Loading...
HomeMy WebLinkAbout0166 STRAIGHTWAY - Health 166 Straightway Hyannis. P - A _ 268 103 y r d d k VIC t-- TOWN OF BARNSTABLE I QCATION rli Gy SEWAGE# vf LAGE ASSESSOR'S MAIPs&PARCEL SZ6F, INSTALLERS NAME&PHONE N . i `U SEPTIC TANK CAPACITY / , c7 0,.V LEACHING FACILITY:(type) 4 NJ C, Zv 4i K (size) =7�cj 0f / f NO.OF BEDROOMS \ OWNER PERMIT DATE: 7— —(YP COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �I a So w W � o 1 � Fee No. Dt? � = THE COMMONWEALTH OF MASSACHU.SETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS 2pplitation for 33iom ar *potem°Congtrurtion Verm it Application for a Permit to ConstmetX Repair( )Upgrade( )Abandon.( ) Complete System ❑Individual Components Location Address or Lot No. I Wk ;,�k4 wQ,� Owner's Name,Address and Tel.No. F—ALPN %F Assessor's Map/Parcel � �� ra ` N lQ3 �Ma Installer's Name,Address,and Tel.No Designer's Name,Address and Tel.No. (04b 5,-6k0 Type of Building: Dwelling No.of Bedrooms Lot Size 440)a sq.ft. Garbage Grinder( �} Other Type of Building fXlt No.of Persons Showers( �'/) Cafeteria( ) _Other Fixtures I.AqPl-ro?,Y , I��T-e trJ Sti�lkt Lv�,VPQPZY Design Flow 112)7to gallons per day. Calculated daily flow 33.\ gallons. Plan Date I \ ©�Number of sheets I Revision Date Title .Size of Septic Tank /4g�,3 1560 C,,QA A-&-,k pe of S.A.S. Description of Soils d��X `x �3� '`. Nature of Repairs or Alterations(Answer when applicable) __;ZQ_QQr-1-ID mn Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss=d b d H alth Signed Date ��Sn Application Approved by 44 j --EZ Date 772°—di-0,6 Application Disapproved foiqhe following reasons Permit No. �;?h a In `" �� Date Issued T �n 37v Fee vv r Entered in computer: THE COMMONWEALTH OF-MASS. A 'HU,SETTS Yes PUBLIC HEALTH 151 -"6 TOW" N OF BARNSTABLE. MASOCH.'USETTS 01pplicatio' n for Bigpooal *p5tem Couttrurtion .permit Application for a Permit to Construct(Repair Upgrade Abandon Xomplete System El Individual Components Location Address or Lot No Owner's Name Address and Tel.No. 'j�v Assessor's Map/Parcel Installer's Namee.Address,and Tel.No. Designer's Name,Address and Tel.Np. �5QPI�%C �S+-kpvjl, C- 5:�)q Type of Building: Dwelling No.of Bedrooms 'Z Lot Size 4(- +qq.ft. Garbage Grinder 'A) Other Type of Building R No. of Persons il-? Showers Cafeteria Other Fixtures -Ljc\Q�-rcvy cmc� sw)k_I L_iz,,voo Ky Design Flow gallons per day. Calculated daily flow gallons. Plan,Date 9,4t-\ QQ) Number of sheets Revision Date Title Size of Septic Tank er S 00 S *(2f_')kY�t_T_ype'o_f S.A.S. P107V P-- De -\1C) mcc-,scripti6n'of Soil Nature of.Repairs or Alterations(Answer when applicable) _)rzo� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance,with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been su is-Board of a Ith Signed __-N, Date -7 Application Approved by ;,--/& -4 oh Date Application Disapproved for he following reasons Permit No. �06 7 Date Issued o6 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS '0 CERTIFX Certificate of (Compliance THIS IS I that the On-site Sewage Disposal System Constructed Repaired Upgraded,( Abandoned( by at �U (D HY�)N)0lS,Mjj has been constructe inacor-dance with the provisions of Title 5 and the for Disposal SystemAns6etion Permit No. 00&-337 dated 7 2 6 0,4. 'Installer P Dk�C C,Designer C3�4 C's The issuance of this permit rued as a guarantee that t syste Date Inspects No. Dooro, S3? 1d() Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS miqool 6P.5tem Con.5truction Permit Permission is hereby granted to Construct( )Re .air( )Upgrade(UYAbandon System located at 4-C,\C,KT- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construe ion mpst be completed within three years of the date of t is pe Date: 7 Approved by Town of Barnstable OF1HE 1 Regulatory Services Thomas F. Geiler, Director * snxxsenat.�, ' • ��� Public Health Division QED 1A. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 7-28-06 Designer: Shay Environmental Services, Inc. Installer: Robert Septic Services. Address: P.O. Box 627 East Falmouth Address: 5 Trenton Street MA 02536 Yarmouth, MA On 7-26-06 Robert Septic Service was issued a permit to install a (date) (installer) septic system at 166 STRAIGHTWAY, HYANNIS, MA based on a design drawn by (address) Shay Environmental Services, Inc. dated 7/25/06 (designer) XX I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 'ZN OF MqS • � S,q CARMEN cyGN allE. ' �gnature) 0 SHAY N No. 1181 G/STO' SJIVITAV0a TEre—signer's Signature) (Affix Desi p Here) PLEASE RETURN TO B STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE LOh AT10N VIIAGE SEWAGE # ASSESSOR'S MAP & LOT ' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY e �6u lN. G 00.3SOnD 1 L LEACHING FACILITY: (type)1 �1 �� �) Ca ox � i ., f�+" NO. OF BEDROOMS BUILDER OR OWNER balah lho PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) - Feet Edge of Wetland and Leaching Facility(If any,wetlands exist within 300 feet of leaching facility) Feet Furnished by 1�, 12Ibz t�l _ Aa- r. 01 ox. ca � - TOWN OF BARNSTABLE LA.TIUP: SEWAGE # rV.`1`.LAGE -SSESSOR'S MAP & LOTS/, INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.ITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: _ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by_. Q_ c `� °� N ; No. Q _ L Fee ®( THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Digogar 46p6tem Cougtruction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. �O 1 O-3 Owner's Name,Address,and Tel.No. Assessor's Map/parcel 164 Stew 'TR, Installer's Name,Address,and Tel.N Designer's Name,Address and Tel.No. odn FSti e c ���) aq6-dgo6 Type of BuII ding: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ft.7 VIPJi��e C ss tpv�L Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintpauqe of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the En ' onmental Code an not to place the system in operation until a Certificate of Compliance has been issued by this Board of Heal S' e Date _( /f /015 Application Approved b Date Application Disapproved by: Date for the following reasons Permit No. J C Date Issued `� No. Fee s : a THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 2 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ! Application for 0igpogal *pgtem Congtruction Permit ' Application for a Permit to Construct O Repair O Upgrade O Abandon ❑Individual Components ( ). ❑ Complete System . Location Address or Lot No. 60 i Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /� 4 jt2b T FeP7� 1, Installer's Name,Address,and Tel.No. Designer's Name,,/Address and Tel.No. odne I rA&K- (vob) &-aToz) Type of Bui ding: . Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i i Nature of Repairs or Alterations(Answer when applicable) A „T( �_ ,gyp fade, tlpyice e 'p sc fU a -)L- 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 E yirpnmental Code and�ot to place the system in operation until a Certificate of , Compliance has been issued by this Board of Health. S Date Application Approved b . Date j Application Disapproved by: Date for the following reasons Permit No. �� Date Issued A --------------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,th t the On-site Se _age Disposal System Constructed ( ) Repaired ( Z) Upgraded ( ) Abandoned( )by `C ltC. at V has been constructed in accordance with the provisii s of Title 5 and the for Disposal System Construction Permit No. dated Installer (°CDGi� .� �+��— Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the syste will fu ti desig ed. Date J C l�cJ rj�— Inspector No. } Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Zigonl *pgtem Com trurtton �erTTYit Permission is hereby ranted to Construct Repair rade ( Abandon Yg ( ) P ( pg ) ( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date o this pe it Date Approved by i w a RECEIVED COMMONWEALTH OF MASSACHUSETTS NOV 2 7 2002 EXECUTIVE OFFICE OF ENVIRONMENTAq AFFAIRS ff z wN F f�N,. .��HdLE DEPARTMENT OF ENVIRONMENTAL P O Ei . �.IONEPT. W n r a � � d Q+.y yv o TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 166 STRAIGHT WAY HYANNIS, MA 02601 2,U$� 1,03 Owner's Name: RALPH PENA Owner's Address: 36 MEADOW HAVEN DRIVE MASHPEE, MA 02649 gal Date of Inspection: 11/12/02 opy Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS lnC- Mailing Address: P.O. BOX 2119 TEATICKET,MA. 02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ Conditionally P tses _ Needs Furthe -valuation by the Local Approving Authority Fails / Inspector's Signature: 7` / Date: 11/12/02 i17 The system inspector shall submit a opy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****This report only describes conditions III the time of insl►eclion and Under the conditions of use al (hill time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 ImnPrtinn Fnrm 6/1 VN)M I Wage 2 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 166 STRAIGHT WAY HYANNIS, MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s). Tile system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Page 3 of I I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS, MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance n/a **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a z Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped nLa. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.[ (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section L;or lailed wider Section D shall upgrade(lie system in accordance with 310 CMIt 15.304. The system uwtier should contact the appropriate regional office of the Department. a -Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 Check if the following have been done. You must indicate "yes"or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks X Has the system received normal flows in the previous two week period X Have large volumes of water been introduced to the system recently or as part of this inspection '? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out" X _ Were all system components, excluding the SAS, located on site'? X _ 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 ? X _ 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: Yes no X _ Existing information. For example,a plan at the Board of Health. X _ 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(3)(b)) S Page 6 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x#of bedrooms): 220 Number of current residents: n/a Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of /0 occupancy: 1 /I 2 0 COMM ERCIAL/INDUSTRIA L Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes, volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank, distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes, attach previous inspection records, if any) _ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1936,SYSTEM 1960 BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO r Page 7 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 BUILDING SEWER(locate on site plan) Depth below grade: 9" Materials of construction:_cast iron =40 PVC Xother(explain): ORANGEBURG Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting, evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 3" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 6'X 6' BLOCK CESSPOOOL" Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle:31" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 24" Distance from bottom of scum to bottom of outlet tee or baffle: 0" How were dimensions detennined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box,etc.): NO D-BOX PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): n/a u Cage 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a 6' X 6' OVERFLOW CESSPOOL overflow cesspool, number: 1 n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): OVERFLOW AND LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE. STAIN LINES HAVE NEVER BEEN MORE THAN HALF FULL AND WAS EMPTY AT TIME OF INSPECTION. BOTTOM IS AT 8'6". CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a 9 gage 10 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS,MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. n � V )U'n't src A- 0 C EJ AA 21 A q L4 (a F)o a 10 rage I l of 1 I . w ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 STRAIGHT WAY HYANNIS, MA 02601 Owner: RALPH PENA Date of Inspection: 11/12/02 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked, date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12+ FT. tt THE COMMONWEALTH OF MASSACHUSETTS �$ BOARD O HEALTH, i. .1'' .............OF............ ......................... Appliration -fur Bitipuiittl Works Cnowitrurtion Vrrmft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at "'k----------of - $ !® -_.... r71, -•---••-• J Lo ation-Address or Lot No. t d ' wger ---Address InValler Address QType of Building Size Lot----------------------------Sq. feet V Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building _----___-_-_________.____ No. of persons___________________________. Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- -- W Design Flow........................:...................gallons per person per day. Total daily flow--------------------------------------------gallons, USeptic Tank—Liquid capacity___------.gallons Length------_------- Width---------------- Diameter-----...__.----- Depth-------.__-._. xDisposal Trench—No-____________________ Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No---_---------------- Diameter.................... Depth below inlet____________________ Total leaching area.-__.-..--_.--___.sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date-----_-_--.---------------.---------.... Test Pit No. 1..........•-----minutes per inch Depth of Test Pit____________________ Depth to ground water-....................... LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-----._.____-_.__--_.___ a •------------------------------------••-•--•----•-•-----•-•-----•-----•----•---••-•------------------------•---•--•----------------------------•------------- 0 Description of Soil--------------------------------------•-------------------------------------•-------•--•-------_.--_____..______- ................ •----------------------------------- x U ---------------•-----------•--------------------••-•---_--_______-__-•-------•--•------••---••-------•-•--•--______---------______________---•--•-------------------------------------•----•------------ - ----•--------- ---------- ----------------------------••----- =----- =�,'` =- n ,,jam U Nature of Repairs or Alterations—.,Answer wk n appli ble..___ a 2._.4 ..._ ----------------------------- ................--0------�- ---- ---r'` -° ----------=------------------------------- ---- -()---------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i/ss��ued,by he'board off ealth. Signed_____'_ go- .. Date ApplicationApproved By.................................................................................................. ---•---••--....----- -- ---------------- Date Application Disapproved for the following reasons-------------------------•-------•---------..__._._.______________.._.•.___...._._...____...________..__.______-- --•••--••----•-•---•-----•---••-•---•---------------------------•--•---••----•---------••-----•---------••-----------------------------•-----------•-----•------•------------•------•------------------- Date Permit No......................................................... Issued._ Date 7� No....... F .... ...... THE COMMONWEALTH OF MASSACHUSETTS .� BOARD O HEALTI-, , �. w _... --- ---OF............ ... ¢. J.A.. [�� Appliration' -for Uhipo ialWorks Tottgtrurtiott Urrotit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at � ..J ._ cxa�\ ................................ --- -------L tion-Address or Lot No. r ____ _________ __ O er , Address aW _-----�...-�� � .............................. •-------•-- 4 4 "-- "-----•----------------------------•-------••--•----------•--- I aller Address Q Type of Building Size Lot____________________________Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p-, Other—Type of Building ---- ----------------------- No. of persons..___-____________-______._. Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------ --------------------------------------------------------------------------------------_---- W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity-____._.___gallons Length................ Width................ Diameter................ Depth---------------- x Disposal Trench—No-____________________ Width.................... Total Length-------------------- Total leaching area.-------------------sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area.......___....__..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date----------------------------------= Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water...--------_.--.-_--_- r=, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........._____-.-_..___. 9 •----.....••-----------------------------------•-------------•-••--•-•......------------........-•--...................................................----.. 0 Description of Soil----------------------------------------------------------------------------------------------------------------- ------------------------------------------------------ x U ------------------------------------- ............................................................._.................................................................................................. ------------ ---------- -------------------------------------------------------------------------------------------------------------------------------- d^ U Nature of Repairs or Alterations V,Answer en appli ble.__444--._V-__-.-'.� _...._ ka--�:Ew"'_._ +� ---------------------------------------------- t- V-=�-'.�------- 4-- ------ ------------------- ---------------------------.----------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of ealth. Signe �,, ....... -----•-------• " ----.f__ -- Date ApplicationApproved By-------------------------------------------------------------------------------------------------- ------------------------- -------------- Date Application Disapproved for the following reasons:........................................................................................----------------- ----•- -•-••--•••--•••-•-••-•----------•-----•--•--------------------------•----•-••-•••------•----•-•--••--.....••••-••----••----••••---•••••---•---------•-------•---••-•--•-------•-----------------•---•---- -y ate Permit No......................................................... Issued... / --....... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF........b.. ............................................. 01rrtifiratr of TOmpliatt ae THIS IS O RTI That the Indio' -al Sewa e�ispos System constructed ( ) or Repaired I2 stiller C!2/t at----�2_yZer"::........... L!/ ) __. has been installed in accordance with the provisions of �A 1J'a XI of T x te San' ary Code as described in the application for Disposal Works Construction Permit Nq...�--_- t----__------ dated__ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------------• Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ' BOARD 9HEALTH G ' '. ..............of....... . ------------------- ....�'� -�..._............ No.......... Bi-svoli6____ ork TTO !i rurtiott V utit Permission is hereby granted-------- --------� ----- •----------------------•---•---------••-----•---•-•--- to Construc /4 ) or Repai (� an Indivi .W -age ''-osal ystem atNo. ---_ __J� 1�-----•--_-� .�i_-•--------- -• -------• •--------•-- '.Street 7�1 as shown on the application for Disposal Works ConstruJction -e it _, �;—_. Dated..... '7-- - ---------- — 7J Bo�ylaPd of Health DATE.---- ------- ----- ---------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS _ Town of Barnstable P# Department.of Regulatory Services _ arArit�, • Public Health Division Date --- *AS& $ o0 Main Street,Hyannis MA 02601 161p �e Time Date Scheduled Fee Pd. Soil Suitability Assessment for Spw Qe Dino Witnessed By:. Performed By: LOCATION& GENERAL INFORMATION Owner's Name Location.Address -, CO Address Engineer's Name�Q0E� S4A� Assessor's Map/Parcel: NEW CONSTRUtf',TION REPAIR Telephone# 5 ��W. Land Use - Slopes(g'o) Surface Stones Distances from: Open Water Body ft Possible Wee Area ft Drinking Water well ft h ft Other ft Drainage Way ft Property Line _�-- mensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) SKETCH:($treet name,di r I V ' `}�11 -Ij G-3 35 Depth to Bedrock �� Parent material(ge(ilogic) t� � n,n Depth to Groundwater: Standing Water in Holei weeping Prom Pit Face WW Estimated Seasonal.'High Groundwater !Dt�T��FAAHNA N FOR SEASOiNAL HIGH WATE,R TABLE lD ry In. Depth td sail mettles; ft- �� Method Used: {. Depth dt*erved standing in obs.hole: In Oroundwater Adjustment Depth tolweeping from side of obs.hole: -- A� {actor_- AdI.OroundW4W Level,.,. Index Well# Reading Date Index Well level PERCOLATION TEST Datp � ��j�'' —�---�, Observation Hole# 91me at b" ---�' Depth of Perc --i— Time(9"-6") Start Pre-soak Time.0 --1=-'-'�- End Pre-soak —""'•— Rate Min./lnch Site Suitability Assc$sment: Site Passed Site Failed: Additional Testing Needed(Y/N) . Original: Public Holth Division Observation Hole Data To Be Completed on Back------ x:* `' n test is to be conducted within 100' of wetland,you must first notify the * If percola>�><p prior to begui g Barnstable C4#servation Division at least one(1)wedk p •DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Struc�re,Stones,Boulders. i tenGravel) 0 -co A 2 s Q �R - 1 M-C 5 02,5u 1 n �S DEEP OBSERVATION HOLE LOG. HoIe# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. nsistenc %Gravel) Co A . L i i9 YK 3) A -%o 1p 4 1-pose 01121'4 as�a �,ve.1 DEEP OBSERVATION HOLE LOG Hole# Depth from- Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) {USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi t c Gravel) ;DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stuctum Stones,Boulders. Consistency. rn I • t: Flood Insurance Rate Map: Above 500 year flood boundary No— Yes . Within 500 year boundary No— Yes Within 100 year flood boundary No Yes Depth of Naft4ally Occurring Pervious Material Does at least fo feet of naturally occurring pervi °s material exist in all areas observed throughout the area proposed Or the soil absorption system? 2 Is If not,what is the depth of naturally occurring pervious material? Certification I certify that on• 0 00 (date)I have passed the soil evaluator examination approved by the Department of env' nme'ntal Protectio t a th above analysis was performed by Me consistent with the required ng,expertise and exp rienc es ' ed in 310 CUR 15.017. Signature Date Q:1$EPTI0PERCb0RM.DOC Page 1 of 2 Parker, Alisha 7 01 From: Diane LeRoux [dleroux@hyannisfire.org] ,` ORL Sent: Monday, July 17, 2006 12:24 PM ! To: Parker,Alisha GGG"' VJ Subject: Re: UST Question V" J Hi Alisha, I have no record of UST -=/ b I do have 275 gal. AST removal application/and tank receipt from / /04. If there is an old UST - and if it has to be "filled in place" because of structural issues . .. � Mr.Pena will need application and "permission from the Chief of HYFD" for any filling of tank in place. Diane On Jul 17, 2006, at 11:59 AM, Parker, Alisha wrote: Dear Diane, spoke with Ralph Pina this morning regarding a UST located at 166 Straightway, Hyannis. He mentioned that he also left a message with you this morning as well. Do you have any information of a UST,first of all, and on the AST he replaced about a year ago? He had a home inspection because he is selling the home and the inspector noted that they saw a capped pipe near the new AST and said it was connected to a UST, but Mr. Pina has no recollection of any UST on that site. I don't have record of either here at the BOH. Any info. you could provide me with would be great and I can touch base with Mr. Pina when I hear back from you. I will also look in our old card filing system to see if I find anything as well. Once we determine if there is one there, I can direct him to you for removal/abandonment instructions as I have given him the basics. Thank you for all of your help! f� Alisha Alisha Parker Hazardous Materials Specialist ®� p Town of Barnstable Health Department 112-7 200 Main St. Hyannis, MA 02601 Phone: 508- 862-4645 Fax: 508-790-6304 alisha.parker@town.barnstable.m.a.us 7/17/2006 _ 1ANkchbo"" 3-24' DIAM. ACCESS MANHOLES ) rrrt�.,•��t•,.!�•'; �'. �' t - r i 166 letrelyhtwey *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A -A INLET r' 10' min. from / \ \ Gu T INLET L ' nd tion 1�. Existing Fou a house to se tic tank 9 P D-BOX corer must be PROFILE YIEItP OF ADDITION TO LEACHING SYSTEM ` i THE ACCESS COVERS FOR THE SEPTIC TANK, i Ss tic tank coven must be grade DISTRIBUTION BOX AND LEACHING COMPONENT 1 "TOP OF FOUNDATION ELEV. 100.00 Assumed P wtthln s In. of finished wtthln B In. of finished gradeC: Grade over Septic Tank - 99.00 �Grade over D-Box- 99.00 a owr SAS- 99.00 3• of 1/8' - 1/2' Washed Psaston � � SHALL BE RAISED TO WITHIN 6' OF �-�r� raj�v,:�+s w.;•;,• r,.• *°.' {? lf4 \ 3/4• to 1 1/2 ' Washed Crushed Stone �j FINISHED GRADE. - \ STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EOUALS S 0.02 3 HOLE H-10 4' PVC(CAPPED)INSPECTION PORT TO BE ON ALL OUTLET TEE ENDC, PLAN VIEW ST. BOX 3' Maximum Cover Top OF System- Elev. 96.75 INSTALLED AND TO BE WITHN 9.OF GRADE ` s� O 10 NEW Su0.01 or Greater 3-24•REIMOVASLE COVERS FYIST.PIPE to 1,500 GAL. S. 0.01' A '.. n n O 12' Per /cot 0"EfhetM Depth . . . . . 6eooeii.�aeeo.�etooawwao'�nr/era�tt".:,'•� 3 ; FROM EXIST,FOUNDATION an SEPTIC TANK u7 V. CONCRETE FULL FOUNDA II U ~ei1ei M tV S . a .,-.;. 4• r H-10 II 5 Units 2 6.25' 30' 3 min. deornna . 0.63' (,o inches) 3' 3, INLET e mh�rL m�. Inlet to outlet ..„ ,r "`�T GENERAL NOTES r OUTLET SYSTEM PROFILE 6 in. J/4'-1 1/2• d a 31.25' ' ,o'min T� e1N 1. Contractor is responsible for Digsafe notification compacted stone > i °i , to 37.25' s'-7' - s s'-r and protection of all underground utilities and pipes. Not to Scale - ; Effective Length $ 4'-0•min 2. The septic tank and distri Ldion box shall be set 3.5' 3.5 a e. tquw depth -` a 3,� > s.az' SOIL ABSORPTION SYSTEM (SAS) ;, bs level on 6" of 3/4 -1 1�2 stone. 3. Backfill should be clean sand or gravel with no e In.of 3/4'-1 1/2• p 10 u Prodded compacted stone < Effective VWtn a' INFILTATROR HIGH CAPACITY CH-20 LOADING)/ GEORGE O'BRIEN stones over 3" in size. !, NOTE' ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE GJ '''' `• •'` 't �' ' r j 4. This system is subject to inspection during installation ° (OR EQUIVALENT) Not to Scale 0 in 10'-a, s-°� by Carmen E. Shay - Environmental Services, Inc. w Bottom of Test Hole 1 EJev.-68.00 NOTE: OVERALL HEIGHT OF INFILTRATOR IS IS- /EFFECTIVE HEIGHT IS 10" 5. The contractor shall install this system in accordance Groundwater Observed - NONE OBSERVED CROSS SECTION END-SECTION ------ - with Title V of the Massachusetts state code, the approved plan TYPICAL (HH-10 LOADING) 1500 GALLON SEPTIC TANK and Local Regulations. 6. If, during installation the contractor encounters any NOT TO SCALE soil conditions or site conditions that are different May Substitute with 1500 gallon H-10 Poly-methylene Tank-George O'Brien Co. from those shown on the soil log or in our design installation must halt & immediate notification be made to Carmen E. Shay - Environmental Services, Inc. PERCOLATION �1 EST 7• No vehicle or heavy machinery shall septic over po septic system unless noted as H-20 se tic components. 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. Date of Percolation Test: JULY 24, 2006 9. All Distribution Lines shall be 4" diameter Sch. 40 NSF PVC pipes. Test Performed By. CARMEN E. SHAY, R.S., C.S.E. 10. All solid piping, tees & fittings shall be 4" diameter Results Witnessed By. DONALD DESMARAIS ( Barnstable B.O.H.) EXCAVATOR: Shay Env. Svcs. Schedule 40 NSF PVC pipes with water tight joints. Percolation Rate: Less Than 2 API ® 24" 11. MUNICIPAL WATER IS AVAILABLE TO THE SITE and Surrounding Properties. Test Hole Test Hole No. 1 No. 2 LOTS #88 DEPTH SOILS ELEV. I DEPTH SOILS ELEV. 0 99.00 0 99.00 DOTE• Sandy Loam Sandy Loam THE PROPERTY LINES ARE APPROXIMATE AND COMPILED FROM THE PLAN BY CB HUMPHREY COMPANY tO.rR 3/2 10 YR 3/2 LAND COURT PLAN LCC 11328-B, SHEET 1 0"-6• Ae 98.50 0•-6• Ae 98.50 DATED 928 AND S NOT�INT INBER TENDED TO BE A SURVEY PLOT PLAN LOTS #89 & #9O �nmy oamy IT SHOULD BE USED FOR NO PURPOSE OTHER THAN I THE SEPTIC SYSTEM INSTALLATION. 46,870 Square Feet 10 vR a/s 10 rR s/s I °' 98 6"- 24" 8, 97.00 6"- 24" Bs 97.00 168.0 � Medium/Coarse Medium/Coarse Sand Sand NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE ✓' 2•S Y 7/4 25 Y 7/4 FROM THE EXISTING CESSPOOLS TO BE DISPOSED 24"- 132 G 2a•- 132 C, OF AS PER BOARD OF HEALTH SPECIFICATIONS. EXISTING CESSPOOLS TO BE PUMPED DRY & FILLED IN PLACE I I � ------------ ----- SHED PROJECT BENCH MARK ASSESSORS MAP - 268 PARCEL - 103 TOP OF FOUNDATION ro ZONING - RESIDENTIAL ELEV. = 100.00 (Assumed) ••� FLOOD ZONE C �p Perc �11 Depth to Perc: 30" to 48" Perc'Rate= 2 MPI Grc;undwater Not Observed THERE ARE NO WETLANDS LOCATED WiiTHIN .A,200' RADIUS Observed H 0 S 10 1 t t I too Obs ADJUSTED2 Elev. = None OF THE PROPERTY EXISTING \_ a 2 BEDROOM f I ► ; HOUSE All OUTLET PIPES FROM THE LEGEND , SET DISTRIBUTION BOA SHALL BE EXIST. SET LEVEL FOR AT LEAST 2 FT. 12' ��COVER \ 3- 6•OUTLET r •• a.�. 2 / DRIVEWAY 166 ,� 1 / ` \ - KNoatouTs 8X0 DENOTES PROPOSED OUTLET ' 12' NLET - SPOT GRADE II �\ ����_\\\�� �''� ��\ _ :i e•,,,. �s• ' X DENOTES EXISTING 104.46 -Tl ti \� i i' `� i •�\--- -99 +as•, Las• SPOT GRADE it III i, // �� PLAN SECTION CROSS-SECTION PL PROPERTY LINE (� II III c i 3 HOLE DISTRIBUTION BOX H-10 LOADING PROPOSED CONTOUR NOT TO SCALE o 97- - -- - -97 EXISTING CONTOUR Design Calculations DEEP TEST HOLE & V1o'� V C i spool O NEW PERCOLATION TEST LOCATION 2 ' 1500 gal. i Septic Tank p Number of Bedrooms: 2 Equivalent to 220 Gal./Day (330 Gal./Day Min. per Title V) FENCE / I Garbage Grinder: No Failed I0 Leaching Capacity Proposed: 330 Gol./Day Minimum (Min. Per Title V) Cesspool I\ TEST HOLE #1 Septic Tank - 2 x 330 Gal./Day 660 USE NEW 1,500 GAL. Septic Tank. PRIVATE DRINKING WATER WELL \ ELEV.= 99.00 D-Box SOIL ABSORPTION AREA: Using percolation rate of G2 min./inch Bottom Area: 0.74 gal/sq. ft. x 370 sq. it. = 273.8 gallons REVISIONS Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons I I I --_ O M� drli'•' ' I i/ - � ""� • ,,. f .5' Providing: = 331.80 gallons NO. DATE: DEFINITION j I j �� �� ��`���' .��, • ., ,�,' ` \ Use: (5) INFILTRATOR HIGH CAPACITY H-20 IJNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, 97.2 `��\\ TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE ON THE ENDS. NO STONE UNDER. TEST HOLE #2 ailed ELEV.= 99.00 Cesspool PROPOSED FOR * PREPARED�.� 2°5•° SUBSURFACE SEWAGE DISPOSAL SYSTEM I OF RALPH 8c OLGA PENA # 166 STRAIGHTWAY 1 I , I It I , 166 STRAIGHTWAY HYAN N I S, MA 1 1 Ilk II I HYAN N I S, MA PREPARED BY: 1 �A I \ 1 02630 U . AR YL fir;. C.4RHEY E. SHA Y I ENVIRONMENTAL SERVICES, INC. 1' 'II IIII 0 20 40 50 o p II CO 0. �FG1 E��a P.O. BOX 627 ' 1 Q, ST EAST FALMOUTH, MA 02536 SCALE: 1"=20' sANITARIPN TEL/FAX : 508-539-7966 SCALE: 1"=20' DRAWN BY: CES DATE: JULY 24, 2006 PROJECT#SD-943 FILENAME: SD943PP.DWG SHEET 1 OF 1