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0210 WALNUT STREET (HYANNIS) - Health
210 Walnut Street. Hyannis A = 310 040 i 1 a 0 f IF p II i f 'I n n v A __ Date: / 12V lj TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: - U X R t� � �0 BUSINESS LOCATION: ,10 LV 4 L_0 V4 e>+ ",kylU IS , y0A INVENTORY MAILING ADDRESS: I 10 i.ly A-4— VUU-� 54- t4� �40- TOTAL AMOUNT: TELEPHONE NUMBER: C? 360, 610 C�4 CONTACT PERSON: PC- EMERGENCY CONTACT TELEPHONE NUMBER: 50? 360 9 0F`t MSDS ON SITE? TYPE OF BUSINESS: pig i r0j 1 ryz INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW )d USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant' Signature Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town [which' you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) .Y 1f. e DATE: a J.U/ o'P15 Fill in please: K. l , I tg ,• . APPLICANT'S YOUR NAME/S: L p� AP2. BUSINESS YOUR HOME� ADDRESS: 02 10 ��t��UcJ Jf !�y A�t/MJ S r✓Ifi ��a l%tal!`Ct�'' I�iF.:Y7'r l�f�@� �1�{r���;,''a({�/.� {/[ 1y .�. � ��T' �4 �II?N/:gSi 1'�..' it7t3R " 9!'` TELEPHONE # Home Telephone Number rl :17ru!1v'_`.71'c;4'' {+1-IT ¢'•r ✓S 9 d —[ / NAME OF CORPORATION: NAME OF NEW BUSINESS L_U X(J y PR �,J t i N_E-) `, _TYPE OF BUSINESS P JN�1 A)c) IS THIS A HOME OCCUPATION? )K YES NO ADDRESS OF BUSINESS A-10 Wf'o- y�i V� S� µv,,g,v�..� rvvsr Col6vl MAP/PARCEL NUMBER 3 i'0 r 6 D (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO R'S OFFICE This individu I he* b e infer . d of ny er t requirements that pertain to this type of business. ut Ved igpatu COMMENT : rr 1` r� 2. BOARD OF'fiEALTH This individual ha n infor e the p it requir ments that pertain to this type of business. Aut rued Si ature** MUST COMPLY WITH ALL COMMENTS: 3. CONSUMER AFFAIRS LICENSING AUTHO This individ as e f r d f the s' g irements that pertain to this type of business. Authorizedff ure** COMMENTS; Al- Depaitruent�own of Barnstable. P#of Regulatory Services • �.A1WsrA8iB. Public Health Division Bate. 16q ems$ 200 Main Street,Hyannis MA 02601 Iq li , � � Date Scheduled �'Time � Fee Pd. ,mCY oll Suitabilio Assessm' ent for Sew e Dispos l Performed By; /1 Y/r�,l� t`tV 4 10, Witnessed By: 7 1i �� LOCATION & GENERAL INFORMATION Location Address .' (J t✓v , ) 1— S�T Owner's Name .�G�v ' b i Address Assessor's MaplP4rcel: I Engineer's Name NEW CONSTRU( '.n N REPAIR Telephone# _61 3,60 Land Use 1�►� t'° 41 Slopes(�o) rt' Surface Stones /v v Distances from: Open Water Body ft Possible Wee Area ! V b ft Drinking Water Well ft ))rainage Way > ft Property Line --/O_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) w ��Gt 1 i 2 r.:a .I p.....u9 p•) L J iN i rn j Parent material(geologic) i Depth to Bedrock wa Standing Water in Hole' Weeping from Pit Depth to Ground (er. g _ Estimated Seasonal?(-ligh GroundwaterV. DtTERMINATION FOR-SEASONAL HIGH WATER TADLE Method Used: r I ln. Depth abperved standing in ohs:hole: in. Depth to Sgll m9ttles: ft! in. ©roundwhter Depth to;weeping from side of obs.hole:. Adjustment ! Adj.Actor Adj,OroundwaterL.evel,,e Index Well# _ Reading Date: index Well level -a PERCOLATION TEST . Date T1►ae. Observation I Time at 9" IkL Role# � Time at 6" Depth of Perc Z�------ .. - -- Time(91'-6�) Start Pre-soak Time-@ -- - - — rv' - End Pre-soak � Rate MinJinch Site Suitability Assessment Site Passed Site Failed; Additional Testing Needed(YIN) Original:,Public kc`alth Division Observation Hole Data To Be Completed on Back— -you must first notify the ***If percolaibn test is to be conducted within 100' of wetland, Barnstable Conservation Division at least one(1) wedk prior to beginning. 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 ►e c� 3 r, 2 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. Consistency.%Gra el Iffodvt G"1c . AA D EP OBSERVATION HOLE LOG Hole# Depth from' Soil izon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel 777 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Cher Surface(in.) DA) (Munsell) Mottling .(Structure,Stones.Boulders. Consistency, Gravel)_ Flood Insurance Rate Mau: v _ - Abo a 500 year flood boundary- No� Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi u aterial exist.in all areas observed throughout the area a proposed for the soil absorption system? 0 . If not,what is the depth of naturally occurring perkious material? Certification I certify that on 1 (date)I have passed the soil evaluator examination approved by the Department of Enviroi imentall Protection and that the above analysis was performed by me consistent with the requireTfftiqiq2,expertl§e and experience described in 3,10 CMR 15.01 . Signature 'IV Date � Q:\SEPTICVERCFORM.DOC Ji1L/01/201 PEN 03:58 FM FAX No, P. 001l011 Fowls of Barnstable ' Regulatory Sex-Oces Thomas F.Geller,Director Irarne�z, C "M Public Health]Division �a A. Thomas NICXean,Director - ZDO Main Street,Hyannis,KA,02601 Office: 503-862.4644 Fax: 503-790-6304 Installer& Designer Certification Form IA115 Date: Sewage Permit# alaIf Assessor's MapTarcel 51D Designer- e.�_'�i Syl Installer: / Address: _ 4Fi� Address: On �\+ �W VVas issued a permit to install a (dat (i stal r) VgBv�`�Uf �17 t5 septic system at 17asc1 on a design drawn,by (address) , dared 1 (designer) ( certify- that the septic system referenced above was installed substantially according to the design, which may t c e „ - n lud minor approved changes such a� ate relocation� r PP � a 1 rat relo a .t,a of 15e distribution box and,'or septic tank. usE—o ,l� s C."$ s_ sk" V\AS 1 certify that the septic system referenced above was installed with major changes (i.e. greater Char_ 10' lateral relocation of the SAS or any vertical relocation or any component of, the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. OF D E (Installer's Signature) yt �1NITARM } (Desig='s Signature) WEN DesipeA's Stamp Here) PLEASE RETURN TO BARNSTA13LE PIU13LIC HEALTH DIVISION CERTIFICATE OF CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FOPINI AND AS-BUILT CARD ARt, RECEIVED BY THE BA NST.ABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: HealtivSeptic/l}esigrer Certification Form 3=16.0doc TOWN OF BARNSTABLE LOCATIOrI � L/fi� — SEWAGE# VILLAGE t, ASSESSOR'S MAP&PARCEL /6 (5j INSTALLER'S NAME&PHONE NO. loe,i Ell SEPTIC TANK CAPACITY �► ��J` LEACHING FACILITY:(typ F (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If anywetlands exist within 300 feet of leaching fac� ' ) Feet FURNISHED BY . 3 No. !3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: } PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pglitation for Viso Y bpstem Construttion permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lo -Owner's Name,Address,and Tel.No ` J� Assessor's Map/Parcel In'9stalller's e,A essOT44 o. l signgr's Name Address,and Tel.N GAG. �GVJ ,�o e �tG' / ': 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(min.required) C/ gpd Design flow provided _ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) p 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 of Hea Date h 1 Application Approved Date f Application Disapproved by Date for the following reasons i Permit No. Date Issued 14Wa 5/� Hazardous Materials Inventory Sheet Checklist ,5 Date Physical Street Address-Check database to ensure it exists L_.. Working Phone Number Actual Amounts -( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials) /jam Storage Information - location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. /__---Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? - provide a vehicle washing policy and plain it - note that it was given Attach the Business Certificate with your sign off and comments *'T e inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. I;' - t.,». ....-. t.•.»« ...�....-...:.;:,�:atir�.i.-i::d"vI.,,L; %"• "tiv+w.^;+...,:«-., ...:yuc„u...:w..:.•-s..:...... 1 . �v'W 'r-.�'�•:......_ 4?•f"�`-w.w....+Y-�v,-^ .: _ No. ca Fee `d® THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN'yOF BARNSTABLE, MASSACHUSETTS Yes plitation for is astir pstem (Construction Verfi t Application for a Permit to Construct Repair ` PP ( ) (� Upgrade( ) Abandon( ) El System ❑Individual Components A Location Address or Lod lyo.'pZ�� v wner's Name,Address,and Tel.NoyZQ'.CJC Assessor's Map/Parcel Installer's,N��►►�nne;Address,any-el.No. j ,D. signe 's Name,Address,and Tel.No v Type of Building: Dwelling No.of Bedrooms Lot Size y(o FD sq.ft. Garbage Grinder( ) Other Type of Building 'S No.of Persons Showers( , ) Cafeteria( ) Other Fixtures Design Flow(min.required) (5) gpd Design flow provided � ,d gpd Plan Date . Number of sheets Revision Date Title \ — r Size of Septic Tank Type of S.A.S. 11A Description of Soil 4 - Nature of Repairs olr Alterations(Answer when applicable) j Date last inspected: f 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 of Health. fSq. nedi -- � Date Application Approve Date C)-,' Application Disapproved by j Date for the following reasons , Permit No. _Zj c'�� U Date'Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (certificate of Compliance THIS IS TO CERTIFY,that the Orte-Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by at as been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No d �`a dated Installer./��d' / �lli' Designer #bedrooms Approved design flow , „/•� pLgpd r The issuance of this 'e t shall not be construed as a guarantee that the system will ctio�n as designed. Date Inspector G? r' No.(�b f 3 `c� © Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS l •. 1 D� s� sai bpsteln CD11strUtt1011 Vermlt i Permission is hereby granted to Construct( ) Repair( Upgrade( ) ,Abandon(. ) System located at / 144 i Y and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with i Title 5 and the following local provisions or special conditions. Provided:Construction must be co pleted within three years of the date of this 1permit. ( �� —---- Date �� r} �- 3 Approvedlby - �, l_ _ ru ru M1 OFFICIAL USE I N Postage $ ! \ N��1 Certified Fee O Return Receipt Fee Postmarlt C3 (Endorsement Required) i l Here !�Restricted Delivery Fee O (Endorsement Required)_ / r i / /I✓ O Total Postage&Fees' t0_ /! Nb�,N ru a J ao M. Sena N, %'.Mr. & Mrs. Dennis Connors PO Box 85 west Hvannis-MA 02672 Certified Mail Provides: o A mailing receipt /��" e A unique identifier for your Mailp'iece o A record of delivery kept by the Postal'Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. n Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. e For an additional fee, delivery, may be restricted to the addressee'or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired;please present the arti- I cis at the post office for postmarking. If a postmark on the Certified Mail t- receipt is not needed,detach and affix label with postage and mail. ,IMPORTANT: Save this receipt and present it when making an inquiry. I PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 o p t r=1 ti �• Em'. Ln m Postage r Yam, Certified Fee Return Receipt Fee Postmark (Endorsement Required) Here O Restricted Delivery Fee' Zi r'1 (Endorsement Required) c O Total Postage&Fees 1$ r David Holt @ Today Real Estate 1533 Falmouth Road/Rte.28-. i� 'Centerville, MA 02632 t Certified Mail Provides! (ex ene8fl zooz eunr'oosc w,o�sd a A mailing receipt o A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. 'n Certified Mail is not available for any class of international mail. E a NO INSURANCE COVERAC-� IS PROVIDED with Certified Mail. For valuables,please consider Ins�ted or Registered Mail. • For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized a ent.Advise the clerk or mark the mailpiece with the endorsement°Restdoted-Defivery". RI if a postmark on the Certified Mail receipliis desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. x IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail. addressed to APOs and FPOs. SENDER- COMPLETE THIS SECTION CO MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. A ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Die of elivery I ■ Attach this cans to the back of the mailpiece, - or on,the front if space permits. D. Is delivery address different from Item 1? ❑Nes. 1. ArtiG6.'Addressed to: x i If YES,enter delivery address below: ❑ No j Joao M. Seria I % lVlr. & Mrs. Dennis Connors POBox 85 S lceType I West Hyannis, MA 02672 rtiftedMail ❑Express Mail b4tegistered ❑Return Receipt for Merchandise N ❑Insured Mail 1:3 C.O.D. 4. Restricted Delivery?(Extra Fee) ❑ye!ar I 2. Article Number '"7 p 12 1 10 ' 0 it 2 8'4 3 118126 (transfer from service label) Ps Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 f f • Sender: Please prin, your name, address, and ZIP+4 in this box • � c'ti�yi zEt— c- `''�� Town of Barnstable ' ublic Health Division I o e✓ F200 Main Streety jyannis, MA 02601 ca i :: 00:;_� _� r��rlr��1llru���rinn�jrlr)r�l�rrrl�)r�ilr,�rtl�r�lt,)rrrr�)�r) i { Town of Barnstable Barnstable Regulatory Services Department i `AB r Public Health Division I i639. ♦� 200 Main Street, Hyannis MA 02601 zoos Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012 1010 0000 2843 2126 Marchl1, 2013 - Joao M Sena % Mr. & Mrs. Dennis Connors PO Box 85 West Hyannis Port. MA 02672 • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 210 Walnut Street, Hyannis. MA was last inspected on 8/03/12 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • System needs to have PVC outlet tee replaced You are ordered to repair or.replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period .will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH S c ean, R.S. CHO • Agent of the Board of Health. Q:ISEPTIC\Letters Septic Inspection Failures or Future Eva11210 Walnut St Hy Mar 2013.doc r` l: Town of Barnstable Barnstable 44&—N% Regulatory Services Department "�"'�"a�'� MRNSTARLE, MA ` public Health Division T SS J.F .639 °l- "M a. 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3524 6710 September 4, 2012 David Holt @ Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 The septic system located at 210 Walnut Street,Hyannis,MA was last inspected on 8/03/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Septic system is in hydraulic Overload You are ordered to repair the septic system within sixty (60) days from the date you receive this notification by repairing the leaking septic tank and by rectifying the problem of having the septic components beneath the driveway which are not H-20 loading. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T BOARD OF HEALTH , omas McKean, R.S. CHO ,, Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\TOB Itr I. UNITED STATES POSTAL SERVICE '�x �,aF��lasS��,Y I • Sender: Please print your name, address, and ZIP+W1r*t9 box • ^»>,.u'� P Town of Barnstable Public Health Division 200 Main Streety Hyannis, MA 02601 ![ E COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete ,k Sign re item 4 if Restricted Delivery is desired. t O Agent ■ Print your name and address on the reverse X t ❑Addressee so that we can return the card to you. B. Receiv y(Printed Name) Dade ofpelivery e Attach this card to the back of the maiipiece, � G or on the front if space permits. D. Is delive ddress different from item 1? ❑Yes 1. Article Addressed to: If YES,en r delivery address below: ❑No :s David Holt @ Today Real Estate 1533 Faimouth Road/Rte 28 Centerville, MA 02632 a. 13 Certified Mail Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise — —-, ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?Pft Fee) ❑Yes 2. Article Number 7 0 1.11 0 821 b b 0 8 0 0 552 4 6 710 (Transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 1025s5-02 M-tsao Town of Barnstable Barnstabhe �pF THE Tp Regulatory Services Department 1 e"aC I li+ BARNS'rABLE, +I • • o • • MASS. A VVV 039. Public Health Dlvlslon 9�Ar�°—"M 0.1 200 Main Street, HY Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3524 6710 September 4, 2012 David Holt @ Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 The septic system located at 210 Walnut Street, Hyannis, MA was last inspected on 8/03/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: 0 Septic system is in hydraulic Overload You are ordered to repair the septic system within sixty (60) days from the date you receive this notification by repairing the leaking septic tank and by rectifying the problem of having the septic components beneath the driveway which are not H-20.loading. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF BOARD OF HEALTH omas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\T0B Itr Commonwealth of Massachusetts U�,,! = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St ' Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every- Hyannis MA 02601 8-3-12 - page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address - E. Falmouth MA 02536 ' City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification L ' I certify that I have personally inspected the sewage disposal system at this,address and that-Me :5 E information reported below is true, accurate and complete as of the time of the inspection. Thwinsp ion was performed based on my training and experience in the proper function and maintenance of on s e sewage disposal systems. I am a DEP approved system inspector pursuant to;Section 15.340 „. Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 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•11/10 Title 5 Official Inspect Fo Subsurface sewage Disposal System•Page 1 of 17 in 1 Commonwealth of Massachusetts . Title 5 Official Inspection Form a o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis - MA 02601 8-3-12 page. City/Town State Zip Code Date of Inspection 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: 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.', t ' t 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): c - t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name a + information is Hyannis MA- required for every y .. 02601 8-3-12 page. City/Town 'State Zip Code Date of Inspection B. Certification (cont.) _ 4 B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ •obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): El 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 ❑ 4 N ❑ ND (Explain below): t C) Further.Evaluation is Required by the Board of Health:, , ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if, the system is failing to protect public health, safety or the environment.' 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ' ❑ ' Cesspool or privy is within 50 feet of a surface water ❑ f` `Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 .. ,_, Title 5 Official Inspection 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' 210 Walnut St' Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 page. _ City/Town State Zip Code Date of Inspection B. Certificatio.n,(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: ❑ 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 ® El ' ` clogged SAS or cesspool r w Discharge or ponding of effluent to.the surface of the ground or surface waters El ® 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 orcesspool ' Liquid depth in cesspool is less than 6" below invert or available volume is less❑ ® r, than Y2 day flow ' t5ins•11/10 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 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 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 k 4 and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- ❑ ' E,--. 10,000gpd. ® El criteria 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 El Elthe system is located in a nitrogen sensitive area (Interim Wellhead Protection 1. Area— IWPA) or a mapped Zone II 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•11/10 • 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 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 page. City/Town 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 ® El available note as NIA) ® ❑ 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? ®. 0 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 . page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 295Gpd/2yrs 9 ( Y 9 (gP ))� Detail: Sump pump?. ❑ Yes ❑ No Last date of occupancy: Date 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-11/10 , Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title •5 official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St 3 Property Address Bank Owned Contact David Holt Today Real Estate 1-800-966-2448 ( G Y ) Owner Owner's Name ° information is required for every Hyannis MA 02601 8-3-12 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: 3` gallons How was quantity pumped determined? . Reason for pumping: Type of System: ® Septic tank, distribution boz, soil absorption system , ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ti Shared system es or no if es-attach previous inspection records if an .❑ Y (Y ) ( Y � P P � Y) ❑ 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. t ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System°Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s" 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required foi-'every Hyannis MA 02601 8-3-12 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: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): , . . Depth below grade: 241- 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): r _ 1811 Depth below grade: feet' Material of construction: ❑ concrete. ❑ metal ❑ fiberglass ® polyethylene ❑ other(explain) - t s If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal Sludge depth: 12" t5ins•11l10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts _ W Title 5 Official Inspection-. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St a Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 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 16" 211 Scum thickness Distance from top of scurri to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 12" 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.): k Plastic tank 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 El-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-11/10 ° Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection' Form 14 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 210 Walnut St `. Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 f page. City/Town. State Zip Code Date of Inspection ' D. System Information (cont.) r y Comments (on.pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): t r ' 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: t 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 e t5ins•11/10 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 - M 210 Walnut St Property Address, Bank Owned Contact David Holt Toda Real1Estate 1-800-966-2448 . - ( Y ) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Distribution 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 leakage into or out of box, etc.): Good condition with stain lines and liquid above inlet invert. Pump Chamber.(locate on site plan): Pumps in working order:;; ❑ Yes ❑ No Alarms in working order: z` ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation ion not re uired : If SAS not located, explain why: = t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts A Title 5 Official flnspection Form QW Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 210 Walnut St , Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name - information is - required for every_ Hyannis. w MA 02601 8-3-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5-infiltrators 0 leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number, dimensions ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Coniments (note condition of soil, signs of hydraulic failure, level.of ponding,damp soil, condition of vegetation, etc.): r , Infiltrator leach field was filled beyond capacity at inspection. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts + Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form =Not for Voluntary Assessments ,M 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)' Owner Owner's Name information is H anniS ° MA 02601 8-3-12 required for every y page. City/Town 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 4 Comments.(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): , • + • ., t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 210 Walnut St Property Address 4 Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 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 • EGG 10-:e t _ G EL 1: . . -•E'- off! ' �C- �D , 33 ' 1 ' t5ins•11l10 3- ' 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 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-3-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam ❑ Check Slope ❑ surface water k ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 t. feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record 4 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: Original design plans show no groundwater at 12'. .:q r .. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection 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 ay' 210 Walnut St Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information i e required for every Hyannis MA 02601 8-3-12 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 AsBuilt Page 1 of 1 �� /lvrrly yr fltinitia fswLs; ' ,OCATION , 1_— �c{r✓I cl SEWAGE # TILLAGE X'i�n ��5 ASSESSOR'S " &LOT NSTAL,L.ER'S NAME&PHONE NO. MPTIC TANK CAPACITY .BACHING FACILITY: (type) D/S (size) IUILDER CAR OWNER 'ERMITDATE: COWLIANt E DATE: �cparation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility lFeet �ivate water Supply Well and Leaching raciiity (I.{'iuiy ivells exist on site or within 200 feet of leaching facility) Feet ?dge of Wedand wad Leaching Facility(If ataxy wetlands exist within 300 feet of aching facility}� �Pect 'aunished p- kG EIIE/=/ 'T Q O � G �D _D� ^�` 33 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=310040&seq=2 10/1/2012 TOWN OF BAkNSTA.BLE '�/�� ,OCA 1"ION 0T / SEWAGE # /ILLAGF 1— 1-4✓1 n .'S ASSESSOR'S DW & LOT NSTAL, .EPVS NAME-&PHONE NO. ;EMC TANKCA.PACI TY -.EACHING IPACIILITY: (type). � °��L: D°�S (size) ;0.OI~'EED➢i.00MS. „3.._. MILDER O OWNER..._.. -- W ... ,a _ .� . � � - t 18 'EIMITDATL7:_____c.,,, ,,,., COMPLIANCE DATE: _ eparation Distance Between the: s: naximum Adjusted Groundwater Table to the Bottom of Leaching Facility eee 'ivate Water Supply Woll and Leaching Facility (if my walls exist net site or,within 200 feet of leaching facility) idge of Wetland mid Leaclting Facility(I'any wetlands exist within 300 feet of ac➢sing facili Vanished by t � t GJ SU e � 1 �V TY) b ' w � w . p a TOWN OF BA.RNSTABLE f'L ,OCATION `® �U �7/-�T S7� SEWAGE # a GtC j—J,2 VILLAGE icS ASSESSOR'S MAP & LOT 31 D`L b INSTALLER'S NAME&PHONE NO. : SEPTIC TANK CAPACITY .C � LEACHING FACILITY: (type) 'tom e'--� ze) NO.OF BEDROOMS^ (v/ m BUILDER OR OWNER Z PERMIT DATE: I COMPLIANCE DATE: I 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 W s ( i V �J W N CD �b 'Dz . Q No. 21001 r S-`I FEE 137-0' COMMONWEALTH OF MASSACHUSETTS E4: Board of Health, 1)�jr'��S�C���E' ,MA. APPLICATION FOR DISPOSAL SYSTEM CONSTR UCTION PERMIT Application for a Permit to Construct( ) Repailxupgrade( ) Abandon( ) - Complete System ❑Individual Components Location AID S Owner's Name M, i Map/Parcel# Address Lot# ' '� Telephone# Installer's Name Designer's Name 5 t Address q i ` Address Telephone# a 1{l a Telephone# , Type of Building 4,e,n ON Lot Size 'sq.ft. Dwelling-No.of Bedrooms c, l F'212. Garbage grinder ( ) Other-Type of Building f��(�i�— p No.of persons Showersx,CafeteribP-<) Other Fixtures Design Flow (min.required) 3Z' gpd Calculated design flow Design flow provided gpd Plan: Date (8`oZ� � Number of sheets Revision Date Title pnec� Drv►s -M . Uce�e- Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator (na Date of Evaluation 10 aq 10 DESCRIPTION OF REPAIRS OR ALTERATIONS af) 1 The undersigned a e o install a ove described Individual Sewage Disposal System in accordance with the pro4risions of TITLE 5 and further agrees to o lac tem in operation until a Certificate of Com fiance has been issued by the Board of Health. Signed i Date iPections �, '"".�'r`:�,.-',,,�"�`-»cr..r�¢s+F'-` .. '',�`' �Y'`�ys-..-..��t '-•.. •w+"""'"+.r,�`- `�'.+•-t�ti'„r1C��,,,`�----'' ++'�li�:'�3^*l'"^""""""""'"�,•. - No. y�J ( ' t w FEE J D COMMONWEALTH OF MASSACHUSETTS 't Board of Health, 3rrf)S\CA\0Q MA. t FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIt Application for a Permit to Construct( Repair( UpgradeO Abandon( -aComplete System 0 Individual Components Location (� a I r)oA- Owner's Name 14-ar, 'Snhinc nh Map/Parcel# 310 Ie Address :5" Lot# rt A r Telephone# Installer's Name Designer's Name Address A_ jp he (Qn �i c"i r A r NP Address Telephone# at{�r'- �� Telephone# � Type of Building :Y "hS7 \C� .. t'C`n\ Lot Size . sq.ft. a Dwelling-No.of Bed rooms Garbage grinder ( ) m H; ,other-Type of Building No.of persons ` Showers' Cafeteriw-, ) Other Fixtures LP l�:G ^� i lK 1 C 'S Design Flow (min.required) gpd , Calculated design flow '57�` Design flow provided: "5 gpd Plan: Date (8�� `Q Number of sheets + j (_ _ _ -,Revision Date N n � Title .a: .•� ' Description of Soil,,(s) . .:: /l 1 Soil Evaluator Form No. Name of Soil Evaluator l rtvw rr , s,(nM . Date of Evaluation 10 a C) La DESCRIPTION OF REPAIRS,ORALTERATIONS gam.•. . ,,M��Y 4 l . ..,` o The undersigned agree/s to install the' aliove described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to no place system in operation until a Certificate of Co' fiance has been issued by the Board of Health. Signed Datex17- -Y. P1 i 4nspections "" 4 9 No. Zoo s-S2 t FEE 'y COMMONWEALTH Of MASSACHUSETTS Board of Health, I, VA s��� _A. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: s at 2(Q 4, Q,,.` f has been installed in a ordance with the pro sio s of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to l application No. �� .7 dated /O 31 1 Approved Design Flow (gpd) z.: Installer �"•^.«�,._ \ (�c f -7 1 _ LZM* Y`/� f/�_ �u / Date:_J 1�l• ! I d 3 Designer: �_ ""Inspector: - :.rd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. r; 200 _ 527 ✓0 ^ No. � FEE COMMONWEAL L- OF MASSACHUS ETTS Board of Health, /t $ V c ✓ , MA. 01, DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granfed to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system (fug - Lh/�L/� as described in the application for at 2 1(2) Disposal System Construction Permit No. Z603`527 dated s 1 Provided: Construction shall be completed /w/itthi thh ee years of the date of this r i to on itions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date I K �j/v0 Board of Health I TOWN OF BARNSTABLE LOCATION C210. f�"`' ��� �7- SEWAGE # a O j_S; E ° ASSESSOR'S MAP &LOT 0 VILLAG `© b INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:'(tyPe) d7�'-� r/J Sze) NO.OF BEDROOMS BUILDER OR OWNER - PERMIT DATE: l COMPLIANCE DATE: Separation Distance Between th Feet Maximum Adjusted Groundwater Table o the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site of within 200 feet of leaching facility) exist Edge of Wetland and Leaching Facility(If any Feet within 300 feet of leaching facility) Furnished by- �I e ®f- ¢..jam I z 0 i i - Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location Ok� Lot No. Owner: L �16, 1 Address: 1 � Contractor: Address:- Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OA Appropriate index well..................... OWater-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... m nth/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ..............................................:........................................... STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ............................................ ......;........................... k Figure 13.—Reproducible computation form. 15 Sep - 20-01 13 : 52 bARNS'TABLE HEALTH DEPT 50E�7906304 N • UL 4\ - S/25;01 C)TICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM "hereby certify that the engineered plan signed by me u tec is Cbr�, concerrung the property located at cy meets all of the i, Po.v;ng criteria'.� • This failed system is connected to a residentjal dwelling only. There :ire no _ommerial or business uses associated with the dwelling, 'F�e sail is cidss!tied as CLASS I and the percolation rate is less than or equal to -r>~nutes per inch. The applicant may use histoncal data to conclude this fac: or may :onduct are!irnw.ary tests at the site without a health agent present There :s no increase to flow and/or change in use proposed • There are ,ro variances requested or needed, The bottom of the proposed leaching facility will not be located less than fourteen l,) lee: aonve the maximum adjusted groundwater table elevation. (Adjust the nundwaier table using the Frimptor method when applicable) Please complete the following: �. "fop of Crouno Surface Elevation (using GIS information)rR "; G.V,' 1c�at:or, �_ ad;ustmcn( for high G.W. :)TI-TRENCF BETWEEN an B S C)I ED _ _ DATE: to A NOTICE . 3asec -i-ori t^e above irfarmauon, reoair permit wil! be issued for 'oedrooms `'r% :dd!W nal bedrooms are authorized to the future without engineerec i p!,c s_a,tem plans. �•:nn!C:Ou �ucc.im9 ' HYANNIS LEGEND PROPOSED CONTOUR RCp` +p: 9® PROPOSED SPOT GRADE PP 33� UPOLE -- 98 -- EXISTING CONTOUR ROv1E 28 RO�r 310 PARc 42� + 96.52 EXISTING SPOT GRADE F 28 310I ----- 27 "� � � W— EXISTING WATER SERVICE v�J v2 109. / TEST PIT 0. S83•08'40 W _ oc 10.04 O TH-1 TH-2 LOT B , 42.4 Ct v_ 0 PARCEL ID: 42.4 - = 310/040 ;,-''� 241'(D G 'P N0 _ = AREA=7680t S.F. ' `, LOCUS MAP 2.4 �1��0°� _ -%� t `' LOCUS INFORMATION �6'• 1'��, \ G� _ = 6 = r'' ' '' ��c.�Py i,�' CB `'`` PLAN REF: 19212/9 TOF 44.0 _ TITLE REF: 1 AP 312 _ p� ='�� PARCEL ID: MAP 310 PAR. 40 0, \, ZONING: "RB" r0, a, `� 20 = FLOOD ZONE: "C" - _ _ COMMUNITY PANEL: 250001-ODDS-C DATED:08/19/85 IBM. _ - SEPTIC SYSTEM \ v 4 .0 =- oo°° REPAIR PLAN PARCEL ID: 30"0 - N I 037 `9 `� I n ` LOCATED AT: 310/ s ` , /b �� 431 210 WALNUT STREET N �'� �3 vEN� ''� HYANNIS, MA. _GENERAL NOTES: rn 12"P �6° 1 ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL PREPARED FOR !2 PARCEL ID: 30ARD OF HEALTH AND THE DESIGN ENGINEER. DENNIS C 0 N N 0 R S 310/039 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 43.0 OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE -OCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR JUNE 24, 2013 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4. ANY CONDITIONS 'ENCOUNTERED DURING CONSTRUCTION DIFFERING OF FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN PARCEL ID: ENGINEER BEFORE CONSTRUCTION CONTINUES. 310/038 5• ALL ELEVATIONS BASED ON ASSUMED DATUM. `� DAF R N G- 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ! -rHE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 1140 ,iEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. HATER SUPPLY PROVIDED BY TOWN WATER SERVICE. ,psl 8. A,LL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. IlLi 1 ,13 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 10. ,EXISTING LEACHING PIT TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. MEYER CX SONS, INC. 11. 9$ HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY P.O. 9 81 !ND IS NOT TO B 0E CONSIDERED A PROPERTY LINE SURVEY X 13. F40 PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING EAST SANDWICH, M A• 02537 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. OTHERWISE) 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW .FOR THE USE OF A GARBAGE GRINDER (508)362-2922 16. `NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING SCALE: 1 "=20' f, SHEET 1 OF 2 J#1555 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:39.71 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=44.06 INSTALL RISERS & COVERS OVER, INLET, & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER OUTLET AND SET TO 6' OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.)I AND SET TO 3" OF F.G. INSTALLED F.G. EL.=43.Of F.G. EL.=42.4t F.G. EL: 42.5t F.G. EL: 42.5(MAX.) LENGTH QF MAss9 •.� $ 9.45" � DAI '�9N 9" MIN COVER/ M -YLR 0 36' MAX COVER L = 20' L = 1O'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) L " No. 1140 ® S=1% (MIN.) 0 S=1% (MIN.) 0 S=1% (MIN.) r 12.J7" 4"SCH40 PVC - 4"SCH40 PVC 4"SCH40 PVC RfC/SjE�� 10•I • 14• 6' 10.75" TO SANI TAR�Pa INVERT INV.=40.0 �tEilO INV.= 39.75 INV.= 39.25 COUPLER DETAIL �1Z ?j GAS BAFFLE) PROPOSED D-BOX INV.=39.35 3 ROWS OF 6 UNITS ® 5'/UNIT + 1 COUPLERS ® 1.16'/UNIT = 31.16'/ROW 'n INV.=39.55 DB-3 SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1,500 GALLON POLY SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING SEWER OUTLET BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS 60" NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BREAKOUT=TOP ELEV.-39.71 GRADE ON A MECHANICALLY COMPACTED SIX INV. ELEV.= 39.25 INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 38.38 EXISTING SUITABLE 310 CMR 15.221(2) MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK 5' MIN. ABOVE BOTTOM OF 2 88 WITH 1,500 GALLON SEPTIC TANK IF FAILED, T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.88' = 8.64' DAMAGED, NOT H2O LOADING, OR UNDERSIZED. (6.98' PROVIDED) USE 3 ROWS.OF 6-ADS ARC 36HC 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL.=31.40 -_ (H20) UNITS - NO STONE W/ 1 COUPLERS GAS BAFFLE AS REQUIRED r IN EACH ROW SEPTIC SYSTEM PROFILE TYPICAL SECTION --' N.T.S. 1s" N.T.S. SQL LOG P#:14040 DESIGN CRITERIA DATE: JUNE 19, 2013 NUMBER OF BEDROOMS: 3 BEDROOM DESIGN SOIL EVALUATOR: :ARREN M. MEYER, R.S., CSE #1614 SECTION 10.75" INVERT WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH HEIGHT END CAP SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN I DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. Elev. TP- 1 Depth Elev. TP-2 Depth ADS - ARC 36HC CHAMBER (H2O LOAD) NOT DESIGNED FOR GARBAGE GRINDER GARBAGE GRINDER: NO 42.40 0" 42.40 0" ( ) A LOAMY SAND A LOAMY SAND MODEL ARC 36HC SEPTIC TANK: 330 1GYR 3/2 f 1OYR 3/2 gpd x 200% = 660 gpd USE EXISTING 1,500 GALLON POLY SEPTIC TANK 41.90 B 6' I, 41.90 B 6" LENGTH 63" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT LOAMY SAND LOAMY SAND 10YR 5/8 11 5/8 EFFECTIVE LENGTH 60" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY P 39.57 34" ,I 39.57 34" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. PERC TEST C �' C SIDE WALL HEIGHT 10.75" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) ® 37.90 I OVERALL HEIGHT 16" PRIMARY S.A.S. OVERALL WIDTH 34.5" 4640 TRUEMAN BLI/D HILLIARD, OHIO 43026 MEDIUM MEDIUM 10.7 CF s USE 3 ROWS OF 6 - ADS ARCHC 3616 H2O UNITS-NO STONE SAND l SAND CAPACITY 80.0 GAL AovANceD DRAINAGE SYSTEMS INC. AND EXTENDED 1 .16 Wl COUPLER IN EACH Row 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM SITE PLAN BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) (CHAMBERS: 6/ROW)18 UNITS x 5.0 LF x 4.80 SF/LF = 432.00 SF 31.40 132"I 31.40 t32" 210 WALNUT STREET, HYAN N IS, MA (COUPLER: 1/ROW) 3 UNITS x 1.16 LF x 4.80 SF/LF = 16.70 SF I TOTAL AREA = 448.70 SF PERC RATE <2 MIN/IN. IN "C" HORIZON) Prepared .for: Connors DESIGN FLOW PROVIDED: 0.74GPD/SF(448.70SF) = 332.03 GPD > 330 GPD req'd NO GROUNDWATER OBSERVED Surveying by: SCALE DRAWN DATE: . Engineering by: Y 9 Meyer&Sons, Inc. ArscDougau Survey NTS D•M•M• 06/24/13 " I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 p0 BOX 961 508 419-1086 'I valuations and that above analysis has)been performed b me consistent with the ( ) REV. DATE: CHECKED SHEET NO. to conduct soil a at the o y os be P Y W/CH MA 02537 EAST SAND requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999. 508-362-2922 D.M.M. 2 Of 2 V, "i U� qr +/ 43 Prn oisw4w"am SHALL�,K 41 I F'[FIEZ too b 6 n.-from TO` st'2*inchee a 'PROPIL )K AF '40 P.V.C" AY! 2 F1. h sieotic tank' Z"': Schedu PVC w/Choircod Odor,filter of 1/0' /27,�WcmhW',JP*O9ton# mumiid)� septic 6wmm:nwo bb As iuin TOP OF FOUNDA110A. ....... 'ed 6u Stan,* WILLI Bumpus, ROAD 9rado /4 'Of rffdehw�� �Voeh �".00 O"id,oiIer swftjw* ------------- S 'S. HOLE,h-10 3- _902 DIST, N A _74* Of SAS EW foot EftecOve Depth ntow,Exu .n"DATION T :SE T1 Units I! H-10 0.8.3' (10 inches) CONORM niLL �y 10 ,DfS M180tiON bX -P ue 314OLE� 6 In.of,3/4*-1 llr,, > ad Effective Length compacted CY) SYSjIM EROFILE 140T C Not to Scole 76 LOCUS MAP 4 SOIL ABSORPTION SYSTEM (SAS) INFILTATROR HIGH CAPACI TY -GENERAL . NOTES 8 In.of —10, 14 WANG)/ GEOROE. 0BRIEN 31,V 11'2* , M 1 .1 4) 1, I L,,: uf*ctive VWth Not to Scale compacted xtotm Co'ntroctor�,,Is�responsible for Digsofe notification 10 (OR EQUVAENT) MUST HAVE RISERS TO WITHIN 6" BELOW GRADE 97.00 /EFFECTI 18,10, and,,protection. of-oil unde ALL COMPONENTS VE rgr�uhd utilities and pipes. Oi No Growdwater Obswved 0 144* NOTE: OVERALL HEIGHT OF INFILTRATOR IS,18* 2. The Septic' ton'k,onj distr* box shall be set I ution of�2 level on 6 Stone. With no 3., Back ill should I be clean :sand or gravel, stones over 3", jn'�size. t 'to 4. This system is subjec during installation �by Carmen IE. Shay 11rivironmental Services-Inc. 41holl Instal. this system in accordance The,contractor' with Title V of the Massachusetts state code, the approved plan and Local T Regulations., EST , installation th 6. If, during e �controctor encounters any il conditions or site conditions that are different OCTOBER 2§. ��003 so' Dote of Percolation Test: T469 Perform"ed By- CARMEN E.,,',SHAY, R.S C.S.E. from those, shown on the-soil log or in our design t n must m Results Witnessed By'',WAIVER ( pee',Bornstobte B.O.H.) installatio halt ediato notification,be made to Cormeh E-,, Shay Environmental :,Setvices, ne. SHAY.�..ENMRONMENTAL .SER\ACES.4'INC. L 'A ver the Percolation Rate: Less Thon'2:1,MPI 0 48" OT 7, 'No vehicle or.heavy rmochineey 'shall rive a LOT #7 -20 septic components., septic system,,,un ss , oied" as H, Install uf-Tite-bos'baffle� or equals on all out let tee ends. 'stribu ion 9.- All,Di t nes -shall -be '4" diameter'Schedule NSF PVC, pipes. AI solid pipin �,Aees:�& ittings shall be, e 0.' 1 g 4" PVC 4- diamet'r V th� 'water,III en ipe :Sche dule:'40. PVC Oipes,wi joints.,:,'', Test Hole ce and Abutting 11 �.Municipol Wat6r"is onn66tid Ao ALL,OF The Residen 'No. 1 P rties ithin 1 0 eet. '56' rope 5 DEP TH SOILS N 36d 95.56' 0 oie 99.00 THE PROPERTY LINM"ARE' ROXIMATE AND 2 Cess 7. SHED COMP' b L FROM,�TH S Lowny ILE E URVEY�'PLAN GENERATED BY Sand NtLSbWB SE NTERVILLEi: EAR OF'"N 10 YR 3/2 PROJECT �BENCH' MARK ENTITLED ".,PLAN'�OF D IN: BACON PARK 'A, 98.50 TOP OF,:FOUNDATION HYANNIS, -MA* oATED 15, 1962 NOT� 11 100 OO'L (Assum-ed) 4ENDED'-TO:BE-_,A'8URVEY PLOT PLAN ELEV. Is AN[ L L IT SHOULD Failed BE USED FOR NO PURPOSE OTHER THAN 5/6 -SE n PTIC: SYSTEM INSTALLATION., Cesspool THE 0 Be 95.00 6' 4e EXISTING i,,CESSPOOLS TO BE PUMPED OUT AND 1500, a] TION REMOVED TO FACILITATE,,NEW-SEPTIC SYSTEM INSTALLA Septic%nk Q) 2-5 Y 7/4 D K 8. 1 87 00 �4 44 NOTE. ANY'STRIPPED SOIL CONTAINING LEACHATE -FR OM fHC,tXISTING'CESSPWLS ,T0 BE 'DISPOSED TIONS. t OF AStPER, HEALTH S�ECncA BOAR0 OF �7, -WITHIN -ZOO'-OF JHE-PROPERTY 99 NO -WETLANDS-�ARE-FRES ENT, LOT, #q 'ASSESSORS MAP 310, PARCEL' 040 3 BEDROok CARA C9 LEGEND '. Ilit 10 P ere Depth to Perc., 48',to 66"Pere Rate= Les�S' Tha 2 MPI LU Z 1&4X 1 DENOTES PROP'OSED, ater Not Observed Gr6undw SPOT GRADE - No' Observed ESHWT C ADJUSTED H 20 Elev. None EXISTING 4b X 104.46 ,SPOT GRADE PL ' LOT B,�.II PROPERTY LINE -,98 8 7,680,Square 496P�-- PROPOSED,�CONTOUR C:,/ U) W —97 , EXISTtNG CONTOUR 53.45 1. 092 S 29d::47 3 El DEEP TEST HOLE & :3--24*OIAM. MANHOLES, I PERCOLATION TEST LOCATION t FOOT�,STOCKADE FENCE WA-E ET an INLET (40 FOOT RIGHT ACCESSOVERS FOR THE SEP11C TAkk. TION OF WAY)" BOX AND LEACHING COMPONENT, SHALL BE RAItED'TO VAT14IN 6",Or 'EPTIC , UPGRADE PROPOSED S OF ' YST U FINISHED GRADE EM STEEL RE)WORCED PRECAST,CONCRETE,,,, INSALL TUF-117E GAS SAFF'LES OR tOUALS R ON ALL OUTLET TEE ENDS P .E ARED FOR" PLAN IEW MIL ON SALIZAR 3-24 faWYABLE AT , 47 "WALNUT, STREET I Min. C1eCnIrW@ wet t-,v~ Oul"T HYAN �is �'�:MA Ca I C Uldtiotlr Desian ,U*"depth 0 PREPARED BY: Number of Bedrooms- 3 Equi�olent to 330 (330 Gal.,/Doy Min. per Title V) Garbage Grinder..No A R.MEA SffA E. y E Leaching Capacity Propoaed:,136 'Gal'/Dby Minimum (Min. Per' Septic,Tank 'L '-,,3,x'330 cd./Doy'=�660 'USE 1,500 GAL. Septic Tank. 40, :50 S - ,ENVIRONMENTAL SERVICES, INC. .20 CROSS ,SECTION END EC 0 "SOIL ABSORPTION AJREA:, U ff 'of <2 min./inch sing t ercola on,,ra a Bottom Area- 017*4al/sq: ft�_,, 370 sq', �ft. 273.8 gallons P'.0.11 Box _,62T�l P= —m-4 a. sq S EAST, FALMOUTH, :,MA 02536 ideWall 0.71 g gallons, x 7, t ft sq. ft. 58 Q � GALLQN TANK MCAL 150 Providing: �331,80,gallons -0 TEL/FAX '� 61 OT,10:SCALt;'- 1`_20" N tib INCHES) EFFECTIVE'DEPTH, CALE, ' CES � DATE. OCTOBER_�2 Be:, DRAWN BY. (5), iNFILTRAT OR HIGH C;APACI T`Y H-40 ,UNtTS,- H,AVING A 0.8�' SCALE'ELEV 00 A 9, 2003 S NE SIDES, AND' .3.5 -�O _,,WA$HED_ TO F 'SHEET, 1 Of 1 to BE .USED WIH 4.0 ON THE �O DING, PROJECT#SD4 S NDER- ON,THE�.ENDS. NO STONE 99:�:' FILENAME: D499PP.DWG