Loading...
HomeMy WebLinkAbout0383 PITCHER'S WAY - Health M � • MHya s nnl t �„� 4 F Mc, a .� a S.. .r' & •s .A e �,���a �d� �il.:� T��g ao f�'4ti• < �a'3, �*r e-,'��" ;+.f, a r. ,�1 � d kt e TOWN OF BARNSTABLE LOCATION3?3— P. ,C ( SEWAGE# VILLAGE ,l ASSESSOR'S MAP&PARCELi� �I INSTALLER'S-NAME&PHONE NO. Aiadmg Z SEPTIC TANK CAPACITY ,a LEACHING FACILITY:(type /' �/. (size) NO.OF BEDROOMS OWNER PERMIT DATE: ® COMPLIANCE DATE: tJ Separation Distance etween e: 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 fa ili ) Feet FURNISHED BY .:` S a A-3 � . el Bq No. 1�✓ ' � . Fee a THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Migool *V.tem Cow5truction Permit Application for a Permit to Construct( )- Repair(P<'U'pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addressor Lot No.3RS 4�C Owner's Name,Address,and Tel.No� �'X1171- Assessor's Map/Pafcel n 0 Installer's Nail Address,and Tel.No. oow Designer's Name,Address and Tel.Nol-���e, A�e� t>?` CJ®7ClCi �a� s �/ f�D P3 �G ¢'✓4 t�FiG �/�le tl Type of Building: Dwelling No.of Bedrooms Lot Size ���4sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ' gpd �T Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature ofairs or Alterations(Answer when applicable) v -2f _ 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 H th. -- Sig ed Date �� v Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. f(�^ Date Issued No. t/ i Fee /j Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: x P,UBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for, Migpogal *pgtem Cowaruction Permit , Application for a Permit to Construct( ) , Repair(Upgrade( `Abandon( ) ❑ Complete System ❑Individual Components r� f` .f.rrn. — .. � 4.l � Location Address or Lot No., T�fCl��l� �/ .Owner's Name,Address,and Tel.Ngl_-!�1%/( Assessor's Map/P eel f' r. Installer's Na e,Address,and Tel.No. Designer's Name,-Address and Tel: Type of Building: r t " �r� Dwelling No.of Bedrooms ,�" ^s L of Size sq. ft. Garbage Grinder ( ) Other Type of Building i No.of Persons Showers Cafeteria d Y �- Other Fixtures - �> t Design Flow min.required) gpd Design flow provided �j gpd Plan 11 Date Number of sheets Revision Date ( / Title .:✓' � -:,-t..:t' f' .°. < � ,, tr Size of Septic Tank.' p f7 © Type of S.A.S. Description of Soil Nature o' Repairs or Alterations(Answer when applicable) ATV 91— `if . . Date la t inspected: Agreement: , 2 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 rCompliance has been issued by this Board of Health. — Sig ed / �� i Date > Application Approved b Date PP PP Y Application Disapproved by: ," w„ _ Date for the following reasons ——.—.—.Permit No. �����' L _——--�.Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site,$ewage Disposal System Constructed-( _ ) Repaired- (� Upgraded ( ) Abandoned by �l at has been constructed in accordance with the provisr� of Title 5 and the for Disposal System onstruc Permit No (' "'� � dated Installer Designer #bedrooms Approved design floe 3 3 0 gpd The issuance of thi e it shall not be construed as a guarantee that the system ill unctio as desig ed. Date � C`� Inspector r S• i No. Y ) �� --r� J �Fee �j l.� �-✓ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Zigogal �&pgtem CongtructionaPermit- Permission is hereby granted to Construct ) Repair ( ) Upgrade ( ) Abandon ( ) System located at � �� l and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction ust b' completed within three years of the dame o e it. Date Approved b,by ���''.•���S �. e Town of Barnstalble '"E' i.� Regulatory Services Thomas F. Geiler, Director • sniwsrnei.€, 9�A NAM Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-362-4644 Fax: 503-790-6304 Installer& Designer Certification Form Date: Sewage Permit# Zd 1 d —227 Assessor's Map\Parcel �Z&q 0?3 Designer: 1V1AY0,,0 NOW/ Installer: Address: I Address: IK W, �G�h��INiG� 025�� D On ///JdA� a permit to install a (date G (inst'allller) septic system at D� t �S VV based on a design drawn by /j /�� (address) �l 1�( ' "I I"�6 fits dated b 1 (designer} X I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF MAss9�y 'll DAR E M ME (Installer's Signature) t 0 RfC/SiE�� SgNITAR\P� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BA TABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-264doc i Town of$Aans-table. P#--�3�'° � ofTME c� Department of Regulatory Services / Public Aealih Division Date_ eu.9s ,<6Jy. ems$ 200 Main Street,Hyannis MA 02601 Time Fee Pd. G1 U Date Scheduled i I i Soil ,Suitability Assess M"ent.for Sewage pisposal I J�.t Y��lil !��l C� �✓ �' Performed By: Witnessed By: ' i LOCATION & GENERAL INFORMATION Location Address 39 S P l 1 Ctf e le S WA 1 Owner's Name �� N�pn►F� MT C� ��r Po 6a Sv 13C Address pl A (J N I S C"A I D�� � ) %L&� Assessor's Map/Parcel: 3 I Engineer's Name� � �@/ ��/• � z- NEW CONSTRUt'�`fION REPAIR j Telephone# �� 3� 297z Land Use �7eS/�t°� L� Slopes(9'0) �- Surface Stones G ? OU ! J ft Drinking Water Well �l ft Distances from: Open Water Body ft Possible Wee Area i - prainage Way ft Property Linc ft Other ft SKETCH:(Street name,dimensiorisbf lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) a� as 130.00 „ .._. -- T�eFCIgN pG j 1 RFM K I l 1 N i R97 Eq r �VFD pd EX IS CHI G 20 " m ' m� 0 �Ir-0 I I I o ! I —� F ° q-9 i j m LA p I +Z G� WATER LINE__ 3 TDNf I V J 1 GARAGE Wq�t J I i / 1 � I i I - ' I �- j I \ STONE DRIV II t i Parent material(gedlogic)G IuL1Gt-r GU L✓�S� 1 Depth to Bedrock --- -----� ( Q��N i Depth to Groundwater Standing Water in Hole: Weeping from Pit Face I Estimated Seasonal il-Iigh Groundwater I)tTERMINATION FOR SEASONAL HIGH WATER TA19LE Method Used: C� � ,�n4'I S,� i ]n. 8r� � _'to. Depth to sall ttl9t[Ics: Depth observed standingan obs.hole: {t. Depth toiweeping from side of obs.hole: e i in. Or factOf to-,I A nt ddJ 3�ater Level ZO�t Index Well# _ Reading Date: Index Well level - Adj /NI/w_Zq v /a i D PERCOLATIiION TEST Date Time Observation r< Tune at 9" A - Hole# i A, Time at 6" ------- Depth of Pere7L 6/ Time(9"-6', Start Pre-soak Time.@ - i End Pre-soak � 1 Rate MinJlnch 11 Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed x Site Failed: Original:.Public xie$Ith Division Observation Hole Data To Be Completed on BacK-- ***If percola#Pn test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation DiNision at least one (1)wedk prior to beginning. J DEEP OBSERVATION HOLE LOG Hole#_L Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 7�0► ��'� UX�✓l� Gch� �d J 5y'' 76�' 5erneJ o�nd 2.5 y 61 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) 4S �J�� /Z� y CC�. Z• �/ DEEP OBSERVATION HOLE LOG Hole# w Depth from Soil Hori Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. 0. Consistent %Gravel z DEEP OBSERVATION HOLE LOG Hole# >� Depth from Soil Horizon \ Soil Texture Soil Color Soil Other Surface(in.) `(USDA) (Munsell) Mottling (Structure,Stones,Boulders. "�. Consisten ra I t Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No J Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? j!�f If not,what is the depth of naturally occurring pervious material? Certification I certify that on �U (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 t ining,expertise and experience described in 3,10 CNM 15.017. Signature Date Q:\.SEPTICIPERCFORM.DOC i 1 Commonwealth of Massachusetts o71�9'�q,3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Ln 383 PITCHERS WAY Property Address � NUCCIO Owner Owner's Name Q? . information is -v required for HYANNIS MA 02601 8-23-16 every page. Cityrrown State Zip Code Date of Inspection h!: A 41 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: A. General Information p When filling out forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 I l City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuantto Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8-23-16 ns nature 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 I, at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G1 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: AT TIME OF INSPECTION SYSTEM MET ALL PASSING REQUIREMENTS. THIS REPORT DOES NOT PREDICT THE FUTURE PERFORMANCE UNDER THE SAME OR INCREASED USE.TANK NEEDS PUMPING.THIS REPORT IS NOT TO BE USED AS A BEDROOM COUNT DETERMINATION. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: , ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 'Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every 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 ❑ ® 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This � asses system if the well water analysis, performed at a DEP certified Y p Y laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 2per assessors DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. City/Town State Zip Code Date of Inspection D. System Information Description: according to as-built card system consists of a 1500 gall tank 1000 gall pc a d-box and 16 biodiffusers in an 11.32x25ft area Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2014--------298 2015-------208 SYSTEM NOT DESIGNED FOR USE WITH GARBAGE DISPOSAL. Sump pump? ❑ Yes ❑ No Last date of occupancy: UNKNOWN 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 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: UNKNOWN Date Other(describe below): 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: j 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): PUMP CHAMBER AS WELL 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 , 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2010 PER AS-BUILT CARD Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: 1 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: P t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts h v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Cityrrown 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.): TANK HAD A ZABEL FILTER THAT WAS CLOGGED AT TIME OF INSPECTION IT WAS CLEANED AND RE INSTALLED. TANK NEEDED PUMPING AT TIME OF INSPECTION. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Citylrown 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.): TANK WAS IN NEED OF PUMPING AT TIME OF INSPECTION. 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 I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): BOX COVER WAS TO GRADE AND FUNCTIONING PROPERLY AT TIME OF INSPECTION. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working es order: Y No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): WE MANUALLY RAN PUMP AND ALARM AT TIME OF INSPECTION . * 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: NO OBSERVATION PORTS WERE ABLE TO BE LOCATED. I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 16 biodiffusers ❑ 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.): no observation ports were able to be located but there were no clear signs of failure in area of s.a.s at time of inspection. 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 F Depth of scum layer Dimensions of cesspool I Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Assessing As-Built Cards Page 2 of 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , yt 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): f 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.): l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=151044&seq=1 9/15/2016 Assessing As-Built Cards Page 2 of 2 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=118085&seq=1 9/16/2016 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM , 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Cityrrown 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: 5 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 8-2016Date ❑ 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: i You must describe how you established the high ground water elevation: design plan 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 383 PITCHERS WAY Property Address NUCCIO Owner Owner's Name information is required for HYANNIS MA 02601 8-23-16 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION tJ-)A SEWAGE# r/ VILLAGE f /• ASSESSOR'S MAP&PARCELoni� ---Z'S INSTALLER'S NAME&PHONE NO. f SEPTIC TANK CAPACITY LEACHING FACILITY:(type NO.OF BEDROOMS OWNER W PERMIT DATE: COMPLIANCE DATE: vko Separation Distance e: 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 leach ili Zl/ 2 -_ Feet FURNISHED vb �y http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappa1=269093&seq=3 9/19/2016 f T14E7-r Town of Barnstable Barnstable PAHmV Regulatory Services Department aica UI t nA nvsrgaLE. - `. Public Health Division � µ A�674• � ems ' 200 Main Street, Hyannis MA 02601 2007 Oft-ice: 508-862-4644 Thomas F.Geder,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205009502 6/17/2010 Today Real Estate c/o David Holt 1533 Falmouth Road . Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 383 Pitchers Way, Hyannis, MA was last inspected on June 2, 2010,-by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. You are,ordered to repair or replace the septic system within Sixty (60) days from the date you receive.this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER 0 THE BOARD OF HEALTH Thomas McKean, R.S., CHO 'Agent of the Board of Health I.l;JCOO _. Commonwealth of Massachusetts Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments „ 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 _ 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. A. General Information 1. Inspector: l� Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 16.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® .Fails ❑ Needs Further Evaluation by the Local Approving Authority - 6-2-10 Inspector's Signature Date The system inspector shall.submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gp.d 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. Need`s new leach field and new septic tank. See comments. I P _ l System t5insp'official document-.03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal •Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined (Y, N, ND)in the ❑ for the following statements. If"not determined,"please explain. ❑ 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 p 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. ND Explain: ❑ 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 t ❑ obstruction is removed t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every H annis MA 02601 6-2-10 y page. r City/Town State Zip Code Date of,Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: 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 manne.rwhich 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 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. k ❑ 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. t5insp official document•03/08. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 f Commonwealth of Massachusetts . Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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: r r D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No _ ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters 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 '/ day flow ❑ ®' Required pumping more than 4 times in the last year NOT due to clogged or obstructed.pipe(s). Number of times pumped: ❑ ® Any portion of the 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. t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 16 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No f ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either`fifes" 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.ddrik'ing water supply ❑ ❑ . the system is within 20.0 feet of a tributary to a surface drinking water supply:, El 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. t5insp official document•03/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts ry - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 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? ❑ ®• Has the system received normal flows in the previous two week period? F ® 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)] t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: 4-2010 Date Commercial/Industrial Flow Conditions: Type of Establishment: . Design flow(based on 310 CM 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: Last date of occupancy/use: Date Other(describe): t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 0 383 Pitchers Way 'M Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information 'Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If es vol y volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other (describe): Approximate age of all components, date installed (if known) and source of information: 1997 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is H required for every annis MA 02601 6-2-10 y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 48"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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 36"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: 1000 gal Sludge depth:. 12" Distance from top of sludge to bottom of outlet tee or baffle 20" 3" Scum thickness . 5 Distance.,from top of scum.to top_of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 14 How were dimensions determined? Tape t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 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.): Tank is showing signs of age and cracking and should be replaced. 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.): 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): t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert N/A 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 t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 -- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 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 infiltrators ❑ 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.): Infiltrators and surrounding stone had signs of hydrolic failure with signs of back up into septic tank. t5insp official document•03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 • il w Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): 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.): t5insp official document•03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 16 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)' Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. o t I f r ' i i + I i i i, t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 383 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 6-2-10 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: 9 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: j ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show groundwater at 9' t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 ~� v TOWN OF BARNSTABLE " LOCAT.) SEWAGE # . VILLAGE ASSESSOR'S MAP &LOT .1 O 73 INSTALLER'S NAME&PHONE NO. -�Je SEPTIC TANK CAPACITY _ 4-X' 5T` t;�=�dG� LEACHING FACEL=: (type) l-OLO Qc­d4'= -C_,Xt--16�L (size) (off( NO.OF BEDROOMS 3 BUILDER OR OWNER q = PERMITDATE: 8 "a. q"/ 7 COMPLIANCE DATE: f 9 J9 7 Separation Distance Between the: Maximum Adjusted Groundwater Table.and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland'and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �. '-°s-�'- \. � � �YJ r . a ' y � = � TOWN OF BARNSTABLE L06Ct1�T1ON 3S 3 1 c US W A SEWAGE # `• VIL-LA-GE 0 a A h rA 15 ASSESSOR'S MAP & LOT O 3� INSTALLER'S NAME.& PHONE NO. l J- C 710, n SEPTIC'TANK CAPACITY MOO LEACHING FACILITY:(type)?per C4,4er (size)• i boo PU61 ic. NO. OF BEDROOMS_ 3 PRIVATE WELL OR PUBLIC WATER W q BUILDER OR OWNER b W f) DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No k' f`1 _ o , I s r No. <� Fee THE COMMONWEAL OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Dizpozar *p!tem Construction Vermit Application for a Permit to Construct( )Repair(grade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. ;3O Z o� Owner's Name,Address and Tel.No. Assessor's Map/Parcel ���... oq3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �u7o .02 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 33 D gallons per day. Calculated daily flow 411-l0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. I.Ty'r%.'t-yaS Description of Soil Nature of Repairs or Alterations(Answer when applicable) .-rw5TVUt o Low o�E-0r1 Lr--- Lot'] 4 s7PA-C, �1-2cv 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 be is e Date i Application Approved Date 491� 1�?9l`F7 Application Disapproved for the following reasons Permit No. Date Issued____�v ZC;:17 TOWN OF BARNSTABLE LOCATIONS"i i�--Vvelr s SEWAGE # \VILLAGE (��<<ti f, 1 S n ASSESSOR'S MAP & LOT L,�• 0 93 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) L.oL-> (size) :NO.OF BEDROOMS- BUILDER OR OWNER CSZQ - QwcQ PERMITDATE: "a:.q / 7 COMPLIANCE DATE: Separation Distance Between the: -;Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet :::Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 0 No. Fee !g� THE COMMONWEAL OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for Miopoml *pgtem Construction Vermit Application for a Permit to Construct( )Repair(t� Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 303 Pi-xv— Vc u.1f1_ Owner's Name,Address and Tel.No. Assessor's Map/Parcel oa(aGt_ oq 3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms - Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 33 D gallons per day. Calculated daily flow 4-IU ...gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank K 5 rtry,_ %OCU Type of S.A.S. irTvc��u25 LLw ��� Description of Soil Il't Nature of Repairs or Alterations(Answer when applicable) .2'W STV!-A 0 S'r L Oyr.Gi l� tia�Gt1�Z-yi�`��+25 (`I L/157UA-e— Al2e*, y 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 beau is o eat Signed Date - Application Approved Z { Date .e' 4?jg--9 Application Disapproved for the following reasons i Permit.No. A Date Issued 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER hat the Oozsa jSewage Disposal System Constructed( ) Repaired( )Upgraded(V�) Abandoned( )by �--?� o��,� -u�c�`�S at -A 63 GA�e is A ti c� t has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated e' ;?,F'.07"7 Installer ' Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date `� �- �- 9 - a 7 Inspector C� 9 No. � -------------------------Fee `�✓ �/•yv THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Wigoa[ *pgtem Construction hermit Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( ) System located at r:r x y-I c-V ,rS w V1V and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date off it. Approved Date: 6y,, J f NOTICE: This Form is to be used for the Repair of Failed Septic Systems Only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL NVORKS CONS'11tUCTION 1'EltNil'l'(NVI-1'11OU'I' DESIGNED PLANS) , A-C hereby certify that the application for disposal works construction permit signed by me dated S''-2)9-i7 , concerning the property located at 3�3 ®�`� �s ww�'�— l�-� meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic syste m • There are no private wells within 15o feet of the proposed septic system • The observed groundwater table is a feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change In use proposed • There are no variances requested or needed. SIGNED: DATE' LICENSED SEi'TIC SYSTEM LER IN THE TOWN OF BARNSTABLE NUMBER IAltach a sketch plan of the proposed system. Also if the licensed Installer posesses a certified plot plan, this plan should be submitted]. O O ,�� L - TOWN OF BARNSTABLE .00A11ON �3 J-e l-e s5 [ SEWAGE # 1I L.LAGE 14614 r e 5 A,SSESSOR S P AP&LOT NST I-ER's NAME PHONE NO. -- ;EP71C TANK CAPACTxx 160 EACHNG FAA LITY: {type) - I-'^-�� 1 -6-ik 7�� (size,) WIY DER OR OWNER 'ERMITDATL7: COMPLIANCE.DATE: separation Distance Between the: rlaximutn Adjusted Groundwater Table to the Bottom of Leaching Facility met Yivatc Water Supply WeH and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) 'Age of Wedand rutd Leaching Facility(if any w lands exist witWn 304 feSqf leaching ucility) L/4 ---eet �urnished t LL t' � � �� .�.J � � i x �' .� --� \ SURVEY REFERENCE: _ a \\ < LEGEND BERRY PLAN OF LAND BY: BEARSE AND LAW, SURVEYORS PROP. 1 ,000G PROF. I ,50OG EX15T. I ,000G \; \ n PUMP CHAMBE SEPTIC TANK SEPTIO-TANK \ DATED: MARCH 20, 1964 \\. [�—1 PROPOSED CONTOUR PRINCESS } TO--5E REMOVED `.\ \\ ® PROPOSED SPOT GRADE• LOT 9,� `, \\ EXISTING CONTOUR SITE 2 :% \ \ + 96.52 EXISTING SPOT GRADE _ REA = 12526 sf +� a \01 \ , \� W— EXISTING WATER SERVICE WEsr MgIN .. ' PROP. 5 FT. 1�p oo {�" \\\ �'� �\ - TEST PIT SrREEr ti 501L REMOVAL (SEE NOTE 17) �\ \ �P��� , LOCUS MAP N.T.S. \i �® A s k Z I \\ GENERAL NOTES: \\ \\ �` I \\ 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL its I \ BOARD OF HEALTH AND THE DESIGN ENGINEER. -1—28 \ 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE 0 LOCAL RULES AND. REGULATIONS. // � 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR STONE \ \ \ WAl \ \ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE , \ \ / �'^� \ DESIGN ENGINEER. \ \ �' \ i� I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING p \, \ -p __ ! ii I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN o ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. \ \V \\ GP�P \ \ P�� �i O 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF \ \ ♦\. ���� \ i' N� �� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. BENCH MARK \ \ ��IE \ i \p O 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. \ p� GAS / i� 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TOP OF GAS GATE \\ \\ �� �� S\pN� ,�--�� GATE Q L" TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. ELEVATION = 25. 21 \.\ \ �� i/ �� i. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY \ \� \ � �\ THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING BARNSTABLE GIS DATUM \ \ \ � \ yam' \ v CONSTRUCTION. 10. EXISTING LEACHING (IN AREA OF PROP. SYSTEM) TO BE PUMPED AND REMOVED. \ \ \ P •\ \ i 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY i, DESIGN CRITERIA \'\ \\ \ %"� �� AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO OTHER PRIVATE WELLS WITHIN 200 Fr. OF PROPOSED LEACHING \ \ 2 i h DESIGN CRITERIA: EXIST. 3 BEDROOM DWELLING(M It, Z-�tell) \. ���" ii � + 14. ALL PIPING TO BE 4 SCH 40 ® 1/8"/FT (UNLESS SPEC.) \ i i 26 1.5. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN \ �=' � iL��� \ FOR THE USE OF A GARBAGE GRINDER i I i Q P 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING DAILY FLOW: 110 G.P.D./BR \' 28 iii OF ,yes 17. REMOVE ALL UNSUITABLE SOILS 5 FEET AROUND LEACHING TO (DESIGN FLOW: 3BR x 110 GPD/BR = 330 gpd (MIN REQ D) i i G� ��� f9� EL: 19.51 OR TOP OF Cl (MED. SAND) LAYER AND REPLACE WITH 'bARBAGE GRINDER: NO i�0 y✓+ CLEAN MEDIUM SAND PER TITLE V. -SEPTIC TANK: 330 gpd x 200% = 660 gpd : USE'EXIST. 1,000G TANK DAR M 18. PLACE 40 ml POLY BARRIER AROUND LEACHING ON ALL SIDES AT EDGE 1 vs OF SOIL REMOVAL FROM EL. 26.88-22.88 TO PREVENT BREAKOUT PROPOSED PUMP CHAMBER: 1000 GALLON 0. LEACHING AREA REQUIRED: (330) = 445.94 S.F. PRIMARY S.A.S. •74 USE 4 ROWS OF 4 - 11 ADS 1100BD BIODIFFUSER UNITS-NO STONENITAR\Pa PROPOSED SEPTIC SYSTEM UPGRADE PLAN BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIODIFFUSER) ��� 383 PITCHERS WAY, HYANNIS, MA (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.70 SF/LF = 470.0 SF Prepared for: Mike Dedecko TOTAL AREA = 470.0 SF Engineering by: Surveying by: SCALE DRAWN MAP,' 269 DARREN M.MEYER,R.S. Soo Teoh Abvlr+ommemW. 1" 209 DMM DESIGN FLOW PROVIDED: 0.74GPD/SF(470.OSF) = 347.8 GPD > 330 GPD req'd LOT.' 093 Poeox98t (508) 364-0894 - EAST SANDWICH,MA 02537 DATE: CHECKED 508-3622922 08/01/10 DMM 1 of 2 NOTE: MAGNETIC TAPE.TO BE PLACED OVER ALL COVERS NOTE: TOE PREVENT-BREAKOUT, THE PROPOSED ELEV. TOP PROPOSED TANK PUMP CHAMBER FINISH GRADE SHALL NOT BE < EL:26.88 FOUNDATION INSTALL RISERS W/IN 6" OF FINISH GRADE INSTALL RISERS to FINISH GRADE INSTALL RISERS W/IN 6" OF FINISH GRADE FOR A DISTANCE OF 15' .ARO.UND THE (Existing) PERIMETER OF THE S.A.S. = 29.39 FINISH GRADE=27.75 EL.25.5t EL.25.5t EL.25.5t EL.25.5f F.G. EL: 28.Ot MIN. COVER OVER S.A.S. 9" I MAINTAIN 2X MIN SLOPE OVER LEACHING AREA MAX. COVER OVER S.A.S. 36" f' ! INSTALL TWO INSPECTION PORTS(MIN,) SANITARY TEE L -15'(MAX) to PVC " 0 P " SCH 40 „ ,y CELLAR FLOOR i 46-2x 10 0 S SCH MIN. 2 ORCE MPtN ® S= 1� (MIN.) 6INVERT _ n • (MIN.) TEE's ARE TO BE 14 (MIN.) 10" F D-80X INV.=26.65 w a" scN 40 PVC INV.= 23.50 t8" INV.- 26.85IL 4 ROWS OF 4 UNITS AT 6.25'/UNIT - 25' ROW TEE SHALL NOT EXTEND / Exist. Invert w FILTER INV.=23.45 PUMP OFF 4" BELOW FLOW LINE INV.ELEV.=26.49 INv.-z1.75 t2" y(usE oe-5) SOIL ABSORPTION SYSTEM (PROFILE) Prop. Invert OF M INV.=24.0 PROPOSED 1,500 GALLON SEPTIC TANK �� INV.-23.70 � gfs9�y INV.- 23.75 GAS BAFFLE TO BE INSTSALLED ON 1000 GALLON PUMP CHAMBER(H-10) ? G OUTLET TEE AS MANUFACTURED BY ( DWRE RESTORE VEGETATIVE COVER TUF-TITE, ZABEL, OR EQUAL NOTES. 1) CONTRACTOR SHALL VERIFY ALL EXISTING 4) GAS BAFFLE W/ FILTER TO BE INSTALLED ON OUTLET TEE No. 1140 TO WITH CLEAN PERC SAND TO TOP OF CHAMBERS PIPE INVERTS PRIOR TO CONSTRUCTION. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. r, 2) TANK, PUMP CHAMBER AND D-BOX SHALL BE SET 5) INSTALL SANITARY TEE IN D-BOX LACE FILTER FABRIC LEVEL AND TRUE TO GRADE ON A MECHANICALLY 6) PLUMBING TO BE RAISED TO MEET OUTLET ELEVATION. �1 BREAKOUT=TOP ELEV.=26.88 ` "' '_'' '' '•. : :. OVER ALL UNITS ' N I TAR� "^ (RECOMMENDED) COMPACTED SIX INCH CRUSHED STONE BASE INV. ELEV.= 26.49 •• ( AS SPECIFIED IN 310 CMR 15.221(2). 3) INSTALL INLET & OUTLET TEES AS REQUIRED. SEPTIC SYSTEM PROFILE ��a C BOTTOM ELEV.= 25.96 EXISTING SUITABLE 2.83' MATERIAL 5' MIN. ABOVE BOTTOM OF N.T.S. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH 4 x 2.83' - 11.32 (5.05 PROVIDED) USE 4 ROWS OF 4-HIGH CAPACITY INSTALL 1' PVC.CONDUIT TO HOUSE FOR WIRING ADJ. GROUNDWATER EL.=20.91 PROVIDE WATERTIGHT CONCRETE RISER = ADS 110OBD BIODIFFUSER UNITS-NO STONE WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM WITH SECURED COVER TO GRADE FLOAT TO GP 2000 HIGH WATER ALARM PANAL ON CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. NEMA 4 JUNCTION BOX CORROSION RESISTANT TYPICAL SECTION & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 1 HOISTING CABLE 7xl9 STAINLESS STEEL BY 1-1/4" PVC CONDUIT. JOINTS TO BE MADE SOIL LOGS "'T's 1/8" DIAMETER. / 1,760 LB. STRENGTH. WATERTIGHT 2"BALL VALVE w/ UNIONS SCH. 80 PVC P#:13007 PC INV.(IN)=23.45 GEORGE FISHER CO. MODEL N0. 560 OR EQUAL ' { 2"SCH. 40 DISCHARGE TO D-BOX W/PRESSURE FITTINGS ALARM ON EL: 22.11 2"SCH. 40 TEE w/ CLEAN-OUT CAP Elev. TH-1 Depth Elev. TH-2 Depth PUMP ON EL: 20.78 PROVIDE 1/4" WEEP HOLE IN DISCHARGE DATE: JULY 28 2010 -p- PIPE FOR SELF-DRAINING FORCE MAIN 25.84 0 25.80 Q" PUMP OFF EL: 20.45 SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 FILL BOTTOM OF " 2" BALL CHECK VALVE SCH. 80 PVC FILL PUMP CHAMBER /z 100 P.S.I. FLOWMATIC MODEL No. 2085 { WITNESS: DAVID STANTON, BARNSTABLE BOH 22.01 A 46" 22.05 A 45" ELEV.= 19.45 2" SCH. 40 PVC DISCHARGE PIPE i LOAMY SAND LOAMY SAND PROVIDE 2- WIDE ANGLE FLOATS, BARNES SEV412 PUMP .4 H.P. 115 V I 10YR 5/1 " 10YR 5/1 " ^; FLOAT NOA: PUMP ON/OFF (BARNES 073618 OR EQUAL) 2" DISCHARGE PASSING 2" SOLIDS OR EQUAL 21.34 54 21.13 56 FLOAT NO.2: ALARM ACTIVATION (BARNES 073612 OR EQUAL) TESTHOLE Al: B B NOTES: SANDY LOAM SANDY LOAM NOTE: PUMP CHAMBER TO BE FACTORY WATERTIGHT AND SEALED WITH THOROSEAL OR EQUAL 1.) ALARM TO BE AUDIOVISUAL AND ON GROUNDWATER OBSERVED AT EL. 18.51 1OYR 6/8 10YR 6/8 i SEPARATE CIRCUIT FROM PUMP, INDEX WELL: MIW-29 ZONE: D PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT 2.) ELECTRICAL PERMIT REQUIRED. i LEVEL: 7.2 ADJUSTMENT: .2.4 ft. 19.51 76" " THROUGH WIGGEN PRECAST CORP., BOURNE MA. (800) 564-6774 3.) ALARM TO BE LOCATED IN AN EASILY ADJUSTED GROUNDWATER AT EL. 20.91 Cl 19.55 C1 75 PUMP & ACCESSORIES AVAILABLE THROUGH WILLIAMSON ELECTRIC (781) 444-6800 ACCESSIBLE EXTERIOR LOCATION. obs.h20 018.51 MEDIUM obs.h26 018.51 MEDIUM _ - . PUMP DETAIL 4.) PUMP TO BE INSTALLED IN STRICT SAND SAND w 2.SY 6/6 Z,SY 6/6 CONFORMANCE WITH MANUFACTURERS SPECS N.T.S. 1 5. PUMP CHAMBER To BE FACTORY WATER SEALED - i� 15.34 126" 15.30 126" BUOYANCY CALCULATIONS DOSING & STORAGE REQUIREMENTS PERC RATE <2 MIN/IN. (IN "Cl MED. SAND" HORIZON) Septic Tank - 1500 GALLON (H-10)LOADING Pump Chamber - 1000 GALLON (H-10)LOADING DAILY FLOW: 330 GPD BOTTOM OF SEPTIC TANK EL.- 19.50 BOTTOM OF PUMP CHAMBER EL.- 19.45 DOSING REQUIRED: 4 CYCLES/DAY (SAND) PROPOSED SEPTIC SYSTEM UPGRADE PLAN HIGH GROUNDWATER EL.-20.91 HIGH GROUNDWATER EL.- 20.91 330 - 4 = 82.5 GALLLONS/CYCLE BUOYANCY FORCE PER FOOT OF DEPTH: DISTANCE. REQUIRED BETWEEN PUMP 383 PITCHERS WAY, HYAN N IS, MA 5.83'x 10.5'x 1.0'x 62.41be/cu.ft. - 3819.82 Ibe/ft BUOYANCY FORCE PER FOOT OF DEPTH: 5.4XI x M DI x AC x 62.41ba/cu.ft.-5= 1. Iba/ft ON AND PUMP OFF; FLOATS: MAXIMUM DISPLACEMENT- 20.91-19.50- 1.41' MAXIMUM DISPLACEMENT- 20.91-19.45= 1.46' MAX.UPLIFT PRESSURE- 1.41'X 3819.82 Ibe/ft- 5385.95 Iba. MAX. UPLIFT PRESSURE- 1.46'X 2824.4 Ibe/ft- 4123.62 Iba. 82.5 GAL/CYCLE 250 GAL/FT = 0.33 FT/CYCLE (4") Prepared for: Mike Dedecko WEIGHT OF EMPTY SEPTIC TANK - 12,000 Iba. WEIGHT OF EMPTY PUMP CHAMBER- 8,000 Ibe. Engineering by: Surveying by: SCALE DRAWN WEIGHT OF FILL(COVER)OVER PUMP CHAMBER: WEIGHT OF FILL(COVER)OVER PUMP CHAMBER: STORAGE REQUIRED ABOVE WORKING LEVEL: 310 GALLONS DARRENM.MEYER,R.S. Eco Tech Env. DMM 5.83'x 10.5'x 1.0'(ove.)x 110 Ibs/cu.ft. -6733 Ibe. 5.46 x 8.29'x 1.0 (ave.)x 1101be/cu.ft. - 4978 Ibs. STORAGE PROVIDED: PO BOX881 N.T.S. TOTAL COUNTER WEIGHT- 12;000 The+ 6733 The- 18,733[be TOTAL COUNTER WEIGHT= 8,000 Ibe+ 4978 Ibs= 12,978 Ibe INV.(IN) EL:23.45 - PUMP ON EL:20.78 = 2.67' EASTSANDWICH,MAo2537 (508).364-0894 DATE CHECKED SHEET NO. 18,733 Ibs>5385.95[be O.K. 12,978 Iba>4123.62 Iba O.K. STORAGE PROVIDED' = 2.67' X 250 GAL/FT = 667.50 GALLONS 5o8462-292 08/01/10 DMM 2 of 2