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HomeMy WebLinkAbout0227 SCUDDER AVENUE - Health 227 SCUDDER AVENUE, HYANNIS A = 289 081 i ZV V qTOWN OF BARNSTABLE LOCATION aD�� .�,r. QPN Aya SEWAGE#QQ3aa b-a� VILLAGE,,�y ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 4� v 8'�� IC® LEACHING FACILITY:(type) z.0 � o�, ,�-� (size) a,�7 X NO.OF BEDROOMS OWNER -_.► `e PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: 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 V4etot No.&"V 0 r Fee f� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes appficatiou for Bisposal 6pstem (Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(✓jAbandon( ) ❑Complete System ndividual Components Location Address or Lot No.��"7 S� �cG rr Owner's Name,Address,and Tel.No. tea—-776` Assessor's Map/Parcel Q g JA (A'^"`O as W vC ' Installer's Name,Address,and Tel.No. 5b'W"Y � �F'`' Designer's Name,Address,and Tel.No. pcn. V � �� �� Type of Building: Dwelling No.of Bedrooms Lot Size C—)© sq.ft. Garbage Grinder( ) Other Type of Building S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) %CD gpd Design flow provided gpd Plan Date S( � Number of sheets Revision Date Title Size of Septic Tank <�Qcn C. Description of Soil Nature of Repairs or Alterations(Answer when applicable) � ! \-_1 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. Si Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No.b�� Date Issued ' No. +� f.. Fee - Entered in computer:`� THE COMMONWEALTH OF MASSACHUSETTS 1e PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS appYicatiort,rfor misposat *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(%/)"'Abandon( ) ❑Complete System dividual Components Location Address or Lot No.�a 7 SGG, -f— Owner's Name,Address,and Tel.No. �� 77 /Sj�:T , Assessor's Map/Parcel Installer's Name,Address,and Te1!No. Cj�-$�c�-�S`�' Designer's Name,Address,and Tel.No. o, 33l 4 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons` Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title ' Size of Septic Tank t ('�S ;�r- ', pe of S.A.S. Description of Soil C 'O A r Nature of Repairs or Alterations(Answer when applicable) op 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. Si Date r} Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ?2,r 2 Date Issued (> --------------------------------------------------------------------------------------------------------------------------------------- < THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(V)" 4.Abandoned( ). at ���, _ nsr-- , has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ) dated D_,e Installer ,, o_, � g�:, c�Designer ^ 1z f #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will fun iyasdesild. Date 0 + J Inspector Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) r Upgrade(V41" 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. 1 Provided:Construction must be co pleted within three years of the date of this permit. Date �(t� c� Approved by Town of Barnstable Regulatory Services Richard V. Scali,Interim Director snxxerADM Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 . Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: � �(� Sewage Permit# Assessor's Map\Parcel 01 081 Designer: M e>q(Lr //,V(/ Installer: Address: C 9 Address: On was issued a permit to install a date) (installer) septic system at 22.7 SLo01)t-�f— Tfvlq—� R40%based on a design drawn by (address) I \(\\ILA pZS dated (designer) �S X I certify that the sep 'c 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 certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) OF (Installer's Signature) �lo. 11�C0 8� 16 (Designer's Signature) (Affix ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH D ON. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc c; ,. TOWN OF BARNSTABLE V LOCATION ��_7 � � /`�`�-- SEWAGE #`s &—;33 VILLAGE I ASSESSOR'S MAP & LOT.aC INSTALLER'S NAME & PHONE NO. 64.YbTZ� � SEPTIC TANK CAPACITY 000 LEACHING F CILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLI_C_WATER BUILDER OR OWNER(i� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No :u/ .r S d. v �9 NO... = VEO Fas.... 4�,9�j 88//4ftbb `(Q"=?tZtj= HE COMMONWEALTH OF MASSACHUSETTS -to S�BOARD OF HEALTH SOWN OF BARNSTABLE Appliration for Uiripwi al World, Towitrnrtion 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair (--I an Individual Sewage Disposal System at: Io a o - idne/ Or Lot N Opener Address w Obert�.C. i :..Co �`.c .. ml `Ils-.../`» Ss._O'-.R Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms------------ ------------------------_...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons......................... Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- - - d ---------------- .._............gallons. WSeptic Tank—Liquid Td capacity gallons Length._._-....... Width--- Diameter................ Depth..............:. x Disposal Trench-- No. .................... Vidth.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet......_............. Total leaching area..................sq. ft. Z Other Distribution box (k-7 Dosing tank ( ) Percolation Test Results Performed by.......... ............................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ G% Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-----__---_..__-.._-__-. pr ..................................... ...................................................................................................................... 0 Description of Soil..................................•------................---•----•-------•----- --------------------------•--•---•-----•----------•----------••••••••••............._... ............... `�C�l................................................. UNature of Repa'rs or A1_er tio�Is—Answer when applicable._ .n. .................I���__ G? �_'��..... ..` !�'� _...... X - - - 7�'��`e------•---------------------------- -------- --------------------------------- --•----- ------... .......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian as been i -d y th and of health Signed .... � .................................................................... .................................... Dare ApplicationApproved By ......................................... - ------------------------ ............................................ � Date Application Disapproved for the following reasons: ......................................... .............. ..... ............................................... ............................... . -- Permit No. .............. Issued ------- l '.- .................... Da[e.................. n•^w v..c"V t..:....r...•-`v..,+`i.. v.v^. L,�-�.rr'./'.�•' `J���/•.� .�-✓v :�-�� ...�. .��-_ W;♦ ....-r,,�.�ti.-:.�- v-.,, - .�tir .yz.-�.�. _y_ -F No................-....... Fas.... 4. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE / Appliratiun for Diripaiial Works Towitrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair (---I an Individual Sewage Disposal System at: )-3 r7 Sc e� n- y-e. lac f ....:................................................ •-------------•--• mot --------- Locat.u.n-Addres SC ( o _.__ ._ V�f� � • Z rAt N � s? he I Cont. c: Y�x c J �ddressiis....m�ss 0 i Installer� Address Type of Building Size Lot...........:................Sq. feet d Dwelling —No. of Bedrooms-----------_�_______________ ______ -- Pnstonttic Garbage Grinder aOther—Type No. of persons ______-_-__ Showers Cafeteria eher fixtures ...................................................... --•-------------- ------------------- •(( .)). w Design Flow........./.).0.................. -__.-gallons per person per day. Total daily flow_.___.�.3n .......gallons. WSeptic Tank—Liquid capacityM Megallons Length__._-�/-_.__-_ Width_.S'......... Diameter_____ _________ Depth.................. x Disposal Trench--No. .................... Width.................... Total Length.-.................. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (!-' Dosing tank ( ) ~' Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................mtnutes per Inch Depth of Test Pit.................... Depth to ground water........................ Gr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ....-----•-•----------------•-•-•----•-........-••-------•----•--••----•---••......-•--•---•--------....---••••--•••--••••------...........-•-.....---.------ DDescription of Soil........................................................................................................................................................................ x U •-••-•-•-----•...••-----•--•-....-------•---••-•--------------------------•-----•-•••._.....-•------••---•--••-••----------••--•----••••--•--------•-•••---•--------......--•-----..........-----•-•---- -------------------------------------------•-•••.•••-•••-••------------•........-•----------••...•----•------.............•---•...•-••------••-••••-•---•-------------•-•-•-•................................. U Nature of Repa'rs or Al eratio s—Answer when applicable.. 5`�--�:_l.....ZC -- - Yj-t1.... _�J /3- ----•-. } P----•---------------------------------------------------------------------------------•----•----------..................---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliiannccehas been is�ied y the 'bard of health. �y Signed ............... ,_. , . ... ............................................................... e .Application Approved By ..... ............. ................. c Dare Application Disapproved for the following reasons: ......................................... _.....-------.--------._.--------------------------------------------------------------------- ... ....................................... . . . ................. . ... ....................................._...........I.._......................... -------------- --------------------- Permit No. ....t�...:. ................� Issued ��`� ........... ............. to f Daze THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE V-TTertifirate IIf (famplianre THIS IS TO CERTIFY, That the (Individual SeaageInsllDisposal System constructed ( ) or Repaired by ¢ .h�r�. �Icu�.. at ..................................... . has been installed in accordance with the provisions of TITLE of The Statefnvironmental Code as described in the application for Disposal Works Construction Permit No: ...__ .�..'7, .. dated THE ISSUANCE OF THIS CERTIFICATE SHALL NO BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......_.......... .J�.'...f..-- .... Inspector ................... - ��- .>_......._......------- _... .................................................... ----------- --------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLFEE No..........•••--•••----� FEE.............. . ' Diupulltt urhv /Tunutrurtiun Permit Permission is hereby granted........ ... 67q....... � I?.l.C- ....................... to Construct ( or Repair (�) an Individual Sewage Disposal System at No.................. S�. Cr - ` 1 r / !¢ _. ...r.. 17111..................................................................... St cet as shown on the application for Disposal Works Construction Permit N�at,A7.!!24Mated_.1��._��-......�: Ip3oard of Health DATE--Z.l..- ..,���,�7..... FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS t , ' G r TOWN OF BARNSTABLE LOCATION � v�-U� /���. � SEWAGE # Lf/ I VILLAGE* /-ll , Gwi LOT ��ASSESSOR'S MAP & r r INSTALLER'S-NAME & PHONE NO. b CC Iat4 i SEPTIC TANK CAPACITY CJ LEACHING FACILITY:(type) NO, OF BEDROOMS 13 PRIVATE WELL OR PUB TER BUILDER OR OWNER / l�fC-h� Ce j . DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No / G L" G( k I i G ���.. 12 Commonwealth of Massachusetts Executive of Environmental Aff airs ®� D—EP 0 � Cr 1 Department of 1990 C �j Environmental Protection 1 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � 9 � PART A CERTIFICATION Property Address: Sc,AA,--xz— ft�-.Vc;— ; W,t\%ter.,, o- "N-av_3 Address of Owner: y�Qa� �- e— (if different) Date of Inspection: �3,��� Name of Inspector: Michael DeDecko Company Name, Address and Telephone number: Atlantic Environmental P.o B ox 2384 - M ashpee M a 02649. Tel : (508)4771420 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 Signat Date: The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (301 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 or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. C` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: l S , Owners : ,v Date of Inspection : INSPECTION SUMMARY: Check A, B, C, or D A)) SYSTEM PASSES: `4 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 15.303. Any failure criteria not evaluated are indicated below B) SYSTEM CONDITIONALLY PASSES: -•-- One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determinate (Y,N, or ND). Describe basis of determination in all instances. If "not determinated",explain why not. ---- The septic tank is metal, 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. ---- 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). ---- 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address : o'Q1 Owner : }tt , <,, Date of Inspection : C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---- Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system is failing to protect the public health, safety and the environ- ment. 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 of water -•-- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING INAMANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. -•-- The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. ---- The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. ---- The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well ---- The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analy- sis 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 notoogen is equal to or less than 5 ppm. D)SYSTEM FAILS: . •• I have determined that the system violates one or more of the following failure criteria as defined in 310 CM 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. . 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:Owner: Date of Inspection: D) SYS T E M FAI LS (continued) -- 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 over- loaded or clogged SAS or cesspool. -- Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 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 cesspool or privy is within 100 feet of a surface water supply ortributary 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 ana- lysis. 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. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 Owner: , Date of Inspection : E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flow of system is 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 : --- the system is within 400 feet of a surface drinking water supply --- the system is within 200 feet of a tributary to a surface drinking.water supply --- the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped Zone I I of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CM 5.00 and 6.00. Please, consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: �-7 O wner. Date of Inspection: Check if the following have been done : -x Pumping information was requested of the owner, occupant and Board of Health. --x None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N IA. --x The facility or dwelling was inspected for signs of sewage back-up. -x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. --x All system components,excluding the Soil Absorption System,have been located on the site. ---x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees,material of construc- tion, dimensions, depth of liquid, depth of sludge, depth of scum. ---x The size and location of the Soil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods ---x The facility owners and occupants if different from owner were provided with information on the proper maintenance of Subsurface Disposal System. i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: ? Owner: Date of Inspection: RESIDENTIAL: Design flow : 32CG gallons Number of bedrooms : o'3 Number of current residents:a-2.. Garbage grinder(yes or no) : Laundry connected to system(yes or no): y-c5 Seasonal use (yes or no) : L.,c Dater meter readings, if available: Last date of occupancy : �-�c:Q�s �- �1•��S COMMERCIAL/INDUSTRIAL : Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings,if available : Last date of occupancy : Other: (Describe) ............................................................................................................ Last date of occupancy: GENERAL INFORMATION PUKING RECORDS and source of information: r-...t .......... System pumped as part of inspection (yes or no) :.....�...... if yes, volume pomped : .................... gallons Reasonfor pumping :............................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: o-3.1 �"�� P�Y� Owner. Date of inspection: TYPE OF SYSTEM -k 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) --- Other (explain)........................................................................................... APPROXIMATE AGE of all components, date installed (if known)and source of information ......................................................................................... ................................................................................................................................................ ................................ Sewage odors detected when arriving at the site : (yes or no).............. SEPTIC TANK : . (locate on site plan Depth below grade: ....fir. Material of construction: concrete ......... metal ........ FRP ........ other(explain) ............................................................................................................................................. Dimensions: .i?. Sludge depth:....P.`.`..... e, Distance from top of sludge to bottom of outlet tee or baffle:.......`.3�............... Scum thickness :....C>.".......... Distance from top of scum to top of outlet tee or baffle: .............(.cl" .............. Distance from bottom of scum to bottom of outlet tee or baffle :....... .......... Comments : (recommendation for pumping ,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structur inte ity evidence of leakage,etc.).................... l . l .. 't .. ..,................ . ,. ` 4.►- ...c ..Ca.�.,�........... SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: uef.�ru•v Date of inspection: GREASE TRAP - (locate on site plan) Depth below grade: ............... Material of construction: ........concrete.........metal........FRP........other(explain).... .......................................................................................................................................... Dimensions:............................... Scum thickness:........................ Distance from top of scum to top of outlet tee or baffle:....................................... Distance from bottom scum to bottom of outlet tee or baffle:............................... 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.)........................ ................................................................................................................................................ ......................................................................................................................................... TIGHT OR HOLDING TANKS:.... (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FRP..........other (explain).......... ................................................................................................................................................ Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches, etc.) ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: `01 S�vc�c�,•L� Owner: Date of inspection: DISTRIBUTION BOX:..Uf-5 (locate on site plan) D epth of liquid level above outlet invert:.Zgv. .w Comment: (note if level and distribution equal evi ence if s lid carryover, evidence of leaka a into r out of box, etc.). �.4 . - .. .. .. � �>.10:: a .,... ......................................................................:......................................................................... PUMP CHAMBER:..... (locate on the site) Pumps in working order: (yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ............................................. .............................................................................................'.. ................................................................................................................................................ 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: .... ......................................' ... .......................................................................................... Typ..e: leaching pits, number•. ...i.. . X lo.fly_ leaching chambers, number:........ leaching galleries,number:........... leaching trenches,number ,length:..................... leaching fields, number,dimensions:................... overflow cesspool, number:.......... Comments: (note 99ndition of soil , s' of hydraulifa�il ur�(level of ponding, condik n etatian, I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR T C SYSTEM INFORMATION (continued) Property address: Owner: $-�,J Date of inspection: CESSPOOLS:....QC�.. (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: ..................... Indicator of ground water: .................... inflow (cesspool must be pumped as part of inspection) ................................................................................................. ................................................................................................. Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ................................................................................................................................................ .......................................................................................................................................:........ PRIVY : .... . (locate on the site) Material of construction: ................................... Dimensions: ...................... Depth of solids: ................ Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address :Owner: Date D ate of inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100' Q4�� 31 AZ- 3`1 LA 6 z O 3 � DEPTH TO GROUNDWATER: O `1 Depth to groundwater: .2.0..feet Method of determinatiTpr approximatirre: ................................................................................................................................................. ti 1 LEGEND HYANNIS - , PROPOSED CONTOUR IYE . ® PROPOSED SPOT GRADE ST..MAIN STREET EXISTING CONTOUR -- -v + 96.52 EXISTING SPOT GRADE z i W— EXISTING WATER SERVICE n P� TEST PIT LOCUS r. Irn 227 SCUDDER AVE 26 129.27' __ --I 25 LOCUS MAP 112 ft y' (f) 26 / t / LOCUS INFORMATION \ / / PLAN REF: 038/091 / TITLE REF: 25124/333 C I PARCEL ID: MAP 289 PAR. 081 FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE 1� PAVED DRIVEWAY � L'p 1 1 / 0 � SEPTIC SYSTEM REPAIR ' PLAN o LOCATED AT: o ! 227 SCUDDER AVENUE OH �H �o o r� �� /�' HYANNIS, MA II o m I 'I �/ r PREPARED FOR N r -, I JAM ES FETZER m ' 0oz 0 -9 z z 0 READY ROOTER EXC. mI + z / 2� ft //' G p vent -24 AUGUST 31, 2020 o ', LOT 12 - P-2 I AREA = 12900 sf+— �� TP- F A!q C m `'LAN BOOK 38 PAGE 91 m 'ASSR MAP 289 PCL 81 // // �' SHE�t AR E\ / / N / I M �. 1140 ---T---129.34' i 24' 25 26 26 QNITAR\a� �/ l i BENCH MARK TOP OF SONOTUBE — MEYER & SONS, INC. • 26.03 P.O. BOX 981 P L_ A N BARNSTABLE GIS DATU EAST SANDWICH, MA. 02537 SCALE: 1 in = 20 ft PH: (508)360-3311 0 20 40 FAX: (774)413-9468 0 10 20 40 meyerandsonstitle5®gmail.com SHEET 1 OF 2 J 1894 I 'I ELEV. TOP NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS ROP FND.sting) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (24.50) (Ex= 28.02 F.G.EL: 26.5 F.G.EL: 25.5 F.G. EL: 24.80 VENT a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA ' a• i 'f F.G.EL 21.31 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" . , :? STONE OR FILTER FABRIC DOUBLE WASHED STONE 6" . _ I 4" SCH 40 PVC " " ®ma®• O Emma i 10 ) e 14 ® S= 1% (MIN.) ®®®®®®®®®®® 1 a' TEES ARE TO BE INV. 9.85 F '� 4" sCH 4o PVC i 2' E F. DEPTH mm®am®®ammm INV.20.05 1 INV. 19.65 4' 2 X 8.5' 4' BAFFLE LE PROPOSED DB-3 EFFECTIVE LENGTH = 25' ExlsnNc OUTLET DISTRIBUTION BOX INV. 20.30 (H20) INV. ELEV.= 19.40 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON ��`� of �gss9� BREAKOUT OUTLET TEE AS MANUFACTURED BY ELEV.= 20.40 NOTES: TUF-TITE, ZABEL, OR EQUAL o DAM E E �, TOP CONC. ELEV.= 20.40 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR To CONSTRUCTION o. 140 ' INV. ELEV.= 19.40 Ealliglliill mmm . 2) D-BOX SHALL BE SET LEVEL AND TRUE TO a®am m a m GRADE ON A MECHANICALLY COMPACTED SIX �E6/$(t��" maaamam INCH CRUSHED STONE BASE, AS SPECIFIED IN Sq P� BOTTOM EL.= 17.40 ®®®®®®® NITAR� 3.75' 5 FT. 3.75' 310 CMR 15.221(2) 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK WITH 1500 GALLON SEPTIC TANK IF FAILED, SEPARATION 6.00 FT. EFFECTIVE WIDTH = 12.5' DAMAGED UNDERSIZED. / SEPTIC SYSTEM PROFILE a) INSTALL INLET & OUTLET TEES W SOIL ABSORPTION SYSTEM (SECTION) GAS BAFFLE AS REQUIRED BOTTOM OF TESTHOLE EL: 11 .40 _ (500 GALLON H2O LEACH CHAMBER) GENERAL NOTES: DESIGN CRITERIA 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS TPT#: 20-172 BOARD OF HEALTH AND THE DESIGN ENGINEER. NUMBER OF BEDROOMS: 3 BEDROOM DESIGN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: AUGUST 24, 2020 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: DESIGN PERCOLATION RATE: <2 MIN/IN - 310 CMR 15.405 (1) (B): WITNESS: DAVID STANTON, BARNSTABLE HEALTH DEPT. DAILY FLOW: 110 G.P.D. X 3 BR = 330 G.P.D. 1) A 1.10 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING GARBAGE GRINDER: NO (not designed.for garbage grinder) TO BE 4.40 FT (MAX) BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED) Elev. TP-1 Depth Elev. TP-2 Depth 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 23.95 A 0" 23.90 0" SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXIST. 1.000 GAL. SEPTIC TANK TO INSPECTION NSPEN ON A D APPROVAL BY THE BOARD OF HEALTH AND THE LOAMY SA/N2D A LOAMY S�A/N2D LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. 23.45 6" 23.23 8" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING B B ' FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN LOAMY SAND LOAMY SAND USE, TWO (2) 500 GALLON H2O PRECAST LEACH CHAMBERS W/ 4 ENGINEER BEFORE CONSTRUCTION CONTINUES. 21 77 IOYR 5/8 26" 21.s2 IOYR 5/8 25" STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. C C 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF BOTTOM AREA: 25 x 12.5 = 312.5 SF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. MEDIUM MEDIUM 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. PERC TEST SAND SAND SIDE AREA (25 + 12.5) X 2 X 2 = 150 SF 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED o EL 18.28 2.5Y 6/4 2.5Y 6/4 TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. Vs. 330 G.P.D. req'd THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 11.45 150" 11.40 150" PROPOSED SEPTIC SYSTEM UPGRADE P LA N 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PpRC RATE <2 MIN/IN. ("C2" HORIZON) 227 SCUDDER AVENUE, HYANNIS, MA AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY NO GROUNDWATER OBSERVED 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Prepared for: Fetzer/Re dy Rooter Exc 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. Design and Site Plan by: SCALE DRAWN DATE 15. ALL PIPING TO BE 4" SCH 40 • 1/8"/FT (UNLESS SPECIFIED) • I, Darren M. Meyer.,R.S., CSE, hereby certify that I am currentlyMEYER&SONS,INC.approved by MADEP pursuant to 310 CMR 15.017 N.T.S. DMM 08/31/20 M UIR to conduct soli evaluations and that the above analyeie has been performed by me consistent with the PO BOX 981 REV DATE roquiremente of 310 CMR 15.017. 1 further certify that I have passed the Soil Evai. Exam in October, 1999- EAST SANDMCH,MA 02537 . CHECKED SHEET NO. 506,362--2922 DMM 2 of 2 1 _