HomeMy WebLinkAbout0105 STERLING ROAD - Health � r11n� Rd f -
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TOWN OF BARNSTABLE
LOCATION N 5 af,YWi l 0(. SEWAGE# �(11 q-3J
VILLAGE HIJ AhhiS ASSESSOR'S MAP&PARCEL Z
INSTALLER'S NAME&PHONE NO. �lJ► y�( XLU V(�fi16�-���)342"D�q�
SEPTIC TANK CAPACITY ►shb J�;Vo {ti.rC� etr
LEACHING FACILITY:(type) V i Vt (size) s ('
NO.OF BEDROOMS 3 -
OWNER L.bk(Al d ClAar bmeakA
PERMIT DATE: COMPLIANCE DATE: db
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 eac ing Facility(If any wetlands exist within
300 feet of leac ing ity) �,3 Feet
FURNISHED BY
T ti
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MV04)(A U
No. 37 ) Fee 8 '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye--f:�
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Nplitation for Disposal 6pstem Con;,ompleteSystem
ttion Permit
Application fora Permit to Construct( ) Repair( ) Upgrade(/Abandon( ) ❑Individual Components
Location Address or Lot No. �� ll. Owner's Name,Address,and Tel.No.
I
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Afy� S - p�` L f 2-G6-+�, 579- -7 3
Type of Building: ) �.L
Dwelling No.of Bedrooms � U Lot Siz� sq.ft. Garbage Grinder( )
Other Type of Building �1� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 1%30 gpd Design flow provided ss gpd
Plan . Date Whi 1110 Number of sheets 13 Revision Date
Title
Size of Septic Tank Type of S.A.S.ya)!5 p I t- r-hN-,-
'Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
&
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued b and f
Signed Date
Application Approved k Date
Application Disapproved by Date
for the following reasons
Permit No. `� Date Issued C!
G , ' Fee
No. ,
THE COMMONWEALTH-OF MASSACHUSETTS Entered"in computer: Ye
PUBLIC HEALTH DIVISION TO� N OF BARNSTABLE, MASSACHUSETTS
21pplicatlon for -118tJ0lial Wpstem Construction Permit
Application for a Permit to Construct( ) Repair( ,) Up rade(/Abandon( ) ! omplete System ❑Individual Components
Location Address or Lot No. (S l .fit Owner's Name,Address,and Tel.No.
9 I
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
l h G T1e� •66 r--"f k pomp'A [Ali W,13
Type of Building: (� __d
Dwelling No.of Bedrooms �•E'X Lot Size ?,./)I,C" sq.ft. Garbage Grinder( )
Other Type of Building (C No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) h gpd Design flow provided 9 v gpd
. Plan Date L h i I i a Number of sheets .9 Revision Date
f
Title
Size of Septic Tank Type of S.A.S. n�.
Description of
Soil / ,t
a I b A hA l—<&�d M-ham'4 h bl C h6—4 C6
Nature of Repairs or Alterations(Answer when applicable)
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Date last inspected:
- Agreement:
'► The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposalF system in
accordance with the provisions of Title 5 of the Environmental Code and not o plyake `�he�system in operation until a Certificat of
Compliance has been issued by this Board f
Signed Date' / - �r x
t
Application Approved b.��_ Date
Application Disapproved by Date
for the following reasons
"Permit No. Date I u d.
- - - - - -- t ----
-- --- -'--- --------------
THE COMMON A ) OF SAVHUSETTS +
BARN .TABS MASSAC� 7SETTS e
' q .
kertificate of Comphan>ce ,
�` g P Y ( ) p i ( ) Upgraded THIS IS TO CERTIFY,thatkhe n-site Sewage Disposal system Constructed Re aired^ U aded
Abandoned( )by
at has been constructed in accordance
with the provisions of Title 4nd t K Disposal System Construction Permit Ngx lei - dated
Installer A. 1. t Designer
#bedrooms +_ Approved desig ow r} gpd
The issuance of tgiseN it shall not be construed as a guarantee that the system w I cti,.ri as desi d.
r `�$
Date t7 I-1 ci Inspector P
1VV
--- --- - --- ----- --/------ ------------ - --------- --- ------- --------------` � ~'r. �/ j -----------------------
No
- Fee /o d
F MASSACHUSETTS THE COMMONWEALTH O
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Constructio Verrnit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( Abandon( )
System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
ua.
Provided:Construction must be completed within three years of the date of this p'rmit.
Date Approved b \e
i
` 'own of Barnstable
_
".Regulatory SE',I'V1CeS .
t Richard 536fi, Tntet iin Di -cc tot-
BA nvsraBL,;s i
Pub}ic Health I)ivisi<
i634• ��
°—Ma=% 'rbofnas McKean, Qirec:tor.
200 Plain Street,I3yannis,MA 02601
'Office: 508-862-4044
i dv, 508-79,0-6,,04,
Installer&Designer Certifieation Forlri
Date: �� � ServagePermit#:, 'L()�.�_ Assessor's tiap`tPal'cel. - (O
�aZC,: Installer: Q',n .c
Address: 1Z. 4 Cr sZ� IZJ1dd:ress:
t
Oil
l�•-rY�e�r�u��.�/-� G'��t.� _....�.C�.s_���:s�. �t 1�__..Q2:,(�.��S
(date.) "c
�..- -__ ^c�t�l s issued a permit to install a
Installer)
F Septic systen! dt y ,._lam_..�_. DI f�based on a design drawn.by
~
- (addi,�ss)
L�r tc i n-ee'(1 6Vec,f
_ dated
_ l certify that the septic system referenced above tic as insialled:substantially accordiiti; io
the design, i lIieh r ay include minor approved changes such*as lateral relocation of the
distribution:box and/or septic tame. Strip out (if retlui ed) was inspected and the soils
were found'satisfa.ctory.
I certify that the septic system referenced above vvas itistallecl with tilajor than«es { ,e.
greater than, .0' lateral relocation of the SAS or any vertical relocation of any component'
at the septic system} but in.accordance.with State & Local Regulations: Plan revision Or
certified as-built by but
to follow. Strip out(If required')was inspected;arid the!soils
Jvere'Pouni sati.sf,� toil°:
I certify that the system.referenced above Nvas'cUnstrtictecl in with tht tcriti:
f the l`a� til?proval1etters( l'apfIicuhla)
��+a �S4cyL
sF`
pe irGR r�
PACE
Installer's Signature CtVt4
N0.35i08
Al
L esigiier's Sigiiatnrc} , (Affix Designe ere)
PLEASE. RETURN TO''BARNS7`ABLr,, PUBLIC;, HE2ldTf4 D1V1iSION. CGRTIFiCATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL Bum THIS FORM AND':AS
TIL'TI T CARD ARE REC:I?TVED BY THE HARNS'T'AinX,PUBLIC HEALTH DIVINION
hl1Lkj`' ti 1, )U.
rtiticztion'FormRcv8-14-13.dac
Engineers note:This certification is limited to are as built inspention of system cornpone,ils as installed prior to backfill.The
engineer did not supervise construction of the systern.'The ins ialler assumes resoonsibil'ty for all:natorials,wor mansnip,backfdhng
to specified grades with proper compaction and setting risers,'covers as shown on the design plan.
4tc 32334 P a J 67 04731+6
09--27-2019 a 02=000
NOT NOT NOT NOT
AN AN AN AN
OFFICIAL OFFICIAL OFFICIAL OFFICIAL
COPY COPY COPY COPY
NOT NOT NOT NOT
AN AN AN AN
OFFICIAL OFFICIAL OFFICIAL OFFICIAL
COPY COPY COPY COPY
NOT N*ED RES +CTON NOT
AN AN AN AN
OFFICIAL OFFICIAL OFFICIAL OFFICIAL
W11EREASGZWtitution Pies,LLCc15 PV North Md&)Street,Randolph,MA is the
owner of 105 Sterling Road,Hyannis,MA,02601,which premises are shown as Lot 29 on a
plan of land drawn b1pCharles N.SW&y,Inc.,Elders-Serve dated 05/26/1967 and
recorded with BarnsMe County Riptry of DeedDlh Plan Book=3,Page 65;
OFFICIAL OFFICIAL OFFICIAL OFFICIAL
WHEREASCstitution l�aties,LLCe owner qd#lot has agreed with the
Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be
included in any horKhtfilt on sai4,1@tps a pre-coon to obtain a disposal works
construction permit*1jompliance vo*310 CUR M&State En nmental Code,Title V,
Minimum Requigsttig thlb jbt >
WHEREASC,Kyrown of Marble Boaffiffiflealtb,asCaO -condition to granting a
disposal works construction permit for aseptic syAt�in compliance with 310 CMR 15.200,
State Environmental de,Title ' ' imum R eats for ubsurface Disposal of
Sanitary Sewage0 �ricec§� AZ g p A e construction of a
single famil=h0neq, s prope uirmg aa agr re restriction on the
number ofbmm any house constructed on the of be put on record with the Barnstable
County Registry of Deeds by recording this document,
NOW THEREFORE,Constitution Properties,LLC does hereby place the following
restriction on the above-referenoed land in accordance with their agreement with the Town of
Barnstable Board of Health,which restriction shall run with the land and be binding upon all
successors in title:
1. 105 Sterling Road,Hyannis,MA 02601 may have constructed upon the lot a house
containing no more than three(3)bedrooms.Constitution Properties,LLC agrees
that this shall be a permanent deed restriction affecting 105 Sterling Road,Hyannis,
MA.
For title of Constitution Properties,LLC,see the deed recorded with Barnstable Registry of
Deeds,in Book 32268,Page 55.
Bk 32334 Pg168 #47316
NOT NOT NOT NOT
AN AN AN AN
WITNESS my h q40I',l tb W frc pf*VbeVdVXa016FF I C I AL
COPY COPY COPY COPY
Cons ' n p %1,D
NOT NOT NOT
AN AN AN
OFF ICIAL OFFICIAL
Y COPY
By: Mi ha 1 F 'co,Tr1v'bnaJr g
NO NOT T NOT
AN AN AN AN
OFFICIAL OFFICIAL OFFICIAL OFFICIAL
COPY COPY COPY COPY
COMMONWEALTH OF MASSACHUSETTS
NOT NOT NOT NOT
AN AN AN AN
Norfolk,ss. OFFICIAL OFFICIAL OFFICIAL OFFICIAL
COPY COPY COPY COPY
On this 25 of Sep" 2019,before,the undo ed notary public,personally
appeared Michaell Ar ST
co,Mana as aforesaiwved to m ugh satisfactory evidence
fi
of identificationo s hi iEr's 6jjnqAbe �s)whose name is signed
on the preceding or8aed docuynd ac" ed to me"They signed it voluntarily for
its stated purpose.
NOT NOT NOT NOT
AN AN AN, AN
OFFICIAL OFFICIAL I
COPY COPY
My Commission Expires: JENNML iAMOUREM
NO M PUBW
cwffonw&ahh of
1A Com .- non�uZjD�Fx�ires
BARNSTABLE RE61SMY OF DEEDS
J01m F. Mead% Rehr
EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON 7/23/19:
I. Variance — Septic:
A. Peter McEntee, Engineering Works, representing Ronald Charbonneau, Exec.
- 105 Sterling Road, Hyannis, Map/Parcel 268-164, 13,005 square feet lot,
requesting three variances for a repair of a failed septic system.
John Norman expressed concern that the tank is over 30 years old and
recommended using a new combination tank/pump chamber.
Upon a motion duly made by Mr. Norman, seconded by Dr. Guadagnoli, the Board
voted to grant the variances with the following conditions: 1) the septic tank will
be upgraded to a combination tank and pump chamber and any minor changes in
the distance of variances will be acceptable to allow the tank and pump chamber to
fit and 2) a three-bedroom deed restriction must be recorded at the Barnstable
County Registry of Deeds. (Unanimously, voted in favor.)
- y
tIKWE r Barnstable
Town of Barnstable
BARNSTABLE
MASS. 0g Board of Health B
��fo►�`�°� 200 Main Street, Hyannis MA 02601 2007
Office: 568-8624644
FAX: 568-790-6304 Paul J.Canniff,D.M.D.
John Normani
Donald A.Guadagnoli,M.D.
July 26, 2019
Mr. Peter McEntee, P.E.
Engineering Works
12 West Crossfield Road
Forestdale, MA 02644
RE: 105 Sterling Road,Hyannis A 268--164
Dear Mr. McEntee,
You are granted variances on behalf of your client, Ronald Charbonneau, to construct an
onsite sewage disposal system at 105 Sterling Road, Hyannis, Massachusetts.
The variances granted are as follows:
310 CMR 15.405(1): To construct a soil absorption system five (5) feet away from the
side property line, in lieu of the minimum ten feet separation distance
required.
Section 360-1 of the Town of Barnstable Code: To install a pump chamber 73
feet away from a bordering vegetated wetland, in lieu of the minimum 100
feet distance required.
Section 360-1 of the Town of Barnstable Code: To construct a ' soil absorption
system 83 feet away from a bordering vegetated wetland, in lieu of the
minimum 100 feet distance required.
These variances are granted with the following conditions:
(1) The existing 1,000 gallon septic tank shall be replaced with a new 2,000 gallon
(1500/500 combination) tank. The plans shall be revised to show the required
septic tank replacement.
(2) No more than three (3) bedrooms maximum are authorized at this property.
Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type
Q:\WPFIIES\McEnteeCharbonneau Sterling Road Hyannis Variances 2019.docx
rooms are considered "bedrooms" according to the MA Department of
Environmental Protection.
(3) The applicant shall record a properly worded deed restriction, signed -by
the owner of the property, at the Barnstable County Registry of Deeds
restricting the property to three (3) bedrooms maximum. A copy of the
recorded deed restriction shall be submitted to the Health Agent prior to
obtaining a disposal works construction permit.
(4) The septic system shall be installed in strict accordance with the revised
engineering plans.
(5) 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 revised plans.
Physical constraints at the-site severely restrict the location of the septic system due to its
proximity to the pond and high groundwater. The proposed system will be redesigned to meet
the maximum feasible compliance standards contained within the State Environmental Code,
Title V.
Sincerely yours,
y .
Paul a D.M.
Chairman
c
Q:\WPFILES\McEnteeCharbonneau Sterling Road Hyannis Variances 2019.docx
a �
i
DATE:
$95.00 FEE*:
i y rj Y
I BA MASS' I C��
� MASS. $ REC.BY
�
i639 ♦0 ',; Town of Barnstable
QED MP't
SCHED.DATE;-,o'-')02®)?
Board of Health
^` 200 Main Street, Hyannis MA 02601
Office: 508-862-4644
Paul J.Canniff,D.M.D.
FAX 508-790-6304 Donald A.Guadagnoli,M.D.
Junichi Sawayanagi
VARIANCE REQUEST FORM
LOCATION
Property Address: Q H A t S
Assessor's Map and Parcel Number: Size of Lot: 13 —0 O--C—
Wetlands Within 300 Ft. Yes Business Name:
No Subdivision Name:
APPLICANT'S NAME: leek-e-r Q G Phone 5-0 V'
Did the owner of the property authorize you to represent him or her? Yes ✓ No
PROPERTY OWNER'S NAME CONTACT PERSON
Name: 1�,nc.\Gi Cti C.?CC,Name:
1 $-7 1 (0 1-1 ativl-,,',C-CLL t--cl.-,.k 12 W� Cy-.
Address: ems_ ,� (: `Z rci 3 C Address:_IF&�ne StXXr.— �/�Pq � �L4
Phone: 70Y—9 7-2 Phone: 5-6 9- 97
EMAIL: V Ca v�--
VARIANCE FROM REGULATION(Incf.Reg.Code ) REASON FOR VARIANCE(May attach separate sheet if more space needed)
'4�n LAos (a,)
l,e cp.l Red Ch,r:pt 3(0.6—1 tftL
A {}-s 4.r_d. LAAkc—
NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System
Checklist (to be completed by office staff-person receiving variance request application)
Please submit first four on list as 5 collated packets.
A. Five(5)copies of the completed variance request form
B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or
secondary treatment unit(S.T.U.).
C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email:
heal th@town.barnstable.ma.us
D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(I)electronic
version.
A completed seven(7)page checklist confinning review of engineered septic system plan by submitting engineer or R.S.
Signed letter stating that the property or business owner authorized you to represent him/her for this request
Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or
local sewage regulation variances only).
_ Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only).
r Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3) New
owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an
increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance").
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Paul J.Canniff,Chairman
NOT APPROVED Donald A.Guadagnoli,M.D.
C:\Users\decol1ik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\QDLJENHC\VARIREQ Rev APR 4-
2018.docx
r ,
Engineering Works, Inc.
12 West Crossfield Road, Forestdale, MA 02644
'A Tel/Fax(508)477-5313
June 20, 2019
Town of Barnstable
Board of Health
200 Main Street
Hyannis, MA 02601
Re: 105 Sterling Road, Hyannis, MA (Assessors Map 268, Parcel 184)
Upgrade of a failed Soil Absorption System
Dear members-of the:Board:
On behalf of my client, Mr. Ronald Charbonneau, the following variance requests are
being made for upgrade of a soil absorption system.
• 310 CMR 15.405(a)—CONTENTS OF LOCAL UPGRADE APPROVAL
1. A 5' variance, S.A.S. to front property line, for a 5' setback.
• LOCAL REGULATION Chapter 360-1: Location of components with respect
to water body's
2. A 27' variance, pump chamber to bordering vegetated wetland, for a 73'
setback. MASS DEP requires 25'.
3. A 17' variance, S.A.S. to bordering vegetated wetland, for a 83' setback.
MA DEP requires 50'.
Variance requests are being made due to site constraints.
Sincerely,
Peter T. McEntee P.E.
• • V' COMPLETE THI SECTION.ON.,DEL,IVERY
■ Complete items 1,2,and 3. A. Signature
El■ Print your name and address on the reverse X Agent
so that we can return the card to you. 0 Addressee
■ Attach this card16-tlie-back Of the mailpiece, B. Received by(Printed Name) C. Date of Delivery
or on the front if space permits. 1 I
1. Article_Ad_dre_ssed to: D. Is delivery address different from item 1? ❑Yes
- -- _ If YES,enter delivery
'address below: /0
41
Prop:ID:268099 SkiG
I
B ARNSTABLE,TOWN OF
367 MAIN STREET
HYANNIS$MA 02601
��✓ 3. Service Type ❑Priority Mail Express@
it I�Illl Illl 111I Il Ill ll l l III I l i(I'll II II III ❑Adult Signature ❑Registered Mail
0 Adult Signature Restricted Delivery ❑Registered Mail Restricted
kir Certified Mail@ Delwery
9590 9402 4784 8344 0950 97 ❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
2. Article Number,(Transfer from service label) ❑Collect on Delivery Restricted Delivery El Signature Confirmationym
❑Signature Confirmation
{1 1 i7 018 1 113,0 0 0 0 0 0 48 6 3 9 7 2 Restricted Delivery Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKING#
First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
9590 9402 4784 8344 0950 97
United States •Sendee:Please print your name,address,and ZIP44®in this box•
Postal Service �— -- - — - — -
Engineering works, Inc.
112 West Crossfield Road I
Forestdale, MA 02644
M
II
Jill l:
e e e 7ASignature
■ Complete items 1,2,and 3.
la Print your name and address on the reverse ❑Agent
so that we can return the card to you. ❑Addressee
e Attach this card to the back of the mailpiece, eived) d Name) C. Date of elivery
or on the front if space permits.
,—A -A X D. Is delivery address different from item 1? ❑Yes
j If YES,enter delivery address belo •• ❑No
Prop IDi 268164
CHARBONNEAU, ROGER L ESTATE"I
18716 HAMMOCK LANE
DAVIDSON,NC 28036 I�C
II i IIIIII IIII III I II IIII I I I IIIII I II I I II I II II III 3. Service Type ro Priority Mail Express
❑Adult Signature ❑Registered Mail?"'
❑Adult Signature Restricted Delivery ❑Registered Mail Restricted
9 �Certified Mail® Delivery
590 9402 4464 8248 141 0 80
❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
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l —;^'-- Mai ❑Signature Confirmation
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PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt .•�
uses�ncr!v��.#w
First-Class Mail
t. Postage&Fees Paid
USPS
Permit No.6-10
9590 9402 4464�8248 1410 80
United States •Sender:Please print your name,address,and ZIP+40 in this box•
Postal Service
Engineering Works, Inc.
12 West Crossfield Road
'Forestdale, MA 02644
• Complete items 1,2,and 3. A. Signature 1:1 Agent
• Print your name and address on the reverse
so that we can return the card to you. X 1:1 Aodressee
• Attach this card to the back of the mailplece, B. Received by(Printed Name) C. Date ry D IN
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or on.the front if space permits. 1 )0 5
1 -article-Aridra�cerl-tn D. Is delivery address different from item I 's/
If YES,enter delivery address below: No
Prop I D:268197
CHIPMAN, EDWARD A &MARJORIF,
1 13 STERLING RD
1-'I'YANNIS, MA 02601
3. Service Type 0 Priority Mail Express@
0 Adult Signature 11 Registered MaHT"
0 Adult Signature Restricted Delivery 0 Registered Mail Restricted
4oP Certified Mail® Delivery
9590 9402 4464 8248 1411 03 0 Certified Mail Restricted Delivery 0 Return Receipt for
10 Collect on Delivery Merchandise—1'r,--fP.rfrnm-service1abq1) 0 Collect on Delivery Restricted Delivery El Signature ConfirmationTM
7018 _ __I-m--1---f-Mail El Signature Confirmation
01100.13lP -3444 Aail Restricted Delivery Restricted Delivery
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PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
UPS r
�''�`��~•E~ '�`-" First-Class Mail
Postage&Fees Paid
LISPS
Permit No.G-10
9590 9402 4464 8248 1411 03 -
United States •Sender: Please print your name,address,and ZIP+4®in this box*
Postal Service
Engineering works, Inc.
,12 West'Crossfield Road
orestdale, MA 02644
I
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- i
'111'11IN'fUl'lll.11rl Will,tjIr IJillrtiilrII/ilI/ ill Ill '
o Complete items 1,2,and 3. A. Sign a
® Print your name and address on the reverse X ❑Agent
so that we can return the card to you. ❑Addressee
■ Attach this card to the back of the mailpiece, B. Receive by Printed Name) C. Date of Delivery
or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
If YES,enter delivery addref below: ❑No
Prop ID:268204" M ,
{ ''MCCREA, KEVIN
218 WEST SPRINGFIELD STREET
f30STON, MA 02118V/� I
IIIllllll I'll IIIIiI Illl II Illil l Il l I� Il I li III 3. Service Type ❑Priority Mail Expresso
❑Adult Signature D Registered Mai�TM
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9590 9402 4464 8248 1411 10 [*Certified Mall@ Delivery
❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
❑Collect on Delivery Restricted Delivery Signature ConfirmationTM
_2._Article Number(Transfer from service label). ❑Signature Confirmation
n-i-insured Mail 9
7 018 .0'3 6i0;:0 0:0 0 3 91:7.3 41S.' i 1 er 500 Restricted Delivery
s f 4.6ed Mail Restricted Delivery=
f $ )
PS Form 3811,July 20*15 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKING#
First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
j 9590 9402 4464 8248 1411 10
I �
i United States •Sender:Please print your name,address,and ZIP+4®in this box*
i Postal Service
Engineering Works, mc.-
i 12 West Crossfield Road
i =orestdale, MA 02644
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tems 1,2,and 3. A. Signature
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--- D. Is delivery address different from item 1? Ye
If YES,enter delivery'addrgss below: Cl No
Prop ID:268205 s �n�(/�
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I ' SULL,IVAN, WALTER C& MAUREET
70 BRINGTON RD ' JUL 10 2019
BROOKLINE, MA 02446 4 J
3. Service Type _`;�.--13 Priority Mail Express®
SignatureEl Adult
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Postal Service
,Engineering works, Inc.
12 West Crossfield Road i
�Forestdale, MA 02644 E
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7/1/2019 AbutterReport
Board of Health Title V Septic Variance Abutter List for Map
& Parcel(s): '268164' 1
Direct abutters (no set distance) and the properties located across the street.
Total Count: 5 " Close
Map& parcei w n e Addressl Addr :�s 2 L,.n�d
&y staf ezip
BARNSTABLE,
268099 TOWN OF 367 MAIN STREET HYANNIS,MA 19847/223
(BRNWATER) 02601
CHARBONNEAU, 18716 HAMMOCK DAVIDSON,NC
268164 ROGER L ESTATE LANE 28036 BA19P1010EA
OF
CHIPMAN, HYANNIS, MA
268197 EDWARD A & 113 STERLING RD 02601 12377/2
MARJORIE M
218 WEST BOSTON, MA
268204 MCCREA, KEVIN SPRINGFIELD 02118 24860/88
STREET
�_...._ ...w.... _. _.._ ._
SULLIVAN,
268205 WALTER C & 70 BRINGTON RD BRO0KLINE, 4615/1
MAUREEN &FORD, MA 02446
GRA
This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters. If a certified list of abutters is required, contact the Assessing
Division to have thislist certified.The ownerand addressdata on thislist isfrom the Town of Barnstable Assessor's database asof 7/1/2019 .
t
r
r
http://maps.tomofbarnstable.us/arci rns/appg eoapp/AbutterReport.aspC?type=BOH 1/1
Town of Barnstable Geographic Infori'nation System July 1,2019
a 269114 265111
268273 269168
#297 #55 26$304 #73' 268199 #138 268207 269095CND 290104CND #9282
268094 #53 O ® #129 268168 #127
268274 288187 049 Ca 268167 #125 289161
#291 #E 39 #1 268172 #3g
268170 268171 #so-
268198 : .'.;;:...:.`...;:;. ..s #66
26827e 26° 268202 #121 268205:; 2#7 L L'N�/jR.
#268 :d`•.::. "ice:' 268`69
268275 288197: 7`•' #80» A 289135
#118 #113* :?.: ..;; ,' • V a89
268096
268151
268201 268164;
268160
726821 #51 ;•: #69 289027
#1230 2 C]
#79
8'
268161 268152
26 097
#81
#14
29 288 8
#�48 268203
#115 # r 268162
.68278 t 91 y
'W#87
268159
M
253
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6 9 -
268153
26827 09 2 8 8 - P
a
#249 #234
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- - 268158
26
8281 #37
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#2 6
39
2 81 7
268 280
268154
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#24 7
34
268224
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268155
#225 #42
26
8239
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t L :..
268240- G #216 ::;;;:(:':7.;- '.iI L`%':::':.' : ':= ::;:-':..`::{•::}'.i: :J:i:: . •,. #45
: -:::::.•.•.::.t...::•.•..•.
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268 238
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6
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268 27
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268235 #177 268303
#34 • #0
268245
#351 C ,aqw t, 268103 .,.•:...:.:. ....: .:::...::•:.
268219 h #166 26821 268 268126 @P68127
268234 #167, 268124 268125 E#52 #`� f
�6#842,4�6(� 4 268123 '#36� '#44
� 8 122 #28 268128
#157 #18' #62
DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:268 Parcel:164 Board of Health Title V Septic Variance N
boundary determination or regulatory interpretation. f=nlargements beyond a scale of Selected Parcel
1?-100'may not meet established map accuracy standards. The parcel lines on this map Abutter List Type-Direct abutters(no set distance)and the properties located
are only Seraphic representations of Assessor's tax patcels. They are not true property across the street. Abutters W E
boundaries and do not represent accurate relationships to physical features on the map f' `
such as building locations. Buffer
Y7/1/2019 AbutterReport
Board of Health Title V Septic !Variance Abutter List for Map
& Parcel(s): '268164'
Direct abutters (no set distance) and the properties located across the street.
Total Count: 5 close
Mailing Count Deed
Ma &Parcel
Ownerl Owner2 Address 1 Address 2 Country P CityStateZip
BARNSTABLE, HYANNIS,MA
268099 TOWN OF 367 MAIN STREET 02601 19847/223
(BRNWATER)
CHARBONNEAU, 18716 HAMMOCK DAVIDSON,NC
268164 ROGER L ESTATE LANE 28036 BA19P1010EA
OF
CHIPMAN, HYANNIS,MA
268197 EDWARD A & 113 STERLING RD 02601 12377/2
MARJORIE M
218 WEST BOSTON,MA
268204 MCCREA,KEVIN SPRINGFIELD 02118 24860/88
STREET
SULLIVAN,
WALTERC & BRO0KLINE, 4615/1
268205 MAUREEN &FORD, 70 BRINGTON RD MA 02446
GRA
This list by itself does NOT constitute a certified list of abutters and is provided only asan aid to the determination of abutters.If a certified list of abutters is required, contact the Assessing
Division to have this list certified.The ownerand addressdata on thislist isfrom the Town of Barnstable Assessor's database asof 7/1/2019.
http://maps.tovmofbarnstable.us/arcims/appgeoapp/AbutterReport.aspWtype=BOH 1/�
Engineering Works, Inc.
12 West Crossfield Road, Forestdale, MA 02644
Tel/Fax (508)477-5313
June 20, 2019
Re: 105 Sterling Rd, Hyannis, MA (Assessors Map 268, Parcel 164)
Upgrade of a failed Soil Absorption System
Dear Sir/Mam:
Please be advised that an application for variances from the Massachusetts Department
of Environmental Protection, Title 5, and Local Regulations have been submitted to the
Barnstable Health Department for approval. The following variances are being
requested:
• 310 CMR 15.405(a)—CONTENTS OF LOCAL UPGRADE APPROVAL
1. .A 5' variance, S.A.S. to front property line, fora 5' setback.
• LOCAL REGULATION Chapter 360-1: Location of components with respect
to water body's
3. A 27' variance, pump chamber to bordering vegetated wetland, for a 73'
setback. MASS DEP requires 25'.
4. A 17' variance, S.A.S. to bordering vegetated wetland, for a 83' setback.
MA DEP requires 50'. -
The application and plans are available for review at the Barnstable Health Department,
200 Main Street, Hyannis, MA, Monday through Friday (excluding holidays) from 8:30
a.m. to 4:30 p.m.
A public hearing will be held, to discuss the proposed work, on Tuesday, July 23, 2019,
at 3:00 p.m. The hearing will be held at the following location:
Town Hall Hearing Room—2"d floor
367 Main Street, Hyannis, MA
erely,
Peter T. McEntee P.E.
TRANS. NO.:
CITY/TOWN: L 13 �=✓1 S �1-
J
APPLICANT: 0'-d^-C'&a ,�� `y•n,n c�
ADDRESS: VC-5-
DESIGN FLOW- �3 C) gpd
REVIEWED BY: Q� DATE: —7
N/A OIL NO
GENERAL
Legal boundaries denoted[31.0 CMR 15.220(4)(a)] t�
Street, Lot, tax parcel number and lot number noted on plan. [310
CMR 15.220(4)(u)]
Locus Provided [310 CMR 15.2204(t
Plan proper scale? (:I"=40'.for plot plans, 1"=20' or fewer for ✓,
components) [310 CMR 15.220(4)]
Easements shown [310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- if not, a variance is,required [31.0 CMR. 1,5.41.2(4)]
Location of impervious surfaces (driveways,parking areas etc.) ✓
1310 CMR 15.220(4)(d)]
Location all buildings existing:and proposed 310 CMR ✓
15220.(4)(c)]
Location and dimensions of system components and,reserve
areas. [310 CMR .15.220(4)(e)]
System.Calculations.[310 CMR 15.220(4)(f)]
daily flow
septic tank capacity (required and rovided) ✓
soil absorption system. (required_and rovided)
whether s stein designed for garbage grindei c/
North.arrow[310 CMR 15.220(4)(g)] +✓
Ex isting and proposed contours[310.CMR 15,220(4)(9)]
Location and log of deep observation holes(existing grade el, on
each test) [310 CMR 15.220(4)(h)]
Names of soil evaluator and.BOH representative [310 CMR
15..220 (h) and(i)]
Location and date of percolation.tests (performed at proper
elevation?) [310 CMR 15,220 4 i)]
Percolation test results match loading rate? 31.0 CMR 15.242
Certification statement b Soil Evaluator[310 CMR 15.220(4) " ]:
Observed and Adjusted groundwater(inethod_for adjustment
given or. indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)]
Address Sheet 1 of 7
r
J
NIA OK NO
Location of every water supply,public and privatey,[310 CMR _, p
15;220(4)(k)]
within 400 feet of the proposed system location in the case
of.surface water supplies and gravel packed public water supply
within 250 feet of the proposed system location in the case
within 150 feet of the proposed system location .in the case
of private water s ply wells
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch.basins
located within 50.ft. [310 CMR .15220(4)(1)]
Waterlines and other-subsurface utilities located [310 CMR
15.220(4)(ni ] (if water line cross see 310 CMR 15.211.(1)[1])
Profile of system showing invert elevations of all system
components and the bottom of the SAS "310 CMR15.220(4)(6
Stamp of designer [310 CMR 15.220(1) and 310.CMR 15.220(2)1
Stamp of Registered Land Surveyor(required if construction
activities within.5 ft. of lot line) 310 CMR 1:5.220(3)].
Test Holes adequate(two in eaeh of the primary and reserve
lidless trenches as permitted in 310 CMR 15.102(2) or as
approved for an upgrade under LUA at 31:0 CMR 1.5.405(1)(k
Test hole adequate to demonstrate four feet of suitable material?
[310 CMR 15.103(4)] ✓
Test Holes adequate to confn-rn adequate groundwater separation?
[31.0 CMR 15.103(3)]
Benchmark within 50-15' of system 3.10 CMR 15220(4
Materials specifications noted? [various sections of 310 CMR
15.000' ✓
System components not> 36" deep(unless Local Upgrade /
Approval or LUA re uested) [310 CMR 15.405(1(b)] r/
:address
Sheet 2 of 7
I_
N/A OK NO.
SEPTIC TANK
Size OK? [310 CMR 15.223(1
Inlet tee located ten inches below flow line 310 CMR 15:227(6)]
Outlet tee 1.4" or 14"+ 5" per foot for increase ft depth [31.0 CMR
15.227(6)]
Outlet tee with gas baffle or approved filter [310 CMR. 15.227(4)] ✓
Note regarding installation on stable compacted base [310 CMR
15.228(1)]
Separation between:inlet and outlet tees (no less than liquid.
depth) [310 CMR I5,227(2
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5))or permitted for
'upgrades under LUA 1310 CMR 15.405(1) k ]
minimum cover 9" (Tanks buried more than 9"must have risers
on all openings and on the d-box) [310 CMR 1.5.2228(l) and 310
CMR 15.232(3)(f)]
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (by 7/07) -31.0 CMR 15.228(2)]
Access to within 6 of grade one port for systems<.1.000gpd,
two for systems>1000 gpd [310 CMR 15.228(2)]
All at-grade covers secured to unatithorized.access? [310 CMR
15.228(2)]
> ,10 ft from building foundation [31,0 CMR, 15.211(1)]
Buoyancy calculation Required/Done 3'.10 CMR 15.221(8)]
H-20 Where appropriate? 3.10 CMR 15.226(3)]
Setbacks from resources[3,10.CMR 15.211.
Niulh�,Com artment TkanksF
Re uired when other than sm le-fandl dwellin or flow>1.000
d 310 CMR 15.223 1 (b)]
First compartment 200% daily flow; Second compartment 100%
daily flow 310 C:MR 15.224(2) and 3 ]
"U" pipe through or over baffle, outlet of each compartment with
gas baffle or approved filter [310 CMR 1>5.224(4
Address Sheet 3 of 7
_._..._........_.........
_ 1
N/A. OK NO
BUILDIIYG,SEWER:AND O'I'HER,_1PIPING, ;:
Located at least ten feet from any water line? [310 CMR
15.222(2)]
Disposal piping at least 18" below water line (when water and
sewer cross, see 310 CMR 15.211 1 1
Cleanouts required/provided ? 310 CMR 15.222(8)]
Thrust blocks s ecified in force mains? 310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
[310 CMR 15.222(6)] f
Proper pitch on all rains? (.005 within gravity-distributed trenches
and beds) [31:0 CMR 15.251(9) and 310 CMR 1.5.252 2 c)
Siphonproblem/(leachfield below ump chamber
Endca s or vent manifoldspecified?`
Size and orientation,of discharge holes specified? (not smaller
tlhan..M"riot larger than 5/8") [310 CMR 15.251(8) and 310
CMR 15.252(2)(11)]
Materials specified (310 CMR 15.251(5)specifies various pipe /
types allowed
DISTRIBUTION'"X
Stable compacted base [310 CMR 15.221(2) and 310 CMR
15.232(2)(a))
Splash plate.or baffle tee required on inlet/provided? (when /
pressure.sewer to d-box or steep pitch of gravity sewer) [310 ✓
CMR 15.323 3 (a
Riser if deeper than 9" 3.10 CMR 15.232(3)(f)]
Inside minimum dinnension 12 [310 CMR 15.232(2)(b ]
Minimum sump b" [310 CMR15132(3)(e)
Watertight cover if<2000gpd); waterproof manhole if>2000gpd ✓/
310 CMR 1:5.232(3)(d)]
PIJ VIP CHAMBERS
Capacity(emergency storage above working—design flow)? [310
CMR 231 2 ] t/
Proper setbacks [31.0 CMR 15:211 (same as se tic tanks)]
Watertight 20-in miniurri access manhole at least 20"MUST BE /
TO GRADE 310 CMR 15.231(5)] V
Service components accessible.(not too deep with piping,
disconnects accessible)
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag f
mode. 31.0 CMR 15.231(6) and 8 ]
Stable Compacted Base. 310 CMR 15221 2 l
Buoyancy calculations needed.?Provided? 310 CMR ISM 8)]
Address Sheet 4 of 7
f
N/A OK NO
SOI`LA� ORPTIONSI'STEMS{SASj GENERAL a
W.. �. b. - ._e
Calculations correct?
4 feet of naturally occurring material demonstrated?[310 CMR
15.240(1)]
-Required separation togroundwater? [310 CMR 15.212) f
Aggregate specified as double washed [310 CMR 15.247(2)]
System Venting.required/provided? (system under driveway or
>3 6" deep) 310 CMR 1.5.241] `/
Inspection ports specified and within 3"final grade? [310 CMR
15.240(13)]
Breakout requirements met? (No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document]
GAL £E1IESPPITS CIIAMBICRS �310 CMR 15 253
,.. ,. ., >. . ,..x.. .,._.
Chambers and.Gal. in trench configuration supplied with..inlet
every 20 ft. [310 CMR :1.5.253(6)]
Each structure with one..inspection rianhole:(if>2000 gpd:mist. , n
be tograde) 31.0 CMR 15,253.(2)] /V
Aggregate:P minimum- 4'maximum. [310 CMR 15.253(1)(b)]
2' sidewall credit maximum [310 CMR 15,253 l)(a)]
In bed configuration, inlet every 40 sq. ft. [310 CMR 15.253(6)]
T�ZElVCHES�1��CMR 15 Z""51; `,
Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)]
1.00 feet-maximum length. [310 CMR 15.251(1)(a)]
Minimum separation 2x effective depth or width whichever
greater(3x if reseive between trenches) [310 CMR 251(1)(d)]
Situated along contours [310 CMR 15.251(2)]
Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document]
BEll,SAS(Maximum size of bed or„fielt] 5000 pd)„. , ,
minimum 2 distribution lines [310 CMR 15.252(2)(a)]
Maximum separation between lines 6' [31,0 CM R15.252(2)(d)] f
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)'e)]
Aggregate depth below discharge pipes 6" minimum, 1211 /
maximum. [310 CMR 1.5.252(2)(: )] `�
Se aration.between beds 10' minimum. [310 CMR 15.252(2)(f)] _
Bottom area used in'calculations only [310 CMR 15.252(2)(1)]
Address Sheet 5 of 7
I�
i
N/A OK NO
Pressure Dosed System ? .Provided pump and piping
calculations as required 310'CMR 15.220(4)(r)] e/
Pressure dosing required:on all systems>2000gpd or alternative
systems under remedial approval[310 CMR 15.254(2) and ILA
Remedial Use Approvals]
If used in gravelless systein.-make sure jet is directed.as notao.
scour soil interface[Guidance Document]
Inspections once per year.(systems<200.0.gpd)or quarterly
(>2000 d) ggood,to note on plan[310 CMR 15.254(2)(d)]
Construction in fill -Did the plan specify that the fill shall meet
the specification of 310 CMR 15.255 3 ?
Impervious barrier and/or retaining wall? [Guidance Document] A.
Impervious barrier installation must be supervised by
designer[310 CMR 15.2.55(2)(b)]
Retaining wall must be designed by Registered Professional
Engineer 310 CMR 15.255(2)(a)]
Side slo e not exceed 3:1 ? [310 CMR 15.255(2)]
Breakout requirements met? [3.10 CMR 15.2-52(2) and
Guidance Document]
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended 3.10 CMR.15.255 2 (e)]
Gru'velless,Systcr�ajtl/19f Appraval,LettersJ
Check DEP Approval.letters for credits,and desi conditions
Tf used with pressure dosing do riot allow pressure discharge
to scour soil interface
Alternatcye'Se tic's stem,�/AFC rwul Letters - ,r ,, .., ,. , ,
Was DEP Approval .Letter provided and/or have you
reviewed the letter for conditions.
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a note on the plan.regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a copy of amaintenar ce,
Variances ;` s
�Are�.the variances listed on the plan ? [310 CMR 15.220
X/
4
RLS Stamp necessary on plan if a component is within five /
feet of roe line [310 CMR.15.412(4)] V
New construction or increased flow proposed [Refer to 310 /
CMR 15.414]
Address Sheet 6 of 7
E
N/A OK NO
Is the system in a Designated Nitrogen Sensitive Area(Zone II for
a public supply well)? [310 CMR,.15:.214, 310 CMR 15.215 and
310 CNM 15.21.6 also refer to Policy regarding upgrades of such'
existing.exiqigg.systems]
Is the system proposed on the same lot as served by private well.?I
[310CMR15.2142 ]
Are the nitrogen loads proposed in compliance? [310 CMR
15.216(1
Pum in. to se tic tank,? [310:CM.R 15.229
Shared System [3°10 CMR 15..200]
Address Sheet 7 of 7
•f/
• ,t
T
Barnstable
,oF"TKE Town of Barnstable
Inspectional Services ;eeieaC"®
ttb�t'XBLF,.
Public Health Division
e
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas A.McKean,CHO
FAX: 508-790-6304
CERTIFIED MAIL#7015 1730 0001 4987 7749
May 13, 2019
CHARBONNEAU, ROGER L
18716 HAMMOCK LANE
DAVIDSON,NC 28036
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 105 Sterling Road, Hyannis, MA was inspected on
04/08/2019 by Joseph M. Martins, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Needs Further Evaluation"
under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following:
• Leaching lines are obstructed.
You are ordered to repair or replace the septic system within two (2) years from the date
you receive this notification.
Failure`to repair/replace the septic system within the deadline period will result.in future
eriforcement action.
PER ORDER OF THE BOARD OF HEALTH
h c ean, R.S., C
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mail ing\Fail ed or Needs Further Evaluation Letters\105 Sterling Road Hyannis.doc
p . oOMEN
.
Er
rO Certified Mail Fee '9�'02122
$ 1.•
Extra Services&Fees(check box,add/ee§�appibp ate)
r q ❑Return Receipt(hardcopy) $ /Crn U [�
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Total Postage and Fei r�ti
$ CHARBONNEAU, ROGERzL"
� 'SentTo 18716\HAMMOC,K.LANE
Street andApti iVo.;or DAVIDSON;'�NG28@36
City,State,Z%P+4�
:441.
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A. Signature �—
■ Com fe items1'2,and 3. ---------
■ Print your'naine and,-address on the reverse X ❑Agent
E so that we can return the card to you. ❑Addressee
■ Attach this card to the back of the mailpiece, B. Received ame) C. D to of Delivery
or on the front if space permits.
1. Al D. Is delivery address different from item ? ❑Yes
IiF If YES,enter delivery address below: ❑No
CHARBONNEAU, ROGER L
18716 HAMMOCK LANE
DAVIDSON, NC 28036
II I IIIIII IIII III I II IIII III I I III II II I IIII IF Service Type ❑Priority Mail Expresso
El
❑Adult Signature ❑Registered MaiIT""
❑ dult Signature Restricted Delivery ❑Registered Mail Restricted
9590 9402 4798 8344 8567 83 ertified Mailo y Delivery
Certified Mail Restricted Delivery feturn Receipt for
❑Collect on Delivery erchandise
-Article_Numberffransfer fromservice label) ❑Collect on Delivery Restricted Deliveryignature Confirm
ationT^'
e, , , ,{ � ❑Signature Confirmation
7 01151117 3 O 1 b 0n01�14A 8 7 7 78 7 7 7 4 9 • '�Restricted Delivery � Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKNG#
First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
9590 9402` 344 8567 83
i
United States •Sender:Please print your name,address,and ZIP±4®in this box*
Postal Service
Ot
Town of Barnstable
Health Division
200 Main Street
Hyannis, MA 02601
I
1.11,;111'I l is fit,111 i y 1111:1.1,1 111'11111111111 111.��d1,
i l
Town of Barnstable
a
+ BARNSfA6LE.
9�A b 9 ,�� Regulatory Services Department
fFD MA'S a
Public Health Division
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Richard Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6, 2007
Rev. 5/11/16
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §360-44 and Title V: 310 CMR 15.000)
An"x" marked in the ❑ is the failure criteria and associated repair deadline
60 DAY DEADLINE CRITERIA
❑ Discharge or ponding of effluent to the surface of the ground
❑ Pumping more than 4 times during the last year not due to clogged or obstructed
pipe.
❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool
ONE (1) YEAR DEADLINE CRITERIA
❑ Static liquid level in the distribution box above outlet invert due to an overloaded or
clogged SAS or cesspool
❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation
❑ Any portion of the cesspool within a Zone 1 to a public well
❑ Any;portion of a cesspool within 50 feet of a private water supply well with no
acceptable water quality analysis. (This system passes if the water analysis
indicates the well is free from pollution).
TWO (2) YEAR DEADLINE CRITERIA
❑ Single Cesspool
❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation
of a driveway due to 11-10 components, etc)
❑ Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OT ER
e-A /t lo e-
Repair deadline: 411 C
I
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA ✓
Property Addressi
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@venzon.net
Owner Owner's Name Cra
information is
required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection i".�
C�
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. Inspector Information
on the computer,
use only the tab Joseph M Martins
key to move your Name of Inspector
cursor-do not Accu Sepcheck
use the return Company Name
key.
17 Northside Drive
Company Address
South Dennis MA 02660
City/Town State Zip Code
508-385-5891 SI 147
Telephone Number License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address
listed above; the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems.After conducting,this inspection I have determined
that the system:
1. ❑ Passes
2. ❑ Conditionally Passes
3. ® Needs Further Evaluation by the Local Approving Authority
4. ❑ Fails
4/22/2019
spector'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 form should be sent to the system owner and copies sent to
9Y P
the buyer, if applicable, and the approving authority.
Please note: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.
t5insp.doc-rev.7/WO18 Tine 5 Offidal Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) System Passes:
❑ I have not found any information which indicates that any a failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any re criteria not evaluated are
indicated below.
Comments:
2) System Conditional Passes:
❑ One or more system components as described in the"Conditional Pass" ction need to be
replaced or repaired.The system, upon completion of the replacement repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the fol wing statements. If"not
determined,"please explain.
The septic tank is metal and over 20 years old*or the septi to ( ether metal or not)is structurally
unsound, exhibits substantial infiltration or exfiltration or to k is imminent. System will pass
inspection if the existing tank is replaced with a complying s tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structur sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 y rs o is available.
❑ Y ❑ Na ❑ ND(Explain belo
t5insp.doc•rev.7/26WS Title 5 Official Inspection Form:SubsurfaceSevage Oisposal System Page 2 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@vedzon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
2) System Conditionally Passes(cont.):
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
❑ Observation of sewage backup or break ou/YN
er I el in the distribution box due
to broken or obstructed pipe(s)or due to a u van distribution box. System will
pass inspection if(with approval of Board o
❑ broken pipe(s)are replaced N ❑ ND(Explain below):
obstruction is removedN ❑ ND(Explainbelow):
distribution box is leveled or replacN ❑ ND(Explain below):
❑ The system required p m i ore than 4 times a year due to broken or obstructed pipe(s). The
system will pass insp cti i with approval of the Board of Health):
❑ broken pipe( ) replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction ' removed ❑ Y ❑ N ❑ ND(Explain below):
3) 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.
a. 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:
t5insp.doc•rev.7/26/2018 Title 5 official Inspection Fort:Subsurface Sewage Disposal System-Page 3 of 18
c� Commonwealth of Massachusetts
Title 5 Official Inspection Form
'0 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est.of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspecti
C. Inspection Summary (cont.)
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetat wetland or a salt marsh
b. System will fail unless the Board of Health (and Publi ater Supplier, if any)
determines that the system is functioning in a manner at protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption ystem (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a rface water supply.
❑ The system has a septic tank and SAS and t SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS a d the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and S 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 w er ana is, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates s n and t presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provi d at other failure criteria are triggered.A copy of the analysis must
be attached to this form.
c. Other:
SYSTEM IS 52 YEARS OLD AND SAS IS WITHIN 92'OF POND. ORANGEBURG PIPE IS
THROUGHOUT THE SYSTEM. SAS IS WITHIN 0.5'OF HIGH GROUNDWATER.
ORANGEBURG PIPES EXITING THE DBOX ARE OBSTRUCTED AND ONLY A 1" SNAKE CAN
GET THROUGH EACH LINE.
4) 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
t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ ® 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%day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply
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 2000 gpd- .
10,000 gpd.
® ❑ 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.
5) Large Systems: To be considered a large system the system mu s erve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems,you must indicate either"yes"or"no"t ach he following, in addition to the
questions in Section CA.
Yes No
❑ ❑ the system is within 400 feet of surface drinking water supply
❑ ❑ the system is within 200 fe of a tributary to a surface drinking water supply
❑ ❑ the system is located i a nitrogen sensitive area(interim Wellhead Protection
Area—IWPA)or a pped Zone II of a public water supply well
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c%Atty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
If you have answered"yes"to any question in Section C.5 the system is considered a significant
threat, or answered"yes"to any question in Section CA above the large system has failed.The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner
should contact the appropriate regional office of the Department.
6. You must indicate"yes"or"no"for each of the following for all inspections:
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?
El ® 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)]
t5insp.doc•rev.7/260118 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information
1. Residential flow Conditions:
Number of bedrooms(design): N/A Number of bedrooms(actual): 3
1 I : 11 # f bedrooms): 330
DESIGN flow based on 310 CMR 5 203(for example: 0 gpd x o bed oo s)
Description:
1000 GALLON SEPTIC TANK, DISTRIBUTION BOX, AND A LEACH FIELD. SYSTEM
CONTAINS ORANGEBURG PIPE AND FIELD IS ORANGEBURG PIPE AND STONE.
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Does residence have a water treatment unit? ❑ Yes ® No
If yes, discharges to:
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 ears usage d 26
9 ( Y 9 (gP ))�
Detail:
2017: 18,750 G ; 2018: 0 G LAUNDRY GOES OUT FRONT ON TO GROUND.
Sump pump? ❑ Yes ® No
Last date of occupancy: 2017
Date
t5insp.doc•rev.7/26Y2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
2. 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
Water treatment unit present? ❑ Yes ❑ No
If yes, discharges to:
Industrial waste holding tank presen . ❑ Yes ❑ No
Non-sanitary waste discharged to t e tie system? El Yes ❑ No
Water meter readings, if,available,
Last date of occupancy/use: Date
Other(describe below):
3. Pumping Records:
Source of information: UNKNOWN
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped:
gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc-rev.7262018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 8 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owners Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
4. 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/Altemative 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 11A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components,date installed(if known)and source of information:
52 YEARS. SYSTEM INSTALLED IN 1967 PER TOWN HEALTH DEPT
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. 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: >6
feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
NO EVIDENCE OF LEAKS.
t5insp.doc•rev.726=18 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 1
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: APP 8.5 X6X5 1000 G
Sludge depth: 18 INCHES
Distance from top of sludge to bottom of outlet tee or baffle 18 INCHES
Scum thickness 0 INCHES
Distance from top of scum to top of outlet tee or baffle 6 INCHES
Distance from bottom of scum to bottom of outlet tee or baffle 12 INCHES
How were dimensions determined? CORETAKER
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
HAS CONCRETE INLET TEE AND CONCRETE OUTLET TEE. PUMPING IS RECOMMENDED NO
EVIDENCE OF LEAKAGE. HAS ORANGEBURG LINES IN AND OUT.
t5insp.doc-rev.7262018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 16
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartiaw@verizon.net
Owner Owner's(dame
information is required for every Plymouth MA 02360 4/8/2019
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
7. Grease Trap(locate on site plan):
Depth below grade: N/A
feet
Material of construction:
concrete metal fiberglasspolyethylene other(explain):
❑ ❑ ❑ 9 ❑ ❑
Dimensions:
Scum thickness
Distance from top of scum t/evidence
or baffle
Distance from bottom of scutlet tee or baffle
Date of last pumping: Date
Comments(on pumping recnlet and outlet tee or baffle condition, structural inte rity,
liquid levels as related to ouce of leakage, etc.):
8. Tight or Holding Tank(tank must be pumped at tim/inspectiopno) n site plan):
Depth below grade:Material of construction:
❑concrete ❑ metal ❑fiberglae ❑other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
t5insp.doc•rev.7/Y M18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank(cont.)
Alarm present: /etc.):
❑ No
Alarm level: ng order: ❑ Yes ❑ No
Date of last pumping:
Comments(condition of alarm and fl al
V
V
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
9. Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert AT INVERTS
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.):
HAS ORANGEBURG PIPE IN AND OUT . BOTH LINES OUT ARE OBSTRUCTED. ONE PIPE IN
AND 2 PIPES OUT.
t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owners Name
information is required for every y PI mouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order. ❑ Yes ❑ No*
Alarms in working order. ❑ Yes ❑ No*
Comments(note condition of pump chamber, conditio of pumps and appurtenances, etc.):
* If pumps or alarms are not in worki order, system is a conditional pass.
11. Soil Absorption System(SAS)(I cate on site plan, excavation not required):
If SAS not located, explain why-
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
® leaching fields number, dimensions: 6,X10 APP
❑ overflow cesspool number.
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.MAWS Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c%oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
11. Soil Absorption System(SAS) (cunt.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
THERE IS STONE IN THE FIELD FAIRLY CLEAN.
12. Cesspools(cesspool must be pumped as part of inspection) (loc to 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' flow ❑ Yes ❑ No
Comments (note cond' on of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5insp.doc•rev.726=8 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 18
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green.N#311, PMB 601 dphartlaw@vedzon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
13. Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydrau' failure, level of ponding, condition of vegetation,
etc.):
t
t5insp.doc•rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est of Roger Charbonneau c%Atty Don Hart 3 Village Green N#311, PMB 601 dphartlawQver¢on.net
Owner Owner's Name
infbrmation is
required fd Plymouth MA 02360 4/8/2019
required for every
page. c4frown State Zip code Date of Inspection
D. System Information (cont.)
14. 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
F fto Wr C1 a
A 8
w
1 O
2 O
Ark- 2a.s
�►3= 36.s as= 37 3 s, HQ
A(f =4 4' , 8ct=21.S
As= 57.5`1 651=24'
N_
t%W.de-rev.7/l6MB Tft 5 OM"bmpecbm FOM Siftafeoe Sewage Diet SysWm-Pie 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owners Name
information is required for every Plymouth MA 02360 4/8/2019
Cityrrown
page. State Zip Code Date of Inspection
D. System Information (cont.)
15. Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 5
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: 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:
FRIMPTER
You must describe how you established the high ground water elevation:
HAND BORING :GROUNDWATER FOUND AT 6.5. GRADE TO SAS BOTTOM IS 4.5. MIW29C
ADJUSTMENT IS 1.5'. SEPARATION MATH: 6.5-(4.5+1.5)=0.5'.
Before filing this Inspection Report,please see Report Completeness Checklist on next page.
t5insp.doc-rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
105 Sterling Road, Hyannis, MA
Property Address
Est. of Roger Charbonneau c/oAtty Don Hart 3 Village Green N#311, PMB 601 dphartlaw@verizon.net
Owner Owner's Name
information is required for every Plymouth MA 02360 4/8/2019
page. Citylrown State Zip Code Date of inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
® A. Inspector Information: Complete all fields in this section.
® B. Certification: Signed& Dated and 1, 2, 3, or 4 checked
® C. Inspection Summary:
1, 2, 3, or 5 completed as appropriate
4(Failure Criteria)and 6(Checklist)completed
® D. System Information:
For 8:Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
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THE COMMONWEALTH OF MASSACHUSETTS
ROAD® HE L H
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System a
...._�.�._. .. ..•_--V d..__.._ _._' - _a..�_..�.....AwR- _•-___-••- •______` ........................•............._._
-- -- - -------
cation.Addr o Lot No.
o
L Owner Address
/ . ---------- -.>----------------------------------- -----------------------------------------------------------------------------------------
Installer Address ,
Type of Building Size Lot_. ....Sq. feet
U Dwelling No. of Bedrooms----------- .Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ___________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ..__..
d _ --------
Desi Design gallons per person per day. Total daily flow....... ---___-_-----------------gallons.
g ••----•-- � ---
Septic Tcutk Liquid capacity gallons Length---------------- Width---------------- Diameter_._---.-------- Depth-._____.-_--.
xDisposal Trench—N _ ____________________ Width-- __..__ _-- Total Length_ _.....___ Total leaching area _6...sq. ft.
Seepage Pit No________ _________ Diameter_ __.__.. __ Depth below inlet_______._.._ Total leaching area _ sd. it.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date----------------------------------------
Test Pit No. 1................minutes per inch Depth of "lest Pit.................... Depth to ground water_.-.-.-.-----.--..------
(i Test Pit No. 2................minutes per inc Depth of Test Pit.................... Depth to ground water------------------------
a' .-••-•---------------- ------------- --- .........................................................................................................
0 Description of Soil------------------------ -•-•---------------------------------------------------------------------- -----------------------------
W -----------------------------------------------------------------------------------------------------------------------------------------------------------
UNature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------.-_._-___--------_--------__. .
Agreement
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanity Code—The undersigned further agrees ce the system in
operation until a Certificate of Compliance has n issued by th and of eah
Signe ...-----•.- 1 / ?�
/� Da
Application Approved By...... 6 - .---------------- .... � D t -
ate
Application Disapproved for the following reasons---------------------------------------------------------------------------------------------•-------------------
..................-••----•-•...-••••-----------••------------------------------------•---•----------'---•-•-••---•-•. -
Date
Permit No. Issued /
Date
No..... 6 Fss.. ..................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEP LTH
Appliration -for Uitipofiat Worko Tututrurtinn Vrrmit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual, Sewage Disposal
System a ,e�a
4 1 rr p A� A cation Add§r{�btt v tj�"'""'"/{ ® , p r Lot No.
__t, ___"i`.=f$�E,g -•-----• =�"'a ---""-"—b' --------------•-•------- I'��-- --•-tea-"-'-- - -#
Owner Address
W `'-•-•- ------ --=`--•-- -•---•.....................••..
� Ins$:taller Address „�
Type of Building Size Lot_- _^'!;.- !" -____Sq. feet
Dwelling4fNo. of Bedrooms-________-_ ..........................Expansion Attic ( ) Garbage Grinder ( )
per-, Other—Type of Building ____________________________ No. of persons----------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures _-•--- ------------------------
WDesign Flow_,_______________ ___ ,_ _ gallons per person per day. Total daily flow............ -----..._____...................gallons.
WSeptic Tank L Liquid capacity{__(' _gallons Length---------------- Width---------------- Diameter __ .......... Depth-_------------
Disposal Trench—Np_ ______________•_____ NNIid li____.___ __.______. Total Length________._.. Total leaching area-_- __ -$ .__sq. ft.
P �w Depth below inlet...... ; Total leaching area '- __ ----sq. ft.
Seepage Pit No_____________________ Diameter._,___f__'._ �_.
Z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed by.........-................................................................ Date----------------------------------------
Test Pit No. 1----------------minutes per inch Depth of "best Pit-------------------- Depth to ground water....................
�14 Test Pit No. 2................minutes per in c1 Depth of Test Pit.................... Depth to ground water__.-_-________-____
O - --------------- .A-------------------------------------------------------------------------------------------------------
Description of Soil------------------------ °° ------------------
V ---------------------------------------=-------- -----------------------------------------------------------------------------------------------------------------------------------------------------
W ---------------------------------- ---------------=------------------------------=---------------------------------------- ------
U Nature of Repairs or Alterations—Answer when applicable.____________ _________________________________________________________________________________.
-----•--••-------------•----------------=------- -...................
-----•---------------------------------•------•------------------------------------ -------------------------- :--------
Agreement:
The undersigned agrees to install the aforedescribed. Individual.Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanita>y--.Code— The undersigned further agrees'=not•to pl"Ace the system in
operation until a Certificate of Compliance has been issued by the board of health; _J' ¢
-I g E•.. •- •.---•------•----- ...................
\ j w % ae
\ f D
Application Approved BY----- -------•---------
Date
Application Disapproved for the following reasons:-•-•-----------•---=---.._ -------•---==--•---------------•-------------------- •-•-------••------•--
--•-•--•-••--•-•--•-----------------•---------------••---------•-•----••-•--•--••--•--:••••.•-•-------------=-•----------------•--•--------=----•-•-----••--•-••---•------------•------•----•--.......
Date
1""
Permit No.---•----•-•---•••--•-••••-••-=•-••----•-•-•-•-... ... Issued. l�---/7' .............
Date
THE COMMONWEALTH-OF MASSACHUSETTS
BOARD .Q,F HEALT
i arr � F
•" ' ................OF......... .: t 't° ..`.. ..... :.-.. f
O.rrtifiratr of -0,11mphaurr
THIS IS TO CEI�ITIFY, That the Individual Sewage Disposal System constructed ( ' ) or Repaired ( )
by ------•------- . ••--
a Insta er
�g
� .Aa:.✓a� '' "---------------- ---------------------------------------------------------
has been installed in accordance wit the provisions of Arttcl XI of The State Sanitary Code a descr•bed in the
application for Disposal Works Construction Permit No........
____________________ dated__.._____U__�_�/-y��___________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FICTION SATISFACTORY.
"7�SF{
DATE 7• _!/-------/ --{ i Inspector �� :.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEAL
,. 4 k
-' No... ..._.. FEE_ ,-_ --•----
rhWEIT ntitrurtion rrrmit
Permission is. ereby granted = __ � j. '� I - .:...........:...
to C y
ruct (- ) or Repair •( )z6 IndlvidU41-`Sewage Disposal Xystem .
7'4 .....................Street"
as shown on the application for Disposal Works Construction P rt�}lt No _ '___ . l Dated..:--- Y4/ .' "s.
•-------
_... J ......................------
Boar d of Health f'
DATE 7 1I7-- 5 '`✓.
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -
OFFICIAL VACCINATION
a MASSACHUSETTS
zo 001 ®1
y°`T"Er°�♦ TOWN OF BARNSTABLE
i BMSTADLE, i
"b BUILDING INSPECTOR
Aj�,o MaY°r'
APPLICATIONC��s 1��� T IM I I ,1 �� n
FOR PERMIT TO .............. ..... ...................................... ................................ .......
TYPE OF CONSTRUCTION ` ^..r�..:....:........ ....:.... ......... :....:... ......... ......... .:.:::... ...:....:........
SS
19........
TO THE SPECTOR OF BUILDINGS:
all—
.The undersigned hereby applies for a permit according to the followin information:
1
Location ...L b ....... :.. �..:.:. �(L� 1 r� Cs<�c �.. .. A io,o c S ......
.....�. .... `�. ......
ProposedUse .A.........................Iy ..... .!. ,. ..... ......................... ............... .. .......
`� .
tc� 1
Zoning District ........... ..l ................................... Fire District........
e�
Name of Owner ..........................
........... ........... ....:... .............:....... ..........Address ....... ......... ......... ....... .A............................
S
Name of Builder rn7
.... ..............................................................Address ....... ......... ...............................................................
Name of Architect ......" Address -
.......... ......... ...... ....
Number. of Rooms ........ .. ....:....L...... . ..:......fl r�...S.....Foundation . . a....
Exterior ...........J .Roofing .......... ....5 �lc�............................................................
Floors ......... ........ ......... ........ .:....... .......:.Interior .......
Heating Q .S ........ � ..: ..... .�: ... :. .Plumbing �d QQ�.....
.... ...:
0
Fireplace :..Approximate Cost .....a. �.................... :,:...... .. . ...::........
av� 2
Difinitive Plan Approved by Planning Board:Lr ---_-------
19
Diagram of Lot and Building with Dimensions „
Zj
j7- no
�1
-
L7
r
hereby agree to,conform to all the Rules and Regulations of Town of Bar ble re ard' g`the above
construction.
_ Name �r��o
'
� -
Cmr�`
� Surrey Construction --=^
�
�
16z2l one story
No ................. Permit for .................................... v
�
single
- dwelling '
.............
0{�
' / . Road
Location --.—...............------------- �
_.._____..z�,azzo�s____.____'______
C°"`,
Surr ~~�° //
Owner ---.������—Co��������tion����----.. '
' frame
Type of Construction .......................................... . .
--.-- --.---
-----......---.---..... --
�
p #�g ' --
�» --_------ �� ----.—.`=---.
�
Il�-
]� �� �~ y
Perm Granted ` ~ 'yJ ' -
Date of. Inspection
19
--- Completed— -- ��—��
v � P/�N��
^~ �
'
��mmmx` ��mmm REFUSED `
'
'
' _,___..~__,_,._^,-------.- lV `
. '
..................
................................... ... .......................................
'
-'_—.—.---.--.----..—.—.--.-..----.
'
�C
_--=.---.-..----.—^—,.----~.—.' '
.
'
_____----------- lV
Approved .
^
—.------_.-----....—'--.—~--...
-----------------~~---~..—.'
`
_- '
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which
you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
G
DATE: ��YQg
Fill in please:
APPLICANT'S YOUR NAME/S:
sf BUSINESS YOUR HOME ADDRESS:
TELEPHONE # Home Telephone Number
NAME,OF CORPORATION:
:NAME:OF NEW BUSINESS TYPE OF BUSINESS
IS THIS,A HOME OCCUPATION? YES NO77
ADDRESS OF BUSINESS // �`
MAP/PARCEL.NUMBER a� (P I�o: (Assessing]
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST .GO TO 200 Main St. - (corner of Yarmouth
Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally opera a yo�usin�ss in this town..
("A BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
2. BOARD OF HEALTH
This individual has beyR informed of th ermit re"ements that pertain to this type of business.
MUST COMP
u orized Signat * �Y WITH ALL
COMMENTS: 4RDOUSMATERyq�SREOif A3:1
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
Hazardous Materials Inventory Sheet Checklist
Date
hysical Street Address-Check database to ensure it exists
Working Phone Number
c Actual Amounts—(i.e.gas being used to fuel machines,thinner to
clean brushes all count as hazardous materials)
4--'storage Information—location of storage,how long is storage for?
If none,note that.
y isposal Information—where and who? If none,note that. .
4- pplicant Signature—understand what is listed and noted.
Staff Initial—any questions,know who to ask.
�L Vehicle Washing/Rinsing?—provide a vehicle washing policy and
explain it—note that it was given.
Attach the Business Certificate with your sign-off and comments.
"The Inventory form should explain what-the business consists of and the procedures
they are doing. Notes need to be left to explain what you discussed with them
.. �/"r^.. - 1-r�1_ ..., t � .�.�.� ,•, . � _s. ... _. �'"+:r¢dK+-� ry�,. ` r_.t�-r �t..-t'r'!.Irt�r=1�
Date:
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: i °ems _&-CAEWA0 ( �'K654- age
BUSINESS LOCATION: �6 L C /�`/rflir/k�'Fl.. M-• 6--40/ INVENTORY
MAILING ADDRESS: - 6 0 A 11-19K TOTAL AMOUNT:
TELEPHONE NUMBER: 2 Z1.2
CONTACT PERSON: le ( I OL i4p✓Ou/
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: P01h Ir- O&6VEf"7€kF • 1
INFORMATION/RECOMMENDATIONS: Fire District:
r"1L_f'!, _ _.—E' r.1 r^ i�i-• )�� ,.. �=J ��f� �}//v'� �� f l"C f
tv
Waste Transportation: Np Last shipment of hazardous,waste:
Name of Hauler: AfD Destination:
Waste Product: /13 Licensed? Yes
NOTE: Under the provisions of Ch. 111 , Section 31, of the General Laws of MA, hazardous materials use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health and the Public Health Division have determined that the following products exhibit toxic
or hazardous characteristics and must be registered regardless of volume.
Observed/Maximum_ Observed/Maximum
Antifreeze (for gasoline or coolant systems) Misc. Corrosive
NEW USED
Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
' Hydraulic fluid (including brake fluid) /U Refrigerants
N� Motor Oils Pesticides
NEW .r USED / (insecticides, herbicides, rodenticides)
)t'l/k Gasoline, Jet fuel, Aviation gas N Photochemicals (Fixers)
1V.1A Diesel Fuel, kerosene, #2 heating oil NEW — USED
Misc. petroleum products: grease, ti Photochemicals (Developer)
lubricants, gear oil -'NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways &garage(��tl'5 Wood preservatives (creosote)
i Caulk/Grout N Swimming pool chlorine
Battery acid (electrolyte)/Batteries N Lye or caustic soda
Rustproofers �'� Misc. Combustible
Car wash detergents N Leather dyes
Car waxes and polishes Fertilizers
Asphalt & roofing tar N PCB's
'145Vt 9-t1 Paints, varnishes,-stains, dye_ s N� Other chlorinated hydrocarbons,
04V6 64 Lacquer thinners d (inc. carbon tetrachloride)
'--' NEW -- USED / Any other products with "poison" labels
d ' Paint &varnish remoF�011fee)
lossers (including chloroform, formaldehyde,
, Misc. Flammables hydrochloric acid, other acids)
Floor &furniture strippers Other products not listed which you feel
Metal polishes jaybe toxic or hazardous (please list):
946 Laundry soil & stain removers
(including bleach)
Spot removers & cleaning fluids
(dry cleaners)
6N - Other cleaning solvents
d Bug and tar removers _
efil& Windshield wash
WHITE COPY HEALTH DEPARTMENT/CANARY COPY-BUSINESS
LEGEND suorni Rd N Locus N
i -
'20 —— EXISTING CONTOUR Sterlin Rd
x 20.98 EXISTING SPOT GRADE Rd 5 �
22 PROPOSED CONTOUR 3
--$,H.•yq<-- OVERHEAD WIRES Bens N o Frost Ln
W EXISTING WATER SERVICE Pond a
Arbor
O G EXISTING GAS SERVICE s
STRIPOUT BOUNDARY � 24,22 War
(TO "C" HORIZON-SEE NOTE 11) O- ( - WF-1
6.98 O WETLAND FLAG j' s
EXISTING S.A.S. ';X\ \ TEST PIT ear
(APPROXIMATE LOCATION) BENCHMARK �teu
TO BE REMOVED-SEE NOTE 11 ` x cal-
2 45 0
PROPOSED SEPTIC TANK/PUMP CHAMBER BENCHMARK- LOCUS MAP
�
1500/500 GALLON CAPACITIES X2.89/ ��� `� NAIL SET, EL.=22.92 NOT TO SCALE
EXISTING SEPTIC TANK
I TO PUMPED, RUPTURED, FILLED 22, • 2 GENERAL NOTES:
a TP-�,.0- �� 23.45
WITH SAND & ABANDONED •gyp, ���> 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
N ? 80.;�` S •- ��� BOARD OF HEALTH AND THE DESIGN ENGINEER.
m2''.,�.F' �` O O. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
Op, TBM2 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
21. "A $ 22,92 LOCAL RULES AND REGULATIONS. except as requested below:
` A a ' -310 CMR 15.405(1)(a): CONTENTS OF LOCAL UPGRADE APPROVAL
L�O x 1,47 �� �� ' �* 1 A 5' variance, S.A.S. to
' 2 1' ) property line (front), for a 5' setback.
/ �� /✓, �• O -LOCAL REGULATION Chapter 360-1, Location of Components with
Respect to Water Body's:
L�Oj 18 78 c� �j� 2) A 32' variance, pump chamber to Bordering Vegetated.Wetland,
for a 68' setback. MADEP Title 5 requirement is 25'.
�61 3) A 17' variance, S.A.S. to Bordering Vegetated Wetland, for a
9 83' setback. MADEP Title 5 requirement is 50'.
/ I I RE7 ALL 22.41 3, THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
4_1 /EXISTING 2108.•„.: TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
/ 2 1
WF-6 1J3 �ISPLIT--LEVEL . ..:: .:.:' ., i;: = / DESIGN ENGINEER.
• �� �Y�?ECK(obove��� HOUSE(#105) 1 .;' FAVED..r :.'`G."` j/ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
I .T.0.F.=22.Of1 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
• AITIO(below) CELLAR FL.=188..6f DRIVEWAY:`..::' ENGINEER BEFORE CONSTRUCTION CONTINUES.
GARAGE Y` 5. ALL ELEVATIONS BASED ON BARNSTABLE GIS±..
18' S ' p 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
X WF_5 SLAB=18.5t C� �S •` THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
14.92 15.69 18, J �9.20 15 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SUPPLY.
• INSTALL A 40 MIL POLY LINER 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM.
TOP OF LINER, EL.=21.0
X 14,90 17,69 C G ' .';: BOTT. OF LINER, EL.=18.5 9• ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
LOT 29 F �d': AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
13,005fSF oc�o WF-4 � 17 9 ✓� DIRECTED BY THE APPROVING AUTHORITIES.
15.64 1, 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
p 17,29 ���� h BENCHMARK-1 CONSTRUCTION.
�COR-ISTOOP, EL.=21.85 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
• \� ��� IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
Ben'5 Pond x \+ 15'" ""�� REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
WATER SURFACE EL.=14.0 14,87 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
16.75 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
MAY 21, 2019 WF-3
15,36 SHED 13. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED EXISTING
4/ 7O� `• _ PLAN REVISION 7/24/19 SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THE PLAN.
S), O.3' �. 1) ADD 1500/500 GALLON SEPTIC 14. REPLACE ORANGEBURG PIPING FROM HOUSE TO TANK WITH 4" SCH 40
\S TANK/PUMP CHAMBER PER BOARD PVC PIPE. INSTALL TEES AS SHOWN ON PROFILE, SHEET 2.
WF_2'
\O x 15.52 OF HEALTH CONDITIONAL APPROVAL.
ly 15.53 of MAssq PARCEL ID. 268-164
WETLAND CONSULTANT �`�P �y�
SABATIA, INC. , o PETER T. ' PROPOSED SEPTIC SYSTEM UPGRADE PLAN
21 Observotory Ln WF-1 M E CZ) STERLING ROAD, HYANNIS,
(508)Poca 563-5349 MA
MA 02559 15,32 b N CIVIL o. 35109� Prepared for: Ronald Charbonneau, 18716 Hammock Ln., Davidson, NC 28036
(508) 56
FLOOD ZONE DESIGNATION
. R£G/STE��� 'c OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
1 L
MAP NO. 25001 CO568J I CHARBONNEAU, ROGER L Engineering Works, Inc. 1"=20' P.T.M. 180-19
EFFECTIVE DATE: JULY 16, 2014 18716 HAMMOCK LANE 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
ZONE X (NON HAZARD) ""j IZ N2 � DAVIDSON, NC 28036 (508) 477-5313 6/17/19 P.T.M. 1 Of 3
NOTE: TO PREVENT BREAKOUT, CONTRACTOR - -7/7—
PROPOSED D—BOX SHALL INSTALL A 40 MIL POLY LINER EXISTING
INSTALL WATERTIGHT RISER, FRAME TOP OF LINER, EL.=21.0 F17 HOUSE(#105)1
° PROPOSED SEPTIC TANK/PUMP CHAMBER & COVER SET TO 6" OF GRADE BOTTOM OF LINER, EL.=18.5
PROVIDE RISERS WITH APPROVED FRAMES & COVERS PROPOSED S.A.S.
OVER EACH ACCESS MANHOLE AND SET TO FINISH GRADE. MANHOLES BROUGHT TO GRADE SHALL BE INSTALL ONE INSPECTION PORT (MIN.)
T.O.F.=22.0t
SECURED TO PREVENT UNAUTHORIZED ACCESS. F.G. EL.=22.6f F.G. EL.=21.5 to 22.6t N
S¢,,
F.G. EL.=21.7t F.G. EL.=21.6f PROVIDE ENOUGH WIRE MAINTAIN 2% GRADE (MIN.) OVER S.A.S. �- ~j
EXISTING SLACK TO REMOVE PUMP ` 4 DIAM. INSPECTION PORT, �
L 14'(MAX) 15' x 30' LEACHING FIELD W/3-4" PERFORATED IN S.A.S., SOLID b'? O
® 5=1 1 MIN.) TOP EL=20.59 pROVIDEC ST BLOCKS 4 SCH40(PVC) PVC DISTRIBUTIO ABOVE S.A.S., WITH SCREW CAP �.' 6'' �c� ---- 00
SET TO WITHIN 3' OF GRADE.
4"SCH O PVC qT ALL BENDS CAPPED ENDS
3. e e 6" EFF.DEPTH T
10 10 INV. EL.=20.30 END
TF,�'S ARE TO BE 14 `. INV.=20.60 SLOPE OF PERF. PIPE- 0.5% ) 1n
INVERT a SCH ao Pvc INV.=20.77 I PROPOSED S.A.S.
30' EFFECTIVE LENGTH — —\
1 STANDING PROPOSED D—BOX I I
=19.50 (ZABEL G.W. EL. 14.5 3 OUTLETS (MIN. SOIL ABSORPTION SYSTEM (PROFILE)
(zneeL oa eoua.), EL. 14.8 ) I � �� I
BOTT. EL.=14.92 MAX.AX.INV G.W.G. . EL. INV.=20.45 I 30
CONNECT TO EXISTING INV.=15.2s SEPTIC LAYOUT
SEWER OUTLET EFFLUENT FILTER SHALL BE INSTALLED ON OUTLET ESTABLISH VEGETATIVE COVER
INV.=21.37t TEE AS MANUFACTURED BY ZABEL OR EQUAL. FILTER
(VERIFY) SHALL BE INSPECTED AND CLEANED ANNUALLY. 3/4"-1 1/2" DOUBLE WASHED STONE
(See Pump Detail, Sheet 3 of 3)
APPROVED FILTER FABRIC
FINISH GRADE
1500/500 GALLON SEPTIC TANK/PUMP CHAMBER [_�EL.=21.6 to 22.6t DECK
H-10 TANK
ENT. ENT.
BREAKOUT ELEV.=20.80 r
NOTES: BEDROOM BATH KITCHEN
1) PUMP CHAMBER .& D—BOX SHALL BE SET LEVEL AND BOTTOM ELEV.=19.80 130 SF —J DINING
TRUE TO GRADE ON A MECHANICALLY COMPACTED 6' S' MIN. SEPARATION TO G.W. 72.T5' 5' 5' 2.5' HALL
CRUSHED STONE BASE, PER 310 CMR 15.221(2). AND 4' A NATURALLY 15' EFFECTIVE WIDTH UP
2) INSTALL INLET & OUTLET TEES AS REQUIRED. AND
PERVIOUS SOILS —
3) MAX. COVER TANKS, D—BOX & S.A.S. SHALL BE 36". SOIL ABSORPTION SYSTEM (SECTIONS BEDROOM EST. HIGH G.W. EL: 14.8 100 SFRENT.
LIVING ROOM
4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS -
PRIOR TO CONSTRUCTION.
5) EFFLUENT FILTER SHALL BE INSTALLED ON OUTLET
TEE AS MANUFACTURED BY ZABEL OR EQUAL. FILTER
SHALL BE INSPECTED AND CLEANED ANNUALLY, OR AS
REQUIRED TO RESPONSIBLE TO SCHEDULENT K UP. THE UPPER LEVEL
CLEANINGS.
IS SEPTIC SYSTEM PROFILE
SOIL LOG PATIO
ENT.
DESIGN CRITERIA DATE: NOVEMBER 28, 2018 (REF. TPT 19-22)
#
SOIL EVALUATOR: PETER McENTEE E#1542
WITNESS: DAVID STANTON RS HEALTH AGENT FAMILY/ENTERTAINMENT
NUMBER OF BEDROOMS: 3 ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH ENT.
SOIL TEXTURAL CLASS: CLASS I DN
DESIGN PERCOLATION RATE: <2 MIN/IN 21.8 A LOAMY SAND 0 21.8 A LOAMY SAND 0' GARAGE
DAILY FLOW: 330 GPD 1OYR 4/2 1OYR 4/2
DESIGN FLOW: 330 GPD 21.3 B 6" 21.3 B 6"
LOAMY SAND LOAMY SAND GARAGE ENT. ENT,
GARBAGE GRINDER: NO 1OYR 5/6 1OYR 5/6
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 19.8 C 24" 19.9 C 23" LOWER LEVEL
.74 GPD/SF PERC
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 24"/42" FLOOR PLAN
PUMP CHAMBER: 500 GALLON (INFILTRATOR IM-540) M-C SAND M-C SAND
PROPOSED D-BOX: 1 INLET, 3 OUTLET (MIN.), H-10 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
INSTALL AN 15' x 30' LEACH FIELD 14.8 HIGH G.W. _ 84 14.8 HIGH G.W. _ 84" 105 STERLING ROAD, HYANNIS, MA
SIDEWALL AREA: NOT APPLICABLE 14.5 SRTDG�G.W. 88" 14.5 SRTDGO G.W. 88" Prepared for: Ronald Chorbonneau, 18716 Hammock Ln., Davidson, NC 28036
BOTTOM AREA: 15' x 30' = 450 S.F. 13.2 103" 13.0 105" Engineering by: SCALE DRAWN JOB. NO.
TOTAL AREA:...;.................................450 S.F. PERC RATE: <2 MIN. IN. Engineering Works, Inc. N.T.S.
S STANDING GROUNDWATER, EL.=14.5 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED 1SSHEEETINO.
LEACHING CAPACITY = 0.74 GPD/SF x 450 SF = 333.0 GPD ADJ. HIGH G.W.(REDOX), EL.=14.8
(508) 477-5313 6/17/19 P.T.M. 2 Of 3
• "
NEMA 4 20 DIA. COVERS
`JUNCTION BOX CORROSION RESISTANT (TYP.)
& LIQUID-TIGHT CABLE CONNECTORS SUPPORTED 12'-2"
PROVIDE WATERTIGHT CONCRETE RISER WITH BY 1-1/4" PVC CONDUIT. JOINTS TO BE MADE
SECURED FRAME & COVER TO GRADE WATERTIGHT. USE SJE RHOMBUS-JB PLUGGER
OR EQUAL. PROVIDE ENOUGH SLACK TO EMOVEWPUMP F IRE _F I TI
INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING
HOISTING CABLE. 709 STAINLESS STEEL WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM I I I I
1/8" DIAMETER. 11,760 LB. STRENGTH FLOAT TO SJE RHOMBUS TANK ALERT XT ALARM PANEL A I I I i A
PROVIDE ENOUGH WIRE ON CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. 6'-8"
SLACK TO REMOVE PUMP 1
INV.(IN)=19.25 2" BALL VALVE (FIELD ADJUST FOR 20 GPM RATE)
(INSTALL QUICK DISCONNECT FOR EASY REMOVAL) I I I I I
ALARM ON EL: 16.76 2"SCH. 40 DISCHARGE (THROUGH RISER=SEE PROFILE) I I I I
•
PUMP ON EL: 16.59. 2" 90• ELBOW W/ 1/4" WEEP HOLE I I I I I
{ FOR SELF-DRAINING FORCE MAIN I I I I
PUMP OFF EL: 15.92 18 16 2" SWING CHECK VALVE — —L �— — — I — — —
BOTTOM OF
PUMP CHAMBER g" 2" SCH. 40 PVC DISCHARGE PIPE
ELEV.= 14.92 ADDITIONAL 3/16" VENT HOLE (MIN.) ABOVE PUMP FLANGE 4" KNOCKOUTS PLAN VIEW
PROVIDE 2- WIDE ANGLE FLOATS: 4 (TO PREVENT PREMATURE PUMP BURNOUT) (TYP.)
FLOAT NOA: PUMP ON/OFF (BARNES 073618) BARNES SEV SERIES PUMP .5 H.P. 115 V
FLOAT NO.2: ALARM ACTIVATION (BARNES 073612) 4"(8" H-20)
(ON SEPARATE CIRCUIT FROM PUMP SPECIFIED) 2' DISCHARGE PASSING 2' SOLIDS 20" DIA. COVERS
/— (TYP.)
PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT 5" /
THROUGH WIGGIN PRECAST CORP., BOURNE MA. (800) 564-6774 :. ':, r, .::>.= ::.s.:x• . ;:::;:,':
PUMP & ACCESSORIES AVAILABLE THROUGH W►LLIAMSON ELECTRIC (781) 444-6800
PUMP DETAIL 4" INLET KNOCKOUTS
5'-8" 4" OUTLET 3n
N.T.S. . 7
(6-'2" H-20) Orr KNOCKOUTS :} 4'7"
4'-3" SUPPORT (SEE NOTE 3)
%'(4'9" H-20)
r BEAMS LIQUID
(4'-5" H-20) >`•t COMPARTMENT (TYP) LEVEL
ALL AVAILABLE
1-4" POLYSEAL ! 5
'INLET 4"(6' H-20)
3-4" POLYSEAL OUTLETS 22" CROSS SECTION A-A �i
BUOYANCY CALCULATIONS
WT of H-10: 18,852 LBS.
NOT REQUIRED, TANK IS ABOVE WATER TABLE 4" wT of H-20 24,721 Les.
� SPECIFICATIONS �
1.) CONCRETE 4,000 PSI AFTER 28 DAYS.
2.) CONSTRUCTION CONFORMS TO' DEP TITLE V REGS.
< 310 CMR SECTION 15.226.
3.) TONGUE & GROOVE JOINT- SEALED W/ BUTYL RESIN
4" 4.) REINFORCEMENT PER ASTM C1227-93.
WIGGIN PRECAST CORP DB3H2O ' 14" 5.) ALSO AVAILABLE IN H-20 LOADING.
CROSS SECTION PLAN VIEW 6) PRVIDE POLYMER WATERPROOF COATING
DOSING & STORAGE REQUIREMENTS SECTION H-20 LOADING PLAN H-10 SEPTIC TANK/PUMP CHAMBER 1500/500
DESIGN FLOW: 330 GPD SPECIFICATIONS WIGGIN PRECAST CORP., BOURNE MA. (800) 564-6774
DOSING REQUIRED: 4 CYCLES/DAY (SAND) 1.) CONCRETE STRENGTH 5,000 PSI ® 28 DAYS.
330 = 4 = 82.5 GALLONS/CYCLE 2.) CEMENT, PORTLAND TYPE II PER ASTM C150-81 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
DISTANCE REQUIRED BETWEEN PUMP 3.j REINFORCEMENT PER ASTM C1227-93 105 STERLING ROAD, HYANNIS, MA
ON AND PUMP OFF FLOATS: 4. 15" RISER SECTIONS AVAILABLE
82.5 GAL/CYCLE — 125 GAL/FT = 0.66 FT/CYCLE (USE 8")
Prepared for: Ronald Charbonneau, 18716 Hammock Ln., Davidson, NC 28036
STORAGE REQUIRED ABOVE WORKING LEVEL: • 330 GALLONS DB-3 Engineering by: SCALE DRAWN JOB. NO.
STORAGE PROVIDED: DISTRIBUTION BOX: 3 OUTLET Engineering ineerin Works, Inc. N.T.S. P.T.M. 180-19
INV.(IN) EL: 19.25 - PUMP ON EL: 16.59 = 2.66' 9
STORAGE PROVIDED = 2.66' x 125 GAL/FT = 332.5 GALLONS WIGGIN PRECAST CORP., BOURNE MA. (800) 564-6774 12 West Crossfield Road, Forestdole, MA 62644 DATE CHECKED SHEET NO.
(508) 477-5313 6/17/19 P.T.M. 7 -Of 3
•ifs
�¢ LEGEND Suomi Rd LOCUS N
E
� ——20 —— EXISTING CONTOUR _ � sterrn Rd
x 20.98 EXISTING SPOT GRADE
\ Rd 5
22 PROPOSED CONTOUR Bens 3
1 —�/-/• OVERHEAD WIRES Pond � o Frost `r'
W EXISTING WATER SERVICE L A
24,22 G EXISTING GAS SERVICE Arbor ;yoy
STRIPOUT BOUNDARY o
(TO "C" HORIZON—SEE NOTE 11) O. / WF-1 O WETLAND FLAG
�\ /
6,98
EXISTING S.A.S. TEST PIT ear
(APPROXIMATE LOCATION) �` P BENCHMARK E�a0o
TO BE REMOVED—SEE NOTE 11 ` x 2. 45 0 +� LOCUS MAP
PROPOSED PUMP CHAMBER •. ` oL ��, BENCHMARK— NOT TO SCALE
LO INFILTRATOR IM-540 22,E/ ` �� NAIL SET, EL.=22.92
CIO X
�r GENERAL NOTES:
EXISTING SEPTIC TANK �, , 2
(TO REMAIN-SEE NOTE 14) c�a 2 TP\ O 23.45
` ,O ^;.;. � 'P ��j 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
TOP OF TANK, EL.=20.65 80, OS� N 5r S BOARD OF HEALTH AND THE DESIGN ENGINEER.
N •.
INV.(OUT), EL.=19.30f 2:`.�4�,.F �O�O• 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
Cl- LL ,""'Y� , gyp, TBM2 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
/ 21.1 �` ` :�i ^'� 22.92 LOCAL RULES AND REGULATIONS. except as requested below:
� � •�ws .,�'•., � —310 CMR 15.405(1)(a): CONTENTS OF LOCAL UPGRADE APPROVAL
x 1.47 ' '\ �' 1) A 5' variance, S.A.S. to property line (front), for a 5' setback.
�' ` '`'" 2� ,r��• Q —LOCAL REGULATION Chapter 360-1, Location of Components with
Respect to Water Body's:
6 Dc V7 2) A 27' variance, pump chamber to Bordering Vegetated Wetland,
5 Leg 18.78 M� 1 for a 73' setback. MADEP Title 5 requirement is 25'.
161 5 :.. 3) A 17' variance, S.A.S. to Bordering Vegetated Wetland, for a
`1�21 9 '"
• 83' setback. MADEP Title 5 requirement is 50'.
L I RE7. ALL 22.41 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
21 Q8,•;. , TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
WF-6 ,ice 9 �SPLITSLIEI/EL �" :..; -'." / DESIGN ENGINEER.
11 73 02 <' �o '�� \''" / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
• \ �i HOUSE(#105) 1 7 ":PAVED:." /
\ \ rJECK(obove�l / •OUSE22.0 5 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
\ \ ATI0(below) CELLAR FL.=18.6f1 "'DRIVEWAY: � •` ENGINEER BEFORE CONSTRUCTION CONTINUES.
•� \ �� ". ''." 5. ALL ELEVATIONS BASED ON BARNSTABLE GIS±..
GARAGE 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
X WF-5�(c�_ 18 .15 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
14.92 15.69 �9.20
\ J 7. WATER SUPPLY PROVIDED BY TOWN WATER SUPPLY.
INSTALL A 40 MIL POLY LINER 8• THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM.
• \\ ."" " TOP OF LINER, EL.=21.0
�L C G ." ' BOTT. OF LINER, EL.=18.5 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
LOT 29 X 14,90 17,69 F . . \ 'c�P." AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
DIRECTED BY THE APPROVING AUTHORITIES.
13,005±SF Fo . WF-4 r
\ 17,9 y�_ 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
-� 15,64
•` \ � THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
F� . \ 17,29 BENCHMARK-1 CONSTRUCTION.
0 tx CMR./STOOP, EL.=21.85 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
tx�� IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
Bens Pond x \+ 15'" "?� REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
WATER SURFACE EL.=14.0 14.87 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
16,75 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
MAY 27, 2019 WF-3 4 OF 41
15.36 P�� SSA 13. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED EXISTING
�O> �• SHED ��\ cyG SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THE PLAN.
N S>. 03, o PETER T. 14. REPLACE ORANGEBURG PIPING FROM HOUSE TO TANK WITH 4" SCH 40
3>,
• McENTEE PVC PIPE. INSTALL TEES AS SHOWN ON PROFILE, SHEET 2.
�
CIVIL 15,53 x 15.52 No. 35109 PARCEL ID: 268-164
WETLAND CONSULTANT /0STER��
SABATIA, INC. , Io � PROPOSED SEPTIC SYSTEM UPGRADE PLAN
21 Observatory Ln WF-1 • 105 STERLING ROAD, HYANNIS, MA
Pocasset, MA 02559 b a� ,� , kc
(508) 563-5349 15,32 �� Prepared for: Ronald Charbonneau, 18716 Hammock Ln., Davidson, INC 28036
t : SCALE DRAWN JOB. NO.
b Engineering y
FLOOD ZONE DF_ IGNATION OWNER OF RECORD P.T.M. 180-19
MAP N0. 25001 C0568J CHARBONNEAU, ROGER L Engineering Works, Inc. 1"=20'
EFFECTIVE DATE: JULY 16, 2014 18716 HAMMOCK LANE 12 West Crossfield Road, Forestdale, MA 02644 DATE. CHECKED SHEET NO.
ZONE X (NON HAZARD) DAVIDSON, NC 28036 (508) 477-5313 6/17/19 P.T.M. 1 Of 3
EXISTING SEPTIC TANK & NOTE: TO PREVENT BREAKOUT, CONTRACTOR
PROPOSED PUMP CHAMBER PROPOSED D—BOX SHALL INSTALL A 40 MIL POLY LINER
PROVIDE RISERS & COVERS AS DESCRIBED: INSTALL WATERTIGHT RISER, FRAME TOP OF LINER, EL.=21.0
1) SEPTIC TANK INLET COVER SET TO 6" OF GRADE. & COVER SET TO 6" OF GRADE BOTTOM OF LINER, EL.=18.5
2) SEPTIC TANK 20" OUTLET COVER SET TO GRADE PROPOSED S.A.S.
3) PUMP CHAMBER 24" ACCESS RISER/COVER SET TO GRADE INSTALL ONE INSPECTION PORT (MIN.)
COVERS SET TO FINISH GRADE SHALL BE SECURED F.G. EL.=22.6t F.G. EL.=21.5 to 22.6t
MAINTAIN 2% GRADE (MIN.) OVER S.A.S.
EL.=21.6(EXISTING) F.G. EL.=21.6
4' DIAM. INSPECTION PORT,
L - 14'(MAX) 15' x 30' LEACHING FIELD W/3-4" PERFORATED IN S.A.S., SOLID
4a PVC ® S=1% (MIN.) ABOVE S.A.S., WITH SCREW CAP
fFEIN
24" DIA. PRp IDEC -fBLOCKS 4"SCH40 PVC SET TO WITHIN 3' OF GRADE.
L — 6' AT ALLBENDS D ENDS
® S=1% (MIN.) TOP=19.81 6" EFF.DEPTH
4"SCH40 PVCINV.=20.60 I SLOPE OF PERF. PIPE = 0.5% I INV. EL.=20.30(END)
NV.=20.77 30' EFFECTIVE LENGTH
PROPOSED D—BOX SOIL ABSORPTION SYSTEM (PROFILE) DECK
47 3 OUTLETS (MIN.)
Wools �'19401INV.=20.45
INV.=19.20 °E�u" MAX. G.W. EL. 14.8
STANDING
EXISTIN G.W. EL. 14.5 ESTABLISH VEGETATIVE COVER
INV.=19.3t
SEPTIC TANK EXISTING BOTT.=15.26 3/4"-1 1/2" DOUBLE WASHED STONAE EXISTING
(FIELD VERIFY) See Pump Detail APPROVED FILTER FABRIC SPLIT—LEVEL
Sheet 3 of 3 FINISH GRADE HOUSE(#105)
PROPOSED 500 GALLON SEPTIC TANK EL.=21.6 to 22.6t
INFILTRATOR IM-540 GALLON PLASTIC TANK
BREAKOUT ELEV.=20.80
NOTES:
1) PUMP CHAMBER & D—BOX SHALL BE SET LEVEL AND BOTTOM ELEV.=19.80
TRUE TO GRADE ON A MECHANICALLY COMPACTED 6' 2.5' S' 75' T25'
5' MIN. SEPARATION TO G.W. N
CRUSHED STONE BASE, PER 310 CMR 15.221(2). AND 4' OF NATURALLY 15' EFFECTIVE WIDTH . `SSt
2) INSTALL INLET & OUTLET TEES AS REQUIRED. OCCURRING PERVIOUS SOILS — O. Z' 'S� (D
3) MAX. COVER TANKS, D—BOX & S.A.S. SHALL BE 36". SOIL ABSORPTION SYSTEM (SECTION) 4%
8 14 p
EL W HIGH G. . : . a' 6 h
4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS EST. � 2
PRIOR TO CONSTRUCTION. 6'• ��. 00
5) EFFLUENT FILTER SHALL BE INSTALLED ON OUTLET I
TEE AS MANUFACTURED BY ZABEL OR EQUAL. FILTER — -----
SHALL BE INSPECTED AND CLEANED ANNUALLY, OR AS
REQUIRED TO PREVENT BACK UP. THE HOMEOWNER IS
RESPONSIBLE TO SCHEDULE CLEANINGS. SEPTIC SYSTEM PROFILE i PROPOSED S.A.S.
SOIL LOG T------
r 30' —
DESIGN CRITERIA DATE: NOVEMBER 28, 2018 (REF. # TPT 19-22)
SOIL EVALUATOR: PETER McENTEE SE#1542
WITNESS: DAVID STANTON IRS HEALTH AGENT
NUMBER OF BEDROOMS: 3 SOIL TEXTURAL CLASS: CLASS I ELEV. TP— 1 DEPTH ELEV. TP-2 DEPTH
DESIGN PERCOLATION RATE: <2 MIN/IN 21.8 A 0" 21.8 A 0"
LOAMY SAND LOAMY SAND
DAILY FLOW: 330 GPD 10YR 4/2 10YR 4/2
DESIGN FLOW: 330 GPD 21.3 B 6" 21.3 LOAMB LOAMY 6"
GARBAGE GRINDER: NO 10YR Y 5/6 D 10YR 5/6 D
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 19.8 C 24 19.9 C 23'
.74 GPD/SF PERC
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 24 /42
PUMP CHAMBER: 500 GALLON (INFILTRATOR IM-540) M—C SAND M—C SAND
PROPOSED D—BOX: 1 INLET, 3 OUTLET (MIN.), H-10 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
INSTALL AN 15' x 30' LEACH FIELD 14.8 HIGH G.W. _ .84" 14.8 HIGH G.W. _ 84" 105 STERLING ROAD, HYANNIS, MA
EDXEDOX
SIDEWALL AREA: NOT APPLICABLE 14.5 STDGO G.W. 88" 14.5 STDG. G.W. SW 88'' Prepared for: Ronald Charbonneau, 18716 Hammock Ln., Davidson, NC 28036
BOTTOM AREA: 15' x 30' = 450 S.F. 13.2 103" 13.0 105" Engineering by: SCALE DRAWN JOB. NO.
TOTAL AREA:.....................................450 S.F. PERC RATE: <2 MIN./IN. Engineering Works, Inc. N.T.S. P.T.M. 180-19
STANDING GROUNDWATER, EL.=14.5 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
LEACHING CAPACITY = 0.74 GPD/SF x 450 SF = 333.0 GPD ADJ. HIGH G.W.(REDOX), EL.=14.8 (508) 477-5313 6/17/19 P.T.M. 2 of 3
NEMA 4 JUNCTION BOX CORROSION RESISTANT
PROVIDE WATERTIGHT 24" RISER WITH & LIQUID—TIGHT CABLE CONNECTORS SUPPORTED
SECURED FRAME & COVER TO GRADE BY 1-1/4" PVC CONDUIT. JOINTS TO BE MADE
(INFILTRATOR TW RISER SYSTEM OR EQUAL) WATERTIGHT. AN SJE RHOMBUS—JB PLUGGER
OR EQUAL IS RECOMMENDED. PROVIDE ENOUGH WIRE
SLACK TO REMOVE PUMP
INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING
HOISTING CABLE 7x19 STAINLESS STEEL WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM
1/8" DIAMETER. / 1,760 LB. STRENGTH. DIA. FLOAT TO SJE RHOMBUS TANK ALERT XT ALARM PANEL
ON CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP.
I NV.(IN)=19.20
2"SCH. 40 DISCHARGE (THROUGH RISER—SEE PROFILE) DECK
2" BALL VALVE (FIELD ADJUST FOR 20 GPM RATE)
ALARM ON EL: 16.78 (INSTALL QUICK DISCONNECT FOR EASY REMOVAL) ENT. ENT.
2" 90' ELBOW W/ 1/4" WEEP HOLE 7
PUMP ON EL: 16.53 BEDROOM BATH
i FOR SELF—DRAINING FORCE MAIN 130 SIF KITCHEN DINING
PUMP OFF EL: 15.95 18 15. 2" SWING CHECK VALVE
BOTTOM OF
PUMP CHAMBER 8" 2" SCH. 40 PVC DISCHARGE PIPE HALL uP
ELEV.= 15.26 WALL THICKNESS=0.2" ADDITIONAL 3/16" VENT HOLE (MIN.) ABOVE PUMP FLANGE BEDROOM LIVING ROOM
PROVIDE 2 FLOATS: (TO PREVENT PREMATURE PUMP BURNOUT) 100 SF BEDROOM
FLOAT N0.1: PUMP ON/OFF—POLYLOCK FLOAT PROVIDED WITH PUMP 10o SF
LIBERTY LE40 SERIES PUMP .4 H.P. 15 V
FLOAT NO.2: ALARM ACTIVATION FLOAT—PROVIDED WITH ALARM PANEL . .
(ON SEPARATE CIRCUIT FROM PUMP SPECIFIED) WITH 2" DISCHARGE, OR EQUAL ENT.
PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT
CAPE WINWATER WORKS CO., HYANNIS, MA. (508) 862-0166 UPPER LEVEL
NOTE: APPROVED ALTERNATE MAY BE SUBSTITUTED.
PUMP DETAIL
N.T.S.
PATIO
ENT.
1-4" POLYSEAL I
INLET FAMILY/ENTERTAINMENT
_ 3-4" POLYSEAL OUTLETS 22" -ENT.
BUOYANCY CALCULATIONS 4" °N
` 4„ GARAGE
NOT REQUIRED, TANK IS ABOVE WATER TABLE
N 04 " GARAGE ENT.
N ENT.
4„ LOWER LEVEL
WIGGIN PRECAST CORP DB3H2O 14"� -
CROSS SECTION PLAN VIEW
DOSING & STORAGE REQUIREMENTS H-20 LOADING FLOOR PLAN
DESIGN FLOW: 330 GPD SECTION PLAN
DOSING REQUIRED: 4 CYCLES/DAY (SAND)
330 - 4 = 82.5 GALLONS/CYCLE SPECIFICATIONS
1.) CONCRETE STRENGTH 5,000.PSI 028 DAYS.
DISTANCE REQUIRED BETWEEN PUMP 2.) CEMENT, PORTLAND TYPE II,PER ASTM C150-81 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
ON AND PUMP OFF FLOATS: 3.) REINFORCEMENT PER ASTM C1227-93
82.5 GAL/CYCLE - 138 GAL/FT = 0.6 FT/CYCLE (USE 7") 4.) 15" RISER SECTIONS AVAILABLE 105 STERLING ROAD, HYANNIS, MA
STORAGE REQUIRED ABOVE WORKING LEVEL: 330 GALLONS Prepared for: Ronald Charbonneau, 18716 Hammock Ln., Davidson, NC 28036
STORAGE PROVIDED: DB-3 Engineering by: SCALE DRAWN JOB. NO.
INV.(IN) EL: 19.20 - PUMP ON EL: 16.53 = 2.67' DISTRIBUTION BOX: 3 OUTLET En ineerin WOYks, .Inc. N.T.S. P.T.M. 180-19
STORAGE PROVIDED = 2.67' x 138 GAL/FT = 368 GALLONS g� g
WIGGIN PRECAST CORP., BOURNE MA. (800) 564-6774 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
(508) 477-5313 6/17/19 P.T.M. 3 Of 3