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HomeMy WebLinkAbout0321 OAKLAND ROAD - Health t321 Oakland Road Hyannis A=271-092 {p) { n !j a k F M TLy yr^ 1 TOWN OFF BARNSTABLE- LOCATION SEWAGE# oQ®\")— �(5_'3 VILLAGE -(` ,� ASSESSOR'S MAP&PARCEL a-71 INSTALLER'S NAME&PHONE SEPTIC TANK CAPACITY C.A(, LEACHING FACILITY: (type) (size) NO.OF BEDROOMS L� OWNER PERMIT DATE: ( COMPLIANCE DATE: J Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY � pe�`� '.'✓� ter'i ` JJ . ram" O Cis No. g-O 'Lf Fee (� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Nplitation for Vsposai �6pstpm Construction Permit F y Application for a Permit to Construct( ) Repair(v�Upgrade( ) Abandon( ) ❑Complete System 2 ndividual Components Location Address or Lot No.�j a ,wi�z , Owner's Name,Address,and Tel.No. `s'.a 37 a Su? Assessor's Map/Parcel '] l 3 1 OdeK�a e�,C� Q A,n Mvlt O 6© Installer's Name Address,and Tq1.No. $aQ-5�,070 a Designer's Name,Address,and Tel.No.SX�- 33 ern -�?q c��c s��-9ai,� o,• Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ��� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � 1 o gpd Design flow provided gpd Plan Date a 0�0 (� Number of sheets Revision Date Title Size of Septic Tank 50 C C'•. Type of S.A.S.CQ Arc_.Y: �,lw.►v�.�� e�,�,.e�,. Description of Soil Nature of Repairs or Alterations(Answer when applicable)a,,� w l \-l-O O !k • a O 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. Signed Date i Application Approved by -- Date �- Application Disapproved by Date for the following reasons ®�Permit No. Date Issued �' °2 No. Z O I -Lf 53 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN.-OF BARNSTABLE, MASSACHUSETTS Yes ltlrlcat101I for Disposal A O.pstem Construction Permit Application for a Permit to Construct( ) Repair(vrUpgrade( ) Abandon( ) ❑Complete System Eelfridividual Components Location Address or Lot No.�j a •AK\A I4c.V , Owner's Name,Address,and Tel.No. So'?'.a 3 7- Assessor's Map/Parcel a'7 S 3 \ C)dKl a r�c7� Q . A n MBA O SO Installer's Name Address,and T@1,No. -15U?-S �,,-Ug0 a Designer's Name Address and Tel.No.S�2'303-331" ]Zr..cs2rs� �.�-�c,►-- �� �,•e.T-`•••.So,....5; (3203-7 Type of Building: Dwelling No.of Bedrooms Lot Size C sq.ft. Garbage Grinder( ) Other Type of Building GS No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 0 gpd Design flow provided y�l gpd Plan Date �. 0�0 (� Number of sheets �o Revision Date Title Size of Septic Tank 76p Gal l`r)c �Type of S.A.S.Co \c., C�..�w.ln� w7/ S,z , Description of Soil Nature of Repairs or Alterations(Answer when applicable) .wSw l \�- O O `t ry 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. Signed Date-�Q dt1 {'7 Application Approved by 1J. Date 2- a �l Application Disapproved by 1 Date for the following reasons Permit No. 0 _ Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(t/}' Upgraded( ) Abandoned( )by � �;- at has been constructed in accordance ^� with the provisions of Title 5 and the for Disposal System Construction Permit No.961 -t( dated Installer ,� Designer (�,e�f �,1- is S�y\j; C #bedrooms Approved designer. gpd The issuance of this permit shall not b-e/c'nst-rutted as a guarantee that the system ViIl function as de igped. ��r/i1"f5 /� / Date Inspector --------------------------------------------------------------------------------------------------------------------------------------- No. U� — �( J Fee /cq) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal 9ppetem Construction permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 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. 1 Provided:Const ction ust be co within three years of the date of this permits Date � � ( � Approved by � 1 Town of Barnstable Regulatory Services Richard V. Scali,Interim Director BAMSTABIZ MAS& Public Health Division 1639. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 s Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: ll Sewage'Permit# ao��-�(S� Assessor's Map\Parcel t� Designer: I v l e.\"� I J 6�1 s� 10(.ZInstaller: -P 8 Address: Address: On SZ f�\.� was issued a permit to install a (dat ) (installer) septic system at j� 0h t'-' -WO kO based on a design drawn by (address) , J�►`l �� 9v`�•-o dated (designer) in I certify that the septic ern 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 out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if'required)was inspected and the soils were found satisfactory. I certify that the system referenced above was construct e with the terms of the IAA approval letters (if applicable) t Rft (Ins tiller's Signa e) : 91 esigner's Signature) (Affix Desig fei amp Her PLEASE RETURN TO BA STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc TOWN/OF BARNSTABLE i LOCATION 321 b R�ccrtd SEWAGE# `VILLAGE P%`lA ll.c 5 ASSESSOR'S MAP&PARCEL s., t INSTALLER'S NAME&PHONE NO. cc �2Jrm V SEPTIC TANK CAPACITY U� -3& size FACILITY: e ^'LEACHING C NO.OF BEDROOMS q t OWNER ' t PERMIT DATE:y1 1> �' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY lRy r erA W N w cj\ I� _ _ ____,. _J CB✓C `CST _ �� L-� . No. � �_., Fee ` "' 7 r: THE COMMONWEALTH OF MASSACHUSETTS Entered in compute UBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS y Application for Digotal *pztem Cottgtructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade(x) Abandon( ) ❑ Complete System OIndividual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 321 Oakland Road, Hyqg is, MA Keung Yau Fung Assessor's Map/Parcel p � 1 Lantern Lane, Burlington, MA 01803 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �41,,ex '�/,v � he BSC Group, Inc. 49 Route 28 West Yarmouth MA 02673 Type of Building: Dwelling No.of Bedrooms 4 Lot Size 18,952 sq. ft. Garbage Grinder ( NQ 3 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 440 gpd Design flow provided 479 gpd Plan Date 8-3-11 Number of sheets 2 Revision Date Title Design For Sewage Disposal System Repair Size of.Septic Tank Existing 1,500 Type of S.A.S. ARC 36 — Leaching Chambers Description of Soil See Plan Nature of Repairs or Alterations(Answer when applicable) Replacing leaching pit with chambers Date last inspected: Agreement: The undersigned agrees to ensure the constructio and maintenance of the afore ftcribed on-site sewage disposal system in accordance with the provisions of Title e E it n ental ode and n t to pla t e system in operation until a Certificate of Compliance has been issued this B rd t Sig7yv: ate kApplication Approved by DateApplication Disapproved Date It for the following reasons ®g Permit No. 9 OW 4 / Date Issued ;' � � 1 "or o. Fee Lx Y Q - eqj THE COMMON V kUgH OF MASSACHUSETTS Entered in computer: 'PUBLIC HEALTH DIVISION - TOWN OF BARNSTAME;yMASSACHUSETTS Application for 3kponl *p!gtem Cow6truction Permit Application for a Permit to Construct�K) Repair( ) Upgrade(x) Abandon( ) ❑ Complete Sysiem"K Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 321 Oakland Road, H is, tdA Keung Yau Fung 14 Assessor's Map/Parcel 1 Lantern Lane, Burlington, MA 01803 In Name,Address,and Tel.No. Designer's Name,Address and Tel.No. _ ,4k/LI�`� ./�fJ he BSC Group, Inc. 33& P� 49 Route 28. West Yarmouth MA 02673 Type of Building: **"- Dwelling No. of Bedrooms 4 Lot Size 18,952 sq, fl.. Garbage Grinder ( N9 r: Other Type of Building No.of Persons .* Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 40 gpd Design flow provided 479 gpd. r Plan Date 8-3-11 f Number of sheets 2 Revision Date Title Design For Sewage Disposal System Repair Size of.Septic Tank Existing 1,500 Type of S.A.S.A$6 36 - Leaching Chambers Description of Soil See Plan Nature of Repairs or Alterations(Answer when applicable) Rep$aciriR leaching pit with chambers l: 4 Date last inspected: t -r Agreement: Thee ndersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title?-of-thelnviron, ental rEode and Aot to place the,system in operation until a Certificate of Compliance has beervissued by this Board of�Headth:(, Si g,,n ed�V4 U DateApplication Approved by ///�_ A➢ �g�� W /1,(.[ Date X � Application Disapprovedfby: .. / �I / Date / for the following reasons . Permit No. / > �! Date Issued ---------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance �f THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( -) Abandoned( )by Aie t>-1 �,,/� ' at ?i�, (_�iii t'!�t�.,.,{( �,�� /,`.�1//a n/7/-' Ai A has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. // ""_�4/.'a C.�- dated Installer �C1� Designerr��E-' #bedrooms Approved design flow gpd The issuance of this permit s�,ha I not be construed as a guarantee that the system will fu�c`tii�on as designed. Date % / / Inspectorrv- P T —--.�.—.---•—.—.__...�—�— .rm--.Q� r r— ___ —_—_ — No. /�/' Fee �`--------- vr� ' THE COMMOXWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �IuuIqoM �§p!gtem Con5truction permit Permission is hereby granted toConstruct ( ) Repair ( /) Upgrade (4 ) Abandon ( ) System located,at /-�'1( 'l Z i 1�r ton eft 1�`/E r( IT-. 17)m A.-P✓�� l nV A•A 0.,L k f1f and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of th Date Approvedby t- Abl" ( P _ .. 09/13/2011 13:20 5083856383 PKM CONTRACTORS INC PAGE 02 Town of.Barnslable Regulatory Services g Thomas V, Geller,Director , KAM �` Public Healilt Division. Thomas McKean,Director 200 Main Street,Hya ials,MA 02601 Office: 508452.460 Pot; 508-790-5344 J aller.&D-gaigger CergWcattogm Form Date. Abol-bJ Sewage Permit# � Assessor's Map\Parcel Designer: -bSC, GQavf Mr, Installer: Addrass: to gVF : U 1,)-1 .D Addrws: on b2ide ^ was.issued a p it to install a septic system at. J based on a desip drawn by (addreq) - 1;SG_ 6.Rov P 4 1114 dated (design} • I certify that the septic system referenced above was installed.s ubstar domy according to the des p,which may include nmaor approved changs such as lateral relocation.of the - disla'buticn box and/or septic.t=k. 4 i con*that the septic systmn 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 septi.a system)but in accordance with State&Loaal ReplatYOris, flan:revision or certiged as-built by designer to follow. v ATI is stallcr'5sipatOre , � CML No.40MG 10NAt ti ` ] S1 St",Here) RE' 'fi]R1V TO BAN9`L'ABL$ F(7SLIC HEGTUIV x!T CaNJ'P'LLANt:$_ L NOTBOTH. Lg—=l TF CIS B IS UMM �SiY'TIZJ TMS.M.RM A!`tD AS-RLJLL.? CAl A tE Q'He�slthrSeptialDestgnar Cnetlfi�adon Form 3•xi'i-0A.doo I HARRISON ' FUHS, REALTORS® z " ' 349 Route 28,West Yarmouth,MA 02673 __.The Locals _;,,,. Choice SINCE 1958 September 6,2011 To: Barnstable Board of Health From: Kevin Fuhs Subject: 321 Oakland Road,Hyannis I sold the above named property to the current owners,Keung Yau Fung and Su Zheng Zhen on March 22 2002. The home was a 4 bedroom home 'with 2 /z baths and remains the same today. The town field card lists the home as a 4 bedroom. I saw no evidence of any modification to the interior of the home. It appears that the home always had 4 bedrooms and the construction looks to be 1960 vintage. If you have any questions,please call me. Sincerely Yours, Kevin Fuhs ® MLS 800.474.8076 508.771.7974 Fax: 508.771.0588 s www.capecodrealtDrs.net • sales@harrisonre.com ' Town of Barnstable P# Department of Regulatory Services BARMABM . Public Health Division Date loMAM �c3�� 059. �e� 200 Main Street,Hyannis MA 02601 D MCA� Date Scheduled Time Fee Pd. -. A0 Soil Suitability Assessment for Se a Disposal Performed By: &10- Cy 1=) Witnessed By: LOCATION & GENERAL INFORMATION Location Address 321 Oakland Road Owner's Name Fung, Keung Yau& Hyannis, MA Zhen,Zheng Su Address 321 Oakland Road, Hyannis, MA Assessor's Map/Parcel: Map 271, Parcel 092 Engineer's Name BSC Group, Inc. Telephone# NEW CONSTRUCTION REPAIR X (617)896-4590 Land Use Residential Slopes(%) .eL Z-'?, Surface Stones Distances from: Open Water Body F� ft Possible Wet Area M If fr- ft Drinking Water Well ft Drainage Way N A ft Property Line ft Other ft l SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) z 271004001 6 Ya ® -•eW 271083 Y _ ��71003 Y 240 . 005 YJ35 Y796 Q 8 271004002 Y.12 - —. 271004008 - 9 271094 - Y23 4�2 t Y353 moaao°3 Y n ►#® 271061 Ali 'p 323 271089005 271001 27 1084 Y 30� 'p200 Y308 .. 271N28§ e t - 271060 0309 9 .Z Parent material(geologic) Depth to Bedrock /�1 pt CD Depth to Groundwater: Standing Water in Hole: ( oti e Rouaoa Weeping from Pit Face Gi L Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABU Method Used: ' Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date 8 / r( Time 1 Z;c� Observation Hole# ✓7 Time at 9" Depth of Perc .�, O � Time at 6" Start Pre-soak Time @ 2.:Do Time(9"-V) End Pre-soak Rate Min./Inch C Z ' /L'Z � q_ �t(r 9 r, Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC . f DEEP OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Graven 0-0.4. f} LS Z•5�{ �t AJfri 0.6— Z.. 1 a K2 6�G N I A .7 — I d G' z ►v► S Z 5 6 I4 kb we w I cob ce s DEEP OBSERVATION HOLE LOG Hole # 2- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) .� .o — �• S' �'_, /�j � .�. �'� �/.3 �a„� 7 ice.,' DEEP OBSERVATION HOLE LOG Hole# -3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) o .yel.z s iv 2 j:/ -- , s a, sti f A jO," DEEP OBSERVATION HOLE IOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency %Gravel) �/2'1ty Am UC 13 Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes X Within 500 year boundary No X Yes Within 100 year flood boundary No X Yes Depth of Naturally Occurrinia Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification ,,rr I certify that on MUL a005(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with' the required training,expertise and experie ce described in 310 CMR 15.017. Signature Date 1"lO— Q:\SEPTIC\PERCFORM.DOC s 2112 BH HALL BED BED �4 #3 S ECOND FLOOR DECK FAMILY ROOM ' BH^ i. { KITCHEN` BH7B�ED :. 'GARAGE f . . AREA , A x BED f LIVING #2 4. FIRST FL00R HARRISON ROUTE EALTORS W.YARMOUTH,MA 02673 1-506-771-7974 IV qY COMMONWEALTH OF.MASSACHUSETTS ' • EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 14 DEPARTMENT.OF ENVIRONMENTAL PROT ;. EIVED r r, d �, g FEB 3 2002 TOWN OF BARNSTABLE- .' qt HEALTH DEPT. 4 * ; t TITLE'5wi . OFFICIAL INSPECTION FORM—NOTFORVOLUNTARY ASSESSMENTS ` . SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM $"PART CERTIFICATION'.' Property Address: 321 OAKLAND RD BARNSTABLE;MA 0260rt,4 t Owner's Name: C/O VINNIE DOLIMPIO AT KINLIN GROVER'REAL ESTATE ` Owner's Address: 4 WIANNO AVE OSTERVILLE MA 02655 1.�. '� r Date of Inspection: 2/1/02J . � Xh� 3� Name of Inspector: (please print) JOHN GRACI " $' Company Name: SEPTIC INSPECTIONS ' '. Mailing Address: P.O; BOX 2119 TEATICKEtNk.'02536 ' Telephone Number: 508-564-6813 FAX 508-564-7270 h r� CERTIFICATION STATEMENT f 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below,is, true,accurate and complete as of the time of the inspection.The inspectton`;was performed based on my training and ; ,�, experience in the proper function and maintenance of on site sewag6%isp6sal systems. ham a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15 OO..tI) The system �. � )P� �. ,' {; X Passes WFA _ Conditionall Passes t R� _ Needs�Furt er valuation by the Local Approving Authority r _ Fails Inspector's Signature: Date: 2/1/02 shall submi co of this inspection re ort td't&Approving Authority(Board of Health or DEP),wtthut- *"; The system inspector sha copy P P 1 a 30 days of completing this inspe ion. If the system is a shared systemor has a design flow of 10,000 gpd or greater,thezf�� E inspector and the system owner shall submit.the report to the appropriate regional office of the DEP.The original should be ; i � r a' sent to the system owner and copies sent to the buyer, if applicable,#and tlte;approving authority. ` 4# y Notes and.Comments SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPIVIVNG EVERY TWO YEARS TO PROLONG THE;3f� f . .4111, SYSTEMS USEFUL LIFE. '' } v¢ ris AIN ****Phis report only describes conditions at the time of inspection andynder the conditions of use at that time 'fhi9 t X inspection does not address how.the system will perform in thefuture under the same or different conditions of uses ' JtA z}� 5 t Title 5 lncni rtinn Fnrm F/15/�(10Y1 Page 2 of 11 ` z i 4 } OFFICIAL INSPECTION FORM—NOT FORYOLUNTARY ASSESSMENTS : k ` SUBSURFACE SEWAGE DISPOSAL,:SYSTEM INSPECTION FORM ' PART A)R , CERTIFICATIONi(continued) .j Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601 � ' Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REA0ESTATE � 4 ' Date of Inspection: 2/1/02 t t Inspection Summary: Check A,B,C,D or E/ALWAYS completetall of;Section D d , A. .System Passes: 1 X I have not found any information which indicates that any of the failureycriteria described in 310 CMR 15.303 or,or 310i z{ CMR 15.304 exist.Any failure criteria not evaluated are indicated below ,� Comments: [(} SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THKO-il, SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system componentsas described in the"Conditional,Pass';section need to be replaced or repaired. The system, ' upon completion of the re lacement'or repair as approved b the Board of Health,will ass. "I P P P P PP Y x44 h P >, Answer yes,no or not determined(Y,N,ND)in the for the followingstatements. If not determined please explain a*Y 7y � } n/a The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibit ^ substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced N 'A d with a complying septic tank as approved by the Board of Health. a s ° � *A metal septic tank will ass inspection if it is structural) sound,not;leakin and if a Certificate of Compliance indicator +' P P P Y g P g, that the tank is less than 20 years oldis'available. a Y`' tND explain: n/ai, eft n/a Observation of sewage backup or break"ut or high static water level in the distribution box due to broken or obstructed 01 yp ;tl pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board c,f � s' Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced r • 2 ' ND explain: n/a `Y n/a The system required pumping more thanA times a year due to broken or.obstructed pipe(s).The system will pass ¢ inspection if(with approval of the Board of Health): rx is _broken-pipe(s)are replaced _obstruction' is removed ND explain: n/a Page 3 of 11 'z L OFFICIAL INSPECTION FORM-NOT F.OR,VOLUNTARY ASSESSMENTS dh t SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION FORM PART,'A CERTIFICATION(continued) w Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601 ' Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE qt•. Date of Inspection: 2/1/02 C. Further Evaluation is Required by the Board of Health: A w.,-p„ • of ��. Conditions exist which require'further evaluation by the Board of Health in order to determine if the system is failing to:' F protect public health,safety or the'environtrient. •, t:m a 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerrwhich will protect public health,safety and the environment: 1"y¢ _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within'50 feet of a bordering vegetatedrwetland or a salt marsh } C a 6J 1'� '•C .X � X 2. System will fail unless the Board of Health(and Public Water;Supplier,if any)determines that the f t system is functioning in a manner that protects the public health,safety and environment: 4 # _ The system has a septic tank and soil absorption system SAS and the SAS is within 100 feet of a surface water..'�� i Y P rP Y _{. supply or tributary to a surface water supply. �' '•f PP Y rY � , _ The system has a septic tank and SAS and the SAS is within"a Zone I of a public water supply. xr _ 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 usedto deteiinine distance n/a i **This system passes`ifthe well'water analysis,performed at:MY certified laboratory, for colifotm bacteria and; volatile organic compounds,indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm;provided that no other failure criteria are triggered Acopy P of the analysis must be attached to this form. , ° i sY , $ `4 �1. 3. Other. � n/a s• i . Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR fiVOLUNTARY ASSESSMENTS f.. SUBSURFACE SEWAGE DISPOSAL-'SYSTEM INSPECTION FORM 41 PART A�� b NI . CERTIFICATION,(contmued) t t t 7 ar+ 1 i!6 a Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601 ' { Owner: C/O VINNIE DOLIMPIO'AT KINLIN GROVER REAL ESTATE . Date of Inspection: 2/1/02 D. System Failure Criteria applicable to all systems: r { You must indicate"yes"or"no"to each`of,the following for alLinspections: Fr 1 Yes No _ X Backup of sewage into facility or system component due.to overloaded or clogged SAS or cesspool w _ X Discharge or ponding of effluent to the surface of the gro..und or surface waters due to an overloaded or clogged,, ; SAS or cesspool , _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool' 4 X Liquid depth in cesspool is less than 6"below invert or available`yolume is less than '/z day flow X Required pumping more than 4 times in the last year NnTduetoclogged or obstructed pipe(s).Number of tunes { o .y pumped nLa. _ X Any portion of the SAS,cesspool or privy is below high groundwater elevation. X Any portion of cesspool or privy'is within 100 feet of a suiface:water supply or trib ry to a surface water sup,, *W X Any portion of a cesspool or privy is within a Zone 1 of a publicwell. _ X Any portion of a cesspool or privy is within 50 feet of a private";water sup well. " A +S _ X Any portion of a cesspool or privy;is less than 100 feet but greater tha 0 feet from a private water supply well with} ' no acceptable water quality.analysis. [This system passes,�f th ell water analysis,performed at a certified laboratory,for coliform bacteria and volatile o anic compounds indicates that the well is freeF � from pollution from that facility and the presence of.+h monia nitrogen and nitrate nitrogen is equal.. r t less than 5 ppm,provided that no other'failure c eria are tri ered.A co of the anal sis must be gg PY Yoh ' attached to this,for'm;J _ (Yes/No)The system fails.I have determine that one or.,more of the above failure criteria exist as described-hill310� `` CMR 15.303,therefore the system fails'The syste wner should contact the Board of Health to determine what will be .- yi necessary to correct the failure w E. Large Systems: { l To be considered a large system t system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd ti kz You must indicate either"yes"or' o to.each of the following i i f « l (The following criteria apply t arge systems in addition to the criteria above) yes no H X the system is ithin 400 feet of a surface drinking water supply X the syst is within 200 feet of a'fributary to a surface drinking water supply + , X th system is located m anitrogen sensitive area(Interim Wellhead-Protection Area—IWPA)or a mapped Zone II of a public watdr`�supply well ,.�° '• i3 If you have answered"yes4s,to any question in Section E thesystem is considered a significant threat,or answered =Y " es" in Section D above the lalf e s stem has failed,The owner or operator of any large system considered a significankt�thre�t , under Section)✓or tailed under` ectioii 6 shall upgrade the system 1t1 aeoerdanee with 310 CMR 15.304.`I he system bwii®t' r { %1F.{Y: A x should contact the appropriate regional office of the Department1, F• d �. 1� Page 5 of 11lf # .' 4 (( tE ��?� �., •' 'i��d i �j�€� . of'L0. .,: #111 OFFICIAL INSPECTION FORM—NOT FWVOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAUSiYiSTEM INSPECTION FORM CHECktIST 7 <x a * < � Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601 Owner: C/O VINNIE DOLIMPIO AT:KINLIN GROVER REAL ESTATE J w r U, Date of Inspection: 2/1/02 Check if the following have been done You must indicate"yes"or, no q as to each of the following: t. Yes No ti X _ Pumping information was provided by the owner,occupant,or.Board of Health ij + 4 tf X Were any of the system.components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous tw6meek:period? �1 r _ X Have large volumes of water,been introduced to the system recently or as part of this inspection? 'i� x _ X Were as built plans of.the system obtained and examined?(IfIthey;were not available note as N/A) L W 41, tyyy Yi l 3 X _ Was the facility or dwelling inspected for signs of sewage tack up?? X _ Was the site inspected for signs of break out? "V, h� i, X _ Were all system components,excluding the SAS,located on site? E. : 1p ,r ,.; X _ Were the septic tank manholes u Rove red,opened,and thexinterior of the tank inspected for the condition of the,;s ' ` baffles or tees,material of construction;dimensions,depth of liquid;;depth of sludge and depth of scum ? a X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance y �, t,. of subsurface sewage disposal systems The size and location of the,Soil Absorption System(SAS).on the,site has been determined based on: ,mow r � 4 d Yes no Fi X _ Existing information:For e�Cample,a plan at the Board of Health , X Determined in the field(if any'of'the failure criteria related to PPart#C.is at issue approximation of distance is € , # unacceptable)[310 CMR 15.302(3)(b)l ?N 1k1A9 t4.d :!?,I' ' - 1;o-! tp rb4 cy e�F t b "1 r b ry' i F r { Page 6 of 11 k i OFFICIAL INSPECTION FORM—NOT KQR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL;SYSTEM INSPECTION FORMpo� `# PART C Y K . SYSTEM INFORMATION Property Address: 321 OAKLAND RD BARNSTABLE,MA.02601' O' k. Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL.ESTATE Date of Inspection: 2/1/02 'c,t r FLOW CONDITIONS ' RESIDENTIAL Number of bedrooms desi n '4 Number of bedrooms(actual) .41,'ti .h,., { DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#;of bedrooms):440 t ,�^ z ^]> Number of current residents:2 r Does residence have a garbage grinder(yes or no): NO 4n Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] r+t�M 'Ef i- Laundry system inspected(yes or no) NO ' l Seasonal use:(yes or no):NO Water meter readings,if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NOty- Last date of occupancy: n/a � a COMMERCIALANDUSTRIAL f r z �bx x Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO ` Industrial waste holding tank present(yes or no): NO 4 h . Non-sanitary waste discharged to the Title St'system(yes or no) NOW ►'; Water meter readings, if available:'n/a ���* y r �" w Last date of occupancy/use: n/a'; >: OTHER(describe): n/az � a =t GENERAL INFORMATIONAF' + w r� rk� a . Pumping Records 4 ^ " Source of information: n/a Was system pumped as part of the in. (yes or no):NO 5 a If yes,volume pumped: n/agallons--`How was quantity pumped determined?n/a *E , Reason for pumping: n/a I TYPE OF SYSTEM xr X Septic tank,distribution box,soil absorption system r ' _Single cesspool K ',F a _Overflow cesspool _Privy t .s r _Shared system(yes or no)(if yes,attach previous inspection records,af.any) F z xr F Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from4 x h ' ;. �4 W system owner) _Tight tank Attach a copy of the DEP approval { k .tq � Other(describe): n/ah ,' Mp` v YY a a � , Approximate age of all componentg;date installed(if known)and source of information: ". y. 1964 HOUSE-NEW SEPTIC IN 84-PERMIT 99-2-84 4 ;r Were sewage odors detected when arr vin at the site es or no : NO; ? ?I 1 g . (y ) a ,t. VX k Firt • �� S• 1 � 4 5.T_RI, Z�+ +TES"'. • Page 7 of I 1 f ' OFFICIAL INSPECTION FORM—NOTFOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART- SYSTEM INFORMATION(continued) Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601a }j Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE " Date of Inspection: 2/1/02 « e J s BUILDING SEWER(locate on site plan) �� , g' c x9 rt a! Depth below grade: 42" 4 � Z I Materials of construction:_cast iron X40 PVC_other(explain): n/aj ji-a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.) r, TOWN WATER '.. SEPTIC TANK: X(locate on site plan) #y i r Depth below grade:36" r tp" Material of construction:Xconcrete metal fiberglass of eth lene other explain n/aN. { If tank is metal list age: n/a Is.age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate)) £ . ,n E� » 1 11 1 11 1 11/1 Dimensions: 150OG L 10 6 H:S; 7. W 5 8 �. Sludge depth:4" ` '+ j Distance from top of sludge to bottom of outlet tee or baffle 30" A.) Scum thickness: 8" �p Distance from top of scum to top of outlet tee or baffle: 6" { Distance from bottom of scum to bottom of outlet tee or baffle: 10"; ; ' `z How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related V�' { to outlet invert,evidence of leakage,etc.): .:I. ,r 1 SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLYs t� RECOMMEND PUMPING EVERY`TWO YEARS. 4 "' GREASE TRAP: _(locate on site plan), S � : Depth below grade: n/a 't !: Material of construction: concrete metal fiberglass_polyethylene``other(explain): n/a ` Dimensions: n/a Scum thickness: n/a r r ,i Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/aii! 4 - Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle,condition,structural integrity, liquid levels as related , to outlet invert,evidence of leakage,etc`): 7 ' 41 ?S•t 8 i' ',4� �''` >.:`' ��it� ,:4�.{ n +� �,. V. d t � r Page 8 of 11 AM. e , OFFICIAL INSPECTION FORM—NOT FOR,VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL:;SYSTEM INSPECTION FORM R : PART C" x � SYSTEM INFORMATION(continued) fi s Property Address: 321 OAKLAND RD`BARNSTABLE,MA 02601 t Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE X K. Date of Inspection: 2/1/02 «4 wg TIGHT or HOLDING TANK:' (tank must be pumped at time of inspection)(locate on site plan) 1y Depth below below grade: n/a Material of construction:_concrete_metal_fiberglass�olyethylene� other(explain): n/a s ° Dimensions: n/a µ, R Capacity: n/a gallons ,s Design Flow: n/a gallons/day 4'.. Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no):NO � kf Date of last pumping: n/a � 4171 Comments(condition of alarm and float switches,etc.): a n/a p ter„ " DISTRIBUTION BOX:X(if present must be opened)(locate on site plan). " Depth of liquid level above outlet invert: LEVEL WITH BOTTOMrOFPIPE n. Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage tntof or out of box,etc.): " APPEARS STRUCTURALLY;SOUND'AND FUNCTIONING',PROPERLY t PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO 9 Alarms in working order(yes or no):NO' Comments note condition of um chamber,condition of um s and a urtenances etc.): n/ak K' iA # S 3 5 s < R Page 9 of 11 37 - ;it4 WSO RX r INSPECTION FORM—NOT:FOWVOLUNTARY ASSESSMENTS y OFFICIAL INSPEC .' { SUBSURFACE SEWAGE DISPOSAL;SYSTEM INSPECTION FORM SYSTEM INFORMATION(continued) Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601? Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE ` Date of Inspection: 2/1/02 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: r r _ n/a F4 k Type s ` 1000 GAL 6' X 6' leaching pits, number:'}�' 1 r n/a leaching chambers, number::- n/a .: n/a leaching galleries, number ' '- n/a 0 leaching trenches, number, length: n/a xu n/a leaching fields, number;� N n/a - ' y, � n/a overflow cesspool, number..,,,` n/a n/a innovative/alternative system` „ > Type/name of technology% n/a F $ I Comments(note condition of soil,signstof hydraulic failure, level of ponding,damp soil,condition of vegetation,etc) a4 LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.PIT NEVER HAD MORE THAN OF LIQUID IN IT AN D ,,ND BOTTOM IS'AT 9'.PIPE COMES IN�6am"}LOWER THAN NORMAL. ¢� CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a r Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a f Materials of construction: n/a . a ` Indication of groundwater inflow(yes or no): NO �` x j Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): ' � ^� �{• Asa: •�,e"�`: . : PRIVY: (locate on site plan) t, { + A s w 4. Materials of construction: n/a 1 P `.; Dimensions: n/a .a Depth of solids: n/a ` s'.. �� ep Comments(note condition of soil,signs,of hydraulic failure, level of ponding,condition of vegetation,etc.): 4t r, 't `� c• +t sf r � RC, Page 10 of 115 a i } u X+t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS i SUBSURFACE SEWAGE DISPOSAL`,SYSTEM INSPECTION FORM PART Q� SYSTEM INFORMATION(continued) Property Address: 321 OAKLAND RD BARNSTABLE,MA 026014 Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE ` } • Date of Inspection: 2/1/02 t �.y SKETCH OF SEWAGE DISPOSAL SYSTEM ✓j + v ,t • i Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks10 r F ' h Locate all wells within 100 feet.Locate where public water supply eptters the:building. '. 1 ra,n� k 77, 6 F � 4 � � :. ; /df w(\1 F AC 5n a. z 31 r F ' L f " 1n • ' Page 11 of I 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL�SYSTEM INSPECTION FORMAN PART C;` �} SYSTEM INFORMATION(continued) �;yL. �'*aA Property Address: 321 OAKLAND RD BARNSTABLE,MA 02601 4 Owner: C/O VINNIE DOLIMPIO AT KINLIN GROVER REAL ESTATE s Date of Inspection: 2/1/02 .; SITE EXAM Slope _Surface water ; : _Check cellar ' Shallow wells a Estimated depth to ground water 12+feet ! Please indicate(check)all methods used to determine the high ground water elevation: ': ' ' NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a _ � i YES Observed site(abutting property/observation hole within 150,feet of SAS) ' NO Checked with local Board of Health-explain: n/a NO " Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a 4 i You must describe how you established the high ground water elevation: ' L-- y DETERMINED BY HAND AUGER- 12+FT. 1 S � Y l. if f j ;i G=x�fr ptr. :;. R " 3 , < x.. P W 1110\,"EA NI LTH OF ASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON AiA 0210E (617) 292-550o TRUDY CONE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Adfeu:321 Oakland.. Rd.. ,Hyannis Name of owner Beverly Cohan �+ Address of Owner: c;n m p Date of Inspection: Name of Inspector:(Please Print) Wm. E . Robinson Sr . I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: V 1 C e Mailing Address: OX ;°, e Yl 2 V 1 1 e, 1VIH Telephone Number: 7 7 5T8 7 7 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails �` Inspector's Signature: w Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS �? �ECEIVEO r JUN 1 8 1999 TONM OF IWIVAU S HEALTHDEK A, revised 9/2/98 Page Iorll £ �' ;� Prm.ied on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART A 1 CERTIFICATION(continued) 'ropertyAddress321 Oakland. Rd.. , Hyannis , MA - Jwrw: Beverly Cohan Date of Inspection: INSPECTION SUMMARY: Check O B, C, or D: A. SYS PASSES: ' I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYS EM CONDITIONALLY PASSES: 0 e or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon co pletion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, o, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",'explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. 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). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken of obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/2/98 4,.A. + Page2ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued). Property Address: 321 Oakland. Rd.. , Hyannis, MA Owner: Beverly C oh ° Date of Inspection: C. 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 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 AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and 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 presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). OTHER revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropertyAddress:321 Oakland. Rd.. , Hyannis , MA Owner: O Bute yCohan Date of Inspection: S / 5' ' D. S STEM FAILS: You mu t indicate either "Yes" or "No" to each of the following: have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this etermination 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. E. LARGE SYSTEM FAILS: You must in icate either "Yes" or "No" to each of the following: Th following criteria apply to large systems in addition to the criteria above: Th 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 he Ith and safety and the environment because one or more of the following conditions exist: Yes o 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 owne+r or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of I e Department for further information. revised 9/2/98 Page 4of11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 321 Oakland. Rd.. , Hyannis, MA Owner: Beverly Cohan Date of Inspection: 16—19 7 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No, Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks an&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 NIA. _ 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. V — All system components, excluding 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: v 1 Existing information. For example, 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)) _ The facility owner (and occupants,if different from owner) were provided with information on the proper nwintanance f SubSurface Disposal Systems. . revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION $Fop"Address:321 Oakland. Rd.. , Hyannis, MA Owner: Beverly Cohan ' Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:5, 0 g.p.d./bedroom. Number of bedrooms (design):,3 Number of bedrooms (actuap�I- Total DESIGN.flow :34 0 Number of current residents:- Garbage grinder(yes or no):.,�,O Laundry(separate system) (yes or no),46; If yes, separate.inspection required Laundry system inspected.(yes or,no) Seasonal use (yes or no):LO Water meter readings, if available (last two year's usage(gpd): 1998 30, 000 gal Sump Pump(yes or no): 1'0 1997 30, 000 gal. Last date of occupancy: /� COM ERCIALIINDUSTRIAL: Type f establishment: Design flow: gpd 1 Based on 15.203) Basis o design flow Grease t ap present: (yes or no)_ Industria Waste Holding Tank present: (yes or no)_ Non-sani ary waste discharged to the Title 5 system: (yes or no)_ Water ter readings,if available: Last da a of occupancy: . OTH :(Describe) Last a of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no) VZ:'g If yes, volume pumped:,o�®-'0-6 gallons / Reason for pumping: �6i'rYLo L, ✓t G /C- TYPE 0 YSTEM 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 Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other !�y APPROXIMATE AGE of all components, date installed(if known)and source of information: ��'�.iP S! ✓ lQ. Z f2 Se j. Sewage odors detected when arriving at the site: (yes or no)/L revised 9/2/98 Page 6of11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'roperty address:321 Oakland. Rd.. , Hyannis, MA , Owner: Beverly Cohan Date of Inspection: BUIL ING SEWER: (Lo(al on site plan) Depth elow grade:_ Materi I of construction:_cast iron_40 PVC_ other(explain) Dista a from private water supply well or suction line Diam ter Com ants: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ (locate on site plan) i Depth below grade:.Z- Material of construction:_ oncrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age_ Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: Sludge depth: Q Distance from top of sludge to bottom of outlet tee or-baffler e , 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 dimensions were determined: 'omments: v (recommendation for pumping; condition of inlet and utlet tees or bafflers, depth of liquid I vel in relation to outlet invert, structu al integrity, evidence of leakage, etc.) e ��f GR E TRAP: (locate on site plan) Depth elow grade:_ Materi of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimen ons: Scum ickness: Distan a from top of scum to top of outlet tee or baffle: Dista a from bottom of scum to bottom of outlet tee or baffle: Date f last pumping: Co ants: (reco mendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evide ce of leakage, etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Aroperty Address: 321 Oakland. Rd.. , Hyannis, MA . Owner: Beverly Cohan Date of Inspection: 6-z1V-- V Pl TIGHT OR HOLDING TANK:. (Tank must.be pumped prior to, or at time of, inspection) (locat ,on site plan) Depth b low grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(explain) Dimensi0 s: Capacity: gallons Design fl w: gallons/day Alarm pre ent Alarm lev k Alarm in working order: Yes_ No_ Date of p evious pumping: Commen (conditio of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:r-",/ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equ I, evidence of solids carryover, evidence of leakage into or out of box, etc.) - PUMP CHAMBER:_ (locate on site plan) Pumps in working order:(Yes or No) Alarm in working order(Yes or No) Com ents: (note condition of pump chamber, condition of pumps and appurtenances,etc.) revised 9/2/98 Page 8orn r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM f PART C SYSTEM INFORMATION(continued) 'rop"Address: 321 Oakland. Rd.. Hyannis , MA Owner: Beverly Cohan Date of Inspection:S Q / SOIL ABSORPTION SYSTEM(SAS):�+/ (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number:)— leaching chambers,number:_ leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failures level of ponding, damp soil, conditi of�vegetation, etc.) / J® lip E 7' i".3 Tl -n .tom CESSPOOLS:_ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: )epth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comma; ts: (note co dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate n site plan) Materi s of construction: Dimensions: Depth f solids: Com ants: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) property Address: 321 Oakland. Rd.. , Hyannis, Y.A. s . )caner: Beverl C�ghan Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) QoGa �� co revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) top"Address:321 Oakland. Rd.. , Hyannis , MA Owner: Beverly Cohan Date of Inspection: NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells X Estimated Depth to Groundwater LP`C L Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site (Abutting property, observation hole, basement sump etc.) Determined from local,conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) revised 9/2/98 Page 11of11 TOWN OF BARNSTABLE LOCATION 3 r). 1 0,6 �,�o� '�� SEWAGE # VILLAGE p ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITYId-0-0 a-✓ LEACHING FACILITY: (type) &f=± ?�,P `� (size) 44% NO.OF BEDROOMS 3 BUILDER OR OWNER G PERMITDATE: COMPLIANCE DATE: 27 Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 wetlands exist . within 300 feet of leaching facility) Feet Furnished by T b l v � T V ` L TOWN OF BAIUJSTABLE 1J , LOCATION �n SEWAGE # `TILLAG ^4ASSSESSOR'S MAP & LOT��I"" INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size)(s NO. OF BEDROOMS � 1 Gt)Cn BUILDER OR OWNER 1 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 wetlands exist within 300 feet of leaching facility) Feet Furnished by �C,� G� ���� 5 m- 3 No. a" v. Fee$50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pprication for �N.5paal *pgtem Conelruction Vertu Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components c lion Address or Lot No. Owner's Name,Address and Tel.No. Oakland Rd., Hyannis , MA Beverly Cohan Assessor's Map/Paz el 1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E . Robinson Septic Service M-99 61089, Centerville , MA Type of Building: Dwelling No.of Bedrooms 3 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 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil S and. Nature of Repairs or Alterations(Answer when applicable) New 1 , 500 gal. tank and. D-b o x Connected to existin�g leachpif . 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 Certifi- cate of Compliance has been iss ed by this o of Health. Signed 6 Date Application Approved b Date a—FTP� �` Application Disapproved for the following reasons CC Permit No. Date Issued „•. s .-Ak No. �' '� m Fee$5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ” Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ., ZlppYtcation for 33ioaal *pgtem Construction 'Permit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components c tion Address or Lot No. Owner's Name,Address and Tel.No. � Oakland. Rd., Hyannis, MA Beverly Cohan Assessor's Map/Parcel / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service M-Pff61089, Centerville , MA Type of Building: Dwelling No.of Bedrooms 3 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 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Sand h } Nature of Repairs or Alterations(Answer when applicable) New 1 , 500 gal. tank and D—box connected to Pxisting IPanhnit . 1 ! 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 Environmental Code and not to placethe,system in operation until a Certifi- cate of Compliance has been iss ed by.thj§,Aoar4Kof Health. Signed •:` Date Application Approved b Date '`.� �I Application Disapproved for the following reasons Permit No. Date Issued f ' — —————————— THE COMMONWEALTH OF MASSACHUSETTS Cohan BARNSTABLE, MASSACHUSETTS, r! .,,. (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal SysterrrPCon cted Repaired,,( )Upgraded( ) Abandoned( )by Wm. E. Robinson Septic Service 321 Oakland. a. , Hyannis, v at has been construc!0 in accordance with the provisions of Title 5 an the for Disposal System Construction Permit No. .c dated Installer fP IF,&A7 j- f(i�S'6/f/ Designer 1 The issuance of tha permit shAll not be construed as a guarantee that the syste as desiYI o4d. Date 61 1 Inspector 11-function ,� �� ��T� --- ------------------------------Fee $50 — THE COMMONWEALTH OF MASSACHUSETTS Coharm PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS xiqoal *pWm (fongtruction Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) Systemlocatedat 321 Oakland Rd. , Hyannis, M 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. Date: <.5 Approved b NOTICE: This Form Is To Be Used For The Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated / v y concerning the property located at 321 Oakland Rd., Hyannis, NM meets all of the following criteria: There are no wetlands within 100 feet of the proposed leaching facility. _rTThere are no private wells within 150 feet of the proposed septic system. T ere is no increase in flow and/or change in use proposed. here are no variances requested or needed. -� If the proposed leaching facility will be located with 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Evaluation(according to Health Division well map) l� SIGNED:�f i^�—( �—�✓ ✓� DATE (� V LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be subrgitted). i rn i r AsBuilt Page 1 of 1 i TOWN OF BARNSTABLE LOCATION I Dc el e .41 'ea'/ SEWAGE# 95 -d- VILLAGE � l�1)�5 ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) 9,Ai,l� NO.OF BEDROOMS 3 _ BUILDER OR OWNER �- PERMUDATE: `I COMPLIANCE DATE:19 7 C:J Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Fat Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by l' a a7 N http://issgl2/intranet/propdata/prebuilt.aspx?mappar=271092&seq=1 9/7/2011 t 0 C T ION SEWAGE PERMIT N0. VILLAGE /�aM�-o�7`4�i•(,c.. � /�'Yam.�w�f INS:V LLER'S NAMEA ADDRE S -�G.ctit� Gtl d- U Of D E R ; OR OWNER - io. DATE PERMIT I S S V E D DATE COMPLIANCE ISSUED / /�/ � S Q J No. ` • Fps �. ... .....— THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH O.�✓N.................OF......... f�.!ZK.S�ff 1 ........................................... Appliratiun for Bi-quiff al Works Tamitrurtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ----- --------- A��... ------- .........'...........................�,�.2............................................. ���p��� Location-Address or Lot No. 1.!. ._... .. ....-•-------------••....................•..... ..........--...................................................................................... -------Owner ------------•---•-••-•---••-•--_Address Installer Address Pq UType of Building Size Lot../P `I,_ Ms"_____--•Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building No. of persons............................ Showers — Cafeteria d Other fixtures --------------------------------- - � � W Design Flow..............lld.......................gallons per per day. Total daily flow---------RjRa___.._...._..__..__....__gallons. % If WSeptic Tank—Liquid capacity.2l9_oo.gallons Length_L/'._!/"_ Width---6.-'-es.... Diameter________________ Depth-S'1.4.... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--____-:�r---------- Diameter--------/0------- Depth below inlet........4_....... Total leaching area...R.21.....sq. ft. Z Other Distribution box ( v) Dosing tank ( ) '-' Percolation Test Results Performed ................. Date..' . . 14 Test Pit No. 1.... 2.....minutes per inch Depth of Test Pit..... Depth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------•-------.....----•-------...-----------------•------....---•--•---.--............................................................. O Description of Soil--C�---.3G�-"--?�A�!..�..S6t�.� 1�_ . fir."_-/D8-••_/�1D---.� N�..G�J..�rttut�..�..I�!.�r------ U ---------------•--••--•--• l.3tt.AtA.S— _./S.l�..':.G�.L Js[ 1!���2.._..SrS�I1tD_�__.1Y�Q J9 .d--- --••---- W --------------- .......... ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U •Nature of Repairs or Alterations—Answer when applicable_________________________________________________________________________________•--_.--_--__-. ---------•-----------------------------------------------•---•-----------•--------•••.._....-••-••---•-._.........------------•--------•-------------••-----------•---•---••-•--••••-•••--•-•......... Agreement: The undersigned agrees to install the aforedescr' ed Individual Sewage Disposal System in accordance with the provisions of=PU 5 of the State Sanitary Co — e u de igne .!t rtl:er rees not to place the system in operation until a Certificate of Compliance has bee ss b e b rd .... Date Application Approved By •--•-----• ---•- -------•---- ••. .............................................. /-" ) Date Application Disapproved fort oll g reasons: • ..... .................... _........-•--•-----------------------•---•---•--...---------------------------------••-----•-------------------........................................................�•.........-------------•--•---- U «..- Date PermitNo......................................................... Issued....................................................... Date L/ 7 Y No................_....... t FEs............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applirtttion for 15ispnottl Works Towitrnrtinn Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: •--------——------W--- ! - .. .....or -----....•----•-•-----•----------•-•--•-• A� Location-Address ......... _. ...............Lot No. a C) /k Owner Address Installer Address Type of Building Size .........Sq. feet U Dwelling—No. of Bedrooms.......................................::...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----•-----••----------------•-• • ....................... Design Flow..............C� '...•........•....._....__gallons per person per day. Total daily flow.........r"'^'?.........................gallons. WSeptic Tank—Liquid capacity.? �'e.gallons Length.Z1'...!L Width__f,_:�_- Diameter________________ Depth....:..t....:-. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._---_-_--=---------- Diameter........ 2....... Depth below inlet........r':..:...... Total leaching area....:.."'.....sq. ft. Z Other Distribution box ( .-) Dosing tank ( ) Percolation Test Results. Performed by...Z::...'r......_...: ':......... .... _/_'-..------------------ Date..` _l_......./_...e1............. as Test Pit No. 1... __.=---_-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........................ Rik ....-•-••-••-•--•••---------•-••-•--.......•-•-•............................•-----------...-- ......--•--------••-•--••...._-•--•-•-•.........-••---....... O Description of Soil - =................. --------------------------------,.........................................'!=-----------------".........-----------------------•---•---........ --- �i i.. . a r. r....................................................a r. ..i ( 1 W .....................------•-----•....._........•----------...............•----•---------•---•---------._.._........•---------------•-----•-••••••--•-••••-••--••-•--••---............................ UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescrilie I Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— he unde igned"further grees not to place the system in operation until a Certificate of Compliance has been/is s b I band o 'h'r �. -• . :- ••-• --------- ---- -• ...................................... -- Date Application Approved By.... .......... ..._...w. ---------------------------------------- Date Application Disapproved for t ff oll • g reasons------------------------------------------------------------------------------------------------------•••---•-- --•------•----•-----•--•-•-••---------•-•••--•-•....•---•---•---•-•---•-----•-----------•...-•-.......--•••---•----•---•-•-------•---•---•-•-••--•--•--------------•-----------• ...................... Date PermitNo......................................................... Issued.-•------------------------------------ " Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O�F ' EAL�TH ..........................................ft � OF..................... ..,?,''.. , eC....................................... �r�ifirtt#r ,af f�:unt�littnrr TH b$Pi (;,URTIFY, That the Individual S wage Disposal System constructed ( or Repaired ( ) ....... nstaller --------- .. t nstaller has been installed in accordance with the provisions of TIT e,State San I,F >oT itary Code as described in th application for Disposal Works Construction Permit No-------9(/............... dated-.--------- "�... 4�-1 THE ISSUANCE OF THIS. CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................. Z' �1f11- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OFjWEALTHH �s !/� '� 't-'�. -Iee.._............................ No.......O.. / FEE............... �t��trr�l��rk� �nn,��nr�inn rrntt'� Per>ss,.on is ereby.granted----------------------------------------•-••------------------------------------------------------------.......-•-•--•-•••-.............._._.. to Const fair ( ) an •v�71 e-" e Disposal System '.uat No. . -•---... :. .................................... - -------- Street «: x 4 f as shown on the application for Disposal Works Construction Permit -__-_•----_______ D'ated.......................... ` - ----- ----- /ij M 31, Board of Health DATE ......................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No, r i - :S-;5 Fss....IQ._............ f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABL" E- r Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal System;at: ,.---1 ls---------------------------------- ------------•---------..._..---------.........._...._..------_------------_------..........------. dress Location Ad or t No. _-0Q RFIA:__1�9�CA -----•--------------=•--------------------------------- Z!..0 .�.l ._ � , .._ rams ................... Owner Add ess ............................................................ ���._M4 !3._ r.+e�...WRA. leac�tau�:W_.._......------------. Installer Add s dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( } Garbage Grinder ( ) '4 Other—T e of Buildingt............................ No. of persons____________________________ Showers — Cafeteria 0.' Other fixtures -------------------------------- - d -------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length________________ Width-----------_-- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water______-_______________-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ----........................................................................................................................................................ 0 Description of Soil...............................................................................:........................................................................................ x W ------••-•-------------------------------------- ------------••••---•-----------------•--------------------- ----------••------------------------ ------ UNature of Repairs or erat-o s—Answer when applicable__IK21�XY___lGt.00j4t.Q_. .�� "._li,?�.4 n,e+__Ca►s____.__.. .1, �?=- --. ----------------------------------------------------------------------------------------------------------------------------------•-- . Agreement: The undersigne agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance een issued by he board of health. Signed ........... u. ....... ---------- ------------------------ - -------- ............ . .•. Dace .. Application Approved By --- ------ ` - = - - ---- ---------------------------- ------...... .....kzL.`m---ant�� Application Disapproved for the following reasons- -----------.......................................--------------.................................................................... .................................................................................................................................................. ..............Dace------------..... _ r- Permit No. ............ /qq...........76- ---------------- Issued ------.....-----------...----....------------------ ---------- Dare No. •-- _..... ..... # THE COMMONWEALTH OF MASSACHUSETTS & BOARD OF HEALTH � TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrurtion j[rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -` •...............................................•-- .32-1.CXL_ � _. Q1._.. �.�� ---------------------------------- -= - n�I 11 Location-Address + / or Lot No. ---`•GyRf��CLjor .... ......... .._ �����..._"U `Y cnnlS �A. .................. owner 35�.Mli-n.S r � ,.l a c-� +� ------------------••--- d,,,.,--.Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 ' Other—Type of Building No. of persons---•------------------------ Showers — Cafeteria P4 Other fixtures ......................................... W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity_:..........gallons Length---------------- Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.............._..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. ` Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by......................................................................... Date........................................ ,.-1 i ,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-___--__-__-_-__-_..,__. Test Pit No. 2................minutes per inch Depth of Test Pit____-_----..___--_-- Depth to ground water........................ a, 0 Description of Soil............................................................................... x i W ' ...•--------------------------------------------------------------------------------------------------------------t ------------ - UNature of Repairs or aerations—Answer when applicable. -151W-__l0-poa--- scscL-.�gi ..lu�s o----_c�........ rp ��� --- ----------------------------------------••------------•------...------. -, Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with • the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as-been issued by the board of health. Signed............�SoF -G---- c,44s l.?.:..7.:89..--------.. (/ ..\. � Application Approved BY r . --.. / } --- ------------------------------"--"------------------....---... - t -�ce/� 7 ' Application Disapproved for the following reasons- -------------------------- .................... .......................................-...................'..................... ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- Q e� Date PermitNo. ------------<1...1....--------7---,,tom-...-------_-_-- Issued ---------- ..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 7 Tierttfira e of Grayltnure THIS IS TO CERTIFY, T t the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY ------------------------ -- -------------------------- ...................................... .................... �`-/�--------- / / Installer at -------------.3 ---------- .. 4.1�--1 1�1. .. ,%.v... .... 4�has been installed in accordance with the provisions of TITLE 5 The State Environmental Code as described in the application for Disposal Works Construction Permit No. .:-.--- r�-..._...--. dated ................................................ PP P �:��---&- - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE,THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.... '.''", t' i p y Ins ect --- -'----- iyG�A� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE _ No..1:.7 FEE....�G..-— �i��u�ttl urk� �un��r�r#iun rrntif Permission is hereby granted----------4.t..6............... -•-•-----•---------------•--.................----•--•--.............. to Construct ( ) or Repair an Individual Sewage Disposal System at No........; -� Q l3. l C!c� v .................. -- -;Y tea. .. -•---•-----------•--------•---. �--...------•-----....-- Sireet QQ as shown on the application for Disposal Works Construction Permit N .I!I``� - ---- Dated.......................................... ............................ .__ __--.---------.............-----................-••...---- DATE. ....................... v Board of Health FORM 36508 HOBBS dt WARREN.INC.,PUBLISHERS _ 4 LEGEND HYANNIS i . --� PROPOSED CONTOUR o ® PROPOSED SPOT GRADE p EXISTING CONTOUR 0 + 96:52 EXISTING SPOT GRADE W— EXISTING WATER SERVICE z o ROUE 28 TEST PIT LOCUS a t SCALE 1"=20' } Z o o u, Ct 1, >� i LOCUS MAP — — 194.63' o - f� - - - LOCUS INFORMATION • ` PLAN REF: 132/085 TITLE REF: ---- LOT q PARCEL D: 2571 271 056 ----------- LOT 092 rn- `- ------ vent r AREA = 18951 sf+- ; FLOOD ZONE: "X" i PLAN epp 132 PEE 85 O Cj```f✓� ° COMMUNITY PANEL: 25001C0562J OATED:07/16/14 _, 7:C; I aSR MAP271 PcL 92 ' 32•° _ `nn� � SEPTIC SYSTEM REPAIR PLAN s y o ( . \� LOCATED AT: 0� OAKLAND ROAD- ' rpp-35 �, HYANNIS, MA k 20 ft \ c PREPARED FOR BENCH MARK CESAR MATA/ TOP OF FOUNDATION .. } -.- EXISTING \� READY ROOTER EXC. 60. 53 DWELLING °' DECEMBER 20, 2017 BARNSTABLE GIS DATU EXIST. 1,50OG TOP OF FN D!l ' SEPTIC TANK EL = 60.53+ - OF A R PLAN _ , �� I m I o. 1140 SCALE: 1 in = 20 ft rp-, t 0 20 40 ` G rp 2 o m <. I i i m QNI TAWO m I i, 0 10 20 40 8 rrio D D > I MEYER & SONS, INC. I 15',4.34 ! P.O. BOX 981 EAST SANDWICH, MA. 02537 EDGE OF PAVEMENT PH: (508)362-2922 O A K LAIN D R O /�/A D FAX: (774)413-9468 meyerandsonstitle54gmail.com SHEET 1 OF 2 J 1855 NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE; TO PREVENT BREAKOUT, THE PROPOSED FINISH GENERAL NOTES: TOF SEPTIC TANK GRADE SHALL NOT BE < EL:56.0 FOR A DISTANCE INSTALL RISERS & COVERS OVER INLET & 15' AROUND THE PERIMETER OF THE S.A.S. PROPOSED D-BOX 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL EL=60.53t OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED S.A S +' f BOARD OF HEALTH AND THE DESIGN ENGINEER, , INSTALL RISER & COVER INSTALL LOCKING COVERS IF AT FINISH GRADE INSTALL A RISER OVER ONE CHAMBER MIIN SET TO 6" OF GRADE ( ) 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS F.G. EL.=60.Ot AND SET TO 3 OF F.G. , OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE F.G. EL.=59.70t F.G. EL: 59.80t LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: F.G. EL: 60.0(MAX.) VENT • - 310 CMR 15.405 (1) (B): 1) A:3.00 FT. VARM CE FROM 310CMR15.221(7) TO ALLOW LEACHING • TO BE 4.00 FT /VE11T PROVIDED) ' '•- 9" MIN COVER/ ..' I - (MAX)( ) BELOW GRADE VS FT. H2O ` 36" MAX COVER L = 25' L = 25'(MAX) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 0 S=1% (MIN.) EL=56.94 ® S=1% (MIN.) ® S=1% (MIN.) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 2" OF 3/8" DOUBLE WASHED DESIGN ENGINEER. STONE OR FILTER FABRIC :r 3/4" - 1-1/2" 4• ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ' t0` DOUBLE WASHED STONE FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �• INV.=55.90 to a ENGINEER BEFORE CONSTRUCTION CONTINUES. 48"UQUID �INV.=55.65 ®�®® Q ®®®® 5..ALL ELEVATIONS BASED ON ASSUMED DATUM. LEVELPROPOSED ®®®®®®®®®®® 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF dt : GAS BAFFLE ®I 31aama ®®®® THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF INV.=55.20 ®®®®®®®®®®® HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. INV.=55.40 DB-5 7. DWELLING IS SERVICED BY MUNICIPAL WATER: 4� EXISTING 1.500 GALLON SEPTIC TANK ) 3.2 +: 3 X 8.5' 3.25' 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE EXIST. SEWER OUTLET EFFECTIVE LENGTH = 32.0 LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK. INV. ELEV.= 55.0 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PIPE INVERTS PRIOR 70 CONSTRUCTION BREAKOUT 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY EL, 56.0 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY GRADE 2) BOX SHALL SET LEVEL AND TRUE TO TOP CONC. ECEV.= 56:0 13. NO KNOWN PRIVATE WELLS WITHIN 100 FT. OF'PROPOSED LEACHING GRADE ON A MECHANICALLY HANICALLY COMPACTED SIX INV. ELEV.= 55.0 !!7 14. ALL PIPING TO BE 4" SCH 40 ® 1/8-/FT (UNLESS SPEC. ) INCH CRUSHED STONE BASE, AS SPECIFIED IN r 88a 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW 310 CMR 15.221(2) E3E310 FOR THE USE OF A GARBAGE GRINDER. 3) REPLACE EXISTING 1,500 GALLON SEPTIC TANK BOTTOM EL.= 53.0 ®a t 4' 516. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING WITH 1500 GALLON SEPTIC TANK IF FAILED, tDAMAGED, NOT H2O LOADING, OR UNDERSIZED. SEPARATION 4.00 FT. I EFFECTIVE 4) INSTALL INLET & OUTLET TEES W/ GAS BAFFLE AS REQUIRED BOTTOM OF TESTHOLE EL 49.00 SOIL ABSORPTION SYSTEM (SECTION) - SEPTIC SYSTEM PROFILE GROUNDWATER PER GIS EL. 30.0 (500 GALLON (H-20) LEACH .CHAMBER) OF M,gssq� N.T.S. DESIGN CRITERIA o� DARR IotJ s # NUMBER OF BEDROOMS: 4 BEDROOM DESIGN No. 1140 "' SOIL LOGS SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) DESIGN PERC RATE: <2 MIN/IN DATE: AUGUST 1, 201 1 DAILY FLOW: 110 G.P.D. X 4 BR DESIGN FLOW: 440 G.P.D. ' aSANITAR�a� GARSAGE GRINDER: NO (not designed for garbage grinder) SOIL EVALUATOR: CRAIG A. FIELD 1 WITNESS: DON DESMARAIS, BARNST. HEALTH a` SEPTIC'TANK: 440 gpd 'x 200% 880 gpd RE-USE EXIST. 1,500G SEPTIC TANK LEACHING AREA REQUIRED: (440)/0.74 594.59 S.F. , Elev. TP-1 Depth Elev. TP-2 Depth Elev. TP-3 Depth Elev. TP-4 Depth 59.00 LOAMY SAND o" 59.10 LOAMY SAND 0" 59.60 LOAMY SAND 0" 59.60 LOAMYkSAN o" USE THREE (3) 500 GALLON H-20 PRECAST LEACH CHAMBERS 2.5Y 5/1 W 3.25' STONE ON ENDS AND `4' ON SIDES: 32' L x 13' W x 2' D 2.SY 5/1 10YR 4/3 10YR58.42 7" 58.606" 59.10 6 59.10 6"B LOAMY SAND B LOAMY SAND B56.92 1oYR s/s 25„ 1oYR s/s LOIOYR ArY S�o B t 10AMY ri . C 1 57.10 C 1 24" 58.42 14" 58.42 I 14 BOTTOM AREA: 32 x 13 = 416 SF MEDIUM MEDIUM C 1 MEDIUM C 1 MEDIUM 1 ` 2.5YND 2.5Y SAND 2.SANDj6 2sAND SIDE AREA: (32 + 13) X 2 X 2 ' 180 SF 56.25 33" 56.28 34" 56.78 34"• 56.78 34" . TOTAL SQUARE FEET PROVIDED. = 596 vs. 594.59 REQ'D C2 FINE - C2 FINE - C2 FINE C2. FINE - DESIGN FLOW PROVIDED: 0.74(596 S.F.) = 441 G.P.D. vs. 440 G.P.D. req'd MEDIUM MEDIUM MEDIUM MEDIUM t SAND SAND SAND SAND 2sY 7/2 2.5Y 7/2 2.5Y 6/4 _ 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 49.00 120' 49.10 120' 49.60 1 120' 49.60 120' MA HYANNIS,PERC RATE <2 MIN/IN. (`Ct." HORIZON) PERC RATE <2 MIN/IN. ("Ct' HORIZON) <� 321- OAKLAND ROAD, • NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED Prepared for: Mata Ready Rooter Exc. f System Design and Topography Plan by: SCALE DRAWN DATE MEYER BSONS,.INC. N.T.S. DMM 12/20/17 1, Darren M. Meyer. R.S:, CSE, hereby certify that I am currently approved bLbyme EP pursuant to 310 CMR 15.017 PO BOX981 n to conduct soil evaluations and that the above analysis has been performed consistent with the REV GATE CHECKED SHEET N0. EAST SANDWICH,AM 02537requirements of 310 CMR 15.017, I further certify that I have Dossed the al. Exam in October. 1999. 508-W-2= OMM 2 of 2 i REVISIONS 1 500 GALLON SEPTIC TANK (EXISTING) DISTRIBUTION BOX DETAIL (DB-6) ARC 36 LEACHING CHAMBERS NO.� DATE DESCRIPTION SOIL TEST PIT DATA - NOT TO SCALE NOT TO SCALE NOT TO SCALE NOT TO SCALE REMOVABLE 5" 4" COVER NOTE TEST PIT TP-1 TEST PIT TP-2 TEST PIT TP-3 TEST PIT TP-4 �' RAISE AT LEAST ONE " 114.0 GRD. EL. 114.2 GRD. EL. 114.4 1. INLET AND OUTLET TEES SHALL BE INSTALLED EXISTING COVER TO WITHIN NOTES' GRD. EL. 113.9 GRD. EL. 6" of FINISHED GRADE IN EXISTING TANK O 3" O 26" 1. DIST. BOX TO WITHSTAND H-20 LOADING. tEE SHEET 2 SHGW EL. 103.9 SHGW EL. N A SHGW EL N A SHGW EL. N A USING SEWER eRiC1C AND GENERAL NOTES: i:T?T177T 1 TEES SHALL BE SCHEDULE 40 PVC AND SHALL MORTAR AS NECESSARY 2. PROVIDE INLET TEE OR BAFFLE WHERE A A A A BE LOCATED WITHIN 12 INCHES OF TANK WALL 6" MAX 13" SLOPE OF PIPE EXCEEDS 0.08 FT./FT OR 1. THIS PLAN IN ONLY INTENDED FOR THE LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND 3. ORANGEBURG PIPE TO BE REPLACED BY 4" PVC IN PUMPED SYSTEM. 2.5Y 5/1 2.5Y 5/1 " 10YR 4/3 " 10YR 4/3 j . r�i ,• , DESIGN AND CONSTRUCTION OF THE B 70 B g 5 6 (IF ANY FOUND). 3. FIRST TWO FEET OF PIPE OUT OF DIST. SEWAGE DISPOSAL FACILITY. g .B BOTTOM ON LEVEL } BOX TO BE LAID LEVEL LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND STABLE BASE L 2. ALL CONSTRUCTION METHODS AND 6" MINIMUM MATERIALS SHALL CONFORM TO 310 CMR 10YR 6/6 10YR 6/6 10YR 5/6 10YR 5/6 " " 4. ALL PIPE CONNECTIONS AND CONCRETE d: :"a ': ::a 3/ / CONSTRUCTION SHALL BE WATERTIGHT. 15.000 AND BARNSTABLE BOARD OF " " " SECTION VIEW 4 TO 1-1 2 ELEV=111.8 25 ELEV=112.0 14 24 ELEV=113.0 14 ELEV=113.1 16 CRUSHED STONE " = 5. FILL ALL UNUSED KNOCKOUTS WITH HEALTH REGULATIONS. C-1 C_1 C-1 C-1 PRECAST SEPTIC TANK a 10 - �= 3. THERE ARE NO KNOWN OR PROPOSED MEDIUM SAND MEDIUM SAND MEDIUM SAND MEDIUM SAND +.' MORTAR. LOCAL UPGRADE APPROVAL R E Q U E S TE D PRIVATE WELLS LOCATED WITHIN 150 FT. 2.5Y 7/3 " 2.5Y 7/3 " 2.5Y 6/6 " 2.5Y 6/6 " _ 6. CONCRETE COVER SHALL BE RAISED TO OF THE PROPOSED LEACHING FACILITY. 33 34 34 34 2 16 • WITHIN 6 INCHES OF FINISHED GRADE. 310 CMR 15.221(7): TO ALLOW A�( INCREASE IN THE MAXIMUM ALLOWABLE COVER OVER THE 4. IF AN OVERDIG IS SPECIFIED, REMOVE ALL i - LOCATE .e .I ' LEACHING CHAMBERS FROM 3 FEET TO 4 FEET. TOPSOIL, SUBSOIL AND OTHER INLET TEE 90' ELBOW ON a 24" I I 12" DIA. COVER UNSUITABLE MATERIALS. C-2 60" C-2 AND 66" r .} UNDER COVER OUTLET TEEI 5 ALL EXCIF AN AVATED ADIG TEDI MATERCIFIED, REPLACE IALS AlS WITHIN THE MEDIUM/FINE SAND MEDIUM/FINE S 2.5Y 7/2 2.5Y 7/2 C-2 C-2 �•>''::_:e F-::•e :e$.:': ::' a e_;''e:'' ::o (6) 5" DIA. KNOCKOUTS LIMIT OF EXCAVATION WITH CLEAN TIGHT / COBBLES MEDIUM/FINE SAND MEDIUM/FINE SAND iTYP• TIGHT Y 6 4 2.5Y 6 4 PLAN �(IEW GRANULAR SAND, FREE FROM ORGANIC 25 / / MATERIAL AND DFI.ETRIOUS SUBSTANCES:. I CROSS-SECTION VIEW N WA , � N A R " N .WA R N WA G �- 24" MIXTURES AND LAYERS OF DIFFERENT ELEV 103.9 = 120 ELEV 104.0 120 ELEV 104.2 120 ELEV 104.4 120 PLAN VIEW CLASSES OF SOIL SHALL NOT BE USED, I FILL SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A SIEVE DESIGN CALCULATIONS ANALYSIS USING A #4 SIEVE SHALL BE �� NOTES, ' PERFORMED ON A REPRESENTATIVE NO GROUNDWATER OR REDOXIMORPHIC SOIL EVALUATION. SIZE OF EXISTING SEPTIC SAMPLE OF FILL UP TO 454% SIEVE. WEIGHT FEATURES OBSERVED DURING 1. LOCATION AND S MAY BE RETAINED ON THE �t4 SIEVE. DESIGN FLOW: SUCH ANALYSES MUST DEMONSTRATE ESTIMATED °, SYSTEM COMPONENTS WAS OBTAINED FROM THAT THE MATERIAL MEETS EACH OF THE -Z SEASONAL HIGH RECORD PLANS ON FILE AT THE BARNSTABLE GROUNDWATER ONSITE SOIL EVALUATION HEALTH DIVISION. 4 BEDROOMS ® 110 GPD/BDRM = 440 GPD FOLLOWING SPECIFICATIONS: .10OX MUST PASS #4 SIEVE PERCOLATON BH 2. PRIOR TO COMMENCING ANY WORK, THE 1O% MUST PASS #50 SIEVE DATE: 8-1-2011 TEST RANGE CONTRACTOR SHALL CONFIRM THAT THE „BOTH REQUIRED SEPTIC TANK: 0-20X MUSS PASS #ao � SDI TEST BY: BSC GROUP. INC. HALL BUILDING SEWERS ARE `CONNECTED TO THE 0-5R MUST PASS #200 SIEVE WITNESSED BY: DON DESMARIAS, R.S. EXISTING SEPTIC TANK. . IF ANY OTHER 440 GALLONS X 200% 880 GALLONS 6. EXISTING UTILITIES WHERE SHOWN ON THE LICENSED SOIL EVALUATOR: CRAIG A. FIELD, PLS. UNSUITABLE CONDITION IS FOUND THEN THE CONTRACTOR MATERIALS � � SEPTIC TANK PROVIDED = 1,500 GALLONS (EXIST) PLANS ARE APPROXIMATE. THE ENGINEER PERCOLATION RATE: < 2 MINS./INCH (TO BE REMOVED) BED BED SHALL CONTACT BSC GROUP AT (508) DOES NOT GUARANTEE THEIR ACCURACY SOIL CLASS: CLASS 1 ,#4 #3 778-8919 IMMEDIATELY. OR THAT ALL SUBSURFACE STRUCTURES LT.A.R.: 0.74 GPD/S.F. SIZE OF LEACHING FACILITY REQUIRED: ARE SHOWN. CONTRACTOR SHALL VERIFY 3. CONTRACTOR SHALL INTERCONNECT ENDS OF THE SIZE, LOCATION AND ELEVATION OF CHAMBERS WITH 4" SCH. 40 PVC PIPING. DESIGN PERC. RATE: <2 MIN/INCH INVERTS OF UTILITIES AND STRUCTURES, SECOND FLOOR LONG TERM APPL. RATE: 0,74 GPD/S.F. WITHIN THE LIMIT OF WORK, PRIOR TO THE � START OF CONSTRUCTION. IF ANY DATUM 440 GPD = 0.74 GPD/SF = 595 S.F. DISCREPANCIES ARE DISCOVERED OR FIELD N76.20'30-W CHANGES REQUIRED, THE CONTRACTOR �09.25' SIZE OF LEACHING FACILITY PROVIDED: SHALL NOTIFY THE ENGINEER IMMEDIATELY. VERTICAL DATUM: ASSUMED 7. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PROPERLY COORDINATING THE BENCH MARK SET: NAIL IN 15" .OAK TREE PROPOSED CONSTRUCTION AC�nvinEs MATH DECK USE (27) ARC 36 CHAMBERS IN FIELD DIG-SAFE AND THE APPLICABLE UTILITY ELEV. 115.47 CONFIGURATION COMPANIES, AND SHALL COMPLETE THE FAMILY �► / PROPOSED,.WORK WITHOUT ANY ROOM w % IN ACCORDANCE W/ GENERAL USE APPROVAL INTERUPTIONS IN SERVICE. SYSTEM PROFILE 4 • AREA = 4.8 SF/LF 8. CONTRAOTOR IS REQUIRED TO NOTIFY - . • BH ' �� � THE EFFECTIVE LEACHING DIG-SAFE, PER MASS. STATUTE CHAPTER NOT TO SCALE -- ' 27 UNITS X 5.0 LF/UNIT X 4.8 SF/LF = 648 SF 82, SECTION 40 (1-888-344-7233) A N •• l r ;� M" F 1 HOURS PRIOR TO TH" 40 SCH. 40 PVC aC #321 ° 3 ROWS WITH 9 �INITS/ROv,y �,a3MUla 0 2 L-25 FT. g EXISTING EL=A S-0.017 BH BED W 4 BEDROOM START OF CONSTRUCTION. TOP FOUNDATION VENT KITCHEN DWEWNG 648 S.F X 0.74 = 479 GPD FIRST PIPE LENGTH OPEN #1 f 9. THIS SYSTEM IS NOT DESIGNED FOR THE TO BE SET LEVEL GARAGE AREA 274 DECK TOF=115.08 • O P USE OF A GARBAGE GRINDER. EL•=114.1, 4" SCH. 40 PVC. FOR MIN. 2' -- INv=111.78 ; 479 GPD PROVIDED >` 440 GPD REQUIRED 102' 0 1.02X FINISH GRADE s - _ O INSTALLATION OR USE OF A GARBAGE 4" PVC SCH 40 BED • GRI ALLOWED PER 310ER AT IP CMR 1 240(4).ROPERTYIS T LIVING #2 w{R SFRv // Qa ,� • �As S` ew i ZV LOCUS INFORMATION- ROOM 1=g =D I=G H LEACHING FIRST FLOOR v GROUP 1=C I=E1=FCHAMBERS < ; CURRENT OWNER: KEUNG YAU FLINGBSC5 OUTLET GARAGE ; , SU ZHENG ZHEN ;r 5.1 SEPARATION D-BOX EXISTING 1,500 GALLON :� o '� � O � 349 Route 28, Unit D W. SEPTIC TANK PER TITLE 5 TITLE REFERENCE: DEED BOOK 14960, PAGE 350 INSPECTION ESTIMATED S.H.G.W. u' v� 02673 mouth, Massachusetts EXISTING 1, l PLAN REFERENCE: PLAN BOOK 132, PAGE 85 r�oTE: EXISTING FLOOR PLANS ° ° TANKLLTo REM N ON SEA 5087788919 ASSESSORSPARCEL: 921 ©2011 BSC Group. Inc. MAGNETIC REFLECTIVE TAPE SHALL BE PROVIDED NOT TO SCALE (PING � � T IN THE TRENCH OVER ALL PVC P -�.w•� OBSERV. ° - PORT -:< ZONING DISTRICT: RB ® o y' SETBACKS: FRONT 20 PROJECT TITLE: o TP-1 ;� SIDE 10' SCHEDULE OF ELEVATIONS PROPOSED _31 s ��-� VENT � REAR 10' DESIGN FOR 10.g• 2 MINIMUM LOT SIZE: 43,560 S.F. SEWAGE . DISd'OSAL TOP OF FOUNDATION 11 .08 A ExtsTlNc LOT AREA: 1ss52t S.F. - ° TP-4 TP-2 4 INVERT AT BUILDING 111.78 B (EXISTING) NITROGEN SENSITIVE SYSTEM REPAIR " T TANK IN 110.54 C EXIS " PVC AREA: ZONE it 4 INVERT AT SEPTIC ( ) ( TING)) PROPOSED LEACHING FEMA FLOOD " (EXISTING) GOOSENECK `_ - ��•0' FIELD SHALL ARC 36 ZONE DISTRICT: ZONE C SIST 4 INVERT AT SEPTIC TANK (OUT) 110.29 D (E ) H CHAOF MBERS IN FIELD EXISTING #321 IN 109.87 E CONFIGURATION o LEACHING OVERLAY DISTRICT: WP 4 INVERT AT DIST. BOX ( ) PIT " DIST. Box (OUT) 109.7o F OAKLAND ROAD 4 INVERT AT D S ( ) 4" PVC `'= w r'� VENT STACK .. c -r- H YAN N I S INVERTS AT LEACHING FACILITY: 11�5 LOCUS MAP Z �Gp N 0 20 " " FINISH GRADE ' WIDE NE C0 ppENT _ NOT TO SCALE BARNSTABLE, MA 4 INV. AT LEACHING CHAMBER 109.58 G IEL, a� �- BENCHMARK " / �VVATa01�1 A. _T BOTTOM OF CHAMBER_ �- _ THENAIL SET IN 15 OAK TREE. ELEV 115.47 O SEASONAL HIGH GROUNDWATER- 103.9 J w > PREPARED FOR: ___ _ •- �_ x �, KEUNG YAU FUNG & _ SU ZHEN ZHENG o c 1 LANTER LANE BURLINGTON, MA 01803 �N of MAs °. ----TO LEACHING 28 DATE: AUGUST 3, 2011 Mor FACILITY 0RIAN G. COMP. DESIGN: B. YERGATIAN YERGATIAN P L A(� I \ /I C\/3, C ATIVIL PLAN v VIEW V V LOCUS CHECK: K. HEALY DRAWN: K. HEALY .o' No. 6 p at•. NO 38�099~ VENT DETAIL SCALE: 1" 10 FEET FIELD: P. HAGIST , .,. NOT TO SCALE FILE NO. 49595-SEP.DWG 0 5 10 20 FT. DWG N0. 6069-01 [JOB NO. 4-9595.00 SHEET 1 OF 2 REVISIONS NO. DATE DESCRIPTION 63.5' 13' GENERAL NOTES: 1. THIS PLAN IN ONLY INTENDED FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE DISPOSAL FACILITY. 2. ALL CONSTRUCTION METHODS AND 33.8' ' MATERIALS SHALL CONFORM TO 310 CMR 15.000 AND YARMOUTH BOARD OF ADS SEWER & DRAIN. AND/OR HEALTH REGULATIONS. ADS TRIPLEWALL OR CM U 3. THERE ARE NO KNOWN OR PROPOSED PER LOCAL REGULATION PRIVATE WIELLS LOCATED WITHIN 150 FT. OF THE PROPOSED LEACHING FACILITY. 6' 4. IF AN OVERDIG IS SPECIFIED, REMOVE ALL MIN. • TOPSOIL. SUBSOIL AND OTHER ® UNSUITABLE MATERIALS. 5. IF AN OVERDIG IS SPECIFIED. REPLACE ALL EXCAVATED MATERIALS WITHIN THE --rn LIMIT OF EXCAVATION WITH CLEAN GRANULAR SAND, FREE FROM ORGANIC 60r MATERIAL AND DELETRIOUS SUBSTANCES. END CAP END CAP END CAP —� MIXTURES AND LAYERS OF DIFFERENT FRONT VIEW SIDE VIEW REAR/TOP VIEW CLASSES OF SOIL SHALL NOT BE USED. FILL SHALL NOT CONTAIN ANY,MATERIAL LARGER THAN 2 INCHES. A SIEVE ANALYSIS USING A #4 SIEVE SHALL BE PERFORMED ON A REPRESENTATIVE A.ull SAMPLE of FILL. UP TO 45X BY WEIGHT DISTRIBUTION BOX MAY BE RETAINED ON THE #4 SIEVE. SUCH ANALYSES MUST DEMONSTRATE ARC 3 6 CHAMBER AND END CAPS THAT THE MATERIAL MEETS EACH of THE 3 ROWS OF 9 UNITS IN EACH ROW (45.01) FOLLOWING SPECIFICATIONS: NOT TO SCALE 100X MUST PASS #4 SIEVE 10X MUST PASS #50 SIEVE 0-20X MUST PASS #100 SIEVE 0-5X MUST PASS #200 SIEVE 6. EXISTING UlIU71ES WHERE SHOWN ON THE PLANS ARE APPROXIMATE. THE ENGINEER DOES NOT GUARANTEE THEIR ACCURACY OR THAT ALL SUBSURFACE STRUCTURES ARE SHOWN. CONTRACTOR SHALL VERIFY THE SIZE. LOCATION AND ELEVATION OF INVERTS OF UTILITIES AND STRUCTURES. - WITHIN THE LIMIT OF WORK, PRIOR TO THE START OF CONSTRUCTION. IF ANY DISCREPANCIES ARE DISCOVERED oR FIELD CHANGES REQUIRED, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY. 7. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PROPERLY COORDINATING THE PROPOSED CONSTRUCTION ACTIVITIES WITH DIG—SAFE AND THE APPLICABLE UTILITY COMPANIES. AND SHALL COMPLETE THE PROPOSED WORK WITHOUT ANY N❑TESL - _, i ` INTERUPIIONS IN SERVICE. 1. EXCAVATE AND LEVEL INSTALLATION AREAS. 6. ENDS OF ROWS MAY BE CONNECTED WITH PIPING TO IMPROVE 8. CONTRACTOR IS REQUIRED TO NOTIFY DIG-SAFE. PER MASS. STATUTE CHAPTER DISTRIBUTION. 2. SMOOTH IRREGULARITIES IN THE EXCAVATION. A► 82. ,SECTION 40 (1-888-344-7233) A LEVEL, FLAT SURFACE IS REQUIRED. 7. FILL PERIMETER AND INTERIOR SIDEWALL, AREAS TO TOP OF MINIMUM OF 72 HOURS PRIOR To THE CHAMBERS WITH NATIVE SOIL AND WALK INTO PLACE. AVOID, LARGE START OF CONSTRUCTION. 3. INSTALL ARC LEACHING' CHAMBERS IN ADJACENT' ROCKS OR DEBRIS IN COVER MATERIAL. ° IF SYSTEM IS CONSTRUCTED IN 9. THIS SYSTEM IS NOT DESIGNED FOR THE ROWS TO COVER DESIRED AREA. FILL, SELECT FILL SHALL BE PLACED BETWEEN CHAMBERS AND EXTEND TO 1 USE of A GARBAGE GRINDER. A HEIGHT OF 2' INCHES ABOVE TOP OF CHAMBER. INSTALLATION OR USE of A GARBAGE 4. INSTALL UNIVERSAL END CAP AND SECURE IN PLACE GRINDER AT ORHIS PROPERTY Is NOT WITH BACKFILL. 8.0 COVER ARC LEACHING CHAMBERS TO A MINIMUM OF 12' OF GRANULAR c ALLOWED PER 310 CMR 15.240(4). COVER AFTER CONSOLIDATION FOR H-10 APPLICATIONS. AVOID LARGE ROCKS 5. INSTALL 4' PIPE TO EACH ROW OF ARC CHAMBER OR DEBRIS IN COVER MATERIAL. COVER HEIGHTS AND LIVE LOADING USING KNOCKOUTS PROVIDED IN THE UNIVERSAL END LIMITS ARE IMPACTED BY BOTH SOIL TYPE AND COMPACTION REQUIREMENTS. CAPS. CONTACT ADS WHEN POOR SOILS ARE ENCOUNTERED AND FOR MAXIMUM FILL HEIGHTS. LIVE LOAD CONDITIONS ARE NOT RECOMMENDED. n-6(' C Gnu 349 Route 28, Unit D .44 ARC 36 CHAMBER TYPICAL CLUSTER SYSTEM INSTALLATION 17.5' W.7a3rmouth, Massachusetts NOT To SCALE 03' 14' 508 778 8919 INSTALLED ©2011 BSC croup. Inc. 04' LENGTH PROJECT TITLE: INSPECTION FRAME NEQUAH 13' 6.5' DESIGN FOR R-1978 OR APPROVED EQUAL 1HREADED CAP � 9 SEWAGE DISPOSAL FINISH GRADE 04.51 �' SYSTEM REPAIR POST END INVERT HEIGHT DOME END O 321 � tH OF Mgs OAK LAND ROAD BRIAN G. YERGAT AN HYANNIS OBSERVATION PORT SHALL BE INSTALLED 0 4• PERF. C VIL 33' UTILIZING THE KNOCKOUT ON THE TOP OF SCHD. 40 PVC No 06 THE ARC 36 CHAMBER AND SHALL EXTEND o F BARNSTABLE, MA 0 0� DOWN TO THE EXISTING SUBGRADE. SEE F S SHEET 1 OF 2 FOR LOCATION OF /0 j OBSERVATION PORT. 3 l , PREPARED FOR: KEUNG YAU FUNG & U ZHEN LANTER HENG 1 Z LANE BURLINGTON, MA 01803 O ARC 36 SIDE PORT COUPLER DATE: AUGUST 3, 2011 SUBGRADE NOT TO SCALE j COMP. DESIGN: B. YERGATIAN CHECK: K. HEALY DRAWN: K. HEALY OBSERVATION PORT FIELD: P. HAGIST SCALE: NONE FILE NO. 49595-SEP.DWG DWG NO. 6069-01 SHEET 2 of 2 JOB NO. 4-9595.00