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Home My WebLink About0179 OLD CRAIGVILLE ROAD - Health l79 Old Graigville Road Hyannis A=248 — 144 -001 i i i i i i i i Commonwealth of Massachusetts a�v `�T 00l W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 2-1 0 179 Old Craigville Road Property Address KI Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection 65 1 Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information . on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brett Hickey use the return Name of Inspector key. B&B Excavation Company Name 374 Route 130 Company Address Sandwich Ma 02563 Cityrrown State Zip Code (508)477-0653 SI 13747 Telephone Number License Number B. Certification 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: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-24-17 Inspector's Signature Date The system inspector shall submit a copy of.this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of.completing this inspection. If the system 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. ****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. t5ins•3113 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System -Page 1 of 17 �.l" N Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System was in working order at time of inspection. Dwelling had a garbage grinder but it was removed as system was not designed for it. 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ N.D (Explain below): !i t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 _ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 health, safety or the environment. 1. System will pass unless,Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters t due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page'4 of 17 - Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a`tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5of 17 P Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is Hyannis Ma 02601 10-24-17 required for every y page. CityFrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(Actual) 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 331/GPD t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2.years usage (gpd)): See below Detail: 2015-29,920gallons 2016-60,588 allons Sump pump? ❑ Yes ❑ No Last date of occupancy: 1 month Date Commercial/Industrial Flow Conditions: Type of Establishment:. NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No' Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑' No Water meter readings, if available: _ t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 e Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Date of last pump is unknown per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined?. Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500gallons Sludge depth: 2 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 34" Scum thickness 0 11 Distance from top of scum to top of outlet tee or baffle NS Distance from bottom of scum to bottom of outlet tee or baffle NS How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is not in need of pumping at this time but should be pumped every two years for maintenance. Grease Trap(locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: , gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 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.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up or carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: (2) 500 gallon ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Chambers were dry with no staining. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA 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 El Yes ❑ No i . t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17" . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 179 Old Craigville Road Driveway Driveway BH Al-14' A2-14'6" A3-37' A4-43' B 61.32' B2.2T6„ B3-25' 134-29' 1 Shed 2 3 a 0 Shed t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c M 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: NO GW @ 132" feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 11-3-05 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page, t5ins•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 179 Old Craigville Road Property Address Vincent Anton Owner Owner's Name information is required for every Hyannis Ma 02601 10-24-17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 t 9116/03 Notice: This Form Is To lie L7sed For tfie Repair Of Failed Septic Systems.Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM hereby certify that the engineered plan signed by me dated 1► 3/ 0 concerning the property located at 1"7 9 OW 0:vkQ l 1�e (ZA 44 d try�/ meets MIl of the following criteria: 0 This failed system is connected to a residential dwelling only. There are no corranerciat or- - business uses associated with the dwelling. • The.soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes Per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation tests at the site without a health agent present. There is no increase in flow and/or change in use proposed • There are no variances requested or needed. ® The bottom of the proposed leaching facility will_be located no less than five feet above the maxinwm adjusted,groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: 'I A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation AL+adjustment for high G.W. DIFFERENCE BETWEEN A and B SIGNED : `tam .DATE: �1l Cj� NOTICE Based upon the above information;a repair permit will be issued for bedrooms maximum. No additional bedrooms.are authorized in the fixture without engineered septic system Plans gASeptiv*e tw=W.doc T UWN OF BARNS':ABLE w i LCi=JA`:I.ON 71 cx�n aw1ai - m, SEWAGE # --0,30** VL]LAGE ASSESSOR'S MAP & LOT t,NSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2 45d6 (size) NO.OF BEDROOMS BUILDER OR OWNER VIM PERMITDATE: OMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ,�e �� .. �w ° �� . TOWN OF BARNSTABLE LOCATION l 79 C rl� SEWAGE # V11LAGE W ,s,. ASSESSOR'S MAP LOT INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY F b IOC r,GS s�GIs Gwi�/ p vc p�P� LEACHING FAC)LITY:(type) (size) _ ENO, OF BEDROOMS z PRIVATE WELL OR PUBLIC WATER pkbl.'e BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: I� VARIANCE GRANTED: Yes No o� w s ,00� 1, 350 Main St. • W. Yarmouth, MA 02673 9775-6264 a Div1slon o/.Canto Energy Corporation •Sbptic'Services • Pumping Installation September 9, 1988 Re: Septic Evaluation: 179 Old Craigville Rd. , Hyannis To Whom It May'-.Concern: l'he septic system at. the above-noted loeation was evaluated by A&B/Canto on August 30, 1988. This system is located to the right side of therdwelling and consists of two (2) : .block cesspools .approximately 12" below grade 'and connected by PVC piping. 7 -system was found to be in good condition and working order at the time of ".inspection. •r • The system does not meet. the requirements of the State Environmental Code, Title 5: Minimum Requirements for the 'Subsurface Disposal of Sanitary Sewage because of the block cesspool, but is allowable under the current Board of Health regulations until failure:. If you have any questions, please call me at 775-6264 between 8:00am and 4:30pm Monday through Friday. , Sincerely, a 'Robert O. .Murphy i iom:rlt c i r- No.? 5 Fee PU THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for ;Di!6po5aU*p!5t'em CowatuCtion Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /-lq 040 4 01111UE il4'• Owner's Name,Address,and Tel.No. V//t/AgW Assessor's Map/parcel a 6 L f OJ v Installer's Name,Address,and Tel.No.aW�W17-,6 Designer's Name,Address and Tel.No. LI-5 qv-YES 4�-4yG. kS k uil sf , . 13 Type of Building: Dwelling No.of Bedrooms Lot Size 7 ta sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 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) 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 Envi ental ode and not to place the system in operation until a Certificate of Compliance has been issued by this Bo of He S gned Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. osw rj 5 b Date Issued f l: ° ;c Fee DO ' a THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _ PUBLIC HEALTH DIVISION - TOWKOF BARNSTABLE, MASSACHUSETTS Yes gig` apprication for �i.5pogal ��p�emc Gantt •uction Permit ..._ -. .1 ",; M, Application for a Permit,to Construct( ')" Repair(' ) Upgrade O Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. /I Owl✓c.IV 10 u- k�O t Owner's Name,Address,and Tel.No. (///y~ Assessor's Map/Parcel �G l Installer's Name,Address,and Tel.No. aa(�}/t/��0 `� Designer's Name,Address and Tel.No. /tst0 IMILLI q010-9" E//'U/, U S / "!!sr fi60 `f77-5213 Type of Building: 2 Dwelling No.of Bedrooms 3 Lot Size Q 7 f 'l sq.ft. Garbage Grinder ( ) Other Type of Building No,of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 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) 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 Environ ental de and not to place the system in operation until a Certificate of Compliance has been issued by this Boa of He •4t t'�. XSi ned Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No:•,,, 00 IS J b Date Issued ----------------------- -------------- ,.. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( (/) Upgraded ( ) Abandoned( )by /Uf 'OT-rl-- at has been constructed in accordance J with the provisions of Title 5 and the for Disposal System Construction Permit No. 9M 51 I dated Installer kmow ,9Ydrxr-- Designer 6y-K(Aas #bedrooms Approved design flow 30 gpd The issuance of this permit shall not be const•ued as a guarantee that then stem will c i a es ned. Date In§pecttor_P - ---- +—'—�y�--------------------------------/------ No. P'`"' 5 5� Fee /� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Di.5po!5 6p5tem Cow6tructiot� erntit Permission is hereby granted to Construct ( ) Repair ( (/S Upgrade ( ) Abandon ( ) System located at 1'72 6 4 C/NQI-4LE/wl 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 in stb-e completed within three years of the date f this p It Date_�� I 14� Approved y Town of Barnstable Regulatory Services i f Tbomsas F.Goiter,Director Pub is Heaaltht Didion Thomas McKean,Director 200 Mmiat Street,hyaeiftis, NA 02601 Office: 508-862.4644 Fax: 508-7W6304 lr►stalier J 2g�i�trtiftatio Lii �� ^ 1 Date: t l I(e �S Sewage permit# _QK J� —Assessor's Map\Paercei Z� ' Designer: F21-e,— nc�� installer: D�� Address: —r;A)sc2 SM Address: ZO _Tt'\- __Fo�o C\C-e Lk r On 11-7�� PRIAV'j6Yj2j:E was issued a permit to install a (date) (installer) - NJ��h\s septic system at V7 et 01d 1 Mrs based on a design drawn by �r�tirtee,rr�.y al�S (ad(ress) Mc f,'-V� dated (designer) i certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. i certify that the septic system referenced above was installed with major changes (i.e. greater than l 0' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State Local Regulations, Plan revision or certified as-built by designer to follow. P9TV T. % IMetNTEE (installer' nature)p,ail 44Mils ih+�101 � (Designer's Signature) (Affix Designer's Stamp Here) ELEASIE LE E Ul 1<� M HKAL IK RIXIStO?d, CLAXIEMAIL OF Q:ReAth/Septic.0tsiper Cenification'Form 3.26.04.doc LEGEND 4 Benchmark set o s Nai( in 2 Ft, oak t v 11'fST Mq1 r. " E.I,=99.95 CAssumedo T 98.09 97,96 yy PROPOSED CONTOUR A/ ST cc u ' Strcet o' yg Jg - 97.94 Li 99 PROPOSED SPOT GRADE pine 97.61 N 87°52'30" E -- - � 97.97 � kaae Fence 97 50 0 -11(�� EXISTING CONTOUR 171,73' Sto 1 /v Lindn Ln L-- .22TP-2 / 110 EXISTING SPOT GRADE _ __ 98.131 P,ed TP-1 / �a Carlotta qv �`\� .PROP S.A.S.3 PROP. t 00A K / lU 97,87 "j D-BOX f 9 I L 7 .p Y �� o ono, a�,c• IF O Oq� vTEST PITLacus 1 PROPOSED O O 98.0j.c (A 2'Gj�T ❑AK L_:�:-==-_--� /al SEPTIC TANK � � 97,56 a � � �£ EXISTING OVERHEAD WIRES = �2 ( 0 27' TOwn '°o LOT 4 0 \-Sd98.47 97.61 Z 27,761t S.F. h� W EXISTING WATER SERVICE o- 0,64t AC, 97.10 ' x 97.17 x 96.30 1 n Map 248 TpFc9 ed) Relacotelnv e9562 ( -- - EXISTING GAS SERVICE w Parcel 144 Deck CA5SUM Du{1et 97.36 EXISTING CESSPOOLS _ o G TO BE PUMPED AND LLING FILLED WITH SAND EXISTING TREE LOCUS MAP N.T.S. I)IVIE97.71. EXISN�USE98 62) x 96.64�'7N\ 97.93 TOF- 97.59 rN ram` x 96.19 E �S ' •r x water svc,Cap�_W `p F 7.40 J916, 6 97.62 �J x 96.13 IV 6�`6' 9 ,1 (4 97.21 x 96.14 Z � A m a, 97.09 96,7 a o t V 3,o v 113.2 S 77°0=4 2 ! 96.58 �N--N No 9`.19' P� GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL + BOARD OF HEALTH AND THE DESIGN ENGINEER. Mq f 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS f p3 ` -v Q� �1�r 109 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 55' tG'I° 00 v �` LOCAL RULES AND REGULATIONS. 81 2524. RO r-J� o PETER T, ENTEE 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �� W S V McIVIL TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE AA CIVIL OL Na. 35109 DESIGN ENGINEER. �_- 23' _--_.�15•g New 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING w i �" i 16'7 �F�is�E�LF% FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Iv i PROP S.A.S. FFSjp \� ENGINEER BEFORE CONSTRUCTION CONTINUES. __ / 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. - Ov AA 6$ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 39,3, V- THE CONTRACTOR OR OWNER TO"NOTIFY THE LOCAL BOARD OF he HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. so t 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 97 S. THERE ARE NO ABUTTING PRIVATE WELLS WITHIN 100' OF THE S.A.S. Deck �Assu ed) 9 ALL AREAS TO A CONDITDIONUAGRDEEDURING UPONCBETWEENCTION SHALL OWNER ANDBE RESTORED CONTRACTOR. PROPOSED SEPTIC SYSTEM UPGRADE 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE SED#Ej9ING 179 OLD CRAIGVILLE ROAD, HYANNIS, MA EXISHUG- THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 62 CONSTRUCTION. TOF-98' Prepared for: Vincent Anton, 171 Old Town Rd, Hyannis, MA 02601 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. Engineering by: Surveying by: SCALE DRAWN JOB. NO. AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). Engineering Works Terry A. Warner PLS 1"-30' P.T.M. 216-05 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND S.A.S. LAYOUT } 12 West e, MA Crossfie0 Road H Long Road Forestdal2644 Harwich, MA 02645 DATE CHECKED SHEET NO. IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. r r (508) 477-5313 (508) 432-8309 11/3/05 P.T.M. 1 of 2 i ' NOTE: TO PREVENT BREAKOUT, THE PROPOSED F.G. EL: 96.6t FINISH GRADE SHALL NOT BE < EL:94.5 .O.F .=98.62 FOR A DISTANCE OF 15' AROUND THE F (EXISTING) PERIMETER OF THE S.A.S. EXISTING F.G. EL: 98.0t(EXISTING) � F.G. EL: 97.0t MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO 2-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER CHAMBER/S TO WITHIN 6" OF FINISH GRADE WITHIN 6" OF FINISH GRADE IN SERIES WITH STONE ALL SIDES SHOWN ❑' PLAN AND SET C❑VER/S L =28' WITHIN 6" OF FINISH GRADE 4" SCH 40 PVC „.....,... . : . L =30' L=5' 4" SCH 40 PVC 4" SCH 40 PVC -—2' LAYER OF 1/8' TO 1/2' @ S= 2% (MIN.) ID ®®®$®�� DOUBLE WASHED STONE Q; 14 @ S= i% (MIN.) 6., i @ S= 1% (MIN.) e 48' LIQUID INV. ELEV.=94.33 2' EFF, DEPTH iiB�®i�® LEVEL INV. ELEV.=94.50 3/4"-1 1/2' GAS 4' 5.2' 4' DOUBLE WASHED INV.EL: 94.80 B❑X FFECTIVE WIDTH = 13,2' STONE INV.EL: 95.05 BAFFLE PROPOSED - PR❑P❑SED S,A,S, PROPOSED 1500 GALLON ,SEPTIC TANK � INV. ELEV.=94.00 GAS BAFFLE TO BE INSTSALLED ON OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV,=94.8 MODIFY INTERIOR PLUMBING TUF-TITE, ZABEL, OR EQUAL —BREAKOUT ELEV.=94.5 TO EXIT HOUSE AT LOCATION INV. ELEV.=94.00 ®®®10® SHOWN ON PLAN, NO LOWER NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING ®®8 ®®ai�B® THAN 36' BELOW T.O.F. PIPE INVERTS PRIOR TO CONSTRUCTION. BOTTOM ELEV.=92.00 2 x B. = 17.0' INV.EL: 95.62t 2) SEPTIC TANK AND D-BOX SMALL BE SET LEVEL 3 AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN) 5' MIN, ABOVE BOTTOM OF EFFECTIVE LENGTH = 23,0' 310 CMR 15.221(2). T,P, EXCAVATION OR G,W. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. S.A.S. SECTION �\\ p� MAfj NO GROUNDWATER, EL.=87,0 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE } AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL; d PETER T. NOTE: SET INVERT AT OR BELOW 'C" HORIZON, IF BELOW McENTEE (3) 5" DIA.OUTLETS ELEVATION 94,0, S❑IL CONSISTENCY AND ABSENCE OF 4' CIVIL tss• '..I�2• SEPTIC SYSTEM PROFILE GROUNDWATER TO A DEPTH OF 5 FT, BELOW BOTTOM No, 35109 N.T.S. OF S.A,S, SHALL BE VERIFIED, 1 , 1' �S/ON L G\ 15.5. DESIGN CRITERIA 8' 4" Dia. Outlets I cat ° 6 4" Dia. Inlets 4 Otlt SOIL LOG NUMBER OF BEDROOMS: 3 BEDROOMS H-10 LOADING z' 0 1 NT'L SOIL TYPE: CLASS I y DATE: SEPTEMBER 20, 2005 D—BOX DESIGN PERCOLATION RATE: 2 MIN. IN, Kr.s. 5'-8" 3" !� SOIL EVALUATOR: PETER McENTEE PE, CSE DAILY FLOW: 330 G.P.D. 4'-10 48"Liquid Level 4_7" WITNESS: NOT WITNESSED-CLASS 1 SOILS DESIGN FLOW: 330 G.P.D 4" GARBAGE GRINDER: NO Elev. TP- 1. Depth Elev. TP-2 Depth LEACHING AREA REQUIRED: (330) = 445.9 S.F. " 98.0 A 0" 98.1 A SANDY LOAM 0„ 74 CERER 0 ®®® SE ION SANDY LOAM 10YR 3/3 10YR 3/3 PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY E3®®ER®®� 33" 97.0 12" 97.1 12" I3®®E3®®® BwSANDYLOAM BwSANDYLOAM I�®®®®®® 7,5YR 4/4 7.5YR 4/4 USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 95.0 36 94.4 44 Ct c1 SIDEWALL AREA: 2(13.2' + 230) X 2 = 144.8 S.F. 102" 3 — 24" Dlo. Covers BOTTOM AREA: 13.2' .x 23.0' = 303.6 S.F. 48„ 42 TOTAL AREA: 448.4 S.F. 4' KNOCKOUT 5'—B' 0C�' 0I PERC PERC 20' DIA. COVER MED. SAND ' MED. SAND 54" DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. 60" 4 5 4" KNOCKOUT O/4" KNOCKOUT 62„ 2.5Y 5/4 } 2,5Y / i'l I - - 3-4" Dia. Inlets PAN 3-4" Dia. Outlets j PROPOSED SEPTIC SYSTEM UPGRADE 4" KNOCKOUT 179 OLD CRAIGVILLE ROAD, HYANNIS, MA 87.1 132" 500 GALLON CAPACITY, H-10 LOADING 1500 GALLON CAPACITY (H-10) 87'0 I' 132 Prepared for: Vincent Anton, 171 Old Town Rd, Hyannis, MA 02601 PERC RATE: <2 VIN/IN PERC RATE: <2 MIN/IN Engineering by: Surveying by: SCALE DRAWN JOB. NO. CHAMBERS SEPTIC TANK 4 EngineeringWorla Terry A. Warner XS NTS P.T.M. 216-05 NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road 22 Lon Road N•TS N.T.S. I Forestdole, MA 02644 Harwich MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 1 1/3/05 P.T.M. 2 Of 2