HomeMy WebLinkAbout0025 NANCYS LANE - Health 25 Naney's Lane
Hyannis
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No. (}� _ 7 Fee ICY),
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es
01pplitation for Mispo8al *pstrm Construction Permit
Application for a Permit to Construct( ) Repair(v� Upgrade( Abandon( ) ❑Complete System individual Components
Location Address or Lot No. 7.5 N oQ n G 4•s, L o,n 9, Owner's Name,Address,and Tel.No. A r 140 Sgc*oS
1-'Fyannt s
Assessor's Map/Parcel Z,Sp
Installer's Name;Address,and Tel.No.(33(� �C,x CwVp+�o n Designer's Name,Address,and Tel.No. F 1 a)ner4-�
314 RO&r- 130 Sgndwio►-N PO 6OX 331 Mo. oZcoyS
Type of Building: �"��—��I'�VY0
Dwelling No.of Bedrooms 3 Lot Size IS, 37 3 sq.ft. Garbage Grinder(No)
Other. Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 30 gpd Design flow provided 3 gpd
Plan Date 31 Z to I Z O Z,O Number of sheets 2. Revision Date
Title
Size of Septic Tank ,0 n) Type of S.A.S. �Z� SOO &16N c ha(n o.c�
Description of Soil-SAe pk o,n S
Nature of Repairs or Alterations(Answer when applicable) d.box and SAS ty 2�tiS�nn
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 Health.
SX,gne P,4Pi Date 3 2-'► 20 O
Application Approved by ki aAON Date
Application Disapproved by Date
for the following reasons
r
Permit No. � Date Issued
_. },r�-z----------- -------- ----------- --
No. (]. (J'� -/� .: Fee—f`/)h .
~ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
2pplitation for Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair(Vj Upgrade( ) Abandon( ) ❑Complete System [Individual Components
Location Address or Lot No. 2 Owner's Name,Address,and Tel.No. f', l�A o c �sj c,,
1Ay(.,,n.;
Assessor's Map/Parcel - lit
Installer's Name,Address,and Tel.No. �3 Designer's Name,Address,and Tel.No.
C)ou Y�l { (mL,w,cv, IAc,
Type of Building: .j1q a-"a f- -�•- S0
f1
Dwelling No.of Bedrooms Lot Size 'z"►T, '�sq.ft. Garbage Grinder(�j o)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 2 Z, gpd Design flow provided "zT� q gpd
Plan Date ^t f to 12 n 2 Number of sheets a Revision Date
Title
Size of Septic Tank o l) Type of S.A.S. (I..)cr61o_�."
Description of Soil e,o
s
Nature of Repairs or Alterations(Answer when applicable) a s r, c-.h c_ .4 ,. 42 ,
t. — CC),k-A
,s
E
.Date last inspected:
3
w 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 Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date C./ (7
Application Disapproved by Date !
for the following reasons
Permit No. Date Issued �)-�f
---------------------------- - - - (-----------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(tertificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(✓) Upgraded( )
Abandoned
At �t has been constructed in accordance
with the provisions of itle 5 and the for Disposal System Construction Permit No„ ,J G dated
Installer f> :? (�, ..,�..i, d Designer
#bedroomsv Approved design flo—'Z 2�� gpd
The issuance of th' pe it shall not be construed as a guarantee that the system w ct as designed)
Date I W I§ Inspector to
- -- ----- -_------ - -- -- -
f
No.� Fee
v THE COMMONWEALTH OF MASSACHUSETTS -'
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
-Misposal 6pstem Construction permit
Permission is hereby granted to Construct( ) Repair(✓) Upgrade( ) Abandon( )
System located at S 1 ¢z�', C
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.
Date (// �1�i Approved by rAA ` � (i �L ! A41
lam`
Town of Barnstable
E' r,� Inspectional Services
Public Health Division
antwsn'asi.s;
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644: Fax: 508-790-6304
Installer& Designer Certification Form
Date: y-q•1Z Sewage Permit# Zozo 099 Assessor's Map\Parcel 250- 1 l I
Designer: 1F1QA\erAu Enuim_mcrcic,.l Installer: , {� FJ(c,-2.00_410✓�
Address: �.0. �O X .331 Address:
y Te �c�-rc�t✓rJ
On y-1-ZO. Q was issued a permit to install a
(date) (installer)
septic system at ZS 1Janat4 S LO based on a design drawn by
(address)
dated 3-2 z,
(designer)
X._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. Strip put (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
r
were:found satisfactory.
I certify,that the system referenced above was:constructed i ece with the to rms of
the RA approval letters (ifapplicable)
DAVID
D.
FIAHERTY,JR. CA
(I taller's Si n e No.1211
0
re�E
sgNITA01
esigner's Signatur (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.
\\toa\depts\HEALTMSEWER conneeMEPTIC\Designer Certification Form Rev 8-1443.DOC
No. iZ � `� Fee c�
THE COMMO1 EALTH OF MASSACHUSETTS
PI7BLC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
ID
isosaY 6pstem CustruttiotrPrtrrct
Permissions hereby granted to Construct( . ) Repair(�) Upgrade(: ) Abandon( }
System located at �;$ o►nc.u'S LO�nn, dL/k
LI
and as desc"bed in't a above Application for Disposal Systein.Construction Permit. The applicant recognized his/her duty:to comply.with
Title 5 and the fohowing local provisions or special conditions.
Provided Conr7761
' ust be within three years of the date of this permit.
Date Approved by
W.
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LO-C TIO,N SEWAGE PERMIT NO.
z z p-
VI E—
INS T A LLER'S NAME & ADDRESS
B UIlD R Okc7AI ER
DATE O .ERMIT ISSUED
�7
DATE COMPLIANCE ISSUED p s - 77
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lti Town of Barnstable
Inspectional Services Department
ana�tv�rra�r.e,
""'9
i639. Public Health Division
�
f0"' A 200 Main Street, Hyannis MA 02601
Office: 508-862-4644
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7015 1730 0001 4988 1111
November 21, 2019
WALKER, PHILIP A JR& WALKER, MELODY J A
25 NANCYS LANE
HYANNIS, MA 02601 4
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 25 Nancys Lane, Hyannis, MA was inspected on
10/24/2019 by Michael T Bisienere, 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:
A Discharge or ponding of effluent to the surface of the ground.
You are ordered to repair or replace the septic system within sixty (60) days 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 E BOARD OF HEALTH
..
o ' ean, R. ., O
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\25 Nancys Lane Hyannis.doc
1
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SHE
Town of Barnstable
�16 9 A Inspectional Services Department
fD MA'S
Public Health Division
200 Main Street, Hyannis MA 02601
Office: 508-862-4644
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6, 2007
Rev. 4/26/19
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 P1AY DEADLINE CRITERIA
ischarge 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
❑ Structurally unsound septic tank or SAS
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:ISEPTICIDEADLINES TO REPAIR FAILED SYSTEMS.doc
Commonwealth of Massachusetts a60F
�- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
u
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis ✓ MA 02601 10-24-2019
page. City/Town State Zip Code Date of Inspection
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 filling out forms A. Inspector Information / - tao
��a
on the computer,
use only the tab Michael T Bisienere
key to move your Name of Inspector
cursor-do not Cape Septic Inspections
use the return Company Name
key.
Co Rivers End Road
Co mpany Address
Teaticket Ma. 02536
City/Town State Zip Code
few
508-280-3356 S13938
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
10-27-2019
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
�e Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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:
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.7/2 612 0 1 6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18
' Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
25 Nancys Lane
V
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is Hyannis MA 02601 10-24-2019
required for every y
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 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
L
Commonwealth of Massachusetts
�- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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:
El 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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
!% 25 Nancys Lane
Property Address
Philip A Walker Jr&Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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 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.
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
.., 25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is Hyannis MA 02601 10-24-2019
required for every
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.
® El etermined 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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
- 4 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
V � 25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms(design): N/A Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): N/A
Description:
Number of current residents: 2
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 years usage (gpd)):
Detail:
-In 2018-19,900 cubic feet were used and in 2017-19,900 cubic feet were used
Sump pump? ❑ Yes ® No
Last date of occupancy: occupied
Date
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
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
2. Commercial/Industrial 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:
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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
h Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
u�
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
page. Cityrrown 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:
1977
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: 17"feet
Material of construction:
❑ cast iron ❑40 PVC ® other(explain): under water I could not tell.
Distance from private water supply well or suction line: Town water
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
The inlet pipe was under waters could not tell.
t5insp.doc•rev.7/2 612 0 1 8 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
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 10"feet
Material of construction:
® concrete ❑ metal El 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:
H-10 1000 gallon
Sludge depth: over flowing at the time of the
inspection.
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.):
At the time of the inspection the tank was overflowing. I recommend the tank and leaching pit be
pumped as soon as possible. The inlet cover is at grade.
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
b Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
c� Commonwealth of Massachusetts
1p Title 5 Official Inspection Form
r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
.� 25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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 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.):
The as built did show a d-box the tank was overflowing and the leaching pit was full so I did not look
for the d-box. It would be.unsanitary to dig futher under these conditions.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
�1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philp A Walker Jr& Melody J A Walker'
Owner Owner's Name
information is required for every Hyannis MA . 02601 10-24-2019
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: one
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
Ell 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
Ala Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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.):
At the time of the inspection the leaching pit was full.
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
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.):
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
tI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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
25 Nancys Lane
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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
2 lraw'ing attached separately
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
LO•C TIaN SEWAGE PERMIT NO.
:z7 — 7l i�
VI E—
INSTALLER'S NAME i ADDRESS
B U It D OR ER
DATE PERMIT ISSUED
-G - 77
DATE COMPLIANCE ISSUED ,?3a _77
w
Commonwealth of Massachusetts
,1P Title 5 Official Inspection Form
Rio Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
25 Nancys Lane
V�
Property Address
Philip A Walker Jr& Melody J A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
page. City/Town 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: 10 plus feet
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:
I auger a hole to 10 feet.
Before filing this Inspection Report, please.see Report Completeness Checklist on next page.
t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
lI; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
!% 25 Nancys Lane
u
Property Address
Philip A Walker Jr& Melody J'A Walker
Owner Owner's Name
information is required for every Hyannis MA 02601 10-24-2019
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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
t
c
CO3 7
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Appliration for Disposal Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at: ( S
ss )�------•-- ---._..... .............................................
--Locatio�ddress o r N Owner A dr
a --•-...... ..... ..........-• ----------------------------
Installer Address JJ
Type of Building Size Lot/-32s .....Sq. feet
U Dwelling—No. of Bedrooms___-. ...............................Expansion Attic ) Garbage Grinder
`4 Other—Type of Building ............... No. of ersons.....................__.___. Showers — Cafeteria
a YP g ------------- P ( ) ( )
P4Other fixtures ---------------------------•-•------------------•-----.......•-••-•-••••---••••-- -•-•---••-••......••• =
W Design Flow........." _______________________gallons per person per day. Total daily flow__-____-- .._ .....................----gallons.
WSeptic Tank—Liquid capacitylAq:1.-.gallons Length Width----4---_..... Diameter................ Depth.._4;.....__..
x Disposal Trench-No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No----- -- ----------- Diameter.__ -.---------- Depth below initryG� Total leaching area.�.Q.'./.....sq. ft.
Z Other Distribution box (/) Dosing tank W l//"" " //— a — 7 7
Percolation Test Results Performed by......_.��___C.P_o., �XA.�--- .--_-•_. Date.._.._ ` AA�7............
`4a Test Pit No. 1----R-------minutes per inch Depth of Test Pit------;k.......... Depth to ground water___�X__c---GX
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
�+ rr' -------------
• --------
•-------
---------------
.... -----------
---•--------------•--
O Description of Soil........... � _..__ ��I'�
----•---------•---••-- .... -------------------
---------------------------
.-------------------
•---------------------------------------------------------------------------
------••------•-----
W
VNature 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 TITU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be n issued bj&e b f health.
Sign :. --
, -r l..............................
Application Approved BY d pate
............... ------ - ?,?........
Date
Application Disapproved for the following reasons---------------•-----•--•------••----•------------------•---------------------------------------------------•-•--
•-----•-------•-••••-•-••.....•-•--••-•---••--•----•-•••-••.....-•--••-------••...............•-•----•---•••-•••---•-•......-•--•------•......----....................................................
Date
Permit No......................................................... Issued--- ±. d..-7-
j w •
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF. HEALTH
Vp tra#tan for Disposal Works '(fnns-trnrtion Vamit
Application-'is'hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
X , ( l
8 S ,j ocati address
� o No
--- - I .. /. »S .............
. ..........-
Owner A
.----...- ---- Yrl 9a--------------------•---•---
... ... ........
Installer• -, Address
d Type of.Building Size Lot u _ .....Sq. fe t
Dwelling—No. of Bedrooms...... ----__--------------__________Expansion Attic ) Garbage Grinder
Other-T e' of Building ._ No. of ersons____________________________ Showers -
a 3'P g -------- --------- -----------p -- ( ) Cafeteria ( )
Other t res ...................................... • --••-----•-•-------•-•-••-•----...__.__..-
W Design Flow...... ___,__gallons per person.per day. Total d ily,flow________ ` ..........gallons.
ir
W Septic Tank—Liquid�.capacit34A�.l�'__gallons Length_- ......
Width_............. Diameter________________ Depth....
.......
x Disposal Trench No _______ Widtbi r _____ Total Length.__..__ Total leaching area ...sq. ft.
Seepage Pit No..................... Diameter Diameter _,�_.____ ___._ De�p�t,jl below in Tof ' g area_ Q_ ....sq. ft.
Z Other Distribution box (/�) 1 Dosing tank 1!T
'-' Percolation Test Result, Performed by. � '�✓ `�si_T _.�'_ _+___.__._. Date.__ . __...
�' Test Pit No. I....____________minutes per inch Depth of Test Pit......____.......... Depth to ground water___.__..________,_._.__:.
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......_.................
D Description of Soil___.____ '........................................................."` ` X_ �`� ____
V ::--------•-----------------••---•-•--•----------•-••------•••-••--------------
-------------------------------------Nat
= =
V Nature of Repairs or Alte ins—Answer when applicable__________________,____.__._________.__...____..:_._.__._____.____.__________.____..___._____..
ry
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIZ- v5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be n issued Pt4e b r health.
Sign, :. .......................
Application Approved By.. r*- -- _"== ........................... .......
Date
Application Disapproved for the following reasons-----------------------------------------•---------------------------------------------------------......--_.....
Permit No , Issued._... :` `_ `.
°Date
_. ._-------t`--•-----_--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
(9rdifirate of ToMolianrr
T4 S T W ERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by... .. .... .. t. ____________!___ ____ _ _ __ ________________-__----
..�----_•
I Ins 1 •
at.__�--- -------. .... le �the
''Q----�` ................................... `-----------•---•----------______------------•--
b i
has been installed in accordance witlf provisions of TI - .of_140 e State Sanitary C de asAes�r ed in the
application for Disposal Works Construction Permit No----- --- ------- ...... dated_--..�-.�__r'.__'____:__. _._._..._______
THE.,:ISSUANCE OF THIS CERTIFICATE SHALL NOT'.BE CONSTRUE® AS A:,GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
}
DATE:': ---••••.!...�=-•. �.... t�-------f------•------•--------•---. Inspector -2.................-----•• - =
i THE COMMONWEALTH OF'MASSACHUSETTS ,
BOARD OF HEALTH
..O F...... eJ
0.0
FEE........................
i froxlho,Tonotr #ion amit
.:.
Permission > hereby granted ..-------•-••__
to Constr o Repair ) an Individual , a".0's-.1
Syst
---- ._. .--•-• --- ..- •--
treets
as shown on the.application for Disposal'Wotks'Construction o. _ ed... i.. _..__ •__________________.
.........................................................
�j Board of Health
DATE . ---• ••--`---_..••••------------ .................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ,
COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM PROFILE Flaherty Environmental Services
TOP OF FOUNDATION BROUGHT TO'WITHIN 6" OF FINAL GRADE
EL. 58.0' EL. 56.0' (not to scale) INSP. PORT W I 3" OF GRADE '
( CLEAN SAND P.O. Box 331
2" of 8" to b" DOUBLE WASHED EL. 56.0' Harwich, MA 02645
4" CAST IRON or EQUIVALENT PEASTONE OR GEOTEXTILE 774.994.1166
MIN. PITCH 1/4" PER FOOT FILTER FABRIC ;
4"SCHEDULE 40 PVC PIPE 4"SCHEDULE 40 PVC PIPE
L VENT IF REQUIRED
• FLOW LINE (first 2'to be level) ''
0' 1.5% 5, 1%
L. EXIST. 1 14" ��—�}r`r-a r�3_.. ��(�.j� 9 0 0 0 0
!" EL EXIST. EL.53.5' 000°000 0 0 0000 0000o000C
EL.53.03' ! °o° ° o o°o°o°o° ��pj 000000°oC
✓/ 0 000oa0 oo00C2.0'
E . 3.2' EL.53.0' 0°o°0°0°0°0°0°0 FR PIE21 0 0000°o—
/GAS BAFFLE H 20 D-BOX o000000000 000000 .4 .A •• • ;00000000C
J 0000 000 000o EL.51.0'
• • 6"CRUSH D STONE OR , SOIL ABSORPTION SYSTEM
"•3. •' •:'•..� 1000 GALLON SEPTIC TANK MECHANICALLY COMPACTED 1 (2) 500 GALLON H-20 CHAMBERS
• • • • i WITH 4'STONE AROUND IN A 5.5'
(DATUM: ASSUMED) (EXISTING) " to 1�" DOUBLE WASHED STONE
4 2 12.83 X 25 X 2 CONFIGURATION EL. 45.5 r
14.7' BOTTOM OF TEST HOLE EL.
- 123,00' 45.5' USGS ADJUSTMENT: N/A LOCATIONMAP
GROUNDWATER ELEV: N/A -�
TH-i TH-2
•.O O ✓ 56
24.5'
LOCUS
v Nancy's Ln.
j 27.4 O EXIST. S.T. o y
BENCHMARK: DECK
TOP OF FNDN N TH
EL. 58.0'
Rt.28
EXISTING
�+ r 3 BR
I DWELLING NTS
Ui
I � DAVID
I J I F R.
LOT 16 1 11
I DRIVEWAY I 15,373 SFt
I I MAP 250 LOT 111 56 T.
I � t/"
`1g dY
54 -� �S 0f DATE.-312612020, REVISED:
NANCY'S LANE
. .: LEGEND / SITE AND AGE PLAN
54 FOR
6` 6 6 G GAS LINE
B& B EXCAVATION,INC./
W w W W- WATER LINE A�RILDO SANTOS
-6 E E-6 E EXIST. ELECTRIC / ?J;NANCY'S LANE
99 EXIST, CONTOURS SCALE : 1 I = 3 Q (HYANNIS) BARNSTABLE, MA
————— 99 PROP, CONTOURS
4•A UoiC U 16 UNDERGROUND UTIL. 5.0' REF PB 288 PB 16
PAGE 1 OF2
........... ...... . .......... ........ ........ ........... .............. .... ........ .......... ..... ............ ........... ................ ........... ............. .......... ........... ........... .............- ................. .......... .............................. ....................... .... ...........................................
GENERAL NOTES DESIGN CALCULATIONS SYSTEM DETAIL Flaherty Environmental Services
P. 0 . Box 331
1. ALL PRECAST COMPONENTS TO BE H-1 0
RATED UNLESS OTHERWISE SPECIFIED.
Harwich, MA 02645
DISTRIBUTION BOX AND ANY COMPONENTS NUMBER OFACTUAL BEDROOMS 3 774.994. 1166
WITH ANY ANTICIPATED VEHICULAR
TRAFFIC TO BE H-20 RATED. GARBAGE DISPOSAL UNIT NO
2. THE DESIGN OF THIS SYSTEM DOES NOT
ALLOW FOR THE USE OFA GARBAGE TOTAL ESTIMATED FLOW
GRINDER. (110 GALIBRIDAYX 3 BR) 330 GAL./DAY
3. MUNICIPAL WATER IS AVAILABLE.
REQUIRED SEPTIC TANK CAPACITY 660 GAL.
4. ALL CONSTRUCTION TO CONFORM WITH
25'
310 CMR 15.000 AND ALL OTHER
SIZE OF SEPTIC TANK 1000 GAL. (EXISTING)
APPLICABLE
PPL ABLE LOCAL, STATE AND FEDERAL
CODES AND REGULATIONS. SOIL CLASSIFICATION
5. INSTALLER/CONTRACTOR TO REVIEW&
VERIFY ALL ELEVATIONS AND DETAILS AND DESIGN PERCOLATION RATE <2 MIN./INCH,
REPORT ANY DISCREPANCIES TO
DESIGNER PRIOR TO CONSTRUCTION OR EFFLUENT LOADING RATE 0.74 GA L.IDA YIF T2
0 0 12.83'
ASSUME ALL RESPONSIBILITY
LEACHING AREA
6. INSTALLER/CONTRACTOR IS RESPONSIBLE (2)x(25.0'+ 12.83)(2) = 151 SF
FOR MAINTAINING SAFE WORK AREA,
25.O'x 12 83' =320 SF
VERIFYING ALL UTILITIES AND NOTIFYING 471 SF x 0.74 =348 GPD
"DIG SAFE- (1-888-344-7233) 72 HOURS
PRIOR TO CONSTRUCTION. USE(2)500 GALLON H-20 CHAMBERS WITH 4'STONE
7. ANY CHANGES TO OR DEVIATIONS FROM INA 12.83'X 25'CONFIGURATIONAS DIAGRAMMED
THIS PLAN MUST BE APPROVED IN
WRITING BY FLAHERTY ENVIRONMENTAL
RESERVE LEACHING CAPACITY NIA
SERVICES AND LOCAL BOARD OF HEALTH.
8, FINISH COVER OVER COMPONENTS IS NOT
TO EXCEED 3'PER 310 CMR 15.000 UNLESS
SHOWN PER PLAN.
9. ALL ABANDONED SEPTIC SYSTEM
(NTS)
COMPONENTS TO BE PUMPED DRY AND
FILLED WITH CLEAN SAND OR REMOVED
AND REPLACED WITH CLEAN SAND.
10.ALL COMPONENTS TO BE PROVIDED WITH SOIL EVALUATION :
WATERTIGHT ACCESS PORTS WITHIN 6" OF TEST HOLE#1 TPT#20-049
FINISH GRADE. Evaluator: David D.Flaherty Jr.,RS,REHS TEST HOLE#2 TPT#20-049
OF�
SE#2755 Evaluator- David D.Flaherty Jr.,RS,REHS
1 1.ALL SEPTIC TANKS, DISTRIBUTION BOXES BOH Witness: Da v1d Stanton,RS SE#2755 DAVI
AND PIPING TO BE INSTALLED Date: March 16,2020 BOH Witness: David Stanton,RS
Date: March 16,2020
F Ea j
WATERTIGHT
12.N0 KNOWN WETLANDS OR WELLS WITHIN TH-I ELEV.56.0'
150 FEET OF PROPOSED LEACHING. TH-2 ELEV.56.0'
0"-6" A LS 10YR 312 6. /8TE
13,THIS IS NOT A CERTIFIED PLOT PLAN AND 0"-6' LS I0YR312
UNDER NO CIRCUMSTANCES IS THIS PLAN 'VITA
TO BE USED FOR ZONING OR BUILDING 6"-24" B LS 10YR 516
PURPOSES. 6 -24 B LS I0YR516
14.LOT IS SHOWN AS ASSESSOR'S MAP 250
LOT 111 .
fERC AT 48' 7 certify that on November 12,2002, have passed SITE AND SEWAGE PLAN
15.LOCUS PROPERTY IS LOCATED WITHIN AN the examination approved by the Department of
AQUIFER PROTECTION DISTRICT(ZONE 11). Environmental Protection and that the above analysis FOR
has been performed by me consistent with the
required training,expertise,and experience described
B & B EXCAVATION, INC./
2411-120 C MS 2.5Y616
in310CMR 15.0182.
- ARZLDO SANTOS24" 12 .5 6
197NANCYS LANE
(HYANNIS) BARNSTABLE, MA
G.W.ELEV.NIA G.W.ELEV NIA
BOTTOM TH-I ELEV.45.5' BOTTOM TH-2 ELEV.46.0'
PAGE 20F2 -31261 DATE. 2020
...........
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U A�No 6232 ti PLAN OF LAND
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�v n �vok r7 aj FRANK CONERY 5 TRENTOPI 57'.
�n FRANK rn
i CERTIFY �4tHAT THIS FLAN SHOWS � CONERY y (iYANA(IS. MASS. 42501
f 1a THE ACTU ; L LOCATION .OF THE w 4? REGIST6RE0 FJr01NF.ER A SURVEr OR
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