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0234 LINCOLN ROAD - Health
234 Lincoln Road 1, k270'=043 Hyannis 3 k t1. i� f ji I t a I e TOWN OF BARNSTABLE LOCATION SEWAGE# 2017—�Y� :VILLAGE ASSESSOR'S MAP&PARCEL2�� INSTALLER'S NAME&PHONE NO. 01'Q.?ti SEPTIC TANK CAPACITY, LEACHING FACILITY:(type) 2 S {(size) �� /3 NO.OF BEDROOMS � _ 3 .1��'-Sy o1 OWNER lam'n v PERMIT DATE: COMPLIANCE DATE: A/ l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility � � f 2 G 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 I r W N W � W � N � v w No. Fee /6® THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:--lexr-- Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for Misposal *pstem Construction permit Application for a Permit to Construct(`) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 414— 1-:"COIN wner's Name,Address,and Tel.No. Assessor'sMap/Parcel 4 lk � (�a f1 0►fo\ Lc%A n¢ L,:hC 'NrA Installer's Name,Address,and Tel.No.��_/}3a-„ 6 s� D1essiignerr''s Name,Address,and Tel.No.SQ$_3��4-541 T W s.CWW DOWN G Ot3 PN-_' Yax" , - Type of Building: Dwelling No.of Bedrooms 4— Lot Size 1 ,1$6 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures AA Design Flow(min.required) p V gpd Design flow provided gpd Plan Date —Ck 1 Number of sheets Revision Date Title Size of Septic Tank 0 Type of S.A.S. 'kit Ld 0 aS Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of Health. g igne Date Application Approved by Date i Application Disapproved by ' Date for the following reasons Permit N Date Issued __�� F Q���• No. �-- � / t.,�� i �, Fee�— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye ,PUBLIC HEALTH DIVISION - T7WN OF BARNSTABLE, MASSACHUSETTS 0[pplitation for Bispo'sal *Pstem Construction Permit Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. ���4- L : 1 ; Owner's Name,Address,and Tel.No. Assessor's Map/Parcel f l Installer's Name,Address,and Tel.No. Designer's Name,Address, d Tel.No. _Tw 60 h:tl � 1 r 1 55^ � �. C;A c ►°�� '`` -'3 po y - Type of Building: Dwelling No.of Bedrooms (' Lot Size , v sq.ft. GarbagfGrinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design Flow(min.required) 4 O gpd Design flow provided le, -' =�`gpdl'''� Plan Date - q - Number of sheets Revision Date � Title Y :Size of Septic Tank 1cQ0 Type of S.A.S. ' Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: „ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar• of Health.' iS g d - , -ti_. Date 'Application Approved by Date / R Application Disapproved by Date for the following reasons Permit Nona ►Qj 369� Date Issued ---------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired( ) Upgraded( ) Abandoned( )by �,�/ I V t at r e(n r r+ \ _ . 5 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NQIQVq— 4 dated LI j Installer �/ �} , c�! � Designed #bedrooms Approved design flow `- 4 4 gpd The issuance of this •ermit shall not be construed as a guarantee that+the system wft as desi ed.) Date _ ! Inspector. 1 , No. _J.� Fee THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Bisposal *pstem,ConstrUction Permit Permission is hereby granted to Construct Repair( ) Upgrade( ) Abandon( ) System located at CS S '' ✓'ti and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction imust be completed within three years of the date of this permit. Date ( �/� Approved by Town of Barnstable Regulatory Services * Thomas F. Geiler,Director `�� * BAMSi'ABLE, M^S $ Public Health Division 1639. Enr � Thomas McKean,Director f {r, 200 Main Street,Hyannis,MA 02601 �rr Office: 508-862-4644 Fax: 508-790-6304: Installer& Designer Certification Form Date: 3 Sewage Permit# Zo(9 - 3?•V Assessor's Map\Parce127 7 Designer: PWN P9 WMN& Installer: rtZIC Address: q3q ROO &A Address: f,o gax -7) o z(o qg On (::t 2 ST Ve U S was issued a permit to install a dat ) (installer) septic system at P-74 LJNCOLN pi), f f-m(III 5 based on a design drawn by (address) DAM P-7- AO�lfftL , M- dated �- q (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved..changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes i.e. P Y J ( greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. JH OF 4f,4 DANIELA. cyGN WALLA m ri� is Signature) CIVIL No.46502 (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE. PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc r Town of Barnstable Barnstable Regulatory Services Department Mftaieac fty � BARN 1 � 1639. ,�� Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 9217 September 27, 2018 TASHEIKO, LEON 3166 E. DESERT WILLOW ROAD PHOENIX, AZ 85048-8312 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 234 Lincoln Road, Hyannis, MA was inspected on 09/17/2018 by Michael DiBuono, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Single Cesspool. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BO RD OF HEALTH G Thofnas McKean, R.S., CHO Agent of the Board of Health Q:ISEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\234 Lincoln Road Hyannis.doc Town of Barnstable • awRrisrnsr.E, 9� " Regulatory Services Department prfD MAC a Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO 2 YEAR DEADLINE CRITERIA Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc c1 Commonwealth of Massachusetts ��- b 13 ` Title 5 Official Inspection Form le Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 234 Lincoln Rd •'° Property Address Leon Tasheiko a Owner Owner's Name 00 information is equired for every Hyannis Ma 02601 9/17/18 X page. City/Town State Zip Code Date of Inspection "a Inspection results must be submitted on this form. Inspection forms may not be altered'n any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information sly 3 3o2h3 on the computer, use only the tab Michael DiBuono key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. 35 Content Lane kCompany Address Cotuit Ma 02635 110 City/Town State Zip Code 508-364-9587 SI 13522 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 9/18/18 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to • the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts g� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is Hyannis Ma 02601 9/17/18 required for every y page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑ I 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: Contrary to asbuilt on file System is a single Cesspool. Chased pipe all the way from the foundation to cesspool. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 i Commonwealth of Massachusetts ,IF Title 5 Official Inspection Form I e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd -u Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts �x Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd �u Property Address Leon Tasheiko Owner Owner's Name information is required for every. Hyannis Ma 02601 9/17/18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd �V Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 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 water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. r 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. 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 II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c , Commonwealth of Massachusetts ,4 Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd u� Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The - owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ❑ 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 septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. CityrTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: Single Cesspool with no overflow Atoumatic failure based on Barnstable Bilaw Number of current residents: Vacant Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ❑ No Water meter readings, if available last 2 ears usage d Na 9 ( Y 9 (gP ))� Detail Sump pump? ❑ Yes ❑ No Last date of occupancy: Date t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd Lu, Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercialllndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Original Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 8"feet Material of construction: ® cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts ,� Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 f cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: El leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert DRY Depth of solid s layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I ' c , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide!a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately I I i i i I t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 9/18/2018 Assessing As-Built Cards • LOCATION SEWAGE PERMIT NO. a.34 l�Nceut �ro�:£T SIY 'qHD VILLAGE �1/PcN 1JlS MP�6S INSTALLERS NAME A, ADDRESS -Z?, TAN+es 1IYawN lS �� -c�ti<d NUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ;5 k D.aewa� I I Re Z zmvlcs ID i • WnNI � 9¢�E Y i 1 � I I 1 ko," >k caw 1 E*S.arwr 6mf�e Ur4CC.N 5jVLj Y rn �� C'pe e�S �o�� 5 e55 �on http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=270043&seq=1 112 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed 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: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Lincoln Rd Property Address Leon Tasheiko Owner Owner's Name information is required for every Hyannis Ma 02601 9/17/18 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ❑ A. Inspector Information: Complete all fields in this section. ❑ B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ❑ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed / / ❑ D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Town of Barnstable p# 16b04 gyp' Department of Regulatory Services. ai -Public Health Division �� �,;Da.to � �A sa3A ,m� 200 Main Street,Hyannis MA 026.01.. rFa tvtAt b e�;, i- �Q 55 Date Scheduled w Tithe Fee Pd 1 U 0 Cl� Soil Suitability Assessment, ®r e rsposq, Performed ByAA-e--M CZVI f-" 5 F-i5NZ. Witnessed By: �u\ LOCATION& GENERA7L INFORMATION Location.Address 2 Owner's Name UP- C9 k/ v1`t S Address 3 j 6 6 E; Df-se---I-- w ; a r2x 11 F11 o e_wA Ac , A Z F sG Li Assessor's Map/Parcel: ''Z-7 0 - O \j 3 engineer's Name j:f y9 n NEW CONSTRUCTION REPAIR -- , `Telephone#, , 570',��--q7"7— S"31 Land Use J 5' l"iqrSurface Stones, "(y -Q Distances from: Open Water Body 66 ft Possible Wet Area A�ft Drinking Water Well 7 S e ft j4 ft Pro ert .Line Drainage Way R Y 7 c)r t— ft Other ft SKETCH:(Street name,dimensions of lot,exact;locations of test holes&p re tests;locate wetlands fn proximity to holes) _.. _... _. _ ............. eAt L� `Z �! L,; kj C o dZ c`1 Parent material(geologic) th�vk �� Depth do.Bedrock o V 6t A-,X- Depth to Groundwater. Standing Water in Hole: O v rT Weeping from Pit Frice C1. Estimated.Seasonal High Groundwater �l f Z 6 jt DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _ ____ in, Depth to Soil Mottles: in. Depth to weeping from side of obs.hole: in, Grotlndwaly Adjustment ft. Index Well# Reading Date: ]ndex Weil level— AqJ,factor,,,,,..• _ - Adj.0rouiidwnter level,_,r PERCOLATION TEST sate Time .� Observation �s Hole# f—� Time at0 Depth of Perc Time at 6" Start Pre-soak Time @ 'lime End Pre-soak Rate Min:/Inch. Z- Site Suitability Assessment: Site Passed j,""' _ Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observ.afion Bole Data To Be Completed on;Back----------- ***If percolation test is to:be conducted within 100' of wetland,you niust first notify the Barnstable Conservation Division at least one(1)week prior to beginning. QMEPTIOPERCFORM-DOC DEEP OESERVA TION HOLE LOG Dole# I Depth,from Soil`Horizon Soil Texture Soil Color Soil Other Surface(in.) (.USDA), (Munsel11) Mottling (Structure,Stones,.Boulders. on i ten ravel 0 — �a Lac." i v°>°Q 4/-- = fo lPu Yrz 5/ji. MJ DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consis cn' % ravel -�, A 5 mow• 11Y�L DEEP OBSERVATION HOLE LOG Hole# Depth from 8 H Horizon Soil Texture; Soil Color' " Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con istenry.%Gravel) DEEP OBSERVATION DOLE LOG Hole# Depth from Soil.Horizon Soil Texture Soil Color Soil Other Surface(ins) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency. n Flood Insurance Rate Map: Above:S00 year flood boundary No— Yes .. Within 500 year boundary No Yes Within LOO year flood boundary No Yes, Depth of Naturally Occurring Pervious Material Does at least four fee't of naturally occurrin g`pervious material exist in all areas observed throughout the area proposed for the soil absorption system! — If not,what is the depth of naturally occurring pervious mataral7, _. Certification I certify that on ''(date)I have passed the soil evaluator examination_approved by the Department of.Enviro'mental Protection and that the above analysis was performed by me consistent with .T the required trainin ertise and experience described in 10 CMR J5 `�.017. Signature, ---- —"" Date Z�' ll1S Q\5413 lePERCFORM:Doc L r � _ 4 9C Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLation for i0isoosAf 6pstent Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.2 70 9 11-3 Owner's Name,Address,and Tel.No. I Assessor's Map/Parcel�� L a e 1041 % 0 Vj �vf Installer's Name,Address and Tel.No.�� Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building -X e� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min./required) 6 gpd Design flow provided b gpd Plan Date !8 ® Number of sheets 2— Revision Date Title Size of Septic Tank ®O Type of S.A.S. &4 Description of Soil Nature of Repairs or Alterations(Answer when applicable) �sG+� f H rJc h Leo CA J4 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 th_ ystem in operation until a Certificate of Compliance has been issued by this Board of Heap . _ / l Signed Date Application Approved by Date "lO f�l Application Disapproved by Date for the following reasons Permit No. ®�� Date Issued — —1 �o•.`.N-`,z- G'u Fee R' Entered in� THE COMMONWEALTH OF MASSACHUSETTS • # ' ;• Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplication for Mi#,posafj_*pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.*2'0 Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel2 L ,,to Installer's Name,Address,and Tel.No.,(-Of G '7G� �/! Designer's Name,Address,and Tel.No. J ir-rS 45 �t i 1C Type of Building: Dwelling No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building d e L No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) b gpd Design flow provided 2?d gpd Plan Date �jy �/ Number of sheets 2 Revision Date Title Size of Septic Tank / "-®(� Type of S.A.S. P _ YP Description of Soil 1 Nature of Repairs or Alterations(Answer when applicable)�GG�.�'' j�.� ,,� �� `ee z ,,� 1, 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 Certificate of Compliance has been issued by this Board of Heal Signed Date Application Approved by Date / Application Disapproved by Date for the following reasons Permit No. goq - Date Issued — —� ----------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by 1 t�t e-0 0-0 at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer �,6 a ( 1// ,, �� r Designer #bedrooms 'L Approved design ow 76 and The issuance of this permit shall not te construed as a guarantee that the system-will-fu'ncti Date Inspector [' ---------------------------------------------------------�-------- No. t9ot/t — 3'1 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) f System located at Z / + U�a A, /.��14 '�1 A, ,s and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 permit."—/---7 (1 Date I��- `�— fr Approved by t g k I'oJn a►f�alrl<�stabi 0FZFfE Tp W s y�v k"o `eguiat1.r11 . vices I��Lllai d SCall, Iti`ter rry I)rt cctar "+ IIAhNST,4IILE 39 ���Q l�ll< 311C J�IeZltlt Dtv>stt�tl q'�otnAra Thomas 1Tcl�eai,�i�ector "< 200 1V[an Street, Hyarinrs, tYTA,.{)2Ci()t ,. ., . , Office SOaS S 2°4144 f. Fay �UK.7<�U G�0.1 t g f t 1, lYi'x' W 44 &i d _ T,nstailer` c4'c DestLncr.Cet t3ficatron orris . v ;L7�rtc Ses+age Pei3x3:t# Avss`cssa°i's M' ,' \Pares I ,0`� 2 �. llesrgnet: ry rieQ ;nk� or�ts � — I12s4allej U + U;�'�a �r� �� r Address 12FU.�� Cros +e t�1 `! rXciclress Ca+nk", . �P N T v. ` F/.� Onl._._— Dula v :.� s 1$sUed aP 1n3tt o insta l a (:date) {ilstallr ) s„ trc s stern atx �- �e�l"� C,`YJyt t� 1 � used~cin a ci,1 i1- d,- ,,, by �y1/�t(r'r' CF�rtcl L�J�, -(,tt jam [ , clat+cl ; i (desrC7n�i) —J� :,D t R` F .x r 1 2 = F "c . ri certify ;that the septic systenifr�fcrcncccl above eras installed SuUtar�t>ally �ccordrrr t�. the , '' n vilirch f I,,, ncl�iidc rnti3or apptoved'cliangesYsuch as laXcral r'. o _ 'ion of"ih distribution bo c arrd/ar scptirc rant: Stirs (7ut.,'(rf iEeliircdj>: sti:.".inspu led and:;ilia �orls r�%ea e fotiid Satisfactoi y ,, .!. s �` '` F #n r a t ( _ y t:.t a y a. n T certify thai rise 5v�tic systcrn rcfcrc nc e;�j abov% gas`rirscall d vjrtlr it�alcr cllargcs (l':c greater tlaaJa �'(}' lateral rcl�ctton":ct the:SAS,oJ ,any ve�trcal .locat'on of'arzy"cirllaonrrt of the septic systclra} but tn-accordance ��ith SGatc c� .C66 12egulat ons Flan re�isran`0i cctttficd as bcrilt by d stgncr to folloiij Stirp alit (rf r lured) was inspcvtcd araci the so;'Is were found strt>sfacto'y , 't I celtJfy ;ilfat the sYstcitI tcterenced above was consttu�ctc taco �Frth nc� terms of the 1 1 approval l .t, s (rf ap I UW-Ie) SNC r fr :r Y ' t<t7 CtI < 1Tnsta1Jer's.Signature) 0`351 < � �rs�� . G # , {De"signer's SJgtianrre} ; ff3x:Dcsrgnet tampl ere} 1 x� ° PLCASE; RI+TURN TO BAR�fSTABI PC1I3:LTC H)'AL1I ll . 'I5tt;y CLIZI II ICATC Olr" -CO"J ZPLIAJ\TC , NylL ,NO.'I` 13 :I,SS CIEll .LF\r1 TL":T30T I TI IT'S zI O 12i�� A. 'D AS , , BUTL ."OkR. ARC RECE`l 'IJ',,Y THE ,. 'AR1�.S1'�BLE P,YII3X�C LIEAf;TE> DI�471S, T,O 1ItAZtiYO:L v - �. ., II 11 r QScpficl))e�igncr Cut+t crrtnn Eo+ni'Rt�,3't t 13.doe, - _,< �, / ¢ Y P i z p LOCATION SEWAGE PERMIT NO. 191 CH O ,VILLAGE �y�N Nti5 MP�s INSTALLER'S NAME i ADDRESS 23 �,� B U I L D E R OR OWNER 23i DA T E PERMIT ISSUED DATE COMPLIANCE ISSUED s�49Y I� { a a a -►a., V � rl Q. 3 .w 1AN J V 1r �� o►�� Z > � O 3IP f _ r No................... `.r' '` Fps...... ....._............... • r4 -:14 THE COMMONWEALTH OF MASSACHUSETTS`. .. BOAR® OF :H- AL TH ...._........ . .................OF.............................._._.......-----........... Appliration for Dioposal Works Toustrur#ion rautit Application.is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .........."b --j �:.� ,........................................ -----------------------------� `�...........--------------..........._ ------------- ----------- Location-Address or Lot No. .....f 1. — .......................... ---•-•--•-----•--------------------•-------•-- Owne Address Wr�J �� ...... ..... �P� ... .............�` ....._ e_Y`i�M1+4 S.... .................. (Q Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...... ............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a Other—Type g -------------•-------------• P ( ) — Cafeteria ( ) d Other fixtures -- -- w Design Flow.............. ............._._.._...._--g-a-llons- - - per person per day. Total daily flow _i_ _._.....______.__..gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width............. Diameter............... Depth................ x Disposal Trench—No. .................... Width-......_............ Total Length...................?Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-------------....... Depth below inlet...........,........ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•---------•------------•-----•------•-------•-•-----------•-•----------------------------------••-•........................................................ 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------....................... W U --••-•--•----••---••................................................................................................--------------•-•-----••---•-•••-•---------------------------•-------.._._..--•-•- w U Nature of Repairs or Alterations—Answer when applicable.........6%0_'�-____L.OZ?C7._.... ..................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'21"L LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hC§s d b he bo Signed . ��Q` /✓� Date Application Approved By......................... ...`..•-:.-..I...-•----------... •------- ......... -P _ _". Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------- -•--------------------------------------------------------------------------------------------------•---..__....--•-----•---------------------------------------------.....----•--••-••--••--•----------- Date PermitNo......................................................... Issued....................................................... Date No...... '� {�•bt ,` "ra .,� FimB4......................_ THE COMMONWEALTH OF MASSACHUSETT 'i , BOARD OF HEALTH .........................O F...............-.......................----------------•----.._........_.......•--......_. ApptirFation for Disposal Works Tonstrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �-- --^ Location-Address or Lot No. Ownet " "w•- es .......................... "..............Kr--_--A-S... - ... -a.'_ =•-------------•---• Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms___.._ )_______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures W Design Flow_____________"`.. .....................gallons per person per day. Total daily flow.......... __..............._....gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length....._.............. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area.................. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by........................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-------------_.......... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --i•-------------- ••--------•- •-----------------•-----------------•..........•---------------•--------------------- DDescription of Soil........................................................................................................................................................................ x V ..••-•---•-••_....•••••-•--•••••-•••--•----•--•-••------•••--••.._...---•-..........•----•....---•••._._...-----•---•••----•--•-•••••-•--•-•-•-•••••-•-•----•-•-••••--•••-•-••••••----•-••-••••-•-•-•••- W -------•••-•--- ------------•----••••-••--••--••-•••-------------•--------------••--------•----- V Nature of Repairs or Alterations—Answer when applicable.______ - i - ______________________ 1�'r. _c A -f` !' ici I.J...................................................................................................... Agreement: The undersigned agrees to install the laferedescribed Individual Sewage Disposal System in accordance with the provisions of iIT11 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sig e�i d.__ ..--•-•--•-- --------- ----- -------- 4y� „c C•M \'�_.e2� �~. -------•-•--- v _ ate '..__ Application Approved By J ____ __-_____ �. . 7,7;-- ------------------------- .--- / i � fat Application Disapproved for the f olloiving reasons:............................................................---------------------------- ...................... .......................................................•-•--•-----------•=------=---------...-----------..__....--------------•-•-•--•-•••-••---•-••-••--- ------•__--- Date ------------•------------ -- PermitNo...................................................--.... Issued_......................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................. .................................... &rtifiraV-M Raw THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Re"p' �0,'-,( ) is ,, has beentatr d irI`acco an �ie provtsionsof T 5 of The State Sanitary Code as described in the application for Disposal Works Construction'Permit,No._U_ C_..__-_G/..#.__.__.____ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................................................•----•-•---•-••-••--••••-•-• Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Permission is hereby granted__._`*�" ..........�_______________ ...________..�_____...._. to Construct ( ) or Repair a( ) an Individuaf Sewage Disposal System atNo.----. ILA .------c� a.r t� ��-�;......S�........................................................................................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated:.......................... / �oard of Health DATE_--••----•-------_--- J/ — 5-----•---•-•-•••••------•• a` FORM 1255 A. M. SULKIN, INC., BOSTON No.:... °C- °<S� F�$.,.. "�..—........ THE COMMONWEALTH OF MASSACHUSETTS ?e X BOAR® OF .HEALTH ... ........................... ............OF........... �i F' cS`l 'fI"�L=�........................ Appliration for Dispati al Works Cnnnitrurtiun ramit Application is hereby made for a Permit to Construct ( or. Repair ( ) an Individual Sewage Disposal OSystem at d _e�... c-:............... - s "r ........... � .._..._. ..�........._......_ _..:......__...._.............._........�_t N............................................ cation-Address o. ..: .v � n �� .. �^ ..�.- .-•---•--•--------...................---....--.------.own ddress Installer Address Type of Building Size Lot/!f5�2 -----Sq. feet U. Dwelling—No. of Bedrooms.......3................................Expansion Attic ( ) Garbage Grinder ( ) �- p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................... .. WDesign Flow.......... _______________________gallons per person per day. Total daily flow_...____ .................................gallons. WSeptic Tank—Liquid capacity/O—OVgallons Length.... ....;. Width... .._`..... Diameter................ Depth....:....... x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area.....................sq. ft. Seepage Pit No.......I............ Diameter.l-??.+... ;_. Depth below inlet...6..`........ Total leaching area.-d--?- '.Y-. -+.0 Z Other Distribution box Dosing tank ( '-' Percolation Test Results Performed by .. ��-1._.. ....W �-(r. y------------------:_. Date__ ..'Z'_ ------------- 4 Test Pit No. 1.._42,minutes per inch Depth of Test Pit../��...... Depth to ground water..&)��::E�i1`— r% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.. ' P4 ••--•--•••-•......-----••---•-. .......................................................... 0 Description of Soil------•----� -----------/�'OP. ............................................................................................................ w UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLE 5 of the State Sanitary Code— The unders' ned further agrees not to place the.system in operation until a Certificate of Compliance has bee issued by the boa d o ealth. Signed............. ............._... ............�. ... •----------- D to Application Approved B /o PP PP y------dam- .* = ......................... "- -- -- f Date Application Disapproved for the following reasons----------------•-------•---•-------••------------------•--------------=--------------•-....................... ......................................................................................................................................................................................................... Date Permit No.. - /o.s"---•-------- Issued Date No.. :., .�% .. ;�g� Fus......." _`.`....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I .......I-ti ��----------------OF........... ?U "T t +L_ ......................... ,� �irtt ion fox Bisvvii al Works Tomitrnrtion ami# Application is'hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal " System at: icJT - _ ...........1. �c tw................. .......... �f - ..........__. --- t ----- -----•--------------------------• Location-Address or No. ' E _ .. ?_: =... -`�-'--'------------•---------------------------------. G y �-v— — - Address ..... U ; b GG`- C, -----••••---•-••-----•----•----.....---•-....._...--•..................•---...........__....----- � Installer A ress UType of Building , Size Lot... .. --_-Sq. feet Dwelling—No. of Bedrooms.... ................................Expansion Attic ( ) Garbage Grinder Other—T e . a yp of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------•----------------------------------------------------•--------- Desi Flow........._ w gn ' ______________________gallons per person per day. Total daily,flow-------.___._. ............................gal lons. W Septic Tank—Liquid capacity l�.Q9`egallons Length---- _��...._._ Width...--__-._.. Diameter---------------- Depth....4.1..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.................... ft.. . # • - Seepage Pit No..._..../._.---__-- Diameter. .._4.+`'�_f Depth below inlet....4*_.`....... Total leaching area.5 �.... i)(rft. Z Other Distribution box ( Dosing tank ( . aPercolation Test Results Performed by �-v.�_.._ ... l L. etc'¢ /�U .-• Date... "_ �:.F-f.` ....--•..:... Test Pit No. 1....�-'`-4--minutes per inch Depth of Test Pit.__/`� /`__-•- Depth to ground water.-�117._..��"' fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..40............... Ox �.......................................................... Description of Soil...........' `' ..........t ': - _....••---..............................................................-................................. x U ---------------------------•----------------------------......----------------.....--------------------------------------------------------------------------------------------------------------------- w UNature of Repairs or Alterations—Answer when applicable.........................................:..................................................... •--------------------------------•---•---------------------•------••-----------••---------...--•------------•••-----------------------------------------------------•.................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITTLZ' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................•-----------------•---------....--------•------•-• ........................ Date ApplicationApproved By.................................................................................................. ---------='........ Date Application Disapproved for the following reasons-------------------------------------------------------•--------------------------------••- -•--------......... -•-•................•--------•--------------•---•-•------------------------------------•---------•--------------------••=---------=---•----•---•---•--•--•----•-•---••-••--------••-----•-•---•...•---- r Date PermitNo......................................................._ Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................... ....................OF..................................................................................... Trr#ifiratr of Tontpituncr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by--------•------------------••------•---------•-•------•-----------._.-------------------------------------------------------- •-•-----------•.-.--•---------......----------------------•--•-•---•--- 4"l /i•. c cG! s„ Installed yea.r i at......................................... has been installed in accordance with the provisions of TITL. 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......... ..................... dated.................................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................f ..�:(= �.............................. 4.Inspector....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH X / ................ ...................OF..................................................................................... rr No......`.................• FEE.... ---•---•----.... in�ros�tl orn ��annion [rrntii Permission,is hereby granted.......................� -'�/&-)-------------------------------....----------•-----..............----..........._ to Construct (' ) or Repair ( ) an Individual Sewage Disposal System at No ........... Street as shown on the application for Disposal Works Construction Permit No '1 ::_----___• Dated...-_ . �." . Board of Health DATE..................... ....... / ...... y FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • tom. LEGEND Routs 2 N W- 98 -- EXISTING CONTOUR H;��ad x 100.98 EXISTING SPOT GRADE £ gWeberr5 = o` LI NCO LN ROAD -w EXISTING WATER SERVICE � m •e �� 00 -6H. EXISTING OVERHEAD WIRES ' " r5 38,97 3813 37.69 TEST PIT a Vest o HIGH OF PAVEMENT 38.48 yo;h SCHOOL q O _ BENCHMARK St,ee LOCUS - 40 5 ---40- - 6o.ob' LOCUS MAP 38,62 IP FND NOT TO SCALE EXISTING CESSPOOL (APPROX.) 38.83 38.15 TO BE PUMPED, FILLED WITH E' 40.99 SAND & ABANDONED, OR REMOVED -o N- e LEACH PIT _� •� � 39,93'• f SHOWN ON AS-BOIL T CARD g f; 1 ?- _ G g9 UNDER NOTED ONRMIT AS-BUIL94CARD T �Q% I 1 W `T ; 58�P;t GENERAL NOTES: 41.60 �N. O I ,. .. PB E AS "NOT EXISTING" 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL N��' �•. 40;77 BOARD OF HEALTH AND THE DESIGN ENGINEER. 17' o_ O .,'; 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS I OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE ®:TP-2 .: \ LOCAL RULES AND REGULATIONS. PROPOSED ' 10 x�41, 6 ��"'� T 1 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR SEPTIC TANK T 3 �: TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 17' 0 O ® '' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERfNG 10' FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN (min.) N �41,67 I ' ' 41,55 a ENGINEER BEFORE CONSTRUCTION CONTINUES. �' \ �� 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. o 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF BENCHMARK o BM x 41.50 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF ORANGE PAINT MARK �--_ 42.56 o HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. ON BOTTOM STEPS -� 0 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. EXIST. EL.=42.56 , SEWER o INV.=40.7f 8. THERE ARE NO WELLS WITHIN -150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS /EXISTING I L AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE LOT 48 o RINSE HOUSE(#234) x 42.51 + 4 ,18 OT �O DIRECTED BY THE APPROVING AUTHORITIES. T.O.F.=43.4f 3� 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY o \ ly THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING r� PATlO CONSTRUCTION. 4.29 �x ; f - 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Z 43.49 J_ IN THE AREA BENEATH AND FOR 5 ON ALL SIDES OF THE S.A.S. AND 43.56 + 43,78 • , REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). + 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 43.37 OF MAS INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. \ SHED a o PETER T. 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC r McENTEE _ SYSTEM COMPONENTS NOT SHOWN ON THE PLAN 0.00 v CIVIL \`- F No. 35109 LOTS-49�-- ---__+ 4 , 5 E�,Sj PARCEL ID: 270-043 s,400 SF -� 45:47 \ F PROPOSED SEPTIC SYSTEM UPGRADE PLAN - , \ \-4-6 60.00' to tit 234 LINCOLN ROAD, HYANNIS, MA x " Prepared for: DiBuono Sewer & Drain, 35 Content Lane, Cotuit, MA 02635 45.2 OWNER OF RECORD 46�5 � � TASHEIKO, LEON Engineering by: SCALE DRAWN JOB. NO. 3166 E. DESERT WILLOW RD Engineering Works, Inc. 1"-20' P.T.M. 262-18 PHOENIX, AZ 85048-8312 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. C/O PIXLER, LARISSA T (508) 477-5313 10/30/18 P.T.M. 1 of 2 - t�Y t t NOTE: TO PREVENT BREAKOUT, FINAL GRADE SEPTIC TANK SHALL NOT BE AT, OR BELOW, E'=38.2 INSTALL RISERS & COVERS OVER INLET & FOR A DISTANCE OF 15' FROM THE EDGE OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D-BOX OF THE PROPOSED S.A.S. EX/STING RINSE INSTALL RISER & COVER PROPOSED S.A.S. HOB/"E 234 SET TO 6" OF GRADE INSTALL RISER & COVER OVER EACH CHAMBER AND BH ° � ` T.O.F=43.4f SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT F.G. EL.=42.5f F.G. EL=41.3t FRONT F.G. EL.=42.Ot F.G. EL.=41.6t _ L = 15' 3'(max.) _ ' ® SCH4 (MIN.) ® S=l% (MIN.) ® S=1%5(MIN.) 2" LAYER OF 1 8" TO 1 2" 4"SCH40 PVC 4'SCH40 PVC 4'SCH40 PVC / / N 6" DOUBLE WASHED STONE io"I 6. as $ as (OR APPROVED FILTER FABRIC) t4 INV.=39.75 48" LIQUID aaaaaaa --3/4" TO 1-1/2" DOUBLE f ^ 40 cT-M'- LEVEL ADD PROPOSED 4' 4.8' 4' WASHED STONE � LIN to tO GAS eAFFLE INV.=39.00 _ INV.=38.83 p INV.=39.50 �� EFFECTIVE WIDTH ='12.8' Uj JW AIM AM3 OUTLETS INV.=37.70 a �. PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS to ILO ' • ' CONNECT TO EXISTING SUITABLE SEWER PIPES SURROUNDED WITH STONE AS SHOWN N AT HOUSE, AT OR ABOVE, INV.=40.7t(verify) H-10 RATED I a TOP CONC. ELEV.=38.5t NOTES: BREAKOUT ELEV.=38.20 INV. ELEV.=37.70 ®aBB aaaBa 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & aaM6309 aaa aaaaaaaaaaa INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. BOTTOM ELEV.=35.70 TIC LAYOUT 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 4' 2 x 8.5'=17.0' 4' TRUE TO GRADE ON A MECHANICALLY COMPACTED 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' SIX INCH CRUSHED STONE BASE, AS SPECIFIED PERVIOUS MATERIAL IN 310 CMR 15.221(2). 5' (MIN.) ABOVE G.W. LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO G.W., EL.=30.7 = ®®®® ®®® 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE Ea AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. I F- E3 E3®E3 E3 E3 ® EO EO E3 E3 33" W E3 ED E3 E3 U E3 ED Ea E3 U E3 SEPTIC SYSTEM PROFILE N Z ®�®®® ® ®®® c SOIL LOG i o2" DESIGN CRITERIA DATE: OCTOBER 26, 2016 (REF#15,807) 4" KNOCKOUT SOIL EVALUATOR: PETER McENTEE PE(SE#1542) NUMBER OF BEDROOMS: 2 WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT 20" DIA. COVER SOIL TEXTURAL CLASS: CLASS I ELEV. TP-1 DEPTH ELEv. TP-2 DEPTH 4" KNOCKOUT I--," 4" KNOCKOUT DESIGN PERCOLATION RATE: <2 MIN/IN 41.4 A 0" 41.2 A 0" 58" (0.74 GPD/SF LOADING RATE) SANDY LOAM SANDY LOAM DAILY FLOW: 220 GPD 10YR 4/2 10YR 4/2 DESIGN FLOW: 330 GPD 40.9 B 6" 40.7 B 6" 4" KNOCKOUT SANDY LOAM t SANDY LOAM GARBAGE GRINDER: NO 1oYR 5/8 10YR 5/8 LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 38.4 Cl PERC 36" 38.4 Cl 34" .74 GPD/SF 500 GALLON CAPACITY, H-10 LOADING PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY CHAMBERS PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS USE 2-500 GALLON LEACHING CHAMBERS IN SERIES MED. SAND MED. SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 2.5Y 6/6 2.5Y 6/6SIDEW 234 LINCOLN ROAD, HYANNIS, MA _. BOTTOM LL AREA: 2(12.8' + .8' x X 2 = 151.2 S.F. Prepared for: DiBuono Sewer & Drain, 35 Content Lane, Cotuit, MA 02635 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:.... ........... ...............................................471.2 S.F. It30.9 126" 30.7 126" Engineering Works, Inc. N.T.S. P.T.M. 262-18 I DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD 1.2 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. NO GROUNDWATER, PERC RATE: <2 MIN./IN. (508) 477-5313 10/30/18 P.T.M.- 2 Of 2 b SYSTEM PROFILE NOTES (NOT TO SCALE) 1. DATUM IS NAVD 88 5 PROVIDE MIN. 20" DIAM. WATERTIGHT MARK CORNERS OF ACCESS COVERS TO WITHIN 6" OF FIN. GRADE LEACHING FIELD W/ PROVIDE INSPECTION PORTS TO 2. MUNICIPAL WATER IS EXISTING 3 tir REBAR SET 4" BELOW THIN 3" OF FINISH GRADE Q> \ TOP FOUND. EL. 47.3' GRADE 2% SLOPE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 39.0' MINIMUM .75' OF COVER OVER PRECAST FILTER FABRIC \ 4. DESIGN LOADING FOR ALL PROPOSED PRECAST 8 37-38' TOP 35.62 FINISHED GRADE- 4" LOAM & SEED OR PAVE AS REQ. UNITS TO BE AASHO H-M Route Z PRECAST H-10 / O LOcu Q RISERS (TYP.) 5. PIPE JOINTS TO BE MADE WATERTIGHT. a 210 4"OSCH40 PVC CLEAN FILL2:�tx 6" MIN. SUMP PIPES LEVEL 1ST 2' �o,�s boo 0' '� _..'�•:. 12" MIN. TNT. DIM. 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE e PERFORATED PVC 5' O.C. S 0.005 o WITH 310 CMR 15.000 (TITLE 5.) ti• 10" 1500 GAL H-10 14" o V.I.F. 35.87' STONE LEACH DOUBLE WASNEI o 7. THIS PLAN IS FOR'PROPOSED WORK ONLY AND �sf �00 TEE SEPTIC TANK TEE 35.62 ° ° ° ° ° 8 STONE LEACHING FIELD o 6"DEPTH MIN BELOW INV. NOT TO BE USED°FOR LOT LINE STAKING OR ANY /0 0 ° o ° ° WATERTEHT D'BOX 35.1 GAS BAFFLE::: °g4)0°o�°,°o°o°o° FOR LEVELNESS 35.27' LEVEL Bt1TTOM o OTHER PURPOSE. 4' LIQ. LEVEL (ACME OR EQUAL) 35.52' w 35.35' ` 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. o 30.0' to 0 R .00000000°o°e°o°000000a0000°000000000°000°00000 'I _ \\0 ° ° ° ° ° ° ° ° ° ° ° ° �34-60' 9. COMPONENTS NOT TO BE BACKFILLED OR o�A 01 0000000 0 o r_r_n_n_n_3.o o CONCEALED WITHOUT INSPECTION BY BOARD OF = G� 6" CRUSHED STONE OR MECHANICAL 5.0' ~- OFALTH HEALTH AND PERMISSION OBTAINED FROM BOARD p\d COMPACTION. (15.221 [2]) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR 2 5 2 ADJUSTED GROUNDWATER 29.6' CALLING DIGSAFE (1-888-344-7233) AND MAP ( % SLOPE) ( 7. SLOPE) ( 1 7. SLOPE) VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS CUS S OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF FOUNDATION 22' SEPTIC TANK 5' D' BOX 10' LEACHING WORK. SCALE 1 =2000,f FACILITY 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 271 PARCEL 75 BE REMOVED BENEATH AND 5' AROUND THE PROPOSED LEACHING FACILITY. SITE IS LOCATED WITHIN A ZONE II *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND- UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS SAND. PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 99- EXISTING CONTOUR - X 99.1 EXIST. SPOT ELEV. SYSTEM DESIGN: -[99]- PROPOSED CONTOUR GARBAGE DISPOSER IS NOT ALLOWED 198.41 PROPOSED SPOT EL. - 50 EXISTING 4 BEDROOM DWELLING TH1 TEST HOLE DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440 GPD 2% SLOPE OF GROUND �g USE A 440 GPD DESIGN FLOW UTILITY POLE :� SEPTIC TANK: 440 GPD (2) = 880 FIRE HYDRANT ) q USE A 1500 GAL. SEPTIC TANK NOTE: NOT ALL SYMBOLS'MAY APPEAR 11 DRAVANG ��� �� LEACHING: - F { 0 �If-, PAV 440 GPD / (.74) = 595 SF REQUIRED Eo DR'VEWA,Y ° 46 ah 30' X 20' = 600 SF OK TEST HOLE LOGS �8_ 600 SF X .74 = 444 GPD OK M 0 RAMP coNc.o° �42 USE A 30' X 20' PIPE AND STONE LEACHING FIELD ENGINEER: CRAIG J. FERRARI, SE #13871 o M 47 M F( N�aE 41 WITNESS: DAVID W. STANTON RS a S - 40 8 2 2019DATE: °CONC'°. 3g 47 EXISTING PATIB - - - - - 37.5 . °. / PERC. RATE = < 2 MIN/INCH U 4� BENCHMARK: DWELLING MA TOP OF STOOP TOF=47.3 APPROVED DATE BOARD OF HEALTH ° CLASS I SOILS P# 19-95 =47.8 NAVD88 2 0 �g o 9 ELEV. ELEV. a LOT AREA O O �„ 4 36.5' 0„ 40' 46 10,780± S.F. LECTRIC 16.7' FILL A M 46 18 LS �5 k^, o m - - - - \ �� TH 1 a- A 499 1OYR 4/2 45 40 Ls B �s kk�� '400"�, 36 35 TITLE 5 SITE PLAN k� 26„ 1OYR 2/1 LS 40C� i OF 5' REMOVAL F UIT E SOIL REQUIRE � �M B 24„ 10YR 5/8 38' 3� AROUND PER METERTABLE 0 LEACHING FACILI i'HOFM AS #274 LINCOLN ROAD. DOWN TO [TABLE SOIL LAYER. REPLA �e��-� Assgc 1 0'" t LS WITH C AN MED. SAND, �' 'Y o DANIEL TO EET f o G� �s DANIEL A. A CI ICATIO F CMR 1 55(3 OJALA 4 of^10YR 4/6 H Y A N N I S, M A i 39" 33.2 No.40980 ~q No.46502 PREPARED FOR PERC C1 C Sao sTE�G> tq�oEssv yo SL �� Ior�n� =`- �. BARBARA LANG CS l�� `�s � 10YR 6/6 G-W ADJ. DATA: ' V\U% _ -�t ,�r �� 60 31 .5 WELL: Al W-230IF: DAME t� \ DATE: AUGUST 9, 2019 10YR 7/4 ZONE: D � JAIL,% ADJ: 0.1' I 131 IVIL off 508-362-4541 C2 JULY 20191 IL ;)„%4'��'� 050°� fax 508-362-9880 � N o ��^ 0` downcope.com MIS 6 = ply, �OWO cage ell hieering, 1dc. 108" 10YR 6/1 27.5' 120" 30' Civil engineers F GROUNDWATER ENCOUNTERED AT 84" EL. 29.5' Scale: 1"= 20' � land surveyors 9J9 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 LICE # ' 9-240 19-240 LANG.DWG 00 D/ST , L�Erg /-� p 1 r -r- 1 ! 11 �ti... Y _ IIJ .qD /.c,l r4 �$N D TO AV E d 11 E.XTE�./D F3L L- F-1 nPL/C�9 BLE - — - �-a - pr-oPc�s�d c�rnvnd Pr of, le k4 2/Z. SC,9LE I " _ �' ---- S � C� / C� /�J - -_ V E ,2T SCF-9LE / ' _ / ©' MAI�JHGLE COVERS 7`0 4AJl7-H;I-./ 12^ SCHED. 40 P V. C. 0,2 -f L 04-j -T ; , EOu.9L `rt� SEPr/C �r-►�,n,rt-1ur» %" pter -•�'oo-J-) �2washed sfane . __� � � `/AJ T I. �,_"_"__'_7 --/A./---,-•- . 0 0 A( o O e p O O D/57" BOX O ---+ �o'd/a a ° a•, Sump o s e o /OC�O G�?L. SEPT/C T,9AJ,< o f e o ! o o 0 f 1-4 P l `r Al 100.(c�-• l0i • _3__ je D,2OO/"I f-�4C/SE � t 1 � (n o d;�Pos�r� J. �H�oB t' rz e►-� , -.--.--- _- �0 A2C. ,r?f� TE- C 49 t3oa rz� v-y`- f r`e:t1-� h �/--4TE Ls%'DAY D/Li zo• 7-f1/VK � 3 30 x S S 49 S # oy o - - -- TEST H O L E I T E S 7- ,G-/o L Er #,E .o. USC- I_ TFiu,� LU0-) h1 sue- ti fi E FF Z�E P "H � ' mil. QS• l 5 y3 Sa/�- z ' _ �---- 1 I - 97. ,= 2 5 rJ' MED D G w f3 L L - /._.._..� �_ . ( , � _ �9'�.8 �. P, .- Ski n.1�7 85 1447 AJOD�' &,A � G L- A L F�f2ooOSEL7 0/,/ $r� © Off./ -HIS f'L. F��/ DOES 0,2 : D ? YEr�CH MFi/2K Go/VF�7,2'M To THE SU1Z-D/ti1G sE-7-- F4- _ /OO G//)eE MEIVTS © -'NE- G / nJG�3G tiJ /c ©F Z> `T o v- O r3.> 7-L->!rV A O /f4,2 c D F0,2: _- ,��. . • � C r9 L E : f-7 S S N O[.�/ n,1 1:)F4 T E E'VERETT 0 H. lEY i v HINCKLEY v 1 7137 O 1 p � / yr 13230 <. S",STOk / , l E G f / 9Nn 5 Ru Y�t°� �1 L_.. (� C__ X /S-t-r n e va f�0 n BL D Ca. S ETEj ,4 c,L �.�� �?SicR�c��a`� 9 .srnivA� �� /`- 7 O c.J T L"`�.�'1 proposed e le va-f-ran eE E.+•/TS . __i,_- �,___o-___ o -- �t'O 'oSc'?O� Gat'► fC71/t-S -/ It, " ' cat r- � /� ., 8 O,�,t2 c') • O,�' N� f-"1 L 7-H __ __.