HomeMy WebLinkAbout0033 OAK HILL ROAD - Health 33 Oak Hill. Road_
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11!�n� aG,-/r6fjP&, 'TOWN OF BARNS ABLE
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LOCATION :r�5 0.4 SEWAGE #
VILLAGE i ASSESSOR'S MAP & LOT
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INSTALLER'S NAME&PHONE NO. 20 i x.-6 ��' 17
SEPTIC TANK CAPACITY 1c�b
LEACHING FACILITY: (type) 7- (size)
NO.OF BEDROOMS y
BUILDER OR OWNER
PERMIT DATE: 2 COMPLIANCE DATE: --.2--
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom/ells
lity Feet
Private Water Supply Well and Leaching Facility (on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any well
within 300 feet of leaching facility) Feet
,Furnished by
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TOWN OF BARNSTABLE
LOCATION Y &Z SEWAGE #
VILLAGE ASSESSOR'S MAP &LOTS
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY e— �>�✓
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LEACHING FACILITY: (type) A91:4 (size)
NO. OF BEDROOMS *_
BUILDER OR OWNER
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist '
on site or within 200 feet of leaching facility) Feet`';
Edge of Wetland and Leaching Facility(If any wadands exist `
within 300 feet f le hin ility)
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
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Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
2p plication for ;Sigogar *pgtem Congtructfon Permit
Application for a Permit to Construct( )Repair(x)�Upgrade( )Abandon( ) ❑Complete System El Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
33 Oak Hill Rd. Jack Nesbit
Assessor'sMap/Parcel ICenterville . Same
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Servic Craig R. Short
P.O. Box 1089 P.O. Box 1044
Centerville, MA 02632 S. Dennis, MA 02660
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building res i dent i a 1No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) W r_? w i l l i n s t a l l a n e w 'T'i t 1 e-5
septic system to the plans of Craig R. Short dated 8/20/02_
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 ioff the Envir nmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this o ealth.
Signed '' Date 0—
Application Approved by Date
Application Disapproved for the following reas ns
Permit No. Date Issued
No. y, F05.0 . 00 /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
-- Yes
PUBLIC HEALTHDIVISION -.TOWN OF BARNSTABLE., MASSACHUSETTS
" Yicatior� for topozal *_pgteiu Conotruction Permit
Application for a Permit to Construct( . )Repair(xy)Upgrade( )Abandon( ) °O Complete System ❑Individual Components
Location Address or Lot No. 3 3 Oak Mill Rd. Owner's Name,Address and Tel.No. Jack Nesbit
Assessor'sMap/Parcel Centerville 5r` Same 4?__-6
Installer's Name,Address,and Tel.No. / v �/- Designer's Name,Address and Tel.No.
Wm. E. .Robinson,Septic Service Craig R. Short
P.O. Box 1089 P.O. Box 1044 �.
Centerville, MA 02632 S. Dennis, MA 02660 -
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building r e s i dent i a 1No'.of Persons Showers( ) Cafeteria( )
Other Fixtures -
Design Flow --gallons per day. Calculated daily flow gallons.
_ Plan Date Number of sheets Revision Date
Title
'* Size of Septic Tank Type of S.A.S.
4 '
Description of Soil ;
Nature of Repairs or Alterations(Answer when applicable) We will install a new T i if t P—5
septic system to the plans #d Craig R. Short dated 8/20/02.
Date last inspected:
y3 Wt Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system,
`t Oil in accordance with the provisions of Title 5 of the Envir nmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this B o ealth:
Signed 6/ \, � '_4 Date
t Application Approved by Date
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Application Disapproved for the following reas n
Permit No. ..•— Date Issued '
Nesbit THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(xx)Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Set>r<ice
at 33 Oak Hill Rd. , Centerville has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
InstallerWm. E. Robinson Sr. Designer Craig R.dShort
The issuance doff t s pe t shall not be construed as a guarantee that the syste it futict`on as de si, ed�
Date 6 E / U 2 Inspector /P•
No. (f .r t
Nesbit THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
I ig oga[ *patent Con5tructiou Permit
Permission is hereb ranted to Construct( )RepairXcx )Upgrade( )Abandon( )
System located at Oak Hill Rd. , Centerville
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:Constructiol'i must a completed within three years of the date of t hermit.
Date: Approved by
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TOWN OF BARNS ABLE
LOCATION
�; o-4 1,�.I/ a2,% SEWAGE # Wa'L UO
ASSESSOR'S MAP & LOT a -
ELLAGE '0
INSTALLER'S NAME&PHO NO.
SEPTIC TANK CAPACITY f c5�0—60
LEACHING FACILITY: (type) �'`r (size)
NO.OF BEDROOMS ,
BUILDER OR OWNER J �6
PERMIT DATE: 9-''0e�a COMPLIANCE DATE:.
Separation Distance Between the: Feet
Maximum Adjusted Groundwater Table to the Bottom of Leachi acility
Private Water Supply Well and Leaching Facility (If any lls exist Feet
on site or within 200 feet of leaching facility)
Edge exist
Edge of Wetland and Leaching Facility(If any Feet
within 300 feet of leaching facility)
Furnished by
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DATE: .8/1.7/98
PROPERTY ADDRESS: 3-3 Oa ill Road H annis Ma s.
02601
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On the above date, I Inspected the septic system at the above address.
This system consists of the following:
1 . 1 -6 'x8 ' block cesspool. -
2 . 1 -6 '�10 ' block cesspool.
3 . 1 -6 'x8 '• cesspool in front yard.
Based bn my lnso- ctlon, I certify the following conditions:
3 . This is not a title five septic • system.
4 . This' is a sewage system that 'is in proper working order
at *the present.
SIGNATURE: G`'1
Name J P Macomber Jr...
COmpany._`�• P_Maco�ber & Son,_Tnc ;
Address:_-Banc-6�-----=�-- --
Cente�rvill,e , Mass__02-632 '
Phone:___S08�Z7�..3338-_-_-__ '. 1
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
•
.pOSEPH P. MACOMBER & SON, INC*
Tanks-Ceupoolrleachflelds
Pump+d & InIt4iIa
Town Sewer Connections
P.O. Box 66' Centerville, MA 02632.0066
7 7-- -3 3 38 7 7 5-6412
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL RRO`TE ION
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ONE WINTER STREET, BOSTON, MA 02108 6 ` f9,2=9500 1
WILLIAM F.WELD R�,C,�\"C Q� TRUDY CO:
Govcmor �' 01 ,g SCCtct
ARGEO PAUL CELLUCCI ' �j�Q ` DAVID B.STRU.
Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM IN P,�E;CTION EYgN�`` Commissio
PART A N
CERTIFICATION
Property Address. 33 Oakhill Road Hyannis,Mas.s. Address of Owner:
Date of Inspection:g/17/9 g (If different)
Name of Inspector: app o�vdhR.-M ember Jr.
I am a DEP �,tem.inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: J.P.Macomber & Son Inc.
Mailing Address: BOX 66 Centerville,Mass. 02632
Telephone Number:
CERTIFICATION STATEMENT
I certify that I have personally inspi.cted the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of i. < action. The inspection was performed a P pe pe ed based on my training and experience in the proper function and
maintenance of on-site sewage c'is-oral systems. The system:
,Passes
Conditicr.: ly Passes
Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature?all
Date:
The System Inspectormit a copy of this inspe/,on'
port to the Approving Authority within thirty(30) days of completing this
inspection. If the system is a sh:.r, J system or has a design flow of 10,000 god or greater, the inspector and the system owner shall submit
the report to the appropriate reg o I office.of the Department of Environmental Protection. The original should be sent to the system owne
and copies sent to the buyer, if c.t ,"cable, and the approving authority.
INSPECTION SUMMARY: Cl,(,_; A, B, C, or D:
A] SYSTEM PASSES:
G' 1 have not found any inn nation which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria net :c ;,sated are indicated below.
COMMENTS:
61 SYSTEM CONDITIONALLY l't SES:
�® One or more system cc.ii,,.or,ents as described in the "Conditional Pass" section need to be replaced or repaired. The system, upo
completion of the repl<(:� ent or repair, as approved by the Board of Health, will pass.
Indicate,yes,Lno, or not determin_,.' (Y, N, or ND). Describe basis of determination in all instances. If`not determined', explain why not.
The septic tz,- metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance (;r, ht-d) indicating that the tank was installed within twenty (20) years prior to the date of the inspection;,o
the septic tar,;,, ,ether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank
failure is imrn,r. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved Board of Health.
(revised 04/25/97) Page 1 of 10
DEP on the World Wide Web: http://www.magnel.state.ma.us/dep
Printed on Recycled Paper
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 33 Oakhi l l Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection:8/17/98
BJ SYSTEM CONDITIONALLY PASSES (continued) >
,ff�fQ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the
Board of Health). Describe observations:
broken pipes) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four 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
obstruction is removed
Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
.106 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
AV Cesspool or privy is within SO feet of a surface water
IJ
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
A44 The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and the SAS is within 50 feet of.a private water supply well.
' ► The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that
the well is free from pollution from that facility and the preserice of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm. Method used to determine distance 4 (approximation not valid).
3) OTHER 4 �J
dor
(revised 04/25/)7) P&ge 2 of 10
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 33 Oak Hill Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection: 8/1 7/9 8
D) SYSTEM FAILS:
You must indicate ei;r,er "Yes" or "No" as to each of the following:
_4oO I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Yes No /
Backup of sewage into facility or system Component due to an 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.
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 Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a 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 I of a public 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
EJ LARGE SYSTEM FAILS:
You must indicate either "Yes" or "No" as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
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)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please.consult the local regional office of the Department for further information.
(revised 04/1S/97) P•p• 3 of 10
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 33 Oak Hill Road Hyannis,Mass.
Owner: Tom Carroll
Date of I nspection:8/1 7/9 8
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes No
Pumpinginformation was provided by the owner, occupant, or Board of Health.
None of the system components have been pumped for at least two weeks and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or
as part of this inspection.
As built plans have been obtained and examined. Note if they are not available with N/A.
✓ _ The facility or dwelling was inspected for signs of sewage back-up.
_ The system does not receive non-sanitary or industrial waste flow.
_ The site was inspected for signs of breakout.
_ All system components,-W-luding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of
baffles or tees, material of construction, dimensions;depth of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System on the site has been determined based on:
_ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of
Sub-Surface Disposal System.
ZExisting information. Ex. Plan at B.O.H.
_ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) (15.302(3)(b)j
(revised 04/25/97) Faye 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 33 Oakhi l l Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection: 8/1 7/9 8
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 1-M o�/bedroom for S.A.S.
Number of bedrooms:
Number of current residents:
Garbage grinder (yes or no):7�
Laundry connected to system (yes or no): j
Seasonal use (yes or no): g (y=13j !
Water meter readings, if available (last two (2) year usage (gpd): — a 33.50 CrAP-6.
Sump Pump (yes or no):A0
Last date of occupancy:
COMMERCIAUINDUSTRIAL:
Type of establishment: 44
Design flow: A))4 allons/day
Grease trap present: (yes or no),"
Industrial Waste Holding Tank present: (yes or no)"
Non-sanitary waste discharged to the Title 5 system: (yes or no)&J-
Water meter readings, if available: VA
9Vfi
Last date of occupancy:
OTHER: (Describe) 49
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of in
anon:
System pumped as pan of inspection: (yes or no)
If yes, volume pumpe��,
allons ��l
Reason for pumping: n,, Y,
TYPE QF 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)
I/A Technoloetc Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information: �JJ V-,/. �►� J,4�1
Sewage odors detected when arriving at the site: (yes or no)
(revised 04/25/97) page 5 of 10
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SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 33 Oak Hill Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection:8/1 7/9 8
BUILDING SEWER:
(Locate on site plan)
!f
Depth below grade:
Material of construction: _40 PVC _other (explain)
cast iron
1
Distance from irivate water supply well or suction line _
Diameter IV
Comments: (condition of joints, venting, evidence of leakage, etc.)
Joints appear t i aht rN= axzi danaa Of 1 akagp --
System s vented t-hrn,igh the hn1isa NTGAt -
SEPTIC TANK:AbOe.
(locate on site plan)
Depth below grade:
Material of construction0.4 concreteA metaW±FibergIassA�&olyethyleneoV other(explain)
If tank is metal, list age," Is age confirmed by Certificate of ComplianceR (Yes/No)
Dimensions: 1¢
Sludge depth:_A*
Distance from top of sludge to bottom of outlet tee or baffle:Alk
Scum thickness:A)
Distance from top of scum to top of outlet tee or baffle:_AVA
Distance from bottom of scum to bottom of outlet tee or baffle:_
How dimensions were determined: ^
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
Se$tic tank i s not rpaani- -
GREASE TRAP:.. we_
(locate-on site plan)
Depth below grade: AM
Material of construction-.,g9concretefi/AmetaL/AFiberglasWAPolyethylene4/ other(explain)
J$
Dimensions: iV
Scum thickness: 44
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:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage,-etc.)
Grease trap is not =rpcpnt
(revised 04/25/97) Paq• 6 of 10
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 33 Oak Hill Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection: 8/1 7/98
TIGHT OR HOLDING TANK:f/1Ut(Tank must be pumped prior to, or at time, of inspection)
(locate on site plan)
Depth below grader
Material of constructionvAconcreteA//&netaL�/AFiberglass/Polyethylene eAother(explain)
AJA '
Dimensions:
Capaciry: AM gallons
Design flow: AM gallons/day
Alarm level: Alarm in working order4)d Yes;&No
Date of previous pumping: _
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
Tight or holdinq tanks are not present
DISTRIBUTION BOX:&oe,
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or,out of box, etc.)
Distribution box is not present.
PUMP CHAMBER:
(locate on site plan)
Pumps in working order: (Yes or No)
Alarms in working order (Yes or No)V
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
Pump chamber is not present.
(ravla.d 04/15/97) D.g. 7 of 10
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:33 Oak Hill Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection: 8/1 7/9 8
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:
leaching chambers, number:
leaching galleries, number:
leaching trenches, number,length: C/
leaching fields, number, dimension
overflow cesspool, number:
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
Loamy sand to medium coarse sandrNn aign-c of hydraij i r-
failure nr pnnd i nqy Al l x7e�cgetat i on J s normal-
CESSPOOLS:
(locate on site plan)
Number and Configuration: s )—
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool: - 1' 1
Materials of construction: I/L°1
Indication of groundwater:
inflow (cesspool must be pumped as part of inspection)
Pumped inflow cesspool Should be pumped annually sPPinq that
there- is a garbac}e disposal present.
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
Same as above
PR IVY:1j)—lz _
(locate on site plan)
Materials of construction: W/A" Dimensions: I"
Depth of solids:"
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
Privy 'is not present
(revised 04/25/97) Pag• 8 of 10
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Progeny Address: 33 Oak Hill Road ,Hyannis,Mass.
O"net: Tom Carroll
Dare or Inspection: 8/1 7/98
SKETCH CIF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
� Cy 77111
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(r.vl•.d 0%/25/31 P.y. a or 10_ .
SUBSURFACE SEWAGE DISN.';> ,t. SYSTEM INSPECTION FORM
C
SYSTEM INFOR`.', .rION (continued)
Property Address: 33 Oakhill Road Hyannis,Mass.
Owner: Tom Carroll
Date of Inspection: 8/1 7/9 8
Depth to Groundwater,ge Feet
Please indicate all the methods used to determine High Groundwater Oevation:
Obtained from Design Plans on record
_Z<Observa(ion of Site (Abutting property bservation hole, basemr.r*sump etc.)
Determine it from local conditions
Check with local Board of health
Check FEMA Maps
Check pumping records
;�/Check local excavators, installers
Use USGS Data
Describe in your own words how you established the High Groundwater Elevation. Must be completed)
Used water contours Map.
Gahrety & Miller Model
12/16/94
it
(rsvissd 04/25/27) Psg �Qof 10
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TURN OF Barnstable BOARD OF HEALTH
SUBSURFACE SEWAGE DISI'USAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED
STREET ADDRESS 33 Oak Hill Road Hyannis,MaSS.
ASSESSORS MAP , DLOCK AND PARCEL #
OWNER' s NAME Tom Carroll
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P.Macomber Jr.
COMPANY NAME J.P.Macomber & Soll 'Inc.
COMPANY ADDRESS Box 66 Centerville,Mass. 02632.
Strevt Town or City State LIP
COMPANY TELEPHONE ( 508 1 775 - 3338 FAX (508 1 790-1 57
a
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposaj system a '
this address and that the information reported is true , accurate , and
complete as of the time of ,inspection , The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on
site sewage disposal systems ,
Check one:
System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or ..t-he environment as defined in 310 CMR 15 . 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form .
Sys telr FAILED*
The inspection which I have �concted has found that the system fails tc
Protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form .
Inspector Signature Date
One copy of this certification must be provided to the OWNER, the BUYER
( Where applicable ) and the DOARD OF 11RALTiI.
* If the inspection FAILED, the owner or"operator shall upgrade ' the system.
within o'ne year of the date of the inspection, unless allowed or required
otherwise as providdd in 3.10 CMR 16 , 306 .
partd -doc
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THE COMMONWEALTH OF MASSACHUSETTS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BE IT KNOWN THAT
Joseph P. Macomber, Jr.
Has satisfied the Department's qualifications as required and is hereby
authorized to use the title
CERTIFIED TITLE S SYSTEM INSPECTOR
as provided in 310 CMR 15 .340 and Section 13 of Chapter 21A of the
General Laws. Issued by The Department of Environmental Protection.
hilic x. 1995
Actmy, Director of dw l)' i i)H Of Water Pullutioll C Unlrol
TOWN OF BARNSTABLE
LOCATIONa e%t1,W SEWAGE #
VILLAGE • p, ASSESSOR'S MAP &LOT
~ .. INSTALLER'S NAME&PHONE NO. p
SEPTIC TANK CAPACITY 4 A
LEACHING FACILITY: (type) ��( (size)
NO.OF BEDROOMS _ p
BUILDER OR OWNER
PERK ITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
•• „ Private Water Supply Welland Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet"':
Edge of Wetland and Leaching Facility(If any, w ands exist
within 300 feet fie hin ility)
Furnished by
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ASPHALT SHINGLES BLOCKING 4'-O'O.C.
SIMPSON1 142.6 12 IN FIRST TWO JOIST AND RAFTER
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JUNCTIONS TYP. FG
TYP- EAVES
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LEFT ELEVATION r CROSS SECTION JOB: 1001
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DATE: 3/15/10
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A z m 33 OAK HILL ROAD, HYANNIS MA FINE LINE ARCHITECTURAL DESIGN
8 WEST BAY LOAD OSTERVILLE, I"IA 02655.
N $ DETAILS
PHONE. 508-4-20-120G
SOIL TEST.
TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR BATE OF SOIL TEST G a Z
ELEV. _ /���� 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND SOIL TEST DONE BY Sze✓ s/Ta�z7 AA
ASSUMED WITNESSED BY
( w
) CONCRETE
---�---
COVERS 4" SCHEDULE 40 PVC PIPE LOAM AND SEED OBSERVATION
PEBRCOA PERCOLATION
ELEv.= ��9�
MIN. PITCH 1/8 PER FT. " MIN./INCH AT INCHES
2 LAYER' OF DEPTH HORIZ TEXTURE COLOR MOTT. OTHER
/8 :To 1/2-
LEGEND: ,, ,, b p M v /oyR
2� 4" CAST IRON PIPE " " AX. MAX. 9$ G7
WASHED STONE
- Mlt4. EXISTING SPOT ELEVATION OOxO �2 � SG n or �/ ' ��
(OR EQUAL) MINIMUM _ 98 �NTREQUIRED T __
PITCH 1/4 PER FT. 7fl FINALINSPOT OELEVATION
--00----
N` FINAL CONTOUR 0 34,
Q `G
FLOW LINE. 9<.0.0
SOIL'i TEST LOCATION
I N S'Tr�}�..L _ 10" °i UTILITY POLE _ -O- MEd T
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FfEC7-0a ELEV. - �11Z ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ -�-- se" '
TOWN WATER -W W C C�a►r
MIN: - 9 7 �7 2-0»� ° °. /7�:Ga o CATCH BASIN ®�
ELEV. o o
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101"a ELEV. _ [.7L GAS ELEV. _ 9T" 6" SUMP 9 ,S"'D �° CLEAN NOUT G
ELEV. S o o ° C.O.
BAFFLE13 ❑ L7 ❑ ❑D ❑ ❑ ❑ ❑ ❑ 0 2 ° _
DISTRIBUTION ° ° CES�PooL C.P.
LI UID OUTLET - V ELEV. o o° ° 0 0 o ELEV. `7� 3
TEE
DE TH (TO BE PLACED ON FIRM BASE) BOX
4 FEET 14 INCRES TO DE WATER TESTED Z
` 500 GALLON DRYWELLS WITH ,
6 FEET 24 INCHES 1 500 GALLON IF MORE THAN ONE OUTLET STONE IN AN
r � k /Vd WATER ENCOUNTERED AT _L. .Z ELEV. _ _� 7•0
7 FEET 29 INCHES -ry (TO BE PLACED ON FIRM BASE) /.�' x 24' x �' TRENCH FORMATI IN z WELL NA
8 FEET 34 INCHES SEP I IC TANK 33/4 TO 1 1/2 CLEAN SORPTION INDEX
" " SOIL _ ZONE X
DOUBLE WASHED STONE
ADJUST X
FREE OF FINES & SILT SY,73TDA.... (SAS) DESIGN CALCULATIONS
NUMBER ;OF BEDROOMS 12 3
SEWAGE DISPOSAL .SYSTEM PROFILE OBSERVEDUSGS WATERRTTAB TABLE ELEV.
WATER TABLE ELEV. _ __, GARBAGE DISPOSAL UNIT �o
NOT TO S(,ALE TOTAL ESTIMATED FLOW
BOTTOM OF TEST-HOLE ELEV. _` _&7,a
102.9 k// 330 GAL./DAY
REQUIRED SEPTIC TANK CAPACITY c10 GAL.
ACTUAL SIZE OF SEPTIC TANK _Sgo GAL.
h SOIL CLASSIFICATION .�
DESIGN PERCOLATION RATE < MIN./IN.
4 / EFFLUENT LOADING RATE o� GAL./DAY/S.F.
LEACHING AREA J3x2�-'t �-' K 7� '� 77 SQ. FT.
101.8 LEACHING CAPACITY (AREA X RATE) GAL./DAY
\
RESERVE LEACHING CAPACITY N GAL./DAY
NOTES:
\ 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.
TITLE 5 AND THE TOWN RULES AND REGULATIONS FO
R THE SUBSURFACE
A DISPOSAL OF SEWAGE.
�. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
92.7 L!\ 4 \ �c� '�'�7
WITHIN 6" OF'FINISHED GRADE.
? 3. ALL COMPONENTS .OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
\ \ 9 .5 \ 01 6 WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
I \ \ 101.1 10 FT. OF DRIVES OR PARKING AREAS. H ' 20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS:
1 4. ANY MASONRY UNITS USED TO BRING 'COVERS TO GRADE SHALL
BE MORTARED IN PLACE.
\\ 5. NO DETERMINATION HAS BEEN MADE AS TION
TO COMPLIANCE WITH
- OFEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO
■' 79.8 \ l 86.� 90.4 \ I OEi 1 AI d SUt.�y.i�t triivn'f r rcvIh nr r Rwr 1„TE AJTH R.TY.....:
1 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR
T-
1 J IS TO CALL DIG-SAFE AT 1-888-344-7233 AT LEAST...72 HOURS
PRIOR TO COMMENCING,WORK ON SITE.
7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
SIT
E CONDITIONS N S PRI
OR TO COMME
NCING WORK
K ON SITE. ANY VARIATION
' IS TO BE! BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
1 / 8.I MMEDIATELY 8 PARCEL IS IN FLOOD ZONE
2.3 C
� ) / - -9, LOT IS SHOWN ON-ASSESSORS MAP _- Z AS PARCEL 73
x I 10. ALL UNSUITABLE MATERIAL SHALL BE D FROM UNDER, N
0
/ J,I 96.6 / 100.5 FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORP11ONSYSTEM,
`� AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3)
SHELL@� OF
(I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT.
� F
400.0 oR �~ ' n . �nr. 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND
C�i.11.a � ,�,�pF'M
■ 8 .3 / 1 S(O,;i" OR REMOVED
98.4 '�• C3, 1
98.5 100.2 Nw. o IL i N
�6 0� /� BECK
90 :313; APPROVED: BOARD OF HEALTH
9 8.5 'QCiS F\ a O ?
8,7 ,�0 SU10*
S`
f'TL�"C T C7 2 / I v�
s 99.7 ��,' 8� DATE AGENT
x 90.4 £xrsnNc,
7 v ,o 072 /� / L4 DWELLING
Cam`G p , � � � \ �V. V F: �.
� `�'�'�'`' PROPOSED SEPTIC DESIGN
F Uwa?2 i / 0 99.4 v
99.3 FOR
99.
99.2cO�Cx �qG N 9 \
z6 JOHN NESDIT
f �/
x 4.9 6.6 9.2 X 0'
99.2
LOT 4A '6'
G' (C� . 99.1
� G v c st E vE' OAS 1�IL1� RD
f
`-96 Vie J 9 9.0 O Z C7 N 6;
CRAIG R $HORT
TG h' l i
� r
t Lt��8.9 9AZI� C TZ ' .a.!' s 235 GREAT WESTERN ROAD
508_ P. 0. BOX 1044
zZ .� aevS 398-8311 SOUTH DENNIS, MASS. 02660
v. DATE 20 D Z SCALE " _ 20
'
REVISED JOB NO.
31
M 101.6
"LOCATION MAP REVISED SHEET 1 OF 1
0 2002 CRAIG R. SHORT, P.E.