYANNIS PORT MA 02647 8/19/2009 required for every page, CityfTown State Zip Code Date of Inspection. C.-Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes .No 0 ❑ Pumping information was provided by the owner, occupant; or Board:of Health ❑- 0 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? , 0 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) x❑ ❑., Was the facility or dwelling inspected for signs of sewage back up?„ Was the site inspected for signs of break out. X❑, ❑ Were all system components, including the SAS, located.,on site 0' ❑,- 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? 0 Was the facility owner(and occupants if different from owner) provided with inf_or_mation_on_the proper maintenance of subsurface sewage disposal systems? , The.size and Location of the Soul Absorption System (SAS)on the site has been determined based on: ❑ ❑ Existing information. For example,a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] _- 11 1 AMP mic WYANNIRPnIPT mA in .mina Title 5 Official InsDection Form:Subsurface Sewaqe Disposal Svsiem Page 6 of 16 Commonwealth of`Massachus2tts E" Title .-5 Official Inspection F o i5F j Subsurface Sewage Disposal System Form -Not for Vol'untary...Assessments 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name information ie required for every HYANNIS PORT MA -02647 8/19/2009 page. City/Town State. Zip Code Date of Inspection , D. System Infor iat ors Residential Flow Conditions: Number of bedrooms (design):" 3 '.Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR,15.203 (for example; 110 gpd x#of bedrooms): . 330 Number"of current residents 4 Does.residence have a garbage grinder?. ❑Yes 0 ' No ' Is laundry on a separate sewage system? [if yes separate inspection required] ❑Y6s, F, No Laundry system inspected? ❑Yes 9 No ° Seasonal use. ' ❑Yes 0 No NA Water meter readings, if available(last 2years usage (gpd)): Sump pump? " ❑Yes No Last date of occupancy... CURRENT` +: ° Date' Coii-rimercial/industrial l=low Conditions. �Type.of Establishment,"' Design-flow-(based on 3.1.0._CMR-1.5 203): auons per day(9pa) -- -- Basis of design flow(seats/persons/sq:ft., etc.): -Grease trap presents ❑Yes El „No Industrial waste holdingaank present? ❑Yes ❑ 'No Non-sanitary waste discharged to the.Title 5 system? []YesEl 'No Water meter readings, if available: Last date of occupancy/user Date Other(describe): SS I AWr GVF NVAM UMPCIPT MA M, nsrnd - Title 5 Official Insoection Form:Subsurface Sewaqe Disposal Svstem-Page 7 of 16. Commonwealth of Massachusetts4 , action • rmu d� 1; Subsurface Sewage Disposal System Foim - Not for Voluntary.Assessments 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name information is ` required for every HYANNIS PORT MA 02647 ". 8/19/2009 page. City/Town. State Zip Code Date of Inspection D. System Information (cont.) , General,Information n3 Pumping Records: Source of information 2008 Was system pumped as part of the inspection? ElYes Z No If yes, volume pumped gallons How was quantitypumped'determined? , Reason for.pumping Type of System: ® Septic tank, distribution'bo ;soil,absorption system x. Single cesspool A • 0 r 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.;., r inspection of the l/A system.by system operator under contract . r (] -Tight tank..Attach a copy of.the DEP-approval 4. Otlier(describe): }` t S Approximate age of all components,'date•installed (if known)and source of information 99 Were sewage odors detected when arriving at the site? OYes Z No ce i'nvc nvc-uvni.iniiconoT nee.r.,...mvna'- Title 5 Official Insoecfion Form:Subsurface Sewage Discosal Svstem•Pace 8of 16 - f" '>voJ��3�]L�E�Ith. ®f IVI, aCh�ise F z i I;, Subsurface Se+iaage Disposal System Form Not for Voluntary Assessments � —r — 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name informatiori is HYANNtS PORT MA 0264T 8/19/2009' required for every, page. City/Town State Zip Code Date of Inspection D.'Systems Inform affon (cont.) ,' Building Sevier(locate on:.site plan) . t Depth below grade 4-g : : feet Material of construction. a b k.i ❑cast iron k 40µPVC' ;Y a❑ other"(explain) � ^ y ''Distance from private water supply well or suction line: feet Comments (on condition of joints, venting evidence of leakage etc,): a v s , W ,.CAMERA LINE,FCLEANZ SOLID o Septic Tank(locate�on site plan): , Depth below grade: 41 feet Material of construction concrete ❑ metal ❑fiber lass,: ❑ polyethylene ❑ other(explain) If tankyis metal list age years -_ 1s age confirmed by Certificate of Com.pliancb? (attach a copy of_certificate) QYes ❑ No M 1500 GAL PRECAST. Dimensions Sludge depth r Distance from top of sludge to bottom of outlet tee or baffle 28' Scumrthickness r 111 r Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 171 -PLANEHow were dimensions determined? TAPE -SLUDGE JUDGE _ F f Gc i me=MX NVAKIN16G(PT MG nr,r,.nAma Title 5 Official Inspection Form Subsurface Sewage DiscosalSvstem•Peas 9 of 16 cam` Comm-onyvea.lth of, Massachusetts I IS Titile, 5 Offi0a.' ] InspbCtloo Fbi I_, h � Subsurface Se�an�ace Disposal Syste Form N ry.Assessments 55.LACE AVE Property Address TATE ISENSTADT. Owner Owner's Name information is HYANNIS PORT MA 02647 8/19/20C9 required for every page. City/Town State Zip Code Date of Inspection ®. 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.): TANK AT 4'WITH COVERS AR 6". IN & OUTLET TEES. NO SIGN OF OVERLOADING-OR LEAKAGE Grease Trap(lacate•on'site plan)` Depth below grade: ° feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other_(explain): Dimensions:'.: Scum thickness Distance`from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or:baffle --- = =—Date-of_last pumping --- ----- - =-- --- Date :C6mmentSr on pumping recommendations, inlet and outlet tee or baffle condition, structural Integrity, liquid levelsas'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): . __.:.._..._..............,...,,,, ,,, ,,,,,,,,,, - .. ,-..,cnc. ....i.._.,,.....,,,,❑..,,....c,i,�s�e cd., ,.e nie��e�i c„«em.o ..en�s a \ Commonwealth of Massachusetts Title, 5 uiftici l I e o ' Forte R I_ Subsurface Selojacci9 Disposal Systems Form,- Not for Voluntary,Assessments.. /. %. 55 LAKE AVE ` Property Address TATE ISENSTADT f " Owner Owner's Name information i e required for every HYANNIS PORT MA 02647 8119720G9 page. City/Town State Zip Code Date of Inspection D. SysteM Information (cost.) _ Tight otHolding Tank(cont.). Dimensions: Capacity: . _. gallons , Design Flow: . gallons per day Alarm present DYes ❑' No Alarm levels. 4 Alarm in.working order: ❑ Yes El No Date of last pumping + [)ate Comments (condition of alarm and float,switches, etc.): , *Attach,copy of.current pumping.contract(required). Is copy attached El 'Yes ❑` No ' Distribution Box'(jf present must be opened).(locate on site plan): ", Depth of liqquid level above outreflinvert' 0 -- Comments{note if box is-level_and distribution to outlets equal,-any evidence of:solids carryover,:any- evidence of leakage into or out of box, etc.): CAMERA.OUT.TO DBOX, CLEAN &SOLID. NO SIGN OF OVER LOADING OR SOLID.CARRY OVER. Pump Chamber(locate on site plan): Pumps in working order: ❑Yes ❑ No Alarms in working order: ❑Yes ❑ No Q.h.. -q—, a nien i;z—t—.P.—11 of iR . < Common of Massachusetts - =sction ` I i Subsurface Seviage Dis6osal System Form -Not for Voluntary Assessments / 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name : information is HYANNLS PORT _ MA 02647 8/19/2009 required for every page. City/Town State, Zip Code Date of Inspection D. System .Information (cont.) 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: Type: ED leaching pits number: .,leaching chambers number: .2 0 leaching galleries number: ❑ , leaching trenches. number, length: ..' p a _ , 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.): . LEACHING IS 2-500 GAL DRY WELLS. 13'X25' LEACHING AT 4' BELOW GRADE. 8"WATER IN CHAMBERS. NO SIGN OF OVERLOADING OR SOLID CARY OVER: Commonwealth of Massashusetts - sec Form i, Subsurface:Sewage Disposal Systems n=arrra -Not for Voluntary,Assessrnents.-. 55 LAKE AVE . Property Address TATE ISENSTADT ; Owner Owner's Name. information is required for every HYANNIS PORT :MA' 02647 8/19/2009 page. . City/Town State Zip Code Date of Inspection D. Systbm Information (coat.) 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 OYes No.,-, Comments(note condition of'soil, signs of hydraulic failure, level of ponding, condition of vegetation etc.): t . Privy(locate on site.plan): Materials of.construction: - �.-Dimensions Depth of Solids- Corn (note condition of soil, signs of hydraulic failure, level of ponding condition of.vegetation, d- etc.): Commonwealth of Massachu-setts � Ins r J I_ Subsurface Se Disposal System Not for Voluntary.Assessments .,; 55 LAKE AVE Property Address _ TATE ISENSTADT Owner Owner's Name information i e required forevery HYANNIS PORT MA 02647 8/19/2009 page. City/Town State Zip Code Date of Inspection 00, System;Informal .on (cont.) 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 feat. Locate where public water supply enters the building. 03 4 ,,s -.y. �_ CommohVisalth of Massachusetts -on Form i•T I Subsurfaoa Seviatge Disposal Syst-em Form -Not for`Voluntary Assessments' \ j 55 LAKE AVE Property Address TATE ISENSTADT Owner Owner's Name '. information i e required for every HYANNIS PORT MA 02647 8/19/200a page. City/Town State Zip Code Date of Inspection D. Syptem 1nformat!0n'-(cont ). . Site Exam: FE Check Slope SOME r x❑ Surface water. NONE 0 Check cellar YES.DRY° O • ,Shallow wells Estimated depth to.hlgtiground water. feet Please indicate all methods used to determ.ine•the high ground water elevation 0 Obtained from system design plans on record.` T If checked,.date of design plan reviewed: 11/18/99 Date -Observed site (abutting propErty/observation hole within 150 feet of.SAS) ❑ Checked with.local Board of Health -explain: r __: _ - ❑ ' Checked with-local.excavators, installers" ocumentation):- El Accessed USGS database explain: • . You'enust.describe how you established the high ground water elevation: TEST HOLES PER PLAN. 11' NO WATER • NOTE: BOTTOM OF LEACHING IS 13 ABOVE TEST HOLE c❑i'evc evc uvnnuucanaT RA i.nvna � � � - � Title 5 Official.lnscection Form:Subsurface Sewace Disposal Svstem•Page 15 of 16 TOWN OF BARNSTABLE LOCATION SS' sli�. SEWAGE # VILLAGE ASSESSOR'S MAP INSTALLER'S NAME&PH NO. "' �� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) 13 X o?S NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE:''/2.'-2' /_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 lea hing facili Feet Furnished`by ;,. j r .t. t. r A r 1b 'i 1` 1.� `M No. '1 �' - Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS c, ZIppiication for Migool *pgtem Congtruction Vertu Application is hereby made for a Permit to Construct(\ )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No� /jZJi<if�L ��/ One�r / J Address �Tel. (JfAI Install s Name,Address,and T 1.No. Designer's Name,Address and Tel.No. ?7,17C14r2—� Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder( ) Other Type of Building l No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow e> gallons per day. Calculated daily flow 34-1 gallons. Plan Date I Z - Z. Number of sheets Revision Date Title Description of Soil(//)0- A- )3 w- C" (4 A/a W iid-EFR,2 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 provi ions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has Pqeh issued b s Board of He lth. Date Si ed c>wa Application Approved by Application Disapproved for the following reasons Permit No.9 Date Issued '� � - � ——————————————————————————————————————— d i - 7 Fee h THE COMMONWEALTH OF MASSACHUSETTS 1Fjf PUBLIC�HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Mt!6po of *pgtem Cong rurtton Vermtt Application is hereby made for a Permit to Construct c7C )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No.s /�� LS;7 owner's Name,Address and Tel.No. Install Install,X Name,Address,and Ty 1.No. Designer's Name,Address and Tel.No. 771- y(z Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building tr —7 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 34-2i gallons. 1 Plan Date i Z - z.z-9 Number of sheets Revision Date Title Description of Soil( A- A- 13 w- < (Z) E-4 - Gy)- My,2 -C L r• 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 n issued b s Board of He Ith. Si ned Ovv ..P Date 44 Application Approved by Application Disapproved for the following'reasons1' ` Permit No. Z 'Date Issued y — ——————————————————————————— ———————— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of CompliariceF�\, THISIS TO CER .FY,that the Ori=site.Sewage Disposal System installed( )or repaired/replaced( )on 'by for as has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compl'nce with the provisigns.�et forth below: 'q 1 No. t Fee d'afO`1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HIEALjH DIVISION - BARNSTABLE, MASSACHUSETTS ILI Mie;po5at *raem Cottgtruction Permit Permission is hereby granted to are �41 57_ to construct( pa( )an On-site Sewage S• stem 1 cated at 4_ I , 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. All construction m st be co pleted within two years of the date below. Date: ZC Approved by —� s Z. i TOWN OF BARNSTABLE LOCATION ! �zt L�iut, SEWAGE # VILLAGE ASSESSOR'S MAP & i z INSTALLER'S NAME&PH SEPTIC TANK CAPACITY �?!� =- - - LEACHING FACILITY:'(tyPe) S Di'Y/.t/�/�S Aio (size) 13 X "4S � NO. OF BEDROOMS ` BUILDER OR OWNER PERMITDATE:"� �"� 14 COMPLIANCE DATE: �" .w- ra T, 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. j within 300 feet of lea hing facili �. .'. ." Feet" t Furnished by I ► S n 0 aLu9ir.3 123 f , 70P OF FOUNDATION � + — 20' MIN 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC MIN. PITCH 1/8 PER FT 2 LA YER OF EL=121' EL=112'- 118"-112" WASHED S719NE CONCRETE COVER EL =111.5 ' 4" SCH40PVC (OR EQUAL MINIMUM " P17CH 114 PER FT. CLEAN SAND 3A ,� '' 25, FLOW LINE EL=108.5 INVERT 110" 14" 0o0o O o000 MIN —2.0' ° o° 0 0 0 0 0 0 0 0 0 0 0 °g°o ° INVERT LEVEL o00 ° o0000000000 0 ° G� �6 SUM o 0 00000000000 °°o ° INVERT BAFFLE EL = 108.35 INVERT IN °oco 00000000000 ° S EL,=105. 7 4 = 108.6 EL- 108.25' EL.= 108 -- 4'L. - E __ 00 GAL LEACHING CHAMBERS �-, (2) 5 (70 BE PLACED ON FIRM BASE) '; DISTRIBUTION = 07. EL. _ MECHANICALLY COMPACTED OR 6" OF STONE7' L_ BOX _ 150Q__GALL ONS TO BE WATER TESTED 12.B' X 25' TRENCH FORMAT/ON SEPTIC TANK PLACE ON 6" STONE c,j 314" M I-112" SOIL ABSORPTION DOUBLE WASHED STONE SYSTEM (SAS) PROFILE OF BOTTOM OF TEST HOLE ELEV.=_ 92 ' SEWAGE DISPOSAL SYSTEM -- NOT TO SCALE OBSERVATION HOLE 1 i ELEV.__ 103' PERCOLATION RATE _:s�2 ( MIN./ INCH AT �6=''=4�- OBSERVATION HOLE 2 ELEV.=_ 99' _ DEPTH HORIZ TEXTURE COLOR MOTT OTHER DEPTH HORIZ TEXTURE COLOR M07T. OTHER DECOMP SINC LEAVES I ECOMPO /NC LEAVES 0-3" 0 — — TWIC SNEEDLES 0-4" 0 — — TWIGS,P EEDLES 3-5" E LOAMY,FINE SAND 10YR 4/2 SINC CRAIN,LOOSE 4-6" E SANDY LOAM 10 YR 3/2 MASSIVEFRIABLE MASS VE FRIABLE 6-11" A SANDY LOAM IOYR 2/1 �MASSI VFRIABLE 5-10 A LOAMY,FINE SAN IOYR 4/4 p p GENERAL NOTES I1-14" Bwl LOAMY SAND 10YR 4/2 tMASSt FRIABLE 10-26" Bw OAMY,FINE SAND lOYR 5/6 MASSIVE VFRIABLE 14-21" Bw2 FINE SANDY LOA IOYR 516�MASSt FRIABLE 26-132" c FINE SAND 10 YR 7/8 S'NC GRAIN,LOOSE 21-43" CI LOAMY SAND 10 YR 6/4 MASSIVE VFRIABLE 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 43-132" C2 FINE SAND 10YR 616 TITLE 5 AND THE TOWN OF —BARN�TARLE---- RULES AND / SINGLE A/N,LOOSE REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. NO WATER ENCOUNTERED NO WATER ENCOUNTERED 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO SOIL TEST- P# 9586 WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12 DATE OF SOIL l EST 11118199 SOIL TEST DONE BY BERNARD J YOUNG 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF VVILLU WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN WITNESSED BY: DONNA MIORANDI . S LIEBERMAN y 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CAL CULA TIONS.' No. 23971 USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 3 ��0\. I T IL 1 USED TO BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . . . . . . . . �Fss7 E 4) ANY MASONARY UNITS BE MORTERED IN PLACE. GARBAGE DISPOSAL . . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH TOTAL ESTIMATED FLOW DA Y �1 q�110 DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO ( I10_—GAL/BR. 3/DAY x _--_ BR.) 330 GA / OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. INSTALL REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR (2) 500 GAL LEACHING CHAMBERS SOIL CLASSIFICATION . . . . . . I IS TO CALL "DIG— SAFE" A T 1—800—322—4844 A T LEAST 72 HOURS WITH 4' STONL" ALL AROUND .. DESIGN PERCOLATION RATE 5 MIN./IN. PRIOR TO COMMENCING WORK ON SITE. 12.8 Xr 25 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . 74 GAL/DAY/S'F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. , LEACHING CAPACITY (AREA X RATE) 347 GAL/DAY, .. 347 V LEACHING CAPACITY . . . 8) PARCEL IS IN FLOOD ZONE___�'____—. � RESERVE LEACH GAL/DAY- 9) LOT IS SHOWN ON ASSESSORS MAP __287 AS PARCEL _23=1_, } (25XI2.8X 74)+(25+25+12.8+12 8)X2X. 74) SHEET 2 of 2 JOB NUMBER __52385 _____— ` HYANNISPORT TOWN WATER AVAILABLE 4$0�is' w O us goo _ --4IkT FENCE/HA Y BA a 94 \ CLUBUPOLE L•�P��g J ti i 4v lT All, J Off, APRON P BENCHMARK.• R \\ ` TOP OF C.B. ' .00• ��` LOCUS MAP ELEV.= 100.0(ASSUMED) ` 6'4 Me _ `� �\�9 ASSESSORS MAP- 287, LOT 23-1 Tp,d--- \ a cB/D r PLAN REF- 113149, LOT 5 �\ \' ZONING: "RFI a _ �--- _ �, �o� ❑ FLOOD ZONE. llk �' COMMUNITY PANEL# .10e ` `�� 250001 0008 D PAM DA TED.• 712192 M " a, GROUNDWATER OVERLAY. AP" a 114 AS/LOT 146 116 (VACANT) 118 HousE , 12O _� —— �� ,,R .� ��I of SITE AND SEPTIC PLAN Of • EXISTING �� M� PROJECT L OCA T/ON r ',1 �j NEM Ft7UNDAT/ON J& , �� AS/LOT 22 ct y� LOT 5, LAKE AVENUE 171, —— 'OP 3 AND - 0 o Oti ✓� L EBERWILLIAMAN HYANNISP0RT, MA. No. 2397`,o �I �0 4A Q� 13 - APPLICANT AS/LOT 23-1 ry`Zo•ry tY 9 ; MIKE VILLANI AREA= 12,696t SF ' YANKEE SURVEY CONSUL TAN TS N60 4 P.O. BOX 2653'05'E 84.82' i UNIT 5, 40B INDUSTRY ROAD AS/LOT 23-2 I MARSTONS MILLS, MA. 02648 I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE PH.(508)428-0055 - FAX(508)420-555J ' IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN NOTE' TH MNONWEALTH OF MASSACHUSE775 SCALE. 1"=30' DA TE. 711,6100 FINAL BUILDING GRADING AND RETAINING WALLS BY OWNER/CONTRAMR - ` _ o O� PA UL A. MERITHEW, P.L S. DA T RE V. REV.' JOB NO. 52385 SHEET 1 OF 2