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c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
Hyannis, MA 95 Linda Lane, H
Y
Property Address
r a
John Parent 95 Linda Lane
Owner Owner's Name e
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
i
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When A. Inspector Information �/ ��1�
filling out forms / -NX3
on the computer, Armando Panto a
use only the tab 1
key to move your Name of Inspector
cursor-do not Accu Sepcheck
use the return Company Name
key.
17 Northside Drive
Company Address
South Dennis MA 02660
City/Town State Zip Code
reNm 508-385-5891 S114296
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
Cti�irytrv► 10. .,_ 3/9/2020
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.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18
Commonwealth of Massachusetts
(0 Title 5 Official Inspection Form
1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town 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:
I
2) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass" se ion need to be
replaced or repaired. The system, upon completion of the replacement repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND) for the lowing statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the sept' ank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or nk failure is imminent. System will pass
inspection if the existing tank is replaced with a comp ing septic tank as approved by the Board of
Health. kil
*A metal septic tank will pass inspection if it' structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less an 20 years old is available.
❑ Y ❑ N ❑ ND plain below):
�I
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
r
y Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town 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 Heal approval if
pumps/alarms are repaired.
❑ Observation of sewage backup or breakout or high static water level in a distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven ' tribution 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):
�P
❑ The system required pumping mor than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(wi approval of the Board of Health):
❑ broken pipe(s) are re aced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is re ved ❑ Y ❑ N ❑ ND (Explain below):
3) Further Evalu ion is Required by the Board of Health:
❑ Conditio s exist which require further evaluation by the Board of Health in order to determine if
the sy m 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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
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 mars
b. System will fail unless the Board of Health (and Public Water Supplier, if an
determines that the system is functioning in a manner that protects the publ' health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and th AS 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 Z e 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is withi 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is ss 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, p ormed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the prese ce of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other f dure 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
: Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
u
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town 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
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than 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.
5) Large Systems: To be considered a large system the system must serve a fa ' y 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 foil ing, in addition to the
questions in Section CA.
Yes No
❑ ❑ the system is within 400 feet of a rtace drinking water supply
❑ ❑ the system is within 200 f of a tributary to a surface drinking water supply
❑ ❑ the system is locate in a nitrogen sensitive area (Interim Wellhead Protection
Area— IWPA) o 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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
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 afl 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, e�(-'n he 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
cam, Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Description:
1500 GALLON SEPTIC TANK, DISTRIBUTION BOX, AND 2 LEACH TRENCHES 26'X4'X2'
Number of current residents: 0
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
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 175
9 ( Y 9 (gP ))�
Detail:
2019: 36,000 G : 2018: 92,000 G
Sump pump? ❑ Yes ® No
Last date of occupancy: 11/2019Date
t5insp.doc•rev.7/26/2018 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
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions:
Type of Establishment: z z
Design flow(based on 310 CMR 15.203):
Ga ns 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 prese ❑ Yes ® No
Non-sanitary waste discharge o the Title 5 system? ❑ Yes ® No
Water meter readings, if ailable:
Last date of occupa y/use: Date
Other(describ elow):
3. Pumping Records:
Source of information: PER BARN WWTP: PUMPED IN 2016
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
u
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
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:
AGE: 19 YEARS OLD. INSTALLED : 8/30/2001. SOURCE: BARNSTABLE HEALTH DEPT.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: —2
feet
Material of construction:
® cast iron ❑ 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: CROSSES . PLAN CALLS FOR
SLEEVING ,NOT DETERMINED
Comments (on condition of joints, venting, evidence of leakage, etc.):
NO EVIDENCE OF LEAKAGE.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
r� Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank (locate on site plan):
Depth below grade: 1
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: 10'X6'X5', 1500 GAL
Sludge depth:
10"
Distance from top of sludge to bottom of outlet tee or baffle
19"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
5"
Distance from bottom of scum to bottom of outlet tee or baffle
18"
How were dimensions determined? CORETAKER
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
PUMPING RECOMMENDED DUE TO SOLIDS EXCEEDING MORE THAN 20% OF LIQUID LEVEL.
HAS INLET PVC TEE, HAS OUTLET PVC TEE WITH 19" LEG AND GAS BAFFLE. LIQUID LEVEL
IS 48"AT OUTLET INVERT. NO EVIDENCE OF LEAKAGE.
t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
r� Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
7. Grease Trap (locate on site plan):
Depth below grade: NO GREAS RAP
feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ lyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum/evidenceof
or baffle
Distance from bottom of sc outlet tee or baffle
Date of last pumping: Date
Comments (on pumping re , inlet and outlet tee or baffle condition, structural integ
liquid levels as related to out[ ence of leakage, etc.):
Ap
8. Tight or Holding Tank (tank must be pumped at time of inspectio (locate on site plan):
Depth below grade: NO TIGHT TANK
Material of construction:
❑ concrete El metal ❑ fibergl s ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
I
Design Flow:
gallons per day ,
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18
c Commonwealth of Massachusetts
a Title 5 Official Inspection Form
1- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
u
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank (cont.)
Alarm present: ❑ Yes No
Alarm level: Alarm ' working order: ❑ Yes ❑ No
Date of last pumping: ate
Comments (condition of alarm and float switc s, 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 AT INVERTS
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.):
PIPES IN: 1. PIPES OUT: 2 . IN GOOD CONDITION. EVEN FLOW DISTRIBUTION. PIPE TYPE
SCHEDULE 40.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18
Commonwealth of Massachusetts
M Title 5 Official Inspection Form
j- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑
Alarms in working order: ❑ Yes No*
Comments (note condition of pump chamber, condition of pumps and appu nances, etc.):
Alf
* If pumps or alarms are not in working order, stem is a conditional pass.
11. Soil Absorption System (SAS) (locate o site plan, excavation not required):
If SAS not located, explain why:
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: 2 (26'X4'X2') W
STONE
❑ 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
M1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cost.)
11. Soil Absorption System (SAS) (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
NO SIGNS OF HYDRAULIC FAILURE. STONE IS CLEAN AND DRY. GRADE-TO SAS BOTTOM IS
5.3'
12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool AP
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs o ydraulic failure, level of ponding, condition of vegetation,
etc.):
10,
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts
:. Title 5 Official Inspection Form
�- i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
' V
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
13. Privy (locate on site plan):
Materials of construction: NOT APPLICABLE
Dimensions NOT APPLICABLE
Depth of solids NOT APPLICABLE
Comments (note condition of soil, signs of hydraulic failure, level f ponding, condition of vegetation,
etc.):
NOT APPLICABLE
NP
t5insp.doc-rev.7/2 612 01 8 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
y 95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town 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
L
4 �(
O V
` o
2a` ( =20'
DDZ-22'
C3
k cL(
t5lnsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page.- City/Town State Zip Code Date of Inspection
D. System Information (cost.)
15. Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 1
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: PLAN DATE IS 8/30/2001
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
i
❑ Checked with local excavators, installers- (attach documentation)
® Accessed USGS database - explain:
GOOGLE MAPS, CAPE COD COMMISSION GROUNDWATER CONTOUR MAP,
FRIMPTER.
You must describe how you established the high ground water elevation:
GROUNDWATER CONTOUR IS 49'ASL. GROUNDWATER CONTOUR IS 24'ASL W A MAX RISE
OF 8'. GRADE TO SAS BOTTOM IS 5.5'. SEPARATION MATH: 49-(24+8+5.5)=11.5'.
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
c Commonwealth of Massachusetts
:. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
95 Linda Lane, Hyannis, MA
V
Property Address
John Parent 95 Linda Lane
Owner Owner's Name
information is required for every Hyannis MA 02601 3/6/2020
page. City/Town 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:
i
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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18
a..
�1 4�
A Town of Barnstable
Ir
Board of Health
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,RS.
FAX: 508-790-6304 Sumner Kaufman,MSPH
Wayne Miller,M.D.
October 19, 2005
Mr. John Parent
95 Linda Lane
Hyannis, MA 02601
RED 95 L1ndaLane ,H ann s� r � � � "
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Dear Mr. Parent,
You are granted a conditional variance to construct a garage close to the
leaching facility at 95 Linda Lane, Hyannis.
The variance granted is as follows:
310 CMR 15.211 (1): The soil absorption system will be located four (4) feet
away from the foundation wall (slab), in lieu of the ten (10) feet
minimum separation distance required.
This variance is granted because the physical constraints at the site severely
restrict the location of the garage and soil absorption system due to small size of
the parcel.
Sinc rely your
ayn , M iller .D.
Chair n
Q:HEALTH/WP/Parent variance2005
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Internet access to delivery information is not available on mail
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o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
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delivery.To obtain Return Receipt service;please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
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required.
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cle at the post office for postmarking. If a postmark on the Certified Mail
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Internet access to delivery information is not available on mail
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DATE a
FEE
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REC. BY�'_//&�
wM
�ToW --of�rnstable
A SD, DATE:
.�;r
Board of Health
200 Main Street,Hyannis MA 02601
Office: 508-862-4G44 Susan G.Rask,R.S.
FAX 508-790-6304 Sumner Kaufman,M.S.P.H.
Wayne A.Miller,M.D.
VARIANCE REQUEST FORM
LOCATION
• Property Address: 4 e f" '
As Map and Parcel Number: - Size of Lots t
Wetlands Within 300 Ft. Yes Business Name:
No Subdivision Name:
APPLICANT'S NAME: ��C3 i r4iiE-nr c�2t�. phone 6 S "
Did the owner of the property authorize you to represent him or her? Yes i No ��'
PROPERTY OWNER'S NAME CONTACT PERSON
Name: ito A, i-,A iZC ,V ! Name: S el
ff .
Address: 0 i tv A q 14)t zi•�j :mil a Address:
Phone: — � � •� ,c� Phone:
VARIANCE FROM REGULATION aistRaO REASON FOR VARIANCE(May attach if acre space needed—)y f
• •"f `i'" C;.��a(v t" ��1� �t"a}t,;�t, ti.•4 i" %t' I/!� htt.r
S+.�t"� t•t7 � ,�-n :v l`9 � C•- __ I�C 5(l:i�C c"� t`'r i<c f Y r.`D t L"t" tt-'r3 C:'t.,e n���'' !'i f`."f 4�
e.
• �'tr C i.i.< �'� Z�J
NATURE OF WORK: House Addition ❑lit] House Renovation ❑ Repair of Failed Septic System ❑
Checklist (to be completed by office staff person receiving variance request application)
Please submit copies in 4 separate completed sets
Four(4)copies of the completed variance request form
Four(4)copies-of eaginmed plan submitted(e.g.septic systemplans)
Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)
Signed letter stating tbat the property owner authorized you to represent him/her for this request
: Applicant tmdeistands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense
(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only) .
Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same
ownedieasee only], outside dining variance renewals [same owner4 asee only], and variances to repair failed-sewage disposal systems
[only if no expansion to the building proposedD
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Wayne A.Miller,M.D.Chairman
NO APPROVED Sumner Kaufman,M.S.PIL
REASON FOR DISAPPROVAL Susan G.Rask,R.S.
Q:\HEALTH\Applicatioa Forms\VARIREQ.DoC
TOWN OF BARNSTABLE
LOCATION 9Jfl�(J� L,AN� SEWAGE
VILLAGE
ASSESSOR'S MAP & LOT
INSTALLER'S NAME St PHONE NO. A & B CANCO 775-6264
SEPTIC TANK CAPACITY 1 SG U
LEACHING FACILITY:(typef,,�l{,,}c,�4rPN (size) 761�(
NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNERj�L��E�I�J
DATE PERMIT ISSUED: /o
DATE COMPLIANCE ISSUED: 10 Z Z- 6
VARIANCE GRANTED: Yes No
_�
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Fee 5�w
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pprication for ]Dizpool *pgtem Construction Permit
Application for a Permit to Construct( )Repair(V<Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. j L; (A n-C_ Owner's Name,Add rees and Tel.No.
�`Ja Assessor'sMap/Parcel y vsto
Installer's Name,Add,*,&&IOANCO �6 4 f$ 7 Designer's Name,Address and Tel.No.
350 Main Street ZGl� U�- ��
W. Yarmouth, MA 02673 3�'g- ?7 ( O
Type of Building: f
Dwelling No.of Bedrooms _i�� Lize sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date )_07—30 - O ( Number of sheets C Revision Date �1
Title S"Ye., ^ Sec✓aS C__
Size of Septic Tank /.S 00 Type of S.A.S. QCAC(2f P S �o,1C11 lX3
Description of Soil � li4✓1
Nature of Repairs or Alterations.(Answer when applicable)
DESIGNING ENGINEER MUST
M,,-,1 AL II I Ili-; Fi
-,,
F N�i.- SYSTEM 1 J— a Yam✓ Ya'N ♦.l i i..,,.e a
Date last inspected: ACCORDANCE TO PLAN:—
LA
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 Envirkponme ode and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of ` th q /
Signed Date l C�b /
Application Approved by ` Date /111!1
Application Disapproved for the following reasons
Permit No. 11W F 1 Date Issued ✓d V,--az
Fee
- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1/
` es
N" PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
w
Zipplitation for �Dioaal *pmern Construction i3ermit
Application for a Permit to Construct( )Repair( grade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. C(� ' ,� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel ��1 �'� f
P-/ ec,n-M L3
Installer's Name,AddreA A 91.GANCO ,4 "40 . Designer's Name,Address and Tel.No.
350 Main Street t C r i 7
W. Yarmouth, MA 02673 J�78 . 7 ( p
Type of Building: IZF
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date — 3,0 - 0 ( Number of sheets / "—Revision Date N/64
Title
J Size of Septic Tank /S Uu Type of S.A:S'/Q) cc,f{n Tf 06'X
J Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 1��e r
Date last inspected: '
Agreement: r
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 Environmen ode and not to place the system in operation until a Certifi-
Cate of Compliance has been issued by this Board of a th. q
'. Signed Date ( b I
Application Approved by
Date s
Application Disapproved or the following reasons
Permit No. / Q��' Date Issued
THE COMMONWEALTH OF MASSACHUSETTS -
BARNSTABLE, MASSACHUSETTS
Certificate of Compli re
THIS IS TO CERTIFY, that the On-site Sewage Disposal System"Constructed( )'Repaired ( yKpgraded( )
Abandoned( )by 0 ` / J
at , has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction_Permitddated
Installer Designer
The issuance of this pe t shall not be construed as a guarantee that the s .ste ill function as designe .
Date_ Ib a2 )(bl Inspector
� ...... T-
No. �"d �/ /�cj ————•---———---____—•—-------- Fee � �----------�-
rv��s� THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
ioogar *pgtent Canttructo ' ,N�
si Permission is hereby granted to Construct( )Repair( pgrade )Ab TA
Y T ON AND ER MU$T St►'� ,,,
System located at 12 't'C ��EC WAS I N�TAI '
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this it. f
'Date: 1 i' ".[ � Approved b
OCT-18-01 08 :51 AM BAY HARBOR REALTY 5083627072 P. 02
OCTOBER 15, 2001
TOWN OF BARNSTABLE
HEALTH DEPARTMENT
ATTN: ED BARRY
AS OWNER OF PROPERTY LOCATED AT 95 LINDA LANE IN HYANNIS,
MA., I AM WRITING TO CLARIFY THE BEDROOM SITUATION.
THIS HOUSE WAS ORIGINALLY A THREE-BEDROOM HOME WITH THE
DINING AREA LOCATED AT THE END OF THE LIVING ROOM.
AS MY MOTHER BECAME OLDER AND NOT IN GOOD HEALTH, IT
BECAME EASIER FOR HER TO USE THE THIRD BEDROOM AS HER DINING
ROOM.
PLEASE BE ADVISED THAT THIS HOME HAS ALWAYS BEEN A THREE-
BEDROOM HOME.
SINCERELY,
BRAD SKLAREW
0 13E Wns7'.ss'1► M E*NS l fiE, LEE E'er.-N AND A"QUY r r L'i3'. �
-
ENCll�ll 'EIz TO '�tlf Y �I' n ' ��t�.rra£+t.�; SON, 'IE OW LEAC � ARE 4 O
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10/25/2001 07:37 50839877101 DEMAREST—MCLELLAN PAGE 02
O@MAREST MoLELLAIV ENU1 ERINO
October 25,2001
Lee McConnell, R.S.
Barnstable Health Agent
367 Main Street
Hyannis,MA 02601
RE: 95 Linda Lane
Qofifii—vffie, MA
/.lyanyh
Dear Lee:
On October 19,2001 Demar st-McLellan Engineering verified suitable soil conditions at
the above referenced site. M dium—coarse sand was found to a depth of approximately
12'.
If you have any questions or equire any additional information please call me at
399-7710.
Sincerely,
Thomas McLe an,P.E.
24 School St. P.O.jX 463 West Dennis,MA 02670 (508)398-7710
�� �
TOWN OF'BARNSTABLE T r � ��
' 4
pr sv
LOCATION / S N�4 LAND SEWAGE #�60I'CP�O
I VILLAGE- /G1'/- C /ASSESSOR'S MAP LOT
INSTALLER'S'NAME Sz':PHONE NO. A & B CANCO 775-6264
SEPTIC TANK CAPACITY SG U atfr
LEACHING FACILITY:(type(��{r�c�'eNC�fcS (size)
NO OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
.a -':" .'! ,:' .. ..•,: .`-` ., 1Au�I i 4r1 + y141r1 14 1 !+Iftf1 Yt IS �hti
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE: COMPLIANCE ISSUED: /G Z2' 61
t I
yARIANCE GRANTED: Yes No
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LOT 54 HYANNIS
w AREA=11055i-S.F.
LOCUS MAP
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PLAN REF. 165-41
�. ASSESSORS MAP 248-88
5, ZONING.• "RE"
24. SETBACKS.• 20,-10,-10
o „ 16:4 ;;, G� DEED REF 14384-283
FLOOD ZONE. FLOOD ZONE.
w ,,,, PLOT PLAN OF LAND
A.M. 248-221 `J„ 20• o LOCATED AT
LOT 56 „>16 u o 95 LINDA LANE
,,,,,,,,,,,,,,,,,,,,,,,,,,,.cn
i I► HYANNIS, MA:
�.► PROPOSED �►o
17 5' COBBLE STONE ' GARAGE �►
o PATIO -►I J 21.7 ;
1_ _ tatR.
o_ i PREPARED FO •
22 .
o -
. ,. E'RIC CUNNINGHAM
12 82 ®,&*A4AA JULY 11, 2005
0"E �r �� v REV `A UG UST 08, 2005
N79423j
® REV
, , _ ® REV
YANKEE LAND SUR VEYORS •
A.M. 248-163 ` � & CONSULTANTS
A.M. 248-217
LOT 53 GRAPHIC SCALE P o. Box 2s5
LOT 55 20 0 10 20 40 UNIT 1, 40 INDUSTRY ROAD
MARSTONS MILLS, MA ,026'48 .-'
TEL• 508—428—0055 FAX. 508 °420.=;5553
. 1 inch = 20 ft.
SHEET 1 OF.1 JOB #•- ° 53920 JF
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terra 28 ASSESSORS HAP: 248 .PARCEL: 88 I'��;.'kS'T HOLE LOGS NOTES:
FLOOD ZONE:e C N 1. VERTICAL DATUM: ASSUMED FROM QUAD (NGVD +/-)
ENGINEER: THOMAS McLELLAN, P.E.
2. MUNICAPAL WATER IS AVAILABLE,
LOCUS DATE. '8-30-01 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM.
PERCOLATION RATE: < 2 MIN f IN 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10
PINE ST.
LOADING SPECIFICATIONS.
5. PIPE PITCH = 114" PER FOOT, (UNLESS NOTED OTHERWISE).
x 1 H 1 4ao TH-2 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE SET LEVEL.
G�l�ti ELEV 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE
Frtt 48.5 USE OF A GARBAGE DISPOSAL,
HORIZON 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
LOAMY SAND STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL
LOCATION MAP f4- foYR z/z 47.8 HEALTH REGULATIONS.
LOT 54 LOAMY S .VD � 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR
11,056 t S.F. fOYR 5/8 TO CONSTRUCTION.
(0.25 t AC.)
s0" �� 10. GROUND COVER OVER ALL SEPTIC SYSTEM COMPONENTS NOT TO
C HORIZON EXCEED 3.0'.
MEDIUM,54 SAND 11. EXISTING CESS POOL TO BE PUMPED AND FILLED WITH SAND.
BENCHMARK AT �" 4 12. PROPOSED SEWER LINE TO BE ENCASED WITHIN A 6" PVC PIPE WHEN
PK NAIL ` WITHIN 10' OF EXISTING WATER SERVICE.
ELEVATION s 50.o , NO GROUND J�ATER ENCOUNTERED I& D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW.
(RAND WA ER%, r�sX34.7)NO 14. DESIGN ENGINEER TO VERIFY 4' OF SUITABLE SOIL BELOW LEACH AREA
AT TIME OF CONSTRUCTION.
E
LAN SEPTIC SYSTEM DESIGN
INDA 49. 6
'r LOY ESTIMATE: BED
EDGE...F-PAUL- /
q� /� �� �r ;BEDROOMS AT 110 CAL/DAY/BEDROOM = 330 GAL/DAY ROOM
48 fa/ �s 48. 6 S!
4 / � g0
/ 00' / YIN SEP"'IC TANK: FAMILY
_ I
47 ' Q- CAL/DAY x 2 DAYS = 6.60•GAL BATH DROOM G ROOM
PAVED 1 ` U6"E t500 GALLON SEPTIC TANK
'� BED LIVING KITCHEN
47 :Cp c LE'AC'HING.AREA; ROOM ROOM
►-� USE 2 LEACH TRENCHES 26' x 4' x 2' DEEP
DE'AL`A: ,25 .: = 12(� : :. � !' DAY .y lSI"INC I �(!OR 1LA.4
__. _ _ L,
t BOTTOM AREA: 26' x 4' = 104 SF (74) = 77 - GAL/DAY
INV.s 47.4 tN i • CAPACITY =166 GAL/DAY
SIN / 48. 8 1 , x 2 TRENCHES = 332 GAL/DAY
j(IN / 1 'g4x Mt;s1 GkTA'k
tNv: 47.4C'!'ON PERMIT FRO9:
y y oo bh Gam; =TBxJCtWD[DIYISION pa;Oit'
o , ,�$may SEPTIC SYSTEM SECTION
ELytNG>s so.s °' 2" PEASTONE
Ist Zr R c COVERS WITHIN 12" OF r
1 / FINISHED GRADE . 314 - 1 1 2"
50.9 (ONE INSPECTION COVER /
FIRST FLOOR ELEV. TO BE WITHIN 6- OF GRADE) WASHED STONE
3' MAX.
l yVEL COVER
D Rrvt :1
i.. r
. / ELEV.= 46.0
46.55
47
ELEV.
46 8
1500 GAL D-BOX �13.3
45.52
\ t ELEV. SEPTIC TANK 45.69 (6" OF ELEV. ELEV.
N,48 47.4 & 47.4 (6" OF STONE UNDER OR ELEV. STONE 26'
-' - �47 ELEV. MECHANICALLY COMPACTED) UNDER) 2 LEACH TRENCHES
end BENCHMARK AT (EXISTING) TEE SIZES: GAS BAFFLE 45.5 ' (26' x 4'-x 2' DEEP)
WOOD STAKE INLET: 6" UP, 13" DOWN AT OUTLET TEE ELEV.
ELEVATION 48.7
OUTLET; C UP, 14" DOWN
SI T E'� AND SEWAGE PLAN
KEY:
EXISTING CONTOUR: APPROVED BY: DATE:
PROPOSED CONTOUR: ........ LOCATION
EXISTING SPOT ELEVATION:
PROPOSED SPOT ELEVATION:025 95 LI NDA LANE
`" "�c
TEST HOLE; �a �n s
`' JOHN `
Z. � LE, MA t, 17 y n l�
McLEtl M I
UTILITY POLE: -0- civu DEMARES1,,lk.
FENCE LINE: �,t+jc. ¢�� " No.ssl5s` i PREPARED FOR.'
w I, x o •r
HYDRANT: -b- �'tss\0
RETAINING WALL: DM `'" A & .B CANCO / SKLAFEW
TREE: DEMAREST-McLELLAX ENGINEERING 1 yr( SCALE: 1" = 20' DATE: 8-30-01
24 SCHOOL STREET P.O. BOX 463 ` 1 '
DM
WEST DENNIS, MASSACHUSETTS 02670 THOMAS MCLE LAN, P.E.if'JOHN DEMAREST JR., P.L.S. REFERENCE: PLAN BOOK 165, PACE 41
PHONE FAX : (508) 888-7710
b
��AtiA Must
f CAA .�O'.'ON PERMIT FRS;,
t�CuI2rsE8IN(i DIYJSION me R -
�+ TJC4'IJDf
20 ASSESSORS MAP. 246 _.
NOTES.
R� 'ST HOLELOGSPARCEL
AS
SUMED ED FROM QUAD NGVD +
j i. VERTICAL DATUM. �' _ (
FLOOD ZONE: C l v �
ENGIEER:- THOMAS MCLELLAN P.E.
' LOCUS - • 2. MUNICAPAL WATER 1S AVAILABLE.
DA
TE'L' 8 30-01
3. SCHEDULE 40 — 4 PVC PIPE TO BE USED THROUGHOUT SEPTIC :SYSTEM,
PERCOLATION RATE: < 2 MIN IN ' _ ,
� 4. ALL PRECAST UNITS TO CONFORM WITH AASHfiO >H 10 :
LOADING SPECIFICATION
PINE
ST. S.
5. PI PI C PE T H 1/4 PER FOOT; UNLESS NOTED OTHERWISE).
.� (
_ x U ,i ,. TH--2i
49.0 6. FIRST 2' OF,PIPE OUT OF D-BOA. TO BE SET LEVEL.
ELEV- � 7.":THE SEPTIC SYSTEM HAS NOT.BEEN DESIGNED TO ACCOMODATE THE
FILL
9 USE OF A GARBAGE DISPOSAL.
4a.5
0
4
G 8, ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
o A xORtO
LOAMT 4 D'
STATE OF :MASS. ENVIRONMENTAL CODE (TITLE FIVE AND LOCAL
» IOYR . ,E ; t
LOCATION MAP 14 ,�' 47
B HEALTH REGULATIONS.
HO I�B R 0
9. CONTRACTOR TO VERIFY LOCATIONS F A
LOT 54 LOAD,'- SAI�'t1 T O ALL UTILITIES PRIOR
11056 S.F. n
fO YR /� TO CONSTRUCTION,
t 30 :, 4ss
25 AC. 10. GROUND V OVER
(D, t ) , ROU D COVER O E ALL SEPTIC SYSTEM COMPONENTS NOT TO
C HORIZO!� EXCEED 3.0.
r
.IlE'DIL Iaf SAND
11. EXISTING CESS POOL TO BE PUMPED AND FILLED W 2,5Y 7/4 � D WITH SAND
12.'PROPOSED SEWER LINE TO BE ENCASED WITHIN BENCHMARK AT � � 4f.5 E N E S D H A 6 PVC FIFE WHEN
PK NAIL WITHIN 10''OF EXISTING WATER SERVICE.
ELEVATION 50,0
NO GROUND .ATLIt ENCOUNTERED 13. - OX O WATER TESTED O V, D B T BE A E TED T ENSURE..LEVELNESS AND EQUAL FLOW.
(ABUTTING TOPO RAPHY SHOWS NO
_ GROUND �'�., R E!IE`V. � 34.7 14. DESIGN ENGINEER TO VERIFY 4 OF SUITABLE SOIL BELOW LEACH AREA
AT TIME OF CONSTRUCTION.
,
L
SEPTIC SYSTEM .D.�'SLG.N
I
N
.D
A 49
L
�1`¢O ESTIMATE. BED ,
PAVE .
pG
E
OF ....--�-- ROOM '.
E —�""" BEDROOMS AT GAL DAY BEDROOM — 0 GAL DAY
49
s ;
48 1CY_ 49. 6
ct>.
T'
f o 0 SEPTIC TANK..
47 90 BATH�' DINING FAMILY
GAL DAY x 2 DAYS 660 GAL- � ROOM ROOM
x
1
T D 1 U ,G LON SEPTIC N
P
AVE -. SE.:,.L ALTANK
1
I
C •. E
�- ' _ CP. �
BED
LIVING
. . KITCHEN
�t7
- y
/ .._ ROOM
. . > L.E ACHING AREA.
r
I
, ,
USE 2 LEACH r.�E, C. Es (26 x 4 x 2 DEEP
. ' _ `�;�D.� .AfiEA.. 26 -� . � - .� i �..� C, .OAY _ � __ _ __ �. _ l Lr'§r G D
�'T - �_.__.,..��. _....•x .c0 ..� .� 1� � Lf . , __..,._ ,.�' '_S'I _ _ -,FLOOR FLAN ,:: -.•-_
-�.... _ .�DTrDM AREA.: .�6 4 104 SF Z7 'cAL DAY= I
f0"
` r llt 1
N c
_r '
4 _
166
47 . . CAPACITY CAL DAY'
NY. . . 49
4
f
_ . •� 48. 8
x 2 TRENCHES
,. 332 'GAL` DAY
,� a
. ,
r lt;.nNxOBTAIN ,
�C r MUST
4 P ._
NV �..x
nT
I 1 ,. 1� ,IONPERMIT2 � .
I _., ..jd ,- FROh. �r
rat-C �, -, I h..E RING 0;v � ,. ., m DIVISION: , th N PR.�DR
1 G
Ca . : c+�
�N � . . SEPTIC SYSTEM SECTION
o EXISTING Y / �►
EDROO �n - „
N 2 FEASTONE"
11ELIJ 0.9 . .
f D � 5
o R
c
f
st
FLOO
\ a- COVERS l►ITHIN 12" OF
- 1
c
FINISHED GRADE
I
3 4 i 1 2'"
5os / /
(ONE INSPECTION COVER
M
TO BE WITHIN 6 OF GRAD
e j
FIRST FLOOR ELEV. E) SASHED STONE
\
3.MAX.
E
L
vLE 'COVER
R
A
_. DR
IVE
E'LEY.— 46.D
1 401
46,55
,
47 \ 24
ELEV.
i ,
r
.., 47. 8
- -- � 46,8
-- -- -- ._ _ � ' a D—.BOX 43,37
2 1500
. 8 �GAL
\ 1
f 2 \45.62
ELEV.
E V.
SEPTIC TANK
45.89 6 OF
ELEV.
LE
48 �-
47.4 � 4?',4 6 OF TONE U( S UNDER OR ELEV. STONE 26
ELEV MECHANICALLY
HAN COMPACTED) UNDER)
2 LEACH-TRENCHES
EXISTING
45,5
2nd BENCHMARK AT (EXISTING) 'T :EE SIZES GAS BAFFLE (26 x 4 x 2 DEEP)
WOOD STAKE
AT OUTLET TEE y, ,
INLET. 6 UP, 13 DOWN ELEV.
ELEVATION 45.7 ,
{ ,
I
,
OUTLET, 6' UP 14 DOWN
_ t ,
SITE r W ,�-r
_ KEY. ,� � AND L �J � ��`E PLAN I
it-� APPROVED BY. DATE:
EXISTING'CO�lVTOUR,
PROPOSED CONTOUR: .............. ...............
L 0CA TION
EXISTING SPOT ELEVATION.
25.5
s
PROPOSED � v .e � ..�
95 LINI�A NE'
SPOT ELE ATION. 25 � ,a �
TEST HOLE:
aJ.. T ,s
a Z. ...� t t7�1 Kn )5
MA
UTILITY
S r—
r
L TY`POLE.
.°fit.
FENCE LINE.
XIAIM c
No s
u
PREPARED FOR
c�
HYDRANT: -C�- two
4
s
A B CAN CO AFEiY
ISM � ,� � �,��. c�Cc �' / S'I�L
RETAINING WALL: � u
a
TREE. DEMAREST-McLELL ENGI E I G, - --
AN N ER N SCALE._ 1" 20 DATE.... ..8 3D d>
24 SCHOOL STREET P . BOX 483
I
CH T A
P BOOK 1 5
01 51
WEST DENNIS YASSACHUSETZ'" 0�. 0 REFERENCE.
LAN B K 6 FACE 41
DM ..��. _ TXIO�'AS McLELLAN P.E. JO J
� PHONE � `li"Ax . 50' 9B 71v HN , DEMAREST R�, P.L.S.
is iJ}
T£�._ AT h
� AL_ A ,
T
,TON ,
,,. PERMIT
ix 1 G�
.,, FRUh, ,.
IhsERTN M
f ,
G DIVISION
PRIOR,
I