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HomeMy WebLinkAbout0055 VINEYARD AVENUE - Health 55 Vineyard Hyannis A 291 - 132 e y 11 7 l TOWN OF BARNSTABLE_ LL'' LOCATION t�5� SEWAGE#p 6'— 7Y® VILLAGE ASSESSOR' MAP&PARCEL +vJ INSTALLERS NAME&PHONE-NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) f[C4V-,r (size) 50 iC NO.OF BEDROOMS per — .Fc r 14 OWNER Vim. v '- PERMIT DATE: f��i�,?� COMPLIANCE DATE: C� 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 �4-b. IVA* 1 .�V No. lD "LU� ,. =�, Fee �vv t a THE COMMONWEALTH`OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipprication for Mi.5po!5a19pp6tem Cou5tructiou Permit Application for a Permit to Construct O Repair O Upgrade ) Abandon O Complete System F-1 Individual Components Location Address or Lot No. 'vie rOwner's Name,Ad ress,and Tel.No. Assessor's Map/Parcel ' y 3apA�S Installer's Name,Address,and Tel.No. `��" _ Designer's Name,Address and Tel.No. S 5� �(G� 1 � annt5 aZ og77�1 � P���'`ba7r F m 253� Type of Building: 11 Dwelling No.of Bedrooms Lot Size J sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min,required) '-3 3cl gpd Design flow provided 7 13 ' 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) 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 itle 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by thi Boar of Healt j� D r Si ed Date 6 vl 2 Application.-Approved Date ti r Application'Disapproved,by: .:.Date for.the following,reasons Permit No. "" SD Date Issued �© Xw No. c5m" �vJ� �1 .�.. �.... Fee Y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: y PUBLIC HEALTH DIVISION.-.TOWN,OF BARNSTABLE, MASSACHUSETTS Yes F 3pp ication for � gpogar *Votem Cottgtruction Permit Application for a Permit to Construct O Repair O Upgradey) Abandon O Complete System ❑Individual Components IK Location Address or Lot No.5 c YC" wner's Name,Adtlress,and Tel.No. Q,n►�1S �I Assessor's Map/Parcel i 5 37 Installer's Name,Address,and Tel.No. ��S Designer's Name,Address and Tel.No. 1 1957, qyannt,5 ozw I %ZA TI pe of Building: n z Dwelling No.of Bedrooms 0 Lot Size �J R) f sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �/�/ °'] Design Flow(min.req fired) 3a gpd Design flow provided 7 ( 3 ' / d gP Plan Date I Q -7 (xp 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) ( �"--- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of Healt S'gned Date VUUbel Application Approved Date 1 / V L Application Disapproved by: Date for the following reasons Permit No. / Date Issued / b THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance -r e THIS IS TO CERTIFY,th t the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by ' �e r`�5 S f? 4,e-' ,� . at 5 ►//l f)e Lia 0 4Wd0n1,5 has been constructed in accordance with the pro isions of Tit the for Disposal System Constr ction Permit No.c�c� -" 7 5� dated 10 h R Installer /tx- Designer -SA 4 3 #bedrooms Approved design flow gpd The issuance of this permit sh/all of be co.sstrued as a guarantee that the system will Fiction as s, ed. Date O Q J-3 / 1� Inspector No. � 0 !��� Fee U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS wigpogal 6pgtem Congtrurtton Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade (y.!) Abandon ( ) System located at i n e cod CLl'l Yl 5 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 co pleted within three years of the date f this pe tt. Date �� ( I � Approved`by__ 01/20/2017 19:33 FAX IR002/002 Town of Barnstable Regulatory Services Thomas F. Geilear,Director MMSTABM KAM 1639. ' Public health Division D '� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 509-862-4644 Fax: 508.790-6304 Installer& Designer Certification Form Date: 10-23-06 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 10/18/06 _ Robert Septic Service was issued a permit to install a (date) (installer) septic system at 44 Vineyard Avenue, Centerville.MA based on a design drawn by (address)' Shay Environmental Services Inc. dated 10/17/06 (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. 4� 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. (I ler's Si } , �o CA M 181 0 (Designer's Signature) 0 (Affix M PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLLAll10E WILL NOT BE IS TJU,19_FORM AND AS- BUILYCARDARE- 0 A s :E IiC E LTH D SON. THANK YOU. Q:Health/Septic/Dcsigncr Certification Form Town d M table' Departmant of R ri'Services Public Heal4fh:Division Date NAM'a 200 Maao Street.Hyaaats MA OMI *61 Fee Pd. Date Scheduled ,foil Suitability Assessment for S age Disp al witne"ed Br. Performed B) LOCAnON&GENERAL> ORMATI0 �9✓ J Location Address' �-�✓,r �, ,arm Addressc00%z �� i .l MA Assessor's Map/P$tceJ: .`1'NBW CONST tl.J iMONl RBPAat I Teleph # ��f�✓i/aL Slopes(`�) Surface Storrs Land Use �'� ft Dr g Wader Welt Open Distances from: Water Body�ft. Possible Wet Area?�— Drainage Way 7,2Qn! ft Property Crop dirrreasi of lot.exact locatieas of test holes do pare tests,locate wetlands is proxitY to holes) SKETCH:( j All . 1 71: t X_ m �'j E QUTY✓ i Depth to BedMk parent material(ged.10gte) ��^� � �73' pit Hen Weeping tlom Depth to GroundwaW. Standing Water in Hole:' BstimaW Seasonal;igh Gmundwalor nON FOR SEASONAL H1GH WATER' ABU D��[�'C .N Mcdwd Used End lo. Depth t0 wll tttoalee: F✓.0 fw Mp� ervw amadiag in oba 6olc 1p= t)ronndWrort aide at oba=bole: Adj.faetot..==. �_�pdwW 4wsl -- Depth tolwcepiag ti g l index Well level - = Index Well# Reading I)ao4 �_ _� ^zx +� Data=,.�..�... ' I- M c�' PERCOLATYON T lion -nine at Hole# Time at Depth of Pere Start Pre-soalt Time ✓a;oo.►�� j Fad Pie soak �C21W Rate Min.11ach " ng Needed Adddron t,Tjwd C Site Passed Site Failed: i Site Suitability Asse�smon ' le on Back Ori na(; Public Health TNvisiO° Observ�o�Hole Data To Be C�iPPtCd notify the * a 'On test is to be conducted within 100'of Weal beg nning� *�' If percol �.__ __ _. „„�a n wetik nrlo Dt,L.I,U IILSJ.t(VA x..0.t-i LUG dole Depth from Soil Horizon ' Soil Tulare soli Color soil other Sttrfaoe ra) (USDA) (Mansell) Mowing PUMP= Stones,Boulders. ravel 3 J I DEEP OBSERVATION HOLE LOG. Hole# _ Rom Soil Horizon Soil Teahrrs Soil Co Surface(in.) (USDA) (b? lto Soii Other Mottling (Structure,Stones,Boulders. 96 ra 'DEEP OBSERVATION HOLE LOG Hole# mpth from. Soil Horizoo Soil Tature Soil Color • Soil other Surface(in.) (USDA) (Mansell) Mottling (Strumm Stones,Boulders. PEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horlsoo Soil Triture Soil Color Soil Atha Surface(io.) (USDA) (Mansell) Mottling (Sete.StonesjBWldm, ;.. Omni)Xls"gLCan ya,�_/32" •C : /o — w Flood Insure*Rate Man: Above 500 year flood boundary No— yin-Z within Soo year boundary No_ Yes within too year flood boundary No— Yes Depth of Nahainft occarrilng,Perylow Haterfa Does at least thfir feet of naturally occurring POM068 material exist in all areas observed throughout the area proposed the soil absorption system? If not,what-is the depth of naturally occurring pervious material? CertlBeatton I certify that on. 44M (date)I have passed the soil evaluator exeminadorrapproved by the Department of Vnvironmental Protection and that the above analysis was performed by me consistent with . the required tM i "e described in 310 CMR 15.017. Signa Date °ti . oF,�sgc STEUP N y�r Q.%9BP W%PBRCV0RM.DOC MALL in ND.6�27 Q PQ 11/07 2005 16: 18 FAX 781235 3700 BRUCE E LINSKV 1a 012/022 s COMMONWEALTH OF MASSACHUSETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION -TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM . PART A CERTIFICATION Property Address:55 yiuFyaa'a, ljamd- A O�?&4/ bn-ner's lame: AAJ917' o u PC)r2T O%N ner's Address: 1)aic of inspection; 1 i`.-- 1P, 2UU� fi2EVt5E'� 6v� Name of Inspector: (please print) 0 QAc) (:u,nl�s►nyNal>>c; WIr,15Qiue9 ou,o'ICg-rAL. \ladling Address: CA.ri�EQ� AAA U13 30 'I'i�l(:phonc Number: , SOS -C.6 2- 01 2& (:l.;lt'141-4CATION STATEMENT I cci iil'y That i have personally inspected the sewage disposal system a this address and that the information reported b�!ow is Iruc, 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 Needs Furdier Evaluation by the Local Approving Authority Fails inspector's Signature: Date: id Zia 2ZQo S � TIIQ sysicm inspector shall submit a c y 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 fipd nr greater,the inspector and the system owner shall submit the report to the appropriate regional office of the 11:;'. The ori;inal should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authc�rtty. ' . \01%'siulclConuncnts SiNfS(tr CESSPo�C A`��GAA& _ lr�4iCveC� Ste/ sM L S , �,a7-'E 1'to tNl=o Ft? 'I'll is report only describes conditions at the time of inspection and under the conditions of use at that limo. 'phis inspection does not address how the system will perform in the future under the same or different ('011dilions of use: Title 5 inspection Form 6/15/2000 page 1 11/04/2005 16: 18 FAX 781235 3700 BRUCE E LINSKV la 013/022 ' I',d�c3of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Properly Address; '57', Owner: pw kl po oT Usl d u ill'1 nsPection: i n-1 9 -Q t l miwction Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Pusses: _ I have not found any information which indicates that any of the failure criteria described in 310 CMR I i.30,i or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or r�p:dirrd.The sysieni, upon completion of the replacement or repair, as approved by the Board of Health, will pass. n nswer yes,no of not determined(Y,N,ND)in the for the following statements.If"not determined"please cxhlain, The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally udd>:uuud,exhibits substantial infiltration or cxfiltration or tank failure is imminent. System will pass inspection if the Cxisding tank is replaced with a complying septic tank as approved by the Hoard of Health. "'n n►clal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance imiic:dlin;dial the tank is less than 20 ycarg old is available. \th �xplaut: nhsel•vation of sewage backup or break out or high static water level in the distribution box due to broken or 01su-11ctcd pipe(s)or duc 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 NO Cxplain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will Kass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Nils explain; 11/04/2005 16 : 18 FAX 781235 3700 BRUCE E LINSKV 16 014/022 P•11,C of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Properly Address: JS OANncr: 1):itc ol'lnspection;10-� 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 Iau l mg to protect public health,safety or the environment. I. 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 wedand or a salt marsh 3. Systatn will fail unless the Board of Health(and Public water Supplier,if any)determines that the S3'stern is I'unctioninb 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*".Metbod used to determine distance "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 dhe presence of anunonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other lriilurC criteria arc triggered.A copy of the analysis must be attached to this form. 3. Other: r;,�,. c r,..•,.� t,,,, t:,.r,,,air c��nnn 3 11/04/2005 16: 18 FAX 781235 3700 BRUCE E LINSKV la 015/022 l'a_;v 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:� y,�,F yA2n t-I�au�rc� rrcr• Daw of Inspection: p—t -o D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: No V 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 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 %day flow x Required ptunping 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 surface water supply or tributary to a surface water supply. X 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. .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.] 5 (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. 6 1?. ).;urge Systems: 'Fo he considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 YOU must indicate either"yes"or"no"to each of the following; Mw following criteria apply to large systems in addition to the criteria above) v" 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 locutcd in a nitrogen sensitive area(interim Wellhead Protection Area—1WPA)or a mapped Zone I I of a public water supply well 1 f you have answered "yes" to any question in Section E the system is considered a significant threat,or answered in Section D above the large system has failed.The owner or operator of any large system considered a Si;tni ticant ducat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR I-104.The system owner should contact the appropriate regional office of the Department. 4 11/04/2005 16: 18 FAX 781235 3700 BRUCE E LINSKV 016/022 )';I c 5 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address, A (N-11Pr• 1)a1P nl'Iuspecliun: /p p,bS C.hcck if the following have been done.You must indicate"yes"of"no"as to each of the following: Vc5 No • Pumping information was provided by the owner, occupant,or Board of Health XWere any of the system components purnped out in the previous two weeks ? _ Has the system received normal !lows 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) K Was the facility or dwelling inspected for sighs of sewage back up'? Was the site inspected for signs of break out'? 7� _ Were all system components,excluding the SAS,located on site? k Were;the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of•idle baffles or Iccs,material of construction,dimensions, depth of liquid,depth of sludge and depth of scum? •__ Was the facility owner(and occupants if different from owner)provided with information on the proper Ili)1I)lCnance of subsurface sewage disposal systems'? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: no X Existing information,For example,a plan at the Board of Health. Deterrtuned in the field(if any of the failure criteria related to Part C is at issue approximation of distance IS nnaccclxable) (310 CMR 15.302(3)(b)] 11/04/2005 16: 18 FAX 781235 3700 BRUCE E LINSKV 16 017/022 J'aLsc 6 of I i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION I'rupct ty Address: s U1N,�,71A LJ) 6\lE '1 l�IVU.t S Owncr:-� Au�atPUP7� _ Dare nrinspection: FLOW CONDITIONS It l•:S I D ENTIAL Number of bedrooms(design): Number of bedrooms(actuaI): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):2-2 b Number of current residents: Dm�s residence have a garbage grinder(yes or no): �v Is 1„nndry on a separate sewage system(yes or'no):]�jt[if yes separate inspection required] Laundry system inspected(yes of no): Seasonal use: (yes or no):�fZj eater meter readings, if available(last 2 years usage(gpd)): SUMP pump (yes or no): W 0 1-:1:'1 elate of occupancy:rd_zLL%T COMMERCIAL/INDUSTRIAL 'I'�y>c of cslablishmem: _ I h•.,an flow(based on 310 CMR 15.203):_ gpd I13,k of d Sign flow(seats/persons/sgft,etc.): CJrrasc[rasp present(yes or no):_ -— Industrial waste holding rant~present(yes or no): von-sanitary waste discharged to the Title 5 system(yes or no): wilier meter readings,if available; dale 01'occupancy/usc: OTI IEll(describe): GENERAL INFORMATION I'umping Records ha -Source uf info l'ntalion: W Was system pumped as part of the inspection(yes or no):a* YeS I f ycs, volume pumped:irb Oo gallons --How was quantity pumped determined? Reason for pumping: t !V F c. TYP1;Ol,SYSTEM Septic tank, distribution box,soil absorption system b'Single cesspool Overflow cesspool Privy _51rirA cystcnt(yes or no)(if yes, attach previous inspection records,if any) _ lrlrtovalive/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained front system owner) 1',ght tank _Attach a copy of the DEP approval Oihcr(describe)' Approximate age oral]components,date utstallcd(if known)and source of information: In e 2 0- W ct-c sewage odovs detected when arriving at the site(yes or no): eat% 11/04/2005 16 : 19 FAX 781235 3700 BRUCE E LINSKV 1a018/022 Paqc 7 oI'I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Pruperty•Address: 512 (.)wtter: LAULN9d2r Dar(•of inspection: )WILDING SEWER(locate on site plan) I),•Inli below grade: O Mute•-ials oCconstruction:_cast iron kc_40 PVC__other(explain):, 1)i,<<wce from private water supply well or suction lice: N Uommznts(on condition of joints, venting,evidence of lea age,etc.): S ISi'TW TANK:,(locate on site plan) Oepth below grade: i` Burial of construction:_concrete_metal_fiberglass_polyethylene olltcr(cxplain) 1 C lunl< i5 tttctal List age:_ is age confirmed by a Certilicatc of Compliance(yes or no):_(attach a copy of :crtilic�[e) 17imcnsions; Sludge dcp[h;_ Distance from top of sludge to bottom of outlet tee or baffle: ticum thickness: 1)istonce from top Of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: l Iow wrre dimensions determined: _ C'nmmcros (on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels dz, related ro outlet invert,evidence of leakage, etc.): G(tEASI+ T11AI':_(locate on site plan) l cpih below gradc:_ Mliel•ial of coils utiiction:_concrete_metal_fiberglass polyethylene`other (c�hlaut): llintensions: Sriinl lhlChnC55: l"t,stance from top of scum to top of outlet tee or baffle: I)istancc from bottom of"scum to bottom of outlet tee or baffle: Uolc.of last pumping: ('c1111111ents (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels icla[cd to outlet invert,evidence of leakage, etc.): r,It VIMA 7 11/04/2005 1619 FAX 781235 3700 BRUCE E LINSKV 16 019/022 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) t'rolwrty Address: S< V�_��-Z/1,2J� I.•.J-f ia.ti rt1s__-•---•-- ner: Date of lucpectian: • -p TlGf1T 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): Diliicnsions: _ (:opacity, gallons 0i stun Flow: gallons/day Alarm present(yes or no): i1 tar m level: Alarm in working'order(yes or no): Date of lase pumping: C•oninients(condition of alarm and float switches,etc.): DISTRIBUTION BOX; (if present must be opened)(locate on site plan) Duprh 01'liquid level above outlet invert: ('ni uncnts(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of lcak2C1-.r in10 or out of box,etc.): PUMP(.HAMBr,,R: (locate on site plan) PUrups in working order(ycs or no): -alarms in working order(yes or no): C:umments(note condition of pump chamber, condition of pumps and appurtenances,etc.): 11/04/2005 16: 19 FAX 781235 3700 BRUCE E LINSKV 1a 020/022 • NILYC9ofI OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) t'roperty Address: !S-S VINE 14M DrA'1'J'S Owncr; nAt)L NR0Pi Daie of Inspection: I 6-1% '0� ISUI L ABSORPTION SYS,rE m (SAS): (locate on site plan,excavation not required) It SAS not located explain why: Type _...__ Icaching pits, number;_ leaclling chambers,number: leuching galleries, number: _ io.-ICNng trenches, number, length: , _Icachintz fields, number,dimensions: overflow cesspool, number: _ nwovafive/alternative system Type/name of technology: (unmicivs(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, (:1'SSI'001.S: X (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration-, P S'rA AIQL4rD Depth - top of liquid to inlet invert; Q'- I h hth of solids layer: 24 l)chih of scum layer: i l yestNb f)"'IcnsionS of cesspool: (Q`l, G' M itcrial9 of construction:�ynIDC0�3LAC�' lnclication of groundwater inflow(ycs or no): N o C'umments(note condition of soil,signs of hydraulic failure,level of ponding,condition ofve etation,etc.): - n►t ._ 5 cK Cc�sS9Cet_ �� Arta L _.._ (locate onsite plan) MalcriMs oEconstruction: f�iniensions: Dq: 111 of solids:—— C'mm1"cnts (note condition of soil,signs ol'hydraulic failure,level of ponding,condition of vegetation,ctc.): 11/04/2005 18: 19 FAX 781235 3700 BRUCE E LINSKV IR 021/022 Pa-c 14 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) I'ruperty Address: U,NF N Owner:�C3L�F n�Pe�2y Date of inspection: f o_t Q ,O,S SINI:'I'L'1I OF SEWAGE DISPOSAL SYSTEM I'l-ovide a sketch of the sewage disposal system including ties to at least two permanent-reference landmarks or belichimuks. Locate all wells within 100 feet. Locate where public water supply enEers the building. Q,�lL(L z�r 10 11/04/2005 16: 19 FAX 781235 3700 BRUCE E LINSKV [6 022/022 1'a"c 11 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 'k"�7 gn Date of Inspection: - SITE, EXAM Slopc Stu-face Water Check cellar ti11a110W wells I,;y11111MC(I(lclitll to grourid wirer (o feet Plcasc indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked,date of design plan reviewed: _ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain; Checiced with local excavators, installers-(attach documentation) _ Accessed USGS database-explain: VOU must (ICSCribc how you established the high grow water elevation: _. CeSSP0 of ' COMMONWEALTH OF MASSACHUSETTS (I; EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION ,1M Syev TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM `. PART A CERTIFICATION Property Address: L&FA-4,p _dLIO&a- O'lAOUis 44A 026041 Owner's Name: To Aljlj 40c k/&Q T Owner's Address: Date of Inspection: l OBI A -2U0� C2G V ISEJ (�t,•� Mine of Inspector: (please print) OCAD :r,(-j94 !M Company Name: L.11A1b2tuee I NVt2QruMG-Wr 4- Nlailing Address: t Q-1 N . Iv4 w s r2�1 CA2vEQ ✓l-4 01330 Telephone Number: 50S -q6 Z- 01 Z9 C(?RTI hICATION STATEMENT I certify.flint 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 Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: to--ls -2©0.� 'I'hc system inspector shall submit a c y of this inspection report to the Approving Authority(Board of ealth orb DI l') within 30 days of completing this inspection. If the system is a shared system or has a design fle of 10,00 pil or greater, the inspector and the system owner shall submit the report to the appropriate regional ce of the 1)1;I'.The original should be sent to the system owner and copies sent to the buyer, if applicable, and approvi�ig !utliority. ' N-oics and Comments Sy , Nr CE 55POO , �i�,�-n 1 ^ /T 1 L S , �C7�n— Wit+ Fe *"'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. "Title 5 Inspection Form 6/15/2000 page I Paee 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A F CERTIFICATION (continued) Property Address:_ � utmEyd(?.p ug 9' d�l.ri 5 Owner: QA\lR tJ h6 OT 1):itc of Inspection: .ln 1 g, -p 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. Continents: 13. 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. sty tkz Answer yes,no or not determined(Y,N,ND)in the 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. ND explain: 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:,r 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 obstruction is removed ND explain.- "I'�iln C Ticnartinr� Fnrm 4/1 1;i1000 2 I'a-e 4 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: yi,tT_ qA20 L-�"tA►Jr1iS Owner^ l�i)�J1t?n2T IM i s of I nspection: 1). System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _per Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool 7X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in cesspool is less than 6"below invert or available volume is less than %: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 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. 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 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 forma `65 (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. ls. 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 bad. 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 the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well I f 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 sit,niticant 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. r.­ sir 1;i1000 4 l'age 6 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: UINt—fAlQp Ajg— 1 '1 A-NMN IS Owner: Dw-.urpa p-r D,1te of Inspection: 16-1 R -65 FLOW CONDITIONS II ESI DENTIAL Number of bedrooms(design): Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example:.110 gpd x#of bedrooms):22.0 Number of current residents: 2— Does residence have a garbage grinder(yes or no): *130 Is laundry on a separate sewage system(yes or no):_7b[if yes separate inspection required] Laundry system inspected(yes or no):jib Seasonal use: (yes or no): Water meter readings,if available(last 2 years usage(gpd)): N A Sump pump(yes or no): W 0 l..ast date of occupancy: . M C O NI M ERCIALIINDUSTRIAL Type of establishment: ` Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: ty30-0 S Was system pumped as part of the inspection(yes or no): Y-gS If yes, volume pumped: Argo gallons--How was quantity pumped determined? Reason for pumping: r-y2pUgn �Tg.-o I N f ((-?YATW4J "TYPE OF SYSTEM _Septic tank,distribution box,soil absorption system b,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 fi•om system owner) "fight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: ►4PPQoc Z 6-3, 5 \Pere sewage odors detected when arriving at the site(yes or no): at Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: �4y r+%rr4 t9 VVVA Owner: J)AUtN00Q-r Date of Inspection: l b-1 b-6f BUILDING SEWER(locate on site plan) Depth below grade: d Materials of construction:_cast iron ts40 PVC_other(explain): Distance from private water supply well or suction line: 9 Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass__Solyethylene .other(explain) if tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or.no):_,(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): GIZEASE TRAP:_(locate on site plan) L)epth below grade:_ 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: Late of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 ------------- Page 8 of 11 i • OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: \j j j e3A-" Owner: �AU�hLPGI R- Date of Inspection:_gyp—i p, o 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISl'RIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakne into or out of box,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): T;0. G T—rn f;—r—411 VlAnn 8 f - Page 9ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: VINC�:J&aD _14--I A-nt tJ i S Owner: I)Aur'NC'Opl Date of Inspection: 16-(S 'O+S SO L ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) 1 f SAS not located explain why: 'Cype leaching pits, number:_ __ . _ 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.): C I�SS I'OOLS: x (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: I 5,ranro,4a Depth-top of liquid to inlet invert: 2 1- llepth of solids layer: 90 Depth of scum layer: f l-oCy_t tr6 Dimensions of cesspool: (n"4G' Materials of construction: C-(NDeLaLdC,e Indication of groundwater inflow(yes or no): gL Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of ve etation,etc.): __-- 5 n)L 15 �I-,4 W©t.W cum - SInI&cz, Cd fa-&t. ;CT n.✓17ccG� --------- -A I L S I'1.ZIVY: (locate on site plan) M.uerials of construction: Dimensions: Dcpth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 ; OFFICIAL INSPECTION,FORM,—NOT,F.OR�V,OLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM > PART,C h SYSTEM INFORMATION.(continued) . Property Address Owner: V)Z0FKP027 Date of Inspection: 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. c2lk8 � T rla lncr+art nn T7 rm 4/1 4"MAW) 110 l No. � C.� � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISI N - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppricatiou for ioogat *r6tem Conttruction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. SS ni r7,n Owner's Name,Address and Tel.No. Assessor'sMap/Pazcel �/i\7 /voo- / Installer's Nam ,Address,an Tel.Np. Designer's Name,Address and Tel.No. /�f/.L� 141OC. Q�x+rn. 2 A n .>, .4, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable)ag,0 /n40ge + 7 •— / //�� Date last inspected: Agreement: ` The undersigned'agree to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the pr isi s of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has b n i s ed by this=�h. Signed ce Date Application Approved by Date Application Disapproved for the following reasorf Permit No. Date Issued No. I CvVJ Fee y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBL � Yes MASSACHUSET IC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Zipplication for igoar *pztem Construction Permit Application for a Permit to Construct( Repair-( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components l Location Address or Lot No. f , Owner's Name,Address and Tel.No. (// /Z. ?1 Assessor's Map/Parcel S Installer's Name,Address,and Tel.No.• Designer's Name,Address and Tel.No. Type of Building: Dwelling No:of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil A Nature of Repairs or Alterations(Answer when applicable) _ ter• r 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 pro isions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- �, cate of Compliance has b en issued by this '�f H th. a Signe Date Application Approved by Date Application Disapproved foOeYoll'o'w'i4 reason Permit No. Date Issued ------ ---------------------- --- ----=—`— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(Repaired ( �_ pgraded ( ) Abandoned( )by. d G at S n . v. e 4 A has been constructed in accordance with the provisions of fitle 5 and the for Disposal System Construction Permit NoW7 dated Installer ooe,'�) (fin .,9 4 Sz,12s Designer The issuance of this permit shall not be construed as a guarantee that the systp4 will function as de ' ne Date//1 T —Inspect r ' 11 r — ————————————— -�--- ——— ----- _.--- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Mf 6potaf p5tem Con.5truction Permit Permission is hereby granted to Cons ct Repair( Upg d )Indon ( ) System located at VA R 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:Construction must be completed within three years of the date of th' pe it. Date: �" / Approved by '��// L � SwiL►>fticMlFs. rc!•"`` .;s '"'w�" ��7M c ,: i •..mow+' . .ca.„�,A, ;. *NOTE. ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A -A --- -10' min. from Existing Foundation I house to peptic tank PROFILE VIEW OF ADDITION TO LEACHING SYSTEM e TOP OF FOUNDATION = ELEV. 100.00 (Assumed) cova must be tank coven AN1vt be eRhkrxto 6'R9X W/St" Cover - ` ' �? � r ' wry - f In 6 in. of finished g"We -�` ', 55 VNrttByard Avg 3 Grads over D-Ow-94.00 over SAS 94.00 r , j Crania over Saptk Tank- 9Z00 3 HOLE H-10 3• of 1/8" - 1/2" Washed Peoet DIST. B0� 3/r to 1 1/2 " Wod,ed Crushed St s t7�gr4t at+�e i . � 1 , r } •';8st ' IS = 0.02 4•PVC(CAPPED)Nf5PEC110N FORT 10 K ' a s ► ! ._. os I ` !e 3' Maadtrenr Cover Top OF System- Mm=91.23 MULLED AM To BE wln,nl 6'of GRADE - 0 32 NEW S"OL01 or Greater 0,Ivorillo o a 1,500_GAL. S. ' Exrsr.p>PE 0 a SEPTIC TANK 0o �' a01 Far foot 7•ETMcw.Depu� .. I _ "qdgo FRQI EXIST.F!Z) al + ••n a et st OONCREIEFULL po sr H-10 ; �: 01 D.L33 (1D inches) .125' units 125 , �200dFM�6Ms►�[CORO2bOdtNiYllO.anayr4„t.wer } �.t .,^� m 4.. ar 6 khof 3/4•-1 1/r o SYSTEM PROFILE C Cam" etas o ( 51 GENERAL NOTES Not to Score - c 3.F, .5' N EffectiveLength s m � 1. Contractor is responsible for Digsofe notification, Verification of Utilities 10' 's SDIL ABSORPTION SYSTEM (SAS) and protection of all underground utilities and pipes. 6 mpg 2. The septic tank and distrl ution box shall be set compacted stone o Effective ' o INFILTATROR HIGH CAPACITY CH-20 LOADING)/ GEORGE O'BRIEN level on 6" of 3/4"-1 1/2" stone NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE 5' STRIPOUT ALL � L AROUND � m (OR EQUNALENT) Not to Scale 3. Backfill should be clean sand or gravel with no NOTE: OVERALL HEIGHT OF INFILTRATOR IS 1e" /EFFECTIVE HEIGHT IS 10" stones over 3" in size. Bottom of Test Hole 1 Elev.- 8100 4. This system is subject to inspection during installation P E R C 0 LATI 0 N TEST P# 11298 Graandeat r observed- NONE 065E VO by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance with Title V of the Massachusetts state code, the approved plan Date of Percolation Test: MAY 15, 2006 and Local Regulations. Test Performed By. STETSON HALL. R.S., C.S.E. Results Witnessed By. DESMARAIS (BARNSTABLE BOH) 6. If, during installation the contractor encounters any soil conditions or site conditions that are different EXCAVATOR: Unknown ALL ounET Pm flies im from those shown on the soil log or in our design Percolation Rate: Less Than 2 MPI 0 42" t L FOR LEAST 2 --1r CONCRETE COVER SET LEVEL FOR AT LEAST 2 Fi installation must halt dE immediate notification be 3-W Gun.ET �,.«.-.,, made to Carmen E. Shay - Environmental Services. Inc. ns Test Hole Test Hole Test Hole Test Hole 101MO No. 1 No. 2 No. 3 No. 4 _ 7. No vehicle or heavy machinery shall drive over the ss• 1r MET septic system unless noted as H-20 septic components. DEPTH SOILS ELEV. DEPTH SOILS ELEV. DEPTH SOILS ELEV. DEPTH SOILS ELEV. au1LEr : s. 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. 0 96.00 0 96.00 0 94.00 0 94.00 _4F 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. Sandy Sar+dy Sandy Sarniy - Is:e 4" - SCH. 40 T 1.75" 10. All solid piping, tees nit fittings shall be 4" diameter ,gym Loom loam Loam 10 YR 3/1 10 YR 3/1 10 YR 3/2 10 TR 3/2 PLAN SECTION CROSS-SECTION Schedule 40 NSF PVC pipes with water tight joints. A, 95.17 0"-1r A, 95.00 o"-ten A, 92.50 0"_16" A, 92.67 11. Municipal Water is Connected to ALL OF The Residence and Abutting Sand Loamy Loamy Loamy Properties Within 150 Feet. Sand Sand 3 HOLE H-10 DISTRIBUTION BOX 10 YR 5/6 10 YR 5/6 10 YR 4/16 10 VR 4/6 LOT #31 NOT TO SCALE THE PROPERTY LINES ARE APPROXIMATE AND 10"- 26" Be 93.83 12"- 25" Be 93.90 le- 40' Be 90.67 16'- 40"1 B. 90.67 COMPILED FROM THE PLAN BY STETSON R. HALL, ENTITLED worse coarse b► SITE PLAN OF #55 VINEYARD AVE., HYANNIS, MA Coarse COOTse Sand Sand e>a TEST HOLE #4 aJ DATED JUN£ 2, 2006 Sand Sand to YR 6/6 10 YR 6/6 10 YR 6/6 TEST HOLE #3 ELEV.= 98.00 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN 10 YR 6/6 26"- 60" C+ 97-90 40"- 132 G 8100 40"-132" C, 8300 LOT #32 �\ ELEV.-_ 98.00 87.981 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN G s1.00 25"- 37" , THE SEPTIC SYSTEM INSTALLATION. Coarse Coarse Sand Sand / 10 YR 6/4 10 YR 6/6 \`\ i� '96 EXISTING SAS TO BE PUMPED OUT AND FILLED IN PLACE 6011- 120 C= 86.00 37"- 120 Ci 86.00 \��! ^J ter'- - NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE FROM THE EXISTING SAS TO BE DISPOSED _ .' OF AS PER BOARD OF HEALTH SPECIFICATIONS. . RESERVE AEA /� . _ THi::RE ARE..N0 WET'rANDS ARE PRESENT WITHIN 200' OF THE,_PROPERTY Perc #1 Perc 2 Depth t L o Perc: 42" - 60" Depth to Perc: 42" - 60" 26 - �� q' Perc Rate= Q MPI Perc Rate= C2 MPI t D-Box - a ASSESSORS MAP 291 PARCEL 132 Groundwater Not Observed Groundwater Not Observed e . �- ,� e e� e f LEGEND No Observed ESHWT No Observed ESHWT •�' ADJUSTED H2O Elev. = None ADJUSTED H2O Elev. = None TEST HOLE #2 ELEV.= 98.00 I a ''� ' NEW o• •ss' �04X 1 DENOTES PROPOSED 3-24'GAM_ ACCESS MANHOLES ,qs` /15,00 al. 96 9$ 0 SPOT GRADE 10• � -__ ' 00 Septic Tank 46 DENOTES EXISTING :�;• :.:" �;. LOT 43 Foiled SPOT GRADE # cEssPOO�.--'' LOT #45 r TEST HOLE #1 ELEV.= 98.00 - PL PROPERTY LINE NLET "LET 9r PROPOSED CONTOUR THE ACCESS COVERS FOR THE SEPTIC TANK, i i PROJECT BENCH MARK400, ___9g i)15TRLBUTION Box AND LEACHING COMPONENT .' SAS GR ADE. TO WITHIN 6" OF TOP OF FOUNDATION � ' _ - -----97 EXISTING CONTOUR STEEL_ REINFORCED PRECAST CONCRETE INSTALL TUF-TITS GAS BAFFLES OR EQUALS ELEV. - 100.00 (Assumed) PLAN VIEW ON ALL- OUTLET TEE ENDS ' �� � DEEP TEST HOLE & 3-24•REMovAstE CovERs � i •/ PERCOLATION TEST LOCATION 6 FOOT STOCKADE FENCE Nt1Er e•mrm1.}- r dml irat to w6.t 3. OUILE'r •r .aaT T ' R BEDROOM � I to• ' ie'"1 Nr .-��'� �` HOUSE i L E a a.err U4dd depys / ^9 9 P LOT P LAN OF PROPOSED SEPTIC SYSTEM UPGRADE ,o•-o- s-r••:- `\\ PREPARED FOR CROSS SECTION END-SECTION MS. J OAN N E DAVENPORT TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK LOT #44 - i AT NOT TO SCALE 13,186 Sgtfal a Feet +/- , X iE , #55 VINEYARD AV E N U E May Substitute with 1500 gallon H-10 Polyethylene Tank-George O'Brien Co. \`\ W o HYAN N I S, MA Design Calculations 89.65' PREPARED BY: Number of Bedrooms: 2 Bedroom EXISTING ��- --_-`` ���OF lr1gV� Garbage Grinder: No 96---------- -----�--��``� ----- -- R E N� CARMAN E. SHA Y Leaching Capacity Required: 440 Gal./Day AT THE REQUEST OF THE OWNER) ---------------`\��----------- 9e ------ Septic Tank : - 2 x 330 Gal./Day = 660 USE NEW 1.500 GAL Septic Tank. AY NVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of C2 min./inch 1;6 O' Bottom Area: 0.74 gal/sq. ft. x 500 sq. ft. = 370 gallons O� 1 a P.O. BOX 627 Sidewall Area: 0.74 gal./sq. ft. x 99.6 sq. ft. = 73.7 gallons 0 20 40 50 c,STE�� EAST FALMOUTH, MA 02536 Providing. - 443.70 gallons V-FIV- ' YA R.D A VAN CTE' S g' - g ANaT TEL/FAX : 508-539-7966 Use: (7) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, 6mmooF (40 FOOT RIGHT OF WAY) SCA 1"=20' DRAWN BY: CES ATE: OCTOBER 17, 2006 TO BE USED MATH 3.5' OF WASHED STONE ON THE SIDES, AND 3.125' OF WASHED STONE SCALE: 1"=20' ON THE ENDS. NO STONE UNDER. PROJECT#S0977 FILENAME: SD977PP.DWG SHEET 1 OF 1