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HomeMy WebLinkAbout0031 LINDA LANE - Health i 1%ily A LAN (H+YANNIS) A-248-216 a { . J TOWN OF BARNSTABLE LOCATIONS I J_i n eloL L„n, SEWAGE# _2O i3 - 31 VILLAGE {� �(,���� ASSESSOR'S MAP&PARCEL NO 21fo INSTALLER'S NAME&PHONE NO. 9C)be T$,Wr6,_/%C. SBA'-c/3Z-®�30 SEPTIC TANK CAPACITY 1.300 LEACHING FACILITY.(type).3-3d-010 ej"he,rs (size) 33,SX 12.eX Z 0 NO.OF BEDROOMS-. y OWNER KeVIa +gaTky PERMIT DATE: 9"" J 7' /_S COMPLIANCE DATE: r Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A111A Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) A11A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) pP A/ Feet FURNISHED BY,a i11 A-3:y2' 20`y„ k � Dr vewqj l� 60 No. �6 � � Fee /o THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippliLation for Misposar 6pstrm Construction VPrmit Application for a Permit to Construct( ) Repair( ) Upgrade N</� bandon( ) MICKomplete System ❑Individual Components Location Address or Lot No.31 LA- Owner's Name,Address,and Tel.No.78j-_3gq-145 j g Assessor's Map/Parcel '2 Z 1 ' L j a-L, }� S Installer's Name,Address,and Tel.No.S6 8- `132-®S30 Designer's Name,Address,and Tel.No.,520 F-3 Y- fV yLY P-10 Lewr 8, @1�L6� Inc. &-33 Re Vet Ems, .5' D //� ,� t72r,n i S / f7 2 4, Type of Building: Dwelling No.of Bedrooms Lot Size /0 7 7 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow(min.required) No gpd Design flow provided /15 L1 gpd Plan Date - /f-is Number of sheets I Revision Date Title irj&Ln. Size of Septic Tank/, <-6 0 4a-)1®-VN Type of S.A.S.3 j&J L' BGrS 0�y p�S tar e Description of Soil n- 7" 4.®aonj S" ;9- 27" c y/4e+U,4.- -Sand 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 Board Vea Signe Date 9i Application Approved by Date / Application Disapproved by Date for the following reasons Permit No. 5 Date Issued 7 , No. Fee kfv,00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION ,-TOWN OF BARNSTABLE, MASSACHUSETTS I� L Zipplication for Disposal *pstem Construction Permit f f h•'r Application for a Permit to Construct( ) Repair E),Upgrade N,/ bandon Cu M Complete System ❑Individual Components Location Address or Lot No.31 L.i r, a i-f1• Owner's Name,Address,and Tel.No.78/-3$q'H518 Kevin+ Assessor's Map/Parcel 2 N 8 / 2 i j Installer's Name,Address,and Tel.No.-S-6 B- Y37-OS30 Designer's Name,Address,and Tel.No.s0 X-36y- fv v8 Kv&-, T B, ov-rto•:'tic P•o. 3o�c P53ci Nc-rwici, 026yS A �163 / . i72r,�i's ��. b2G / Type of Building: Dwelling No.of Bedrooms Lot Size /0� 7 7 8' sq.ft. Garbage Grinder( ) YP Other Type of Building No.of Persons Showers( ) Cafeteria( ) � g Other Fixtures "� V L� u III Design Flow(min.required) "7 y� gpd Design flow provided /5 5 gpd Plan Date 9 f' Number of sheets / Revision Date Title 31 k i,\J a`n I� .Size of Septic Tank ,s©O �0.110 y Type of S.A.S.3-,5 oQ &-)'v^ a k4L/h bees L l 0-ton e Description of Soil A - ,7 J_0a/ S 6 �' 2 7" _<tA 4:f—zy1 e1'U,,t,, Sow Gs Nature of Repairs or Alterations(Answer when applicable) i j 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 i%> ea Si gne Date Application Approved by Date I Application Disapproved by Date for the following reasons II Permit No. 5 —3 is- Date Issued , r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(1111) Abandoned( )by Ahez!r & 8v-,( to. X AC. at 31 ),i ride. Ln. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NoA 15.3 1 S dated q 1/71/5 Installer RO •8V t!f! nL+ Designer ais River Ems• #bedrooms Approved des' n flow V gpd The issuance o this a iti all not be construed as a guarantee that the system wi fun ` desig Date Inspector4 (� ) ----------�-]--.(-�----F-�----- - - -- ---------------------------- --------y----- No. rJ " 1 J Fee�/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(✓) Abandon( ) System located at -31 L 1 ndG. LA . 1 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 c m{pleted within three years of the date of this permit. �\ i Date "► ! /. Approved b v I AFFIDAVIT I, L) r ✓1 �-e�r1 Y(�, Do hereby swear that when we purchased the house at the foilowirig location, In the year of a O a , It was a bedroom dwelling and is still used as such. date: date: a Owners' signature Town of Barnstable P��mEro�c Regulatory Services Richard V. Scali, Interim Director anaUNS-MLF. M'— Public Health Division s639- �6►�' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: t4-Jam'1J Sewage Permit# Assessor's Map\Parcel 2q B12) 1 _ r Designer: ��(Y}A MGL=tJl,qt1, OE, Installer: POS''rCZ-7 �• 00�- Address: 90 Y ) ) Address: (5,X / S-3 9 C . F NN1S MA OU q )�/q Pal (�,1 , (y)4 DZb qS 0,f On g'��-/� �pt-�' g�Ce, ,tea was issued a permit to install a (date) (installer) septic system at L j&) `J,4� ynt based on a design drawn by (address) THbfy)A I PA c-t, [ L l N) , P,F__ . dated (designer) /I certifythat the septic stem referenced above was installed substantial) according t P Y Y b o the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisl ctory. I certify that e system referenced above was constructed-, compliance with the terms Cofz he IAA proval ers (if applicable) ��r all •s w " ture) _ f �; (Designer Signature) (Affix Des gher's`Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIAINCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Rev 8-14-13.doc 'own of Barnstable Departitnent of Regulatory Services s a S)< t H Public Health Division ,ram, OIl Date � r/ �I. salA 200 Main Street,Hyannis MA 02601 • rEn nta't" Date Scheduled ( Time Fee Pd._ w Soil Suitability Assessment for Sew ge isposal Performed-By:. Q/►���M pkl* Witnessed By: LOCATION&GENERAL INFORMATION Location Address f / Owner's Name nf�ol `GJ�� N � Cr C,,' RIA A I"f Address / Assessor's Map/Parcel: o � b Engineer's Name . NEW CONSTRUCTION REPAIR Telephone# Land Use. 5 Slopes(%) AM-ft Surface Stones Distances from: Open Water Body��b ft possible Wet.Area •• LA Drinking Water Well .M' ft Dral'nago Wily. AIA ft Property Line f_D ft Other ft SIMUCII:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands in proximity to holes) l o.ol ` XISY 'TH-Z, 4 n S Parent material(geologic) Depth to Bedrock, N � Depth to Oroundwater. Standing Water In Hole: tUI�AJF Weeping from Pit Face Nl Estimated Seasonal High Oroundwater Nn - PE FOR SEACQ?�dts�.�p[0�`,><,�i;►TER'x'Aixl,t!, . - Method Used: Depth Observed standing In obs.hole: In. Depth to loll mottles: Dei1th to weeping from side of obs.hole: lit. Oroundwater Adjutttment � Index Well Reading Date: Index Well levol� _„ A ,1hCtor _ ..._. . . ,.. rll Ark.ptnundwdter]oval Observation PERCOLATION TEST ngle 8'&.- 6 lo__ _6'0 f Hole# d Tlnte at 9" Depth of Pere Time at 6" Start Pre-soak Time Q Time(V-0) End Pro-soak Rate Mih./Inch Site Suitability Assessment: Site Passed -Site Failed: Additional Testing Needed(YIN) Original- Public Health Division Observ'ation Hole Data To Be Completed on Back----- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:ISEPTIC\PERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# � Depth from Soil Horizon Soil Texture Shcl Color Soil• Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones;Boulders. nsistency,%'Orayoll (® `�12- t A)OIVE no G � S 2 DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency,%Oa WAf �.. S W H�- 0 . DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soli Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Statics;Boulders. C y Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Z Within 500 year boundary No Yes _ Within 100 year flood boundary No,, Yes - Depth of NaturaHy Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the •�E area proposed for the soil absorption system? - 4-- If not,what is the depth of naturally occurring pervious materiall Certification I certify that on I"q (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required trai 'ng,expertise and a penence described in 10 CMR 15.017. Signature 'Date d f QAS.EPTiCtPBRCPORM.DOC COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION e' ♦ .� f i X 1'sfif.. TITLE 5Y OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION 3 Property Address: 31 LINDA LANE HYANNIS,MA 02601 a $ a�� �0��� t, Owner's Name: JOHN DRISCOLL Owner's Address: 31 LINDA LANE HYANNIS,MA 02601 Date of Inspection:3/12/01 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: `,"P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is st t true,accurate and complete as of the time of the inspection.The inspection was performed based on my training andG'' 4 f experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ,t X Passes _ Conditionally Passes _ Needs Furth valuation by the Local Approving Authority Fails r Inspector's Signature: Date: 3/12/01 ' The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within ; 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments THE SYSTEM PASSES TITLE V INPECTION. RECOMMEND PUMPING NOW AND EVERY ONE TO TWO YEARS i TO PROLONG THE SYSTEM'S USEFULL LIFE. ""This report only describes conditions at the time of inspection and undo: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. E, . } T:rl.. C 1.-�• . rtinr rn•r. /,/1 ci1000 - it t . Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ` s�s PART A CERTIFICATION (continued) ; Property Address: 31 LINDA LANE HY.ANNIS,MA 02601 } �9k Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 Inspection Summary: Check A,B,C,D or E,/ALWAYS 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 in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. , Comments: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING NOW AND EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. B. System Conditionally Passes: R% _ One or more system componerits,as described in the"Conditional Pass"section need to be replaced or repaired.The system, f"s;:•Y: upon completion of the replacement,or repair,as approved by the Board of Health,will pass. t_ Answer yes,no or not determined(Y,N,ND) in the for the following statements.If"not determined"please explain. i try I I. ?Z n/a 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 3 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 y ,. that the tank is less than 20 years old is available. ND explain: n/a n/a 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): _ brol4en pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a ; ;s 4.., ;1: n/a The system required pumping more;than 4 times a year due to broken or obstructed pipe(s).The system will pass 's k i Yaf y inspection if(with approval of the Board'of Health): _broken pipe.(s)are replaced _obstruction is removed a . ND explain: n/a ;r. Page 3 of 11 ` '' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 31 LINDA LANE.HYANNIS,MA 02601 : Owner: JOHN DRISCOLL ,i Date of Inspection: 3/12/01 f j`'XXa C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require furthertevaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. Y V t 1. System will pass unless Board of;Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water ,2 .. _ Cesspool or privy is within 50 feet,of,a bordering vegetated wetland or a salt marsh ±r ' •;to t 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system SAS and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic.tank and SAS and the SAS is within a Zone I of a public water supply. ; 2 5 iY f _ 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 tf supply well".Method used to determine distance n/aq. , "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia 6 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. F J` ` �r -y f- 3. Other: r t n/a �q r f yci: Page 4 of 11 . c . ,14 VOLUNTARY ASSESSMENTS OFFICIAL INSPECTION FORM—NOT FOR 1, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ` PART A CERTIFICATION(continued) j Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 4 r D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged ;; t. SAS or cesspool :' X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/2 day flow _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times ''A= pumped Wa. X Any portion of the SAS,cesspool or privy is below high ground water elevation. ` 1' X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. } X Any portion of a cesspool or privy is within a Zone I of a public well. '°}` X Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ X 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 $ 1� certified laboratory,for colifoem bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or 1 less than 5 ppm,provided that.no other failure criteria are triggered.A copy of the analysis must be attached to this form.] r (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be '. necessary to correct the failure. .. E. Large Systems: , To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: f;'µ, J (The following criteria apply to large systems in addition to the criteria above) yes no 1, X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a,tributary to a surface drinking water supply f x X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped ,F > t Zone II of a public water supply well x ' 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 4 �4 - 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. ' d Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS F:' 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 Check if the following have been,done:You must indicate"yes"or"no"as to each of the following: 6. ' Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _- _ X Were any of the system components pumped out in the previous two weeks? +�' X _ Has the system received normal flows in the previous two week period? "r X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were.:jt available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ 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? ,` r X _ Was the facility owner(andoccupants if different from owner)provided with information on the proper maintenance ' of subsurface sewage disposal systems"? The size and location of the Soil Alisorption System(SAS)on the'site has been determined based on: Yes no Fi X Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is--t issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INNSPECTION FORM i?'4 PART C .a f SYSTEM INFORMATION Property Address: 31 LINDA LANE'HYANNIS,MA 02601 Owner: JOHN DRISCOLL f'_ Date of Inspection: 3/12/01 FLOW CONDITIONS .';\\: RESIDENTIAL ' Number of bedrooms(design):3 Number of bedrooms(actual): 3 t DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 s Number of current residents:2 Does residence have a garbage grinder(yes or.no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use:(yes or no): NO Water meter readings,if available(last 2 years"usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL'. Type of establishment: n/a Design flow(based on 310 CMR 15 203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a -' Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to-the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records x>; Source of information: n/a a � Was system pumped as part of the inspection,,(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a i TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool " _Overflow cesspool _Privy i Shared system(yes or no)(if yes,,attach previous inspection records,if any) _Innovative/Alternative technology: Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP approval Other(describe): n/a 1 1 Approximate age of all components,date installed(if known)and source of information: } 26 YEARS OLD Were sewage odors detected when arriving at the site(yes or no): NO I f° �s A Page 7 of 11 F i f- OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 i BUILDING SEWER(locate on site plan) Depth below grade:0" ' Materials of construction:_cast iron`;_40 PVC Xother(explain):ORANGEBURG Distance from private water supply well or suction line: n/a ='e' Comments(on condition of joints,venting,evidence of leakage,etc.): 'r THERE ARE TWO SEWERS IN 1ST CESSPOOL BOTH ORANGEBURG AT 2'-AND ONE SEWER OF :'. ' ' ORANGEBURG AT 1' 6" `_N 1: SEPTIC TANK: X(locate on site plan) Depth below grade: 12" , _ 1 fiberglass other(explain)n/a ., Material of construction:Xconcrete meta _ g _polyethylene If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) ] Dimensions:2-6' X 6' BLOCK CESSPOOLS" '.' ' Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" Scum thickness: I" Distance from top of scum to top of outlet tee or baffle:0" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined:MEASURED Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): BOTH MAIN CESSPOOLS AND ALL COMPONENTS APPEAR TO BE STURCTURALLY SOUND. RECOMMEND PUMPING NOW AND EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFULL '- LIFE. GREASE TRAP:_(locate on site plan) � ' � Depth below grade: n/a ?;Slot: Material of construction:_concrete_metal fiberglass_polyethylene other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom..of outlet tee or baffle: n/a Date of last pumping: n/a }" { Comments(on pumping recommendations;in t and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.):'" n/a ti ti. �.�f 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) t `.'� Depth below grade: n/a Material of construction:_concrete_metal_fiberglass polyethylene_other(explain): n/a Dimensions: n/a 'ai Capacity: n/a gallons Design Flow:n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO , Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) r i Depth of liquid level above outlet invert: n/a 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.): la r,11-s n/a PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO .d Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): IR;' '; _Z, 11.1 n/a t R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6'X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: 0 n/a innovative/alternative system !" ;Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAD I' OF LEACHING LEFT AT THE TIME OF THE INSPECTION. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a {Y q PRIVY: (locate on site plan) Materials of construction: n/a J +^ Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n/a Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . . PART C SYSTEM INFORMATION(continued) Property Address: 31 LINDA LANE HYANNIS,MA 02601 Owner: JOHN DRISCOLL Date of Inspection: 3/12/01 SITE EXAM _Slope Surface water _Check cellar Shallow wells N' Estimated depth to ground water 10 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design.plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS-10' J` t7, e t t LOCATION ll SEWAGE PERMIT NO. - VItLAGE INST -LER'S ' AME i ADDRESS U" DATE PERMIT ISSUED .2 - DATE COMPLIANCE ISSUED _ _ �\� t �' � �' 0 �� � �,�' fi! ��� �� f �' t 1 ,1 ,I .� , No80 .%a ..... F�$....$....5_%.QQ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------- ---- .._...T.own.. ....oF......&� restable......................................................... Appliration for Diiprniial Workii Cfnnvtrnrtinn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: LindaLane, Hyannis, --..42601.............. .•------------............-----••-------...---..._--------•-••-•----------•-------..........------ ..... Location--Address or Lot No. .....John J.-Driscoll...................................................... 7.._Lzxd a__Sane.,...I annisr..11A.....D2&Lll-_---.----.---•--_ . --. ---•------.... Owner Address a A.&.B--Cesspool Service........................................ -1,2$---Bi,chaps-.Te=ace-g--liyannis.,_MA.....A2601.... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..........3................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building -------------_----_---.- No. of persons---------�L---------------- Showers ( ) — Cafeteria ( ) Q' 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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................................................................... --•--- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.-..------.-.------- Depth to ground water-.-----------------.-.-. (z, Test Pit No. 2................minutes per inch Depth of Test Pit....--......----.... Depth to ground water..----.................. --------•--------------------------•---------------------..........--------------------•---------•--........................................................ 0 Description of Soil..........S.and..................................................................................................................................................... U ---------------------------------------------------------------------------•-----••------------------.....----------------•------------------ .................................................... W ---•---------------------------------------------- ------------------- ............................................................................................................................... UNature of Repairs or Alterations—Answer when applicable.-.installati.on.--of..a.--1-,-QO.Q--gallon.-.px€-�ca,%t, stone..Packed..leach.pit.--�oyer.......... ----•----------•-----------------------------------------------------------------------------------------••---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i?p of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuedZbythe b ............ Date Application Approved BY ... �,lXe �'`z --- ----•-..12�15/BD------------- - Date Application Disapproved for the following reasons:...................................................................... ........................................ --------------•----------•--...------------------------------------............•--------•----------•--••. Datc Permit No.80---------------------------------------•--•-•---.. Issued................. 2115/80 Date No8©-.7z .... Fss5 ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town........OF.....Barnstable._... Appliration for U Utah al Workfi Toutitrnrtion Prrntit Application is hereby made foT a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 31 Linda. Lane, Hyannis, i�1A 02601 ................__..............................-----•--....---•------••-•••-•............-----•. -•--......------••------•--...........•----...--------•--•-----•---------•--------'--.......•-•-•- John J. Driseol[eation-Address �,. or Lot No. 31 Linda ... LaneH 02601•...... ......... .......... - .... Ow ems" Address w A & B Cesspool Service 128 Bishops Terrace. Hyannisd MA 02601_-• .......................................................... ...._........ ---....---•- ------•-••---••--••. Installer Address Q Type_of'$uilding Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...._._... ................................Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building ____________________________ No. of persons....................._..._.. Showers ( ) — Cafeteria ( ) a' 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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------- -------------•---••••-•-••--•----••---••----------••••--•-- Date------...--•-----•-•-----•-••-••--•--- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--_-_-_-__--_--____-_.-. rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •----------•-------------------•••-••-••--••--•--•-----••--•••.......•--•-------•---•-•-••-.............---•---•--••••----•--•----•-•--•--------••-•--•------ 0 Description of Soil........... and-•-•---•--•••.....•..........................................................••-•-•----------------------•-----------••----•----------•-•--------•••---•••--•-••-•----- x U .----------------•----•--••---••-•------••--••--•••---•-•••-•--•--•-•-•-----•••-•••--•-•-••--•----------•••-••-----•••-•---......--•-•------•---••--••---•-•------•---•-•-•..........-•-•••--••••-------- w UNature of Repairs or Alterations—Answer when applicable_.installation­ofa ... 000 lion--p�'e.-Cast, stone packed leach pit (overflow. ------------•-•.................................................................................................................................................................... 1 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 1 the provisions of'T'T p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has jbeenisgued by the b a of 1 t (1 .�f �d / � r�' .121_15J80 1 Application Approved BY------ --------------•-•----•-----------•- ---------12(-1 t-----•--•-•- �. Date ' Application Disapproved for the following reasons----------------•---------------------------------...------------------------------------------------...-•-_..... .....-•-•-•---•--------------•------•---••---•-.....•--••••-••••---••••-- 80 Date \ Permit No--------................................................ Issued.---------------.12/15/80 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable OF..................................................................................... Tr ifirFatr of ToutpliFatta THIS 1ST( CERTIFY Th t the i v a Sewn Dis osal stem cons cte or Repaired ( X) by. -K & B Cesspool Service, 1 ' ' slhops erroe. rannis, �2�601� - ---- •-----------•-------------------------------•----•----.-.---..-•_.--•--•--------•--------------•----•------•------------ at......... 31 Linda Lane, Hyannis, VA 02601 Installer John J. Driscoll ..........•------------------------------•---------•-------------------------•----------.....------------------------------------------------------------------------......•--•--------•-•- has been installed in accordance with the provisions of TI ,' f The State Sanitary Coc�27,irmbed in the application for Disposal Works Construction Permit No-----__.._�........................... dated................................................ TIME ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 12/ /80 DATE.....i......................................................................... Inspector-----r� Z. ..... -----.G-- 5 GL ---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.........OF.......Barnstable $ 5.00 80- ...................... ............................................................--_.. No....................�:9 FEE........................ Dispnsa1 Workii TDnntratrtion Prrutit Permission is hereby granted...................._A & B Cesspool. Service -----------•------•--------•-------------•----- to Constru �11 r ge air an Indi ual Sg e Dis osal st i(LYnc% Lane,(H is, 'idA 0 by -p JSo�n9, Driscoll atNo............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction rmit No...80�r'd'of ed.......12 15/80 12/15/8O lth DATE..................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS N KE Y: CONTOUR: ---- SEPTIC SYSTEM DESIGN SEPTIC SYSTEM SECTION PINE ST PROPOSED CONTOUR: ........••••• 2"PEASTONE OR FILTER FABRIC EXISTING SPOT ELEVATION: 25.5 FLOW ESTIMATE: COVERS WITHIN 6" 3/4"-1 1/2" PROPOSED SPOT ELEVATION: 5.5 101.12 4 BEDROOMSAT 110 GAL/DAY= 440 GAL/DAY OF FINISHED GRADE WASHED STONE N TEST HOLE:* TOP OF UTILITY POLE: -0 SEPTIC TANK: ° FOUNDATION "� n - rt-, „ K m , ,�,N INSPECTION PORT r FENCE LINE: �-„ „m, Grp 440 GAL/DAY x 2 DAYS= 880 GAL m% ELEV.-_97.5 Om LINDALN HYDRANT:-�- 3'MAX. ����� . �Ao RETAINING WALL: ® USE 1500 GALLON SEPTIC TANK 98.12 a 1OM NR mi v`~' ELEV. ( ) LEACHING AREA: ELEV. LOCUS ° USE 3-500 GALLON CHAMBERS(8.5'x 4.8'x 2'EFF.DEPTH)WITH 97.87 ELEV. ELEV. " ° " ° " 94.67 LOCATION MAP ELEV. D-BOX H ° ° ° H ELEV. LOT 66A (10,778 SF) 4'OF STONE ALL AROUND (33.5'x 12.8'x 2'DEEP) ° 1500 GAL (6"STONE UNDER) 4' 4' ASSESSORS MAP:248 PARCEL:216 new lumbin re uired SEPTIC TANK 33.5'x 12.8' > SIDE AREA: (33.5'+12.8')x 2 x 2=185 SF (0.74)= 137 GAL/DAY p g qq PLAN BOOK:520, PAGE:6 due to old orange (6' OF STONE UNDER OR 3-500 GALLON CHAMBERS WITH pipes running under MECHANICALLY COMPACTED 96.67 4'OF STONE ALL AROUND BOTTOM AREA: 33.5'x 12.8'=429 SF (0.74)=317 GAL/DAY concrete slabs ) ELEV. (33.5'x 12.8'x 2'DEEP) TEE SIZES: CAPACITY=454 GAL/DAY GAS BAFFLE - r . INLET:6"UP, 13"DOWN OUTLET:6"UP, 14"DOWN AT OUTLET TEE N REQUIRED VARIANCES FROM TITLE FIVE: 100.0 1.SECTION 15.211 (1):LEACH ARE TO BE LESS THAN 20'FROM CELLAR WALL(VARIANCE OF 9'). TEST HOLE LOGS TH-1 100.0 ELEV. TH 2 ELEV. O/A HORIZON O/A HORIZON ENGINEER: THOMAS McLELLAN,P.E. LOAMY SAND LOAMY SAND 7" 10YR 4/1 99.4 8" 10YR 4/1 99.3 WITNESS: DAVE STANTON,R.S. g HORIZON B HORIZON DATE: 8-11-15 LOAMY SAND LOAMY SAND 34" 10YR 6/8 97.2 32" 10YR 6/8 97.4 BED BED PERCOLATION RATE: <2 MIN/IN C HORIZON C HORIZON ROOM ROOM MEDIUM SAND MEDIUM SAND 2.5Y 7/4 PERC AT 48" 2.5Y 7/4 pA LAME BATH -I ND�- 138" 138" BENCHMARK AT -�.°� 1�` 88.5 8 8.5 CONCRETE BOUND \ NO GROUND WATER ENCOUNTERED ELEVATION=99.97 -_�, �•� \ of: E�-°-GE �"�100� NOTES: 100.9 '30"Ec \ LIVIN Fpch ROOM 1.VERTICAL DATUM: ASSUMED LIVING / 147904 79 50 1 24 le 100.8 ! 00 2.MUNICAPAL WATER IS AVAILABLE. BE USED T SEPTIC SYSTEM. map �z X i v BATH 4.ALL PRECAST UNITS SUBJECT OTO TRAFFIC LOADS TO CONFORMWITH AASHTO H-20 SPECIFICATIONS. �6 ^� i BED 5.PIPE PITCH= 1/4" PER FOOT(UNLESS NOTED OTHERWISE). DINING IT it 100.5 X AREA ROOM 6.FIRST 2'OF PIPE OUT OF D-BOX TO BE SET LEVEL. ' 10' i 7.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE USE OF A GARBAGE DISPOSAL. o W w SUN bh 8.ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE STATE OF MASS.ENVIRONMENTAL m0 i ROOM CODE(TITLE FIVE)AND LOCAL HEALTH REGULATIONS. N 9.CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR TO CONSTRUCTION. m � 10.GROUND COVER OVER ALL SEPTIC SYSTEM COMPONENTS NOT TO EXCEED 3'. EXISTING `�o ST 10' 4 BEDROOM 11.FIELD SURVEY PROVIDED BY TERRY A.WARNER,P.L.S.,HARWICH,MA. m 1 12 min DWELLING i 16 o top Ind=10 . i 12.THIS PLAN REQUIRES THE REVIEW AND APPROVAL OF ONE OR MORE TOWN DEPARTMENTS AND IS SUBJECT TO CHANGE UNTIL SUCH TIME. C� IZ 100.4 th-2 EXISTING FLOOR PLAN 13.EXISTING CESS POOLS ARE TO BE PUMPED AND FILLED WITH SAND OR REMOVED. o it �00 14.D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. T w pch °�°co c`°n 0 0, i th-1 100.4 �z 0 full basement ' slab II bh ►) ik� (orangeberg pipe under ii u slabs) pAVED concrete a ; DRIVE m a\ patio n It CD SITE PLAN Z � p , LOCATION: ,p) 31 LINDA LANE, CENTERVILLE, MA m . -or"q , PREPARED FOR: t S 8142 25„W_------"' of lawn&Hedge- j' }�MA�� - KEVIN & KATHY CRAIG edge , DATE:9-1-15 SCALE: 1"=20' \ BASS RIVER ENGINEERING 100 TH6MAS J. McLE AN, P.E. P.O.BOX 1163, EAST DENNIS,MA 02641 508-385-3426 OR 508-364-9048