HomeMy WebLinkAbout0013 SUDBURY LANE - Health 13 SUDBURY LANE, HYANNIS
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TOWN OF BARNSTABLE
LOCATION 1-3 Sc�'j `-I L1.1 SEWAGE#
VILLAGE iA 1 I ASSESSOR'S MAP&PARCEL -N:7I- -N,1-7
INSTALLER'S NAME PHONE NO.
SEPTIC TANK CAPACITY W-ro-'K
LEACHING FACILITY: (type) LC.1+ (size) 49S <143
NO.OF BEDROOMS 5�4--tL "*116-I&C-4
OWNER t—t I Wei.
PERMIT DATE: 4 1--5-1' COMPLIANCE DATE: V I
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility —4--S Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) N Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) M Feet
FURNISHED BY �s�r✓ r�Pr Crlt�ye..,o..h r
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No. PLO`' Fee w`�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftplication for 3Disposal 6pstem Construction i3ermit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System [Individual Components
Location Address or Lot No. `� � Owner's Name,Addre��,rs�,,and Tel.No. GDP-
Assessor's Map/Parcel Q a� l lt�l1 0 .® l_ Cra&O/
Installer's Name,Address,annd�Tell.No.q!5'0'6-`Y)1—cl 399 Designer's Name,Xddress,and Tel.
�'OYtstr�%—�-rcm,
S oay.48 00695'
Type of Building: 2
Dwelling No.of Bedrooms Lot Size , �g sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.
required) gpd Design flow provided v y� gpd
Plan Date wuwZ �ao) Number of sheets Revision Date
Title l 4e A-13 b(R/L
Size of Septic Tank (W5kA* 1490, X� Type of S.A.S. o Sir S aZ6*1,K . (a;
Description of Soil&,e
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 a o place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date l— `j
Application Disapproved by Date
for the following reasons
Permit No. ,��� � Date Issued
, 1 ^r '-i` l`x„ .•�+a�. +.rah.,.a .�. «y r -Y
'y Mil
No. a ,�. , r Fee
THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: Yes
es
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS -�--
appYication forty "'sposai 6pstem Construrtion Permit
Application for a Permit to Construct( ) Repaid • Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No.to &JAU la/,V_ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 627f ;4 1,1�UVU G4 !S0 a/ 1 a.•qm n 2vid p)G
Installer's Name,Address,and Tel.No.a'OS-'?01-9 399 Designer's Name,Address,and Te04o.
(ZorloIC'U Cvn,�. �T nc C ie t eis', StM1-•
:i��� a} F� 9 lGtt (r ndlAal'o. 4AA 0,108 r. ,.. -.
Type of Building: / d y
Dwelling No.of Bedrooms Lot Size /3,3%& sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) C 3 gpd Design flow provided y gpd
Plan Date Cxk6h 66, cc)s Number of sheets Revision Date
Title 1;1 je S /4 1.3 SLJk&A 1(kU-),9 11i//rja19/S ./u/4 _
Size of Septic Tank:f-Xi fit, •/ y t/),� Type of S.A.S. .t- 57aaa,r,0 11r?el&{,,f'r1,.�,rL,45 Q!S* X J21
Description of Soil 6CLO
I Nature of Repairs or Alterations.(Answer when applicable)
Date last inspected:
Agreement: '' p
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage•disposal system in
accordance with the provi"sions of Title 5 of the Environmental Code and.no to place the sys em'in operation until a Certificate of
I _ -
Compliance has been issued by this Board of Health.
/
Signed Date
Application Approved by / Date
- t
Application Disapproved by Date
for the following reasons
Permit No. Date Issued 1 "�
THE COMMONWEALTH OF MASSACHUSETTS Y
BARNSTABLE,MASSACHUSETTS
~w..• Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage(Disposal system Constructed( ) Repaired(� Upgraded( )
Abandoned( )by L nr A� l"C/Yx F1C�1'1 ,Z-7C '
at: 13-Sj-d L,Ara- ,. i,),p U has-
been constructed in accordance
with the provisions ddof Title 5 and the for Disposal System Construction Permit No.& �k—5 dated O
Installer &r4alo'�&o( %�trSl"•r�1.Y,t ,' ^C. Designer i..JcwdZiN �c'1t .acNp a ,tglg�n.tntP , t C
#bedrooms Approved design flow gpd
The issuance oft this permit shall Act be construed as a guarantee that the s, Z,i ffiiiiietion as desi
Date ) / / �5 Inspector /,4'_/ /P
v
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
= : disposal 6petem Construction Permit
Permission is hereby granted to Construct( ) ,r Repair(N Upgrade( ) Abandon( )
System located at e 14
//mot ,ta e-I C C( 7 a XVi im/ 5
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must b mpleted within three years of.the date of this permit.
G 1-5
Date � � 6�� � Approved by `
f
-21-2018 04:52 From: To:15087906304 Pa9e:1,'1
Town of Barnstable
Rectory Services
Thomas F. Geiler;'Director
BAMW/.VXA
a6M ,0 ]Public Health DIVision
,reK" Thomas McXean,Director
200 Maim Street,Hynnmis,MA,02601
Office: 508-862-4644 Fax: 508-790.6304
]installer&P—eskyacr Certificatioxx 1Foran
Date:.// �' �P SQwsge�er�rei4# Z-D/� ' Aasessor's MapTarcel Z71 7
IDcsigraer: n'
Adldress: 3 /"� Address: _�•a 89'X 70
M 14 Pr /�-AA �
On was issued a permit to install a
n (instAller)
septic system U at 13 L41 L L..,, based on a design drawn by
(addre —1 ji
a
tcw� el /9: P dated l0 .
esi er) _
I certify that the septic system referenced above was installed substautia]ly according to
the design which may include.minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
X certify.that the septic system, referenced above was installed math Major changes (1_e_
. greater thm 10' lateral relocation of the SAS or any'vertical relocation of any eomponemit
of the septic but in accordance with State &Local Regulations. Plan revision or
certified y designer to follow.
(Zr�stallor'S tgmtuxe)
� 'LO''�a ,/�••A''� ••`
(Designer s Sig a e Ada pesigner's Stamp 4ere
PI. AS'Fi, RETC7RN TO laARNSTABL RUBT�7C YDYVYS)ON 8'f�7[CA1'E ®>F
rnt MtA.NGE WILL NOT IaE ISSUED Ti lL BQ TEDIS FORKAND AN BUILT 9AM
ItECE f STAJBx. PUBLIC '�lD Ol�L YOM
Q:Hcaltb/9o�ticlbes�gnor Ccrttfication T?o,nm 3-26-04.doc
Town of Barnstable P#
6�503
t�
�o. Department of Regulatory Services /
(X
x BARNSPABLE,* Public Health Division ell
Date l D 9
9 MASS.
0,5o. �0� 200 Main Street,Hyannis MA 02601 y1�
ArED MA'S� I'ti7
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Date Scheduled Id. Time �'�'"�
- Fee Pd.
P+�
Soil Suitability Assessment for S "'gage Disposal(
Performed By: P,cg trA 9 Gt. Witnessed By: G�
LOCATION& GENERAL INFORMATION
Location Address i?eV`DaU-y W - Owner's Name � 00fNQ
O1 AN NO 7 Address
Assessor's Map/Parcel: 2,71 /Z 17 Engineer's Name �J�[ t I�P��.�IN
NEW CONSTRUCTION REPAIR Telephone# V—3A-L 4511
Land Use /� Z� oGt Slopes(%) Surface Stones
Distances from: Open Water Body /CO ft Possible Wet Area I�ft Drinking Water Well p* ft
Drainage Way + ft Property Line d?o—ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
f
0
Parent material(geologic) C f�� f IV dMPY-S. Dep th to Bedrock
Depth to Groundwater: Standing Water in Hole: P 4-J Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
y
------Depth-Observed.standing.inobs.hole: in. Depth-to soil mottles:- _ in;-
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level
PERCOLATION TEST Date Time
Observation
Hole# Time at 9"
I/
Depth of Pere _ Time at 6"
Start Pre-soak Time @ lVG Time(9"-6")
End Pre-soak d
Rate Min./Inch k" e aA
Site Suitability Assessment: Site Passed_� Site Failed: Additional Testing Needed(Y/N)
Original: Public.Ioa-ith Division Observation rioie Data'To Be Completed`on Back-----------
***If percolation testis to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
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DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
yt
Consistent %Gravel
6-�{ �� b. Alz
1a Y g! Q6
DEEP OBSERVATION HOLE LOG Hole# Cyr
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
}
Flood Insurance Rate May:
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No V Yes
Depth of Naturally Occurriniz Pervious Material
Does at least four feet of naturally occurring pervious-material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certification ,,� ®"
I certify that on rj ,date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature Date hl
Q:\SEPTIC\PERCFORM.DOC
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Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments
;M 13 Sudbury Ln
Property Address t..
Jim Hagemeister
Owner Owner's Nam
information is
required for every Hyannis MA ?�
02601 5-9-16 z
page. City/Town State Zip Code Date of Inspection °, db
W
Inspection results must be submitted on this form. Inspection forms may not be altered in a y
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector:
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S 13971
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true,accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Furt io by the Local Approving Authority
5-9-16
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner,
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form P
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required;for every Hyannis MA 02601 5-9-16
page. qa City/Town State Zip Code Date of Inspection
fi
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes: '
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
System is in good working order with no sign of failure.
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N .❑ ND (Explain below):
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form`
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of inspection
B. Certification (cont.) T
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.): '
❑ Observation of sewage backup or break out or high static water level in the distribution box due
Jo broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in orderto determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins 3/13 Title 5 Official Inspecton Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts -
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis, MA 02601 5-9-16
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment: 1, _
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system.has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate Yes or No to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
El ® 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
t5ins•3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 13 Sudbury Ln
Property Address "
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails.The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA) or a mapped Zone 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 E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
-
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments
M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. Cityfrown State Zip Code Date of Inspection
C. Checklist ,
Check if the following have been done. You must indicate "yes"or"no" as to each of the following:
Yes No '
❑ ®. Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were'any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
0 s ❑ 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?
® Q Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
❑ ® Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any,of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
r
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln
'aM
Property Address
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information 7
Description:
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available (last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 2016
D ate
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection form '
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other describe below):
General Information
Pumping Records:
Source of information: N/A
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy ,
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP,approval.
❑ Other(describe):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
1980's
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 24"feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank(locate on site plan):
Depth below grade: 18"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 gal
Sludge depth:
12"
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage.Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is
required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
20"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
7 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
' 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is Hyannis MA 02601 5-9-16
required for every y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) r
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Good condition with water at working level and no sign of back-up from pit.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3/13 Title 5 Official Inspedon Form:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Foam -Not for Voluntary Assessments
M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number: 1-1000 gal
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach pit in good condition and empty at inspection with stain lines at 30" below inlet invert.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is Hyannis MA 02601 5-9-16
required for every y
page. CityTTown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan): ,
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
13 Sudbury Ln •
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
B
r
b
p . i
I
. _ r
3Q
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts :
Title 5 Official Inspection Form- ,
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:,
❑ Check Slope
❑ Surface water , {
Check cellar
Shallow wells
Estimated depth to high ground water: 20
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
® Checked with local excavators, installers- (attach documentation)
® Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
USGS and town maps show groundwater at greater than 20'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspec5on Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 13 Sudbury Ln
Property Address
Jim Hagemeister
Owner Owner's Name
information is required for every Hyannis MA 02601 5-9-16
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
Z Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
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TOWN OF BARNSTABLE
LOCATION SEWAGE #
VILLAGE /l ASSESSO 'S MAP &LOT Z/7
UQ NAME&PHONE NO. /
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type--/ ,J (size) C)
NO.OF BEDROOMS 2,
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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 faa ) / �� Feet
Furnished bf,40foai
L
L'O C A T 10N SE G E PERMIT NO.
VILLAGE
INSTAI R' �c5G1 R ADDRESS
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BUILDER OR WNE
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DATE PE MIT ISSUED
DAT E COMPLIANCE ISSUED
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..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................T.own.............OF..BaMB.table........................................................
Appliration for Disposal Works Tonstrurtion Prrutit
Application is hereby made for a Permit to Construct (K ) or Repair an Individual Sewage Disposal
System at:
t...#... 4ress- ................... ............. ................................................
Location dd or Lot No.
...Ca.pr i a orzi..Rg a 1-:ty..EM13 t................................ ....76.5---Fal ma u t1i..Ro a d..._Hyamn 1 a...................
Owner Address
...Steve....L.e.he I................................................................ ..................................................................................................
Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling—No. of Bedrooms---3......................................Expansion Attic Garbage Grinder ( )
Other—Type of Building ranch............. No. of persons............................ Showers (2 ) — Cafeteria ( )
Otherfixtures .......................................................................................................................................................
Design Flow........5.5..............................gallons per person per day. Total daily flow...........3.3a........................gallons.
01 Septic Tank—Liquid*capacity;LQ.Q.Q.gallons Lengtk'.6 Width..4.'.I-0" Diameter________________ Depth..5.'.8......
Disposal Trench—No..................... Width............._._._.. Total Length___................. Total leaching area....................sq. ft.
Seepage Pit No....1................. Diameter........6 Depth below inlet.......('........ Total leaching area.....260....sq. f t.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Re�2-'•-•
is Performed by._....Eldre_dge...Engine.ering.......... Date...11=2.5=8.1...............
Test Pit No. I 0....minutes per inch Depth of Test Pit..12............ Depth to ground water-no-ne....enCounte
e
Test Pit No. 2.-NIA.....minutes per inch Depth of Test Pit...W/A......... Depth to ground water----N/A...........
.................................................................................................... I
----------*----------------------------------------
0 Description of soil.......
... .2....'
..........I.Q.1m..&....tap.S.Qll...........................................................................................
-----------**----------............2.1... 1.0..'......medui rnellaw...sand..................................................................................
-
....................................ID......=...12........med,....whLte....sand/:txaces...os..graval/..no...wate.r----at...12 '
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 TLITY-E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee xi issyedV the b ,rd of health.......... ...........
igned. . .. .......I.....t�lz ......... .........
Application Approved By...... .......... .... ................................................................... ......7"
....... ........ . ..............
Date
i/ned -
---- ---- .....
ly..... .... 4 Application Disapproved Irthe ollowin,g reasons:................................................................................................................
.......................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
y Ni .� .� Fes$.............................. '
.� THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-_ .................T awn.......-----.O F..Barns•able...........--------------......................•..----••
Appliratinn for Disposal Works Tonstrndinn thrmit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
...LO.t..' .'a. r. ,; nnis. A4A.
Location dress or Lot No.
-•c_&prj-eo_j ...R-ea ty 'Est-------------------------------- ---7.65--Falmouth--F� achy Hya e-----..---..-------
t"` JOwner �ddresS
a :ue Leb l................................................................ ..................................................................................................
Installer Address
U Type of Building Size Lot............................S q. feet
Dwelling—No. of Bedrooms...3......................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building 1 p,l yp g rs,pyoj�_____________ No. of persons..........__....._.._....._. Showers (2 ) — Cafeteria ( )
a' Other fixtures ............................
W Design Flow.........�5.............................gallons per person per day. Total daily flow.___......_330........................gallons.
04 W Septic Tank—Liquid capacityj,QQQgallons Lengtl$!.6......... Width..)4_1 10.1' Diameter................ Depth....5.!_$.....
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_1............... Diameter........6.1....... Depth below inlet.......6.1....... Total leaching area.....26C....sq. ft.
z
Other Distribution box ( ) Dosing tank ( )
'-' Percolation Test Results Performed by ; i ..........Eldred_e.-E ineer .. Date...11.,2 8l..............
a
,--4 Test Pit No. 1.<2,.0---minutes per inch Depth of Test Pit...12_.......... Depth to ground water.V_pr-le-..P_ .Eounte -
(i, Test Pit No. 2---N/A-----minutes per inch Depth of Test Pit...N/4........ Depth to ground water----N/A----------- e
---------------------------------••-------------•---•----------------•---.._......._......--•........................................................
ODescription of Soil........0.1---•"...2'.........loam... :-.topsail...........................................................................................
......................................... -`-------141------medu ---yellow•-sand--------------------------------------------------------------------------------
W -----•----•-----------------••••----gA ' 1-2=......meta--4h.1te...sand/traae-s
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 ofi:1,; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Complian a has been iss ed by the board of health.
Sign(• �' .....- !'=' ?fi A4te
� , ~..
Application Approved By............•..............
.................................•-•--. --._. ........ •--•----------------•---.
Date
Application Disapprove or the following reasons------------------------------------•-----•--------------------•-----------------•---•-•-•-••----•-•-•-.....-----
-----------------------------------------•-------------------••----------------------...................-•-----•....._...•••••-•---------------------------------------................................
Date,
PermitNo......................................................... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................ .ovm.............OF...........Barnstable..........................................
Trrtifiratr of f�untpli anre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (X ) or Repaired ( )
by....-•---........Steye---Lebel.............................................•-----------------------------------...................---..........---......------.............----
Installer
at.......... 0 .--# a ----. --. ' .l .............................B3mna r--- -•-------------------
has been installed in accordance with he provisions of T191Z - dog tThe State Sanitary, e� �5'cribed in the
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SAT SF TORY.
DATE.-----•............................. .�.!.... . ------------ Inspector..................... :1._k .................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
o To4vn.....OF,
...Ba.rnstable.....................•-............_............
No......................... FEE........................
Disposal Works TMntrnr#aan rranit
Steve:_LOCI.•----•-----••••-•------------•••••-•••---•--••.........................
Permission is hereby granted...................... .... .. . .
to Construct ( or�tRepair ( ) an Individual Sewage Disposal System
at No...... ,G1t sue_ �3 f1 L_ IIYW l'
.-_. ...0 _ tee- ....an .._.. /
Street
as shown on the application for Disposal Works Construction Permit No....................: Dated..........................................
...............
/ / Board of Health
DATE.............................................�._�••-�.7`/- ----....---
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS.
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LEGEND
EXISTING SPOT ELEVATION Ox0 �P�(N OF s CERTIFIED PLOT PLAN
EXISTING CONTOUR —0 ?� q°ti L. v � 22 �„p
FINISHED • SPOT ELEVATION ALBER
FMISHED CONTOUR 0 ��`g A/
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No. 10951 O 1 N
AOVEO$ ®OARD OF .HEALTH A9o�scisTE��� -' �� ��•�.��ss o
S1ONALE
DATE AGENT SCALE, "� 3 D DATE , /v
Ely6 6lti6/NEERlN0 COt /A!
CLIENT________.. I CERTIFY THAT )THE PROPOSED
®tBTIC At REGISTWAtt OB NO. BUILDING SHOWN ON THIS PLAN
CIVIL , LAND. CONFORMS TO THE ZONING LAWS
DR
no .. OF BARNSTABLE , AS$.
112 101414 STREET , CH. BY,
MYAWNI3,, MASS. ` SHEET OF 2 DATE 0. LAND SURVEYdROF
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SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES
MARKED WITH MAGNETIC TAPE OR
COMPARABLE MEANS FOR FUTURE LOCATION.
(NOT TO SCALE)
1. DATUM IS NAVD 88
PROVIDE MIN. 20" DIAM. WATERTIGHT i
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE
2. MUNICIPAL WATER IS EXISTING
TOP FOUND. EL. 61.1' FILTER FABRIC OVER STONE ai 5
o`
MINIMUM J OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 59.0-59.5' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Q\r Royto 28
o
NOTE: 2" MIN. WALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST
PRECAST H-10 THICKNESS REQUIRED BLOCKS OR UNITS TO BE AASHO H-M os
RISERS (TYP.) PRECAST RISERS
,.a., 2'0 4"WSCH40 PVC MORTAR ALL H-10 0
6" MIN. SUMP PIPES LEVEL 1ST 2' COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. Q
�4' INV S EL. 55.70
12" MIN. INT. DIM. (TYP.) 4 , •� v
ENDS SIDES 56.53 Locus
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE o
10" **EXISTING 14" °o°o° 00000000 WITH a� e
TEE SEPTIC TANK TEE * ���� 0��� ao�o-o -aaoa o
EXISTING 57.0 t WATERTEST D'eox 000�a�00000 oo�a�aoaoaa 310 CMR 15.000 (TITLE 5.) �o Q
O%00-
0000000 °°° a a
GAS BAFFLE ..' 0 0 0_ FOR LEVELNESS 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND
;00000 0o a0000aa000� 0000aoaoao� ;00000000 s�
55.97' 55.80 ° ° ° ° °g°o°o°0 53.7 NOT TO BE USED FOR LOT LINE STAKING OR ANY soo Q
°°°°° ° OTHER PURPOSE.
3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
(2) UNITS REQUIRED
ALL AROUND PRECAST STRUCTURES 9. COMPONENTS NOT TO BE BACKFILLED OR
6' CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00, X 12.83', CONCEALED WITHOUT INSPECTION BY BOARD OF o
r COMPACTION. (15.221 [2]) iv CONCEALED
HEALTH AND PERMISSION OBTAINED FROM BOARD
OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP
48:5' BOTTOM TH-2 CALLING DIGSAFE (1-888-344-7233) AND
( 5.7 q, SLOPE) ( 1 % SLOPE) NO GROUNDWATER FOUND VERIFYING THE LOCATION OF ALL UNDERGROUND &
OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000'f
FOUNDATION- EXISTING SEPTIC TANK 18' LEACHING WORK.D' BOX 12' FACILITY ASSESSORS MAP 271 PARCEL 217
11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL
BE REMOVED BENEATH AND 5' AROUND THE LOCUS IS WITHIN FEMA FLOOD ZONE X
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC PROPOSED LEACHING FACILITY.
UTILITIES AND ALL SEWER OUTLETS AND ELEVATIONS PRIOR TO TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY (AREA OF MINIMAL FLOOD HAZARD) AS
INSTALLING ANY PORTION OF SEPTIC SYSTEM FOR RE-USE. REPLACE WITH 1500 GALLON 12. EXISTING LEACHING FACILITY SHALL BE PUMPED SHOWN ON COMMUNITY PANEL #25001CO566J
AND REMOVED OR PUMPED AND FILLED WITH CLEAN DATED 7/16/2014
LEGEND SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF SAND.
NOT SUITABLE
99- EXISTING CONTOUR - SITE IS LOCATED WITHIN A ZONE II
X 99.1 EXIST. SPOT ELEV.
-[99]- PROPOSED CONTOUR
[98.41 PROPOSED SPOT EL. SYSTEM DESIGN.
TH1 GARBAGE DISPOSER IS NOT ALLOWED
TEST .HOLE
Y 62 �R DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD
2� SLOPE OF GROUND 't USE A 330 GPD DESIGN FLOW
UTILITY POLE
32' 1"w LOT 22 rn SEPTIC TANK: 330 GPD (2) = 660
FIRE HYDRANT S76 6 z h,
Is V
'
13,388 S.F. _
NOTE: NOT ALL SYMBOL'S MAY APPEAR IN ORAWINc . - V 1 �s� **RE-USE EXISTING 1000 GAL. SEPTIC TANK
c LEACHING:
p SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD
TEST HOLE LOGS BOTTOM 25 x 12.83 (.74) = 237 GPD
BENCHMARK:
CEMENT BOUND TOTAL: 472 S.F. 349 GPD
ENGINEER: CRAIG J. FERRARI, SE #13871 =60.4' NAVD88
DON DESMARAIS, RS o USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
WITNESS: WITH 4' STONE ALL AROUND
DATE: 10/29/18 TH2 EXISTING
rH1 ��
PERC. RATE _ < 2 MIN/INCH SHED DWELLING
� TOF = 61 .1
CLASS I SOILS P# 15803 ��'�✓ �;� MA
APPROVED DATE BOARD OF HEALTH
ELEV. ELEV.
OppPAVE
4 59.5' p„ 59.5' o ° �\ DECK DRIVE s�
0 0 y^PATIO
A A � 6
LS LS TITLE 5 SITE PLAN
4„ 10YR 3/2 6„ 10YR 3/2 .O OF
#13 SUDBURY LANE
4 B B 96 32'3A, E HYANNIS, MA
LS LS s 4p 91
30" 57.0' 24" 57.5'
10YR 5/6 10YR 5/6 ° PREPARED FOR
CAROLINA AQUINO/
PERC 9 0 BORTOLOTTI CONSTRUCTION
c c
COARSE COARSE DATE: OCTOBER 29, 2018
SAND SAND
------, off 508-362-4541
10YR 7/4 10YR 7/4 i ��AaF M,1SO, a��N OF MAssy fax 508-362-9880
DANlELA. yG� �v pANiEL cyGs downcape.com
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CIVIL
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132" 48.5' 132" 48.5' U 4602 No,4p
Scale: 1
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= 20 °R�r ,E�`� °�w a�
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NO GROUNDWATER ENCOUNTERED AL e �I w land surveyors,
939 Main Street ( R to 6A)
SCE # ' �_�$ , o 0 20 30 40 5o FEET DATE DANIEL A. OJALA, P. P.L.S. YARMOUTHPORT MA 02675
18-381