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HomeMy WebLinkAbout0598 PITCHER'S WAY - Health 598 Pitcher's Way Hyannis F/R A = 270 119 t. li x 0 I� )�M Commonwealth of Massachusetts er, 2 1// W Title 5 Official Inspection Form '�� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 598 Pitchers Way Property Address Dennis Falvi @ Today RealtyG D-7 L Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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. 'mp°'tai"t When filling out A. General Information A forms on the y' computer,use `a-3 only the tab key 1. Inspector: to move your Michael Kellett cursor-do not Name of Inspector ` use the return x key. Aardvark Environmental Inspections Company Name :7 s: P.O. Box 896 Company Address East Dennis MA 02641 City/Town State Zip Code 508-385-7608 S13742 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 0/ C11 04/20/08 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. fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s. 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is Hyannis MA 02601 04/15/08 required for y 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: ® 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 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 ❑ obstruction is removed fail-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 e Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every page. Cityrrown 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): C] 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 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. 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. fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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: 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 1/2 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. fail-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 r I Commonwealth of Massachusetts y Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w, 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply 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. fail-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 I Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Svey`'V 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 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)] fail•011106 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 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every page. Cityrrown 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 Date occupancy: 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: Last date of occupancy/use: Date Other(describe): fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 r Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owners Name information is Hyannis MA 02601 04/15/08 required for Y every page. Cityrrowh State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: p 9 Source of information: not since new system Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) I ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 01/07/05 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No fail•08/06 Title 5 official Inspection Form:Subsurface Sewage Disposal System+Page 8 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 1.8 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: 1.2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No --------------------------------------------------------------------------------------------------------------------------- Dimensions: 1500 gal Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 27" Scum thickness 31' Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? measured fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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.): The tank was sound and tight with tees in place and liquid at outlet invert. 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). fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 or 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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 even 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.): The box was level and tight with no sign of carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No fail•08/06 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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: 2 ❑ 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.): This system has 2 500 Gallon Drywells surounded by 4'of stone. there was no sign of ponding or failure. fail•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owners Name information is required for Hyannis MA 02601 04/15/08 every 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.): fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 f Commonwealth of Massachusetts Title 5 official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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. �1 5 Jb `2 i 37 s0 fail•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 598 Pitchers Way Property Address Dennis Falvi @ Today Realty Owner Owner's Name information is required for Hyannis MA 02601 04/15/08 every 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 ground water: 25 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 maps show an elevation of over 25 feet. fail•08M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Town of Barnstable 0p THE Regulatory Services s.►xxsresc� M Thomas F. Geiler,Director �$ Public Health .Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862 4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified . by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observations and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. I • TOWN OF BARNSTABLE LOCATION 8 =`' SEWAGE # t100.5— 0/� VILLAGE SESSOR'S MAP & LOT 270- !!$ INSTALLER'S NAME&PHONE NO.�fb 2 - 5'20- 1173d' SEPTIC TANK CAPACITY /11-00 LEACHING FACMITY: (type) 2 -.f Do (�g�f�/s'/;1 (size) /3 X 1-5— NO.OF BEDROOMS 2 BUILDER OR OWNER PERMITDATE: /- 7=aS COMPLIANCE DATE: 1-7 93 Separation Distance Between the: Maxiinum 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 leachin facili ) Feet Furnished by Veg4g4 h o a • No. ,2005- 00 Fee U� THE COMMONWEALTH OF MXSSACKJSETTS Entered in computer• • PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 2ppliCotton for dig aal by.5tem Construction Permit Application for a Permit to Construct( . )Repair(r.,-Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. J 3 %C f/C�S Owner's Name,Address and Tel.No. Assessor'sMap/Parcel T`�xff*" D -- // 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Z�r3'��// /S l?I1 (y�rl• J`�,�iT��. 1.�d9�r :GZO 601 �e i�� d$'llya/�`- 3 4ew Tly ` .,1'l A;1AF L� lld9r� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage-disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i sued by this.Board of Health. Signed Date Application Approved by - f Date ! 7 Application Disapproved for the following reasons Permit No. 7 Date Issued US 7�4 _ No. 7 (JL)S rJ Fee UU / Entered in computer: ✓ THE COMMONWEALTH OF MA�S9ACFI�ISETTS p Yes � ;- PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Z(pplicatton for Digpogar *pgteti Cottgtruction Permit Application for a Permit to Construct( )Repair O`Upgrade( )Abandon t , ( ) O Complete System El Individual Components Location Address or Lot No. S9 �>1°I-� /r5 Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. O 9e��/�vs. 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) rWX1"�11 /<GP Ulal, � 4 t�� �n�� �%,�//.fir ��i���.�/:_'`°S ors✓T/ �.1` .5r�err/= 19.E r�.s�,�.,� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i ssed by this Board of He Signed ��� J. aa%% y2-' Date i Application Approved by �'�� st f L� F . _ Date 1! 7`1) Application Disapproved for the following reasons Permit No. a o u S ' o/- Date Issued f /-7/U S --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance �Z B,jruom S THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( -)-Repaired(6-)-Upgraded( ) Abandoned( )by Jds eok:� s L)/ BAg� ,­a_5 at S� t5 42' J, aw 10 L! Ala g*,o. l 3 has been constructed in accordance with the provisions of Title 5.and the for Disposal System Constriction Permit No. uy S-ol dated l�-7% ,_ Installer t/U_S Z�ill,/ 9,4m¢la 5 Designer f5_4,'/1913j1"`�". �i'. Lti&e'& The issuance of this Pe t shall not be construed as a guarantee that the sy\s't/m wilhfunction/s designed.> Date i �� 1<_ Inspector --------------------------------------- No. 2 U o S o 17 Fee %(0 ` THE COMMONWEALTH OF MASSACHUSETTS r .., PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi5po5af *pgtem Con0truction Permit Permission is hereby granted to Construct( ")'Repair( z,)-Upgrade( )Abandon( ) System located at 6 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:- i 17 /U �� Approved by v TOWN OF BARNSTABLE LOCATION �5�9 B � �/mil V49d"l- _ SEWAGE VILLAG / ASSESSOR'S MAP & INSTALLER'S NAME&PHQNE NO. .3A- a SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS_ BUILDER OR OWNER �eki PERMTTDATE: '® —O COMPLIANCE D ATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet of leachin facili ) Furnished by 7-01 III , Town of Barnstable Regulatory Services Thomas F.Geiler,Director NAMWASM KAM Public Health Division 1659.'' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer&Desiener Certification Form Date: —I � � os� Sewage Permit# ZCP '—C i Assessor's Map\Parcel Z-7 6/) ) 1 Designer: F-✓ !�.,n,�-��lt�e� Installer: CS-may` 5 Address: i Z ��% =pass elc� ,n�-�� Address: alvll�_ On �7 0 J e4e 4-ib Iyi Was issued a permit to install a (date) (' taller) septic system at 7`� 1 t EG hem (Ak% based on a design drawn by (address) ru l e Co4,Ce- Y°l. dated I J 6(,S (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 M,��yG Installer's Signature) PETER T. ; ( � ) � McENTEE c� CIVIL m A,. No.351091 �p�F95Ci1STEENG\�� (Designer's Signature) (Affix s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTEL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS,; , -. d ,DLE DEPARTMENT OF ENVIRONMENTAL PROTECTION 12 P-1 Q: i J SVOV FALED INSPECTION r'U� '. iS TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A ,_►AP 7 . CERTIFICATION �ARCEL, Property Address: 598 Pitchers Way Hyannis MA 02601 Owner's Name: Estate of William Baker c/o John Marcelino oil Owner's Address: 3718 Edgehill Drive ;M1N►i Q Cleveland OH 44121 a �� Date of Inspection: November 29,2004 Job#04-387 Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DFI� approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ����ji il►t 111//4i OF Passes ••.;rq�%�� Conditionally Passes Needs Further Evaluation by the Local Approving Authority ATRI •ym X Fails 0 L ;co Inspector's Signature• Date: 11/29/04 �'�. . F1�Q •Q'.�`� The system inspector shall submit a copy of this inspection report to the Approving Authority Bo of H ItttNSP11 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. Notes and Comments: Cesspool with overflow,staining to top of primary cesspool and staining above inlet pipe of overflow pit. r ""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 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 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 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 obstruction is removed 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: T41. C Tnewartinn Fnrm�n Ci�nnn 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 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. I. 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 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 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. 3. Other: i T41.G lncnurtinn Fnrm ail ci�nnn 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X_ _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X_ Any portion of a cesspool or privy is within a Zone I of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ 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 p a DEP certified laboratory,for coliform bacteria and volatile organic compounds 1; s indicates that p 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 forma _Yes_(YesMo)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• You must indicate either"yes"or"no"to each of the following: (The following 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 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. Titlo G incnartinn Fnrm All v')nnn 4 f Page 5 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 598 Pitchers Way, Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _X_ _ Pumping information was provided by the owner,occupant, or Board of Health _X_ Were any of the system components pumped out in the previous two weeks? _X_ Has the system received normal flows in the previous two week period? _X_ Have large volumes of water been introduced to the system recently or as part of this inspection _X_ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ Was the facility or dwelling inspected for signs of sewage back up ? _X_ _ Was the site inspected for signs of break out? _X_ _ Were all system components, excluding the SAS, located on site _X_ _ 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? _X_ _ 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 _X_ Existing information. For example,a plan at the Board of Health. _X_ _ 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)] T41c. C Incnnrtinn Fnrm ail v�nnn 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 598 Pitchers Way, Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 . FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x#of bedrooms): - Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system (yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Two years usage: 45,750 gal.=62 gpd. Sump pump(yes or no): No Last date of occupancy: 6 weeks prior to inspection. COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial'waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system (yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records: last pumped 2 years ago Source of information: Owner Was system pumped as part of the inspection(yes or no): 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 _X_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) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1953+/- Were sewage odors detected when arriving at the site(yes or no): No Titles S invnn tin. P: till,;nnnn 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 BUILDING SEWER: XX (locate on site plan) Depth below grade: 1' Materials of construction:_X_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: 25' Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: No (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:- Sludge depth: - 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: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): GREASE TRAP: No (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.): Titles G incnvrtinn Fnrm�ii si�nnn 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 TIGHT or HOLDING TANK: No (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: No (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: - Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box, etc.): PUMP CHAMBER: No (locate on site plan) ) Pumps in working order(yes or no): f Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Tit1P G incnartinn Fnrm lil zlInnn 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: 598 Pitchers Way, Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29 2004 SOIL ABSORPTION SYSTEM (SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers, number: leaching galleries,number: leaching trenches, number, length: leaching fields, number, dimensions: _X_overflow cesspool, number: One 6x6 block pit 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.): Liquid level currently 18-20" below inlet pipe pit has staining above inlet pipe and deposits of solids on top of outlet pipe. CESSPOOLS: XX (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: One with overflow Depth—top of liquid to inlet invert: 6" Depth of solids layer: Depth of scum layer: Dimensions of cesspool: 6x6 Materials of construction: Block Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): Liquid level at bottom of outlet pipe.Overflow j2ipe has no tee to prevent scum from flowing to overflow pit.Cesspool has staining to top of structure PRIVY: No (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.): Tit1.i Tncnnntinn Fn�m ail ti�nnn 9 i Page 10 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 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. Pitchers Way EKI 50 20 Ti}lc c lncnartinn 1 nrm ail v�nnn 10 f Page 11 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 598 Pitchers Way,Hyannis Owner: Estate of William Baker c/o John Marcelino Date of Inspection: November 29,2004 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 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: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: A perc test will be performed prior to installation to determine groundwater elevation. TiHa C Tncn tinn Rnrm Ail v,)nnn 1 1 ROUTE 28 c � , . . LEGEND agroG o pt 9e PROPOSED CONTOUR LOCUS 9g PROPOSED SPOT GRADE o —110_ EXISTING CONTOUR P +98.3 EXISTING SPOT GRADE 3 s EXISTING CESSPOOLS TO BE PUMPED & I TEST PIT Wa FILLED V/ SAND Dee —W— EXISTING WATER SERVICE " s 0110 k ' Off 0 WEST MAIN STREET ST A" k � g 243 2v 5-A f LOCUS MAP N.T.S. cto h 1 { GENERAL NOTES: Map 270 °: % .• ka" Parcel 120 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL x 91,5 �d9e ° ^� BOARD OF HEALTH AND THE DESIGN ENGINEER. Ma 270 �; . • • a Benchmark Set 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS k P P o Right cor, cons: step OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Parcel 119 a "PROP.-.S:;C'i �l° 0o PRDVIDE• , �' E1,=98,57 (Assumed) LOCAL RULES AND REGULATIONS. 12823 f S.F, O o,1 CLEANOUT 229+ S, ^ - 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �` ` ` PROP. rm TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE SEPTIC �°' ,' 4> DESIGN ENGINEER. `.\ D-BOX TANK 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN cb o �� ENGINEER BEFORE CONSTRUCTION CONTINUES. O • °1��� �� 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. EXISTING ° •••°�' 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF �+ THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 2 9EDROOM C� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. �o HbUSf (#598) i all, TpF=99,26 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. (Assumed) 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. 9. SEPTIC SYSTEM COMPONENTS SHALL BE INSTALLED AS DESCRIBED O,1 C"U ho ^No-` '-�, °� IN 310 CMR 15.000 SUBPART C. I 1 OR', a A 9$ 10. ALL AREAS DISTURBED DURING CONSTRUCTION ARE TO BE RESTORED k AS AGREED UPON BY OWNER AND CONTRACTOR. 11, IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 12. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS '�^a? IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). k 84'1 �F M 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. TER T. Edge of pavement a cti 4, McENTEE a� rn �' '\ o CIVIL N PROPOSED SEPTIC SYSTEM UPGRADE o' , 2� cio No. 3s�o 598 PITCHERS WAY, HYANNIS, MA PITCI��'R S ��a yYAY F fcls��� �-\K1 OWNER OF RECORD ^� FSSIUNAI ��� Prepared for: John Marcellino, 300 Arrowhead Drive, Hyannis, MA Engineering by: Surveying by: SCALE DRAWN JOB. NO. Wil iom Baker - Deceased P.T.M. 02-05 c/o John Marcellino Eng/nWrng�on�r Terry. �arnerP.L.S. 1"=30' 300 Arrowhead Drive I 12 West Crossfield Road 22 Long Road l� ��� Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET N0. Hyannis, MA 02601 (50$) 477-5313 (508) 432-8309 1/7/05 P.T.M. I Of 2 I tr , �1 NOTE: TO PREVENT BREAKOUT, THE PROPOSED TOF=99.26 F.G. EL: 95.6t FINISH GRADE SHALL NOT BE < EL:94.5 FOR A DISTANCE OF 15' AROUND THE EXISTING F.G. EL: 98.25t(EXISTING) l- F.G. EL: 97.7t PERIMETER OF THE S.A.S. r% MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS OVER INLET & OUTLET ; INSTALL RISER OVER D-BOX TO 2-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER CHAMBER/S TO WITHIN 6" OF FINISH GRADE WITHIN 6' OF FINISH GRADE IN SERIES WITH STONE ALL SIDES SHOWN ON PLAN AND SET C❑VER/S L =11' WITHIN 6' OF FINISH GRADE L =16' j L 13'(MAX) 4" SCH 40 PVC 6• 4" SCH 40 PVC {, 4" SCH 40 PVC --2' LAYER OF 1/8" TO 1/2' j 7EL: INJ iD fi" @ S= 1% CMINJ ®®®�®®® DOUBLE WASHED STONE 41 PROPOSED @ S= 1% CMIN.)1500 GALLON INV. ELEV.=94.83 2' EFF. DEPTH ®®®®®®®S SEPTIC TANK INV. ELEV.=95.00 3/4'-1 1/2' 4' 5.2' 4' DOUBLE WASHED FFECTIVE WIDTH = 13,2' STONE INV.EL: 96.25t TIE IN TO SEWER OUTSIDE FOUNDATION INV.EL: 96.00. INV. ELEV.=94.00 INSTALL INLET & OUTLET TEES TOP CONC. ELEV.=94.8 —BREAKOUT ELEV.=94.5 GAS BAFFLE TO BE 'INSTALLED ON INV. ELEV.=94.00 ®®Moo OUTLET TEE AS MANUFACTURED BY 00100530®®®E30 TUF-TITE, ZABEL, OR EQUAL I ®®®®®®®®®®® BOTTOM ELEV.=92.00 =..-- 3' 2 x 8,5' = 17.0' 3' SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO 5' MIN, ABOVE BOTTOM OF EFFECTIVE LENGTH = 23,0' GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED T,P, EXCAVATI❑N OR G.W. STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). NO G,W, ENCOUNTERED LEACHING SYSTEM SECTION MAffq�y SEPTIC SYSTEM PROFILE BOTTOM ❑F TP EL 86,9 o PETER T. � McENTEE (3) 5" DIA.OUTLETS CIVIL 1s.s' 16' 2, N.T.S. No. 35109 ► DESIGN CRITERIA A RFcis1E�`����e �,. i 1 FSS A EN�� SOIL LOG NUMBER OF BEDROOMS: 2 BEDROOMS 6' /1 ' NTA lJ DATE: JANUARY 5, 2005 SOIL TYPE: CLASS I H-10 LOADING 2' DESIGN PERCOLATION RATE: 2 MINJIN. SOIL EVALUATOR: PETER McENTEE D-BOX INSPECTOR: NOT REQ'D - CLASS 1 SOILS DAILY FLOW: 330 G.P.D. NT.S 'C DESIGN FLOW: 330 G.P.D (min. req'd) GARBAGE GRINDER: NO Elev. TP Depth I 97.9 A SANDY LOAM 0 LEACHING AREA REQUIRED: (330) = 445.9 S.F. 10YR 3/3 .74 97.4 6" �- 23' ®®®® ® ®®®® B SANDY LOAM I---- - -=-=I PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY �- ®®®®®®®®®®® 33" 10YR 5 6 i ` W ®®®®®®®®®®® / ,PROP. S.A.S� N z ® a®®®®®®®® 94.9 C1 3s" ;`------ USE 2-500 GALLON LEACHING CHAMBERS IN SERIES MED. SAND* 102" 2.5Y 6/6 SIDEWALL AREA: 2(13.2' + 23.0') X 2 = 144.8 S.F. 20%GRAVEL Sj ro �� BOTTOM AREA: 13.2' x 23.0' = 303.6 S.F. 4" KNOCKOUT 92.9 C2 6D" so `� TOTAL AREA: 448.4 S.F. 20" OIA. COVER O EXISrtN6 DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. 4" KNOCKOUT O/4" KNOCKOUT 62" MED. SAND* 2 BEDROpM 2.5Y6/e H°uSE #s98' PROPOSED SEPTIC SYSTEM UPGRADE TOF=99.26 4" KNOCKOUT ��sSu/7pp) 86.9 132" PERC RATE: <2 MIN/IN ("c" HORIZON) 59 8 PITCHERS WAY, HYAN N I S, MA 500 GALLON CAPACITY, H-10 LOADING No GROUNDWATER ENCOUNTERED Prepared for: John Marcellino, 300 Arrowhead Drive, Hyannis, MA Engineering by: Surveying by: SCALE DRAWN JOB. NO. CHAMBERS S.A.S. LAYOUT Engln�ringl�orkr Terry ll'arnerP.L.S. NTS P.T.M. 02-05 KM 12 West Crossfield Road 22 Long Road Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 1/7/05 P.T.M. 2 Of 2 V 4