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HomeMy WebLinkAbout0071 WACHUSETT AVENUE - Health 71 Wachusett Avenue, Hyannis �l TOWN OF BARNSTABLE L�:aTION -J 11414C4gl5; V ,dd&e SEWAGE #vb�26.2aa ALLAG ASSESSOR'S MAP & LOT.2'97-o-76 INSTALLER'S NAME&PHONE NO. �a��iYa� ;;s � ��� SEPTIC TANK CAPACITY of aog LEACHING FACILITY: (type) 5 PO e;'aL 6&14 ---J Cr'a (size) S'q 'X13 ',4.2 ' NO.OF BEDROOMS BUII.DDR OWNER PERMITDATE: P42-01'r� COMPLIANCE DATE: o �� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S¢ 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 C-V,e -.f , • V f tN V4.. N 008 i No.. , f Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYicatton for Miq;poal *pMem Cori.5tructiou Verna Application,for a Permit to Construct( ) Repair(d Upgrade( ) Abandon( ) U Complete System ®Individual Components Location Address or Lot No. /o/ejr �La �r Owner's Name,Ad ress,an TeL No Zs' 7-076 �r�r� Assessor's Map/parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �l��)C-eW6 `-, Q � vP, 77 Type of Building: ` _ Dwelling No.of Bedrooms _ 9 Lot Size /J`��� Z sq.ft. Garbage Grinder .( Other Type of Building ���/ e4tz- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ?� gpd Design flow provided -77� 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 Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board f He Ith. ` Sign Date S //mil Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued F+ No. � ..� �. �. :€. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes i ` Zipplicatio"n for �N!6po$a[ 6p5tem Con.5truction permit Application for a Permit to Construct( ) Repair(4 � Upgrade( ) Abandon( ) U Complete System D Individual Components Location Address or Lot No. e,Ad)ress,and Tel.No. Z 9 7-07d 7 I cc/aCr�s ' a Owner's Namc Assessor's Map/parcel Installer's Name,Address,and Tel.No.� Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms —? Lot Size 1J�/l Z• sq.ft. Garbage Grinder (•� j Other Type of Building 5/C�-e6r_e No.of Persons Showers( ) Cafeteria4( ) Other Fixtures Design Flow(min.required) �� gpd Design flow provided 7 7Z gpd Plan Date j �7 � �, Number of sheets Revision Date Title s ,7/ �/i1 © Z I Size of Septic Tank Z.n� 4?71 Type of S.A.S. 6—.S�✓G9.0Y,lV Description of Soil t Nature of Repairs or Alterations(Answer when applicable) �.f Date last inspected: j Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in ' 1 accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of i Compliance has been issued by this B,oa�rd of He-00th, / 1 Sign d, r/�!N/ ='f .-, Date S Application Approved by l .;� /r ,(r Date Application Disapproved by: Date for the following reasons z � Permit No. Date Issued �. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTI Y,that the Own'-site Sewage DDiis osal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by at / GIILt'� has been c nstructe in accordance n / with the provisions of Title 5 and the fo Disposal System Construction Permit No.0 067 dated Installer 1"�a ��d t Designer i_ #bedrooms '� Approved design flow e7- gpd The issuance of this permit shall notibe con trued as a guarantee that the system wiQI-Cuct`ion d s'igne Date / 'b Inspector t, — —————————————————————————— No. —---—�+�� ._.— —— Fee THE COMMONWEALTH OF MASSACHUSETTS g��0 ' PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �t,Po.5ar 6p5Stem C0115tructton Permit Permission is hereby granted to Construct ( Repair ( L/"' Upgrade ( ) Abandon ( ) Sys)em located at U,,'GVG 4C" 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: Co tructi n must be completed within three years of the date of this it; s Date A roved b pp Y FROM :down cape engineering inc FAX NO. :15083629880 May. 19 2006 12:12FM P1 Town of Barnstable Regulatory Services $ 'Thomas F.Ceiler,Director " Public Health Divisioia sbs¢ " Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 , Office: 50M62-4644 Fax: 508-790-6.104 Installer&Designer Certification Form Date: ��f Sewage Permit# Assessor's Map\Parcel 74 Designer: �00 �. �-�o�• / ►'��rs� Installer: -Z-6 A (4M-b�+O� Address: M1.,!„ HG Le� Address: On .was issued a permit to install a (date) —E (installer) septic system at 7l W ach,,ard�(address) 19e-� ' based on a design drawn by OLZ ._ dated (des er) zi certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. µ of 1,1,g�SgC ARNE H ;r (Installer's Signature) DMA �� CIVIL No. 10792 ( esigner's Signature) (A fix Desig tamp Here) PLEASE RET N TO IRAnNqTART IP PUB If HEALTH DIV SION. CERTIFICATE O>a COMPLIANCE WILL NOT RE ISSUED UNTIL OATH TI:II,FORM ANB AS-IiL'iLT CARD ARE RECEIVE BY T1EIF BARNS ABLE pTIBLIC HEALTH DIVi ION. 'I'H NK YOU. Q:Hraltb/5epdc/Designer Certification Form 3.26-04.doc Barnstable Assessing Search Results] Page 1 of 3 ir .r �hAA.'TAbIS. J _ IG7s. a4 Home: Departments:Assessors Division: Property Assessment Search Results New Search 71 WACHUSETT AVENUE Owner: 2006 Assessed Values: CLARK, RICHARD M&PATRICIA Appraised Value Assessed Value H Map/Parcel/Parcel Extension Building Value: $399,500 $399,500 287 /076/ Extra Features: $2,400 $2,400 Outbuildings: $0 $0 Mailing Address Land Value: $797,700 $797,700 CLARK, RICHARD M& PATRICIA H Totals $ 1,199,600 $1,199,600 2224 RIDGE RD KALAMAZOO, MI.49008-1927 2006 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $227.08 Fire District Rates Town Barnstable-Residential $1.90 $6.31 Barnstable-Commercial $2.51 Commei Hyannis FD Tax(Residential) $ 1,931.36 C.O.M.M.-All Classes $1.06 $6.54 Cotuit FD-All Classes $1.33 Persona Town Tax(Residential) $7,569.48 Hyannis-Residential $1.61 $6.49 Hyannis-Commercial $2.50 Other R; W Barnstable-Residential $1.60 Commur W Barnstable-Commercial $2.46 Total: $9,727.92 Construction Details Property Sketch Legend Building Building value $399,500 Interior Floors Pine/Soft Wood Style Conventional Interior Walls Plastered Model Residential Heat Fuel Gas Grade Custom Heat Type Hot Air Stories 2 Stories AC Type None Exterior Walls Vinyl Siding Bedrooms 7 Bedrooms http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?mapparback=na... 5/11/2006 Barnstable Assessing Search Results; Page 2 of 3 Roof Structure Gable/Hip Bathrooms 5 Full 4: Roof Cover Asph/F GIs/Cmp living area 3900E Replacement Cost $499370 Year Built 1888 S Depreciation 20 Total Rooms 11 Rooms Land d- Lot Size(Acres) 0.34 i" Appraised Value $797,700 Assessed Value $797,700 Interactive Property Map: Ma wires Plug I have visited the maps before II� iGFQ Show Me The Mac /t RR ) April 2001 photos available - a-n Sales History: Owner: Sale Date Book/Page: Sale Price: CLARK, RICHARD M &PATRICIA H Jul 31 1997 12:OOAM 10880/126 $565,000 STEWART, CAROLINE H, STEWART, CHARLES P Jul 31 1997 12:OOAM 10880/123 $ 1 CLARK, RICHARD M&PATRICIA H Jul 31 1997 12:OOAM 10880/131 $ 1 STEWART, CAROLINE H; STEWART, CHARLES P Dec 20 1996 12:OOAM 10534/230 $ 1 STEWART, DONALD M& Dec 15 1992 12:OOAM 8351/117 $ 1 STEWART,DONALD M & Apr 15 1990 12:OOAM P0242EF1 $ 14 STEWART, MARGARET Dec 15 1982 12:OOAM 3630/156 $0 STEWART, CAROLINE H; STEWART, CHARLES P 97P1073FE1 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?mapparback=na... 5/11/2006 w- " Barnstable Assessing Search Results Page 3 of 3 FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparce106.asp?mapparback=na... 5/11/2006 f COMMONWEALTH OF MASSACHUSETTS w EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON, NIA 02108 617-292.$$00 g WILLIAM F.WELD ® � �' TRUDY COXF Governor Secreur) ARGEO PAUL CELLUCCI AVID B.STRUHS Lt.Govemor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ommissioner PART A ' ;/`r CERTIFICATION � � S / � ve,. Property Address:?J t4a6ett& 67"UC.; gYzt ,,t et Address of Owner: �G d Date of Inspection: zoo (qq L (If different) to O Name of Inspector: G 44"— " 1 1 am a DEP approv d syste spector pursuant to Section 1S.340 of Title 5 (310 CMR IS. �4r 99 Company Name: Q �j 1 Mailing Address: f�, Telephone Number: O CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information repone true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: t� Passes _ Conditionally Passes _ Needs Further Evaluation y.the Local Approving Authority _ Fails Inspector's Signature: .��� Date: 2� 7 The System Inspector sha4S_Ubmit a copy o this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, Or D: A] SYSTE PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 1 S.303. Any failure cri r'a of 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 repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of'Health. (revised OV25/97) Pape 1 of 10 DEP on the World Wide Web: httpJ/www.mapnet.state.ma.usrdep Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �' ° /CERTIFICATION (continued) 8roperty Address: (,Vd,C ti6et6 04,-C, &--C .t A6 Y,� Owner: —Gco0— / Date of Inspection���,-- (Q�' BJ SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four 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 CJ FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment: 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. Y) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100'feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Pago 2 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A jCERTIFICATION (continued) Property Address:?l 0106�c(,eJG65 041c,t Owner: Mewe.1rq— 6 Date of Inspection��,,�,,,.t,I` , D) SYSTEM FAILS: I You must indicate eiti•:er "Yes"or"No"as to each of the.following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution boa above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6".below invert or available volume is less than 1/2 day flow. 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I ofta 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: You must indicate either "Yes" or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program t requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B , CHECKLIST Property Address: 7I wacLl_44 5( t&, t Owner: -GLc��1�`f ![ Date of Inspection:T�G.�t`��� Check if the following have been.done: You must indicate either "Yes or"No"as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or / as part of this inspection. _ !`f As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ The facility owner(and occupants, if different from owner) were provided with information on the proper.maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)J t (s#vised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address ((,aGLC�e$��(.� Owner•.Date of Inspection•'���Of ��� FLOW CONDITIONS RESIDENTIAL: Design flow: 116 g.p.d./bedroom for S.A.S. Number of bedrooms:-2- Number of current residents: Garbage grinder(yes or no): Laundry connected to system yes or no): Seasonal use (yes or no): ' Water meter readings, if ilable (last two (2)year usage (gpd): < Q Sump Pump (yes or no):z Last date of occupancy:,��21 � � COMMERCIAUI NDUSTRIAL: Type of establishment: Design flow:_gallons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECOR S ano source of info r anon: (C Y `� O ,� C oo System pu ped as part of ins on: (ye or no) If yes, volume pumped: allons, 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) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known)and source of informations lotvwer, ( Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: f WACLa &let Owner: e�G - l Date of Inspection:����Gi W2 BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction: _cast iron_40 PVC other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete_metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance _(Yes/No) 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 dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural` 'integrity, evidence of leakage, etc.) GREASE TRAP: (locate on site plan) Depth 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: Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural { integrity, evidence of leakage, etc.) (revised 04/25/97) Peg* 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION. FORM PART C SYSTEM INFORMATION (continued) Property Address: ' �Qv i Cie, Owner: ` Date of Inspection• TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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 level: Alarm in working order_Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage 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.) z (revised 04/25/97) Page 7 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: � Owner: c r�� Date of Inspection: �Q Q7 SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding„condition of vegetation, etc.) CESSPOOLS: (locate on site plan) Number and configuration: Gt,C Depth-top of liquid to inlet invert: Depth of solids layer: 12! ' Depth of scum layer:_ Z Dimensions of cesspool: X' Materials of construction::el• °# Indication of groundwater: b inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, con iti n�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.) (revised 04/25/97) Pago 6 of 10 ', t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 0v�^ � Owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM:. include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) W Q'G Imo.(,L�G�'� (�•�'PiV� (�C�i ^ oil t� t, p �l z 1i (revised 04/25/97) Page 9 of 20 re t r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 910)&C 1 LU6eefis Owner: 15FC(- / . Date of Inspection:J�Sz Depth to Groundwater—Feet Please indicate all the methods used to determine High Groundwater Elevation: . Obtained from Design Plans on record Observation of Site(Abutting property, observation hole, basement sump etc.) V/Determine it from local conditions >/Check with local Board of health Check FEMA Maps Check pumping records /Check local excavators, installers ✓ Use USGS Data Describe in your own words how you established the High Groundwater Elevation. us be completed) Y-0 Wv,C�W atcy-&4AJ. tt)afe-K Pe-6oale.= A4 :!6FA Ga �lf - rum - • CLXI�J 4 G5 C_r tAd luCie � OwO 'crr�l�ov�, ���C,e-v�c�GU•o�f-"e►/ (,1.� 5 �ra� �O l,�v`� 6cJc�✓ �� ��2..,J�. 0 f,UGt wec G Vt� cc cti� e� Gzc>�" ,e% 2G 2 2• � u u �t .• �Gyna,t.�d�.c,�e✓ �2G-z� � Y 11 �� • ( - (• f�- 1?TCl a c�1J� C troviaed 04/25/97) Pao 10 of 10 l TOWN OF BARNSTABLE t7f j SEWAGE # I:G�-.�,TIJN �j.r o 0 VILLAGE ������ /�4� ASSESSOR'S MAP& LOT 76 INSTAIALER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACUNG FACELrTY: (type) r (size) NO.OF BEDROOMS BUILDER OR OWNER PERMPTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility). Feet Furnished by G C ', :�.. '. IS - D`r �� ti � n N � C �. \ - '" �• �.�A. .. SYSTEM PROFILE NOTES TOP FNDN. AT EL. 23.2' ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) 1. DATUM IS APPROXIMATE NGVD / a ACCESS COVER (WATERTIGHT) TOP�e WITHIN 6 OF FIN. GRADE 2. MUNICIPAL WATER IS :,EXISTING D /F2_2.O MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 20.T - RUN PIPE LEVEL 2" DOUBLE WASHED PE TONE L US PROPOSED 2000 FOR FlRS7 2 h„ tt 3' MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHOGALLON SEPTIC 18.50' Z-/ H- 20 M�9 18.75' TANK H 20 18.74 ( ) GAS 17.99 5. PIPE JOINTS TO BE MADE WATERTIGHT. r��I BAFFLE 18.16' 00700 0000 17.74' 0 L7 0 O 0 0 0 I� Ca 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH �6" CRUSHED STONE OR MECHANICAL O ED 0 0 0 0 0 � C� MASS. ENVIRONMENTAL CODE TITLE V. Nantucket '_I_ COMPACTION. (15.221 [2D 2' 0 0 0 00 0 CJ 0 0 15.74' SOlL1!!� i DEPTH OF FLOW = 5' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE, DBOX (H-20 BE USED FOR ANY OTHER PURPOSE. SCALE r - 25,000' INLET DEPTH = OUTLET DEPTH = 19" (6) 500 GAL. CHAMBERS (H-20_) 8. PIPE FOR SEPTIC, SYSTEM TO SCH. 40-4" PVC. 5 1 % SLOPE 1 % SLOPE _ . 7.74' 9. COMPONENTS NOT Td'ABE BACKFILLED OR CONCEALED ( % SLOPE) ( ) ) WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION ASSESSORS MAP 287 PARCEL 76 ,, OBTAINED FROM BOARD OF.' HEALTH. LEACHING LOCUS IS WITHIN FEMA FLOOD ZONE C FOUNDATION FACILITY 38' SEPTIC TANK 34' D' BOX 25' 10. CONTRACTOR SHALL. BE RESPONSIBLE FOR CALLING AS SHOWN DIGSAFE (1-888=344­�'7233) AND VERIFYING THE LOCATION ON COMMUNITY PANEL #250001 0006 D BOTTOM TH 2 EL. 8.0' OF ALL UNDERGROUND:&.OVERHEAD UTILITIES PRIOR TO DATED JULY 2, 1992 COMMENCEMENT OF WORK. 11. EXISTING SEPTIC SYSTEM SHALL BE PUMPED AND FILLED LEGEND OR PUMPED AND REMOVED. SYSTEM DESIGN: 100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED +100.00 EXISTING SPOT ELEVATION DESIGN FLOW: 7 BEDROOMS ® 110 GPD = 770 GPD 1OO w`�Ch sG USE A 770 GPD DESIGN FLOW PROPOSED .CONTOUR -__� tt A VP_,hye SEPTIC TANK: 770 GPD (2) = 1540 100 EXISTING CONTOUR USE A 2000 GAL. H-20 SEPTIC TANK lot LEACHING: 2 SIDES: 2 (59 + 12.83) 2 (.74) = 212.6 GPD 21 - gRICKo =- DECK BOTTOM 59 x 12.83 (.74) 560.1 GPD u TOTAL: 1044 S.F. 772 GPD i E-ST HOLE LOGS *CAUTION: `Y'' USE (6) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) stltEVE �'� \� GAS LINE WITH 4' STONE AT ENDS AND 4' AT SIDES DAVID FLAHERTY, R.S. SEVER LINE IN SEWER ENGINEER. w w�T LINE P LINE AREA WITNESS: DON DESMARAIS, R.S. BENCH MARK - CORNER OF CONC. BULKHEAD EL. 22.2 i i MA DATE: MAY 1, 2006 � o EXISTING PERC. RATE _ < 2 MIN/INCH j '� 7 BR DWELLING APPROVED DATE BOARD OF HEALTH o l TOP OF FNDN CLASS I SOILS P# 11294Cv ELEV. 23.2 O � " 4 ELEV. " [ ELEV. e�, TITLE 5 SITE PLAN p 20.5 p 21.0 LOT AREA C� N � ,, OF A 15,172t SQ. FT. q /1LS FILL ��,�: �r 71 WACHUSETT AVE. 10YR 3/2 FLAGPOLES 12" 19.5' 28" 18.7' r DECK {y HYANNISPORT .(BARNSTABL-E),, .MA ti , y B A/B ti CP O a� LS LS PREPARED FOR 10YR 3/3 30" 10YR 6/8/ 1a.0' 36" 18.0' - BORTOLOTTI "CONSTRUCTION/ C1 j,. _ RICHARD CLARK /C1 MS .y . SILT LOAM 58" 10YR 5/6 16.2 '` L 84" 5Y 7/1 cv - DATE: MAY 2, 2006 13.5' /C2 SILT LOAM - CP 115.00' off 508-362-4541 85" 5Y 7/1 13.9' fax 5W-362-9M C2 UNSUITABLE MATERIAL PERC MS C3 lip 2.5Y 6/3 PERC MS 5' REMOVAL OF UNSUITABLE SOIL �`�HOF � � 2.5Y 6/3 LEACHING FAclu� OWN OR of �� ARNE N down cape engineering, inc, SUITABLE SOIL LAYER. REPLACE OJALA 5 I, I 148" 8.2' 156" 8.0' WITH CLEAN MEDIUM SAND. r CIVIL ;LhiA CIVIL ENGINEERS NO GROUNDWATER ENCOUNTERED Na 30792 r LAND SURVEYORS Scale:1 = 20 a 939 main st, yarmouthport, ma 02675 0 10 20 30 40 50 FEET ATE H. OJALA, P.E., P.L.S. DCE #06-106 06-106 BORTOLOTTI_CLARK.DWG (DOF)