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0024 OTIS ROAD - Health
24 OTIS ROAD HYANNIS A = 311 058 r r f TOWN OF BARNSTABLE LOCATION SEWAGE# �201�"fey VILLAGE ASSESSOR'S MAP&PARCEL 3// /- INSTALLER'S NAME&PHONE NO. 110 SEPTIC TANK CAPACITY 0 LEACHING FACILITY: r (type) _Q,;g?e l;`ef (size) q® I's .x NO.OF BEDROOMS OWNER PERMIT DATE: 111:zYlf© COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet ` FURNISHED BY I t`�1 . g �tiaL — 1 = (30 ter, Cl/_ WE Town of Barnstable, )Departinnent of Regulatory.Services Public Health Division Date ld 200 Main Street,Pyannis MA 02601 r Date Scheduled Time I+ee Pd /00 . Soil Suitability .Assessment for Se Performed By: x F/..rt �A/1e.1 _ Witnessed By: i _r l LQ.C.A.TI RT& GENERAL JN:E'OR1VdA.T ON _ 4 e__- Lne24cinAddre n + /)I.p /� Owner s Nacre-y It:"' C./` Address Assessor's Map/Parcel: 3 v 0 Engineer's Name, 1/V' NEW CONSTRUCTION REPAIR Telephone# Land Use:-F IP 6r1,44 4 Slopes M Surface Stones Distances from. Open Water Body ft Possible Wet Area {f Drinking Water Wc11 ft Dramago Way — ft Property Line __i3f��ft Other ft SI TCH:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands to proximity to holes) ER wo za 60 �— Parent material(geologic)(f)/ fw^P! Depth to Bedrock Depth to Groundwater. Slanding Water in Hole: Weeping from Fit Face V v IV,167 I Estimated Seasonal High Groundwater Method Used: DEI'ERMIN.MOIY FOR SEASONAL HIGH WATER TABLE --Depth Observed standing in obs tole: 4. In, -.Depth to sell mottleg,,. Dcpth to weeping from side of obs.hole: IV V. IIn, ©rnundwa[er AdJustment fr. Index Well Reading Date,: Index Well lcYol Adj.Actor,.,,,.,_,.,_Adj.Groulidwaterl_evel— PERCOLATION TEST bate_._..�_ Time Observation Hole# Tlmo at 9" Depth of Pere, Tlme n[6'. Start Pre-soak Time @ /U Time(9"-611) End Pre-soak Rate Mln./lach G'Z Site Suitability Assessment: Site Passed X_ Sitg Fallcd: Additional Testing Needed(YIN) Original: Public Health Dlvlsion Observation Hole,Data To Be Completed on Back--- ***If percolation test is to be conducted within 100' of wetland,you must dust notify the Barnstable Co>aseTvation DiAsIon at least one(1)week prior to beginning. Q:\SEPTIC 13RCPORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders, o ] ten;y,%'Gravei) G— /-/- �d y0L Z/ 10-* 6/6 J511 426GZ mc�5 DEEP OBSERVATIONECOL19 LOG Hole# Depth from Soil Horizon Sail Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (structure,Stones,Boulders. onsis en 95 Gravel) -4 - DEEP OBSERVATION ITOLE LOG I-Tole�. Depth from Soil Horizon Soil Texture Sol]Color Soil Other' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co ] tee G e DIEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stouts',Boulders. Co si t Flood Insurance Rate Map.: Above 500 year flood boundary No— Yes _- Within 500 year boundary No Yes Within 100 year flood boundary No._ Vds Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in a]I areas nbscrved throughout the area proposed for the soil at-scrption system? If not,what is the depth of naturally occurring pervious matarlall Certification I certify that on V` (date)I have passed the soil evaluator examination approved by the Department of Environmental-Protection and that the above analysis was performed by me,consistent with the required training,expertise and experience described in�10 CUR 15.017. Signature- (AL": � Datb y QMEPT1C\PE1ICPORM.D0C � 1jvc� t No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftphCation for Vspo8al 6pStpm ConstCuction 3pPrmit Application for a Permit to Construct( ) Repair(-) Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2-1 0h15 OJ�n�i,s Name,Address and Tel No. �j Assessor's Map/Parcel<� 3i( I)a f-L.e,� S C� 6Ct-rles D�2/Gl. 509`77/ -7p 2 I ller's Name,Address,and Tel.No. esigner's N e,Address, d Tel.No. f� �iXLQ✓�fro� �8- 477--0&5 3 ®wn � InpI (I Type of Building: Dwelling No.of Bedrooms Lot Size ZA sq.ft. Garbage Grinder( ) Other Type of Building ��„��,��/ No.of Persons Showers( ) Cafeteria( ) Other Fixtures lip Design Flow(min.required) L4 lip gpd Design flow provided, L��l' gpd Plan Date f I'l 9-I Ll Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. t 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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar H It . Signed Date J 1-2-4-� Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. 1 Ll Fee I CV L t, t . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:�" PUBLIC HEALTH DIVISIO .- TOWN OF BARNSTABLE, MASSACHUSETTS Yes N, ZIpplicati01l for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 Ll C,)I t� �-,A OYynerIs Namee,Address and Tel.No. Assessor's Map/Parcel L * 3/t 190 rL e� 58 0 /��!d-hQ f'(�j DetO 509 ,77 - 9 y2 I taller's N e,Address,and Tel.No. esigner's Nqpme,Address, d Tel.No. XL0V6Uh9n 50R - y-77-a&5 3 .Type of Building: ~- Dwelling No.of Bedrooms Lot Size Z� sq.ft. Garbage Grinder( ) Other Type of Building <,,A j -G( No.of Persons Showers( ) Cafeteria( ) Other Fixtures 1 Design Flow(min.required) L qV gpd Design flow provided 14 / gpd Plan Date h• (q-1 'Number of sheets ` Revision Date Title Size of Septic Tank, (�� Type of S.A.S. 10 ( _ Description of Soil A I f Nature of Repairs or Alterations(Answer when applicable) e. Date last inspected: ". Agreement: i 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 o�alth. Signed _ Date 1-19 Application Approved by ���-L" Date !��,�L����L Application Disapproved by Date ' for the following reasons 1 Permit No. Date Issued ----------------------------- ------------------------------------------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V/) U aded( ) Jk Abandoned O by D n f at 29 0 t y(6 PaW \v C4 Q n.ij has been constructe accor Ice y with thg prw sions of Title 5 and the for Disposal System Construction Permit No. j �d ed l Installer 1 �bPQI (-ro l� Designer #bedrooms 'y Approved desi n flow 4 1 gpd a :J The issuan e f/tis permit hal of be col ue /as�gua antee that the system c'ogo as dcsi edDate ) "/ � � ��' Inspector / t?&� ------------------ --- - ------ ---- ---- ---------- --------- -- - -- - 11 r ' - No.c � 4 Fee DO . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstrm Construction Permit Permission is hereby granted to Construct( Repair(� ) Upgrade( ) Abandon( ) System located at ,L{ � 1,5 DOD. U Q n n ( J and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. `/�' �/ c Date ( -1"1"T""1 1 f�--f' Approved by (jVA � r`-'cV IJ.�-t�- (i Imo• tA,4 p'U\- C�cc� l I�t.J wG i t J C� FROM :down cape engineering inc FAX N0. :15083629880 ' Dec. 04 2014 10:01AM P1 'Ro"gidatory Service-9 Tho mma KCB+iPer,Dirowfor J Public TImilth Division Office,. 508-867,-46 Fox, 102-790-6304 . sit >iB:�. �Il'� nd:S�dnaBffi`lE+�YEQ� Date: � r .wsgeperm SDI - a�tt'a�lliBgmllt"aun'sRb /(- J . VR-I XAB01II<C1r {(J 1J �X IL✓ a''� ' � rice.. 9"(/( •�- � -d g � M� ? �j Oil. _ 'va s issued a perr o it to njstall a —-_td"��) _ (installer) . .: - • . ., s Yc;� stem at=2-� ©t).S' " s�C baser.on.a'design draw by '9 (address) : !ceTbfy that the geptic, sy0-tft'lli refetence'd abm-c Ntte iakk ll.ecl 6.bst.Rn i.FiIbr ticnorctui. 'tu ,ry the design,wh ch.mny`inolv.dc: 1711'iloj apyoverl changrs sucla as'lPtr��.i.-rel�caCiull o the �ihti•.ibutiou box 9zadlry .9 d(s titult.' �.F r F.. I cc�tif-y tbat the septic sydom 1(fcas.iuFc1 alapve,was installed wifh majas' cb.,nge3 J. Freiherr than 10' Lateral relncgtimi of.-Jae S,AS or any ve�.ttk cal r�:locstic�r�.Of piny coD1t►on.t.ut of the sgli.Fystem,)bat i a'cnardmace 1MA..Siate&. Local-ll.:,egule�tiox►s. Plan,re-vision.nr ' i:extifted as-built:by deci.�,i�tc fU110-vV. �„ OF (inst�llel Signat,Ire). a OJALA t CIVIL Nn:4650a (1,esignc,T's Sign�ttuu) (.!Lffa 1)P9itr.'s;tamp : ,]EA��R i4E t1it.1`3 z . Vos�;4a . lar x �m . 1t i9CA: A3T AA<„^ +,T V A-J F AS-ADALT C .i T1i � . e I � d t t�ARNSITMLL BYA°.LTK DIV1u$i LI- I is Y DTJ- v,-ifirxS n Fnrrn 3-2644.doc ' L0JAWUALgLD)tlU Ln .. • ra ru , O ., I - OfFICIAL USE t,n M Postage $ Oi�(1 �/3'"7 Certified Fee s O Return Receipt Fee Postmark (0�0 Here O (Endorsement Required) D N O Restricted Delivery Fee a 2 or; (Endorsement Required) ru. Total Postage&Fees !O p A Mr. & Mrs. Charles M Derrick 24 Otis Road Hyannis, MA 02601 Certified Mail Provides: o A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. n For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 • • naTl ,w • • sell • n4. I o Complete items 1,2,and 3.Also complete A. Signature i item 4 if Restricted Delivery is desired. ❑Agent,,.: I Q Print your name and address on the reverse X , ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date Of De iverryy 0 Attach this card to the back of the mailpiece, �/��CLS 1 (Yt�i l0 /� or on the front if space permits. I 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes t, If YES,enter delivery address below: ❑No I Mr. & Mrs. Charles M Derrick 24 Otis Road Hyannis MA 02601 3. Service Type ' ❑Certified Mall0 ❑Priority Mail Express' ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number _ (transfer from service labeq 311 t 7 01"4 t_12 D 0'i b�0 01 0 3 5 8 Y;G 215__.`I' PS Form 3811,July 2013 Domestic Return Receipt UNITED STATE .� ,L:`.F ' `" . '�M" �t=Wi�s. a�il�.�c ;ate 9 ° Sender: Please print your name,address,and ZIP+4®in this box* � I Town of Barnstable Public Health Division 200 Main Street i y Hyannis, MA 02601 I I i Town of Barnstable Barnstable A *Wcacdt � • , Regulatory Services Department snxxsrast E NAM Public Health Division _ m 200 Main Streei,',Hyanms MA 0260'1 2007 Office: 508-862-4644 R% ;. Richard V.Scali,Director FAX: 508-790 6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70141200 0001,0358 0215 4" September 23, 2014 Mr. &Mrs. Charles M.Derrick 24 Otis Road Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 }: The septic system located at 24 Otis Road,Hyannis,MA was last inspected on 8/22/2014,by Matthew F �Gilfoy, a certified septic inspector for the State of Massachusetts. The inspection of,tle septic system showed that the system"Fails" under the guidelines_ of 1995 TITLE 5'(310 CMR 15.00) due to the following. i • `Backup of sewageinto facility yor.system component due to overloaded or" , . r clogged SAS or` cesspool • Liquid depth4n cesspool is"less than 6".below'invert or available volume is less., than 1/2 day flow: • Whole system must be replaced. You are ordered to-repair/replace the above listed septic system components within . `sixty (60),days from the date you receive this notification. Failure to repair/replace the°septic system within the;deadline per iod.will result in future enforcement action. R OF THE BOARD OF HEALTH r QASEPTICU etters Septic Inspection Failures or Future EVI\24 Otis Rd Hyannis Sept 2014.doc N '9 htkp;jjissgl2jintranetjpropdatajParcelDekail.aspx?ID=26030 arch p Application Center(2) ®http-•www,town,barnstable,,, Application Center ®Suggested Sites• Web Slice Gallery Favorites ®parcel Detail UF i R 0rt + MASKNA to A - Nh�f � f fly•t1W '; ' r Parcel Info Parcel Developer ID 311.058 lot ILOT 99 Pn Location 124 US ROAD I 62 Frontage Sec ----I Sec ; Road Frontage FN Village HYMINIS I FireJHYANNIS Distnct Town sewer exists at this address FNo Road Index 1189 ' Mp Asbuilt Septic.Scan: Interactive y 4a Map 311058 1 I - Owner Info Owner(DERRICK,CHARLES M&,FWCES W "]Co-owner[ ' ICo-Owner Street124 MS RD I Street2 i I' City HYANNIS I State Zip=02601Country ' t Land Info ;! Acres Use S0.=19ingle Fam MDL-01 Zoning FRB Nghbd 0104 0.19 J' Done �i�::�; '� Local Intranet � (100°1° 5tart �16 , Advertisement Parcel Detail Windows I... Window„ ®(�/ , y 10;18 AM Ivro�ti) ;ysf�m AfQ�--J' 7�5Ni�l�t y Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: C key to move your cursor-do not Matthew F. Gilfoy use the return Name of Inspector key. B&B Excavation ray Company Name 14 Teaberry Lane Company Address Sandwich Ma. 02644 City/Town State Zip Code (508)477-0653 S113640 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this addr!'es and thaaLf..fhe =. information reported below is true, accurate and complete as of the time of the inspection. Tf.j ins p tion 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 1K340 of. Title 5 (310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ? E r. ❑ Needs Further Evaluation by the Local Approving Authority 8-22-14 Inspector's Sig ature 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. i t5ins•3113 Title 5 Official Inspectio r ubsurface Sewage Disposal System•Page 1 o�171 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma.. 02601 8-22-14 page. Cityrrown 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: 13) System Conditionally Passes: ❑ One or more system.components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the.tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): 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 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma:- 02601 8-22-14 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 pipes) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed 0 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. l5ins-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 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is Hyannis Ma. 02601 8-22-14 required for every y page. Citylrown 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 ® E Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 l5ins-3113 Title 5 Off cial Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. CitylTown State Zip Code Date of Inspection B. Certification (coat.) 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. ❑ E 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' gp 000 d. ® ❑ 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 god to 15,000 god. 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 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. City/Town 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? 0 ❑ 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 differentfrom 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): No pains Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): NA 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 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is Hyannis Ma. 02601 8-22-14 required for every y page. City(rown State ` Zip Code Date of Inspection D. System Information Description: Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2012-3700 cubic feet 2013-4000 cubic feet Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Otis Rd 'M Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.).. Last date of occupancy/use: Date Other(describe below): r - General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Cesspools not pumped ass stem was in failure. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ; 'M 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. Cityfrown State Zip Code Date.of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): , Depth below grade: 216„feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appeared to be in good working order no sign of leakage. Septic Tank(locate on site_plan): Depth below grade: NA 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: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 24 Otis Rd M Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 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 Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness, Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of-last pumping: Date 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 M 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 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: 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 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. City/Town 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 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 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 24 Otis Rd M Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: 1 6'x6' ❑ leaching chambers number: ❑ 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.): System has two cesspools piped into seperately for the dwelling. Both then flow into the same overflow cesspool. All three cesspools were filled over their inlets. System must be replaced Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 3 (2 singles piped into one overflow) Depth—top of liquid to inlet invert over Depth of solids layer 1 Depth of scum layer Dimensions of cesspool Materials of construction block Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts - Title- 5 Officiallns dtion Form _ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 24 Otis Rd y e Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma..e 02601 8-22-14 page. City/Town State' Zip Code Date of Inspection D. System Information (cost.) Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspool sizes not determined as the system was in failure and was not pumped due to cost issues. All cesspools filled over inlets. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): a t5ins•3/13 Titlerv5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 17 Commonwealth of Massachusetts _ : m Title & Official :'Inspection .Form Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments M 24 Otis:Rd - :-:RropertyAddress Charles Derrick Owner Owners Name information is required for every .,Hyannis . Ma.. -02601 8-22-14 page. Cityrrown 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 I 3 ,. a A5► A3 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage.Disposal System•Page 15 of 17 i f y Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7M 24 Otis Rd Property Address Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 62601 8-22-14 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: >10feet Please indicate all.methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database -explain:. USGS topo maps showing no high ground water in this area You must describe how you established the high ground water elevation: see above 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 . 24 Otis Rd Property Address k. Charles Derrick Owner Owner's Name information is required for every Hyannis Ma. 02601 8-22-14 page. CityrFown State Zip Code, Date of Inspection E. Report Completeness,Checklist E Inspection Summary: A, 8, C,b, or E checked E Inspection Summary D (System railure Criteria Applicableto All Systems)completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System"either drawn on page 15xor attached in separate file, t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE f LOATION /2 d SEWAGE # Zcoe)` 3 VILLAGE +, ASSESSOR'S MAP & LOT _��F INSTALLER'S NAME=61 PHONE NO. A & B CANCO775-6264 Jie phice. H,41N Lwe- 4 ceIS17 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER "BUILDER OR OWNER DATE PERMIT ISSUED: JL.' I ' DATE COMPLIANCE ISSUED: l VARIANCE GRANTED: Yes No -, �:n an .°�'- 4 S `F. ., _. S } TOWN OF BARNSTABLE LOCATIONr/ n/-A/V SEWAGE# .AGE /✓A111 ASSESSOR'S MAP&LOT3 t 'U-�� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C4�f1, PU�e✓' (size) !'UEI© C*Z. NO.OF BEDROOMS DER OR OWNER 0"'IV-L R�- CHi9R G17 -"PAAMCa 4-�c RA(CK PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet Furnished by—42" 423--le- . 1- 1 0 o � J -� o �; No. ��'� � Fee . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pprication for 33igogal 6p6tem Cow5truction Permit Application for a Permit to Construct( )Repair( 11b"pge( )Abandon( ) O Complete System 5? dividual Components Location Address or Lot No. !. °O^�=� S 2 O as J Owner's Name,Address and TkI.No. Assessor's Map/Parcel r Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 66 Cc-111111� C_0 w e sr '-f A 2wto�i Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Qe No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) n Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss b o Health. Signed Date i 2^ I�A 2000 Application Approved by Date t'oy_ _ Application Disapproved for the following reasons _ �s Permit No. - F Date Issued /_12 No. 7 P7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: . PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE} MASSACHUSETTS Z(ppYication for Migool &pgtem Construction Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System 9-9I dividual Components Location Address or Lot No. t-p Owner's Name,Address and W.No. Assessor's Map/Parcel Installers Name,Address,and Tel.No. Designer's Name,Address and Tel.No. cc, ��p MGM v� 5 t 8 C3 C) { we sr Ali-1Rvv,,our� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building�e s.��, p r r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil ' 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 Environmental Code and of to place the system in operation until a Certifi- cate of Compliance has been is`'s)=bt d o Health. "^ Signed ! Date 11• !q• 2000 Application Approved by Date 1 Application Disapproved for the following reasons Permit No. 'C;:Ofo / Date Issued /S �} 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 o at C, CK has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Pe & D' dated lInstaller C o Designer fl A r I f J, llyfy I t w c The issuance of this permit shall not b,p construed as a guarantee that the s- will.n••will(fu`nction as{designped. �f J Date .�f e�� 10 Inspector 9� � F a't ' r7 / t ----- ----------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS i.400aY *p5tem,onotruction permit Z Permission is hereby granted to Construct )Repair(tom Upgrade( )Abandon( ) System located at ©'Z �) C) 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. hProvided:Construction must be completed within three years of the date of this .eimit. Date: ,��'",R-- L��- �G�� Approved by � ���%�G TOWN OF BARNSTABLE LOCATION G�"�s SEWAGE # ZcL -�3 VILLAGE� ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE NO. A & B.CANCO - ��pir�G� Si�►k wl,41jj Lto e 44 cess fu SEPTIC TANK CAPACITY j UiA(:t1 NU C A%iLL l-Y ALYYCJ NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: l No VARIANCE.GRANTED: Yes i 3 S5' COMPONENTS SHALL BE NOTES + MAGNETIC TAPE OR �e MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROX. NAVD 88 Q TE COVERS TO WITHIN 3" GRADE PROVIDE OBS. PORT WITHIN 3" OF 2• MUNICIPAL WATER IS EXISTING FINISH GRADE E REQUIRED OVER SYSTEM 47.3 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST PoG UNITS TO BE AASHO H-1Q D PEASTONE —I 5. PIPE JOINTS TO BE MADE WATERTIGHT.RIC 44.3' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 310 CMR 15.000 (TITLE 5) o 0 0 0 0 0 0 0 0 0 0 0 0 0 °°°°°°°°°°°°°°°°°° °0 0° °o°o°o° e o 00000o�o00000o°ono a°o o° o00o 0 0 0 0 0 0 0 0 0 0 0 0000000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 00000000000000000000 00000000°0°0°0°0 000° °o 0°00000 43.1 NOT TO BE USED FOR LOT LINE STAKING OR ANY 00000000 0.000 0 0 0 0 0 0 0 0 0 o OTHER PURPOSE. �`�� L cu o� :.005 /' SLOPE r s Q 3/4" - 1 1/2" STONE J 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 0 0 0.5') 9. COMPONENTS NOT TO BE BACKFILLED OR 6.3' CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR 36.8' 1 CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NOT TO SCALE WORK. 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 311 PARCEL 58 SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. SYSTEM DESIGN: ,H MARK - SILL AT ✓ 05 GARBAGE DISPOSER IS NOT ALLOWED 2. ELEV. = 49.0 w 46.99 DESIGN FLOW: 4 BEDROOMS @ 110 GPD = 440. GPD -- USE A 440 GFIDDESIGN FLOW �c-, 1 CP 'o SEPTIC TANK: 440 GPD (2) = 880 0- USE 1 - H-10 1500 GAL. SEPTIC TANK 48.54 47.12 C.O. TH 1 2 G R N y LEACHING: ® 6.3 3 47. 3 SIDES: N/A 49.01 3Z .4 <� BOTTOM 40 x 15 (.74) = 444 GPD TOTAL: 600 S.F. 444 GPD / o. 7 USE 40' x 15' x 0.5' DEEP LEACH FIELD WITH (3) 4" PERF. PVC IN DOUBLE WASHED STONE. i O' I NGE 4 �F II � cNP� 12g�.76 APPROVED DATE BOARD OF HEALTH M A PROVIDE CLEAN—OUTS AT BENDS IN PIPING BETWEEN DWELLING AND SEPTIC TANK TITLE 5 SITE PLAN OF 24 OTIS ROAD HYANNIS PREPARED FOR B&B EXCAVATION/DERRICK NOVEMBER 19, 2014 �FMO�MgS OFMASS9C' off 508-362-4541 DANIEL y�:.� I fax 508-362-9880 DANIELA. Gs A `�� downcape.com a O,IVIL OJAI..A (;I6 No.40980P down cape engineering, //1C. No.46502 ��. ,po o� °�F� ST ,a �q 5' o� civil engineers SUR NAL LNG land Surveyors kk list I, / 939 Main Street ( R to 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 a I S SHALL SYSTEM PROFILE ALL SYSTEM MARKED WITH CMAGNETIC T BE NOTES TAPE OR (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 0 Q ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE 1. DATUM IS APPROX. NAVD 88 PROVIDE OBS. PORT WITHIN 3" OF 2. MUNICIPAL WATER IS EXISTING \ TOP FOUND. EL. 49.0' FILTER FABRIC OVER STONE FINISH GRADE 48.0' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYS EM 47.3' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST �o UNITS TO BE AASHO H-10 . � PRECAST H-10 G��l RISERS (TYP.) 2'0 4"0SCH40 PVC c� ' PIPES LEVEL 1ST 2' 2" DOUBLE-WASHED PEASTONE 5. PIPE JOINTS TO BE MADE WATERTIGHT. OR GEOTEXTILE FABRIC o0 *46.9'f 10^ 1500 GAL H-10 14" 44.3 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE moo o� 45.75' TEE SEPTIC TANK TEE WITH 310 CMR 15.000 (TITLE 5) 45.5 a a a a a a a a a a a a a a a 0 a a a a a s a a a 0°0°0°0°0°0°0°0°0°0°0°0°0°o°o°a°o°o°o°o°o°o°o°o°o °o o° °0°0°0° U e °o°o°o°o°o°o o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o°o o°o 00 0°0°000 GAS BAFFLE °O°O°O°°°°°° 43.8 °o°o°o°o°o°o°o°o°o°o°o°o°o°o°oco°o°oo000000000000 000 00 0000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND �_o�o�o 0 0_ o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0000000 + o00000000000000c o0000000 00000043.1 NOT TO BE USED FOR LOT LINE STAKING OR ANY 6> *46.5 t 44.0 43.83 00000o°o°oao°oao0o°o°000000000�00000000000000000 0000 00 000000o OTHER PURPOSE. 4' LIO. LEVEL (ACME OR EQUAL) 4" PVC SET AT'.005'/' SLOPE s N Q ° + r` ON 6" DOUBLE WASHED 3/4" - 1 1/2" STONE 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 • o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 �OoO000cncnc,°,o°,070o°o°o°oO0 r?o?.°+?02?0000000°� Q\\i Q� N MIN. 12" INT. DIM. °i 6" MIN. SUMP ("40 x 15 x 0.5 ) 9. COMPONENTS NOT TO BE BACKFILLED OR a �- 6" CRUSHED STONE OR MECHANICAL 6 3' CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 [2]) HEALTH AND PERMISSION OBTAINED FROM BOARD MIN _ OF HEALTH. ( 2 SLOPE) (_L.4% SLOPE) ( 1 % SLOPE) 10. CONTRACTORONSIBLE 36.8' CALLING DIGSAFE (HA888B 3 4E 7233) ANDFOR LOCUS MAP LEACHING VERIFYING THE LOCATION OF ALL UNDERGROUND & FOUNDATION- 32' SEPTIC TANK 28' D' BOX 5' FACILITY OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF NOT TO SCALE 29' c _ WORK. *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 311 PARCEL 58 UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS SHALL BE REMOVED 5' BENEATH AND AROUND THE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. J SYSTEM DESIGN: BENCH MARK - SILL AT ,// .05 GARBAGE DISPOSER IS NOT ALLOWED DOOR. ELEV. = 49.0 TEST LOGS 46.99 DESIGN FLOW: 4 BEDROOMS ® 110 GPD = 440 GPD HOLE 7-56 _ - �: _ __:._ - USE. A .440 GPD-DESIGN- FLOW , ENGINEER: ARNE H. OJALA, PE, PLS �� NEE �c 0 o SEPTIC TANK: 440 GPD (2) = 880 WITNESS: DONNA MIORANDI, RS 1 �SocKP CP USE 1 - H-10 1500 GAL. SEPTIC TANK DATE: 1 1/14/14 c < 2 MIN/INCH 48.54 ° 47.12 C.O. TH 1 }I 2 R N pR��� 47 3 � LEACHING: PERC. RATE = No oN 48.77 9 c 6.3 SIDES: N/A 2 CLASS I SOILS P#14556 OR�v4g. P 49.01 ��2 3 ,¢� .4 <� BOTTOM 40 x 15 (.74) = 444 GPD TOTAL: 600 S.F. 444 GPD 8.93 74 EXISTING DWELL. 1' O 47.6 W/ TOP FNDN = / 0 7 USE 40' x 15' x 0.5' DEEP LEACH FIELD WITH (3) 4" ELEV. ELEV. W/ ELEV. 49.0' PERF. PVC IN DOUBLE WASHED STONE. 0++ 4 47.3' p" `� 47.3' s W 'o: o. x � A A LS LS \ R- LOT 99 s2 �\N�F NcE 4 s 8,255 Sq. Ft. 75 1OYR 2/1 1OYR 2/1 ��` �2g' MA 89p 8 O \ p,6'- ���� �5 .76 APPROVED DATE BOARD OF HEALTH PROVIDE CLEAN-OUTS AT BENDS B B .17 IN PIPING BETWEEN DWELLING / LS LS \ Q�' AND SEPTIC TANK 36 36 10YR 6/6 44.3' ++ 10YR 6/6 44.3' �0 \47.34 �� TITLE 5 SITE PLAN , of G` C1 C1 7.59 SAND/GRAVEL SAND/GRAVEL 47.17 24 OTIS ROAD 84" 10YR 6/4 40.3' 84" 10YR 6/4 40.3' HYANNIS PREPARED FOR C2 C2 PERC B&B EXCAVATION/DERRICK MCS MCS NOVEMBER 19, 2014 OFMAl off 508-362-4541 2.5Y 7 4 + 2.5Y 7 4 + l � o`' DANIEL yam, fax 508-362-9880 / /126 36.8 120 37.3 �o 0 NIBLA. N A. � downcape.com JA NO GROUNDWATER ENCOUNTERED o ®CIVIL No.40980 U No 46 02 OJALA n down cage engineering, Inc. � �o �P civil engineers ST Scole: 1"= 20' SS��NAL ECG sup r land surveyors 939 Main Street ( R to 6A) 4-304 o 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675