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Home My WebLink About0519 SCUDDER AVENUE - Health 51.9 SCUDDI R AVE. , HYANNIS _n A = 287 017 J' e t E, t o 4 •-� "' TOWN OF BARNSTABLE C M LOCATION 5:12 auc&E/L A-U& SEWAGE # VILLAGE wt�r,o � ASSESSOR'S MAP & LOT J. INSTALLER'S NAME&PHONE NO.JbbinY, O 4ef"r 17S-T+7f SEPTIC TANK CAPACITY I5M "f' 90140 CIAM6-1Z, LEACHING FACILITY: (type) DaV G)G 116 2, (size) a X 17 y(015 NO.OF BEDROOMS BUILDER OR OWNER_U a g Se PERMITDATE: 2 11 i a dcac, COMPLIANCE DATE: g*L9666 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) E Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ' P � a 1 1 � e i � r Commonwealth'& Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments „ 519 Scudder Ave. Property Address F Robert Cato ' Owner Owner's Name/ information is r required for every Hyannis Ma. 02601 05-11-2018 page. City/Town State Zip Code Date of Inspection su 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 filling out forms A. General Information 1303 g on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere use the return Name of Inspector key. Cape Septic Inspections �y Company Name 624 Old Barnstable Road Company Address Mashpee Ma. 02649 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 2 05/12/2018 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 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 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: ® 1 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: This 3 bedroom home has a H-10 1500 gallon septic tank H-10 1000 gallon pump chamber and a H- 20 D-Box feeding two leaching chambers. At the time of the inspection the leaching was dry and there were no visible signs of past hydraulic failure. 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): I t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 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): I 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.doc•rev.6/16 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 M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is Hyannis Ma. 02601 05-11-2018 required for every y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 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)] ,t 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): 355 GPD t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 j f Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is Hyannis Ma. 02601 05-11-2018 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 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: Sump pump? ❑ Yes ® No Last date of occupancy: occupied 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.doc•rev.6/16 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 w„ 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. Cityrrown 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 1f yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc-rev.6/16 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 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is Hyannis Ma. 02601 05-11-2018 required for every y 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: 09-08-2000 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 36"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 28"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: Standard H-10 1500 gallon septic tank Sludge depth: lip t5ins.doc•rev.6/16 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 M 519 Scudder Ave.. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 36" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the tank on a maint. plan with a local septic pumping co.The Barnstable Health Dept. has a list of local septic pumping co. 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is Hyannis Ma. 02601 05-11-2018 required for every 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. Cityfrown 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 U. Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The H-20 D-Box had no visible signs of leakage or evidence of past hydraulic failure. 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: r t5ins.doc-rev,6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i , Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: two ❑ 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.): At the time of the inspection there were no visible signs of past hydraulic failure. 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 n i Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 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.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth Hof=Massachusetts Title lcta... ' nsspecgtio:nyjFor Subsurface,Sewage.Disposal.System Form -Not for Voluntary Assessments 519 Scudder Ave. Property.Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018. page. Clty7own. State_, Zip.Code Date of Inspection•, D.,Syste�.g Information,(coat.) 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 N 6- C N O 'SCL) t5ins.doc•rev.6116 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is Hyannis Ma. 02601 05-11-2018 required for every --y 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: 10 plus feetfeet 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: I augered a hole at a lower elevation and shot it with a transit to show four plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 519 Scudder Ave. Property Address Robert Cato Owner Owner's Name information is required for every Hyannis Ma. 02601 05-11-2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i �ci z,0 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,31 Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 November 26, 20113 Board of Health 200 Main Street Hyannis;MA. 02601 Re: Variance Request 519 Scudder Avenue, Hyannis, MA Members of the Board: On behalf of our client,Robert Cato, we are filing a variance request.from the Town of Barnstable l Ordinances Chapter 360 Onsite Sewage Disposal Systems,Article I, Setback Requirements, Section 360-1 Location of Components With Respect To Water Bodies, to allow a septic tank to be located 81 feet from a BVW where 100 feet is required. A 19 foot variance is requested.. Also to allow a pump chamber to be located 90 feet from aBVW,where 100 feet is required.- A 10.foot variance is. requested. The site is currently developed with a three-bedroom,single-family dwelling on a 0.34 acre lot. An addition and remodeling of the existing dwelling is proposed, along with the relocation of the existing septic tank and pump chamber. There is a bordering vegetated wetland to the east of the dwelling and most of the.site lies within the 1.00 foot buffer zone to the wetland. With the proposed relocation.of the septic tank and pump.chamber, the distances from the wetland are increasing in each.case: Please schedule this variance request for your next Board of Health.meeting. If you have any questions or comments, please contact me at 508-771-7502, ext.'11. Very truly yours, Po K. Lavelle Senior Engineer 'Enclosures 20:13-035-BOH Var. Req.-11-2.6-13 Land Surveys Site Design • Subdivisions. • .Septic Design • Wetland Filings • Planning t C— I DATE.: C !/,2:2 Lf7 -FEE �6 REC. BY 39 � Town of arnst ble k SCHED.. DATE:U� �A Board of Health 200 Main Street; Hyannis MA 02601 Office: 508-862-4644 ...r'f�, _ h Wayne A.Miller,M.D. FAX: 508-790-6304 ` �.`"�� `iG� Junichi Sawayanagi. Paul J-Canniff,.D.M.D: VARUNCE REQUEST FORM LOCATION Property Address: 519 Scudder Avenue Assessor's Map and Parcel Number: M2 8 7 P17 Size of Lot: 14.,:813 s f` Wetlands Within-300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME- Robert Cato Phone 508 827-4515` Did the owner of the property authorize you.to represent him or her? Yes' X No` PROPERTY OWNER'S NAME : : CONTACT PERSON Name: Robert Cato Name: Robert Cato 37. Elm Street Hyannis; MA Address: Address:-3 7 Elm Street, Hyannis, MA 508 827-4515 508 82:7-4515 .a ... , Phone:. Phone: �J VARIANCE FROM REGULATION(List Reg.)' REASON FOR VARIANCE(May attach f more space.needed u� 360-1 Location of septic Relocating septic tank `a3 �d: :'Cump system compenents with. c a er or dwelling add�.ijtion L, " respect to water bodies : Ln NATURE OF WORD:`House Addition IR House Renovation, ® Repair of Failed eptic System I C) Checklist (to be completed`by'office staff-person receiving variance request application) Please submit copies in 4 separate completed sets: _ Four(4).copies'of.the completed variance request form' Four(4)copies of engineered plan submitted(e.g.septic system plans)' _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian . _ Four(4)copies of labeled dimensional floor plans.submitted(e.g.house plans or restaurant kitchen plans). _ Signed letter stating that the property owner authorized.you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail of least ten days prior to meeting.date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Fultmenu submitted(for grease:trap variance•requests only)' Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same'owner/lessee only],. outside dining variance renewals_ [same owner/leasee only],and variances to repair failed se Ne disposal systems[only if no expansion to the.. building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED: ' Wayne:Miller,.Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Cannif�D.M.D. C:\Users\decolli.i\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC. SECTIONS EWER: COMPLETE THIS .MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Si nat re item 4 if Restricted Delivery Is desired. X Agent ■ Print your name and address on the reverse ❑Addressee- so that we can return the card to you. B. Receive by(Print N : Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. t . D. Is delivery add d` nt from item 1 Yes 1. Article Addressed to: ` If YES,,enter deli e address' low: �No 0, Scott-A.Dolesh &Emily H.Groom �8HJ QQS 25 Marl bof5 b:ii i 3. Service Type Sou boro,MA 01772 ❑Certified Mail Express Mail O Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee)-_-7-1 ❑Yes 2. Article Number i ' i (transfer from service label) 7 Q 13 0600` '000 2 r0 9 5 2 7 0 15; PS Form 3811,February 20 • Domestic Return Receipt 102595.02.4il 0 a I. UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 f • Sender: Please print your name, address, and ZIP+4 in this box ' I . [Baxter Nye Engineering&Surveying l Attn: John Lavelle 78 North Street, 3`d Floor I ti I Hyannis,MA. 02601. t II COMPLETE • CO ON ON DELIVERY ■ Complete items 1,2,and 3.`Also m lete A. Signature item 4 if Restricted Delive X Agent ■ Print your name and ad O Addressee so that we can return to you. O B. Received by(Printed N to of Delivery\ ■ Attach this card to th ' of the mail i e; oe or on the front if spa a pe 2 Z� . D. Is delivery address different from item 1? ❑' es I 1. Article Addressed to: If YES,enter delivery address below: No Rose M.. tti T� I Scotco Realt .,, C/O Michael R. Scotti ` P.O.Box 30 3, Se ce Type Winchester;MA 01890 Certified Mall 0 Express Mail 0 Registered 0 RoMm Recelpt for Merohandise N O Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes i 2. Article Number 7`013 "0600 '0d02!i09521 7d53 (Transfer from service fabeg PS Form 3811,February 2004 Domestic Return Receipt fir l� T_- 16595 02 M 1540' UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid I USPS Permit No.G-10 4 ! • Sender: Please print your name, address, and ZIP+4 in this box • I I I Baxter Nye Engineering&Surveying I ! Attn:John Lavelle. ! 78 North Street; 3`d Floor �1 ! Hyannis,MA.02601 IZA I ! � SECTIONSENDER: COMPLETE THIS .MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signat item 4 if Restricted Delivery is desired. ❑i�gerrt ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. ecelved by( Anted Name) C. Date of Deli ery ■ Attach this card to the back of the mailpiece, or on the front if space permits. I 1. Article Addressed to: D. Is delivery address different from item 1 T ❑Yes If YES,enter delivery address below: ❑No Iiyannis Fire District 11 I,Road i Hyannis,MA 02601 3. Service Type ❑Certified Mail ❑Express Mao ❑Registered ❑Return Reoeipt for Memhmxft ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number r (Transfer from service labeq 4 7013 ,0600 0002 0952 7 0 3 9 PS Form 3811.February 2004 Domestic.Return Receipt 102595-6'4-154o_ UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • I Baxter Nye Engineering&Surveying e Attu: John Lavelle 78 North Street,3rd Floor. O Hyannis,MA. 02601 1 � I . I I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION()N DELIVERY ■ Complete items 1,2,and 3..Also complete :A.#ce; eitem 4 if Restricted Delivery is desired; ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. . by(Pd ted Name) C. Date o very ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address diffe ems Yes 1. Article Addressed to: If YES,enter delivery ad ss be[o }�,rlo George A..Ashur&Mary Louise C lBZAdams Avenue 3. Service Type I 0 Certified Mail O Express Mail I Milton,,MA.02186 -. p Registered 13 Return Receipt for Merchandise ❑Insured Mail 13 C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2:`Article Number ,„_ �{. '� :y- Y - f,•k.,_ . (Transfer from sendce tabep 1013 0600 0 00`2 0 9'5 2 9 9 9 5 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-Iy 1w')j MITED STATES POSTAL SERVICE First-Class Mail I LISPS e&Fees Paid I n Permit No..G-10 I I • Sender: Please print your name, address, and ZIP+4 in-this box • jII II I— —Baxter Nye Engineering& Surveying Attn: John Lavelle I 78 North.Street;3`d Floor y I Hyannis,MA. 02601 t I ':=:'�.:E -r i:�=" = 1"'t 111 'l'illIlllli'lt111 Ill III.1IH' 111111fill]' t t 1 i , °fTHET° Town own of Barnstable Barnstable � y y�P Board of Health All-MmicaCm 9ILA MASS. E.Ib 200 Main Street; Hyannis MA 02601 1 m� ass. a i639. �e ArE0 MAt b 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: .508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi M December 16, 2013 - Mr. John Lavelle Baxter Nye Engineering & Surveying 78 North Street Hyannis,.MA 02601 RE: 519 Scudder Avenue, Hyannis A = 287-017 Dear Mr. Lavelle: You are granted variances on behalf of your client, Robert Cato, to construct an onsite sewage disposal system at 519 Scudder Avenue, Hyannis. The variances granted are as follows: Section 360-1 of the Town of Barnstable Code: To relocate the septic tank 81 feet away from a vegetated wetland, in lieu of the one hundred feet minimum separation distance required. Section 360-1 of the Town of Barnstable Code: To relocate a pump chamber 90 feet away from a vegetated wetland, in lieu of the one hundred feet minimum separation distance required. These variances are granted with the following conditions: (1) No more than three (3) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. Q.\WPFILES\519 Scudder Ave Hy CatoLavelleVarian=2013.doc (2) The septic system shall be installed in substantial conformance with the engineered plans dated November 19, 2013. (3) The designing engineer shall supervise the construction .of the onsite sewage disposal system and shall certify in writing to the Board"of Health that the system was installed in substantial compliance with. the engineered plans dated November 19, 2013. These variances are granted because the physical constraints at the site severely restrict the location of the septic system components due to its close proximity to the vegetated wetlands. Sincere yours, Wayne Oiller, M.D. Chairman Q:\WPFILE.S\519 Scudder Ave Hy CatoLavelleVariances2013.doc f - s Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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 filling out forms A. General Information on the computer, I I I use only the tab 1. Inspector: vlil key to move your cursor-do not David D. Coughanowr, R.S. use the return key. Name of Inspector Eco-Tech Environmental r� Company Name 43 Triangle Circle Company Address Sandwich MA �02563 City/Town State P- I�,Code C�5 11111zz' 508 364-0894 1328 ..; 8 Telephone Number License Number -" 8�;6 C;A3 B. Certification sltJ 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.inspeotion was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority December 20 2012 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 i the same or different conditions of use. d I Z 013 t5ins•11/10 TL/I nspection Form:Subsurface Sewage Disposal System•Page 1 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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: Inspector's Note==> The septic system described herein is deemed to pass this Real Estate Transfer Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4-5. The scope of this inspection is limited to health and environmental compliance and the septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. 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 leakinggland if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 519 Scudder Avenue 'M Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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: h ❑ 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•11110 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 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) 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: Y Pp Y You must indicate Yes or No to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or 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 '/z day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 - page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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): n/a-no plan t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20 2012 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? [if yes separate inspection required) ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): 13 gpd Detail: 2011, 2012 Sump pump? ® Yes ❑ No Last date of occupancy: undetermined 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-11/10 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 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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: owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): pump chamber t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments, M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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: Age: 12+ years. Certificate of compliance for new septic system was issued 9/8/2000 (Permit#2000- 473 at Health Dept). 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.): Sewer line appears structurally sound with no evidence of leakage or backup into dwelling. Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10.5 x 5 x 6- 1500 gallon tank Sludge depth: 4 in l5ins-11/10 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 ;M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. CitylTown 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 30 in Scum thickness 1 in Distance from top of scum to top of outlet tee or baffle 9 in Distance from bottom of scum to bottom of outlet tee or baffle 14 in How were dimensions determined? As built card Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping is not required at this time. Maintenance pumping is recommended every 2-4 years. Tank and tees appear structurally sound and functioning as intended. 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-.11/10 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 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 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: 17 concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments cGM , 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. Cityfrown 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 at outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box appears structurally sound with no evidence of leakage in or out. Few solids in sump. 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.): Pump chamber appears structurally sound and functioning as intended. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 1 ❑ 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.): Soils above leaching gallery appear unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. An observation hole was dug into leaching gallery stone and no effluent contact staining was observed in the stone or overlying soils. No standing effluent was observed to a depth of 1 feet below the top of the peastone layer. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form 7 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments note condition of soil signs of hydraulic failure level of ondin condition of vegetation, ( 9 Y P 9� 9 , 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massac`liusetts v:, Ti}trle 5 0=ffici�I II s0o" tion F- rm —' SubsurFace Sewage,Disposal S.ystem;Form-Not;fo�Uoluntary,Assessm'ents t r 519,Scudder A hob Property Address MadeUneBearse;- _ :Owner, Ow -. nees Name informat{on Is H annis Port. MA'..: '0264;T ,December 20; 2012 required-for every . age. Ctt /Town Sfate ,Zi Code+. Date of hs ection P g_; y p. P D System Inforrn:at�on (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage-disposal system;;-including:Pies to at least two permanent reference landmarks or benchmarks Locate,all":wells within 100 feet:.Locate. :where public water:supp 'eniiarsl f1build•ng of. Check one the boxes below iO hand sketch in the area{,t Blow drawing attached separately 1 _ 3. 1, 3 0-7 a 'i r U t5ms 11/10' Title 5,6frlda1 Inspection Form.Subsurtace Sewago D(spo52l,System•:Pagel 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. CitylTown 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: g+ feet Please indicate all methods used to determine the 9 high round water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 8/11/2000 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: Installer's Certification form on file with the Board of Health shows bottom of system to be 5 feet above the seasonal high groundwater table. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 519 Scudder Avenue Property Address Madeline Bearse Owner Owner's Name information is required for every Hyannis Port MA 02647 December 20, 2012 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. w Fee $5 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zfpprication for Miopooar *potem Com6truction Permit Application fora Permit to Constnict( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 519 Scudder Ave . , Hyannisport Mad.eline Bearse Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. -� Wm. E. Robinson Septic Service P 0 Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil S and. Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system consisting of a tank, D-box and. pump station with alarm, and. 2 leach chambers . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuej by this.Boapkof Health. Signe / r Date Application Approved by G� v Date Application Disapproveff for the following re, n Permit No. Date Issued .. �"No. � Fee $50 o THE COMMONWEALTOF MASSACHUSETTS Entered in computer: Yes r. PUBLIC HEALTH DIVISION - TOWN OF B RNSTABLI , MASSACHUSETTS application for Miopoml bpgtem Construction Permit n for a Permit to Construct Repair X Upgrade Abandon El Complete S stem .El Individual Components Application ( ) p ( ) pg ( ) ( ) P Y Location Address or Lot No. Owner's Name,Address and Tel.No. 519 Scudder Ave. , Hyannisport Madeline Bearse Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P 0 Box 1089, tenterville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures `-Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title X Size of Septic Tank Type of S.A.S. S and. Description of Soil � s Nature Title-5 septic stem consisting ,of Repairs or Alterations(Answer when applicable) p y g • of a tank,, D-box and. pump station with alarm, and 2 leach criamber Date last inspected: w -� Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi_' + ' ' cate of Compliance has been issue by fhi o �ealth. Signe, Date. Application Approved by �, �' d Date Application Disapprove for the following rea6 Permit No. Date Issued OF THE COMMONWEALTH OF MASSACHUSETTS Bearse BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Aba Boned( )b Wm. E. Robinsoneptic Service at19 Seudc er Ave . , Hyannisport hasbcen constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N . dated Installer Wm. E . Robinson S r. Designer The issuance of this permit s a 1 ot,.be o strue as a guarantee that the:5 s in 1 nction as '�s'gned� Date � �i �"" V Inspector 0 No. � ��V -----------------------Fee 50 11 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLE, MASSACHUSETTS Bearse Miggogal Opgtem Congtructton Permit Permission is hereby5gir t�dCud C er ctA(v�Repair( rpadoer(t )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to 'rt comply with Title 5 and the following local provisions or special conditions. tl g P Provided:Construction, ust a coUipleted,within three years of the date o t 's rtni Date: I �� Approved by /I. D w U6/" NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, William E. Bob ins on,Srereby certify that the application for disposal works construction permit signed by me dated 0—'f� , concerning the property located at 519 Scudder Aye. , Hyannis or t meets all of the r Mowing criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. e soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. ere are no wetlands within too feet of the proposed septic system sere are no private wells within 150 feet of the proposed septic system ere is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will ggLbe located less than five feet above the tna.�murn adjusted groundwater table elevation: [Adjust the groundwater table using the Frimptor method when applicable) If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(141 feet above the maximum adjusted groundwater table elevation, Please complete the following. A) Top of Ground Surface Elevation(using G1S information) 7 r� B) G.W.Elevation +the MAX High G.W. Adjustment DIFFERENCE BETWEEN A and B i' ' r-' l 4 SIGNED : j V �/��/ DATE: �dl V (Sketch proposed plan of system on backj. q:health folder:cent J ll o � R7�ITrly ( � T yQ J l y 'r. H i i �t� A 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated , concerning the property located at meets all of the following criteria: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system. • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted ,groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) t B) G.W.Elevation +the MAX. High G.W.Adjustment.W _ 0 DIFFERENCE BETWEEN A and B SIGNED : DATE: [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert r TOWN OF BARNSTABLE ' LOCATION 5/ .Scvc�c�-c�2 AV E SEWAGE # - j }-� i VILLAGE NvAnJiyi�,pc�fZ.� ASSESSOR'S MAP & LOT 'I/ - INSTALLER'S NAME&PHONE NO. &6zro0 nFi C_ -27S—g77fo SEPTIC TANK CAPACITY J SOO -t FOLInQ f {,An► iclL LEACHING FACILITY: (type) D12/_t• IDS 9�. (size) -�?4 17.E; $ NO.OF BEDROOMS BUILDER OR OWNER &S�- PERMITDATE: III I a6&0 CQMPLIANCE DATE: 9I9Oado6 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 Furrushed by ,ZU 1 T •.: 1 �A, 1 � o P -P 0 c hN 1 LOCATION SEWAGE PERMIT NO: s 6cucP�2 /q-o E VILLAGE I N S T A LLER'S NAIVE i ADDRESS BUILDER, OR qw-M_ER DATE PERM-IT ISSU-ED DATE COMPLIANCE ISSUED a�! CA s :, No..82_:_.. ._...... Fss....... ...�..00...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T own.O F.....Barn stable....... .................................................. Appliraffou for Bh4pos al Works Tnnitrurtion Prmft, Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 519 Scudder Ave. , Hyannisport, MA 02607 ................_.................................................................. - --•---------....-•-•-•-------------•-•-----•-•-•----•-------------------------•---------... . Madeline, Bearse Location-Address 519 Scudder Ave. , °�yannssport, M4 02647 ......................-.......................................................................... --........--••-......•--•-•------•---••---........--------•---•--•-•-•----•--•------......._.... W A & B Cesspool Service Owner 128 Bishops Terrace, Hyannis, Nk 02601 a -......... •----•-- Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.....................3....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...........a...._..__.___. Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ . Design Flow............................................gallons per person per day. Total daily flow............,...............................gallons. W W Septic Tank—Liquid capacity__•-___-__-.gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0-4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------•-------------------------------------------------•---•--•---•--•......................................................... 0 Description of Soil................Sand...............................................-•-------------------------------------------------------•----•-----•••-•---•-•-•......_----•- x W -------------------------------------------=-------------- -------------•----•----•----...-••-••-••-----••-----------------------•------•-•---...---•-------•-•---•--•••--•-----••••-•----•--•---------• UNature of Repairs or Alterations—Answer when applicable...._installation---of_2.-fl.owdiffusors,.._stone packed.-with. extra stone (overfl ow) ----------------------------------------------------------------------------------------••-•••--------..........------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bard he lth. . n S' ed -. _ - .11e« ... 10/25/82 /Date Application Approved By.......... ---• -•--•--•--- .... -------- ---•------•10l 212 ..................................................•- Date .__. Application Disapproved for t e f o lowing reasons:-------•--------------------•-•• ........................... -•----••--•-------------------------------------------------•-------------------------......-----•----•---•--------------•-•-•--••••------•'-•---••--------•------------• ............................... G� Date Permit No. 82- < Issued 10125182 Date No.----- "� - FnE............$...5.Yp8 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T atQF..........Parrnstable.. Appliratiou for Dhipoiiall0orko Tnnairurtiun Frrutit Application is'hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: •519 Scudder Ave..:..Hyannsp.ort•,--�-----02 -:... ........ ..... ............ r Location-Address or Lot No. Madeline, Bea Be 51Q-_Seudc a _AYe..,.._Ilyaxut�spo t.... 1...SI22�?J7. _..... Owner Address �1 A--�--B_Cessp001 Service-•..................•-------.......---•-•-•- •-•--128-•Bisho�&._Tp=RQp..... I�yaurl &+ I ...A2 Qi Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......................... -__.-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...............2.......... Showers ( ) Cafeteria ( ) a Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter_--__-_--___-_ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by...........................................•-----•------•----...._......._ Date........................................ a�_j Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ` •---•------------------------------------------------------•---......---•-------••--._...._......---......................................................... 0 Description of Soil...................Sand........................................................................................................................................... x �., W -------------------------------------------•---------------------------•---------------•-•--•---------------------------------......----------------•-------•------••---•--......--------------------•-- U Nature of Repairs or Alterations—Answer when applicable---------ine-tallA..-Uon.-.of-.2--flcwdiffusor-8-,---stone .pa.ckecl-wit.h.-extra..,etone.. --•---•------------------=---------------------•--•-------------------------------------------•----•------...------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of.health. Si ned ... Date Application Approved By------- =' 1Il 25�R2___.__ e a lowing Disapproved for easons: .......................•---•-------•----•--------------------...-•-- ................................................................................................................................... Date Permit No........ .......................................... Issued_...........10/25/�2----••------------------- Date TKS COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................T.m....,O F..............................Bamstabla............................. I� TrrtifirFatr of TuutpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( by---------------A__c__B._ ..Bishopa_Terrace....?lyamla,-.K...026II1-.....-----•--•-•-•---------.... Installer at-------------5J-9..S.cudder.."e..,---Hyanniapomt,--VA----.D2047---Tt.. Madeline---Bearsee------___-_-_------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No............ __ _____________________ dated._...._...........1Q�2r $z----_.__.-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT��&NST AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIQN SATISFACTORY. DATE....................10 �� ? Inspector.... .. _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................T.I� ......OF...................Pa-_—tau_e........................................No..._S. FEE..... ...5..110.... Uiopuoal Workii Talmitr uan rrutit Permission is hereby granted.......................A_.A.•R-Ilesspaol--Se-ru'tee•-------------•--•---•-•--------------.--__---•-•---_____-•---•-•- to Construct ( ) or Repair ( 4 an Individual Sewage Disposal System at No.....51Q._acudder__Axa_._,...Hya,nnis_p0rt.,_L'A...W-647..--."4adeline--Rearse------•------•----------------------•---......... Street / as shown on the application for Disposal Works Construction Permit No._..._ .-VG._. Dated_..._..10/25/R2............... ................ Y_.. ...... _.._...f �.._..___.._...._............__.......___........._._- 10 / p2 �afd of Health DATE...................... ( ...........l/-82..............----._........... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - ` A 2oi.s3 o, 10.9+ �Q — ou q f f q 1 G 6 , G \ , 1 \ \N , 1 O\S\ K r / s �/� 6 EX• N,g per, -�4z- 15.8-+ l� qq jq q!! -` r ' S o v 0 Cg BEN HMA ,K: TO OF AL kE o ` f , \N ,j ` ' ! •ham -- �; y.� '-' 'j ' 12"15.4. ,3s9. ` / Pf' BLOCK BORDER o r „� ; 0. r . ' ALONG EDGE OF AL HEDG POST & RAIL. / ' + J FENCE r rr 1 LIGHT \ POST = qq a.. a.:+ Ab 9.6 - J ' wooD TIE STAIR -WELL 9.79.2 7.2 ! + ! 15.9 �. U \ <` 1,' PLASTIC A�IN8� _ u^CATER LINE 4� 7 SCU PAR�r ILY GROOMH' +11.2, g� - 5 Z8� 58 MAP ESH & PAS. n n D 22235 N� '_ Ile, 'Sc SRC . - [�/F DEC GENERAL NOTES 15.7 i-) 7HE WI X OF MIS PtM IS TO SHOW PROPOSED COMPRISED OF- ea2 ASSESSaR'S PAGE 55 _ sCOW tw ' i . I ► oq� ' - I I USK- Ur- Itr F I 014 �>O�V f I _ 444- is. Ur L slI�. 00 IBC Cas �^ '�S � �NI+J6 cowMtJ O - i , ifi 1i 3�al _I ' i Nev IN m 7 tt'/e-WHO! I i I II U CId$W I II O - -- - rtMt�Illr - -=- fool TF OL i! } tl Gl9S, - O � - C'Qut� ._ M _ .z; �- - c°F" or 6 - O v 7 Qr7 z I_ ''I'll'' --i"r" I _ 2 v - avE� c M. T r°UNV'-rI0o - S \1 -(.7- � . I �- - k. W �- � I ur 00 00 lu, �7 i ` I oll o lij Ei 0 zill"ll: i ---- -- + i I Or + 1 way � I i iI + I I� j 0! EL of Exisw n?m FLOOR=16.1 / =, , i >� � ��.. ��,-JtsoasersT.,000�-,o B�►XTER NYE "E7O IM RISERS NO OMM m _ - v E)OSTNG GRADE ! 10.3 MATCH E XWING *0 MADE `I, E�QST7!!G RISERS AND DOWERS TO TSrt-alao�Aaett d G W.a tla.es L w M - •• am `0 `47 WATERTIGHT AND BE BROUGHT MMATCH EXISTING AND MADE 6tiaemdslotoaadtm 4.J6 - � � ENGINEERING & �"'' �- N WmH 6. OF nmH GRADE WATFJ nGHT. ONE To BE: BROUGHT TO FINISH GRADE OVER PUMP s9e.�,dG.w.arYose�(i}� a..eo y � -- -- Rr . FINISHED c>rtADE _ FPCM T �� 4p '= Tda= 1 T�w=�1 d ,} SURVEYING z NX OVER CFNM�.1 9 LF SCH DD PVC FORCE7�NN TO MATCH DaS ING Sd sdsft aDore art-w�sDosed 0oeer0ore tat b by d tart `L' } y J '�:' �� J' NEW 4= SCH 40 PVC; 11 (NO SAGS- PROVIDE POSIM SLOPE BACK Tn EXISTING GRADE OVER DIST. BOX=14t LF AT = NEW INVERT OO�N>�1f�.T M PUMP CHAMBER FOR DRAMACIQ s�aDaea eeraemgraee abase to lkn)w J � �� ><,<CP , I Registered Professional Engineers Ourwaz* 3 LF 4'901 4o t"sA:•2Jafill and Land Surveyors �--6' MIN IGAaE 1/IL !N 11.8.3t1t, 10" MIN. -� 7 �nM) 9rt(aweUrWpWw M Up= ae0 4.a3 1�711 7o= 3.7 :�' ; •`1 �"' • 7 oureeem fIV fi�8.77t t t• PVG �: 78 North Street - 3rd Floor ,� „ „,� Ins REIZE� PIS Ex ETFu,Fxr Lases ter, Tars �• • •'�'"�• Hyannis Massachusetts 02601 wtdTar� I.1 eaa . IlaJU►IJ / ' IN M D PRIOR TO CONSTRt1CT10N. Ile '� FTDU$ Al/�"Y AID WIIiROlS sm aO FORCEMAIN INVERT 2' sM d sor more sat= 3 7 7,3003 � - L �,• •- NOTFY DESIGN ENGINEER IF DWFERENT �* CHM ViK F SNYffAME ROOT 7D MATCH . Tota Lrt al a sa s= 7.8 tei e4a FOR POSSIBLE REDESIGN. 14- Imtrs TO IIOGN t7(51TIdG 5 - ,?- s' 1 ii '` Phone - (508) 771-7502 7 la.ET TEE TO 1 Tate 7.a > ,2 = !t ORs�i _ �;� �. ABOVE OUTLET ELEWMM Fax - (508) 771-7622 . • _ MOM@ Eft ��C� 9" - o 0 o www.boxter-nyle.com 7 NOTE: PLUMBER SHALL REWORK THE WASTE ': � •�6' CRl19ED ftweTart,�s go=-s b w 1"11 44-1 THEPLUMBING FROM THE EXISTING PIPING INVERT OUT 1 500 GALLON SEPTIC TANK sTONE l�E 1 ,000 GALLON PUMP CHAMBER smNE a�E DISTRIBUTION BOX (EXISTING) THE ADDITION TO YIF1.0 THE NOTED INVERT OUT ritic-erpsaaetdG.w.awowes s. w H OF THE �►oonroN TO THE RE7_OCATED SEPTIC TMK RELOCATE EXISTING (RELOCATE EXISTING _of boom of broot), 4AG 1am a &a S T A �HOF � STAMP TO BE 16PU D ON A LEVEL SGIQF EASE BewonofG.W.orMalaes(t), &" TITLE V CONSTRUCTION NOTES: '° D °" " `OR 4 I NO C F 1 TiR Buo r Up= 10 eb 6 JT 0115 '= T=�) TClal .0Tors) �O 1dIATTW. 1 NEW 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TiTLE V OF THE STATE PUMP CHAIM TO BE NSPECTED a CLEWED AW Wlx U �vo. 3 3 SANITARY CODE DATED APRI- 21, 2006, AS AMENDED THROUGH THE DATE OF THIS PLAN, & ANY sad segt moresat-paposee¢a0emaetaart b top d tat LOCAL RULES REGULATIONS APPLICABLE s3 at ww ,� �s cis 2. ANY CHANGE TO TM PLAN MUST BE APPROVED IN WRfi1ING BY THE EIS. ELEVATION BevillatSao L E� INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN PRIOR APPROVAL BY THE ENGINEER. M Sd(adore ar*0VflM Up= low ss p o.ssa a" to 3. WHEN CONSTRUCTION iS COMPLETED, PRIOR TO BACKFIL1 NG, NOTIFY THE BOARD OF HEALTH AGENT AND ENGINEER FOR INSPECTION. Toms Ida ®.��1 � rMt d Tat= 5 7 11.1>?b 4. ALL SANITARY DISPOSAL SYS 04 PIPING M BE 4 SCHEDLU 40 PVC UNLESS OTHERWISE ToVot arson attars art= aA s zs CONSULTANT NOTED HEREIN. ACE VMS& s DES IFE003 rs VARIANCES REQUESTED. &dw of Cw"Ow Expires: Td!lat.t a� 8 4 1.0 = ra� 6. INSUUITE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN 3' OF COVER EXISTING DWEL LM.- R "J OF B NSTABIE 7 TIE SEPTIC SYSTEM DESIGN INCLUDE GARBAGE (�t�ER DISPOSALS. 3 BEDROOMS x IIQMe� MM = 330 GPD 360--1 Bm 3W, �° t �awombe Dab Se'o° Avow CONSERVATION NOTES: EXISTING DV nLM WITH PROK SED ADDITION: S)Sfiem� Sectim 360-1. Lanbon of 51 �e Cmilma Intl Reaped To Water Bodes CONSULTANT 8. WM THE CONTRACTOR SHALL CONTACT DIG SAFE (AT 1-888-�DIG-SAFE) AND UTILITY 3 BEDROOMS x 110/BFDR04M' - 330 GPD 1. To des a septic task bo be looats9d 81 feet fiom a OW s tm 100 feet s 1. NO IOC 6 TO BE VIOW UNiIL FMIS A � B ALONG WTW REOUW COMPANIES TO LOCATE ALL EXiSIING UiiL993, AT LEAST 72 HOURS BEFORE THE START OF 19 fast mimme bads is 74 feet from OW. PHOiOGWPI6 ARE SUBIITTED To CON5ERMTTON COI�l65 M CONSTRUCiION. THE (,CONTRACTOR SHALL DETERMIE TW EXACT LOCATION. BOTH HORIZONTALLY NO pi�w(�ES TO !LEACHING AR5A AREA PROPOSED s � ( ) � ' ' '` ' ` ' GENERAL NOTES: AND VERTICALLY, OF ALL EXISTING UTIUTES BEFORE THE START OF ANY WORK. THE LOCATION OF L To oaosr o pt"ip thanst»er bsi bs: Iodated 90 feet florrl�a am whom 100 feet is ' 2 LWr OF POW SHALL CONSIST OF HAYBALES AND SILT FVXW AND SHALL DOS'TING UNDERGROUND UTILITIES ARE SHOWN IN AN APPROXIMATE WAY ONLY, MAY NOT BE EXISTING SEPTIC TANK AND PLNP CAMBER TO BE RELOCATED ON SITE. avqui+tsd (10 foot -mion ra.nequeAvii) Exb* septic tads 74 feet from ON. M64MED IN GOOD REPAIR L1NM COMPLETION OF HOUSE AND LAIrDSCAPM 1.) TIE NlElrif OF TM PLAYA a 10 9M PROP06m W=AT LOAL4 LIMITED TO THOSE SHOWN HEREON AND HAVE NOT BEEN INDEPENDENiLY VERIFIED BY THE LOCUS AID 6 OOIERlSfD OF: OWNER OR ITS REPRESENTATIVE THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR ANY 3. A COPY OF 1IiE AS-BULT FOUNDATION PLAN SWW. BE DEUVE3�D 1D AND ALL DAMAGES WHICH MK�IT BE OCCASIONED BY THE CONTRACTOR'S FAIUJRE TO LOCATE THE VAUASCO APPROVED' THE: CONSERVATION COMMISSION. Z) ASMo s 270P4 F S6 17 PREPARED FOR : UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM PLAN INFDRMATiON. THE 4. ALL R00F LEADERS SHALL DESIGN TO WV WENS OR L� TREJC ErL CONTRACTOR SHALL NOTIFY THE NUED14TELY FOR POSS13LE R�1. AT UTILITY OE"•6R eT PSIREET Robert 0 DATA/COkN VERIFY RELOCATTEE IF CONF THE LICTING LOCATION PROPOSED PER THE ELECTRIC, GAS. TELEPHONE & sWTH T SI P LIB oa�t,LTAnoN Imue� w azeat 37 EIIM Street DIRECTION. THE CONTRACTOR SHALL PRESERVE ALL UNDERGROUND UTILITIES AS REQUIRED. • ��w 9. THE PROPOSED UTILITY SHOWN HEREON ARE SC1iEYATEC'. FINAL LAYOUT SHALL I d) ElElI1 w 9100i1 IiE m fzEMlc�O TO TIE iaTIOIWI �oEnc A�rrM L1 w Hyan , MA OGW 1 BE AS MIERM"NFD BY THE APPROPRIATE UTILITY COMPMIY. OF iW 000,211)&V ESD600 LIT IEEA RX 125D TC BPS RiK ter. 4) Z"V LIFiORl,NTM I I� 16.7+ PAVED AREA /i J _ ' UM 1OL LOT Nu a WOO S.F 1!L LOT FIiDNTD10E• �' �501 SCUDDER AVENUE � LOST 1�1'M 10 MAP .287•PARCEL'16 �a'' N/F HYANNIS FIRE DISTRICT F OI0 VM - .D' DEED BOOK 418 PAGE 122 � � >� s1�E a 11EIIR »NlD • 15'/ 1s j- r a •, DEED BOOK 588 PAGE 29 f / / / / • ' cw'" t> ' / LINL BIRDNC ifZilf (OR ZS S1dl�► 15.8 .' .x? �-�, �0� ,�V �+b 1 LEaQEke 6 LAB C 1� C �, 190.00' DEED 20f.93" Ci1LC. 8.2 5�) TIE PROPS"LINE / ATM! 91 w NS BISED OM GIR11EJlr IbMAB E REC�D / /�/ ff #A7 COI MM Or PW6 AND DEMS. � , r O ` i i / t _ +9.3 TIE E)dSM FOULMS SIM NNW !�OMMMED FROII AN ON 1NE GUM r RQ. 10.9+ .� O � • �,R 1 �� O HELD SURVEY PERfO< O BY SWER NYE Or14FG & SURVEi7VG D( MG JUKE OF > 2011 28 � ;r, GRASS / ; NG�� --' o a) OOAa�JIITY PIYEL NAwk 2500D1 0006 D tL1M M EJ�.w L141E OF M 2. 1 Q , �OIC�` IP 041 AREA ��\S� / N 199Z 1TE ROOD &SWAM WE 1W DEUM THS AREA AS 8 (5001'R.). 1TE vt -- SUB$!PROPERTY 6 Wr N A SPE X FLOW INIARD AREA r^ ` .' i Z 711 15.6 �1 �, 12p I, \ /' PL N TER ,R SS ;/ j o Ci``� 7) C x ` •0 W/B D B TH EA i = ILai w > - --' p .� ASSESSOR'S i/ oOf �Q . SITE 6 NOT LITTNSI M ACM OF al TOY.DIWNoleND K � � Q N 0 15.8+� 4 gyp. MAP 287 PARCEL 17 10. + .6 o v o . SITE 61I0f OW M AREA OF ESTWIED IMIDIT OF AW E.t>H FIER f- 1 14,813t S.F. OR 0.340 ACRES TOTAL �' � -- ` 'I +� `� `�• J ( ) ,' /'� W i� � O v�. ^ NifSP INP OCIOBFR t. 2010 'E37rN1ED INB'TATS Of RARE E.OLlFT+ 12,577t S.F. OR 0.289 ACRES (UPLAND) , j Q Q B MA FOR USE IM TIE 111 PI9076C=ACT MIA M S (310 CNR 101 c� o o sM + g 40 • SITE DOTS NOr CONDIN A CFRTF0 M WI POOL PER 16E3P WP OCWM 1 ILI V z 1APPROX M + +�ELECTRIC T OF AL ^ 0 2010 'COtI MUM POals' � -' " LEA ►N` NANDHOL �; k r^1 0 "fxi' , �\ � fg.8 __ = 48 �,Q m • SITE 6 NOT EM A PF6XI W WOW PER M:SP INP OCIQM 1. 2MO � Co n L Al 51 Z 5 -_' O YRWIV ii�TM OF Off 9UZS-FOR SIUIES UNDER THE MCS40AWM ♦ ` ,�+ ' rn r EX * G 1 C) FLA:GPOLE-� 2, t p' ' ad fA4 ��OW DOWCM�ACT. IMATIM (321 CMQ]L v % 14.3+�� -,pA 9 �� \ �r + .3 �, • SITE 6 NOT VFM A SE47E APPROVED ZONE I GROLED C06t FMVAM GRASS !' OL 0v= mot, \. \�` S(( � •' ,' ci v FROTBC ?AREk MAGNETIC K. 1 �'� / AREA .o SN , ��P \NG 9. .gyp 5 12 _ - )3 � • ( E tLOJN 360�-45�)IiTT".BtmoN 10 A SALl1BlTt3t tSilwtY BLOCK BORDER ; o \N Z SURVEY NAIL ALONG EDGE OF 15 4 �E R 69, ,, Z EL = 16.01 1 HEDGE µEDGE 1' Wp00 g�pCK�` 0._ % o - 16.0� 13DST & RAIL ,''� R�-�P\N\ •� �NOpO 0� r < . , . �4c08' r.. s'/ , �,.. �'' ,," ' ; •TIE COTTRWO'SHALL OWdTAC'T DiG SAFE(AT 1-d68-Wr-SAFE) NO L1MM FENCE �� F04� E \RSA : s OOLI MES TO LACAiE ALL E7QSIIVG UWDM AT LEAST 72 NOURS PRW TD M rJ N '�ST�IRS / < \SAES SZP START OONSIRUCildt, TFE LOOAiION OF[70STINNG IADERgi01A0 E� m I LIGHT T &0 C' 118.5 I UTILITIES, CON®UTS AND LINTS ARE 9M N M APPRODOM W ONLY. ANY NOT w 2 L G `� ,,_ t + I BE LAM TO i M 910l1, HUM AND MW M RMEARAED OW ON TIE o I I POST i o r --s-A '• _ ORCN �� O AIMABE UMN NOTED TIE C0111R1A W AGRLFS TO BE FIW �t G QtP 9.6 GRASS , RESAONSHE FOR AIM'AM ALL DOGES W= WMIT BE OCGWOIED Or THE �L'-' AREA I F 30 NgSO,� oowiR�croas I�Il11RE To LocArE SAD imp A� uTurlFs txAcrLY. F w HELD OOI�DTTI016 DLFi'E'RS FT101s1 PLAN ImF�AT1011, 1FE OONTFbiCTOR SINALL NOW a #A2 THE BNB AMEBMW FOR POSMI REDESIGN. I '. 15.3+ °` .'k� LNG a\0 S��S ZOR� \N� E\-0��3 9.6 i � 0 S R - � � SOURCE N FAOIL PUIf 6 Ills <EDF COA0D IRTH 08SERVFD EVAENCE of �r` •' 9 . °, �N��G� ' 2 `F�9a S / , i' _,,,,��`( E7OMM THE LOXT LOMM OF �FIEN RES 0 BE m 15• �R `N+�E WOOD TiE - Ytcv' 1 AOgXb1W, COIFLETELY AND FfLMY OEP'i M MERE AIODt110MA1. OR MW ANC ` STAIR WELL DETN!!fD i iON 6 RBXM3k THE CLIENT 6 ADVISED TENT D N ANY BE 1 1 M! Z Q � '- -9------'� + iL�SSAR1r. Q 7 • SEPTIC S STIN TION OOWILD FROM RECORD NUUM PROVIDED SHEET TITLE - BY TIE 801SWE BOARD OF HEALTH A M SW" BE CONSIDERED 9.2 >16 _ S- APPRO�TE ' GRASS AREA i \ ' •'�� • HATER u1(E rfwm COIInq FROM RECORD POTION PROVIDED 1 LEGEND BY ,W , oEP>'RTMEErT A� 9iouD BE CoNs+DERFD APPROXlAAT>r Septic 15.9 r r" G ,� w r _ #A1 • GAS LW NO SERVICE 6 A OOMI MTK)N OF L.00A7EU METER/YID location Plan 1 PLASTIC A�NDE ---"---- EL = ELEVATION OOId°E1CilOtfS PER NATIONAL GRID SN(ETCH S02718. fiffb +11.2 WATER LINE Al GDDDER L 18 GROOM -O- - UTILITY POLE G`. = WATER GA _� SHEET N O G f- y Sty% #MAP 287 PA&EEMILY 1 D4 TEfSEiUT DOLESH PAGE ® = ELECTRIC BOX F SGO� BOOK 22235 = ELECTRIC R1E<ER L W, ,� c t d►� N/ DEED ® = GAS MITER 1 15.7 9, . `"HG +M`�•�C G = GAS LINE VII = WATER LINE DATE: 11�19�13 Its, �" OHW- = OVERHEAD WRES 10 0 10 20 1 4 = TREE L K eas SCALE IN FEET SF _ EROSION CONTROL BARRIER SCALE: 10= 10' 16.6 DRAWNIDESIGN BY: JKL CHECKED BY:SNB J 0 8 NO: 2013-035 C A D D FILE: 2013-035-SPAVg i �C, TOP OF DOSING FNLSHM F100R=18.1 nwa c�+s■e..mm woo.-P"t"sT-,000-wo A� � z - BAXTER NYE Pq Tat-asotacen�e t of G W.a 1rlottks w H - - = j EXiSTNG GRADE = 10.3 WATCH E>QSTNiG ANO W10E E)QSTNG RISERS AND COVERS TO sso ass s.v WATERTIGHT AND BE BROUGHT TO WATCH EXISTING AM MADEbollm wTII IN 6' OF FINISH GRADE WATERTIGHT. ONE TO BE BROUGHT g�d G br@Vt)- _ 3 v ENGINEERING & To F1HfSF1 GRADE OVER PUMP i, r ty T� T�w2 0�, - ,= - ,,. -� N SURVEYING _? y\ //�yv(/(\��y��/ F � F who GRADE OVER piM�BFR= A �y,�� p� �M ry�� y� �y,�� y� T aeo a s o s �, (, 1 a Lr SCH 80 PVC FORCE 1 AIN M MATCH D ING i I \ ,' •`�'� • ` ' ` ✓ NF1N 4• $CHI 40 PVC; 11 (NO SAGS- PROWIDE POSITIVE SLOPE BACK TO EXISTING GRADE OVER DIST. BOX=14t Softegtabovetat-D�aDose0tlmA�boretatbbDCrtatc CrJf �, LF AT 2S: NEW IMIEitf COi l TO EXiSW SEVI T7WC. of T = f r� UL NEW TEE � GAS a E. t `!' °�M Registered Professional Engineers .y a LF 4.9a1 �o Pac zax g ,., s• NIA.----�: � I� and Land Surveyors AIM 0-6-oft (THROITLJNG) sa(abae teiy UP s eo ass Taos a.T ,o" OUT•em "��N Pvc "�""°71t 78 North Street - 3rd Floor UX aoNnvrcral: TO VERIFY E>asrW+G INVERrs Z REM DOSING PUW% C ��' ` ' Massachusetts 02601 1 W� HOLE CONiROLS NRorTat= a, a Hyannis, Ma IN FIELD PRIOR To ax+�sTRucTiON. 11r FLOAZS► AIARY SCH BO FORCOrIAM RWERT EX EF1FtL1EJYi L1MlEs 10 RETrIAN �. __ Ya �. NOTFY DESIGN EirGR� IF DIFFERENT CHECIC VALVE - F SALVAfFABIE FLOAT TO MATCH EXISTING 2' wtaswabovetat= 3� T.3oe �� , ... ^ .� araxx�s a,� •os_ '. • • Total tat wt 8 sd wt- 7.8 1d t3A \, f t ..+ i ._ { ' •'+ ` _` -' ,/ ;y. 01 FOR PossreLE REDESK�N. 'a• HEIGHTS ro MATCH E7fSrING SUbW . -►� :y. •::� - I - -,�- Pl� 7 NLEf TEE 1D 1' _�D Tof1t= Ts > ,2 r.amyl - �.1• - "r- y i"j��:.�i'I Phone - (508) 771-7502 ABOVE OIJW ELE%AAATiON - " � Fax - (508) 771-7622 '�' 9" = 0 0 o www.boxter-nye.com PLUMBER SHALL REWORK THE WASTE e' er . STONE BASE s.p+e Tadt,,�00 ora�-f1+ar�sT-Soo��,o L:.: PLUMBING FROM THE EXISTING PIPING THROUGH 1 500 GALLON SEPTIC TANK smw WE 1 ,000 GALLON PUMP CHAMBER DISTRIBUTION BOX (EXISTING) THE ADDITION TO YIELD THE NOTED INVERT OUT OF THE ADDITION TO THE RELOCATED SEPTIC TANK RELOCATE EXISTING ,RELOCATE EXISTING) ��«-�«o d w.Q�abolto�ot>�>= a� S 4 INt, 10`°0 a" ac TA STAMP , iHOFM TITLE V CONSTRUCTION NOTES: TO BE WTALLm ON A LE�L snILE LIASE t3evatlmofG.w.orMotses(Ry �ssgc lO BE NSTALLED ON A LEVEL STAKE SAGE PROVIDE FOR 4 DOSES PER DAY Hm WITH TITLE V OF THE STATE AHD OWVHBAdC OF FORCF3IAiHI Tate 8uoyarp ,oso atW. a o.1% T t ou�l Total �� o�o� Md EDD n 1. ALL SYSTEM COMPONENTS SHAM BE INSTALLED IN PUMP CHAMBER TO BE NSPEc,7ED CLFJYm AMItWW LY SANITARY CODE DATED APRIL. 21, 2006, AS AMENDED THROUGH THE DATE OF THIS PLAN, & ANY sd hegt abae tat_pmposee gaeeabl tat b"of tat U C LOCAL RULES & REGULATIONS APPLICABLE Pmpmd adore d ,too o. 3 30 �� 2. ANY CHANGE TO THiS PLAN MUST BE APPROVED IN WRITING BY THE DOWERELEVATION eeraso�at top of tat�(rt-� INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN PRIOR APPROVAL BY THE ENGINEER s o A At Sat(above tat}einralcy A� ,o eo 6.67 oss s.zss 2A 3. WHEN CONSTRUCTION IS COMPLETED. PRIOR TO BACKFXUNG, NOTIFY THE BOARD OF HEALTH UA AGENT AND ENGINEER FOR INSPECTION. ® wt or Tall s�i >,.Sao 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4' SCHiEDULE 40 PVC UNLESS OTHERWISET D.E. .f;' 'I�� ' wt ar sot abae tat= z e s.zw CONSULTANT NOTED i�,I. A� M4 pE� VARIANCES REQUESTED: orli� ofc«>d �;�. Tdaltat�t8sdrrt- � Totem 84 > 1.0 Mrs amyl 6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN 3' OF COVER. EXISTING DWELLING: TOM OF BARNSTABLE 7. THE SEPTIC SYSTEM DESIGN DOES HOT INCLUDE GARBAGE GRiNDER DISPOSALS. 3 BEDROOMS x 119ZK R°°M = 330 GPD 360-1 00111 0tri10Am 360, "6* I' Seftd R°Q""1D rNft Onge Sewlffqoad CONSERVATION NOTES: EXISTING DWELLING WITH PROPOSED ADDITION: WM Section 360-1. Location of System Components With Resped To Water Bodiex CONSULTANT 8. THE CONTRACTOR SHALL CONTACT DIG SAFE (AT 1-888-DIG-SAFE) AND UTMY 3 x 1 tQ/BEDROOM = 330 GPD 1. To dm a septic tank bo be hmW 81 feet from a ON ande 100 feet is 1. NO W= IS TO BE DONE VWrI FMIS A & B ALONG WITH! REQI113RED COMPANIES TO LOCATE ALL EXISTING UTILITIES, AT LEAST 72 HOURS BEFORE THE START OF requi W (19 feet va lkimce requested.) bas6rV septic tank is 74 feet from Offl PHOTOGRAPHS ARE SLIBIRfTED TO CONSERVATION COI ON L A F O . GENERAL NOTES: CONSHBICDON THE CONTRACTOR SHALL DETERMINE THE EXACT LOCATION. BOTH HORIZONTALLY NO CHANGES TO LEA LNG AREA ARE PROPOSED AND VERTICALLY. O ALL D(fS71NG UTIt.lT1ES BEFORE THE START OF ANY WORK. THE LOCATION OF 2 To albtr a pump chamber to be I000ted 90 feet from a BVW► rhde 100 feet is 2 IDJETf OF WORK SHALL CONSIST OF HMAYBNES AND SET FE]VCNVG AND SHAM EXISTING UNDER UTILITIES ARE SHOWN IN AN APPROXIMATE WAY ONLY. MAY NOT BE EXISTING SEPTIC TANK AND PUMP CHAMBER TO BE RELOCATED ON SITE. rogtrned (10 feet variocnce rued.) E40bg septic tank is 74 feet from OW. MANfANED N GOOD REPAIR UNTIL COMPLETION OF HOUSE AND LANDSCAPING. 1.) THE NIFTY OF THIS PLAN 5 M SHOW PROP�06ED WORK AT LOCUS LIMITED TO THOSE SHOWN HEREON AND HAVE NOT BEEN INDEPENDENTLY VERIFIED BY THE 3. A COPY OF THE AS-BUILT FOUNQATiON PLAN SHALL BE DELIVERED TO LOCUS AM S COWRLSED OF OWNER OR ITS REPRESENTATIVE THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR ANY VARIANCES APPROVED: THE CONSERVATION C00ASSION. 1) ASSIM011 S MAP 287 PARCEL 17 AND ALL DAMAGES WHICH MKW BE OCCASIONED BY THE CONTRACTOR'S FAILURE TO LOCATE THE PREPARED FOR : DEED B00K 27094 FACE� UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM PLAN INFORMATION, THE 4. ALL ROOF LE 0M SH AIL DISCHARGE TD DRY WELLS OR DRIP TRD CHES CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDfSIGIN. AT UTMY OITIER ROGRT P. COD Robert Cato CROSSINGS. VERIFY IN FIELD THE LOCATION / INVERTS OF ELECTRIC, GAS. TELEPHONE & 5. A WWATRW PLANING PLAN SHALL BE PREPARED N CONSULTATION 37 ELM STREET 37 Street DATA/COMM AND RELOCATE IF CONFLICTING WITH PROPOSED INVERTS PER THE ENGINEERS WITH CONSERVATION COM44 S" STAFF. ffvmis� W 02601 DIRECTION. THE CONTRACTOR SHALL PRESERVE ALL UNDERGROUND UTUITiES AS REQUIRED. ��//�� M 9. THE PROPOSED tmlm CONNECTIONS SHOWN HEREON ARE 9CH0►UTIC. FINAL LAYOUT SHALL OF mum �� HEREON �+cm To TIE NAT10f+1A1. snooETRc VERTICAL LTATIR/ Hy��, Ii/l/'1 02�W 1 BE AS DETERMINED BY THE APPROPRIATE UTA1TY COMPANY. of 1929 (Mt,'VD 29)ANDESDAtII>SHMED BY IDEyA RX 1250 TIC CPS MLRD: l 4.) ZONM iNRItt WMk I I� 16.7+ I PAVED AREA ZON9IG 1 CUIMIT Lv M1JM ZOM>L'MG REL1tW2EAMETITS: MEAL LOf ARDI = 43,5150 SF. Mil. LCT FRONiAGE= 20' 41501 SCUDDER AVENUE WI. LC!Rm = IV MAP 287 PARCEL 16 FRROMIT 171RD = 30' N/F HYANN/S FIRE DISTRICT K DEED BOOK 418 PAGE 122 DEED BOOK 588 PAGE 2:9, '' SIDE�REAR YARD _ 15'/ IS" --Ali , MAX BIADNG HETQMr= 30 (OR 2.5 STOIRISr ' ,A-e A0010 It /• I WHICHEVER is m" none 15.8 N C �r' � bo aw<t i V - �N 190.00' DEED / 20f.93' CALC. 1 74'O ' S) TIE PROPERTY LIIF NFORIIATiON 9OW4M IS LIA'SED ON CURMIT AN ABLE RECORD E NFORI41TD0M1 OWISTi'MG OF PLAINS AMID DEEDS CL '4ffl` o� i i -T Ate- Z +9.3 �� 0 i / l i �- 10.9+ �,�Y p lif EX 1IG FF/O!lRHS SHOWN MERLON WERE CITIAM FROM AN ON TIE CROW (� 1 , , ; • / l��1 `, ��p FED SURVEY PlRH77R11ED BY BOXIER NVE OlC & SURVEI'NG Lx06 JUE OF > 2013. twit �, i �\ �� 0. � N� " GRASS ,, LNG� � o Q) COkWJNTY PTA R N NON 2MMI MM D VW M1 EFFMK WE OF JULY Z 1 , ac'd` to AREA l \`� I r*� �Q- P' N E� , � 1992 TiE HOOD 15WJDE WTE AW L>EFi(ES THIS M EA AS ZOW B (500 M I TIEct VIF d� s � sTJeJracr PROPERiY 6 NOT N A SPECIAL FLOOD HAMAREA �1 1 15.6 `� ` 10.7 i ,�Q (� PL NTER �,R SS ; 4,o h ,- -_ , ,�cf� ; W/B D B TH EA i oI �W ) W Q� > ASSESSORS ' J ' l o -Q • ME 6 NOT r'NW AN A.CEC OF CRITICAL DMVNOM�N AL I- N 0 15.8+ EX. o� MAP 287 PARCEL 17 10. + +a.3 Q (ARrA c�aNc r') �+ 6 l� v ��,O • SITE iS NOr VIM AN AREA OF E37UM HI W OF RARE W'Mn PER �, �, w, Jrc` 14,813t S.F. OR 0.340 ACRES (TOTAL) J WF fA5 __ �,tv ►� 40) 2010 11SRbATm WRDOS OF RIME ftDtW G1 �^ 1 � , � 0 _ __' ' a` O C>>.n.� MlI#3P MAP OCTOBEIt 1, F- 4 �` 12,577t S.F. OR 0.289 ACRES (UPLAND) O o<'� 1 o r*� �`, ® ' - ' �, �p '/ ,,- BE MA K: o v FOR USE RiM TIE W WETIA4DS PROTECTM ACT MIAEITTONS (310 CIIR 10).' t) �• 1 cB C�►� W '� ELECTRIC +' 'NP T OF 2' AL o ac • STE DOES NOT CWIA�N A CINM WIMAL POOL PER t� TAP OCTOBER 1, W AP O Of E OX(M i r I , \ TA N • y4c. �Y k J «o ti�' 2010 'CLRIF VEI W. POOLS' O O n L ¢, 1 5� d►T7fa 5 h _-- E Q O ?'R10RII V NABIM OF SPECIES'FOR SUES UNDER 1IETHE SSAQ iS U .L m 7• EX 'L�• _ - W DL G 1 L FLA'GpOLE- i ` ' a� - _--' #A4 �� SPECIES ACT REQJA710M6 (MI CMRTO1 v �1 % 14.3+�; '% 0T r'N: �� . / �T. ` t .3 o O • SiTE iS NOT Wii�@I A STATE APPROVED ZOW 1 GROTTO Rfl1TER RECHARGE GRASS ' �N>nC ��:8 \" \ S � PROTECTION AREA BENCHMARK: 1 -� �� AREA o ENV d►f \N\NG 'L �p� 12 __-- - .� \ • SITE IS NOT W M A ZOW OF CONTR OM ro A sALTICM L37uARr C7 MAGNETIC BLOCK BORDER 15 4� '' o R��P Be' �3 , '' '' ROJL IV. 360-4s Z SURVEY NAIL 1 A,LO HEDGE E OF , ,, ., Qo �\E ,, 69' - CC*,. 8.) LI I liY NF'OR MION SHO!'�N HFREIREL 16.01 a 16.0�- ' POST & RAIL ,'�� R�P •• .�0�� ERA �4.08, i/ •THE CONTRACTOR SHALL CONTACT DING SAFE(AT 1-888-DING- AND unuTY FENCE �, / / <EpO FS�P\RSl WF i� OWANES ro LOCATE ALL EXJSiEMG UiJX3. AT LEAST 72 HOURS POW M TIE v \ 5 , START OF C01�MSTRUCTION. TIE LIGATION OF L705'RIG UDEIM MD WRASTRUCTURE to 2 I LIGHT - tONC,''ST�IRS / S �btE 1 18.5 1 UiUiIS� COMDLM AND LINES ARE SHOWN N AN AF`IMkWE WAY OHI.Y, WY NOT o POST �� c• -T-d - QORGN fX- g 3'Y P� / 9.6 GRASS ��p MN ABLE U1MY REcM HEI ML THE CWIR VIOR AGREES M BE FULLY dV G P\ p, AREA � �,��''� 07 3p WPOMISBIE FUR MAY MD ALL QAAAGES WHICH iElQlr BE OOfXSIOtIED BY THE �c• FIND OOMAMiM DETERS FROM PLAN LOTION, THE CONTR ACi0R SHALL NM �-- n i 15.1't OCMITRACinR"5 F ro tACATE SAID R4RlSIRUCTURE AND UTIJTES l7UCTLl: F w I R D i � FE MGNEER lWIEDIVO.Y FOR POM.E EDE'Slpi. Q L I ', 15.3+ 4 \\ _;� I \�p\NG R ;L t\t Eo�a 5 9.6 i SOURCE NFOMRIIAWN FROM PLANS HAS WN CMU WIM OBSERVED EVIDENCE OF � r Z' 2 0 E. ' N1 V 00INVIIA TIE U4CT LOCATION OF UNIDHRGROt1MD FEATURES CAN V BE m �� n• R N ' �EOq S'Q�Rc ,, - �, Yam"" NE UTUTES M DEVELOP A VU OF TH T MURGROIIMD WILITIS HOKKX LACIQMG >- oI WOOD TIE LL ,, i llllllll111111 low AOgMaY, COMPLETELY MO REIJaY DEPiCYM *IERE AMITIONY. OR MORE R Z , DO MM NFDRlIITIDN Is REOUIZfDI, THE CLW IS ADVISED UK M M71M WY BE O MECFS 2 $ARY. s T 9 7 ,• , • SEPTIC SYSTEM I�URfUTION COMPILED FROM RECORD NFORIIATION PROVIDED SHEET T 1 T L E _ BY THE BARNSUBLE BOARD OF HEALTH AMID SHOU OME LD LE C 2 zl i m i �\ a `�� 9.2116 g8 $- A'PROXLYATE a GRASS ` • RATER LIVE NFORN AT10N COMPILED FROM RECORD I+I�XTION PR04�ED LEGEND �� 1 AREA. \ G `\ .2 BY THE WATER DUW ME]NT AND SIMD BE OONSDERED APPRO)UTE ml ` 15.9 ,� �y.\ ��,, 1.2 • GAS LINE AND SERVICE Ls A COMB!'iUTION OF LOCATED METER AND � �� 1® �� 1" PLASTIC AVENUE --- EL = ELEVATION (DM WCTiONS PER NATIONAL GRID SI�TCH SO2718 J'- +11.2 WATER LINE 4� SCUDDER EL 18 GROOM -O- = IITAlTY POLE #52� 287 PARC EMILY H� 1 t>4 = WATER G�ATE,/SHUT-OFF SHEET N O y�, MAP DOLESH & PAGE 1 ® = ELECTRIC BOX COTT A OK 222 = ELECTTRIC METER Z 1 0� NSF S DEED BO = GAS METER G 1 y`r / vl �c� 15.7 -Ad ram E N �� w - WATRRuNE / off° s� \� KEGo� G�� DATE : 11/19/13 1 F\C N �� ,� OH W- - OVERHEAD WR S 10 0 10 20 Itl 1 ` Y a2•�I O = TREES SCALE IN FEET SF - EROSION CONTROL BARRIER SCALE : 1"= 10' DRAWN/DESIGN BY: JMQ CHECKED BY:SMB �i J O B N O: 2013- M C A 0 0 F 1 L E: 2013-�SP.