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Home My WebLink About0439 PITCHER'S WAY - Health 439 Pitcher's Way Hyannis F �l r,rIS , -� - A = 270 147 � q�q d s s 0 [� p TOWN OF BARNSTABLE LOCAT►IQN ed� SEWAGE # -- VILLAGE /7 �Z /► ,rj _ ASSESSOR'S MM&LOT INSTALI.EXS NAM£&PHONE NO. SEPTIC TANK CAPACITY LEACFIING-FACILITY: t ) T'i T (size) NO.OF BEDROOMS BUELOER OR OWNER- - PERMITDATE: -COMPLIANCE DAM- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If My wCUs exist on site or within 200 ffiet of leashing facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching.facility) Feet Furnished by upel- Al C Rt �. J i i �J a Q ' No. .,i-�(a .i Fee00 , s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pprtcatiou for Mioogal vpgtem Cougtructiou 3permit Application for a Permit to Construct( ) Repair( ) Upgrade�(J) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name Address and Tel.No.Y��l� ,p �/ Designer's Name,,Address and Tel o. in2I I'e4 EyLo(� fPC �j0/f' /�' �� J�2 6- C, 2 2 Type of Building: Dwelling No.of Bedrooms Lot Size z�3 �Ssq. ft. Garbage Grinder ( ) Other Type of Building /.. LDS No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) y��✓ gpd Design flow provided �, 1� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last.inspected: t 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 o alth. 77 Signed Date v�--- Application Approved by G Y� Date r7 1 Application Disapproved by: Date for the following reasons Permit No. (? KO Date Issued No. Fee 04 _ THE COMMONWEALTH OF computer: �MASSACHUSETTS Entered in com P Y�� es PUBLIC HEALTH DIVISION - TOWN OF BArRNSTABLE, MASSACHUSETTS ZIppYfcation forDtgpogal �p�te�m� �ori�truction hermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ),I 0 Complete,Syst m El individual Components Location Address Lor Lot No.y Q /�/T��/"S �'U�/ T �GI��L E� / // �/ Owner's Name,Address,and Tel.No. �L Y�� l 1 Assessor's Map/Parcel ~ Installer's Name Address,and Tel.No. Designer's Name,Address and Tel. o. X. Type of Building: Dwelling No.of Bedrooms Lot Size�,�23,4' - -C: sq. ft. Garbage Grinder ( ) Other Type of Building t 5 No.of Persons P Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ��'j� gpd Plan Date Number of sheets Revision Date Title U ' Size of Septic Tank a S /O�U Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected:-,-" Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of I Compliance has been issued by this Board of Health. -- \ Signed Date Application Approved by r- VG Date 7 1 Application Disapproved b PP PP Y: Date for the following reasons i 1 Permit No. n 1 oC.-- Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sew isposal System Constructed ( ) Repaired (--- Upgraded ( )by ( ) Abandoned at4s been constructed in accordance with the provisions of Title 5 and the for Disposal System Constftction Permit No.AGA5 l/4?0 dated Installerly� ��vCG Designer #bedrooms Approved design-flow <�C�l� gpd The issuance of this permit sha11 of e construed as a guarantee that the system wil 1 functio as i'gXd. Date l l Inspector ✓ No. � Fee to 0 r. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS xi,5pool *p!gtem Construction Permit Permission is hereby granted to Const - t ( ), Repair ( '' Upgrade ( ) Abandon ( ) System located at 2 -j l/ t / y c and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date 4 7 C), Approved by �� VW j�C� 4,1 21 r .D L I' 1 U Ln Postage $ +ri ri Certified Fee ` O Retum Receipt Fee Postmark O (Endorsement Required) ►( He?e3 L��t 0 ResMcted Delivery Fee M (Endorsement Required) �/ t7 Total Postage 6 Fees s f /j David Holt r Today Real Estate 1533 Falmouth Road/RTE 28 Centerville, MA 02632 Certified Mail Provides: w. o A mailing receipt }� a A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years _ Important Reminders: e Certified Mail may ONLY be combined with First-Class Mail®or Priority Mailm. o Certified Mail is not available for any class of international mail. is NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. r o'For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return:' Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS9 postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement°Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.save this receipt and present it when making an inquiry. PS Form 3800,August 20156(Reverse)PSN 7530-02-000-9047 4.1NITED STAT V . I `> t .. ., ;.. Paid b • Sender: Please print your name, address, and +4 in this box • I I Town of Barnstable Public Health.Division I 200 Main Streety Hyannis, MA 02601 11„1:,1111111 III-of►1i,11,1,1111.111,M1,111,1111¢,t,1,1d M ■ Complete items 1,2,and 3.Also complete A. ignature item 4 if Restricted Delivery is ❑Agent ■ Print your name and address n the reverse X ❑Addressee so that we Can return the card tNyou. B. :'�ve�' Printed Name) Date f fWvery Is Attach this card to the back of the ilpiece, Y� f or on the front if space permits. :-is very address di nt from item 19 ❑Yes E 177 Article Addressed to: - If YES,enter delivery address below: ❑ No David Holt P Today Real Estate 1533.Falmouth Road/RTE. 8 3. Service Type Centerville, MA 02632 y ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes pl P �` - --•... - '... 102595-02-M-164 ' y. w • Town of Barnstable Barnstable °F��Teti Regulatory Services Department e"ac I BA MASS.M public Health Division 9 ASS. �A i639• �� 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO ----CERTIFIED MAIL #7011 0470 0001 4525 6836 May 24, 2012 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 . ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5. The septic system located at, 439 Pitchers Way, Hyannis, MA, was last inspected on 5/3/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. 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 with in the deadline period will result in future enforcement action. PER ORDER OF THE OARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health • Documentl t ��, .� ��/ �� i 1 �� -� �� Commonwealth of Massachusetts Title 5 Official Inspection Form c Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 439 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 y H annis MA 02601 5-3-12 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. A. General Information 114 1. Inspector: ,. f 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 1-508-495-0905 S13971 Telephone Number License Number B. Certification , I certify that I have personally inspected the sewage disposal system at this addne51 and thattbe information reported below is true, accurate and complete as of the time of the inspection. Tlteinsp tion was performed based on my training and experience in the proper function and maintenance-oif on sine sewage disposal systems. I am a DEP approved system inspector pursuant to:-Section 1"40 ofi Title 5(310 CM 15.000).The system: ❑ Passes, ❑ Conditionally Passes ® Fails ❑ Needs Further valuation by the Local Approving Authority 5-3-12 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to:the appropriate regional.office of the DEP.The original should be sent to the.system owner, and copies sent to the buyer, if applicable,and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 - 1 Commonwealth of Massachusetts " N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M y 439 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 5-3-12 page. Cityfrown 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 alpproved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. 11f"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 vnrill 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 Ceirtificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sysatem•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 Pitchers W ay 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 5-3-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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): t ❑ 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 15.303WW that the system is uat tUM-tiaaieg itt a manner which Witt 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 a ' Commonwealth of Massachusetts " W Title 5 Official Inspection Form w' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rY o 439 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 5-3-12 Y page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any'j' determines that the system is functioning in a.manner that protects the public hlealth, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS i s 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 nitrocen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the anralysis must be attached to this form. 3. Other: D System Failure Criteria Applicable to All Systems: Y PP Y 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 surfaice waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to ani overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/day flow t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 y H annis MA 02601 5-3-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either`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 drinking water supply ❑ ❑. the system is within 200 feet of a tributary to a surface drinking water supply El E] the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped`Zone Il'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 shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 5-3-12 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 foiilowing: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board olf 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 perioci? ❑ ® Have large volumes of water been introduced to the system recently oir 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 oif the tank inspected for the condition of the baffles or tees, material of constructi on, 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 (f 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 441044 t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 I L Commonwealth of Massachusetts IM IW Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M °a 439 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 5-3-12 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [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)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 4-2012 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 C1VIR 15.203): Gallons per day Igpd> 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts _ u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name requir atifo is Hyannis MA 02601 5-3-12 required for every y page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (f yes, attach previous inspection records, if amy) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systern-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 5-3-12 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (f known) and source of information: 1976 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24 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: 16" 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 5-3-12 page. CityTrown 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 20' Scum thickness 6„' Distance from top of scum to top of outlet tee or baffle 6„ Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural iintegrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System- Page 10 of 17 <j\, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 5-3-12 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) ' Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow:, . gallons per day Alarm present: ❑ -Yes ❑ No- Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-11/10, Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 439 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 5-3-12 required for every y . page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): Water was at working level with signs of back-up from pit. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located,explain why: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Flage 12 of 17 I Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required fior every Hyannis MA 02601 5-3-12 page. City[rown State Zip Code Date of Inspection D. System Information (cont.) Type. ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: . ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit had clear signs of hydrolic failure with stain line above inlet invert. 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 9 ❑ ❑ t5ins•111110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 5-3-12 page. CityrTown state Zip Cade Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegeitation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Pa ge 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 439 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 5-3-12 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 • r •- O _I[ t5ins•11./10 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 439 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 5-3-12 page. Cityfrown 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: 20 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: ® Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next[)age. t5ins-•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page:16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M r 439 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 y H annis MA 02601 5-3-12 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• 11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable I,E Regulatory Services Thomas F. Geiler,Director BARNSTrABLE. ► N"S& Public Health Division AT 639. Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-362-4644 Fax: 503-790-6304 Installer & Designer Certification Form (p Date: Sewage Permit# / rJAssessor's Map\Parcel -70 1 Designer: _ Installer: Address: Address: �r S On 4 �,.,. was issued a permit to install a (date) Q (installer) septic system.at3 1 �� based on a design drawn by (address) DV_A t/VV e/L4 el dated I (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 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 MAss9c- DARN s (Installer's Si,na re) 1140 '�EGlSTE�� S01 W01 esigner's Signature (Affix Designer's ix Desiners Stamp( d p Here) PLEASE RETURN TO BARNSTA E PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORNI AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-264doc i i Town of BAi i table P# Department of Regulatory Services 't �AxxarAet�, Public health Division Bate ( /�' �rAga s63¢ tee$ 200 Main Street Hyannis MA 02601 Date Scheduled t✓ / Time Fee Pc. - i i - i ,foil Suitability Assessment for Sawage Disposal � Performed By a rrtA Witnessed By: i - LOCATION,&.GENERAL INFORMATION Location Address ( `_� Owner's Name ts Address : ►i^t l s AAA,, Assessor's Map/P4rcel Engineer's Name Dft,C`!o'h NEWCONSIRU�,I;ION REPAIR J I Tel ephone# ! Land Use t/�45 Slopes(90) O S•I Surface Stones �. 9 Z6U ! >zy0 ft 4 Drinking Water Well �ZW ft Distances from: Open Water Body ft Possible Wet Area O V Other ft Drainage Way ft. Property Line k SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) JL I a I wh- F ! i Parent material(geglogic) (at iN) h J Depth to Bedrock / J I Wee in from Plt Face Depth to Groundwater- Standing Water in Hole:' �< i P g Estimated Seasonal Vigh Groundwater WI A i DtTERMINATION FOR SEASONAL HIG[�WATT TA3L� Method Used: � In. in. Depth to Boll mottles: Depth C(b�erved standing in obs.hole: — p Depth toiweeping from side of obs.hole: ! in. ,Orfletor ter,A,dJusttncnt � ! Act.ftetor — Adj.f3raundwnterLavel.;,�,e; Index Well# _ Reading Date Index Well level�: ..,. PERCOLATION TEST . Dates. xlt>fe Observation / Time lit 9". Hole# Time at 6" Depth of Pere r Time(9"-6") Start Pre-soak Time.9 - WA Zit G``t5 N,. i End Pre-soak l Rate MinJlnch ' x Site Failed' Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed Original:.Public 1.4alth Division Observation Hole Data To Be Completed on Back— ***If percolafiibn testis to be conducted within 100' of wetland,you must first notify the Barnstable C41. servation Division at least one (1) week prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture' Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulders. 1 Consistency,%Gravel D rt—C, ► ,M -a 9 - 151;t Lvov o d �s/g DEEP OBSERVATION HOLE.LOG Hole# Z Depth from 'Soil Horizon • Soil Texture Soil Color Soil Othcr Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 01, tof�yy Saxe 434-1 IVA 5- DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# N Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ra I ' T Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes ✓__ Within 500 year boundary No Yes Within-]00 year flood boundary No Y Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio s material exist,in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify,that on q� (date)I have passed the soil evaluator,examination approved by the Department of Environmental Protection and that the above analysis was,performed by me consistent with the require niin?g,,�expertiis�e�and�experience described in a10 CMR 15 / Signature lei �/ V " l Date Q:ISEPTIC\PERCFORM.DOC s1 � � COMMONWEALTH OF MMSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS . DEPARTMENT OF ENVIRONMENTAL PROTECTION ZT0 .... ..�._-_.., F.•..��, ate/ 14 ■ TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 439 Pitchers Wad Hyannis RECEIVE® Owner's Name: Harm Maddox Owner's Address: DateofInspection: 10—.? OCT o 9 2003 TOWN OF BARNSTABLE Name of Inspector:(please print) Wi 1 1 i am _ •Robinson Sr. HEALTH DEPT. CompanyName: .William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: (5 0 8) 7 7 5-8 7 7 6 CERTIFICATION STATEMENT 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 pursuant to Section15.340 of Title 5(310 CVIR 15.000). The system: '/ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ` �✓�� Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of HeaRh-m 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 seat to the system owner and copies:sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 r Page 2 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 439 P i 1- h _rs Way Hyannis Owner:. Harry Maaanx Date of inspections to -17-G 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. Syst m Conditionally Passes: . O e or more system components as described in the"Conditional Pass"section need to be replaced or repaired. he system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer y s,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. Th septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, xhibits substantial infiltration or exfiltrat'o t n or tank failure is imminent.System will pass inspection if the ex isting is replaced with a complying g p septic tank as approved by the Board of Health. •A metal eptic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicaten that the tank is less than 20 years old is available. ND exp in: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstru ed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approva of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND expla : e system required pumping more than 4 times a year due to broken or obstrwed pipe(s).The system will pass inspi ction if(with approval of the Board of Health): broken pipes)are replaced obstruction is removed ND explain: ti `t Page 3 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 439 Pit-chars Way H)ZanTii c Owner: Harr MaddnX Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to'detcrinine if the system is failin to protect public health,safety or the environment. 1. S stem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the s tem 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 2. Syst in will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system i functioning in a manner that protects the public health,safety and environment: _ e system has a septic tank and soil absorption system(SAS)and the SAS is within.100 feet of a surf ce water supply or tributary to a surface water supply. The system has a septic.tank and SAS and the SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is within So 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 frond a }rivate water supply well** Method used to determine distance *• his system passes if the well water analysis,performed at a DEP certified laboratory, for coliform ba teria and volatile organic compounds indicates that the well is free from pollution from that facility and the resence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other fail a criteria are triggered.A copy of the analysis must be attached to this form. 3. OthJr: I 3 Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Properly Address: 439 Pitchers Way Hyannis Owner: Harry Maddox Date of inspection: /0 �lJ D. yslem Failure Criteria applicable to all systems: You ust indic ate. ate"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. 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 f^_et 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of.the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E: arge Systems: To be considered a large system the system must serve a faci!ity with a design flow of 10,000 gpd to 15,000 gpd• You I ust indicate either"yes"or"no"to each of the following: (111e ollowing criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of,a surface drinking water supply 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 I of a public water supply well If you h ve answered"yes"to any question in Section E the system is crosidered a significant threat,or answered "yes"in ection D above the large system has failed.The cmm r or operator of arty large system considered a significa t threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. he system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 439 Pitchers Way Hyannis Owner: Harry Maddox Date of Inspection: Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes No t//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 7 Were as built plans of the system obtained and examined?(If they were not available note as N/A) V— 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 ales 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: Yes . no/ t/ Existing information.For example,a plan at the Board of Health. _./L '— Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)(310 CMR 15.302(3)(b)J 5 S Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 439 Pitchers Way- Hyannis Owner: Harry Maddox Date of Inspection: & f �-G 3 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):., Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): - 6 Number of current residents: Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage syste (yes or no): , [if yes separate inspection required] Laundry system inspected(yes, no) Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)): 2 0 01 -6, 0 0 7 Sump pump(yes or no):_,eL,ti 2 0 0 2-6,6 3 0 Last date of occupancy: i o—7-03 COM ERCIAIANDUSTRIAL Type o stablishment Design I ow(based on 310 CMR 15.203): gpd Basis of Jesign flow(seats/persons/sqft,etc.): Grease t ap present(yes or no): Industri I waste holding tank present(yes or no): Non-s itary waste discharged to the Title 5 system(yes or no):_ Water eter readings,if available: Last d e of occupancy/use: OTH R(describe): GENERAL INFORMATION Pumping Records Source of information: /1i Was system pumped as part oFFc inspection(yes or no):_ If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: T I P�OF SYSTEM YSe tic tank,distribution box,soil absorption system _ P rP Y _Single cesspool Overflow cesspool _Privy _Shared system(Yes or no)(if yes,attach previous inspection records,if any) _Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tigbt tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components dateinstalled(if known)and source of information: y rz- Were sewage odors detected when arriving at the site(yes or no):Z__U 6 ]'age 7 of OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4-3 Pitchers Way Hyanni . Owner:Marry Maddox Date of Inspection: ,LZz='�--(j BUILDIN/cstruction: ER(locate on site plan) Depth belo : Materials _cast iron 40 PVC_other(explain): Distance fate water supply well or suction line: Commentdition ofjoutts,venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) ) Depth below grade: Material of construction: ✓concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ is age confirmed-by a Certificate of Compliance(yes or no):_(attach a copy of certificate) , �. ,► Dimensions: S t� Sludge depth , Distance from top of sludge to bottom of outlet tee or baffle:- . Scum thickness:_Q_n I l , Distance from top of scum to top of outlet tee or baffle:. r Distance from bottom of scum to bottom of outlet tee or baffle: 1 t/ How were dimensions determined: Comments(on pumping recommendations,inlet and outlet tee or baffle conditicn,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP:_(locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Properly Address: 43A Pi tchPrs Way Hyannis Owner: carry Maralral x Date of Inspection: T1GI or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth be w grade: Material o construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flor allons/day Alarm prese Alarm Icvelrking order(yes or no): Date of lastComments float switches,etc.): DISTRI13U ON BOX: (if present must be opened)(locate on site plan) Depth of liquid eve)above outlet invert: Comments(note f box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or ou of box,etc.): PUbIP CHAMBER: (locate on site plan) Pumps in working order( es or no): Alarms in working order( cs or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 439 Pitchers Way Hyannis ti Owner: Tiarry MIddox Date of Inspection:-/[2— 7—o `3 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,ezcavation'not required) If SAS not located explain why: Type eaching pits,number: d� leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: 4 Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): CESS OOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number nd configuration: Depth—t p of liquid to inlet invert: Depth of lids layer: Depth of s um layer: Dimension of cesspool: Materials o construction: Indication f groundwater inflow(yes or no): Comments note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials f construction: Dimensio s: Depth of olids: Comme s(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 439 Pitchers Way Hyannis Owner: Harr Mar1r1nx Date of Inspection:fv 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. J �t S� 10 II� Page 11 of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4-19 Pi tchPrs wav Hyannis Owner: Narrg MAdrInx Date of Inspection: fry -i—G 3 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) �/Checked with local Board of Health-explain: Q 5 Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You m t describe how you established the high ground water elevation: Ti:s Z 11 TOWN OF BARNSTABLE LOCATION &zs A-' SEWAGE# ��/� VILLAGE fib ASSESSOR'S MAP&PAARCE INSTALLER'S NAME&PHONE NO. 1 SEPTIC TANK CAPACITY LEACHING FACILITY:(type).' e) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: MMaximum 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 ' within 300 feet of leaching facility, Feet FURNISHED BYog A3 -3? �19 3i Lq 8-:5 3�s L0 CAJION SEWAGE PERMIT NO. VILLAGE IN1TA LLER'S NAME a ADDREpS I, ,r DE1 :3S 142 Corporation Street OR OWNER Hyannis, Mass. 7-75-08,28 DATE PERMIT ISSUED DAT E•• COMPLIANCE ISSUED �� a _i s No... ...... Fmcl. ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® F HEALTH .. ......-.OF.......................................................................................... Appliraatiaan for Dhipaaii al Warks Tons rnrtiun Famit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at .............. .... ................................_.........---•--=�'-_ - ....................................................... Location s ......_ --•------ �`•-- . (s� p✓ ess / a -•--------- - Own. -•--....----•------------- Installer Address Type of uilding Size Lot............................Sq. feet aDwelling—No. of Bedrooms................................._.......___Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ____________________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter.........._..... Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit________-____-______ Depth to ground water__________________.____- (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •--- -- ----------------- --•---•--•••--..._....__....._......•-•-••--•-•-.._.._...----•--__-•......................................................... 0 Description of Soil__________ _____ _ V ••-•---------------•••---•------••-•-----•------•---•-------••--- ..--------•....---------------------------------------------•----------------------------•----•-••------'----•-•--•---••---- W --------•-------------- ---------•-••--•--••-----•----------- ----------------- /'') -- UNature of Repairs or Alterations--Answer when applicable_.__ 0 'g-, --- ---------•-•----- V -----•------------------•--•---- Agre �� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITiIL4 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issu y the board of health. gn -•• •-• Date Application Approved By-------•---• t -------- Si •••'-•-- ------•------ Date Application Disapproved for the lowing reasons-------------------------------------•------•----••----•-•••:---------•-•-----------••-------•--•------•---__.. --------------•----.....-----------...---•--•----------------..._•------.................................._.. Date PermitNo--------------------------------------------------------- Issued-....................................................... Date No................_....... FE ............. THE COMMONWEALTH OF MASSACHUSETTS ,,. BOARD F• HEALTH ............................................•..............------ Appliratilan for Disposal Works Toustrnrtiun runtit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: ..... _ _ .......... -- - .y,e Locat"on p$. s , �7 ,, 7 ..-•------1 "�=.� y.c.._.'"�•�"�s�...."- ---- z!- _�' !'...... /` -; ..----•-✓• --�`a_ 'C:. "" e,J_e..rfi'W^'�•. i'"ry '................ Own / I ✓' dd� c r ____ _______'W ,-'�; !... ..�.......`... ....._... _........s�. 4 : ?'' .�.....r _ ,,;r,., ----- -------- /-- -. -.-...._. A� res ,R f I Installer Address Type of uilding �` Size Lot_..._...__ _.......Sq. feet V ...........................Ex Expansion Attic .—I Dwelling—No. of Bedrooms_________________ p ( ) Garbage Grinder ( ) a Other a —Type of Building No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------••••-•---•••------•----------........•-----............................................ W Design Flow__________.................................g gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter.----........... Depth................ x Disposal Trench—No. .................... Width..................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-----•-----------•---••-......•................. Date........................................ Test Pit No. 1---------------- inutes per inch Depth of Test Pit..................... Depth to ground water........................ f� Test Pit No. 2................minutes per,inch Depth of Test Pit..............:..... Depth to ground water........................ -------- ------. ------------------------•----.....-- ............................................................. Description of Soil - <°��, ....... •------------------------- --------•-•------------•--- W ----------------•---•-•...---••-------......---------------- ......................................................... - - ---------• x - ---------------------- U Nature of Repairs or Alterations—Answer when applicable...___.._`� � " -- •. ••--- -------- Agr The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliancellias bteen issu by the board of health. ..s: _ s Sign ...... . ..............................•••-- ` Date Application Approved By.......... ......-•••••----- Date------•••..._. Application.Disapproved for the oll"owing reasons:.......................... ---.....---•---------•------------•-•----••---•...--•••-------------•----••---•-•-------•••--•------.....--------••----•- --•••--------•-----•-•------------------------••-----•......---------•--- Date PermitNo......................................................... Issued......... '......................................... Date =� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA6;;H ✓,, . ................p' ...:. ....................... Trrtifiratr of Tunt li urr C'ERZ;yr, That he Individu age Disposal System constructed ( ) or Repaired at.. ? , t-e�'£ C.P?r?� �I ` ns all #, `�4 has been installe i accordance with the provisions of TITLE 5 of The State tary 6 de as described in the application for Disposal Works Construction Permit No..-C!j—__ 2,4Z---- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. �.Q.. _� 3..`:�� .... ........... Inspector---------------- - -------•-- .................... THE COMMONWEALTH OF MASSACHUSETTS " BOARD F HEALTH ......................................... No. ....... ..•.------------- FEE........................ "f ;grante ispo tit rkv Tonstr ion rrniit y Permission is hereby ,i `'°-------------------------•--•-----...... -----• to Constr t ( ) or Re ndivldu Sewage Dispo fal' cs' 3� ) Street as shown on the a 1' ion for Dis osal Works Construction Permit No__ _________________ `dated.... '................................... PP ------- DATE--------------------------••••-----•-• . Board of Health u FORM 1255 A. M. SULKIN, INC., BOSTON 9 1-15 01 J� LOCAT 10 SEWAGE PERMIT NO. 14139 ( (4JAV VILLAGE /71�Q1l/I��C rt INSL&LLER'S NAME i ADDRESS _ IUILDEIII OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE . ISSUED .-d ' - - � ry � � �'G �N � O q'y ��`, �� .. �:,'� ., � .; --. t �. THE COMMONWEALTH OF MASSACHUSETTS BJ�OA R® E I--i E A T H .-••--•-�OW. ...-..OF.- :.. .------------------------------ ApplirFa#ion for Uispvii al Works Tomitrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (X an Individual Sewage Disposal Syat . . .... ---------------- ........... ........................................................................ tion-Address r Lot No. ----------- - - --------- -- -------- --- O rAddress Installer Address Type of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons____________________________ Showers — Cafeteria a d Other fixtures -----•--•---------------------------------------•---.....-•-----------------------------...------------•--------.._....--•--•-----•-----..........----• W Design Flow............................................gallons per person per day. Total daily flow............._..............................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter------ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water............._.......... GX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water______________________;_ �+ - ----------- O Description of Soil !' / ---------- ------- x V - .. ---.. .......... .. f a W •••••-•••-•--•--...••••••••••----••••••••••••-••••• ••• -----••---•-•••--.._`------------- -------- - U Nature of Repairs or Altera ns—Answer when appli Lie ......_ __ •••-••-•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 4: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has sued by the board qf�hee',alltth. Date Application Approved By.......... = ......._ ... ��' ��'8�•••••-•-__-_ Date Application Disapproved for the following reasons:......... ........................................................................._..._......................... .............................................. ----------------------._.....----------.....---------------•••-•-•••-•-••••••---•••----•••••••-•-•••-••------'••••••-••••••-•••••---••••-•••••••--_----- Date PermitNo......................................................... Issued.. ............................... Date � p t No..--w--.._._.......... v` _ �s............._.............� THE COMMONWEALTH OF MASSACHUSETTS —�- BOARD�1'71 F' HEALTH .....!.�. �.� .::' .....OF. l..irf. - -�c-•----------------------------- v ' , pphratiun for Disposal 3rurks Tonstrnrtiun Errant` Application is hereby made for a Permit to Construct ( `°)-or Repair (/X) an Individual Sewage Disposal System at .................................................................................... ....... ........... f ocation-Address s or Lot No. .............. :: !_ ... ..... fi��r- /• ...------•--..._...-•----..._.......-•---••-------•--- ....-•- `� r f r Owne�. ( , / 1 ` 1 Address a ,� ��/� : ii }" . r` .1!..!.-- ---__-__.��:.� _.j:.::'j.� `.-: Installer Address dType of Building l Size Lot............................Sq. feet U Dwelling N-o. of Bedrooms.............................__.___----------Expansion Attic Garbage Grinder Other—Type of Building . No. of persons____________________________ Showers — Cafeteria 01 Other fixtures ------••-•----------------------------------•- W Design Flow............................................gallons per person per day. Total daily flow.....-......................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) - Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date......................................... Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water.................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' .................. ......................... ---------------- •------- ....._...... .............. ___...... _.......... . -------__-••-- Description of Soil •:..-:_............ ... pt_._....r..L'... x UNature of Repairs or Alterations—Answer when applicable_________ ____1 __ -'..-._ .� " Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the,board of health. _ 9-9-tea Application Approved BY....................................:...:........... Date Application Disapproved for the following reasons:.............................--._...-----------------------------------------------------------•••----•-----••- ...................................................... •••-•-------•----------•-•..............•-••••--•--••-••••-•--•••••-------•---------•••-----••••--••;•---•••-•-•---••--•-••-••-----•--•-•-•-•-•-- Date PermitNo--------------------------------------------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ; e- (Irrtifirtt eof hunt li�anrr THIS IS.TO CERTIFY; That the Individual S,&wage Disposal System constructed ( ) or Repaired (��) at-•- ' 2 f _l(� %(<< ` 1-� ---. - 1'.. /fi � ---------•---•----•-•-- - ,� ..._. has been installed in accordance with the Xvisions of TI&D- SbAhe State Sanitary Code as descrked in the application for Disposal Works Construction Permit No----------------------------------------- dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICI E SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTO Y. _ '~ 44 , DATE.................... • L ---•----..-----•••-•._.....-----•---- Inspector.--•..............c ................................... THE COMMONWEALTH OF MASSACHUSETTS SO/ BOARD OF HEALTH 6 / t Disposal r,�,b Tunu#r ionPrrutit__ Permission is hereby granted....•--------------- f -----.. . ................................ to Construct.-( ) or,Repair ( an Individual Sewage,Disposal System Street � as shown on the a plicat-on for Disposal Works Const ---- ted.......................................... 9 � •--=--••--•••.............•-. ---...__........-••-•-.----.--._._...._...... �� Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • Y; 1 LEGEND HYANNIS UPOLEl PROPOSED CONTOUR o 't ® PROPOSED SPOT GRADE �5A o 1 tt C) 0: •� J ,� 1" —— 98 -— EXISTING CONTOUR 9- 1- Z LOT 73 , . + 96.52 EXISTING SPOT GRADE 4i W— EXISTING WATER SERVICE LOCUS �oA`o TEST PIT pLA , G 1'�0„W` `38�Q�•13 C�� o i tj Is, �O G W/ R CB/DISC EX15T. 1 ,0606 PORCH i LOCUS MAP SEPTIC TANK #439 DECK LOT s5 LOCUS INFORMATION ZI DWELLING '; , T i, , AREA=.23ACRES / 1 ' ` - N PLAN REF: LCP 22825P & 219/121-2 0 TOF=38.66 \ TITLE REF: CTF#171983 PARCEL ID: MAP 270 PAR. 147 O 1 v , 0 11 0 i, , __ - -- -�:--- , FLOOD ZONE: „C„ I t` N COMMUNITY PANEL: 250001-0005-C DATED:08/19/85 11 ' _ C L- - _ I N 1 - - ► � 1 N i LT 1 r A" p,SPH ti � SEPTIC SYSTEM tv , L 4 �\ TBM38 OR BLHD DRIVEWAY� � ', � � V w __ -____ _ REPAIR PLAN EXIST. LEACH PIT -------------- ~ i'; J LOCATED AT: NOTE I o ------- -- - �� `;, . 439 PITCHERS WAY m5p ports~ w , , H YA N N I S, M A. p . J I + { TP-1 TP-2 10'0=, 1 - , — _ co ; PREPARED FOR _ I RICHARD & MICHELLE 1 TRI/O G GENERAL NOTES, X I 31 16' to10"0 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL M A D D 0 ' I BOARD OF HEALTH AND THE DESIGN ENGINEER. JUNE 05, 2012 28•I I ` ' CA`C\ 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. ( 9 — 36 ----__—. _FEcE O 6,� `pLAN� �N� of Mgss _ E 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. D �"" " ~' I I N�6• 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING R I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �. �Np, 1140 ENGINEER BEFORE-CONSTRUCTION CONTINUES. ! 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. LOT $4 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OFC/$TES THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �P� 1 +; LOT 75 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. NI TAR �j 14 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED I TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 1 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. MEYER SONS, INC. 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE V. GRAPHIC SCALE h 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION P.O. B 0 X 981 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 20 0 10 20 40 80 A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN IS NOT TO BE ID100DFT. OF PROPOSED LEACHING EAST SANDWICH, M A. 02537 14. ALL PIPING TO BE 4" SCH 40 ® 1/8-/FT (UNLESS SPEC. OTHERWISE)15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW (5 0 8)3 6 2—2 9 2 2 IN FEET ) FOR THE USE OF A GARBAGE GRINDER 1 inch = 20 ft. R 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING SHEET 1 OF 2 J 1435 NOTE: ITO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS IFINISH GRADE SHALL NOT BE < EL:34.21 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=38.66 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 14" OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. INSTALLED LENCIH F.G. EL.=37.50t + OF iT F.G. EL.=37.50t F.G. EL:37.0t F.G. EL: 36.85(MAX.) �, s I 9.45" 090MoI D R-N 4l L 8't '• 9" MIN COVER/ - / �• �. 36" MAX COVER L 60' L = 15'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) 12 37" O. 1140 3. ® S=1% (MIN.) ® S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC C/ � 10- 1 a" s 10.38" TO Sq \Pa INVERT NITAR \IN 35.58 as"UOtAD �INV.=35.33 COUPLER DETAIL I �WL PROPOSED INV.= 33.75 GAS BAFFLE D-BOX 4 ROWS OF 6 UNITS ® 5'/UNIT + 1 COUPLERS ® 1.16'/UNIT = 31.16'/ROW INV.=34.70 DB-5 -2°� INV.=34.5 SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1,000 GALLON SEPTIC TANK EXISTING OUTLET RESTORE VEGETATIVE COVER BACKFILL WITH CLEAN PERC SAND 60" TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION 2 D-BOX HALL BE SET L AN TRUE T BREAKOUT=TOP ELEV.=34.21 S LEVEL D E 0 GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 33.75 INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 32.88 EXISTING SUITABLE 310 CMR 15.221(2) 2.88' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK 5' MIN. ABOVE BOTTOM OF WITH 1500 GALLON SEPTIC TANK IF FAILED, T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH =(4 x 2.88' = 11.52' DAMAGED, NOT H2O LOADING, OR UNDERSIZED. (6.45' PROVIDED) USE 4 ROWS OF 6-ADS ARC 36HC 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL.=26.43 - GAS BAFFLE AS REQUIRED (H20) UNITS - NO STONE W/ 1 COUPLERS 11 IN EACH ROW _ SEPTIC SYSTEM PROFILE ITYPICAL SECTION f6" N.T.S. KM DESIGN CRITERIA SOIL LOG P#: 13658 0 DATE: MAY 30, 2012 • NUMBER OF BEDROOMS: 4 BEDROOM DESIGN SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. #1614 SECTION INVERT SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DON DESMARAIS, BARNSTABLE BOH HEIGHT END CAP DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 440 G.P.D. Elev. TP- _ oeptl, Elev. TP-2 Depth ADS - ARC 36HC CHAMBER (H20 LOAD GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 37.10 A 0" 37.10 A 0" SEPTIC TANK: 440 gpd x 260% = 880 gpd USE EXIST. 1,000 GALLON SEPTIC TANK LOAMY SAND LOAMY SAND MODEL ARC 36HC DISTRIBUTION BOX: 4 OUTLETS MINIMUM 1OYR 3/2 IOYR 3/2 LENGTH 63" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT (MINIMUM) 36.35 B 9; 36.27 B t0" EFFECTIVE LENGTH 60„ TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (440)/0.74 = 594.59 S.F. LOAMY SAND ' LOAMY SAND DIFFER SUGHTLY FROM ACTUAL PRODUCT APPEARANCE. 1OYR 5/8 IOYR 5/8 SIDE WALL HEIGHT 10.38 34.01 C 37"• 34.10 C 36" OVERALL HEIGHT 16" OVERALL WIDTH 34.5" � 4640 7RUEMAN 8L VD PRIMARY S.A.S. i HILLIARD, OHIO 43026 USE 4 ROWS OF 6 - ADS ARCHC 3616 H2O UNITS-NO STONE 10.7 CFIloilo MEDIUM SAND MEDIUM SAND CAPACITY (g0.0 GAL) ADVANCED DRAINAGE SYSTEMS, INC. AND EXTENDED 1 .16 W/ COUPLER IN EACH ROW PERC 0 32.60 2.5Y 7/4 I 2.5Y 7/4 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) PROPOSED SEPTIC SYSTEM SITE PLAN (CHAMBERS: 6/ROW)24 UNITS x 5.0 LF x 4.80 SF/LF = 576.00 SF - - -- (COUPLER: 1/ROW) 4 UNITS x 1.16 LF x 4.80 SF/LF = 22.27 SF 26.43 128" 2s.so 126" 439 PITCHERS WAY, HYANNIS, MA TOTAL AREA = 598.27 SF PERC RATE <2 MIN IN. C2" HORIZON DESIGN FLOW PROVIDED: 0.74GPD/SF(598.27SF) = 442.72 GPD > 440 GPD req'd / (" ) Prepared for: Maddox, NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN MErr &SONS,INC. AfaoDougan Surveying NTS D.M.M. • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 pOSOX981 ( )508 419-1086 DATE: to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANDWICH,MA 02537 CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I Ihove•possed the Soil Eval. Exam in October, 1999. 06/05/12 508-362-2922 D.M.M. 2 OF 2 . i