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HomeMy WebLinkAbout0094 PONTIAC STREET - Health � 4 Pontiac Street .. Hyannis -- A = 269 - 192 7 s7-0 ., i a e t d Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 94 PONTIAC ST. K3 Property Address > JUDITH BILL Owner Owner's Name information is nl S MA. 02601 4/7/18 ��` required for every -" page. City/Town State Zip Code Date of Inspection I� Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael O'Loughlin use the return Name of Inspector key. VQ Company Name 714 MAIN ST. Company Address YARMOUTHPORT MA. 02675 City/Town State Zip Code 508-362-4942 577 Telephone Number License Number B. Certification 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 - 4/10/18 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts _ F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 i Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is BARNSTABLE MA. 02601 4/7/18 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 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"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is gARNSTABLE MA. 02601 4/7/18 required for every page. CityrTown 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 El ® information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 / t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. City/Town State Zip Code Date of Inspection D. System Information Description: 1,000 GALS. H-10 SEPTIC TANK/3-HOLE H-10 D.B./ 3-3050 INFILTRATORS WITH STONE .THERE IS A GARABE GRINDER ON KITCHEN SINK THAT NEEDS TO BE REMOVED. Number of current residents: ONE Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) S , d Laundry system inspected?. ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2016/64,500 GALS. 2017/3,000 GALS. Sump pump? ❑ Yes ® No Last date of occupancy: N/A 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 I Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 I Commonwealth of Massachusetts w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. CitylTown 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: SEPTIC TANK PUMPED 2016+- PER OWNER. 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. City/Town State Zip Code Date of Inspection D. System Information(cont.) Approximate age of all components, date installed (if known)and source of information: SEPTIC TANK INSTALLED IN 1981 AND D. B.AND LEACHING UPDATED IN 2010 PER TOWN OF BARNSTABLE. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 21+ feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): UNKNOWN Septic Tank(locate on site plan): Depth below grade: .66' 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: 8.5'x 4.5'x 5.6' Sludge depth: 3"-6"AT OUTLET COVER. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 25" 3" Scum thickness 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 MEASURE Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): APPEARS TO BE IN GOOD WORDING ORDER , NO NEED TO BE PUMPED AT THIS TIME . Grease Trap (locate on site plan): Depth below grade: feet Material of construction: . ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts • ,w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is gARNSTABLE MA. 02601 4/7/18 required for every 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.): APPEARS TO BE IN GOOD WORKING , THERE IS A RISER 10" BELOW GRADE. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS).(locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 1- 12'x 26'x 2' ❑ 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.): APPEARS TO BE IN GOOD WORKING , NO SIGNS OF HYDRAULIC FAILURE .THERE IS 4" INSPECTION PORT 6" BELOW GRADE. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 I _ Commonwealth of Massachusetts - Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA: 02601 4/7/18 page. Cityrrown State .Zip Code Date of Inspection D: System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 z9 P Y f Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 94 PONTIAC ST. M Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. CitylTown 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 ' W A- 1 a a 3 6•� " 3 a ay 5� 3 a$, y 0 PVC t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >5' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 3/9/10 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: INSTALLER AND DESIGNER CERTIFICATION FORM DATED 3/9/10. ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: CARMEN SHAY SANITARIAN CERTIFIED SYSTEM INSTALLITION LETTER DATED 3/9/10. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts 4W. u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 94 PONTIAC ST. Property Address JUDITH BILL Owner Owner's Name information is required for every BARNSTABLE MA. 02601 4/7/18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked i ® 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 l TOWN OF BARNSTABLE �. LOCATION oI ���o✓7-1.4c- 5TaCr T SEWAGE 0 VILLAGE 441Y, /V is ASSESSOR'S MAP&PARCEL. INSTALLER'S NAME&PHONE NO.Ag,o -7 f- r :3(a, SEPTIC TANK CAPACITYX LEACHING FACILITY.(typeCOD �c73�o f+✓r',>r4�rv-.s(size)2 6;K NO.OF BEDROOMS OWNER PERMIT DATE: �� �/ / COMPLIANCE DATE: Separation Distance Between the: i Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY . 5 2- C3 '0x=/4;� � o sr U - No. 0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(/�Upgrade( ) Abandon( ) [:]Complete System PIl.dividual Components Location Address or Lot No. j04:iy io� ,� (?,,&;r Owner's Name,Address,and Tel.No. lT���7y Assessor's Map/Parcel o� ��� �9`�' �� 4��dl Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. e�OC4`L/ Type of Building: Dwelling No.of Bedrooms C� N Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 4;�ee,_P No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 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: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Heal Signed Date Application Approved by eu Date Application Disapproved by Date for the'following reasons Permit No. cy (p 0 1 Date Issued t y- -may_ No. ') U'h 013 Fee 7" 6 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes1 4plitatlon for Misposaf 6pstrm Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot,No. 9 f✓�p`ram L �� Owner's Name,Address,and Tel.No. Assessor's Map/Parce' Installer's Name,Address,and Tel.No. F Designer's Name,Address,and Tel.No. v Type of Building: cc�� n Dwelling No.of Bedrooms C� N I/� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 4,Te,_ ' No.of Persons Showers( ) Cafeteria( ) Y Other Fixtures q e >Design Flow(min.required) f �• gpd Design flow provided 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: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt . Signed Date Application Approved by Date / Application Disapproved by Date for the following reasons Permit No. 2 a G 1 3 Date Issued L THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(A<' Upgraded( ) Abandoned( )by at 9 S/ 4e.0 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Constructi Permit No. d/6 - Q t3 dated j - I t/- / Installer_t: Z�`�o�`!/� Designer j #bedrooms t�j l/L. , ' Approved design flow iy1 f7- gpd The issuance of is pe /it shall not be construed as a guarantee that the system will funptia as signed. n Date t 71 ' Inspector ( 1 f ' -- - ---------------------------------- No. () / L Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS MispoSal 6pStem Construction Permit Permission is hereby granted to Construct( ) Repair(,Al' Upgrade( ) Abandon( ) System located at J'� �o j✓ �,dj y�/y and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit Date C/ // Approved by No. O�-©/' � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC'HEALTH DIVISION -TOWN OF BARNSTABLE,'MASSACHUSETTS Yes ftpYitation for_*� is o ai *pstrm Construction Vermit Application for a Permit to Construct( ) Repair(. Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or of No. K.4 v i..S Owner'ss�.N ,Addre and el.No. `s¢fi✓/i/4L r ! �� Assessors ap/Parcel l Installer's Name,Address,and Tel.No. Designer's Name,Address,and el.No. Type of Building: Dwelling No.of Bedrooms I;[. Lot Size sq.ft. Garbage Grinder Y 1- Other Type of Building /�f f No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) . ►910 gpd Design flow provided 3 6 gpd Plan Date 3 //!� Number of sheets Revision Date Title ' r Size of Septic Tank 6,e 17 Type of S.A.S. .3 y)10 / �' t� i�2 T 4 .1,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 Compliance has been issued by this Board of Si Date oZ-� Application Approved Date (� Application Disapproved by Date for the following reasons Permit No. aJ 6 r Date Issued A o No. QJ v � iti. y ^' 1 i f' Fee C/V THE COMMONWEALTH OF MASSACHUSETTS'tEntered in computer: : , �'`�-a t Yes PUBLIC HEALTH DIVISION'- TOWN OF BARNSTABLE MASSACHUSETTS \ 01pplitation for ID;I8tJ08aY *pstEtn ConstructionPrYitlt Application for a Permit to Construct( ) Repair( Upgrade( ) •Abandon( ) ❑Complete System El Individual Components ,,fi Location Address or Lot No. �y/�1,✓y,-5 s Owner'/ss�arpe,Address,and el.No. Assessor lGfap/Parc�1L ST �UG'rT 4 0 z �, .. Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. A 2 G/y 4 -d1 4 rti •E._L­� S—�A 5-0 5' i36; �. ��•,. �3� 6� �y s O S3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building �� f No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 .3 , 3 6 gpd Plan ' Date TI A l"(' Number of sheets Revision Date r z Title Size of Septic Tank Ex' T / G O y Type of S.A.S. Description of Soil _ rf Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He Sig �•!C- Date 3 oZ / Application Approved by (" Date . - - Application Disapproved by Date „ for the following reasons Permit No. / Date Issued �. --------------------------------- -------- - ----------`----------- --------------------------- -- -------- �( I S I1 f l THE COMMONWEALTH OF MASS'ACHUSETTS ` �^t 1 BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTTIIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )b ,/'/ /Z G f7 at !j T-' H S 7- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No Z)—07(j dated 3 a-��Q Installer /,I GZ T/ Designer('im #bedrooms Approved design fl9 �p gpd The issuance o thi permit shall not be construed as a guarantee that the system wi Ri n as design Q Date L41 to Inspector --------- ---------------- -------------------------------------- ------------------------------- No. :;Lo I6 — 0 �j Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair(/�~ Upgrade( ) Abandon System located at JAG �✓T/r9rG S7 t f and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ji{, > / Pr'oyided:Construction jnust be c inpleted within three years of the date of thisCby Date 7��Q Approved ��� r 1 m . Town of Barnstable �OFTHE�p� Regulatory, Services Thomas F. Geiler, Director • BAPNSTnai.e. 9 MASS. i639. �' Public Health Division �� AlfDf/1A�p Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Designer: Shay Environmental Services, Inc. Installer: �cZrH � 0 Address: P.O. Box 627 Address: i-�- I East Falmouth, MA 02536 (�- On 10 ic�(ZC:N S1-2Uc.7\,zr was issued a permit to install a (date) (installer) \ — septic system at �� �Cjcl�=UGC _ pl�� based on a design drawn by (address) Shay Environmental Services, Inc. dated (designer) ertify that the septic system referenced above was.installed substantially according to XI; 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. • TN OF h1gS �,;',.f cP ,7 (Installer's Signature) E. No. 1181 0 ��GtSTE�� esi tgnature) (Affix Dest p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE A0 OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU. Q: Health/Septic/Designer Certification Form oF� Town of Barnstable P# - tl Department of Regulatory Services NAM Public Health Division Hate z �a4 6019.� 200 Main Street,Hyannis MA 02601 Date Scheduled a` `3 fia Time Fee Pd j 0 ! o 1� . Soil Suitability Assessment for Sewage Disposal Performed By: pez 'S Witnessed By: V+ LOCATION& GENERAL INFORMATION Location AddressqA Ckc Owner's Name `1 QeIC`5 -t��l�(1p►S i.M Address ��� Assessor's Map/Parcel: Engineer's Name C t"2 M E Ij 0 F1 P, NEW CONSTRUCTION REPAIR Telephone# S ol- T7(,U L.f - 49's loo Land Use R( S t.�lT TkPcL Slopes(%) a Surface Stones_ Distances from: Open Water Body l�11� ft Possible Wet Area 1_ft Drinking Water Well 4-8--ft Drainage Way t y /" ft .Property Line �� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) is - J J Pnc;} t�C- I 3�n s T Parent material(geologic) O151 tS1! Depth to Bedrock N�Q Depth.to Groundwater. Standing Water in Hole: /VC)1VZ n6n Weeping from Pit Face (l e S Estimated Seasonal High Groundwater icy tt A`,,S\.ctiryA DETERAHNATION FOR SEASONAL HIGH WATER TABLE v Method Used: Depth Observed standing in obs.hole: _— in, Depth to soil mottles: Depth to weeping from side of obs.hole: in, Groundwater Adjustment f[. lridcx ---Read:ro rate• Index Well level Aril.faCtdr. ^s Adj..�.r<— _ 'f7rrauntlwn.er Level _ PERCOLATION TEST bate 3 Time Observation Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time @ ®�')0 _ Time(9"-611) M M� End Pre-soak3- Rate Min./Inch LaM�1 Site Suitability Assessment: Site Passed- Site Failed: Additional Testing Needed(Y/N) /y Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:ISEPTICVERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil . Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistencv.% vel tole LZ DEEP OBSERVATION HOLE LOG Hole# oZ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) - I C" +1,- - scr�'8 a s Y 7- U66 51R DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi e Flood Insurance Rate Map: Above 500 year flood boundary No— Yes - Within 500 year boundary N07Z Yes Within L00 year flood boundary N0119, Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervto material exist in all areas observed throughout the area for the soil absorption system? _ proposed If not,what is the depth of naturally occurring pervious material? Certification I certify that on 4--U (date)I have passed the soil evaluator examination approved by the Department of on to of to and that the above analysis was performed by me consistent with the required t inin , xp ti nd exp ience described in 310 CMR 15.017. Signature Date , Q:\S.EF'1'ICVERCFORM.DOC o -`' CERTIFICATE OF ANALYSIS Page: Barnstable County Health Laboratory -- Report Dated: 10/16/2006 Report Prepared For: Order No.: G0638478 Edward H. Bill, III 94 Pontiac Street Hyannis, MA 02601 '� Laboratory ID#: 0638478-01 Description: Water-Drinking Water Sample#: Sampling Location 794'Pontiac St.Hyannis,MA? Collected: 10/12/2006 Collected by: E.Bill Parcel 269.192 Received: 10/12/2006 Test Parameters ITEM RESULT UNITS RL MCL Method# Tested LAB: Metals Hardness 31 mg/L as CaCO 0.1 SM 2340B 10/13/2006 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics I Nitrate as Nitrogen 3.8 mg/L 0.10 10 EPA 300.0 10/12/2006 LAB: Metals Copper BRL mg/L 0.10 1.3 SM311IB 101n/zoo6E , Iron BRL mg/L 0.10 0.3 SM3111B 10/12/2006 Sodium 54 mg/L 1.0 20 SM 3111B 10/12/2006 LAB: Microbiology Total Coliform Absent P/A 0 o SM9223 10/12/2006 LAB: Physical Chemistry Conductance 340 unions/cm 2.0 EPA 120.1 10/12/2006 pH 7.3 pH-units 0 EPA 150.1 10/12/2006 Sodium level'is above the maximum contaminant level. Those o'n low sodium diet may wish_ to con_sult a physician. _j I Approved By: (Lab rector) 3' I RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 AsBuilt � ` f�� Page 1 of 1 LOCATION SEWAGE PERMIT NO. 2V VILLAGE I N S T A LLER'S NAME R ADDRESS BUILDER OR OWNER DA T E P ERMIT ISSUED DATE COMPLIANCE ISSUED ICPO i http://issgl2/intranet/propdata/prebuilt.aspx?mappar=269192&seq=1 7/15/2019 LOCATION SEWAGE PERMIT NO. 9y Pin-b 6cl ko�q V(L L AG E INST ALLER'S NAME a ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED, S-_�, DAT E COMPLIANCE ISSUED R �CIO S� I -o v THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........l o n.-....--.0F... cSr�:. ... Q............................ Apptiration for Disposal Works Tonstrnrtiun rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System a ... _ •----1vab _c-----,�r_.o_ad.................... K [0 �e........... .. .............: ....- ........3 I .. ....... ......_. O ddress - ---------_- Installer Address UType of Building Size Lot............................Sq. feet ,-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of ersons_________________________ Showers a YP g ---------------•--•--------- P --- ( ).-- Cafeteria ( ) dOther 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 a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ' ........------ - Description of Soil----•---••-- L :_..9V&4�crO --•---------------------------• ---------------------------•----------.__. x w x ----•- •-•-• - . .........••- ... ----------- -•-- - ---- --•-•---•--- -- --- --------- -----•-----••---- -- U Nature of Repairs or Alterations—Answer when applicable._____ :._:_1 _� _____,��CC.I_ _.___.P1.�_-------------- ----- ••--------------------••-••••--•----------..__...---•-----•-•••--•---------..._._-•-----......••-----------....-•-•---•------------••--•-•-----...-----•-----------------•--•--••-•--------........---. Agreement: 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 Compliance has een issued by the board of health. Signed..... ram.-Warmh...... Application Approved BY �-� �` '�1� e9??! ,le�--•--------- Date Application Disapproved for the following reasons:----•-----------------•------------------------------•..------•-----------------•-----------------•---•-------•- ..--•-------------•-------...---------.....__.......................... -------------------------------- Date PermitNo.................•....................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS . BOAR® OF HEALT r. ' b . -------------------------••- h ..).awl OF...! N Apptiration Or Dispos al arks Tonstriirtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......�. __.. ;.�i �..... . __... -------------- .... - .... ......._.._.....--------- - c Tess Lot No. ......_--. - J � ---;--.......... r------ ----------- ...------..........................------ ----- _.. ----- L([ Own # f � A�✓ C-• ✓{ ddress -------------'..:-- -- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria P.I 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 ( ) a 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........................ GG --.......................................................... ... . ............................... ODescription of Soil...._.. ^Keq / x _._._ :.----•- ----••••-••-•----••---•••----•---------------••••---•-......••-••-..---•-•...--•-•-....---...-••-•-•--•-•-••-••---•---•---••--••-----••-•--V W -•••••••--••----------••---•-----------•-------••-------------•••-............-••-••......••---------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable_-____0L_.____. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITiE 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 Signed-- = & '1...... _.... I / ate Application Approved BY--•--•--•-••-•..._J��R.4 --1Z ,f• --------------------------•- - ............... Application Disapproved for the following reasons:-------•--------------------••------............•-•-----•-••--.••-• -•-•-•••-•------•----............:_..------ ---•-•-•-•------•---••----------•-----•--••---•-...•••••-----------------------•-------------•-••---••---••--••••---••----------•------••-•••-••---•------•----._....--------------•••--•••••--........_ Date PermitNo.......................................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..�-'a!")......0 F....... ...... l. . .f..: rs...... ............ Trrfifiratr of faomptl anrr TINS IS TO CERTIFY, T at the Ind v*duaI S e Disposal System constructed ( ) or Repaired by �.. '� ?� _� �` 2e. t ;._ _.... *Ins Iler q has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N c '/ __. _ ............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHAL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................�-r` ................................ Inspector-•--- -•----•-•-------•------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BQARDr - HEALTH �............' /; �.t ,� FEE.... .......... g ---- Disposal nn auan rntt -j' Permission is herebyranted• , . ' _.. � � ........ ? -............................ f to Constr ) o e ( an Inividual ea=ag is al S s em ��c r � �� Street as shown on the application for Disposal Works Construction Permit No....................., Dated.......................................... -------------------•-------------------- oard of Health DATE............... �_'.,?=t, 'e;, ...................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS j 77 3" of 1/8" - 1/2" Washed Peastone r �� •t NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. y' aF r1 . ' 10' min. from 3J4' to 1 1/2 DOUBLE Washed Crushed Sto , t '" ; i . _,.t a� Z,� ExistingFoundation house to septic tank �•. "^� D-BOX cover must M TOP OF FOUNDATION ELEV. 100.00 Assumed 20" Min Septic tank covers must be 4 PVC (CAPPED) INSPECTION PORT TO BE thin ¢• of trod. t within 6 In. of nnkkNd grad. " y prods over septic Tank-96.25 Grods over D-sox-9e.00 over SAS- 96.00 INSTALLED AND TO BE WITHIN 6 OF GRADE 3 HOLE H-10 v1 t 1 DIST.BoX : 3 Maximum Cover Top OF Sptsm-Elov. -93.60 .- J „ V7 10' EXIST. 5+0.01 er Greater n 8 1,000 GAL. 10' s- a01"Per foot 24„ S f f eCt2v w�` • M FROM EXIST. FI]UNDATsoN rn SEPTIC TANK ono S2dewal CONCRETE FULL FOUNDA y H-10 •" N 8' 3 Units @ 7' _,21' o M g 2' E DEPTH SYSTEM PROFILE a ln.af 3/4-1 1/2• o M 4' 4' g .5' Not to Scale .5' compacted stops EffeCtive Length ". •. ~'Not to Stole NOTE: SEPTIC TANK �O-Box TO BE CONSTRUCTED ON LEVEL COMPACTED BASE c y' Effective, Vldth 6 NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6"BELOW GRADE 6 In.of 3/4•-1 1/r p S'5perolion ProvWed SECTION A -A GENERAL NOTES compacted atom. o From bottom of SAS to .: PROFILE VIEW OF LEACHING SYSTEM 1. Contractor is responsible for Digsafe notification, Verification of Utilities Bottom of Tat NOW O m and protection of all underground utilities and pipes. c SOIL ABSORPTION SYSTEM (SAS) 2. The septic tank on j distn ution box shall be set 15 Bottom of Test Hole 1 Elev.- 86.00 level on 6" of 3/4 -1 1p2" stone. 3050 INFILTRATOR CHAMBER H-20 (OR EQUIVALENT) 3. Backfill should be clean sand or gravel with no Groundwater Observed - NONE OBSERVED NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30" EFFECTIVE HEIGHT IS 24" stones over 3" in size. " ALL OUTLET PIPES FROM THE 4. This system is subject to inspection during installation PERCOLATION TEST SET LEVEL R A SHALL BE ,r �,� by Carmen E. Shay Environmental Services, Inc. SET LEVEL FOR AT LEAST 2 Fr• NOTE: Top of SAS = ELEV. 95.00 5. The contractor shall install this system in accordance 3- W ouTLET •1 :•. 2 with Title V of the Massachusetts state code, the approved Ian ,. 15 foot Breakout met pp p Date of Percolation Test: MARCH 3, 2010 KNoacouTs and Local .Regulations. Test Performed By. CARMEN E. SHAY. R.S., C.S.E. s5. 12• INLET Existing 3' Retaining Wall To Retaining Wall Bottom Elev. Results Witnessed By. DAVID STANTON (BARNSTABLE BOH) OUTLET 9 9 6. If, during installation the contractor encounters any j EXCAVATOR: SHAY ENVIRONMENTAL SERVICES, INC. a• Bottom of Wall = Elev. 95.00 soil conditions or site conditions that are different Percolation Rate: Less Than 2 MPI 0'•60" ® TP1 ' = " .' 2 from those shown on the soil log or in our design ,66• 4• _ scH. 4o T. ,,,,• 4' NOTE: Basement Floor _ ELEV. 92.50 installation must halt & immediate notification be Test Hole Test Hole made to Carmen E. Shay - Environmental Services, Inc. No. 1 No. 2 PLAN SECTION CROSS-SECTION Crawl Space = ELEV. 96.00 tp 7. No vehicle or heavy machinery shall drive over the DEPTH SOILS ELEV. DEPTH SOILS ELEV. cc Garage Footing Elev 97.00 septic system unless noted as H-20 septic components. 0 98.00 0 96.00 3 HOLE H-10 DISTRIBUTION BOX i °� 8. Install Tuf'-rite gas baffles or equals on all outlet tee ends. NOT To SCALE `t i 4" PVC i 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. FILL Flu 1 I VENT i S 3D 25' 56"E 10. All solid piping, tees & fittings shall be 4" diameter O"-36" 95.00 0•-30• 95.50 Following BASED ON MEETING ® COUNTER 0 9:00 AM 3/23/10 _ , Schedule 40 NSF PVC pipes with water tight joints. 75.01 11. Municipal Water is AVAILABLE to ALL OF The Residence and Abutting ��my gamy PER TOM McKEON - Liner Elevation. to bottom of CRAWL SPAG�E � I TEST HOLE #2 TES HOLE1 Properties Within 150 Feet. NO PRIVATE WELLS PRESENT W/IN 200' 10 YR 3/2 10 YR 3/2 FLOOR 0 ELEV = 96.00 � ELEV.= 98.00 36•-42" A• 94.50 30•-36• As 95.00 1 I THE PROPERTY LINES ARE APPROXIMATE AND PER TOM McKEON - Existing 1,000 Gallon Tank to be t ' y' • e COMPILED FROM THE PLAN BY BOSTON SURVEY CONSULTANTS, ENTITLED L=ay sandy Re-used Even though it is less 10' from FND i ExtsTING 9 'r' SUBDIVISION PLAN OF LAND OF HYANNIS, MA 10 YR 5/6 10 vt 6/6 j j ,Y ,% i GARAGE DATED DEC. 1969, PLAN BOOK 236 PAGE 145 _ 42"-60• Be 93.00 36'-50• Be 93.83 PROJECT BENCH MARK I AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN t 1 ,�;: Garage Footing Med-coarse Mad-Coarse TOP OF FOUNDATION 1 I =t� ► IT„SHOULD BE USED FOR NO PURPOSE OTHER THAN I 1 y o Elev=97.00 THE SEPTIC SYSTEM INSTALLATION. Sand sand ELEV. = 100.00 (Assumed) I 1 r3' • �' 2 r T/4 zs r 7/4 a 1 40 MIL POLYETHYLENE LINER 60•-144 C' 00 50"-144' 86.00 ► 1 ► EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE ► 1 5 ► FROM ELEV. 99.00 to 96.00 AND r i ► I OR REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION ► 1 D-Box �► ( I TO EXTEND 10 FEET PAST SEPTIC TANK AND 10 FEET PAST SAS AS SHOWN NOTE: ANY STRIPPED OUT SOIL CONTAINING- LEAC,HATE t I FROM THE EXISTING LEACH PIT TO BE DISPOSED i ► i �"0� I OF AS PER BOARD OF HEALTH SPECIFICATIONS. i ' t EXISTING Q Failed i 1000 GAL i I r I - __,,_.__. a D W _.___�_ _ _ THERE-ARE-NO Pert #1 Leach . It -- WETLANDS AR _ _ E P,.ESENT WITHlN 20Q OF THE PROPERTY ; Depth to Perc:'`60" to 78 " �/ 1 SEPTIC TANK o 0 1 - Perc Rate- <2, MPI Assumed Groundwater Not Observed �� �, 1 �� , E atU i i ASSESSORS MAP 269 LOT 192 No Observed ESHWT , i c>�w Y 1 I os O ADJUSTED H2O Elev. = Noneko r� o I I LEGEND ► ► I 1 � A EXISTING I I 104X 1 DENOTES PROPOSED Design Calculations LOT #11 , z BEDROOM I LOT #9 0 SPOT GRADE ► aousE I I DENOTES EXISTING Number of Bedrooms: 2 Equivalent to 220 Gal./Doy (330 Gal./Doy Min. per Title V) �' ► I X 104.46 Garbage Grinder: No '► 94 I SPOT GRADE Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) , c ► Basement FI Elev 92.00 I Septic Tank : 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL Septic Tank. 9� s. 1 iL, I I FL PROPERTY LINE SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch Bottom Area: 0.74 gal/sq. ft. x 312sq. ft. = 230.88 gallons o ; I 96P PROPOSED CONTOUR Sidewall Area: 0.74 gal./sq. ft. x 152 sq. ft. - 112.48 gallons J H 't t I I 1 Providing: - 343.36 gallons 0 20 40 50 96 q °' �� 1 _, i i - - - -97 EXISTING CONTOUR Use: (3) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH, -- A` _ ASPHALT IDRIVEWAh DEEP TEST HOLE & (4' W x 7' L) TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND t� 1 j PERCOLATION TEST LOCATION 2.5' OF WASHED STONE ON THE ENDS. " 1 1 _ SCALE: 1 =20 L0� #10 I 1 - I - i .•--. 6 FOOT STOCKADE FENCE 2-16• DIAM. ACCESS MANHOLES 11,435 Square Feet +/-a REVx 3/24/10 - Approvl for re-use f tank per TM and liner Elevation P LOT P LAN 77 INLET ^) OU71 PROPOSED SEPTIC SYSTEM UPGRADE .t � , •'� • THE ACCESS COVERS FOR THE SEPTIC TANK, 75.00 I 1 1 PREPARED FOR DISTRIBUTION BOX AND LEACHING COMPONENT • ^; rev -n'"'� ^�,T-'!w:;:;v i^T.T':-`•-"` SET DEEPER THAN 6 INCHES BELOW FINISHED N4D 09 39 >� , J U D I T H BILL "':' `'• f ' v GRADE SHALL BE RAISED TO WITHIN 6. OF E I I STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. °o oJ� PLAN VIEW INSTALL TUF-TITE GAS BAFFLES OR EQUALS ------ _--------�' ---------- AT ------------- 94 P 0 N T I AC STREET /-3-24• REMOVABLE COBS Bedroom o ' P O N TLA C' s .T'R E'.E' T' H YA N N I S, MA 02601 ' (40 FOOT RIGHT 0 WAY 3 min. clearance � r' 13• saET'r __� PREPARED BY: INLET 6' min. 12' min, Inlet to outlet a'min. ta'min T� Lq�T•wl-•-u• , OUTLET Kitchen �% I T I °' �J Bedroom t1l frlrl E Y E. S111`1 l 6' -T' - .S' -�• RDining a. , bJ so soft " ��,�drain OVER THE COUNTER VARIANCE REQUESTED: � �a NVIRONMENTAL SERVICES, INC. s 1 THORNBERRY CIRCLE i ��, .'•a Wit.,.:• '•....: ti'T'�•S..'r;•..�•: •'• •'•• • "• . ...... ..:"..' -. •e'-0' 4'•_10• t FLOOR SCHEMATIC 1. REQUEST A VARIANCE TO INSTALL THE SAS LESS THAN 20 FEET FROM A FOUNDATION + E • MASHPEE, MA 02649 GARAGE SLAB- A 40 MIL POLYETHYLENE LINER HAS BEEN PROVIDED iTAR TEL FAX : 508-539-7966 CROSS SECTION END-SECTION 2 BEDROOM RANCH / TYPICAL 1000 GALLON SEPTIC TANK DESCRIPTION BY OWNER 2. REQUEST A LOCAL UPGRADE APPROVAL TOput SAS SCALE: 1 "=20' DRAWN BY: CES DATE: MARCH 9, 2010 NOT TO SCALE GREATER THAN 3 FEET BELOW GRADE, A VENT PIPE HAS BEEN PROVIDED. PROJECT#SD1171 FILENAME: SD1171PP.DWG SHEET 1 OF 1