HomeMy WebLinkAbout0033 WASHINGTON AVENUE - Health ton �Nll
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N N OF BARNSTABLE
LOCATION .,, k3 6 �- /►,.A= SEWAGE #
VILLAGER yT0 .Rork" _ASSESSOR'S MAP & LOT 6182
INSTALLER'S NAME&PHONE NO. O-Vt by + IKOV 550 A
SEPTIC TANK CAPACITY /S'0 Q rr 0
LEACHING FACILITY: (type) O )n Q f Fr &L T (size) 7
NO. OF BEDROOMS _
BUILDER OR OWNER MO—29 L@Cl-e-�el'
PERMITDATE: d-S/ COMPLIANCE DATE:
Separation Distance Between the: NU
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 fSo of leaching facility) Feet
Furnished by
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;=
M 5 33 Washington Ave. ";
Property Address
Schiattareggia
Owner information Owner's Name
is required for
every page. Hyannisport MA 02601 6/8/18
City/Town State Zip Code Date of Inspection
(j i
Ui
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:
Frank Nunes III
Name of Inspector
saa
Company Name
Box 841
Company Address
East Falmouth MA 02536
City/Town State Zip Code
508.272.6433 13010
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 16.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
6/8/18
Inspect r' Si natu 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 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
5�)AIA f
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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
I ,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owners Name
is required for every page. y p H annis ort MA 02601 6/8/18
Cityfrown 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:
® 1 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.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
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):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
f
0
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
�M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other: /
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than 1/day flow
t5ins.doc•rev.6/16 Title 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 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. HY p annis ort MA 02601 6/8/18
Cityrrown 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.
[:1 ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA) or a mapped Zone 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.doc•rev.6/16 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
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have.large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ 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?
El® 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): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for
every page. Hyannisport MA 02601 6/8118
Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
4 bedroom permit on file
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available last 2 ears usage d :
9 , ( Y 9 (gp ))
Detail
Sump pump? ❑ Yes ® No
Last date of occupancy: seasonalDate
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.doc-rev.6/16 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
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityfrown 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: Pumped within 2 yrs per owner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
' I
Commonwealth of Massachusetts
o- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
2005 per BOH record
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 18"feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: >10'feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 12"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
H-10 tank appears to be structurally sound
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?('attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500g
Sludge depth:
3"
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
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 >12
Scum thickness 1/2
Distance from top of scum to top of outlet tee or baffle
>2"
Distance from bottom of scum to bottom of outlet tee or baffle
>2"
How were dimensions determined? measured
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pumping suggested every 3 years to prolong the life of the system
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M s•y'' 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float'switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
fn
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for p
every page. y H annis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
o„
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.):
H-10 DB 3 18" below grade and in very good condition
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No"
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for p
every page. ann Fiyis ort MA 02601 6/8/18
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 4 infiltrators
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Infiltrators are 3'6" below grade, they were video inspected and are dry at this time, no indication of
past backup
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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for p
every page. y H annis ort MA 02601 6/8/18
Cityrrown 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.):
Soils are compact and dry
i
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
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
� G
'40
t5ins.doc•rev.6/16 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
4�M , 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: >12
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 2004 NGW 144"
Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
4' seperation per 2005 compliance
❑ Checked with local excavators, installers-(attach documentation)
® Accessed USGS database-explain:
TOPO mapping site is 24'msl and nearby surface water is 6'msl
You must describe how you established the high ground water elevation:
See above
1
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
° M 33 Washington Ave.
Property Address
Schiattareggia
Owner information Owner's Name
is required for every page. Hy p annis ort MA 02601 6/8/18
Cityrrown 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Town of Barnstable
lispBoard of Health
° A 200 Main Street,Hyannis MA 02601
Office: 508-862-4644 Susan G.Rask,RS.
FAX: 508-790-6304 Sumner Kaufman,MSPH
Wayne Miller,M.D.
January 21, 2005
Mr. Kieran Healy
BSC Group
657 Main Street, Unit 6A
West Yarmouth, MA
RE: 33 Washington Avenue, Hyannisport A= 287 -087
Dear Mr. Healy,
You are granted a conditional variance, on behalf of your client, Max Bezahler, to
construct an onsite sewage disposal system at 33 Washington Avenue
Hyannisport. The variance granted is as follows:
310 CMR 15.211: The soil absorption system will be located five feet away from
the property line, in lieu of the minimum ten feet separation distance
required.
These variances are granted with the following conditions:
(1) No more than four (4) bedrooms maximum are authorized at this
property. Dens, study rooms, offices, finished attics, sleeping lofts, and
similar-type rooms are considered "bedrooms" according to the MA
Department of Environmental Protection.
(2) A 40 mil. polyethylene liner shall be installed in between the new soil
absorption system and the neighbor's foundation wall located east of the
SAS.
(3) The septic system shall be installed in strict accordance with the
engineered plans dated December 2, 2004.
(4) The designing engineer shall supervise the construction of the onsite
sewage disposal system and shall certify in writing to the Board of Health
that the system was installed in substantial compliance with the plans
dated December 2, 2004.
HealyBezahler
TOWN.OF BARNSTABLE
LOCATION
SEWAGE #
VILLAGE ASSESSOR'S MAP & LO gxy 7
INSTALLER'S NAME&PHONE N0.. L -or Yoh SAD
SEPTIC TANK CAPACITY '��
��.
�1 r r -
LEACHING FACILITY: (type,) Jn F-r (size)
NO.OF BEDROOMS
BUILDER OR OWNER 20 L3Q"z��er
PERMIT DATE °� S COMPLIANCE DATE:
Separation Distance Between the: Na
Feet
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
Private Water Supply Well and Leaching Facility (If any wells exist Feet
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist ' Feet
within 300 f� of lea�g facility)
Furnished by ` �G
- i
X
- t
DATE: O
BARN8rABILM
FEE:
MASS.
16396 wg 6
REC. BY: . f
Town of Barnstable
S CHED. DATE: /
/0/
Board of Health .
367 Main Street,Hyannis MA 02601
Office: 508-8624644X:FA 508-790-6304 Susan G.Rask R.S.
Sumner Kaufman,M.S.P.H:
Ralph A.Murphy,M.D..
IA
VARNCE REQUEST FORM ' '
LOCATION
Property Address: 33 Washington Ave, Hyannisport, MA,
Assessor's Map and Parcel Number: 287 87 Size of Lot:. 5,000
Wetlands Within 3001;t. Yes Business Name.
�. .
No X Subdivision Name: r'
APPLICANT'S NAME Kieran J. "Healy Phone 508-778-8919
Did the owner of the property authorize you to represent him or her? Yes X No
PROPERTY OWNER'S NAME CONTACT PERSON
Name: Mr:_.Max Bezahl er Name Kieran J. Healy -
Address: 7818` Crefeld Street Address: 657 Rt. 28 Unit 6_
Philadelbhia,, PA
Phone: 215-753-1433 19118 Phone: 508-778-8919
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed)
15 . 211 (1J.
r potection of adjacent building
S•. A. S. 5 ' off Property
in lieu of in ,
Checklist(to be completed by once staff-person receiving variance request application)
Four(4)copies of engineered plan submitted(e.g.septic system plans)
Four(4)copies of floor plan submitted(e.g°house plans or restaurant kitchen plans)
Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
Variance request application fee collected(n,ree ror 8restwd modirtcation renewals,g me,> l vai,nee,ene ,,,[MM60 erflelm onlyt,wide
dining varimee renewals(same ownaeasee/l only],and variances to repair failed sewage disposal-systems(wdy if no expmioo to the building pmposedn
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED
NOT APPROVED Susan G.Rask,R manS.,Chair
Sumner Kaufman,M.S.P.H.
REASON FOR DISAPPROVAL Ralph A.Murphy,M.D.
Q:/WP/VARiREQ
r, �0 _
No. oC THiti COMMONWEALTH OF MASSACHUSltTTS FEE /Po
BOARD OF HEALTH
Ty vti!// OF
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct ( ) Repair (K) Upgrade ( ) Abandon ( ) - 'Complete System ❑Individual Components
Location Owner's Name
Map/Parcel# Address
Lot# Telephone'iI #
nstaller's Name Designer's Name
c�. '�� �co`� C�-vr�-y��\fie ✓l�ozc�� 6 �� �i � � /sr Y�.�� �
Address ddress
YOE q1t bkA <10)-ql. Z z sr 94 9r 9
Telephone# Telephone#
Type of Building: E! ,1—4-Cr Lot Size 49407V Sq.feet
Dwelling—No.of Bedrooms 66 Garbage Grinder
Other—Type of Building No. of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.required) 4(P gpd Calculated design flow gpd Design flow provided gpd
.Plan: Date !a - 7 : 2 o Oaf Number of sheets / Revision Date
Title 1' 15 0
Description of Soil(s) 4-= /
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation 4
DESCRIPTION OF REPAIRS OR ALTERATIONS_
The undersioa,
a rees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and fur ra ees not to placeAsyst�e n operation until a Certificate of Compliance has been issued by the Board of Health.
Signed A A 1411 A D ate
-4nspection Add y-2&49d bolZk4� AS C�="a 07
FORM t - PPLICATION FOR DSCP DEP APPROVED FORM 5/96
EALTH O9 MASSACHS :lJ4
N h � W , �<E.�E p7 o BOARD OF HEALTH
00
ee
OF
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION P �VI.IT
Application for a Permit to Construct ( )';Repair (K) Upgrade ( ) Abandon ( ) - Complete System ❑Individuaj.Componen�
3 (sT s2 v x -� 10 EZR&a/ E.0 f
Location n Owner's Name
HYP
Map/Parcel# Address
Lo[# Telephone# '
nstaller'sName �Designer's Name'A
Address Address
'Telephone# `Telephone#
Type of Building: A? C 5 /A9 Lot Size ✓4'-p04-2 Sq.feet
Dwelling—No.of Bedrooms'', Garbage Grinder (e-A �jj
Other—Type of Building . No.of persons Showers ( ), Cafeteria ( )
Other fixtures °
i Design Flow(min.required) q41"47 gpd Calcnlpte�d,design flow gpd Design flog provided gpd
Plan: Date / 7 - 2-,e/ Number of sheef's i Revision Date
i Title G'S.!<�
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator G• G'/_-'-1_/2 Date of Evaluation //-- fir'- o
1ao i 1 f r
DESCRIPTION OF REPAIRS OR ALTERA'T'I ONS 1�: �`' `3 � '" n �,,_.tiC�
The under siggns agrees.-to•install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further agrees notx`to pYace.the syste' 'n operation until a,-Certificate of Compliance has been issued by the:Board of Health.
.., ;�. „w•
Signed .c'allt JA spate I
hti<specti'ons n
/11 v U
FORM t - APPLICATION FOR DSCP D E P APPROVED FORM 5/9 6 C
f
THE COMMONWEALTH OF MASSACHUSETTS FEE
j ay r&,e,�-BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) ]!Complete System
The undersigned hereby certify that the Sewage Disposal System;Constructe�PRepaired( ),Upgraded( ),Abandoned( )
by: lt1CY�
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design'plans/as-built
plans relating to application No. c'�`.�-061odated Approved Design Flow ) Z/6 (gpd)
i , � (�
i Installer CA-.�JV_to 0I0
Designer: f i 1 Y', Inspeccto—r' � � Date /`�, C0-5s
The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
F
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
zz
No. v � THE COMMONWEALTH OF MASSACHUSETTS FEE
�L7/JlliST.9 BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted o Co truct .Repair ( Upgr d�/ (Abandon ) a.,individual sewage
disposal system at Y �f �/Y L as described
in the application for Disposal System Construction Permit No. e //�/� dated
1 �
Provided: Constru p tion shall be completed within three years of the date of this ermit. 11 local/conditions must be met.
Date /� `7 Board of Health // \
�! /
FORM 2 - DSCP DEP APPROVED FORM S/96 v
FORM 1255 (REV 5/96) H&W HOBBS B WARREN TM PUBLISHERS- BOSTON -
1
MAP 2 ---------------
AP9
287 MAP,-287 ---,
Q -
#3
#-5,7, F-1
a ,
I, AP-2a�
MAP 287 0 97
MAP 287 MAP 287 093 #25 .
039-002 ! 090 #5s
#50 #86
t - MAP 287 '
MAP 2 z i
MAP 28 76
#42 MAP 287 4
O t -
- �.. . 09 ---- �� # MAP 8
AP 287 0
042 #68
28
41 07 1
ED
MA—P287,
85
u
!. M 87 33 Q AP:287
x. I 287- Q.8 —
G88 # 7 2
0 5 6 5s # MAP 2 7
! 08
# 6 #9
M 287
I C - - ------ Q 1
M 33 08 # z
7 , z M 287 7 #58
#45- - " #44 I
28 A�ENE
05 -
,
T -
HUSE� ! MAP 2 7
07
I d
MAP.287
13 7 MAP 287 of 71
5 7 # 55 - d
SCALE: 1"=100' N
MAP 287 PARCEL 087
W " � E
DIRECT & ACROSS THE STREET ABUTTERS. s
*NOTE: Planimetrics,topography,and **NOTE:The parcel lines are only graphic representations DATA SOURCES: Plonimetrics(man-made features)were interpreted from 1995 aerial photographs by The James
vegetation were mapped to meet National of property boundaries.They ore not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD
Map Accuracy Standards at a scale of do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mopped to meet National Map Accuracy Standards
on the map. at a scale of V=100'. Parcel lines were digitized from FY2004 Town of Barnstable Assessor's tax maps. .
These variances are granted because the physical constraints at the site
severely restrict the location of the soil absorption system due to the very small
size of the property.
Sin rely yo ,
n A. filler, M.D.
hair an
HealyBezahler
- -- - -- --- -- - �- r
BS ROU _
February 25; 2005, ►S:Elkins street,,.
} . .
'Boston,.MA_02127
Mr. Tom McKean:
Barnstable Board of Health ;Tei:`617896 00
-- 43
Main Street
Faze 6177896-430i
'Barnstable,MA ;
Re 33 Washington, Street Hyannisport, MA r '
Dear Tom, - r
In accordance with our meeting on February 23, 2005 relative:toYthe unforeseen"-,4
conditions during construction of-the septic system at the above referenced"site,'attached: .
please find an updated plan and a sieve test'of the soil taken from,the bottom of'.the test
pit made.Wednesday.2/23/05-in the middle of the soil adsorptiori system. At the time of.
our'site observation the contractor had removed soil to depth of about 15 feet-at.the east `' r ;1" `
end of the soil adsorption system:.The plan'has been edifed to depict the recent test pit
-and the observed water level.;None of this information has resultedin any design
changees a
The sieve test of the soil collected m the test pit on February 23,2005 is a"loamy sand"
and a class`l soil which has percolation rates below 8 minutes per inch. Base
d,on BSC
1Vlunsell color comparison and according to David W. Stanton(who inspected the
,original test`on-November 8:, 2004) this material is consistent with the color-of that which'
.;
had an on site percolation test of 4 minutes,per inch indicating the material is consistent
under"the"entire'soil adsorption system.
Subsequent to our site visit,'the contractor excavated,attest hole at the eastern"end of the
6h"adsorption system:and'confirmed that there was 4 feet of naturally occurring 'soil
similar to ihatwhich was sampled on February 23, 2005,.`
'Therefore,,BSC is of the opinion that there is 4 feet of naturally occumng permeable
material under the septic,system7'and that the project may proceed with construction under
the approved plan without further action by the.Board of Health: Please'confirm"this
understanding f
Engineers,
y Sincerely,
Environmental
Scientists
The.BSC Group Inc.
G[S consultants
Cris"p m PE PLS
Sr Associate -�
rArc.itects.`
'Ench site plan'and-sieve results Planners
l Surveyors.
1
. i
Date 2/24/2005
Project# 4-8765.00
Pan Empty(lb) 0.09
Pan Full (w) (lb) 1.25
Pan Full (d) (lb) 1.14
Sieve Size Wt. Pan Empty lb);: Wt..Pan.Full. Ib .Retained (lb) Cum. Retained(lb). % Retained % Passing
1" 1.11 1.11 0.00 0.00 0.00 100.00
3/4" 1.27 1.27 0.00 0.00 0.00 100.00
1/2" 1.08 1.08 0.00 0.00 0.00 100.00
No. 4 1.13 1.17 0.04 0.04 3.81 96.19
No. 10 0.98 1.02 0.04 0.08 7.62 92.38
No. 20 0.94 1.04 0.10 0.18 17.14 82.86
No. 30 0.92 1.00 0.08 0.26 24.76 75.24
No. 40 0.85 0.94 0.09 0.35 33.33 66.67
No. 100 0.73 1.10 . 0.36 0.71 67.62 32.38
No. 200 0.77 0.94 0.17 0.88 83.81 16.19
Pan 0.77 0.94 0.17 1.05 100.00 0.00
88C _
JOB NO, S4(95.60
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SOIL TEST PIT DATA: P-10,850 SEPTIC TANK DETAIL: 1 ,500 GALLON DISTRIBUTION BOX DETAIL: NOT TO SCALE LEACHING DETAIL: NOT TO SCALE REVISIONS
4.Omf NO. DATE DESCRIPTION
POLY LINER
NOT TO SCALE N0. OF OUTLETS = cJ '- 30.0 1. 12/23/04 BOH EDIT
TEST PIT ji TEST PIT _ NOTES. 1. SEPTIC TANK SHALL BE STEEL 5. INLET AND OUTLET TEES TO BE CAST IRON, FINISHED GRADE
GRD. EL. 96.7 GRD. EL. 97.2REINFORCED CONCRETE. SCHED. 40 PVC OR CAST-IN-PLACE CONCRETE. o° °o°o°O °o°o o°o°o° °o°o 0°0 0000000000 o o°0 0 °o °o o°0 40mi1 POLY LINE
84 7 83 2 TEES TO BE CENTERED UNDER MANHOLE COVER. REMOVABLE 2' WALLS o °EST HIGH GW DATE: EST HIGH GW pq�; 2. SEPTIC TANK TO WATHSTAND H-10 LOADING NOS; o
FEBRUAR 23. 2005 UNLESS UNDER PAVEMENT, DRIVES OR �� o OBS- rT 2. 02/25/05 TP #2 DURING
NOVEMBER 8. 2004 7 TRAVELED WAYS, WHEREIN H-20 LOADING
SHALL APPLY a 1. DIST. BOX TO WATHSTANO H-10 LOADING HIG DENSITY
TEST BY: TEST BY, UNLESS UNDER PAVEMENT, DRIVES OR 4„ PVC o CONSTRUCTION
o ,2
3. ALL PIPE CONNECTIONS AND CONCRETE T T ov POLYETHYLENE INFILTRATOR 3050 o
THE BSC GROUP, INC. THE BSC GROUP, INC. CONSTRUCTION SHALL BE WATERTIGHT. 2-24' DIA CONCRETE MANHOLES TRAVELED WAYS WHEREIN H-20 LOADING PIPE ° v a o o a o 0 0 0 0 0
.:_ WITNESSED FILE»' W/ METAL HANDLES BROUGHT 15 SHALL APPLY. o a ° a o 0 0 o a o 0 0 0 o a 0 0 0
ESSED BY. WITNESSED BY, 4. FILL ALL UNUSED KNOCKOUTS WITH o°ov o 0 00 0 0 0 o v o 0 0 0 0 °
�,. � TO 6 OF FINISH GRADE
DAVID W. STANTON DONALD R. DESMARAI MORTAR. TEE TO BE UNDER 12" MIN. 6' . 5,5' OUTLETS 9 2. PROVIDE INLET TEE OR BAFFLE WHERE �'• 35• GENERAL NOTES:
M.H. OPENING SLOPE OF PIPE EXCEEDS 0.08 FT/PT OR 1. THIS PLAN IS FOR DESIGN AND
PERC. RATE: � _� PERC. RATE: -.0.- PLAN VIEW - LEACHING CHAMBERS
R ** 3• ,�' e •••• .e ee •• 'ea ibea 7- IN PUMPED SYSTEM. DISPOSAL FACILITY HE SEWAGE
4 4 MIN./INCH MIN./INCH °" "�'�'° $ I- 2" 3. FIRST TWO FEET OF PIPE OUT OF DIST.
„ SOIL EVALUATOR SOIL EVALUATOR 10•_6- RAISE M.H W,� 4 eoTTnM ON LEVEL LOAM & SEED DISTURBED AREAS 2. ALL CONSTRUCTION METHODS AND
96 SEWER BRICK - 6 MIN. 3 4 TD BOX TO BE LAID LEVEL
e.- 'e-:-: _:a STABLE BASE MATERIALS SHALL CONFORM TO MASS.
CRAIG FIELD MARC GABRIEL do MORTAR t 1/2' CRUSHED „ „
EL = 88.7 10-0 = CROSS-SECTION 4. ALL PIPE CONNECTIONS AND CONCRETE D.E.P TITLE 5 AND LOCAL BOARD
NORMAL WATER LEVEL 12 STONE BASE CONSTRUCTION SHALL BE WATERTIGHT. 3 MAX. C MPACTED FlU_ 36 MAXIMUM 12 MINIMUM OF HEALTH REGULATIONS
SOIL CLASS: SOIL CLASS:
1 1 3" 0 0°0 0 000v° �Oo 00°°o° 3" LAYER 3. ALL PIPES LOCATED UNDER PAVEMENT
5. FILL ALL UNUSED KNOCKOUTS WITH MORTAR.
�^- PRECAST SEPTIC TANK 10' 14" HIGH 0 O PEASTONE OR TRAVELED WAY SHALL BE SCHEDULE
108 144 0 Q 40 OR EQUAL.
EL - 85.2 .r INLET TEE � 5•_7• 30 1/2" 30„ T. - 0 DENSITY 0 0 0 REMOVE
L.T.A.R. L.T.A.R. _ - 24 �y
C _ - - Q "V POLYETHYLENE O Q UNSUITABLE 4. THERE ARE NO KNOWN PRIVATE WELLS
MEDIUM SAND 0.74 G.P.D./SQ.FT. C 0.74 G.P.D./SQ.FT. 5'-2" 4•_g" 5•_8* EFFEC. Cb Q INFILTRATOR 3050 000 0 MATERIAL FOR LOCATED WITHIN 150 FT. OF THE
4-0 MIN. eoo am 15 1 Y 0 v
W/TRACES OF SILT MEDIUM SAND - - - z LIQUID DEPTHT e: / DEPTH LEACHING 0 O 5' ALL AROUND PROPOSED LEACHING FACILITY NOR
150' OF ANY KNOWN LEACHING FACILITY.
2.5 Y 6/2 W/TRACES OF SILT 5-8 z - GAS PRECAST DIST. 0 O CHAMBER Q IF APPLICABLE ANY KNOWN WELLS PROPOSED WITHIN
2.5 Y 6/2 :: ==
iv e BOX ` -
144 168
EL = 84.7 „ EL = 83.2 „ -y'�'=-�'`�.::''`~:�.:-: --:'`.-•.�-��::: 47„ .� 50" 4T A�IED sT10/NE 5. A�LLTMT LIMIT OF EXCAVATION REMOVE
_ -: TOPSOIL, SUBSOIL AND OTHER
b a BOTTOM ON LEVEL STABLE BASE Q 3• I` 12' IMPERVIOUS MATERIAL
PLAN VIEW 6' MIN. 3/4' TO �4"l_4' fl�� 7 t/T �� 22' 6. REPLACE
OR OTHER�CLEAN GRANULAR TH CLEAN SHED SAND
LAR SOILS
1 1/2" STONE CROSS-SECTION VIEW PLAN VIEW CROSS-SECTION OF CHAMBER CONFORMING TO THE FOLLOWING
INDICATES INDICATES
y ESTIMATED -� OBSERVED INDICATES INDICATES
SEASONAL HIGH - GROUND WATER PERC. UNSUITABLE SIEVE10% (MAX) Y WT. SHALL
`u
GROUND WATER TEST MATERIAL do x of Nco SIM
DATUM. 4 SIEVE SHALL
VERTICAL DATUM: DESIGN CRITERIA: PASS No. 100
<5 X OF No. 4 SIEVE SHALL
NOTES- ASSUMED - - DESIGN FLOW: PASS No. 200
CLASS I SOIL BASED UPON SIEVE ANALYSIS DATED FEBRUARY 24, 2005. - _ UNIFORMITY COEFFICIENT O No. 4
BENCH MARK SET: 4 BEDROOMS AT 110 G.P.B./D 440 G.P.D. SIEVE </-6.0
.TOP OF STONE BOUND EL=98.50 7. EXISTING UTILITIES WHERE SHOWN
7 IN THE DRAWINGS ARE APPROXIMATE.
PROFILE: NOT TO SCALE REQUIRED SEPTIC TANK: SIBLE FOFORR PROPERLY LLOOCBATING RAND
BENCHMARK 440 X 200% = 880 GAL. COORDINATING THE PROPOSED CON-
EL- GAL. AND THE APPLICABLE UTILITY
EL.-A FIRST PIPE LENGTH / TOP OF STONE BOUND SEPTIC TANK PROVIDED: = STRUCTION ACTIVITY WITH DIG-SAFE
jZ
FOUNDATION CONCRETE COVERS TO WITHIN TO BE SET LEVEL WASHINGTON EL.=98.50 (ASSUMED DATUM COMPANY AND MAINTAINING THE
-99+ 6" OF FINISHED GRADE. FOR MIN. 2' EXISTING UTILITY SYSTEM IN SERVICE.
FINISH GRADE DIG-SAFE SHALL BE NOTIFIED PER
a (Em ••�, �/ SIZE OF LEACHING FACILITY REQUIRED: THE STATE OF MASSACiUSETTS
4' PVC SCH 40 UE
STATUTE CHAPTER 82, SECTION 409
VC _ DESIGN PERC. RATE: 4 MIN./ INCH AT TEL 1-888-344-7233. THE
LNG ' LONG TERM APPL, RATE 0,74 G_P,D/S.F. ENGINEER DOES NOT GUARANTEE
4 PVC SCH THEIR ACCURACY OR THAT ALL
I■G " ► t UTILITIES AND SUBSURFACE STRUCTURES
=o I-E7 " IlPT / ----_-,_EDGE pF- p 440 GPD + 0.74 GPD/SF 596 S.F, ARE SHOWN. LOCATIONS AND
- 5 CUTLET I-F O� \ `G A�MENT ELEVATIONS OF UNDERGROUND UTILITIES
I f \ CONTRATAKEN CTOR SHALLOM RECORD VERIFY
THE
SEPTIC TANK DIST. BOX 7,7' SEPARATION SIZE OF LEACHING FACILITY PROVIDED: SIZE,
LOCATION AND INVERTS F UTiES
l 1 _ AND STRUCTURES AS REQUIRED PRIOR
EST. HIGH GROUNDWATER 1 \ USE HIGH DENSITY POLYETHYLENE TO THE START OF CONSTRUCTION.
/ S '05'00" \ LEACHING CHAMBERS<4 UNITS) 12'X2'X35'
E 51.
0.00' 8. THIS SYSTEM IS NOT DESIGNED FOR
} ' SIDEWALL = 2<12'+3S') X 2' = 188 THE USE OF A GARBAGE GRINDER.
INVERT A GARBAGE GRINDER IS NOT
ELEVATIONS: 3 i BOTTOM = 12' X 35' = 420 RECOMMENDED DUE TO RECOGNIZED
N ADVERSE IMPACTS TO THE LEACHING
sl 9z � MAX BEZAHLER t ' 608S.F. FACILITY
TOP OF FOUNDATION 100.19 A ' ASSESSORS MAP 287 608 S.F x 0.74 GPD/SF = 449GPD 9. IDaTING INVERTS ARE TO BE CHECKED BY
Q 5 000±S.F. THE CONTRACTOR PRIOR TO CONSTRUCTION
PARCEL 87
4" INVERT AT BUILDING B _ �'
' ANY THE FIELD CHANGES THAT NOTIFIEDGINEER IS TO BE E
MAY B
4» INVERT AT SEPTIC TANK (IN) 95.25 C b ' �,�
4 INVERT AT SEPTIC TANK (OUT) 95.00 D o� , REQUIRED.
4" INVERT AT DIST. BOX (IN) 94.80 E 30•3, 3 aF
4" INVERT AT DIST. BOX (OUT) 94.63 F 0. '
SCREENED PORCH b �� �S°�
r co + ow LOCUS INFORMATION
INVERTS AT LEACHING FACILITY: o I t 30•3, 7 No.a2
I
_BSC G
„ � •5 CURRENT OWNER: MAX BEZAHLER � ROUP
4 INVERT AT BEGINNING f
OF LEACHING CHAMBER 94.5 G ( TITLE REFERENCE: BOOK 7620, PAGE 203 657 Main Street,(RT.28)Unit 6
1 •
d o W.Yarmouth Massachusetts
ELEVATION AT BOTTOM g2.5 H o `� 2 STORY o �2v PLAN REFERENCE: BOOK 26, PAGE 95 02673
OF LEACHING CHAMBER o WOOD FRAME �'
ASSESSORS MAP: 287 508 778 8919
GROUNDWATER OBSERVED AT 15' g4 8 J HOUSE W PARCEL: 87 PR
#33OJECT TITLE:
BELOW GRADE IN SOUTHWEST CORNER
TOF=100.2 ZONING DISTRICT- RF-1
EXCAVATION + 1.8' ADJUSTMENT
N/F 3 �--- _j INV=97.5 N/F SETBACKS: FRONT 30'
JOHN A. & HEATHER D.SCHNEEBERGER o \ ►� JOHN J. LYONS SIDE 15
ASSESSORS MAP 287 98 ASSESSORS MAP 287 REAR 15' DESIGN FOR
PARCEL 88 13.0 / PARCEL 86 SEWAGE DISPOSAL
Co 12.2' MINIMUM LOT SIZE: 43,560 S.F.
VARIANCES REQUESTED: 0 uLL FOUNDATION 9a EXIST. TOTAL LOT AREA: 5,000±S.F.
BULKHEAD o CRAWL. OVERLAY DISTRICT: NOT IN A ZONE II SYSTEM REPAIR
TITLE V.- SECTION 15.211: (1) TO ALLOW LEACHING SYSTEM TO BE 5' OFF SIDE ai DECK SONO TUBES
TO BE SUPPORTED
PROPERTY LINE IN LIEU OF 10 . CRAWL DURING EXCAVATION. FEMA FLOOD „C" 7/2/1992
PROPOSED
ZONE DISTRICT. 250001 0006 D #33
1500 GALLON in 7.3' 3
SEPTIC TANK N 0 WASH I N GTON AVE.
"0)
12„ MAPLE - - „ - --_ DECK HYANNISPORT
To BE Bo - - _ _ N
S' - - LOCUS PLAN: NO SCALE
a PORCH REMOVED ' ' ' - - : - • . . . s 1�,� :- M ASSACH U SETTS
g ENT. - - - - - BATH - - - -- PIT #1 - ' ' ' - - ->
0'
BED #1 BED #2 O S 1�
to
CLOSET ' ' ' '
TEST EXISTING �P
4 - IT #2 - - i DWELLING �J PREPARED FOR:
LIVING ROOM 5� PROPOSED 12'x35' S.A.S. - _ . I ON CRAWL N
STORAGE EXISTING - - - . A -ao. I SPACE Q Mr. MAX BEZAHLER
HALL SHED � - . ' - - _ _ N- . 1 � 7818 CREFELD STREET
PHILADELPHIA
N LAUNDRY / EXISTING STOCKAD - ',� CRgj yt� p2 N1�G� PA 19118
1/2 E FENCE GV c p,S vE
CLOSET 8f j<<£ LO p, EN YANNIS
q o qC y .� (215) 753-1433
DINING BATH S83ro5'00„E r- H RD t��'d ❑GLIB HARBOR DATE: DECEMBER 2 2004
ROOM BED #4 BED #3 ELEANORNF MAYFIELD 50•� E��S COMP. DESIGN: K. HEALY
ASSEP IR EL 80 MAP 287 4RHPIGH OSED POLY UER CENTERVILLE �QLaNv� CHECK: D. CRISPIN
KITCHEN PLAN VIEW HARBOR PJE DRAWN: P. HAGIST
N/F FIRST SECOND SCALE: 1' = 10 FEET NOTE:CONTRACTOR TO PROVIDE ADEQUATE BENEDICT F. JR, & JEAN FlTZGERALD FIELD: D. GAZZOLO / J. McCARTIN
3 FLOOR FLOOR ASSESSORS MAP 287 FILE NO. 8765-SEP.DWG
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