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HomeMy WebLinkAbout0007 SAINT JOSEPH STREET - Health 7 SAINT JOSEPH STREET . Hyannis A = 291 — 044 TOWN OF BARNSTABLE LOCATION JCC rNt��k_z �t SEWAGE# ®� ' 3 VILLAGE ASSESSOR'S MA &PARCEL INSTALLER ,P' NAME&PHONE NO.01AK� � o&' ak SEPTIC TANK CAPACITY AI LEACHING FACILITY:(type) I (size) NO.OF BEDROOMS H/' OWNER.-� ��c'� l PERMIT DATE: 1 0-17-/7 COMPLIANCE DATE: ` Separation Distance Between the: *Nr I Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility C #- Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ar� No. Fee to THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEAL.TkL DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpYication for disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address @r Lot No. 7 e� sOwner's ,Address,and Tel.No. Assess r' Map/Parcel OL � I y Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 3� .�S�c:�s �3 ��jfty�.�iN �� '2�Cj`�L'XJ` �S S �N'),-✓c'r'd;,.i �.✓fC Type of Building: Dwelling No.of Bedrooms 1:3 Lot Size /'2!R /;7 2 sq.ft. Garbage Grinder( ) Other Type of Building f N,�,kc) ,, , No.of Persons Showers( Cafeteria( ) Other Fixtures Design Flow(min.required) _:3_3 Q gpd Design flow provided 3YO,!7 gpd Plan Date yL2 5�� Number of sheets ?— Revision Date Title Size of Septic Tank 45ri F iv Type of S.A.S. c fiy n1 ��l y �LIG�M�I'✓f Description of Soil Nature of Repairs or Alterations(Answer when applicable) Lt rj eW Loo`(� ow� � uo Qc, *c 6ei, —5 L, rI Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 1 0 Application Approved by Date Application Disapproved by Date for the following reasons 7 Permit No. Date Issued _ - No. pot Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes y PUBLIC HEAL,_ DIVISION -J WN OF BARNSTABLE, MASSACHUSETTS �JtIYIYAtI"'n for �,igo41 Y *pstetn Construction Permit Application for a Permit to Construct( ) Repair(;'rUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address qr Lot No. ? Owner's N4me,Address,and Tel.No. SGNF �Osr� r'qX1� N ' l AssessdrS�Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. _VvOs�cs A ►3rcywN Tnfi C _yGU- /S5 N 1�tP✓ fyad�! Type of Building: Dwelling No.of Bedrooms ,3 Lot Size /Z, sq.ft. Garbage Grinder( ) Other Type of Building c,, p��� e C, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �T,�� gpd Design flow provided 3A/,`7 gpd Plan Date y f 5//-y Number of sheets ; �1_ Revision Date ' T Title t Size of Septic Tank Type of S.A.S. 2 5 OCR rj G11U r, A-/o <kG. I-r- Description of Soil Nature of Repairs or Alterations(Answer when applicable) ������ o N 1ru-) D -tm4 r A.)D i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date /a 1711 -7 Application Approved by Date /a -/7 Application Disapproved by V Date for the following reasons Permit No. ' Date Issued 0 ' r l T THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( ) Abandoned( )by T0 5_ I at T G �� �; has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.o901 ?j$� dated Installer;. +„1 /�- ' r�� 4 NJC Designer #bedrooms ^�, Approved�esign-f}o gpd The issuance of this permit shall not be co strued as a guarantee that the syste will functio as ig.ed+. Date I// l Inspector --------------------------------------------------------------- No. go l — 3 5j Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) --System located at 7 6 ,_,/- ��G��-,/ �i t r r no— y ,�,1n// 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three'Years of the date of this permit. F Date ' Il x Approved by ( / i Town of Barnstable °F`"Erg Regulatory Services 0 BARNSTABLE. p: Richard V.Scali,Interim Director 9 h1A53. 0 Public Health Division Qp i63q• �� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 installer&Designer Certification Form Date: A-2-/ 7 Sewage Permit# ' Assessor's Map\Parcel Zvi 1 Designer: �ny';nee� /Wor-ts, (ei( • installer: [k,A Address: 1-z w, C rr,s ct-,e(� �cl Address: T-o,est o'le MA 626`i4 On /O /7 was issued a permit to install a (date) (installer) + y septic system at ? 6-.). r,t-- ' Jct . based on a design dram by �e Fe M LEn+ke TL (address) e Eve ine��.'a LJC,-Lu /W C, dated q- 2f-17 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State& Lo6al Regulations. Plan revision or certified as-built by designer to follow. Strip out(ifrecldired)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructs nce with the terms of the RA approval letters(if applicable) �►ts%OF PETER T. a McEMTEE u CML (instal s ignature) No.35109 gfGWER�O (Designer's Signature) (Affix Designer p tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE NVILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. : Q:\Scptic',Designcr Certification Form Rev 5-14-13.doe • D © • IT m C3 OFFICIAL ` , Certified Mail Fee Q Extra Services&Fees(check box,add fee as appropriate) r/. ..•4 '� ❑Return Receipt(hardcopy) $ t \ }k � ❑Return Receipt(electronic) $ t 6-Postnnark9 p ❑Certified Mall Restricted Delivery $ 1 ��AHere O ❑Adult Signature Required $ .1, a 'V ❑Adult Signature Restricted Delivery$ �,, �CC) Om Postage N $ ra Total Postage and Fee $ WADDELL,ALFRED R � Sent To 7 SAINT JOSEPH STREET --- p HYANNIS,MA 02601 .....M. f 3 StreetandA City,State,ZIP+4® :r• r �r r•r•r. Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate a Electronic verification of delivery or attempted return receipt for no additional fee,prrisent this. delivery. USPS®-postmarked Certified Mail receipt to the T n A record of delivery(including the recipient's retail associate. --a signature)that is retained by the Postal Service- Restricted delivery service,which provides M for a specified period. delivery to the addressee specified by n or to the addressee's authorized agent. ] Important Reminders: Adult signature service,which requires the D ■You may purchase Certified Mail service with signee to be at least 21 years of age(not IT First-Class Mail®,First-Class Package Service®, available at retail). -t- or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavallable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified I ■Insurance coverage is notavallable for purchase by name,or to the addressee's authorized agent 7 With Certified Mail service.However,the purchase (not available at retail). C3 of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should beam certain Priority Mail items. USPS postmark If you would like a postmark on f ■For an additional fee,and with a proper this Certified Mail receipt,please present your —1 endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for I—, the following services, postmarking.If you don't need a postmark on this Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portionu of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply F-i You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.rr_-3 electronic version.For a hardcopy return receipt, f, complete PS Form 3811,Domestic Return Receipt,-attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. PS Forth 3800,April 2015(Reverse)PSN 7530-02-000-9047 USPS TRACKING# First-Class Mail Postage&Fees Paid Pems No.G-1�J 9590 9402 1933 6123 1793 82 United States •Sender:Please print your name,address,and ZIP+4®in this box* I Postal Service I / Town of Barnstable Health Division W7200 Main Street Hyannis,MA 02601 � I i I I I I j i ■ Complete items 1,2,and 3. A. Signature 00, ®�• Prin:Jyour name and address on the reverse X t ""` Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. R eived by(Printed Name) C. Date of Delivery or'6n the front if space permits. - -] 1. Article D. Is delivery address different from item J? ❑Yes If YES,enter delivery address below: `\ ❑No ®_ Cl- WADDELL,ALFRED R o 7:SAINT JOSEPH STREETUn c.� HYANNIS,MA 02601 3. Service Type ❑Priority Mail Express® II I�III�I IBI I�I(()II II I I ITIII'I I I��)I I'll I ❑Adult Signature ❑Registered❑ R MailT � ❑Adult Signature Restricted Delivery Registered Mail Restricted 9590 9402 1933 6123 1793 82 nrtified Mail® el;very (�Certified Mail Restricted Delivery 6�etum Receipt for � ❑Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation* o.,[T�ansfer_fmm_service_labell_ .��_ I Mail ❑Signature Confirmation 7 015 1.7 3 0 0001 4990 3974 i Mail l Restricted Delivery Restricted Delivery 00) PS Form 3811,July 2015 PSN 7530-02-000-9053 bomestic Return Receipt Town of Barnstable Barnstable Regulatory Services Department 1 edcaNy BAMSPAUM 9 "`ASS Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 3974 October 6, 2017 WADDELL, ALFRED R 7 SAINT JOSEPH STREET HYANNIS, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Saint Joseph Street, Hyannis, MA was inspected on 09/01/2017 by Sean M. Jones, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BO- RD OF HEALTH G . Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\7 Saint Joseph Street Hyannis.doc Y - • �T�ram, Town of Barnstable i • EARNS i 4 Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA-02601 Office: 508-862-4644 Richard Scab,Director FAX: 508-790-6304 Thomas A-McKean,CHO Feb 63 2007 Rev. 5111116 DEADLINES TO•REPAIR FAILED.SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ An`Y'marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLM CRITERIA ❑Discharge or ponding of effluent to the surface of the ground a ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE(1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone.-1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution . TWO 2 YEAR DEADLINE CRITERIA ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation Of a driveway due to H-10 components, etc) o Leaching pit or cesspool with high liquid level, <12"below inlet (per Town Code §360-9.1) eaching facility withstanding liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: WSEPTIMDEADLINES TO REPAIR FAILED SYSTEMS.doc owl- oqq Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 7 Saint Joseph Street U) Property Address °# Alfred Waddell :w9 Owner Owner's Name _r information is required for every Hyannis Ma 02601 9/1/2017 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms s/ 9,U C on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. Company Na Title V Septic Inspection � Company Name 41 74 Beldan Ln. ICenterville Ma 02632 Cityrrown State Zip Code 774-248-4850 smjonestitle5@gmail.com S14522 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 16.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority r 9/1/2017 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•3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 60 VS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. Cityrrown 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , y 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if, the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. CityrFown 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/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 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 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 EJ ❑ 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•3113 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 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information.'For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts H W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 6 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: 2014-2017 =204.4 daily average. 3/2017-6/2017 = 785.6 gpd average Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M a 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. City/Town 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: 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 ❑ r 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 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 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: system repaired 8-14-2014 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 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.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 10" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. City/Town 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 3" 6" 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 10" How were dimensions determined? opened covers, took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is overdue for a cleaning, heavy solids and grease buildup observed. Water level was even with outlet invert. Outlet tee intact. Risers should be installed to allow easier access. 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 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts N v W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): `Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts H W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 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.): D-box was found to have a heavy buildup of grease. 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: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M .. 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is Hyannis Ma 02601 9/1/2017 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® Teaching chambers number: Biodiffussers ❑ 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.): s.a.s. consists of a field of Biodiffussers. Leaching facility was inspected by opening observation port and from distribution box with camera.Water level was found to be 10" up into the observation port and all lines from d-box has standing water T from box. Leaching facility is hydraulically overloaded resulting in a failing inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer 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 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is Hyannis Ma 02601 9/1/2017 required for every State Zip Code Date of Inspection page. City/Town 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 t - 34 7 -11 2:;17 3-3 C 27 t A. 6 H t5ins•3113 TWO 5 Officid Vopection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massacliusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 1 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: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. 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 i - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ' 7 Saint Joseph Street Property Address Alfred Waddell Owner Owner's Name information is required for every Hyannis Ma 02601 9/1/2017 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t t5ins•3/13 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LOCATION,7 u�r �c '�� S - SEWAGE# VILLAGE �4T_a� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. � :� e.� -Ne SEPTIC TANK CAPACITYX o�fir�e LEACHING FACILITY.(type) (size) .25X I l.'j l NO.OF BEDROOMS OWNER .ac-3,r PERMIT DATE: :,A -i Co I t-( COMPLIANCE DATE: 6-1 L.i - vt+- Separation Distance Between the: Nome c>.t- JP WC 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 A i, ' 34 ►� i- :12 C 1 _ 7 - 11 2-2.' 2.17' C 3-373 3 3 4-27 °7 5--37 -� -L2 .� f l 2 No. r2D I L1 L O Fee l S o THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4pf ration for MispoBal *pstem Construttiun 3permit Application for a Permit to Construct( ) Repair W) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.�y7 S&,.,1- 3me_-f1n`S S l_ Owner's Name,Address,and Tel.No. Ny",k. N e4 Olzc,*j 1Z fGLtG NCJ Cc.MNt/� Assessor's Map/Parcel � Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Av 1G S A Type of Building: Dwelling No.of Bedrooms 3 Lot Size ►2, 1,-22 sq.ft. Garbage Grinder( ) Other Type of Building jZPs,rkts+ia No.of Persons d Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) "3 30 gpd Design flow provided 3<30 42, gpd Plan Date 14 t`1 Number of sheets "a., Revision Date Title Te.�✓' \Gnu Size of Septic Tank I C)CO au i e)t Type of S.A.S. 6 2n 11D \ ic,)AWrS- N','Z0 Description of Soil Nature of Repairs or Alterations(Answer when applicable) 0 12[g, e yNC) S.A.5 q ebwS O °--1 I(or! ADC tGto Vs ID 13tnc) ers 1•E`!2=0 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued — "l •e 1 No..�C� Fee �Q THE COMMONWEALTH OF1 MASSACHUSETTS Entered in computer: ✓_ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYitatiou for Nsposal ,pstem Construction hermit Application for a Permit to Construct( ) Repair()4() Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 Sa,.,t -)tub's S Owner's Name,Address,and Tel.No. Nyli,.,,�� Mc, o2G�f n,chuirJ �vrvNt/5 Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Avg--(00-715-9 Ji�iv a i A 9 a,, c N Type of Building: Dwelling No.of Bedrooms 3 Lot Size 2, i.L2. sq.ft. Garbage Grinder( ) Other Type of Building �� ),.,�}y:1�,4 No.of Persons p howers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '3 310 gpd Design flow provided ';4 -0 gpd Plan Date y y ► Number of sheets 2 Revision Date Title Size of Septic Tank I()M e,I Type of S.A.S. Description of Soil h , Nature of Repairs or Alterations(Answer when applicable) pp �) Clicable) � CQ� S S.A POLO o( ►-t l010 1 \J \ %Lne�) 1l l'l)G P or"A 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 F Compliance has been issued by this Board of Health. Signed Date y Application Approved byAS Application Disapproved by Date` for the following reasons Permit No. 0 a/ 4 6 Date Issued r 1 THE COMMONWEALTH OF MASSACHUSETTS s BARNSTABLE,MASSACHUSETTS (Certificate of (tompliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( ) Abandoned( ).by Ki lr��N '�NC _ f at -7 �,�; �� ,,rn1�'� has been constructed in accordance Lam-, with the provisions of Title 5 and the for Disposal System Construction Permit No.o 6 q q-lb dated �-I I y -1 y Installer D A �fM� Designer ry,.i <.,,.3� S „��c LNr #bedrooms Z / Approved de5igti flow gpd The issuance of this e ' shall of be onstrued as a guarantee that the system fun on a/s designed. Date X Inspector r�( / v No. o — 1 Fee 1 ,50 `� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS -Misposal *pstrm Construction permit Permission is hereby granted to Construct( ) Repair(,,kl Upgrade( ) Abandon( ) System located at ? 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 - i G` ) 9 Approved by ti Town of Barnstable Regulatory Services Richard V. Scali,Interim Director # aAMSUBLE, Public Health Division Thomas McKean,Director � 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 i Installer &Desi ner Certification Form i Date: 1 t l Sewage Permit# D Lsessor's MaplParcel , Designer: L _ � `'�C- Installer: `cl.. ) % Address: Ro ev�t' q� Address: t�.® e4�0 L`( 02,!�L oil " 1 e{ 6S A) was issued a permit to install a (date) --a' (installer) septic system at � � Sf ' Nq a fl NB 15 based on a design drawn by (address) dated (designer) D&�, I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &'Local Regulations,_ Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. i I certify that the system referenced above was constructed in compliance with the terms of the I1A approval letters (i£applicable) OF alley s Signature) o - " t 140 esigner's Signature) ' NtTAO l !' PLEASE RETURN TO BARN ABLE PUBLIC HEALTH DIVISION. CERTIFICATE j OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- i BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. ! THANK YOU. L, Q:\SepticTesigner Certification Form Rev 8-14-13.doc s Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes pplicatiou for �kgonl �p!6tem C0115tructiou permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon(.) ❑ Complete System Individual Components Location Address or Lot No.-I WW 1 �!1 5T Owner's Name,Address,and Tel.No. V`i�"VU L S^A.0-Z&o 1 4tft13 o4ia+se C Assessor's Map/Parcel iRq Installer's Name,Address,and Tel.No. 502-(.t5r0 1AL1 Designer's Name,Address and Tel.No. ,etC ae£ so�J S Type of Building: Dwelling No.of Bedrooms 3 Lot Size \Z,�� 2� sq. ft. Garbage Grinder ( ) Other Type of Building io%AgNm,aZ_ No.of Persons n Showers( .) Cafeteria( ) Other Fixtures Design Flow(min.required) a3(p gpd Design flow provided �(�}o�'� gpd Plan Date All q Number of sheets Z Revision Date Title 9--0myL o `j Size of.Septic Tank 1 600 QA 'C, Type of S.A.S. U.-AD,S t(.2c)6® Description of Soil Nature of Repairs or Alterations(Answer when applicable) P :SOX CkA-,& GA q jezo '®}'- q�_ AI(�7i cEF054A 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 thit Board' f Health. Signed Date 411q t. Application Approved by--,,, Date t-( ; Application Disapproved by: NJ- Date for the following reasons A, Date Issued Lt— Permit No. �C>I� - I ---------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliauce THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (`?() Upgraded ( ) Abandoned( )by at �j _Sa6NT zns-�k s has been constructed in accordance —` '_b1y- INO dated —q-I , with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer V.34�L�►�4v� �.tlh� 1� Designer t&y� , vs-"-s us e bedrooms Approved design flow 3SCD. Q'- gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector ——————————————————————————————————————— No. Fee f THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 1DigooaY *r5tem (fow5trUCtion 'Permit Permission is hereby granted to Construct ( ) Repair O Upgrade ( ) Abandon ( ) System located at . c r. 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. Q Date ��_ ` i L' Approved by 1 r No. tr Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Tkgogal 44p.5tem Construction Permit ' Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon Complete System ©Individual Components Location Address or Lot No. t ��(-� �� ;,T C�Owner's N me,Address,and Tel.No. krk G►-)9N t r J Assessor's Map/.Parcel t .a 'C�2.(.o lRv�of ?� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. `/l3ti\t,�+�C�Y'r..�rv��'�— 1>4t�t(P.�C o�rl, �c:nf r> ,t F ✓�¢.� ,�;'�.a,�} p�io �GIJ �0IC- `��, l 0.r�NiS }?,c• +3Gx `�3i Type of Building: �'- Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building ' �.� ..2�SCivy L. No.of Pe1',00n Showers( ) Cafeteria( . ) Other Fixtures Design Flow(min.required) A \gpd Design flow provided gpd v �v Plan_ Date ,,., / , , , Number of sheets Revision Date Titlelh J?\c�rs) Size of,Septic Tank j yes � E r..,, Type of S.A.S. .-'Deseription of Soil Nature of Repairs or Alterations(Answer when applicable) Jac o¢ !o` ADS. t, WZ(D-tSb - t Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage,disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of I Compliance has been issued by this Boarftf Health. Si nedkkLvi�tt,g r ! =ti t C Datef ,J A Application Approved by :. t I "� Date Applicaton ed Disapprov by Date , s for the following reasons Permit No. b Date Issued L — l Y• THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS • Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) t Abandoned( )by kd A V km t,>u j r-u, at`7 tt ST Nc e p LN is has been constructed in accordance Ll with the provisions of Title 5 aand the,for Disposal System Construction Permit No. '�n'�^ 1b6 dated Iy�'C� Installer �J(IJS� Designerg-<Wy_ 'sC,�,.�5 tee #bedrooms Approved design flow gpd The,issuance of this permit shall not be construed as a guarantee that the system will function-as designed. Date • / ! f, s �. Inspector r No. 1L4 Fee 15 O THE,COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �hgponl �&pgtem Congtruction Permit Permission is hereby granted to•Construct ( ) Repair (�, ) Upgrade ( ) Abandon ( ) System located at 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 t_�'I �"� Approvedlby Town of Barnstable °ptME rOwti Regulatory Services Richard V. Scali, Interim Director 1 BArAB . « Public Health Division 9L MASS. g �ATFC Mp2l A�0 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Homeowner Certification Form for Alternative Systems Property Address: IC81WTOS--E--PU Assessor's Map\Parcel: ��( C) Property Owners Name: F15OG42t- c ® RICHqj10 l'01v►JOAS In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of record must place an "x" in the applicable box next to each line certifying the information. Yes N\A L�J ❑ I have been provided a copy of the Title 5 UA technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) R( ❑ I have been provided with the Owner's Manual �v ❑ I have been provided with the Operation and Maintenance Manual ❑ -\ For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval ❑ 1 /For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5) ❑ If the design does not provide for the use of garbage grinders, the restriction is understood and accepted L� ❑ Whether or not covered by a warranty, I understand the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303 I , b 0 fxw t 5 T 6e gu vA4 agree to comply with all terms and conditions above. Property Owners printed name _ 7' Property 0 rs Signature Date Note: This form must be submitted along with the septic system disposal works . permit application for all I\A systems including new construction, rep airs\upgrades, with and without aggregate (stone) and with conventional design criteria or credited design criteria. . Q:\Septic\IA homeowner certifcation.doc w a t �p � 1 v ' T' a c �: A � r LOs.CATION _ SEWAGE PERMIT NO. Gv i VILLAGE S R' L DDR IN TALLE S NAME A E S S Q UILDER OR OWNER R DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -� c � �i �� G� Sj � �, �� �1 I 0 i � f i �' /� �A � r ..:, '� ��� s z� `�� j P# r down of$Arnsta]ble Department of Regulatory Services ! LJ ffABM : Public Health Division Date ' i639 e$ 200 Main Street,HI an is MA 02601 e Tim Date Scheduled e Fee Pd. ' Soil ,Suitability Assessment for Seyvage Disposal Performed By �"T" A ?-iA P l Witnessed By:DID N 1N i LOCATION & GENERAL INFORMATION., Location Address Owner's Name , Address 1'�a� G W�t2.•C.1� l�/� � - �1 ✓ A tJ(�l � I N D�Tl 1�qt,, �. 1 3 Assessor's Map/P4rcel: �I I Engineer's Name �g,v,; (� 5 / Y �ll P NEW CONSIRU&nON REPAIR — Telephone# al Land Use lJ�� Slopes(%) Surface Stones Distances from: Open Water Body 2-oo ft- Possible Wet Area �t St ft, Drinking Water Well��ft j ft Drainage Way '> 00 it. Property Line ,0 _ft Other . i . SKETCH:(street name,dimcnsiods of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) se L'? r I S I � - I I ' i i I - - i Parent material(geologic) I Depth to Bedrock / Depth to Groundwater. Standing Water in Hole: I Weeping from Plt Face Estimated Seasonal Vigh Groundwater �j 1 J D TERMINATION FOR SEAS OVAL HIGH-WATER TADLE- - } Method Used: I ! th to loll mottles: in Depth Observed standing in obs.hole: in. Dep Depth to;weeping from side of obs.hole: I in. Oroundwnter AdJuetment ! Adj.faetor,.,... ,� AdJ.!]roundwaterlevel.,,,,e, Index Well# Reading Date Index Well level ... ILI PERCOLATION TEST' natp_._____. Time-. Observation' I Tinto at 9" r" ... Hole# Time at 6" Depth of Perc Start Pre-soak Time.@ to Timc(9"-6") End Pre-soak RateMmJInch Site Suitability Assessment: Site Passed '�j\ Site Failed; Additional Testing Needed(YIN) ' Original:.Public H41th Division Observatiori Hole Data To Be ComQleted on Back-- ***If percolaibn testis to be conducted within 100' of wetland,you must first notify the Barnstable C40servation Division at least one(1)week p;<°ioi to beginning. 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) C.h i N t I'2 `off �0 . 7f'—q III" vkv /l-e`'b M DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gra el f::zt t� 3 y 1 MI� l 2 S z' x; DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency. Gravel) t Flood Insurance Rate Ma :A / V Above 500 year flood boundary No T Yes _____ Within 500 year boundary No" Yes Within 100 year flood boundary No 7 Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist,in all areas observed throughout the area proposed for the soil absorption system? Ves If not,what is the depth of naturally occurring p rvious material? _ Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the require ,/e�xper ise and experience described in:U0 CNM 15.017. Signature Date y 4 I .r —._pL-Q:1SEPT1 ERCFORM.DOC " o a�f tor NOS, �(PY Fps..... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH A)...........OF........ .. Appliration for Uiipnsal Workii Tnnstrnr#iun Prrnti# Application is hereby mad for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal Sy st at • r �� s.............................................................. �1Q_:.....STi : l or ... Q ` 1 .oc tion-A dr ss ............... Lot No. Owner Address t a ... 3........................................................ -------------------------------------------. ............ Installer Address QType of Buildi� Size Lot......... .PW.....Sq. feet Dwelling—No. of Bedrooms._.... ._.__. lY-1!....__._._Expansion Attic ( t�c> Garbage Grinder VJ6 '04 4 Other—T e of Building No. of persons............................ Showers — Cafeteria Otherfixtures..................-------------•-----•-•--......---------•. --•--•-----•---------•---•------•-•--•-•--.....••--•---•-••-•---•......-------•------- W Design Flow________________ s�....__...__..____gallons per person e�//da�. TotalPly fpw__._.......�..v3--....0.........gall ns. f. WSeptic Tank—Liquid capacity_.`G6�allons Length_._" x.�a_. Width- :-_7 ___ Diameter________________ Depth...l ' -� x Disposal Trench—No..................... Width.................... Total Length.......- _.. Total leaching area....................sq. ft. �Seepage Pit No.--______- ._-�... iameter.._.....,(...... Depth below inlet.................... 2.._.......... Total leaching area... &.sq. ft. Z Other Distribution box ( �) Dosin nk VYPercolation Test Resul Performed b ..___ // a Y f Date �`4 ----- 1 Test Pit No. 1._t.`Z,minutes per inch Depth of Test it_ . U ..... Depth to ground water0..Ll - _.._P- Gi, Test Pit No. k2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ { E- -------------- -----•......--•.../.- .- ----- . ...... � �CL _._.- .... ._.__ ry�" ...O Description of Soil..._ x O- tu- W -•-•-----•----------------------•-----•-•-......-•----------------------.-----------•--•-•--•-•----•---------------._.._....--------••------•--•----•.-----•.---.._..•-•-•--••----•-•----............... UNature of Repairs or Alterations—Answer when applicable_____________--------------------------_....................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal,System in accordance with the provisions of iITI.L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in p p board t ......operationCompliance -----•-- ae j Application Approved BY - ---- �y/"Z4s!,g f--...•.... .........................•-••-•-•-•-••-•-•--•....._.._. Date Application Disapproved for the following reasons------------------------------------•------------------•------------------------•---------------•----...-------- -•-•....-•••----•-•--•-•-------------•---•••-•---------•-••-•-••-•--••--•------------•----...........--••-•---•-•--•-••--•••-------------•-•-•--•------•••-----•--------•-••-•------------••-••----••--- Date Permit No........ ..................I.----------•---.... Issued------- 6 2��1 1......................... Date ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ............OF..._. vL . pplirFation for 1 Disposal Works Taynstrurtion amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: • - =r—>.� _::.....�.. j - ............. .. .------.. .............................................. - Location-Address or L9t No. � Owner Address + -----------------------------------------------•------------.- ..........----------------.....----------.._..------------------......................----------.- Installer of r TypeDwellinldingNo. of Bedrooms ____ __________Ex Expansion Attic ?Size rLot._ + q. Y = = •-•_..S feet g'' 4",-----A p V� � Garbage Grinder �_k WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------•--------------------------------------------------............ Design Flow................".f_ ....._._....•-__gallons per person Kr d y. Total ily flow.__....._.' __ ....... ns. WSeptic Tank—Liquid*capacity_/ram .gallons Length_ _ Width / _.-_ Diameter................ Depth_. -:4_. x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... ......... Diameter.__.._.,j __.___. Depth below inlet.... ........... Total leaching area-- .'v...sq. ft. Z Other Distribution box ( Dosing-tank Percolation Test Results Performed b .. _ £.__� ' ®® �`�a y { .... �° .�.... .... Date.. "� Test Pit No. 1. .__.._ _minutes per inch Depth/of Test Pit'..(... Depth to ground water o i f''y" a-4__f Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .� D Description of Soil �`. ,rt ►� .............•-----•--•-------------------...........--------....--------------•---......------.................................................... -........................ .--............... ......._. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ---------------------- --•-----•--------------------------•-•----•---•-------------.....-•--------•----...------------------------------------------------............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT12 5 of the State<Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of ComplianAe has been issued by the board of health. Signed---- g ------------ • Date Application Approved By...... _-�� .......•• - _ _sH,---------- Date 'i `-\. Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------•-•----- -••-•-•............•••••••••-••••-•--••••-•••••....•••••••-•-.....•••••••....-•••-----......-•-----•---•-••--•-••.........•••••-•••••••••••••--•--••--: ................................................ Date Permit No......_. .'.I" L '7... �,P._.f :..----._. Issued.....R/:Lg4/T.k............................. Date 1 i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........?:........!..................OF.....!::A..........!.''... : . ........................................... wrtifiratr of TompliFatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ,. y........................... �::........'----- :�............................................ .-•--------.. . ..._......_................... Installer �.__.........._.._�............._._. (� n �.f . has been installed in accordance with the provisions of TITLZ 5 Qf The State Sanitary Code a" described in the application for Disposal Works Construction Permit No.----�_----___-_--y.......... dated--------✓............................._....................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT EE,.CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...... ..................................... Inspector.----J'a�....... ...... -•----....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1� ; b' ............... .. ...OF...:..�=c{:n....K K�A'...................................... a NoC� 7 FEE........................ 14sposM1 Works %'F atsirur#iou rrmi# Permission is hereby granted...........- = -- --------------- ----------------- *----------` : ............ •......... --------.-----•--- to Construct ( ) or Repair ( )a- Ix u l a age Disposal System - -----------------------------------------------------------------•••-•-•••............ Street q � as shown on the application for Disposal Works Construction Permit No..................... Dated.:_.___!_VjI_.__._...._._....__.__._.... .......----•� -................................................................................. rd f Health DATE................................................................................. Gi FORM 1255 A. M, SULKIN, INC., BOSTON . . u • ,► � FAMILY :! KCOROoM fi' �' � � � ��v.�` o At uY F ow : I I a x 3 33o G•P.c• Cj>j-, �/,�t„�L., A, ' 51~PTIG TASK = a3ox15o% =R95G.P c usE I000 GAL. 8C>•(oCo � ,.. �, �.��r ��l D1SPosAL PIT v8E I000 6AL. � � �.: �� .�. 5o S.F �.•5 • 37 5 G.P o � ti boo �a.. s�. i P J" i I3o7T0/K AR�A� . �o �F• �' SS.'(K• IT ` = '�.►fl a 5 0 S.F x too S o G.P _ p p ` 1 WU ; Tr,,Ie.:1�0� 42�j (�•R D. n �; 4SSWlQ�. ToTA1.. DA►►-Y F1.OI/f - 33oG?o• \3' `�'' 4 ` _ PQo p pEQCOLATION 1z rz 1",ri ZM1N 0�1-65�s � � 3C LTom' , CF�•S•. P`SH OF 41,1 •�► II WILLIAM �`� , �� PETER ��,�� I �u�• / w ' G. o SULLIVA"J \ �� I i :3 N Y t y� V y, r q .. - iT f y�' A�7 :�.` '�._�t.'•yi�•j I .. ' uL-t f- 1"'�) / :fir^• ;` .d ;n,,.:, �'� yr V" 1 Sukid SSA 3 •;.s„.t v wk r TOP FWDS 'I�,'.0 i ' $t11'j5U1 o p14T. INJ. L. BVX �r.PTIC. TANK c , 1 V I.�AGW o M~ INY PIT . INV. , t 6 6T�N6 ;.,:.. S CESt.T1F1G0 PLOT PL.p►1J u PRUFILr= L.OZA-T low!14`l &►,1N1 AT E Wo SCALE ScALM. _ ' REF GP-6W Gtc GEIaTIr"Y �tHAT T1+� + GP, uS�:. SHcwN ry��¢i',o►J COMPL-`(5 YIIITN-THE► S I oE1.11J E A►J� l6EaT�AG�R6QV�Q.>:MFiN1Y� DF ZµE � � U TowN or- AND 115, ►j c ��' LOGfsTED WITNIIJ "� FL00D PI.D•IN D AT E alp C I3 _G I'SZ Es76 R Tins PLO.N I'J NOT �n5c v Da OSTrciZVILL& ��`SS• IN5^3°R.�►MEWT SuQVeY -TNE 01:FSE'T5 SUO�t� J rar .�aClf1?A OETEW^{�lE 1..oT \•INE�j APPLICA--W'r U�� INktA1.� t e- {� _ _,N .... ,..... -",C: - v, ..:..:......w _. _:.n: arty .^ _ r1r=:. .x- ; "�" <arrr•�-r:.ft.r-ry^".. 91y�r, ...TOWN- OF BARNSTABLE BAR-W 342 Ordinance or Regulation WARNING NOTICE . 0 L-Q Name of Offender/Manager oz's Jy" dob Address Offender S �i.VS '�� K-�� MV/MB Reg.# Village/State/Zip ac-+Oh U / ?o- SS# C7 Name am pm, on 19 �s Business Address Signature of Enforcing Officer Village/State/Zip I Location of Offense? .��• �7oS- �s y may,p,�' AA T— Enforcing Dept/Division.. Offense /O-T-G'�"/c 411d . 40/ d- yw 6 Facts ar'o c/ b O 4WJA m( !e�J t�lo P''Vk--f- O-1 2uu.-e '�D►' ()V'�' G,t t�.lC-P.,�L . �C f/`c� � L�T��� LtJt �1 r y ,��( 7 CJ�I �' This will serve only; as a warning. At„ this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. TOWN OF BARNSTABLE BAR-W 34.2 j Ordinance or Regulation WARNING NOTICE wN�f Name of Offender/Manager , �S �¢ .�t.�t^�1 G :� a�� �� Address of Offender S (2�.S y_ /f k V-,d MV/MB Reg.# 3Village/State/Zip �C,-l0H f c U o � Business Name /r am�pm, on 19 Business Address +' Signature of Enforcing Officer Village/State/Zip Location of Of fense 7 T�.s ks A j Z Enforcing Dept/Division Offense JA G lk"P Y,1d . 401 It ql d y6 Facts ' t✓' t l D! IV,) /F-I J_e h9J�' Itt%'a' G� r% fr C� /C 1�r*-C�jet' ' / f� I7�� R 1�' !r J �'�'/ � `-�' This will serve only as a warning. At this time no legal action. has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to' gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. ; TOWN OF BARNSTABLE gAR_W 34 Ordinance or Regulation R WARNING NOTICE Name of Offender/Manager, ) !!:!g --4..i ��I 4 . 1 ua "- 1 01A Address of Offender MV/MB Reg.# iVillage/State/Zip f) -100+ i� l lv1 Business Name 's Aam/pm; on .4 "r= 19 > . Business Address '. Signature of Enforcing Officer Village/State/Zip Location of Offense yS . *' " Enforcing Dept/Division OffenseN t ,s J r Facts d t1 `�f t ? 5 �'.�aJ A .';1 '# r }V' e, �° �Lle 6h - (�r" f f f r. )Xf`// This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to' gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. y my .,-n I C3 ME r� ra I I ul CO Postage $ ru Certified Fee C3 Postmark Retum.Raceipt Fee Hale~ O (Endorsement Required) p Restricted Delivery Fee 2 O (Endorsement Required) 'p I r--I MTotal Postage&Fees r �1 r z o David Holt L 09 Today Real Estate i 1533 Falmouth Road/Rte 28 rprlttzryIIIP RAA n7gi? Certified Mail Provides: •� o A mailing receipt r o A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: c Certified Mail may ONLY be combined with First-Class Maile or Priority Mails. e Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested":To receive a fee waiver for a duplicate.return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail j receipt is not needed,detach and affix label with postage and mail. t IMPORTANT:Save this receipt and present it when making an-Inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 4 UNITED STATES POSTAL,SERVICE First-Gass Mail Postage&Fees Paid USPS Permit No.G-10 •Sender: Please print your name, address; and ZIP+4 in this box • Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 i40.} f I � i 'VIC ■ .Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. X ❑Agent j E Print your name and address on the reverse ❑Addressee j so that we can return the card to you. B. R ei d by anted Name) C.pate of Deli very ® .Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No UI David Holt ) Today Rea! Estate 1533 Falmouth Road/Rte 28 3. Service Type Centerville, MA 02632 ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise j ❑ Insured Mail ❑C.O.D. j I 4.: Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7 212' 1 10 0 2 2 2 8 51 0770 I PS Form 3811.February 2004 Domestic Return Receipt 1W59e-02-M-1540 �. Town of Barnstable Barnstable 5�r� Ml-AmmicaCi Y BARNSTABM Regulatory Services Department , I., Y MASS Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 0770 October2, 2013 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 7 Saint Joseph Street, Hyannis MA was last inspected on 9/06/3/2013, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: 0 Backup of sewage into facility or system component due to overloaded 'or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline.period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Tho Lean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\7 Saint Joseph St Hy Oct 2013.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 . page. City/Town State Zip Code. Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: V `� Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code , 1-508-495-0905 S 13971 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 Evaluati by the Local Approving Authority 9-6-13 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-W 3 Title 5 Official Inspection o :Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 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: I 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts ,N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational.System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: , ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh ' t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M e'y 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 ' page. CityTTown 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 �`"'•— ® ElBackup of sewage into facility or system component due to overloaded or ............. clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 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 . 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. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Tithe 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c G M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? o ❑ ® 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? Y ® ❑ 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). 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °7M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13, page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder?' ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 7-2013 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): • Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): 'Grease-trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 9-6-13 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (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): t t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form K Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 16"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ;M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 2" 5" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material.of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 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 N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions:' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of - vegetation, etc.): Leach pit was empty at inspection with stain lines above inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 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 M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 vi I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately I a c` ravl- f�.. J .AO �p ti 5t - Ali 4 , I I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts ry Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record Y 9 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: i ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show no groundwater at 20. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Im Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Saint Joseph St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 9-6-13 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file e t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 . Assessing As-Built Cards Page. 1 of 1 TOWN OF BARmTABLE LOCATIOrI �.S J v hr....SEWAGE .�._ ...._ �>�.i,ac���..._.�.---�--AssEssGns�,qr�►aT misT�l, rJgr,, P110H.No. mc TAMI{CAPACITY '. --Y-- --�---- ' IOco 1si;,c) jNO OF35DROOMs a ---- �i HUIl DER OR TrtimiER PERIr1iT►7ATE_.�..�._..._.�COMOCE DATE._,.._— i'3c�iudtiou Gis��c Ba>,voen�c. . , . Iui�ximumAdjas�d�.nordwa�crTa6lcm�hcaa��omo�l����ingFiicili�y ..r..�.•--�--NO (t�iv,t„�Ya�ur Sui�pl7�IcE aa;d I�tc�ing�ac�ry(If aay�rlls cP�sl au saleor WIND 2w b"I of lut<chi 18 fucili 11 Foci %dgr,of tiVeQ�r�l end Lack faeiliV(kf ll r iian�s ezis� lei i ,+n�luu y,CO���4 of eae{�ing laciliry) �FUTRIs ird by C r�� r � i http://www.townofbarnstable.us/Assessing/HMdisplay.asp?mappar=291044&seq=2 4/3/2014 ti 2 I• I. _ • - - q�:r�� rq to CD Postage $ nJ O Certified Fee �jt}N,S Pos a' C:3O Return Receipt Fee Here (Endorsement Required) ^ O C3 Restricted Delivery Fee t O (Endorsement Required) ?9y� � Total Postage&Fees $ G SSA. ftl �^ I � r%- ; Federal National Mortgage Associates PO Box 650043 Dallas, TX 75265-0043 Certified Mail Provides: a A mailing receipt a A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& a Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSS postmark on your Certified Mail'teceipt is regwred.,�x a For an11additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed;detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 U.NITED,STATES POSTAL,SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 fender: Please print your name, address, and ZI17+4 in this box • I Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 I i I I ' I � I • • • • • +I+ ® Complete items 1,2,and 3.Also complete A..Sig `ur I item 4 if Restricted Delivery is desired. X ent ® Print your name and address on the reverse Addressee so that we can return the card to you.Y B. Received by(Printed Name, Date of Delivery ® Attach this card to the back of the.mailpiece, ,f.• , �' P � F� or on the front if space permits. GRP — — D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below ❑ No i Il,:ederal National MortgageAssociatec4l` t �'O Box 656043 . I ;)alias, TX 75265-0043 + r. I _3, Service Type ❑Certified Mail ❑Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra FeO ❑Yes 2: Article Number7012 ;1Q1�1IOEH` 2851 '1876 -I (transfer from service label) �� � PS Form 3811..February 2004 Domestic Return Receipt 102595•02-M-5540 ram.. Town of Barnstable Barnstable Regulatory Services Department j`W'aC j MgrABM MA, Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1876 January 27, 2014 Federal National Mortgage Associates PO Box 650043 Dallas, TX 75265-0043 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Saint Joseph Street, Hyannis MA was last inspected on 9/06/3/2013, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF BOA OF HEALTH Th an, , CH Agent of the Board of Health • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\7 Saint Joseph St Hy Oct 2013.doc �~ Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=22604 da �irss � i''*.� MD ��b fi'�aT � a« Ems_-.�'�(:l +Lr'l/G%J iGc+,' GY✓'r.-�1 ��� �,��,��q�, M1 W C�Ofi `. Logged In As: Parcel Detail Friday, January 24 2014 Parcel Lookup Parcel Info Parcel 1-044 � Developer LOT 30 ID Lot' Location 17 SAINT JOSEPH STREET 1 1145 Frontage' Sec SAINT PAUL PLACE f Sec Road Frontage 187 __.__. ' Fire r-- Village{HYANNIS District MYANNIS Town sewer exists at this _ Road "m 1408 1 address INo �� IndexNAT 1 Asbuilt Septic Scan: Interactive 291044 1 Mapa1( . Owner Info Co- Owner{FEDERAL NATIONAL MORTGAGE ASSO Owner __-_._._ --- _ Streetl jP0 BOX 650043 _ j Street2 CityDALLAS State TX I Zip75265-004 country! Land Info Acres 10.28 Use IsingieFarn MDL-01 ZoningRB Nghbd[0104 Topography j Level Road Paved Utilities IPublic Water,Gas,Septic Location W Construction Info Building 1 of 1 Year ` Roof - Ext Built�1945 StructGable/Hip Wall Clapboard Livin ---- Roof -� _ AC —� g 1080 �Asph/F GIs/Cmp I None Area Cover— Type ,wuK� , Int r_�______ ___. Bed Style(Conventional !Plastered ( Bedrooms s Wall 2 Rooms MOWyT Int Bath Model Residential Floor(Hardwood Rooms 2 Full s ` 4 BMT .. Heat'------_—.__. Total Grade(Average Type(Hot Water Rooms 5 Rooms fie. Heat Found- Stories 1 1/2 Stories Fuel Gas ation iConc. Block Gross http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=22604 1/24/2014 Yt� a k 4` rq /• / ..r Ln ; .b CO USE Postage $ `s�A N Certified Fee `` h��s 0 Return Receipt Fee �p Postmark - C3 (Endorsement Required) 9�Here A Restricted Delivery Fee N C:] (Endorsement Required) d� rl @ A � � O Total Postage&Fees $ s A ru r FEedeeral National Mortgage Associates �` PO Box 650043 Dallas, TX 75265-0043 Certified Mail Provided �' r o A mailing receipt e A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: 4 o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. e Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. n For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when.making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 �I i �� UNITED STATES POSTAL SERv;ICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please'print your name, address, and ZIP+4 in this box • Town of Barnstable I Regulatory Services Department ; Public Health Division 200 Main Street r Hyannis, MA 02601 I, ,. E..lI l� s�l•i ill f F i£il! it FE 1 l s1Js3 'COMPLE-E rH:S SECTION ON DELIVERY e Complete items 1;2,and 3.Also complete A. Si ure 9 i item 4 if Restricted Delivery is desired. X (�vl ❑P nt s Print your name and address on the reverse / dressee i so that We can return the card to you. B. Received byRHORM:�qo Date o f9I very s Attach this card to the back of the mailpiece, 6 or on the front if space permits. _ �s delivery address different from item 1? 13 Yes s��n y�. f YES,enter delivery address below: ❑No 'FedeeraNational Mortgage`Assoclates PO Box,,650043 i Dallas, TX-75265-0043 —�-Service Type ❑Certified Mail Express Mail ❑Registered ❑Return Receipt for Merchandise.' 0 Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number- (fransfer from service label) 1 i 37 D�l 1,1`D 10 €b 0.2 0 12'8 5=1 12651 PS Form 3811.February 200d, Domestic Return Receipt 102595-02-M-1540 Town of Barnstable Barnstable Regulatory Services Department . � 1A11+i3SA13LE. MAM , Public Health Division m 200 Main Street, Hyannis MA 02601 2007 SECOND NOTICE Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 2651 April 15, 2014 Federal National Mortgage Associates PO Box 650043 Dallas, TX 75265-0043 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Saint Joseph Street, Hyannis MA was last inspected on • 9/06/3/2013, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5(310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification: I Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE rCHO F HEALTH R.S., Agent of the Board of Health • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\7 Saint Joseph St Hy Oct 2013.doc r t OIL— a Barnstable Town of B rnstable " A14ffWeaCft Regulatory Se ices Department BARNSTABM MASS Public Healt Division 200 Main Street, 11yannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1876 January 27, 2014 Federal National Mortgage Associates PO Box 650043 Dallas, TX 75265-0043 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Saint Joseph Street, Hyannis MA was last inspected on 9/06/3/2013, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. F You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. i PER ORDER OF BO OF HEALTH Th an, , CH C Agent of the Board of Health • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\7 Saint Joseph St Hy Oct 2013.doc t� �SME Tap,- Town of Barnstable Barnstable Regulatory Services Department 'cap j 4 f 1ARNSfABLE, Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 0770 October2, 2013 David Holt Today Real Estate 1533 FalmouthRoad/Rte 28 Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Saint Joseph Street, Hyannis MA was last inspected on 9/06/3/2013, by Shawn Meelroy, a certified septic inspector for the State of. Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace.the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement.action. PER ORDER OF THE BOARD OF HEALTH Thom ean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\7 Saint Joseph St Hy Oct 2013.doc r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS x DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON..MA 02108 617-!2�9"2=55�0 WILLIAM F.WELD UT ! 4 1997 TRUDY COXE Governor �. �z Secretary h(�.hLt�:C4= �. ARGEO PAUL CELLUCCI TOWN CF CA,NSTADLE DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECT I Commissioner PART A CERTIFICATION Property Address: 7 St Joseph& St, Hyannis Address of Owner: Jay Casey Date of Inspection: ok 7- ?-7 (If different) 5 Russell Rd Name of Inspector: Wm E Robinson Sr Acton, MA 01 720 I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Wm E Robinson Septic Service Mailing Address: PO Box 1089 , Cent Lary i 11ar MA 02632 Telephone Numbers 5 0 8 1 7 7 5-R 7 7 6 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _✓Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Gv b,i Date: -7 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: AI have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SY TEM 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. Indi to yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:/Avww.magnet.state.ma.us/dep j Printed on Recyded Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 7 St Joseph' s St, Hyannis Owner: Casey Date of Inspection: B] SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four 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 C] RTHER 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to to a surface water supply. _ The se system has a tic tank and soil absorption system an d the SA S is within a Zone I of a public water supply well. Y P _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (zeviaed 04/25/97) Page 2 of 10 r� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 7 St Joseph ' s St, Hyannis Owner: Casey Date of Inspection: `)—A V D YSTEM FAILS: You ust indicate ei;,;er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] GE SYSTEM FAILS: You ust indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The o. ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program require ents of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 7 St Joseph' s St, Hyannis Owner: Case Date of Inspection: ?—pZ Q 12 Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes , No Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. I/ The site was inspected for signs of breakout. �./ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. —The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of / Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 7 St Joseph' s St, Hyannis Owner: Casey Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:33O g.p.d./bedroom for S.A.S. Number of bedrooms:AL-5 Number of current residents:" Garbage grinder (yes or no): X-O Laundry connected to system (yes or no):/—Z--15 Seasonal use (yes or no):-4-0 Water meter readings, if available (last two (2) year usage (gpd): 1996 — 1997 0 Sump Pump (yes or no) 4 O 1995 - 1996 4 , 500 gals n 1994 - 1995 57, 000 gals Last date of occupancy:AL-2-0 T C MERCIAUINDUSTRIAL: Type f establishment: Design flow: gallons/day Grease rap present: (yes or no)_ Industri I Waste Holding Tank present: (yes or no)_ Non-s itary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available. Las to of occupancy: OTHE : (Describe) Last to of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: All System pumped as part of inspection: (yes or no)A�6 If yes, volume pumped: gallons 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( I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: /r ✓L 3 Sewage odors detected when arriving at the site: (yes or no)-,d., (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7 St Joseph' s St, Hyannis Owner: Casey Date of Inspection: 9 t, BU ING SEWER: (Locate n site plan) g Depth low grade: P � Materi of construction: _cast iron _40 PVC _other (explain) Dist ce from private water supply well or suction line Diame er Comm nts: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:-L (locate on site plan) Depth below grade:L-i Material of construction: vt'oncrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) •L �t Dimensions: 4!� 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: m e How dimensions were determined: 0 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) o a N-o�� '' GREA TRAP: (locate o site plan) Depth bel grade: Material of onstruction: _concrete _metal __Fiberglass _Polyethylene _other(explain) Dimensions Scum thick ess: Distance fr m top of scum to top of outlet tee or baffle: Distance rom bottom of scum to bottom of outlet tee or baffle: Date of las pumping: Comments: (recommen tion for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, ev Bence of leakage, etc.) (revised 04/25/97) Page 6 of 10 fi f J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7 St Joseph' s St, Hyannis Owner: Casey Date of Inspection: 9 -a-0-q -7 TIGH OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate o site plan) Depth bel w grade: Material o construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Capaci gallons Design fl w: gallons/day Alarm lev I: Alarm in working order_Yes; _ No Date of p vious pumping: Comment (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: t" (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) G v r PU )con BER:_ (loce plan) Pumrking order: (Yes or No) Alarrking order (Yes or No) Comments- (note(noton of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7 St Joseph ' s St, Hyannis Owner: Casey Date of Inspection: 40-9 7 i' SOIL ABSORPTION SYSTEM (SAS):�� (locate on site plan, if possible; excavation not required; but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: , leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of veget tion, etc.) _ A CE OOLS: _ (locat on site plan) Numbe and configuration: Depth-t of liquid to inlet invert: Depth o solids layer: Depth of scum layer: Dimensi ns of cesspool: Material of construction: Indicati n of groundwater: inflow (cesspool must be pumped as part of inspection) Comm ts: (note co ition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on ite plan) Materials f construction: Dimensions: Depth of s lids: Comments: (note conditi n of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 (i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7 St Joseph' s St, Hyannis Owner: Casey Date of Inspection: 9 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) �3 l_ - i i (revised 04/25/97) Page 9 of 10 v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7 St Joseph ' s St, Hyannis Owner: Casey Date of Inspection: 4 A t—4 7 k Depth to Groundwater /D Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abuttingproperty, p p rty, observation hole, basement sump etc.) /Determine it from local conditions t/ Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in our own words how you established the High Groundwater Elevation. (Must be completed) �a �� lGf3 ! 16le s I (revised 04/2S/97) Page 10 of 10 J T'QWl t 411E 13ARNSTABLE LOCAL LION v>�1r,,LAGE ,�SSE55®R'S lifAi'&.:Lt7C IN5xAL1.1✓R'S NAME& .OliTE 0 lU6o +LI AGILtNG.FACKLi .Y (gYpe) l�N© OF-B.FDl tJtVdS � PE TTDAM .._.... �i3N1Ib�IANG1✓ Sepstretttotn�i+sPxttace�3ete►�eeca tie Maximum Ad�ustc�Gbaur�Jwatet T*.6to tits�nttotri of��;ach2n� Uty w--�� —�-- Fete P�tvae Wt4a Sul �Jc;tncl 1„ ��fittrtg F1c�laty �►y tiaret9s cxtst fees cs+ s>Ite a�:w�ith4n�00 fe�t:uf 1610 logfaeiltty) I;cil,�;crf 1et�ar►d surd LcaC I�i�l;+ac�0(0 at9y avetla.. y exist riD9h;;u'ltl(?fc.e7 t1t eac.lun�I'uril�tya � �:� �� ��OT"�� D 1 tz4 tzz�� L) v c F � HYANNIS -------- \\-- LEGEND ------------------ -I ---- ----- FENC _ PROPOSED CONTOUR o Q 11 \ ® PROPOSED SPOT GRADE ` Z; CE -- 98 -- EXISTING CONTOUR rn 1 P 4 A \' + 96.52 EXISTING SPOT GRADE g t PAv L W— EXISTING WATER SERVICE LOCUS: y 7 SAINT JOSEPH ST. S TRUCKED) n 11�1 CNOT CONS Rr2s TEST PIT 9.56'50"E 1 TP- N l\ x \l 41.7 Fp POND FAWCETTS N7 \ i i T 43.h 43.7 o+ J 4t.7� LOCUS MAP OAKS Mftj O' tO- TBM: o PINE ,' u LOCUS INFORMATION COR. BLHD. v� EXIST 1 ,000G �5. (/� PLAN REF: 167/85 EL=45.00 SEPTIC TANK ��� I ' \ !' t TITLE REF: 27763/279 1 62 \ 2 PARCEL ID: MAP 291 PAR. 44 ZONING: "RB" i UPOLE FLOOD ZONE: "C" \\ - - - - - ,-- - -i- OHW 3 - - - - - - -� Z I COMMUNITY PANEL: 250001-0005-C DATED:08/19/85 O TOF=45.46 SEPTIC SYSTEM LA o #7 �c ----7-- G ;41.5 0REPAIR PLAN O LOCATED AT: - D 7 SAINT JOSEPH STREET HYANNIS, MA. LOT 29 PREPARED FOR I C,' ;r DRIVEWAY D E D E C K O 45 ' J o GENERAL NOTES: -------------------__ Z z 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ! BOARD OF HEALTH AND THE DESIGN ENGINEER. APRIL 14, 2014 1 ; 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS I� GARAGE OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE W / I I LOT 30 LOCAL RULES AND REGULATIONS. ' AREA=12,122f .S.F. �\\ Of yq0 APARTMENT I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR ✓ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE t�P\ i P I DESIGN ENGINEER. a� yG 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING DA REIN M FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN M. , OO ENGINEER BEFORE CONSTRUCTION CONTINUES. O. 114 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. N 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 'Q£GIO r J I THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF SSE ��� I i I �� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 1NITAR�a� 4 Z3 I J 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. J I 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED J� I 66.45 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9.56 "\N 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 99w co SONS / 57 50 LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK. MEYER CSC » D10. EXISTING CESSPOOLS TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. , = INC.'- ' UPOLE R 0 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION L1 \/P 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY P.O. BOX , 9 81 P 1` AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 1_ ° 13. NO KNOWN PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING C 14. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPEC. ) EAST SANDWICH , M A. 02537 1 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A GARBAGE GRINDER 16. NO WETLANDS WITHIN. 150 FT. OF PROPOSED LEACHING (5 0 8)3 6 2— 2 9 2 2 SCALE: 1"=20' °` SHEET 1 OF 2 J1 # 634 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS ,FINISH GRADE SHALL NOT BE < EL:40.50 'FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED'D-BOX PROPOSED S.A.S. T.O.F. EL.=45.46 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. F.G. EL.=44.5t F.G. EL.=44.0t F.G. EL: .43:5f F G. EL: 43.5(MAX.) o OF MgsJ9� DARREN �Gr 9" MIN COVER/ R L = 12' 36" MAX COVER L = 35' L = 10'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) j' �. 1�1,4 0 S=1% (MIN.) EL. = 42.0 0 S=1% (MIN.) 0 S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 1. ' �F6/$TEO 1o"I 14 6 t1,3" TO rANITAR�a� INVERT INV.=40.98 48L f <<o INV.=40.73 INV.= 40.11 1 ' PROPOSED 4 ROWS OF 4 UNITS AT 6.25'/UNIT = 25'/ROW 1 GAS BAFFLE D-BOX INV.=40.21 M M Mg AM INV.=40.38 DB-5 ` SOIL ABSORPTION SYSTEM (PROFILE) ` EXISTING 1.000 GALLON SEPTIC TANK H2O - EXISTING SEWER OUTLETS RESTORE VEGETATIVE COVER BACKFILL WITH CLEAN PERC SAND ( . 75" TO TOP OF CHAMBERS -NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION BREAKOUT=TOP ELEV.=40.50 2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 40.11 GRADE ON A MECHANICALLY COMPACTED SIX ail" BOTTOM ELEV.= 39.27 INCH CRUSHED STONE BASE, AS SPECIFIED IN EXISTING SUITABLE 310 CMR 15.221(2) 2.83' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF 1 �� 76" TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH 4 x 2.83' = 11.32' IF FAILED, DAMAGED, OR .UNDERSIZED. (7.17' PROVIDED) USE 4 ROWS OF. 4-HIGH CAPACITY PROFILE 4) INSTALL INLET & OUTLET TEES W/ BOTTOM' OF TESTHOLE EL.=32.10 = ADS 1620BD BIODIFFUSER (H20) UNITS-NO STONE GAS BAFFLE AS REQUIRED ` - SEPTIC SYSTEM PROFILE TYPICAL SECTION r, rk 16" N.T.S. 1 2" SOIL LOG P#: 14321 DESIGN CRITERIA (PROP IS IN ZONE IQ 1 f 34" �1 DATE: APRIL 3, 2014 NUMBER OF BEDROOMS: 2 BR IN MAIN DWELLING/1 BR IN GARGAGE: 3BR DESIGN SOIL EVALUATOR: t DARREN M. MEYER, RS CSE#1614 SECTION END CAP WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: 2 MIN/INCH 16" HIGH CAPACITY 1620BD (H-20) BIODIFFUSER UNIT LTAR: 0.74 SF/GPD Elev. TP- 1 Depth Elev. TP-2 Depth DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. 43.60 Oj 43.70 0" FlLL I FILL MODEL 16" HICAP GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 42.27 A LOAMY SAND 16" 42.37 A LOAMY SAND 16 LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SEPTIC TANK: 330 gpd x 200% = 660 gpd USE EXISTING 1,000 GALLON SEPTIC TANK - 10YR 3/2 10YR 3/2 EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 41.77 22" 41.87 22" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. B LOAMY SAND B LOAMY SAND SIDE WALL HEIGHT 11.3" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) 10YR 5/8 j 10YR 5/8 OVERALL HEIGHT 16" 991qX 40.t8 C 41'" 40.20 C 42" OVERALL WIDTH. 34" 4640 TRUEMAN BLI/D PRIMARY S.A.S. MEDIUM SAND MEDIUM SAND 13.6 CF • H/LL/ARD, OH/O 43026 USE 4 ROWS OF 4 - 16" ADS 1620BD BIODIFFUSER H-20 UNITS-NO STONE PERC TEST 2.5Y 6/6 2.5Y 6/6 CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSTEMS, INC. 0 38.6 BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF OF BIODIFFUSER) PROPOSED SEPTIC SYSTEM/SITE PLAN (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.73 SF/LF = 473 SF 32.10 1 38" 32.20 138" 7 SAINT J 0 S EP H STREET, HYAN N I S, MA TOTAL AREA = 473 SF PERC RATE: :2 MIN/IN. SOILS IN ("C" HORIZON) Prepared for: Dedecko DESIGN FLOW PROVIDED: 0.74GPD/SF(473.0 SF) = 350.02 GPD > 330 GPD req'd Engineering and Surveying by: SCALE DRAWN DATE: Meyer&Sons, Inc. NTS D.M.M. 04/14/14 • I, Darren M. Meyer,,R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO Box981 to conduct soil evaluations and that the above analysis has been performed by me consistent with the EAST SANDWICH,MA02537 REV..DATE: CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. 508-362-2922 D.M.M. 2 Of 2 L LEGEND N EXISTING S.A.S. x 100.98 EXISTING SPOT GRADE REMOVE WITHIN STRIPOUT BOUNDARY ABANDON OUTSIDE STRIPOUT BOUNDARY —— 98 —— EXISTING CONTOUR o FENCE STRIPO�T BOUNDARY OVERHEAD WIRES SEE (NOTE 11 U UNDERGROUND WIRES 0 Qz W EXISTING WATER SERVICE W ��\ G EXISTING GAS SERVICE N LOCUS: PLA ]NT � TEST PIT y 7 SAINT JOSEPH ST. pAUL _ 1 Y BENCHMARK j N NSIR�CTED� a R-- s �� Sl,Q FAWCETTS S A y -�, �NpT CO V' 86 r07 00 i `� I, LO FFT POND 00 ri n N79o56,50 E"� TP-t o i ��� 1 i W41. ` TP-2433..E \� << 6, " ['�J LOCUS MAP a, ," NOT TO SCALE 4 y/ \ O O (\ \\� / " i 41.7� OAKS `. .. Si \ \ �\ , I"a GENERAL NOTES: ;PINE 1 wO �jl 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL TBM: � I I — 1) BOARD OF HEALTH AND THE DESIGN ENGINEER. COR. BLHD. EXIST 1,000G \� " " •P ��� \�� I ,� 1 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS EL=45.00 SEPTIC TANK DECK �� I , OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 1 LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: UPOLE 310 CMR 15.405(1)(b) CONTENTS OF LOCAL UPGRADE APPROVEL W 1) A 6' variance, S.A.S. to cellar wall, for a 14' setback. 1 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 1 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE p DESIGN ENGINEER. �'- EXISTING 1 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING o, HOUSE(#7) .� �— G 141.5 r FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN TOF=45.461 i 1 "1 ENGINEER BEFORE CONSTRUCTION CONTINUES. W 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. 1 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF %� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF ---------- LU HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. LOT 29 DRIVEWAY O 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. /— 454 _— N 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. i [ I 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE i Z DIRECTED BY THE APPROVING AUTHORITIES. PAOCEL: ID: 291 -044 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY W i GARAGE/ I THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING APARTMENT ; LOT 30 j OF MgSX CONSTRUCTION. AREA=12,122f S.F. qoyG 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS II i 1 vl PETER T. �r IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND I McENTEE �_ REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). CIVIL "' 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE No. 35109 INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. Y� PROPOSED SEPTIC SYSTEM UPGRADE PLAN i, I 5 � 1 66.4 �6Si 7 SAINT JOSEPH STREET, HYANIS, MA S79,56,50 W O A D _ Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 R OWNER OF RECORD Engineering by: SCALE DRAWN JOB. N0. UPOLE WADDELL; ALFRED R 1"=20' P.T.M. 268-17 p 4IL Lj p 7 SAINT JOSEPH STREET Engineering Works, Inc. j 1 HYANNIS, MA 02601 ' 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 9/29/17 P.T.M. 1 Of 2 NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL.=40.5 FOR A DISTANCE OF 15' FROM THE EDGE SEPTIC TANK OF THE PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & -PROPOSED D-BOX PROPOSED SAS 1i OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT INSTALL RISER & COVER OVER ONE CHAMBER ANDIE 2 T.O.F.=45.56 COVER SET TO 6" OF GRADE SET- TO 3" OF F.G. TO SERVE AS INSPECTION PORT EX/ST/NG� F.G. EL.=43.7t - F.G. EL.=44.5f F.G. EL.=44.0f F.G. EL: 43.5t HOUSE#7) MAINTAIN 2% SLOPE} OVER S.A.S. TOF=45.46 _ 1a 29 ' ECK PROP. ® 5�=19 ® SL 1% (MIN.) 2" LAYER OF 1/8" TO 1/2" S.A.S. 4"SCH40 PVC 4"SCH40 PVC s" DOUBLE WASHED STONE 4 f�T. 10"I 6 aeaSBaB (OR APPROVED FILTER FABRIC) `3?' ��• 14" aaaaaaa O- EXISTING 48" LIQUID aaaaaaa --3/4" TO 1-1/2" DOUBLE LEVEL WASHED STONE GAS BAFFLE ADD INV.=40.42 PROPOSED INV.=40.25 4 5.2 I. 4' INV.=40.73 BOX EFFECTIVE WIDTH = 12.8' . EXISTING INV.=40.00 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS S.A.S. LAYOUT SURROUNDED WITH STONE !AS SHOWN H-10 RATED NOTES: TOP CONC. ELEV.=40.7t 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BREAKOUT ELEV.=40.50 INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=40.00Mumma aaaaaaaaaaa 2) D-BOX SHALL BE SET LEVEL AND TRUE TO aaaaaaaaaaa BOTTOM ELEV=3800 GRADE ON A MECHANICALLY COMPACTED SIX . . 4' 2 x 8.5' _ ;17.0' 4' INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING 01 310 CMR 15.221(2). PERVIOUS MATERIAL EFFECTIVE LENGTH = 25.' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. I UE3 Ea Ea 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION ®® ® ®AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL.. NO G.W., EL=89.3 - 33" SEPTIC SYSTEM PROFILE ®® ® ®N z ®® ® ® ®® N.T.S. TYPICAL SECTION 102" DESIGN CRITERIA SOIL LOG P#: 14321 4" KNOCKOUT NUMBER OF BEDROOMS: 2 BR (MAIN DWELLING) + 1 BR (GARAGE), 3 TOTAL p20" DIA. COVER SOIL TEXTURAL CLASS: CLASS I DATE: AP4RIL 3, 2014 SOIL EVALUATOR: DARREN M. MEYER, RS CSE#1614 4" KNOCKOUT / 4" KNOCKOUT " DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH 58 DAILY FLOW: 330 G.P.D. Elev. T P- 1 Depth Elev. T P-2 Depth 0 DESIGN FLOW: 330 G.P.D. 43.60 0" 43.70 0" 4" KNOCKOUT GARBAGE GRINDER: NO FILL FILL LEACHING AREA REQUIRED: (330) = 445.9 S.F. 42.27 A LOAMY SAND 16" 42.37 A LOAMY SAND 16" 74 41.77 10YR 3/2 22" . 41.87 10YR 3/2 22„ 500 GALLON CAPACITY, H-10 LOADING EXISTING SEPTIC TANK: 1000 GALLON CAPACITY B LOAMY SAND B LOAMY SAND CHAMBERS 40.18 C 41" 40.20 C PROPOSED D-BOX:: 1 INLET, 3 OUTLETS, H-10 RATED IOYR 5/8 . 42"1OYR 5/8 N.T.S. - MEDIUM SAND MEDIUM SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PERC TEST 2.5Y 6/6 2.5Y 6/6 SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES ® 38'6 7 SAINT JOSEPH STREET, HYANIS, MA SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 32.10 138" , 32.20. 138" _ BOTTOM AREA: 12.8' x 25.0' 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. PERC RATE: <2 MI IN.. SOILS IN ("C' HORIZON) Engineering Works, Inc. TOTAL AREA:.............................................................. 471.2 S.F. Engineering NTS P.T.M. 268-17 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (598). 477-5313 9/29/17 P.T.M. 2 of 2