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0464 OAKLAND ROAD - Health
"r 464 Oakland Road Hyannis i' A = 272 096 6 tA1 Y 1 � Y i II A 1 I N r s OWN OF BARNSTA.BLE `,LOCATION SEWAGE # VILLAGE o ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY - LEACHNG FACILITY: (type)X4 10,� � S (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland.and Leaching Facility 0 any wetlands ex t within 300 feet of eachin f ity Feet Ftu .fished by ` i O \ I l � s TOWN OF/BARNSTABLE ,OCATION 4i6Y d4kl— fe ,eooe SEWAGE# ,20//— OOY VILLAGE ASSESSOR'S MAP&PARCEL 2 O (o INSTALLERS NAME&PHONE NO. S08-y20-g73�f /a sc��Q� SOS SEPTIC TANK CAPACITY � /��{�r'///1.1�d1� �y00 �SGid LEACHING FACILITY.(type) 2-SOO �'`jl�N�f�,��''f (size)USX /3 NO.OF BEDROOMS 3 OWNER ohh ",g 7-- PERMIT DATE: ./l-s// COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility_(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist Within 300 feet of leaching facility) Feet FURNISHED BY s tut/io-� 1 . i � o .J u� IA Af 0 F a � r MAP 272 PARCEL 106 „ 116.50 / S78.34 2 Ow UP O / � LOT 18 14,244f S.F. Z / HYDRANT MAP 272 PARCEL 096 o � 58.0' 63.3' o oM o � o 15.8' MAP 272 gin_ O / M PROPOSED PARCEL 23-1 / 14'x11.67' 3 ADDITION 34.5' o M `c co #464 SEPTIC M / EC TANK W.. o / 30.8 G N� 0 8 "W MAP 272.34'2 S7 PARCEL 22 O U P 116 50 2.6' MAP 272 PARCEL 97 OF 1'u+S REFERENCES: S9c ADDRESS 464 OAKLAND ROAD yG o EDWARD OWNER JOHN D. KENT tP g� A. REGISTRY DEED BOOK 16737, PAGE 332 STONE (p PLAN BOOK 206, PAGE 57 N 3. 2$ 8 / ASSESSORS MAP 272, PARCEL 96 F is �� ZONING: RG-1 / GP / ZONE II I CERTIFY THE FOLLOWING STATEMENTS TO rP'R Ti P-i P-n P 1 nT P 1 A KI THE BARNSTABLE BUILDING INSPECTOR ^ No. � �" Yt Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPiication for Wootal 6raem Construction Permit Application for a Permit to Construct(GY Repair(4C-pgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.YGy OlofK/!9H ?U Owner's Name,Address,and Tel.No. ✓oti/l Awl— installer's Map/Parcel - D -c Installer's Name,Address,and Tel.No.,f"3-,/2 o-9m3, Designer's Name,Address and Tel.No. p gp- 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 /l Design Flow(min.required) 3 3 V gpd Design flow provided 3 S Z gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Zs?ST,t��� /Soo Gro� J�FlOT�G r"I<- 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 Application Approved by OM& f Date Application Disapproved by: Date for the following reasons Permit No.. 00 Date Issued 7 �5 t ' --FJ•'rn -wi.4� p No. �� 1 ebb ��s „k J% Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION — TOWN OF BARNSTABLE, MASSACHUSETTS Yes r t r 0[ppYication for Miooal �&p!tem Construction Permit Application for a Permit to Construct Repair(/-)--[Jpgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.IV6 owk-1f9"W Owner's Name Address,and Tel.No. Assessor's Map/Parcel Sl��t Installer's Name,Address,and Tel.No. ml Designer's Name,Address and Tel.No. Type of Building: z, Dwelling No.of Bedrooms Lot Size _ sq. ft. Garbage` Grinder ( ) Other Type of Building No.of Persons ` �"' cffe YP g � Showers( Cafeteria( ) Other Fixtures R/ C,w4f v,, Design Flow(min.required) 3 gpd Design flow providel A5/2/`2 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank f Type of S.A.S. Description of Soil r i Nature of Repairs or Alterations(Answer when applicable) Z/IST�11 /5GU Gil �i IOTG �tiZ `'- 'j�0✓ �i6�� li=.�a��� � /�J���lJi'•�S vi J%� `� � S"•l•-.�9-c �r'a�s�- / 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. l Signed r% n �� Date Application Approved by y Date '� S Application Disapproved by: (. Date for the following_reasons1/ �. -- Permit No. avl 00y Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( G) Repaired Upgraded ( ) Abandoned( )by I'Ifll✓11 Z;s � r 7 at k41.0 �/2o�J ����a��/S has been constructed in accordance ' with the provisions of Title 5 and the for Disposal System Construction Permit No. J9 DI/— `0 dated Installer �j� t�`j (/e �j,d``-U S Designer #bedrooms Approved design flown / 3S� gpd The issuance f thi permit shall not be construed as a guarantee that the system willff n,,tVnas designed. Date ' Inspector � , N0. doll (X��( Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwtgpool *p5tem Construction Permit Permission is hereby granted to Construct ( U) Repair Upgrade ( ) Abandon ( ) System located at y( y 6; kZ,,.,,G/ 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. Date 5^(I Approved by + �S. I Darren Meyer, R. S. 17815850293 P. 1 Town of Barnstable Regulatory Services UAMLL Thomas F. Geiler, Director 1 9. Public Health Division a► t' Thomas McKean,Director i 200 plain Street,Hyannis,INIA 02601 Office: 505-362-46.1-t Fax: 503-790-6304 Installer &Designer Certification Form Date: Sewage Permit# 9,0//-,06IY Assessor's Nlap?arcel Designer: �Q v� f"IE-'�+tl-� fnstailer: �} � address: o X �r� , 1 a� Address: F/ 64A�V,001-e"E7*1 E - S FFr U L`��C (l O ZS 3� L4L.,z 0-1 Z r — J0360:: i Z,V d?ir^!>S was issued a permit to install a (date) // ^^ (installer) septic system at 0,�K�,AW12 L based or. a design drawn by sated i 0q I t (desi;ner; x I�certify that the septic system referenced above was installed substantially according to t,,e design, which may include mirror approved changes such as ,ute,al r..locat:t,n o the distribution box andior septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or an,; vertical relocation oL-anv component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by cesignerto follow. of o DAR .� M (I staller's Signature) 1140 ( ianer's Signature) (Affix Designer's Stamp Here) PLEASE RETUR.N TO BARHST E PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE, iSSIYED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. TH.kNK YOU. Q:Heal thiSemidDesi per Certification Fomi 3-26-0,&oc I I P# 13 / 3-5 'Town of BA-IIstable. oft • Department of Regulatory Services • ' - Public Health Division Date �xarenr nrnsa 200 Main Street,Hyannis MA 02601 Time Date Scheduled 0 (v_ Fee Pd. u0 I Soil Si tability Assessment for S`e wage.Disposal Performed By: `', l - "' `" - 'Witnessed B : n f y s G LOCATION & GENERAL INFORMCATION �� Location Address•. %4.. O l_t A � ? Owner's Name mo�t-- ' Address �T D�6�� Assessor's Ma /P�rce1: I Engin`eer's Name I V-r-G✓� /1/l' p 2 7� u °J 36Z— 2 3ZZ NEW CONSTRU�LION I REPAIR X - Telephone# J 0 Land Use t`t$L 0 G t" Slopes(30) V Surface Stones ��y Distances from: Open Water B y ?ZOOft Possible Wee Area•I> ft Drinking Water Well f[ Drainage Way U� ft Property Line D ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 135.00 ft 'LOT 18 AREA = 15728 sf +- - m __ L h TH-1 o i -.-._._._.__._.-4. of �——•—._� EXISTING ~°,. DWELLING TOP OF FNDN w EL = 62.68 K o --- W w a 1 I I i . N f� • Parent material(ge(ilogic) I Depth[0 Iiedtock Depth to Groundwakdr. Standing Water in Hole: /y '4 i Weeping from Pit Face Estimated Seasonali1iigh Groundwater Al l i I D#,TE TION FOR SEASONAL HIG[�WATE RTOLE Method Used: in. Depth to Sall mottles: Depth Cibperved standing in obs.hole: ©taundwater Adjustment tt. Depth toiweeping from'side of obs.hole: ! u A ;f.►efOr..r� Adj.(Iroundwaterl evei.,,.,e, Index Weil# Reading Date Index We11 level -- I PERCOLATION TEST' D$tp x> C Observation Time at 9" -------- Hole# i tl � • Time at 6" .--- -- Depth of Pere �U ko Time(9"-61, - Start Pre-soak Time.@ � � - End Pre-soak 1 C) 1 Rate MmJlnch • Additional Testing Needed(YIN) Si[e Suitability Assessment Site Passed _ Site Failed:__-- Original:.Public I_alth Division Observation Hole Data To Be Completed on Back— ***If percola#0 test is to be conducted within 100' of wetland,you must first notify the Barnstable C44servation DiN ision at least one (1) wedk prior to beginning. i DEEP OBSERVATION HOLE LOG Hole!# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. IConsistenc %Gravel 411 29t1 13 San (ZSIB r .DEEP..OBSERVATION HOLE LOG Hole'# Depth from Soil Horizon Soil Texture Soil Color` :Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. 'Consistency.%Gravel) b`'—S`l . �YPhly N 2,Clk , . , C 2,sV 132 C,� _ oPr4 z,S"713 DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,3'o Gravel 'r I t i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consisten Gravel) i t I . I i Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring 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? eS If not,what is the depth of naturally occurring pervious material? Certification II I certify that on 6tl (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 require r ' in A,expertise and experience described in 30 CNM 15.017. I,• t �V" Signature Date Q:ISEPTIWERCFORM.DOC PROPERTY AoOREss:_,_,464_Oakland Road__„__ MAP Hyannis Mass ® � __ ___ __..PARCEL � (R 02601 ----LOT 1� On the aboye dale, I Inapootod the eeptlo syiteri at the oboyo addrass. Thls ayslom conslata of the lollowing; j i O(d j 1 . 2-6x8` cesspools 2. Main cesspool acts as a septic tank. ZI ea3ed on my Inspectlon, I corilly the tollowln9 cond 1 . This is not a Title Five Septic system. 2. This is a sewage system. .-- 3; The sewage system is in proper working orat the present time. The main cesspool is full and the overflow is' dry.Overflow has never I been filled. $IQNATVRE.,/ Name : atq_r_ )j-------- Company: Jo� . 2h_F _ N• comber—d $on , Inc , Addre93 ;_ Boz_ 66 - -___________ __CIn � � rYille � He ,_ 02632-0066 TmS CERTIFICATION 00e9 NOT CONSTITVTE A OVARANTY OR WARRANTY C P, MAC'OMBER & SON, INC,+nki-09l�pooliI-Li4chllfldi Pump1d G In+Isllld own S#wfr Connio�lont 66 C1ntlrY1111, MA 026J2-0066 77.5JJJB 77$44 12 A� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 464 Oakland Road Hyannis Mass Owner's NameNaney Goggin Owner's Address: 606 Duck farm Roam F Date of Inspection:? 25 01 Name of Inspector: (please print) J.P. Macomber Jr Company Name:Joseph P. macomber & Son Inc Mailing Address: Box 66 C entervi 1 1 P Ma 02632 Telephone Number: 508_775_323z- _. CERTIFICATION STATEMENT I certify that 1 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 inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: rF asses '- Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority _ Fail Inspector's Signature: Date: The system inspector shal mit a copy of this inspection re ort to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the sy tem is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authoriry. Notes and Comments ••';'This report only describes conditions at the time of inspection and under the conditions of use at that T time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I II 1 , Paee 2 of I I , r OFFICIAL, INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Properry Address.464 Oakland Road Hyannis Owner:Nancy Goggin Date of inspection: 7/25/01 Inspection Summary..: Cbeck A,B,C,D or E/A W complete all of Sectloa D A, System Passes V I have not found any information which indicates that any of the failure criteria described in 310 CMR I 5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system is in proper working order at the Present time. B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or rcpaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined" please explain. Th septic tank s metal and over 20 years old' or the septic tank(whether metal or not) is structurally unsound, e t t s su stantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health, 'A metal sepric tank will pass inspection if it is structwally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or hi evel in the distribution box ue to broken or obstructed pipe(s)or due to a broken, senled or uneve distribution box, ystem'wi11 pass inspection if(with approval of Board of Health): broken pipe(s)are replaced _ obstruction is removed — distribution box is leveled or replaced ND explain: " The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _ broken pipe(s)are replaced _obstruction is removed ND explain: 2 t 1 T Page 3 of I I OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:464 Oakland Road Hyannis Owocr:Nancy Goggin Date of lospectioD: 7/25/01 C. Further Evaluation is Required by the Board of Health: Conditions exist which require fiuther evaluation by the Board of Health in order to determine if the system is failing to protect public health,,safery or the environment. 1. S,N'stem will pass unless Board of Health determines In accordance with 310 CMR 15,303(1)(b) that the system is not functioning in a manner which will protect public bealth, safety and the environment: U Cesspool or privy is within 50 feet of a surface water . Cesspool or privy is witbin 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, If any) determines that the system is functioning in a manner that protects the public health, safety and environment: .�Q The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. 'UCH 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 I 0 feet b 50 feet or more from a private water supple well . Method used to determine distance 'This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: - - This is a sewage system'.- 'The system consists of 2-6 'X8 ' block cesspools in series. The main cesspool _acts as a septic tank. Contains solids in place Liquid passes over to the overflow. F. 3 1 3 Page 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 464 Oakland Road Hyannis OwoerVancy Goagin Date of Inspection: Z/ ,f f11 D. System Failure Criteria applicable to all systems: You must indicate 'yes"or"no" to each of the following for all inspections: Yes No/ ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the istribution bo above outlet invert due to an overloaded or clogged SAS or _ Lcesspool /Liquid depth in cesspool is less than 6"below invert or available volume is less than h day flow V Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped 0. _ Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface — �water supply. y portion of a cesspool or privy is within a Zone I of a public well. �y 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. (Tbis system passes If the well water analysis, performed at a DEP certified laboratory, for collform 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. A copy of the analysis trust be attached to this forma yC) (Yes(No)The system fails, I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either'yes"or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no Zthe system is within 400 feet of a surface drinking water supply v th ystem 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 If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 464 Oakland Road Hyannis Owner:Nancy Goggin Date of Inspection: 7/25/01 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes Tv'o — ,(/Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks Has the system received normal flows in the previous two week period ? Have large volumes of water been introduced to the system recently or as pan of this inspection ? Were as built plans of the system obtained and examined?(If they were not available note I y Was the facility or dwelling inspected for signs of sewage back up? i _ Was the site inspected for signs of break out ? _ Were all system components,il$Lding the SAS, located on site ? � � Were the septic tank anholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ? 2 _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil.Absorption System (SAS)on the site has been determined based on: Yes no Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Pan C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 Page 6 of 1 1 r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 464 Oakland Road Hyannis Owner: Nancy Goggin Date of Inspection: 7/2 5/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms);�j�jQ 33D� p Number of current residents: GL Does residence have a garbage grinder(yes or no): Is laundry on a separate sews a system ( es or no :,ILO [if yes separate inspection required) Laundry system inspected (R-s)or no): 5 Seasonal use: (yes or no):� _ 78 D Water meter readings, if available(last 2 years usage(gpd)):� .�D�.�. �i SJ68y'/A( s _ co,0,5 Sump pump(yes or no):Aepyj Last date of occupancy: z1.4 COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons sgft,etc.): Grease trap present(yes or no):&�ff Industrial waste holding tank present(yes or no): - Non-sanitary waste discharged to the Title 5 system(yes or no):AA Water meter readings, if available: AM Last date of occupancy/use: N q— OTHER(describe): N� I GENERAL INFORMATION Pumping Records 11 Source of information: 4dtle AIM t�4 Was system pumped as part of the inspection(yes or no): 4b If yes, volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: 1 AVT 49ew TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Z Overflow cesspool Privy IVftShared system (yes or no)(if yes, attach previous inspection records, if any) Onnovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) /IA Tight tank (Attach a copy of the DEP approval Other(describe): f�f� Approximate aee of all components, date installed (if known)and source of information: 17�;( Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 464 Oakland Road Hyannis Owner:Nancy Go in Date of Inspection: 7 25 01 BUILDING SEWER (locate on site plan) Depth below grade: 6 Materials of construction: rit ast 'iron _40 PVC other(explain):OraM [(7A m(in�OO/ Distance from private water supply well or suction line: /6* J r7VCl w Comments (on condition ofjoints, venting, evidence of leakage, etc.): Mrot 4 house vcl? SEPTIC TANK'-(locate on site plan) Depth below grade: Material of construction://kconcreteKAmetaI k(}fiberglass0olyethylene —other(explain)I ja If tanl: is metal list A Is age confirmed by a Certificate of Compliance (yes or no):_(attach a copy of certificate) Dimensions: Nib Sludge depth: Az A- Distance from top of sludge to bottom of outlet tee or baffle: A�*— Scum thickness: Distance from top of scum to top of outlet tee or baffle: A/& — Distance from bottom of scum to bottom of outlet tee or baffle: f/g_ How were dimensions determined: A/ n- Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): GREASE TRAPA,&ZL(locate on site plan) Depth below grade:" Material of construction:�jQconcrete4ametalt2fiberglas44 polyethylene,j�q other (explain): W)A Dimensions: Scum thickness: .04 Distance from top of scum to top of outlet tee or baffle: 41 4 Distance from bottom of scum to bottom of outlet tee or baffle: ,0/9 Date of last pumping:dj, Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels a related to outlet invert:evidence of leakage, etc): 1_ t�2 O Page 8 of I I ` OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Add ress:464 Oakland Road Hyannis Owner:Nanny Coggin Date of Inspection: 7129101 TIGHT or HOLDING TANKIVIh—e—(tank must be pumped at time of inspect ion)(locate on site plan) Depth below grade: /Vfi- Material of construction: concrete A4 Metal Afiberglasscl—polyethylene other(explain): Dimensions: Capacity: gallons Desien Flow: gallons/day Alarm present N(y��s or no): Alift Alarm level: i� Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float s itches, etc.): i It�q� n r h r)1A kj)Q �CA C no f o CLf,(ZA u DISTRIBUTION BOX: ftM�,(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): not oc!!nen 4. PUMP CHAMBER-W (locate on site plan) Pumps in working order(yes or no):AIA Alarms in working order(yes or no): CAmments(note condition of pump chamber, condition of pumps and appurtenances, etc.): 8 Page 9 of 1 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:464 Oakland Road Hyannis Owner: Nancy Goggin Date of Inspection: 7 25 01 )r SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits, number: Q leaching chambers,number leaching galleries,number: leaching trenches,number, length: leaching fields, number, dimensions: overflow cesspool, number: A �_ _ innovative/alternative system Type/name of technology: Poor 7e (ale— Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, S S �1 r dl ufe. CESSPOOLS: (cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configuration: a Depth-top of liquid to inlet invert: ' Depth of solids layer: Depth of scum laver: Dimensions of cesspool: -'A - (p, Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soi signs of hydraulic fail e, level of ponding, conditio of vegetation, etc.): 1 ie PRIVY: KJDVIoca. te on site plan) Materials of construc 'on:&f14 Dimensions: Depth of solids: C mments(note condition of soil signs of hydraulic failure, level of ponding,condition of vegetation, etc.): ri w no f yes �� 9 Page 10 of I I s OFFICIAL INSPECTION FORM — NOT FO R VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 464 Oakland Road Hyannis OwoerNancy Go in Date of Inspection: 7 25 01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. a S y3` 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 464 Oakland Road Hyannis Owner:Nancy Goggin Date of Inspection: 25 01 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to ground water feet Please indicate (check)all methods used to determine the high ground water elevation: Obtained from system design plans on record - If checked, date of design plan reviewed: 'A , Observed site(abutting pro e—observation hole w't}to 150 feet of SAS) C cked with local Board of Health-explain:,// ;=.:/ 04,) hecked with local excavators, installers-(attach documentation) _Accessed USGS database-explain: You must describe how o you established the high ground water elevation: Used. Gahrety & Miller Model 12/16.194 11 rrr{T -nt•Rrn-r lrn:JeR•nTln nrintrRrmmi-.T+n7r►ITRRnm nsr+flY f7a•7n�1w1' Tn-►7-r v+•.�r-:..-•,r k' 'TOWN OF BARNSTABLE BOARD OF 11EALTII SUIISURFACE SEWAOF DISPOSAL ,SYSTEM INSPECTION FORM - PART D •- CERTIFICATION II •••Tl1�T••.••.:t—T.tII.��TRf1T..11•R.'frt Tlrlf'l7lffllfT'r—{'1 "7Vn1'.q �7R� T1 TI-PT'I�-1. •�..w -TYPE OR PRINT CI,EARLY- P120PERTY INSPECTED STREET ADDRESS 464 Oakland Road Hyannis Mass 02601 ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME ' Nancy Goggin PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr., COMPANY NAME Joseph P. Macomber &''ion Inc COMPANY ADDRESS Box 66 Centerville Ma 02632 Street Town or City State t1P COMPANY TELEPHONE (508 775 - 3338 FAX Q F) -7e�� R w CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and omplete as of the time of -inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check e : Syst t/ e m j . PASSED The inspection «hich I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 : 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have con\__�cted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 3.10 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form , e Inspector Signature Date � v Cyncopy of this rt.ification must be provided to the OWNER, the BUYER re applicable ) and the BOARD OF HEAL711, .gyp i.. • If the inspection FAILED, the owner or operator shall upgrade ' the system within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CMR 16 . 306 . partd . doc PROPERTY AOORESS:, ,3Pj_Oakland Road -_`_Hyannis Mass-_ 02601 ----------------__------ On the aboye data, I Inapeoted the oeptlo syitert at the aboye address. Thla syslem conslals of the following: RECEIVEn 1 . 2-ex8` cesspools , 2. Main cesspool acts as a septic tank. I AUG 15 2001 Sated on my Inspection, I cortlfy the followln9 condltlonas TOWN OF BARNSTABLE 1 . This is not a Title Five Septic system. HEALTH DEPT. 2. This is a sewage system. 3•. The sewage system is in proper working order a.t the present time. The main cesspool is half full and the overflow is dry.Overflow ha never been filled. ✓� SIG NATVRE., Name : .-__..--- Company; Jo• .�n_P N•comb.r-6 Son , Ync , 7 � _-ConCs11l! tL NaV- 07632-0066 TMIS CCATIFICATION OOES HOT COHSTITVTC A OVARANTY OR WARRANTY i JOSEPH P, MACOMBER & SOM, INC. Y+nkt' Oitrpool� t,��chll�ld+ Pumped 4 In+tillid Town Stwor Connrvtlont P,O. 89x 66 ConlirYllk, MA 02637-0066 775JJ38 y756i1Z \ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL, PROTECTION TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 464 Oakland Road Hyannis Mass Owner's NameNaney Gogcrin Owner's Address: 606 buck farm Road F Date of inspection: 25 01 Name of Inspector: (please print) J.P. Macomber ,T_r Company Name:Joseph P. macomber & Son Inc Mailing Address: Box 66 Centervi 1 1 e rota-02632 Telephone Number: 50A-775--AyAg — 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: asses _ Conditionally Passes _ Needs Further Evaluation by the Local Approving Authoriry Fail Inspector's Signature: Dater The system inspector shal mit a copy of this inspection re ort to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the sy tem is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Paee 3 of I I t OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:464 Oakland Road Hyannis Owner:Nancy Goggin Date of lospectioo: 7/25/01 lospectioo Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: J6 I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system is in proper working order at the present time. B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined" please explain. 4,)p _Th septi�Ssupstantial s metal and over 20 years old' or the septic tarJk(whether metal or not) is strucnuaily unsound, e t t infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal sepric tank will pass inspection if it is struetwally sound, not leaking and if a Certificate of Compliance Lndicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or hi evel in the distribution box ue to broken or obstructed pipe(s)or due to a broken, senled or uneve distribution box.)system will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: —� The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced _ obstruction is removed ND explain: 2 L 1 ! Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:464 Oakland Road Hyannis Owoer.Nancv GogGin Date of Inspection: 7/25/01 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 public heakh,.safery or the environment. I. 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 wbich will protect public bealth,safety and the environment: U Cesspool or privy is within 50 feet of a surface water . Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, If any) determines that the system is functioning in a manner that protects the public bealth, safety and environment: ,eQ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. 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 Igo feet btyg50 feet or more from a private water supple well". Method used to determine distance iil/ 'This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: - This is a sewa e system. The system 9 Y y consists of 2-6 'X8 ' block cesspools in series. The main cesspool _acts as a septic tank Contains solids in place Liquid ,passes over to the overflow. 3 L Page 4 of I I ' OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Properry Address: 464 Oakland Road Hyannis Owner:hlaney Goagin Date of lospection: 7 f 2,.4n1 D, System Failure Criteria applicable to all systems: You must indicate yes"or"no"to each of the following for all inspections: Yes No/ �ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool .1/G Static liquid level in the distribution bo above outlet invert due to an overloaded or clogged SAS or cesspool _ d/� squid depth in cesspool is less than 6"below invert or available volume is less than ''A day flow r Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe($). Number of times pumped _ Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface /water supply. �y portion of a cesspool or privy is within a Zone I of a public well. — Wy portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes If the well water analysis, performed at a DEP certified laboratory, for collform 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. A copy of the analysis must be attached to this forma (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: Y To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd. You must indicate either'yes"or"no".to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply ystem 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 11 of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered ..yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 464 Oakland Road Hyannis Owner:Nancy Goggin Date of Inspection: 7/25/01 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes Tv'o _ Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks ZHas the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? (If they were not available note /A). Was the facility or dwelling inspected for signs of sewage back up? j _ Was the site inspected for signs of break out ? _ Were all system components,�R+cluding the SAS, located on site ? Were the septic tank anholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum ? - 2 _ Was the faciliry owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no Existing information. For example, a plan at the Board of Health. _ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 t Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 464 Oakland Road Hyannis Owner: Nancy Goggin Date of Inspection: 7/2 5/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): _ DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x# of bedrooms)aj11Q_,3-jo(7 p Number of current residents:O Does residence have a garbage grinder(yes or n Is laundry on a separate sewa a system (yes or no :.,4,*(� [if yes separate inspection required] Laundry system inspected( S or no): 5 Seasonal use: (yes or no): _ Pg.�,es Water meter readings, if available(last 2 years usage(gpd)):#� 5J'G8)<'/A�lr� -;UV—AP, V_1 _ Co.06 04 r Sump pump(yes or no):diQ Last date of occupancy:J�G11 .cI = COMMERCIAL/INDUSTRIAL Type of establishment: 446 Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/perso�n�s�/sqft,etc.): Grease trap present(yes or no):L�11 Industrial waste holding tank present (yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no):AA Water meter readings, if available: AM Last date of occupancy/use: /V q- OTHER(describe): N+ I GENERAL INFORMATION Pumping Records ' �" Source of information: i .4ol t L4 _Lke Was system pumped as part of the inspection(yes or no): If yes, volume pumped: gallons-- How was quantity pumped determined? fO Reason for pumping: AV7- 42e5' 2 TYPE OF SYSTEM Septic tank, distribution box, soil absorption system Single cesspool Z Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records, if any) &— nnovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) M Tight tank 6,LAkttach a copy of the DEP approval Other(describe): Approximate age of all components, date installed (if known)and source of information: . X Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 464 Oakland Road Hyannis Owner:Nancy Go in Date of Inspection: 7 25 01 BUILDING SEWER (locate on site plan) Depth below grade: _ ) J Materials of construction: rieast iron _40 PVC_other�(explain): �OO I�I�-h/ Distance from private water supply well or suction line: /� wUr101t) Comments (on condition of joints, venting, evidence of leakage, etc.): \-104S_1,-DD2CLLf(Gh*. W�Ud ►denCt' t°���P , r 4IM i,s vc�M/'bt`X�'v &P'setlo? SEPTIC TANK "{locate on site plan) Depth below grade: Material of construction:N—A--concreterAmetal Uylberglass4lbolyethylene _other(explain) k1a If tank is metal list age:"" Is age confirmed by a Certificate of Compliance (yes or no):_(attach a copy of certificate) Dimensions: A16 Sludge depth: nJ Distance From top of sludge to bosom of outlet tee or baffle: A(fi_ Scum thickness: Nft _ Distance from top of scum to top of outlet tee or baffle: Distance [Tom bosom of scum to bottom of outlet tee or baffle: Hoy+ were dimensions determined: JU IT Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): GREASE TRAP,{L(locate on site plan) Depth below grade: Material of construction: concrete422 meta l,t2fiberglas&jgpolyethylenejgother (explain): -0 Dimensions: Scum thickness: 1 Distance from top of scum to top of outlet tee or baffle: 11,9 Distance from bottom of scum to bottom of outlet tee or baffle: l Date of last pumping:d)A Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels a related to outlet invert:evidence of leakage, etc. ?�� 7 Page 8 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Add ress:464 Oakland Road Hyanni s Owner; nr.y t;c)ggi n Date of Inspection: Z/2 r;/D 1 TIGHT or HOLDING TANKA1 (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: 1V," Material of construction: concrete A4 metal Afiberglassel—polyethylene other(explain): Dimensions: Capaciry: gallons Desien Flow: - gallons/day Alarm present(y s or no): Alarm level: Alarm in working order(yes or no):10 Date of last pumping: AA Comments(condition of alarm and floats itches, etc.): Il h� nr hoi�l,gQ �G 1c nofPccsdi. DISTRIBUTION BOX: f(&(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: _ Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): rm nox )� not Qr<nen �. PUMP CHAMBER:I�')�(locate on site plan) Pumps in working order(yes or no): Allt Alarms in working order(yes or no): L (;Rmments (note condition of pump chamber, condition of pumps and appurtenances, etc.): �n�Glnber /� llDf D/�SP1'I�. 8 Page 9 of 1 1 ! OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:464 Oakland Road Hyannis Owner: Nancy GoQQin Date of Inspection: _7/2 5/01 CIS SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: /Er Ty e leaching pits, number: 0) Q leaching chambers, number: Q leaching galleries, number: leaching trenches,number, length: leaching fields, number,dimensions: overflow cesspool, number: A in /� _ innovative/alternative system Type/name of technology: f�nor 78- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, e(c.): Sam. Alo slans 6rQ 11C t Qr re- CESSPOOLS: ✓(cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configuration: o? Depth—top of liquid to inlet invert: ' Depth of solids layer: Depth of scum laver: 7 Dimensions of cesspool: -'I ., 1Px Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of so i signs of hydraulic fail e, level of ponding, conditio of vegetation, etc.): 1 PRIVY: 1Wlocate on site plan) Materials of construc •on: Dimensions: IV Depth of solids: C -mments (note condition of soil signs of hydraulic failure, level of ponding, condition of vegetation, etc.): �� 9 Page 10 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 464 Oakland Road Hyannis OwnerIVancy Gog in Date of Inspection: ? 25 01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i 10 Page 1 I of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 464 Oakland Road Hyannis OwnerlVancy Goggin Date of Inspection: 7 5 01 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to ground water feet Please indicate (check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: &34,�Z04 Observed site(abutting pro pe bservation hole w't to 150 feet of SAS) _ C cked with local Board of Health-explain:,�h �ty.!; Oita hecked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used. Gahrety & MillPr Meal 12/16.1c)4 i 11 r `a•,++5r+.—n,'r7��t— rn�mr•nren/�'1+n rerrmlrM17r+A7err�*rwrn ts*r4'Y 1��77t�nwT .TR7Tr V+Tn—...--.r..•i TOWN OF BARNSTABLE WARD OF HEALTH 0 SUDSURFACF SFWA(;F DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION •••T!•1�T".'::t—T.::I�.�1TIT►.TI•n.�ITlr]Rf 1�11R'T.t•1�1RR'\RR�7—TwR�fiR�1��7R� wl •TrTP'•'T`1. •�..� -TYPE OR PRINT CI,EARLY- PROPERTY INSPECTED STREET ADDRESS 464 Oakland Road Hyannis Mass 02601 ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Nancy Goggin PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr., COMPANY NAME Joseph P. Macomber &''ion Inc COMPANY ADDRESS Box 66 Centerville Ma 02632 Street Town or City State LIP COMPANY TELEPHONE (508 ) 775 _ 3338 FAX w i CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and omplete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance and B 8 Pg , , repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check e : ' / 1/ Systeci PASSED The inspection trhich I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 151303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , System FAILED* The inspection which I have con tcted has found that the system fails to Protect the . public health and the environment in accordance with Title 5 , 3.10 CMR 15 , 303', and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . le Inspector Signature Date ne copy of this . r t.tfication must be provided to the OWNER, the BUYER C ( .here applicable ) and the DOARD OF HEAL'I'll, * If the inspection FAILED , the owner or operator shall upgrade ' the eyetem within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 , 306 . partd . doc v DATE: 7/6/99 PROPERTY ADDRESS:_464 Oakland Road Hyaniis ,Mass ------------------------ 02601 ------------------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 2-6 ' x8 ' block cesspools in series . 2 . Main cesspool acts as a septic tank . Based on my inspection, I certify the following conditions: 3 . This is not a title five septic system. 4 . This is a sewage system. 5 . The sewage system is about 35 years old . 6 . The system is presently dry . 7 . The sewage system is in proper working order at the present time . SIGNATURE:1 Name:_�L>?_ Macomber Jr--__--_— Company: JoseTh_P. Macomber_& Son , Inc . Address:— Box—66 --- --------------- Centerville , Ma . 02632-0066 -------------------- Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY r 01� JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds gV0 �� Pumped & Installed DVED Town Sewer Connections c0. P.O. Box 66 Centerville, MA 02632-0066 J�� 3 1999 775-3338 775-6412 TOKW NAL t y E r� r� r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUDY Cc Secre ARCED PAUL CELLUCCI DAB B. STRL Governor Cc�ss:c SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION P,.opwT,Adr*": 464 Oakland Road Nanw of owner Nancy Gargan Hyannis ,MasG7 s 02601 Address ofOwrser: oat. of Inspection: 7/ O/9 9 Name of Inspector:(PI""Print) Joseph P. Macomber Jr. I am a DEP approved system Irupector pursuant to Section 15.34.0 of Title 5(310 CMR 15.000) conparsyNam.: Joseph P. Macomber & Son, Inc. Ma.INAddress: 2632-0066 Tdaphone Number: CEAnFICAnON STATEMENT I certify that I have personally Inspected the sewage disposal system at this address and that the Information reported below is true, accurste 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•sks as age disposal systems. The system: _ Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails q tnspecttx's i lDate:The System Inspeshall submit a copy of this Inspection report to the Approving Authority (Board of Health or OEP)whhin thirty (30) days c 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 own ' shall submit the report to the appropriate regional office of the Department of'Environmeruai Protection. The original should be sent to me system owner and copies sent to the buyer, If applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page I of 11 C) PnMed m FscyckE type, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Props Ad&.,,: 464 Oakland Road Hyannis ,Mass . Owner: Nancy Gargan Date of 6upecdw: 7/6/9 9 INSPECTION SUMMARY: Check A, B, C, of D: A. SYSTEM PASSES: J,K.,[ I have not found any information wh)ch Indicates that any of the failure conditions described in 310 CMR 1fi.303 exist. Any failure "—�T criteria not evaluated are Indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: One or more system components as described In the 'Conditional Pass' section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health, will pass. Indicate yes,•no,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 exfiluation, 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 pips(s) are replaced obstruction Is removed distribution box Is levelled or replaced - The system required pumpirig•rttore than,four—times t+•yeardue to broken or obstructed pipe(:). The sy7tem will-yesr- Inspection If(with approval of the Board of Heafth): - broken pipes) are'replaced obstruction is removed revised 9/2/98 Page 2ofII - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropertyAddras.a: 464 Oakland Road Hyannis ,Mass . 0wrw. Nancy Gargan' D`u of kupa•ctkxu 7/6/9 9 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further avaJuatlon byths Board of Health In order to datermino If the system Is falling to protect tri public health, safety and the environment. 1) SYSTE3,1 WU1.PASS UNLESS BOARD OF HEALTH DETE)WINES IN ACCORDANCE WITH 310 CJaR 16.303 (1)(b)THAT THE SY IS NOT FUNCTIONING IN A WANNER WHJCHyaL pAQj;ECT THE PUBUC 8.EALTH.AND SAFETY AND THE ET1K18OKWEWT: Cesspool or privy Is within 60 festof surface water Cesspool or privy Is within 60 feet of a bordering vegetated wetland or a salt marsh. Z) SYSTEM Va-L FAIL UNLESS THE BOARD OF HEALTH(AND I'UBUC WATER SUPPUER. IF ANY)DETEYWINES THAT THE SYSr FUNCTIONING IN A MANNER THAT PROTECTS THE PUBUC HEALTH AND SAFETY AND THE ENVIRONMENT: 4P The system has a septic tank and soil absorption system(SAS) and the SAS Is within 100 test of a surface water supp tributary to a surface water supply. The system has a septic tank and loll absorption system and the SAS Is wlthln a Zone I of a public water supply weu. The system has a septic tank and loll absorption system and the SAS Is within 60 feet of a private water supply weu. The system has a septic tank and soil absorption system and the SAS Is less than 100 feet but 60 lest or more Irom a private water supply well,unless a well water analysis for collform bacteria and volatile organic compounds in6catas V well Is free from pollution from that facility and the press ce of immonla nitrogen and musts nitrogen is eQuaJ to or Is than 6 ppm. Method used to datermine distance (approximation not valid).- 3) OTHER System consists of two 6 ' X8 ' block c®sspeels Beth 1.-M-JSpv0!s were dry at time ot inspection . revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (corrdnued) Pro9aMAddrsss:464 Oakland Road 'Hyannis ,Mass . D"rw: Nancy Gargan Dime of 4upection: 7/6/9 9 0. SYSTEM FAILS: You must Indicate either 'Yes' or 'No' to each of the following: 4�2 1 have determined that one or more of the following failure conditions exist es described In 310 CMR 15.303. The basis lot this determination Is Identified below. The Board of Health should be contacted to determine what will be necessary to correct the lailu Yes No / Backup oFeewage into facility-or-v"tem component•due¢o an overloaded orcbgged SAS•orKesspod. Discharge or ponding of affluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distributionbox above outlet Invert due to an overloaded or clogged SAS or cesspool. Liquid depth In cssspoofis less than V below Invert or available volume Is less than 112 day flow. Required pumping more than 4 times In the last year NOT due to clogged or obstructed pipets). Number of times pumped. Any portion of the Soil Absorption System, cesspool or privy Is below the high groundwater elevation. Al 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 1 of a public well. Any portion of a cesspool or privy Is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less-than 100 feet but greater than 60 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, anach copy of well water analysis for colitorm bacteria, volatile otganiccompounds, ammonia nitrogen-and nitrate nitrogen. E_ LARGE SYSTEM FAILS: You must indicate either 'Yes' or 'No' to each of the following: The following criteria apply to large systems In addition to the critorla above: L._K. , The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to pus health and safety and the environment because one or more of the following conditions exist: Yes No� the system Is within 400 last of a surface drinking water supply the system•is-witWn 200 (aelof•*-tuiiwLary-ioasurlaoadrinscwagwalersuPPly the system is located in a nitrogen'sensitive area (Interim Wellhead Protection Area -IWPA) or a mapped Zone 11 of a pvol,: water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult the local region, office of the Department lot further Information. e4ofII Pa revised 9/2/98 e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddrass: 464 Oakland Road Hyannis ,Mass . Owner: Nancy Gargan Date of kupection: 7/6/9 9 k 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 aystemcompoaants.ba+w:b.aan pua►pod+fova2Joasttwo•v+8ak6 aw&tbe'system hasbaooxecaiu+a9w�+as1 Aov rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this Inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or Industrial waste flow. The site was Inspected for signs of breakout. All system components,J�luding the Soil Absorption System, have been located on the site. _t1o,V� The septic tank manholes were uncovered, opened, and the Interior of the septic tank was inspected for condition of batfl or toes, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System orrthe site has been determined based on: _ Existing information. For example, Plan at B.O.H. _V _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable 115.302(3)(b)) _ The facility owner.(and.occupaais.lf diHeraW irnut_ownet).weraprnyided.with lninun"=on SubSurface Disposal Systems. Page revised 9/2/98 l i i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 464. Oakland Road Hyannis ,Mass . Owner: Nancy Gargan Date of Inspection: 7/6/9 9 FLOW CONDITIONS RESIDENTIAL: Design flow: 1119 g.p.d./bedro m. Number of bedroom des NS Number of bedrooms(actual):1 Total DESIGN flow �f/, Number of current residents: Garbage grinder(yes or no):J Laundry(separate system) ( ea or"_;: If yes, so pawsInspection.required Laundry System inspected y( e or no) Seasonal use(yes or no): x1K 0 Water meter readings,if available (last two year's usage(gpd): Sump Pump(yes or no) : Last date of occupancy: COMMERCIALANDUSTRIAL: Type of establishment: /A Design flow: d ( Based n 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present:(yes or no)-&g Non sanitary waste discharged to the Title 5 iy�stam: (yes or no)� Water meter readings,If available: Last date of occupancy: OTHER:(Describe) .(A _ Last date of occupancy: Allf GENERAL INFORMATION PUMPING RAPORDS and our of information: System pumped as part of ins action: (yes or no) If yes, volume pumped: gall s Reason for pumping:TT' TYPE OF SYSTEM AZ 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 sty.Attach copy of up to date operation and maintenance contract Tight Tank V4 Copy of DEP Approval Other APPROXIMATE AGE of all components, date InstaHed4if known)•end source of-information: ---- - - Sewage odors detected when arriving at the site:(yes or no)y"V i. revised 9/2/98 Pa e6of11 e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM WF.ORMATION (corrdrmiod) PsoportyAddr—: 464 Oakland Road Hyannis ,Mass . o'TW: Nancy Gargaij. Dou of —: 7/6/99 BUILDING SEWER: (Locate on site plan)��JJ Depth below grads:?�� MalsrlaJ of construct) n; cast Iron•�40 P C other( xplel Distance ho priv to wat#j supply will or suction Ilne r D(amslor _ Comments:(condition of Joints, venting, ovldenco of(aaka•ge,-etc.) c x: e� roug the house vet . (locate on alte plan) Depth below grads:,dzh Material of construction oncrets�rttataljAFlberglasYVAPolyothylane+✓ALther(,xpi&In) it tank Is Instal, list age4H. 14.ags.confvmed by Cerdficats of Compliance_ (YesINO) Dimensions: , Sludge depth: - Distance from top of aly/1ge to bottom of outlet tes Ortraffls:,�� Scum Wckness: IVA_ Distance from top of scum to top of outlet tie or baffle: Distance from bottom of scum to bonom of OAS' tee or baffle:�/ / How dimensions wars determined: Ally Comments: (recommendation tot pumping, condition of Inlet and outlet loss oabsfilee, depth of liquid level In relation to outlet nvart. tuucwre::nu;: evidence of leakage, etc.) Septic tank is not present - G TRAP: (locals on site plan) Depth below grads: MatstlaJ of constructionYV•�oncrststi�st&LVJ—$F(berglass4L4Polyethylons�/4thar(explain) Dimensions: Scum thJcknssa: Distance from top of scum to top of outlet tee or baffle: Distance from bonom o1 to bonom of oudst tie or,baHts: Date of last pumping: Comments: (recommendation for pumping, condition of Inlet and outlet tea+ or baffles. depth of liquid level In relation to ouUat fn,en. nrucrjrnl Ini.p evidsncs of leakage, etc.) rease trap is not Drpqpnt - - revised 9/2/98 Patc7ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (corronuod) ProperryAd&*--: 464 Oakland Road Hyannis ,Mass . Owner: Nancy Gargan Date of lrupection: y/6/9 9 TIGHT OR HOLDING TANK-_4,&L(,Tank must be pumped prior to, or at time of, Inspection) (locate on site plan) Depth below 9rade:-4V—/1 Material of construction:�oncreteAlAmetal�Fiberglass�olyethylene4Mother(explain) AM .Dimensions: AA Capacity: gallons Design floe gallons/day Alarm present Alarm level: Alarm I working order:Yes No./4 Date of previous pumping: Comments: (condition of Inlet tee, condition of alarm and float switches, etc.) Tight Or o ding tanks nrP not nrPcenr OtSTRIBLrTION BOx:)Q�m (locate on site plan) Depth of liquid level above outlet Invert: 4)14 Comments: (nots.if level and distribution is equal, evideno+ of solids carryover, evidence of leakage Into or out of box, etc.) - - Distribution box is not prPs.ent PUMP CHAMBER:'OvQ (locate on site plan) Pumps in working order:(Yes or No) Alarms In working order(Yes or No)� Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) _ umD chamber is not IrPRPnt ;i revised 9/2/98 Page 8ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .' r PART C SYSTEM INFORMATION (corronued) Ptop*M Address: 464 Oakland Road Hyannis ,Mass . 0wrw: Nancy Gargan Date of Inspection: 7/6/9 9 SOIL ABSORPTION SYSTEM(SAS): approximated by non-Intrusive methods) (locate on site plan, If possible: excavation not required,location may be II not located, explain: Type: leaching pits, number: leaching chambers, number:? leaching galleries,number:__, leaching wenches, number, length: Isaching fields,number, dimen Ions: overflow cesspool,number: Ir Alternative system: Name of Technology' Comments: I ots condition of soil, signs of hydraulic failure,level of ponding, damp soil, condition of vegetation•,etc.) �oam sa san o si hyd in of s rma CESSPOOLS: je— (locate on site plan) Number and configuration: Depth-top of liquid to Inlet Invert: Depth of solids layer: Depth of scum layer Dimensions of cesspool: Materials of construction: Indication of groundwater. Inflow (cesspool must be pumped as part of Inspection) .. id not ass , comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of,vegetation, etc. am PRIVY:&mAJR, Ilocats on site plan! 4.14 Dimensions: Materials of constructign: Depth of solids: . Comments: (note condition of soil, signs of hydraulic failure, revel of ponding, condition of vegetation;etc.) riv , revised 9/2/98 Pier 9of 11 SUBSURFACE SEWAGE DISPOSAL SYSTT-M WSPECTION FORM 410%.� PART C SYSTEM INFOR)AAT10N (corrtkxiaC) PropaMAddrsa: 464 Oakland Road Hyannis ,Mass . ern«: Nancy Gargan i D au of 4up..ct;«:7/6/9 9 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include t(&s to &t Fast two permanent reference landmarks or benchmark& locate all walls wlthln 100' (Locate where pubIlc water supply comas Into house) 4T � 1 O 0 i i revised 9/2/98 Pap 10of II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 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 . f Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed.Site(Abutting property, bservation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps I,—"h cked pumping records Checked local excavators,installers f Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water contours map . Gahrety & Miller Model 12/16/94 J revised 9/2/98 Page 11of11 a 1>•....nr.rani•rs.-•�r• rnrmr•nnn�na�.r�.arn�r•.�wr�n.n.�rwy nr�r+�rn .. � 'TOWN OFBARNSTABLE BOARD OF HEALTH SUIISUItFACF SEWAGE I)ISI'O.SAL 9YSTF,M INBf'FCTION FORM - PART D •- CERTIFICATION �. ti'•tn•�••.•..>-♦..in-.+srnm na•nn.rtr>r>r�rnr++.rr.r-n�+nvrwn.ww.rr•.++e>ew/r�>w..r�n's nr.nn�..rr..r.rr.rrr..r.-...•.-.ter.-•r-� -..• -TYPE OR PAINT CI.EARL)'- PROPERTY INSPECTED STREET ADDRESS 464 Oakland Road Hyannis ,Mass . ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME Nancy Gargsn PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber- Jr. COMPANY NAME Joseph P. Macomber & Son, Inc. COMPANY ADDRESS Box 66, Centerville, Ma. 0263.2-0066 Street Town or City Stat0 11P COMPANY TELEPHONE (508 )775 -3338 FAX ( 508 )790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of ,inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : ,---Z— Systeui PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 , 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have conattcted has found that the system fails to protect the jiublic health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature a4eDate One copy of this tifieation must be provided to the OWNER, the BUYER ( where applicable ) and the I30ARD OF II EAL'i`lI: • If the inspection FAILED, the owner or•"operator shall upgrade within one year of the date of the inspection , unless allowed ortrequiredm otherwise as provided in 3.10 Ch1R 16 . 306 , partd . doc f �- Town of Barnstable Health Inspector Office Hours fttiE ram"c Regulatory Services 8:30-9:30 Thomas F:Geiler,Director 1:00—2:00 « BAMSTABLE. "�: Public Health Division Ar fp�,t A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 " Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT— SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: 3 . � Address: y Map,',�%7?—Parcel Name: Phone 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? ?ZD If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?-,- 2d. Please include a copy of the floor plans for the'entire property- showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO s� I£tle dwellingis'conpected to pulhc sewer,skip questions#4 through#9 below ; 4. Location of dwelling is INSIDE . or OUTSIDE a Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to PUB�WATER? 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE ONLY The Public Health Division has no objection t bedrooms at this property. Special Conditions: 3 �Q�©,�� 4-4 /lesW-* =, 6AGox- 12,r ,,;&d 44 Signed: Date: 2 9 mo-< 0;1health/wpfiles/amnestyapp �� c� �� � �� �� � � � � � ��- � \`� �� . - � ��, �� v � . '� �� C�4 . � � ._ � � � � �� i' I �� I �U � \\ 1 \,1,) � ^^� JJ � �� 'c.l �� ® � —� • � ® �� � � �s. 1J 0 �� � � �- �� � � McKean, Thomas From: McKean, Thomas Sent: Tuesday, February 15, 2005 12:21 PM To: Dillen, Elizabeth Cc: Shea, Kevin Subject: Amnesty Applications The Public Health Division reviewed multiple applications this morning and the following were approved or disapproved: 65 Marsh Lane, Hyannis Connected to Town Sewer APPLICATION APPROVED for 3 bedrooms as requested 19 Saint Catherine Avenue, Hyannis—`--C-� 3 bedrooms existing, four(4) bedrooms total requested,'property is located within a nitrogen sensitive area, 0.33 acre Disposal works construction permit issued 12/30/2003 for three (3) bedrooms Four bedrooms would violate the State Environmental Code, 310 CMR 15.214, NITROGEN LOADING LIMITATION Provision APPLICATION DENIED An Option To Be Provided: Eliminate one of the bedrooms (refer to no door five feet opening policy) 464 Oakland Road, Hyannis GC),>i 1 !--,q A 3 bedrooms existing, 3 bedrooms total requested, located within a nitrogen sensitive area, 0.36 acre However, submitted floor plans show four(4) bedrooms (including private"office"and studio apartment) Four bedrooms would violate the State Environmental Code, 310 CMR 15.214, NITROGEN LOADING LIMITATION Provision APPLICATION DENIED NOTE: Also the existing cesspools are approximately 41 years of age. An Option to be Provided: Eliminate one of the bedrooms (refer to no door five feet opening policy) Ste+C�on do/ 3 P cQrv�.y� tvJJl2 4e q L i �-s �"' vv( ^ram 324 Nye Road, Centerville 3 bedrooms existing, 4 bedrooms proposed, located within a nitrogen sensitive area, 0.49 acre lot NOTES: Assessed as 3 bedrooms, septic system designed for 3 bedrooms, submitted floor plans are not labeled Four bedrooms would violate the State Environmental Code, 310 CMR 15.214, NITROGEN LOADING LIMITATION Provision APPLICATION DENIED Required for Future Review: Labeled floor plans An Option to Be Provided: Eliminate one of the bedrooms (refer to,no door five feet opening policy) 90 Head of the Pond Road, Marstons Mills 3 bedrooms existing, 3 bedrooms requested, property is located within a nitrogen sensitive area, 1.36 acre lot- sufficient for 4 bedrooms max. However, submitted floor plans show 3 bedrooms plus a private"office" room, plus a private"music room"totals 5 bedrooms Septic system designed for three bedrooms according to the disposal works construction permit issued in 1984 Five bedrooms would violate the State Environmental Code, 310 CMR 15.214, NITROGEN LOADING LIMITATION Provision APPLICATION DENIED Options Provided: (a) Eliminate two of the private rooms (refer to no door five feet opening policy), or(b) eliminate only one of the private rooms (refer to no door five feet opening policy) plus have the septic system inspected by a DEP certified inspector 1 { .�Le1 `�-p3j i� Atir � aLtdst�eds*aKy 150 S S, G r. tJ� •� f .itsSIN tN 3 s'-1a 5'-1(r PELLA '. 3'la x TS' 12 CASEMENT NEW AZEK FASCIA&FRIEZE EXIST. BOARDS TO MATCH EXIST. TOP OF PLATE ' t, EM - F - ANDERSEN NEW TM4310 EN + . AN31 BEDROOM 431 ' DOUBLEHUNO 4 4 AWNING (VAULTED CEILING) - © 4 A A TOP Of FOUND. b, q © 30'x ae' A b, +o FOLDING I _ LOS. LEFT ELEVATION N p NOTES: © 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS -� &DIMENSIONS IN THE FIELD ;=7 Q EXIST. NEW RAKE BOARDS EXIST' 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, To MATCH EwsnNo � - a APARTMENT DETAILS,&FINISHES IN THE FIELD WITH OWNER tv O O EXIST. 12 r O O 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT EXIST. FIRST FLOOR TO BE.6'-8"ABOVE SUBFLOOR , dss t r k 4.) ALL CONSTRUCTION TO CONFORM TO THE IRC2009 BUILDING CODE TOP of PLATE W/THE 8TH EDITION MASSACHUSETTS AMENDMENTS 5.) 110 MPH EXPOSURE B WIND ZONE,1.25 ASPECT RATIO p=====_= 6.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, NEW SIDING TO EXIST, �� MATCH EXISTING EXIST. OR HORIZONTALLY W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING rrn - 7.) ALL LVL LUMBERIBEAMS TO BE 1.9e U480 LOAD NEW CORNER BOARDS 8.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE" TO MATCH EXISTING 9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL SIMPSON COMPONENTS 1' 10.) ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS. TOP OF FOUND. TO BE 3000 PSI FLOORPLAN 11.)VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE DURING FRAMING CONSTRUCTION REAR. ELEVATION 12.)SEE ENCLOSED 110 MPH CHECKLIST FOR ADDITIONAL FRAMING REQUIREMENTS LEGEND: 4 CONT.RIDGE VENT 0 EXISTING WALLS CONSTRUCTION TO BE REMOVED 12 NEW ASPHALT SHINGL E8 NEW CONSTRUCTION QExlsr.- _..� _.. 'TO MATCH E�usnNG SO d f TOP OF PLATE p SMOKE DETECTOR IECC2009 RESIDENTIAL ENERGY EFFICIENCY DETAILS Q CARBON MONOXIDE DETECTOR CLIMATE ZONE 5A(USE EITHER PRESCRIPTIVE VALUES OR,RESCHECK CALCULATION 1 TABLE 402.1.1 (MINIMUM PRESCRIPTIVE INSULATION&FENESTRATION REQUIREMENTS) "TT FENESTRAnON SKYLIGHT CEILING WOOD FRAMED WALL FLOOR4�ASEMEWAIL BASEMENT SLAB CRAWL SPACE WALLU.FACTOR U-FACTOR R-VALUE R-VALUE R-VALUVALUE R-VALUE R-VALUE0.35 0.60 38 20 30 0/13 10(2 FT.DEEP) IOM3 NOTES: " 1.R-VALUES ARE MINIMUMS&U-FACTORS ARE MAXIMUMS: °I vim TOP OF FOUND. 2.10/13 MEANS R-15 CONTINUOUS'INSULATED SHEATHING ON THE INTERIOR OR EXTERIOR a OF THE HOME OR R-13 CAVITY INSULATION AT THE INTERIOR.OF THE BASEMENT WALL 3.REFER TO IECC 2009 CHAPTER 4 FOR ALL INSULATION&ENERGY REQUIREMENTS RIGHT ELEVATION - ER COTUIT BAY DESIGN. LLc NEW ADDITION FOR u� l h. ;, w� 7. CONS PoSMALL NOTIFIED IF SCALE,:0�� $ DRAWING NO.: THE IL 43 BREWSTER ROAD "'"EEC "N"e'F`«°,RwD°°" MAS H P E E ,MA. 02649 . Y` SIGNER / KENT RESIDENCE OFTEDMWNDBME9OYOTHDNT�U6E DATE PH. (508)) 274-1166 °F'� A�'� °"'W�� FAX (508) 539-9402 CONSENT OF THE REOUIRE9 THE WRITTEN 464 OAKLAND ROAD HYANNIS, MA- CONSENTOFT"EDE81D7GKrPRER,HE w3/2,zo12 ACT OF ICTURpI COPVILOHf PROTEOItON- . p°f OF 7880. NEW ROOF CONST. x •2 x 12 ROOF RAFTERS S' SOLID 2 B BLOCKING IN THE OUTSIDE'-8' 11'•8" -SIB'COX PLYWOOD ROOOFF SHEATHING 11 TWO RAFTER S CEILING JOIST BAYS -ASPHALT ROOF SHINGLES ®4W o.°.,ALLOW SPACE FOR AIR 6 It 6 POST FROM - _ -15LB.FELT PAPER 6-1' FLOW ON THE UNDERSIDE OF ROOF HDR.TO RIDGE -I I"HI-R 13ATT INSULATION _ SHEATHING - 3.2 x 6 KING STUDS - ®SLOPED CEILINGS(R-A - EACH SIDE OF R.O. -MULTI LVL RIDGEBEAM 3.1 3/4'It 7 UP LVIHDR. - •r - •SIMPSON H 2.6 HURRICANE CUPS • • e — � AT ALL RAFTER ENDS • .' ———————— •ICE/WATER SHIELD AT BOTTOM® - 3'D'OF ROOF ' ( - - -PROP•A VENT BETWEEN RAFTERS r _ NEW 8'CONC. - - -WIND WASH BARRIERS FOUND.WALLS -ALUMINUM DRIP EDGE - '" I, ( L NEWB'x18'CONC.FOOTINGS W/2x4KEY 4 x 6 POST FROM RIDGEBEAM CONT.RIDGEVENT "NEW WALL CONST. DOWN TO NEW HEADER ULTI LVL RIDGEBEAM NEW 4'CONCRETE SLAB- ' 1R".2 x B STUDS o. d-.' 2.1 -PLYWOOD SHEATHING EATHING � f x. SIMPSON BC46 3.8'(R BATT,INSULATION z x 6L®18'o.e. POST CAP/BASE 4.1/2"GYPSUM BOARD ' F - • -.. t2 S.W.C.SHINGLE SIDING MATCH S.TYVEK VAPOR BARRIER(EXTERIOR) A • I ° A A fl A - NEW U7 GYP.ON i z 3 STRAPPOI OD EXIST, 7.POLYVAPOR BARRIER(INTERIOR) A "2 x 8's BETWEEN EACH RAFTE TOP OF PLATE TO PREVENT WIND WASHING :- 0 4 x 8 POST FROM ,. HDR.TO RIDGE 3 1 3I4'x$1R LVL HEADER CONT.VINYL _ 3-2 x 6 KING STUDSSOFFIT VENTS e I J • :EACH SIDE OF R.O. FULL HEIGHT WALL BOTH OENND9 ~ 4 L--------- �--------- =---'� d♦ i♦ ... TO STUDS MFLOOR. - LLEXTEND FTO. UNDER EXIST. Gy_9 ,Lp�' - TO PNCK UP I '`9)' 1��,,///ry+0 3K,2J 3K2J FIRST FLOOR _ POST LOAD - —` 1 SUBFLOOR FROM ABOVE v� t NEW P.T.2x6SiLL Wl SEALER f ___ ___ - r' Of FOOTINOK _——DUE TO LAC EXISTING RIDGE oo NEW 4'CONC.SLAB - EXISTING CONCRETE 12'DEEP O O - ON COMPACTED SOIL , SLAB W)O FOOTINGS - - NEW 8'CONC, C NEWT RIGID INSULATION FOUND.WALLS (R10)W/43'CUTFOR. THERMAL BREAK NEW B'x 16'CONC. +- -- -- FOOTINGSW/2x4KEY. .. A BUILDING:SECTION -NEW BEDROOM FOUNDATION PLAN ROOF FRAMING .PLAN A2 ' , NOTES: NAILING.SCHEDULE 1.) ALL ROOF RAFTERS TO-BE 2 x 12's 110 MPH EXPOSURE B WIND ZONE UNLESS.OTHERWISE NOTED JOINT DESCRIPTION NO.OF COMMON NAILS NO.OF BOX NAILS NAIL SPACING 2.) USE SIMPSON H2.5 HURRICANE CLIPS 1S INSTALL5I8'ANCHOR BOLTSAT71-o.c.MAX AT ALL RAFTERS ENDS UNLESS ROOF FRAMING:. .T _ . W/SIMPSON BPS 518.3 BEARING PLATES BLOCKING TO RAFTER(TOE NAILED) 2.8d:-. x• 2-10d EACH END PLACE BOLTS WITHIN S%IT OF EACH• OTHERWISE NOTED RIM BOARD TO RAFTER(END HAILED) 7.180 3.10d EACH END 8" �" - CORNER AND TO A S'MINIMUM DEPTH 3.)VERIFY GUT TER:TYPE/LAYOUT , WALL FRAMING: WI OWNERS TOP PLATES AT INTERSECTIONS(FACE NAILED) 416d 5.16d AT JOINTS STUD TO STUD(FACE NAILED) 2-tee 2.16d 24'ox. HEADER TO HEADER(FACE NAILED) 16d i. led 1 OF ca.ALONG EDGES _ 13, r FLOOR FRAMING: - b ❑, ,- J018T TO SILL,TOP PLATE OR GIRDER(TOE NAILED) 4•Sd 4.1od PER JOIST' . c - ,...•mw...•"w 'BLOCKING TO JOISTS ROE NAILED) 2•tOd EACH END . BLOCKING TO SILL OR TOP PLATE(TOE NAILED) ""`°"""•" ""' YIBd: 4.16d EACH BLOCK LEDGER STRIP TO SEAM OR GIRDER(FACE NAILED) 3.18d 4.16d EACH JOIST - JOIST ON LEDGER.TO BEAM(TOE NAILED) j 3-Bd 3•/0d PER'JOIST. P.T.2 K 6 SILL W/SEALER ' TYPICAL ASPHALT - j�' BAND JOIST TO JOIST(END NAILED) 3.1Bd: 4.19d PER JOIST - o = ROOF SHINGLES x - �i SAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2.1 e a s ted PER FOOT ngo 5/6'COX PLYWOOD SHEATHING ROOF SHEATHING: `\ a - 2 x 12 RAFTERS .15A FELT PAPER WOOD STRUCTURAL PANELS(PLYWOOD) * <, RAFTERS OR TRUSSES SPACED UP TO I6'e.a 6d 10d- B'EDGEW FIELD SIMPSON H 2.5 HURRICANE CUP$ RAFTERS OR TRUSSES SPACED OVER 16-o.a Sd 10d 4'EDGEW FIELD WIND WASH GABLE ENO WALL RAKE OR RAKETRUSS M OVERHANG 6d 10d 6'EDGEW HELD 3'P WIDE ICENWATER SHIELD BARRIER x GABLE END WALL RAKE OR RAKE TRUSS 8d 10d S'EDGElB'FIELD '• 1k3 ALUMINUM DRIP EDGE WI STRUCTURAL OUTLOOKERS •`- • FASCIA,SOFFIT,6 FRIEZE GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS Sd 100 4'EDGEI4'FIELD 1 x 3 STRAPPING W/ BOARDS TO MATCH EXISTING CEILING SHEATHING: ' ANCHORBOLT DETAIL Ur GYPSUM BOARD GYPSUM WALLBOARD Sd COOLERS — 7'EDGEHO`FIELD WALL SHEATHING: r -.r. -o. V4000 STRUCTURAL PANELS(PLYWOOD)R TYP.2 x 8 WALL$ _ + �� STUDS S .FIBERBOARD AN S 8d tOd 7 EDGEji W FIELD - 112'82sN3r F16ERBDARO PANELS Id � — T EDGEW FlElO 1?OVPOUM WALIBOARO., - 5d COOLERS -- 7'EDGEMW FIELD FLOOR SHEATHING: DETAIL AT,WALL ,) WOOD STRUCTURAL PANELS ELB(PlYWD0)) t 1'OR LE88 THx:KNE88. Sd. fOd S'.EDOFJl FIELD 1GREATER THAN V THICKNESS- 1Od 18d 8•EDGEW FIELD ERROMOORRTHE OOLaroPBARREEFOOUNOM SCALE DRAWING NO. COTUIT BAY DESIGN, LLC NEW ADDITION FOR. THESEOBCTIoN. HR10RTOeTARTOi _"- WI`LBE R�Po IB E FORTHE�CONT � . . .._. 43 BREWSTER ROAD �M VV�;CON11 TIO r=- ------,._ l NonFyINGTHe OESIGWR OF AW ERRORS OR OMISSIONS° MASHPEE ,MA. 02649 KENT RESIDENCE ! HESEppWWM ARE SOLELY FOR THE USE DATE PH. (508 274-1166 I OP THE RAWNMER FtEwR9 GNER=WRITHER USE OP 2012 ) r THESE ORANIPIGB gEQiSRFA THE V.RITfQ/ :. FAX (508)539-9402 464 OAK LAN D ROAD HYAN N I S, MA 'nTEC OPTHE/ COP 3i2 ACT OF 1P8Q'.. ... . ... _ _. ...,.:. -.......... , , _:.,.-zxg.•,.»,.... '. ... .r; „.... .,,...r.„. -..,... ,.,. ... ,.-a, .a•.��+„-saw.,w-a6varL'rsr..a«a4.w<.,==,,a...e.w s-.:. ...,.� ... •r„' i S + � 35 171 t 4 bo I � Ju. i i Y t f1 Si SURVEY REFERENCE: " LEGEND PLAN OF,LAND BY DAVID H. GREEN, SURVEYOR E` l Q DATED: JULY 1966. W i`.. .,. � 3 PROPOSED CONTOUR v) Ld ® PROPOSED SPOT GRADE ) o SITE U 98 —— EXISTING CONTOUR ! „ + 96.52 EXISTING SPOT GRADE r Q BENCH MARK 0W— EXISTING WATER SERVICE a TOP. OF CONCRETE y o a BULKHEAD CORNER TEST PIT 3 z m +�. ELEVATION = 61 . 82 0 BARNSTABLE CIS DATUM. i EXIST. CESSPOOLS ROTE ZS/FALMQUTH RD' (NOTE 10) 135.00 ft LOCUS MAP N.T.S. LOT 18 _ AREA 15728 sf +- ,� f GENERAL NOTES: 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 25`r _ BOARD OF HEALTH AND THE DESIGN ENGINEER. r S PROP. 1,500 GALLON 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS or o U 2-COMPARTMENT SEPTIC TANK OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE ,\ LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE TH-2 ! DESIGN ENGINEER. r ® 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING TH-1 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o ft 1•\ !' / 0 1 I o /`O ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. \ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF i I ! IF-1 ! THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. i w EXISTING 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. s. I( � OF '. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED Mass 0 , DWELLING 0 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE DARE "N tiG co THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING V M CONSTRUCTION. �. Q TOP OF FN�QN No. 1140 w EL = 62.68 10. EXISTING CESSPOOLS TO BE PUMPED, CRUSHED AND REMOVED. > 9 REPLACE WITH CLEAN MEDIUM SAND PER TITLE V. of — // 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PNI TARS --_.__ ____- 1 .l p I 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY II 4 �W AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY Q 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. 14. NO WETLANDS WITHIN 150' OF PROPOSED LEACHING. 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) 135.00 ft 1 3 c� EDGE of PAVEMENT PROPOSED SEPTIC SYSTEM UPGRADE PLAN 464 , OAKLAN P eDar d0 oD, Ke t ANNIS, MA OAKLAND R I A D Engineering by: Surveying by: P SCALE DRAWN a MAP.' 272 DARRENM.MEYER,R.S. Eco—Tech Environmental 1"_20' DMM Po BOX981 (508) 364-0894 ' . 'LOT.' 096 EASTSANDWICH,MA02537 , DATE CHECKED SHEET NO. 508-362-2922 12/06/10 DMM 1 of 2 A t , . 9 , R �PJ✓ t7l 0�{ Ar07 2 GPM p 1 S0�6 T}�rJ k- ELEV. TOP FOUNDATION NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS a (Existing) 62.68 F G.ELi, 61.0- 4 FINISH GRADE= 60.95 F.G.EL:'61.50 , F.G. EL:f 61.0 ., .a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER LEACHING = 3.0 FT. a• h COVERS TO WITHIN 6 OF GRADE RISER TO W/IN 3" OF GRADE 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2' DOUBLE STONE OR FILTER FABRIC STONE WASHED STONE 61, w 4" SCH 40 PVC 4" SCH 40 PVC ®S=2% 10 1 @ S 1� MIN. I ®®®®. 0 ®®®® (MIN.) 14" ( ) 6" ® S= 1% (MIN.) ®®®®®®®®®®® ®®®®®®®®®®® INV.57.50 2 EFF. DEPTH ®®Ea®®®®E3®®® INV.58.25 1NV.57.33 4 2 X 8.5 4 EXIST. OUTLET GAS PROPOSED, DB-3 �' BAFFLE ` EFFECTIVE LENGTH = 25' INV. 58.93 ..:..,....« •. �.... . .... � � . . _ H-10 DISTRIBUTION BOX. • INV. 58.50 4 - PROPOSED 1,500 GALLON 2-COMPARTMENT w- INV. ELEV.- 57.20 SEPTIC TANK f NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING GAS BAFFLE TO BE INSTALLED ON., PIPE INVERTS PRIOR To CONSTRUCTION TOP CONC. ELEV.=57.95 '2) TANK AND D-BOX SHALL BE SET LEVEL AND TRUE; INV; ELEV.- . 57.20 ®® 30 OUTLET TEE AS MANUFACTURED BY TO GRADE ON A MECHANICALL COMPACTED SIX ®®®E TUF-TITS,ZABEL, OR EQUAL. INCH CRUSHED STONE BASE, AS SPECIFIED IN ®®®®®®® 310 CMR 15.221(2) _ ®®®®®®® " 3) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM EL. 55.20 ®®®®®®® �, 4 5 FT. - 4 SOIL` LOGS SEPARATION 5.30 FT. EFFECTIVE WIDTH = 13' . t P#:13135 _ _• k T 500 GALLON LEACH CHAMBER H-10 LOADING t BOTTOM OF TESTHOLE EL: 49.90 SOIL ABSORPTION SYSTEM SECTION) DATE- NOVEMBER '24, 2010 SEPTIC. SYSTEM PROFILE ( ) ) SOIL EVALUATOR: DARREN MEYER, R.S., CSE - WITNESS: DAVID STANTON, BARNSTABLE BOH N.T.S. ° DESIGN CRITERIA HEALTH AGENT Elev. TH- 1 ' Depth Elev. TH-2 Depth NUMBER OF BEDROOMS: 3' BR DESIGN (PROPERTY IS IN ZONE II) MULTI-FAMILY USE 61.10 0„ 60.90 0" r. A LOAMY SAND SOIL TEXTURAL CLASS: CLASS I ; 10YR 3 2 A LOAMY SAND .. SIGN PERCOLATION RATE: <2 MIN/IN DE 60.77 B / 4„ 60.48 tOYR 3/2, 5„ DAILY FLOW: 110 G.P.D. B DESIGN FLOW: 330 G.P.D. LOAMY SAND LOAMY SANG ' SEPTIC TANKREQUIRED 330 Use new 1,50OG 2-comp 58.77 tOYR 5/8 28„ 10YR 5/8 (VOL.( ) gpd x 2 = 660 gpd P C1 58.48 C1 29" GARBAGE GRINDER: NO (not designed for garbage grinder) Septic tank) MEDIUM SAND MEDIUM SAND 4- " LEACHING AREA REQUIRED: 330 gpd/0.74 = 445.94 S.F. ' -.� 2.5Y 6/6 2.5Y 6/6 55.68 65" 55.57 64" USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS (H10 LOAD) c2 C2 WITH, 4 FT. ON ALL SIDES: 25'L x 13'W x '2'D MEDIUM MEDIUM r= BOTTOM AREA: 25 X 13 325 SF COARSE - COARSE , SAND SAND �, SIDE AREA: (25 + 13) X 2 X 2 =. 152 SF BOTTOM OF PERC ®56.10 ,2.5Y 7 3 / / 2:5Y 7 3 TOTAL SQUARE FEET PROVIDED = 477 vs. 445.94 REQ'D 1. DESIGN FLOW PROVIDED: 0.74(477 S.F.) = 352.98 G.P.D. vs. req'd 330 GPD 50.10 132 49.90 132,,. �� OF Mqs ����� PROPOSED SEPTIC SYSTEM UPGRADE PLAN PERC RATE <2 MIN/IN. ("Cl" HORIZON) U DAEM NO GROUNDWATER OBSERVED $ 464 OAKLAND RD., HYANNIS, MA �. No. 1140 Prepared for: Kent * 6�STER�O Engineering by: Surveying by: SCALE DRAWN k S t`� DARRENM.MEYER,R.S. Boo-Tech Environmental N.T.S. DMM f, Darren M. Meyer, R.S., CSE, hereby certify that I om,currently approved by MADEP pursuant to 310 CMR 15.017 AN I TARS Po BOX 981 to conduct soil evaluations and that the above analysis has been performed by me consistent with the 04;�il EASTSANDW/CH,MA02537 (Sos) 364-0894 DATE CHECKED SHEET NO. requirements of 310 CMR 15,017. 1 further certify that I have passed the Soil Evol. Exam in October, 1999. 01 508-362-2922 1 2/0 6/1 0 DMM 2 of 2 4D O 2- Co,",o i SOO Cp 7*f-lk