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0033 PINE AVENUE - Health
33 Pine Avenue Hyannis A= 308 -275 , 1! I I O I t f i f` �y� u i i t /vD - r No D7� do S�t9'l/e �vr record t TOWN OF BARNSTABLE LOCATION SEWAGE# ;Z(�(y 187 VILLAGE lA v ckto ay i ,-ASSESSOR'S MAP 8i PARCEL `7 INSTALLER'S NAME&PHONE NO. Tife"0,3 T n,C SEPTIC TANK CAPACITY 1 SC�o LEACHING FACILITY:(t)pe) L (�O& (size) NO.OF BEDROOMS S OWNER 'Polt()C-J G PERMIT DATE: (i—//-/ V COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility CIWN` 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 QN 7 j`CC)W —r i� c Or3 3 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 33 Pine Ave Property Address Jason Riley Owner Owners Name/ information is every Hyannis required for eve MA 02601 12-19-19 page. City/Town 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. I\A OF tM Important:forms n A. Inspector Information ��f3 ,��'� . q ''-- fillip out forms ��;' •.�y on the computer, use only the tab James D.Sears JAMES key to move your Name of Inspector cursor-do not Jim The Inspector Man use the return % �''• �' �� ' Company Name -.�`% .• � key. P.O.Box 784 °''�, 5 INS �������\ r� 111111 Company Address West Yarmouth MA 02673 City/Town State Zip Code rdma 508A -364-4398 S 1623 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 12-19-19 I s ctor'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts ili� Title 5 Official Inspection Form ^l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owners Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: The system is a 1500 Gal. Tank D Box and six chamber's 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owners Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts _ - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form ,P Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a F' a, 33 Pine Ave �V Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in _ is less than 6" below invert or available volume is less than 1/2 day flow .0 U(`Wt1vC ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 . Commonwealth of Massachusetts ,lp Title 5 Official Inspection Form I o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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)] I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owners Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. 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). 330 Description: 1500 Gal. Tank D Box and six chamber's. Number of current residents: NA Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection Yes ® No information in this report.) El Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owners Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont) 4. 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): Approximate age of all components, date installed (if known)and source of information: 2014 Permit # 2014- 187. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 31"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.): Pipeing is 4" PVC SCH -40. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every _Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 'Depth below grade: 21"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: 1500 Gal. Precast H-10 Sludge depth: 211 Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 8° Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Plan-Tape Sludge Judge 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 at working level. Tank and outlet cover at 21" below grade w/inlet cover at 1'. Inand outlet tee's. No sign of leakage or over loading. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts jp Title 5 Official Inspection Form �o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Fio Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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 16"x16"-35" Below Grade w/cover at 1'. Box is clean and solid w/no sign ofover loading or solid carry over._ t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts ,A Title 5 Official Inspection Form io Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 6 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is six 500 Gal. dry well chamber's. Chamber's at 3' below grade. Chamber's are wet on Bottom w/clean wall's. No sign of over loading or solid carry over. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 < Commonwealth of Massachusetts Title 5 Official Inspection Form J. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every -Hyannis annis MA 02601 12-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 1 . TOWN OF BARNSTABLE LOCATION 3 3 '�,;�,� �,a SEWAGE#_:z0(51 -187 VILLAGE 1-1ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �o� S�� Nc SEPTIC TANK CAPACITY 1 S� LEACHING FACILITY:(type) f t; (2 q•2O f"\Q (size) NO.OF BEDROOMS 3 OWNER 'Pol tCrj r PERMIT DATE: Ci-//-/ V COMPLIANCE DATE: Separation Distance Between the: ASpny e ���by t P Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility OWON4 55) r 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 BYj_ �`fp��,� P I iS oor . 13 f +� N - 22 OoT - a7 1 _ `17 i L 0 Commonwealth of Massachusetts 92. Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owners Name information is required for every Hyannis MA 02601 12-19-19 page. City/Town 9 State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10, feet Please indicate all methods used to determine the high groundwater elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 3-2-14 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: T.H. on Design plan 3-2-14 10' no G.W.. Bottom of chamber's at 5' below grade. Bottom of chamber's at 5' above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ale Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Pine Ave Property Address Jason Riley Owner Owner's Name information is required for every Hyannis MA 02601 12-19-19 page, City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 1t%r, t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 18 of 18 No. U — 7 Fee 60 �. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppliLatlon for disposal *pstrm ColVomplete tots permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) System ❑Individual Components Location Address or Lot No.3.3 iNP AV e Owne N e,Ad ess,and Tel.No. Assessor's Map/Parcel :3 p2_fS �` (�(� Pa d C Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. lc�sA 116`ate 41\y- Scg-L40D-7/5-7 /e� Type of Building: Dwelling No.of Bedrooms Lot Size SSS� sq.ft. Garbage Grinder( ) Other Type of Building 6cg ,.eo No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 gpd Design flow provided '3" gpd Plan Date 1, -i p-i Y Number of sheets Revision Date Title Size of Septic Tank iS00 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ad /,���' S 'e,e'/)j C. / 5DO CaCcad ®f••uIe 12 Ba CAA ) —f L f G Ch"&45 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig i Date Application Approved by Date c L Application Disapproved by Date for the following reasons Permit No. Date Issued L� No. U Fee 160 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ' application for t*wt,41 6pstem Construction Permit Application for a Permit to Construct Repair �U ade Abandon 4plete S stem Individual Com onents PP ( ) P ( ) Pam• ( ) ( ) Y ❑ P Location Address or Lot No.3,3 R v-p Ave Ownel Np e,Address,and Tel.No. Assessor's Map/Parcel 7 I^VIA(� r Qo c Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. _-11JJ�GS ' ! �lU�/_'•�J -l-/�1C SC�-�-)CJI�-7JS`� r I�I `''.Type of Building: IC�4AC ``,Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 6r.),ze No.of Persons Showers( ) Cafeteria( ) " Other Fixtures Design Flow.(min.required) 3`O gpd Design flow provided 3 3() gpd Plan Date� /o• /Al Number of sheets 2- Revision Date Title Size of Septic Tank ,00 Type of S.A.S. LC(� C`fGnrbY/S Description of Soil t� Nature of Repairs or Alterations(Answer when applicable) /�UStG/� Ti Zr S S '0 /C / 5hncv b/�.v�1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig Date !jam Application Approved by Date _1 t Application Disapproved by Date for the following reasons Permit No. 2- G I`r g,7 Date Issued THE-COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate'of Compliance THIS IS�T�O^CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(✓) Upgraded( ) Abandoned( )b fo s T w at. -} ,u 10 k 0e! , („v n l I 1C, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NQ C/ — dated Installer „ 6 2)1 _T nor" Designer ti►3�n� r��,N� LA A' 5 #bedrooms Approved design flow 0:3r--j gpd The issuance of this permit s all not bp cons rued as a guarantee that the system wi4hl==function= i • ed. Date LG' Inspector ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- No. -------- ------------------------------------------------------------------------------------------------ No. v / V ` I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( � Upgrade( ) Abandon r System located atAl 1 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 7ust be completed within three years of the date of this permit. r ; Date �' �( ./ /� Approved by s1vt ' r 06/13/2014 Oe:40 5084775313 ENGINEERING WORKS PAGE 01 i QFYII Of Barnstable Regulatory Services Richard V. S`cali, Interim Director se7e� = Public Health ]Division > " Thomas McKean, Director 200 Main Street,HyzzMi%MA 02601 Office: 508-862-4644 F$X- 508-790-6304 l Installer & Desz er Certification Form Date: l ( Sewage Permit# �nj q -/P-7 -Assessor's 11+1aplParcel c Desiper: gam... e 1nc Installer: rr �•• c Address: 12 W. Cms e IGI Address: X • 6 it t tlrresQ CQ yw►� U 2 G y y W On + , A L �7Z r,a�A `�c, was issued a permit to install a (date) (installer) septic system at 'S , based on a design drawn by (address) !e✓Y't'(. &+ _ee 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. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of my Component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in eompli r8 'th the terms of the 11A approval letters (if applicable) 1%OpAJ PETER T. AAcCIVIENTEE a118r's Signature) � Pto.BBiL ,� ' 6? CSi,g17ex's Signature) IX eSlgner'3 PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DMSION, CERTInCATE AS- OWLIANCECARD ARE RECEIVED BY THE BARNSTABEE PYJBLIC REAL IVISIQN. BUMT TI3ANK I'OTJ. Qmepticoesigner Certification Form Rev 8-14-13.doe TOWN OF BARNSTABLE LOCATION -N,e Ia fl SEWAGE# aO f y -187 VILLAGE 1A ASSESSOR'S MAP&PARCEL 306-2 3 r INSTALLER'S NAME&PHONE NO. �0��1�g� out ? NC f SEPTIC TANK CAPACITY 1 Sbb LEACHING FACILITY:(type) L_C (p (size) NO.OF BEDROOMS 3 OWNER 9ofterj ` PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility f'WiN` !VP(C 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,%�-)ny!,60tLQ o%;T _ 13 nN _ 22 OoT — 2 i,S 27 ��- 1 _ q7 � 2 Town of Barnstable P# Department>of Regulatory Services 's Public,Health Division Date 11 4 s6;y; ♦� 200 Main Street,Hyannis MA 02601 Date Scheduled ` f 94 Time Fee Pd. Soil Suitability Assessment for Se e ,a so a Performed:By: l e 'er��-� e I �'- '" Z Witnessed By: y LOCATION & GENERAL INFORMATIO�� � Location Address 33 ��', N� Owner's Name l,()q le/_ Pvl., C U ` J 1��YIV, S Address �3 ��ne ""-, "�CuNWtS 6Z46OI Assessor's Map/Parcel: ® � —2� y Engineer's Name�,_VrVCC—,,&k-f NEW CONSTRUCTIOppN f REPAIR ✓ Telephone# —Q Y--73-7— -7(o Land Use TV-5:In i Oi\ Slopes M r"�^ Surface Stones Distances from: Open Water Body IVIA ft Possible Wet Area _ft Drinking Water We117 I` 0 ft Drainage Way /T ft Property Line j 157 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test erc ests,locate wetlands in proximity to holes) on C- ri Parent material(geologic) �Gi C.'`c ( ✓�" Depth to Bedrock Depth to Groundwater. Standing Water in Hole: �` Weeping from Pit Face �/� Estimated Seasonal High Groundwater DETERARNATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: —in, Depth td soll mottles: ht: r4th to weeping from side of uos,iioie: tin, ©i�uniiwlii2'r A�1Just>>tc;r. - -- Index Well.# Reading Date: Index Well level_.� �..,, Adj,factor— Adj,:13roundwater Level.— PERCOLATION TEST bate , Time.__ __ Observation Hole# T146 at 9" Depth of Perc '� (. -Z4_ G� "� � Time at 6" Start Pre-soak Time® �.�v�j Time(9"-6") End Pre-soak ` r Z_ Rate Min:/Inch. Site Suitability Assessment: Site Passed � Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTI0P13RCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture sdu Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (S.tructure Stones;Boulders, I to v 4 DEEP'OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) '(USDA) (Munsell) Mottling (Structure,Stones,Boulders. ie DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones;Boulders. Cons' Flood Insurance Rate Map: Above 500-year flood boundary No.,— Yes 4 Within 500'year-boundary No Yes Within 100 year flood boundary No Yes,,. Depth of`Naturally Occurrinetervious Material pervious material exist in all areas observed throughout the Does at least four feat of naturally occurring area proposed for the soil absorption system? __y_ )__._.. If not,what is the depth of naturally occurring pervious material? r._... .-. Certification I certify that on t (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 . training,expertise and experience described in 10 CMR 15.0'17. e required tra g, p p • the eq Signature i 1 •. Date� g I Q;\SEF'I MERCFORM.DOC TAT 30�• �;Z� 5.,. . DINING ROOM YY REAR ENTRANCE DOWN o o O \ O o U;Pv O0 KITCHEN . LIVING ROOM PANTRY N HALLWAY BATH LIBRARY BEDROOM UP . 0 0 0 0 FRONT ENTRANCE MAIN FLOOR AS BUILT E { 1.. , . - , . . • . a- / J ,i,. I ..AI `.. ,T � f \ ',. 37 % , t —bE f —�E '.I •� .. ... �_,---- I-r; I--.I.'_-.I__--.-_I. ..,:�,:L I, .. '. - - - �I - 'To ".. . , , . . \I. 11-7 V+I3033 DCLS2433 F'!, ' 11 HOOD 2 S �' _T_ I , 1 ). ".,.; * BMR30, 83DR30 DC �: Y . . " h , __ • y 3 ` ; f 11 .aT. } �t Ili } I , I m S tl f x it_ I 00 % .X I f i;I Y i1 i I �,, m �o �. (. i. .g-!` , 5. i L) M?r`i' r r } . v r a,: ° I 8L 9M18 qqq��� ii ul i �:� . , . ,,.1 , , "i 0 .., -�iT,�IT. .i! . � , I f Cft __�' q 4 I M rIY .�K t .. -., T . ., �, ,,, �, ., - , -— i � , 1 ;� .. 2�11�� i�,�*--" ,�,�,- , .I— ;I I i TI I i t ''i t ') -r i o �' I. t�I f t7 , ' �, t } 'i,ltl - y i t ..881 - �` id Al r l 131i6I t ' �'I' 84B 6L T , r I� -- € ' r 4 , I r ti� ....1 4+..., b a _ �3 I . ,��. -11-9E • .✓•''r bl EE.L °L9 --- " . I� . . � . � I , 'i".,, ! . .�,:. , . I .�. . I ",11 �_�::-.�, ��,-."..-m�,�!...:" -.., , � . . ". �. . . .. JOB f-1aavQava.�s- 33 1111,m-le A C- SriC- WrAL SHEET NO. _1 1 OF 7 NGD41MG CALCULATED BY 0 *,��*7�7,INC TM DATE OMPAi�1 CHECKED BY DATE 260 Cranberry Highway,Orleans,MA 02653 508-255-6511 Fax:508-255-6700 wwwxeccapecodcOm SCALE r r : r 1 r { • _ i f I-- --- i — { =— i--- - - , t I s ij � f , 41 I - -�- - _-_ ' 1vr r , V 1 S t • r I i --•-1� i - 1 i—' q�--�---i----I----ram--�--- • �- r - — — � _ t_- -- — L • T r {ir 1 —.._T_`T —,�'1}'— �--t�-- _'i_—__L���T y— { T .�{4.., i � ,I I { T'—i ti l I i { I { I I` i__— _ _'—I'_____L-�'—__i._._._'_ v ewce,Ffom NEBS CUSTOM"printing service 1-804888a327 NE8S,Inc.Groton.MA 01J71 '-w.nebs.com Het.Nn:G fe h1aA? ------------ >1 tIL; --------- -A-w- ------------ -------------- ---------- ------------...... ------------ A----------- ------------ .......... --------------- ---- ------- ............. -- ----- ------------ ---- --------- ----------- ------------- - --------------- Ir ca LU ----------- z x "Ou 43 tf.-74f+ .7 Ilk ----------------- • ------ ----- ------ ------- ------------ ............. --------------I------ • • • ------ ------ ----------- ---------- ----- --- --- ------ ------- • • ti --- ---------- ------ ILA 94 . ........ ........... 00 CIA ... ....... w'a YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO BY M.G.L. - it does not:give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, I" FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE: Jl/Z e' Fill in please: APPLICANT'S YOUR NAME: G 0. ;9 BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number: NAME OF NEW BUSINESS �';¢p� /SLrv/,/S S/6 /� TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES: NO ✓ Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS /per EiyT�-1�c'/�'Y�,.-ram i2 ai�O N��9,yic,>s MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMfSSIO`NER'S OFFIC This individual has bAni-qfojQd kfny permit requirements ha ertain to this type of business. Aut orized,Si ture h COMMENTS: ' 2. BOARD OF HEALTH This individual hha e informed of the p mit r�quire, e is that pertain to this type of business. A th_orized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: t- S-S SCLY1IJS ��nS BUSINESS LOCATION: 10S � � �" INVENTORY MAILING ADDRESS: � �—_ S TOTAL AMOUNT. TELEPHONE NUMBER: CONTACT PERSON: ja 4ec EMERGENCY CONTACT TELEPHONE NUMBER: �� c�5 —CAS l MSDS ON SITE? TYPE OF BUSINESS: \ n INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) - Tr Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL: 97.5 FOR A DISTANCE OF 15' AROUND THE g' PERIMETER OF THE S.A.S. 44. SEPTIC TANK PROPOSED D—BOX PROPOSED S.A.S. 36'9 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER AND COVER INSTALL RISER & COVER OVER ONE CHAMBER(MIN.) OUTLET AND SET TO 6" OF FINISH GRADE SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE T.O.F.=101.3t GRADE AS AN INSPECTION MANHOLE. EXISTING .G. EL.=100.2t o " i m if q F.G. EL.=100.4 F.G.FG EL.=100.3f • � I N I � �9 I n L=%10' L 8' L = 17'(MAX) �R yT, I > ® S 1 . (MIN.) ® S 14 (MIN.) ® SCH4 (MIN.) �� ,EXISTING in I p 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC fill • 2" LAYER OF 1/8 10 14" 12" ®O® WASH/ED DOUBLE HOUSE(#33) T.0.F.=101.3f INV.=98.00 48" LIQUID (OR APPROVED FILTER FABRIC) 20.1' LEVEL INV.=97.75 INV.=97.50 GAS BAFFLE IF 2.5' T 3' — 2.5' 3/4"-1 1/A2" 28.1' ~$' INV.=97.67INV.=97.00 EFFEC IVE WIDTH — 8 DOUBLE WASHED H-10 RATED STONE PROPOSED SEPTIC TANK USE 6 LC-6 LEACHING CHAMBERS IN SERIES WITH 2.5' OF DOUBLE WASHED STONE—ALL SIDES TIE IN TO EXISTING SUITABLE SEWER 4' OF DOUBLE WASHED STONE—ON BOTH ENDS AT HOUSE, INV.=98.30t(VERIFY) I H-20 RATED NOTES: TOP CONC. ELEV.=97.8 —BREAKOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ®®®Q®®® S.A.S. LA UT INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=97.00 ELEV.=97.5 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND BOTTOM ELEV.=96.00 --mi EM E3 E3 E3 E3 TRUE TO GRADE ON A MECHANICALLY COMPACTED 4' 6 x 6' = 36'' 4' SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING r , ——4" ——— 310 CMR 15.221(2). PERVIOUS MATERIAL EFFECTIVE LENGTH -44 zo• oa covEa 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION I I AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO G.W./BOTTOM OF TP„ EL=90.2 4— Cn 14" KNOCKOuT 4' KNOCKOUTI SEPTIC SYSTEM PROFILE L—————— 4' KNOCKOUT J • N.T.S. 72" PLAN VIEW DESIGN CRITERIA SOIL LOG _ _ NUMBER OF BEDROOMS: 3 BEDROOMS DATE: MARCH 2, 2014 (REF#14,315) ® ® ® 0 ® ® ® 122' ® 0 SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: PETER McENTEE PE(SE#1542) DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DONNA MIORANDI R.S. HEALTH AGENT INVERT I ® ® ® ® ® ® E3 I I I DAILY FLOW: 330 GPD ELEV. TP— 1 DEPTH ELEV. TP—2 DEPTH I DESIGN FLOW: 330 GPD 100.2 A 0" 100.2 A 0.1 r 72" 1 as" SANDY LOAM ;;SANDY LOAM SIDE VIEW END VIEW GARBAGE GRINDER: NO—AND NOT PERMITTED WITH THIS DESIGN 10YR 4/2 10YR 4/2 99.2 6 12" 100.4 6 loll PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY LOAMY SAND LOAMY SAND WIGGIN LC-6, H-20 LOADING LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 972 C10YR 5/8 36" 972C10YR 5/8 36„ LEACHING CHAMBER PERC .74 GPD/SF 36"/48" N.T.S. USE 6 LC-6 LEACHING CHAMBERS IN SERIES WITH 2.5' OF DOUBLE WASHED STONE—ALL SIDES M-CAND ND PROPOSED SEPTIC SYSTEM UPGRADE PLAN 4 6 2.5Y 6 OF DOUBLE WASHED STONE—ON BOTH ENDS 33 PINE AVENUE, HYANNIS, MA SIDEWALL AREA: 8.0' + 44.0' ?x 2 x 1' = 104.0 SF J Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BOTTOM AREA: 8.0' x 44.0' = 352.0 SF Engineering by: SCALE DRAWN JOB. NO. 456.0 SF 90.2 120" 90.2 120" N.T.S. P.T.M. 125-14 TOTAL AREA:........................................................... PERC RATE <2 MIN/IN., "C" HORIZON Engineering Works, Inc. k 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(456.0 SF) = 337.4 GPD NO GROUNDWATER ENCOUNTERED (508) 477-5313 6/10/14 P.T.M. 2 Of 2 LEGEND N LOCUS x 100.98 EXISTING SPOT GRADE; ® I —— 100 —— EXISTING CONTOUR ~ 5`` MP�N ST Z H:W.— OVERHEAD WIRES oar st W EXISTING WATER SERVICE MAIN ST s $ o EXISTING CESSPOOLS TEST PIT �e °mom o '° 2ssg9 SHALL BE REMOVED BENCHMARK e< P o�° A (SEE ALSO, NOTE 1 1) ,aa $�0 5° Tara Hyannis Golf Club N rt ISC ,16 0 ,.— S 24!31 30 100,80 fence line S roo Cemetary 108.02 f ' x 0.71 + 100,86 �? 100.20 L .00.57 I ,y ENCHMARK LOCUS MAP QP-2 TP 1 MAGNETIC NAIL SET NOT TO SCALE GARDEN EL,=100.23 :.:; 100.52 x 100.51 100,42 . ••••••••........... . MA�.NA1'L.' GENERAL NOTES: x 100.25 ;:•I 100,23: a 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL (• BOARD OF HEALTH AND THE DESIGN ENGINEER. 100,22 20'/o I '.: PAVED.�. � 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS of , '_:' WAY 100�22 W �100 � �` .;••...,. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE � O OI 4 .;;.:::. N LOCAL RULES AND REGULATIONS. O N1 ;, v 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE lOp DESIGN ENGINEER. 0 00 Q...•:: O p DI N ::.: :,,.` / N -.;:!;.:. ON 0 ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �I :I 100A2•::':; :� FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 0 0 EXISTING 100.39 ENGINEER BEFORE CONSTRUCTION CONTINUES. �:.:. USE 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. HO 33 100.29 h.::'•:::.:I m T.O.F.=101.3f '' ; 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. "W .". PROPOSED 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE SEPTIC TANK `t 8. THERE ARE NO ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S. x 100,35 i 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 100,46 �, ' xl AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE / LOT 2 x 100,46 DIRECTED BY THE APPROVING AUTHORITIES. �} MBL 308-275 �0 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY /O' 2 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 9,585±S.F. i ;r CONSTRUCTION. 99. 100.00' ' l�P� 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND — — REPLACE CE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). —N-1-6`56-00—W———99 RR1 _a Mqs 12. AREAS REQUI�HEA ERIALS SHALL BE UP 99,82 ® edge of pavement 99 9&' 100,03 P�� 19� INSPECTED BTH DEP�ARMEN�RIOR�BACKFILCATCH BASIN �` yG99,65 o PETER T. j (( ( 13. THIS PLAN IS PURPOSES ONLY AND }, g Wl IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. t McENTEE o 14.CIVIL PINE A VENUE No. 35109 THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THE PLAN. SA PROPOSED SEPTIC SYSTEM UPGRADE PLAN OFS o A LNG` 33 PINE AVENUE, HYAN N S, MA 4 J(U/ 0 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. Engineering Works Inc. 1"=20' P.T.M. 125-14 POLLOCK, WAITER B III 9 g � ' 1 33 PINE AVENUE 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. HYANNIS, MA 02601 (508) 477-5313 6/10 14 P.T.M. 1 Of 2 - i - 4