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Home My WebLink About0141 WAYLAND ROAD - Health 141 WAYLAND ROAD Hyannis A = 271 — 223 . ' ' ►.� Town of Barnstable w � �ARN>�fAB1.B. MAW Regulatory Services Department Public Health Division 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-862-6304 Thomas A.McKean,CHO September 3, 2020 Paul and Colleen Sherbertes 141 Wayland Road Hyannis Ma 02601 RE: 141 Wayland Road, Hyannis Dear Mr. and Mrs. Sherbertes It has come to the Town's attention that there is a pool construction business being run out of this location. I suggest reviewing Chapter 240-46(Home Occupation) and Chapter 108(Hazardous Materials)of the Barnstable Town E-code, which respectively pertains to Zoning and Health Regulations. Running a home business must be processed through Zoning in the Building Department. You will need to contact them and make sure you are in compliance with their regulations. I handle the Hazardous Materials permits and would like to come out and conduct a simple inspection to see where you stand as far as Hazardous Materials(Chapter 108)and set you up to be in compliance. My phone number is 508-680-3294 or you can contact me through my Town email at Anthony.gerace@town.barnstablema.us. Thank you. Sincerely, Anthony Gerace Hazardous Materials Specialist Public Health Division f C:\Users\geracea\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\4SKACXPU\Anthony gerace.doc 141 wayland rd.docx r - ;? Zz3 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 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. Important:When A. General Information filling out forms on the computer, [vim use only the tab 1. Inspector: key to move your cursor-do not David D. Coughanowr, IRS use the return Name of Inspector key. E Tech Environmental Company Name -P.0. Box 1265 Company Address West Chatham MA 02669 City/Town State Zip Code 508 364-0894 1328 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes y��p�HOF�y�Ss'c ❑ Conditionally Passes ❑ Fails DAVID tiG ❑ Needs F U CtSUG�lT ii n N Local Approving Authority No.1328Pa A \J June 12, 2014 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. a ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does'not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspecti Fo :Subsurface Sewage Disposal System-Page 1 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 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: Inspector's Note==> The septic system described herein is deemed to pass this Real Estate Transfer Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4-5, or specified by local regulations. The scope of this inspection is limited to health and environmental compliance and the septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. Removal of garbage grinder is recommended. 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,septtc tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltrafi66/or(anklfailure Is;imminent. System will pass inspection if the existing tank is replaced with a complying septic tanklas approved by the Board of Health. f�rV7NAHh)UU ) t� *A metal septic tank will pass inspection if it is structurally{sound,r,notJeaking and if a Certificate of Compliance indicating that the tank is less than 20 years older available. ❑ Y ❑ N ❑ ND (Explain below): i y t5ins-3/13 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 ,M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. 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 El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,a 9 p Y Y 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Y H annis - MA 02601 June 12, 2014 r page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ 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 99 P 1:1 ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El Z 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 'h day flow t5ins-3/13 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 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. 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. ❑ ® 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 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 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? ® ❑ 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 CM 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 gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. CityrTown State Zip Code Date of Inspection D. System Information Description: System was installed by John S. Lebel in 1982. 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 Seasonaluse? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 32 gpd 9 ( Y 9 (gpd)): Detail: 2012: 14,213 gallons 8,977: gallons Sump pump? ❑ Yes ® No Last date of occupancy: not determined 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments °wM 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. CitylTown 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: owner's agent 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 stem p y ❑ 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 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: 31+ years. Certificate of Compliance for original system issued 12/15/1982 (Permit#82-505). Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 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.): Sewer line appears structurally sound with no evidence of leakage or backup into dwelling. Septic Tank(locate on site plan): Depth below grade: 1.25 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate)- ❑ Yes ❑ No Dimensions: 8.5 x 5 x 6-1000 gallon Sludge depth: 7 in - t5ins•3/13 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 ^M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name °equine tifo is Hyannis MA 02601 June 12, 2014 required for every y _ cage. 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 27 In Scum thickness 2 in Distance from top of scum to top of outlet tee or baffle 9 in Distance from bottom of scum to bottom of outlet tee or baffle 13 in How were dimensions determined? Design plan 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 is not required at this time. Maintenance pumping is recommended within 2 years and every 2-4 years thereafter with year round occupation. Removal of garbage grinder is recommended. Tank and outlet tee appear structurally sound and functioning as intended. Inlet cover is under deck and not accessible. No evidence of leakage in or out was observed. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. CityTTown 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 at 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.): Camera inspection showed no adverse conditions. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soils above leaching pit appear unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. A hole was dug into leaching pit stone and no effluent contact staining was observed in the stone or overlying soils. No standing effluent was observed to a depth of 2 feet below the top of the peastone layer. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 June 12, 2014 page. 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.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 . _ June 12, 2014. 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 El drawing attached separately L Oo CAA T§O S -OF SEPTIC COMPONENTS -DISTANCES IN DECIMAL FEET A 8. l 19 25 LEACH 2 23 ' 29 PIT 3 28 33 4 35 39 ODISTRIBUTION BOX 2 B 1000 GALLON SEPTIC TANK 1A A A / o i o v� 508 364-0894 L—p n Ifs THIS SKETCH ISBEST VIWED IN . A 1!p AND* V D ROAD - COLORE V ICYFORMAT I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage.Disposal System-;Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name equir information fo is every y ;equired fo Hyannis MA 02601 June 12, 2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 15+ 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: 9/7/1982 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: Barnstable GIS Department F You must describe how you established the high ground water elevation: Approved design plan on file with the Board of Health shows bottom of system to be 4 feet above the bottom of a witnessed test pit in which no groundwater was encountered. Town of Barnstable GIS Department records indicate that the property is over 15 feet above groundwater table. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 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 °M 141 Wayland Road - Assessor's Map 271 Parcel 223 Property Address Angeline Theodore Owner Owner's Name information is required for every Hyannis MA 02601 . June 12,2014 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist z Inspection Summary` A, B, C, D,or.E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System.Information— Estimated depth to high groundwater ® Sketch of.Sewage Disposal System either drawn on page 15 or attached in separate file GEOHYDROLOGICAL PROFILE NOT TO SCALE. Z Q CA- PRECAST Z 0 LEACH o W I +; PIT BOTTOM OF a LEACHING I_ PER DESIGN PLAN `LEACHING IS ABOVE HIGH GROUNDWATER O GROUNDWATER NO ELEVA TION GROUNDWATER PER GIS MAPS ENCOUNTERED t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17.of 17 c IL L ® CATION n SEWAGE PERMIT No. VILLAGE If 14 INSTALL R'S NAME A D D R I S S 6 U I L O ER OR o W N E OAT P I R M I T . ISSUED BATE COMPLIANCE ISSUED � . zS 1� 2 i i 7 33 . �zg 3S 1� No..-2 2? Fps........, . .'..... �THE CQMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • ,� P......TO'M........_......OF..............13.a=.atable.............................................. �Z-7 AVVI ration for Dispaiial Works Tonstrurtion-Pgrmit 4 1 q j Application is hereby made for a Permit to Construct x) or Repair an Individual .Sewage Disposal I System at: .2Q... ............. ...............................Lo-t.4 T-k3:�M........................................ Eocatiq*��Ald�ress, or ...........q4,P_r.1QQrr1..ReA1tY...Trut........................ .......7.65...Falmuth-.11=4...113ranx)Is.............. Steve Lebel Owner Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............3.............................Expansion Attic Garbage Grinder ( ) Other—Type of Building ..ranch--_----_- No. of persons............................ Showers ( Z — Cafeteria ( ) Otherfixtures'...................................................................................................................................................... Design Flow...............55.11,111.1,11,11,1111-ll-Il.gallons per person per day. Total daily flow...............3.30....................g-,Jlons. 04 Septic Tank—Liquid capacityl-0.00.gallons ,Length._8.-1.6..'_ Width...4.*10. Diameter---------------- Depth...5!.841... Disposal Trench—'No..................... Width_-___:_.__._________ Total Length.._.__.__.._________ Total leaching area....................sq. ft. I � Seepage Pit No......I............. Diameter.....6............. Depth below inlet__.._('._.___._._. Total leaching area.....2a...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-----Eldredge.-Engineering......... Date...U.2-5.S1............... Test Pit No. 1.<---2A.O.minutes per inch Depth of Test Pit.....12.1...... Depth to ground water.none---encounte Test Pit No. 2....AN/A...minutes per inch Depth of Test Pit.__Nlk........ Depth to ground water---- e. .......... --------------------------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil..................0.!...........2-1......... 0-ii---------------------------------------------------------------------------------- �4 I.................................................2.......;-....10........neLdImLye low---san&.................................................................... U ...........................................I....10.1.........12........med....-WhIte---sand/tra.ced---ot..gravel/no..water.'..at 12' U Nature of Repairs or Alterations—Answer when applicable__________________________ _ ............................................................... ...................................................................................................................................................................................................... Agreement: The undersigned agrees to install the, aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'll-E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss,u d by, the board of health Z4 ..... .;:�_�.. ..... .......... Signed- Date Application Approved By......... ...................................... //j ----,e ft,................ Date Application Disapproved for the following reasons:...............................I......................................................... ..................... ........................................................................................................................................................................................................ Date PermitNo....................................................... Issued....................................................... Date No.......-�►�__t.......... Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF: HEALTH Town Barnstable . ..............OF........--.-.-.......-......_-.._..._.--..............--................................. Apptiration for Ulliv gal Workii Tomitxnrtiun umit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal # , 1 H nnis MA ... ..-Capricori ' tad ust-''�' 765 Falmouth Sbat, Hyannis ... -• -• - ---------------------•-----•-•---•----- ........ --•-----...-------•--...--•--•-••-•.......-•••-•-...._..-•-.._..:_..................... : teve Le�beY Owner Address a -•.................................•----•-•..--.............._-............-._............----•-.. ..........-._.._..........----•--...----*-...•----•--•-------•--•-•--• ...................... Installer Address Type of Building 3 Size Lot________________ Sq. feet ., Dwelling—No. of Bedroom aMCh_______________________________Expansion Attic ( ) ' rbage Grinder ( ) Other—T e of Building ........ No. of persons____________________________ Showers — Cafeteria ¢ �P-1 Other tures ---------------------..................=..................---•--•-----------------------------------••- �.0{�0_._ ..........................................moons.. W Deslgn Flow______________________________ gallons per persc�}.�p�r�day. Tota��l�flow WSeptic Tank—Liquid capacity............gallons, Length................ Width................ Diameter................ Depth................ x Disposal Trench--3,No.____________________ Wicl6x_,................. Total Length.... _&........... Total leaching area_.._-_z66......sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) DosingMfr6dke Engineering 11-25-81 Percolation Test Re 1t2.0 Performed by------------------------------------------ F__--___-____-_-........ Date................� 12- nome---�neounte - Test Pit No. 'I...N/A_....minutes per inch Depth of Test.Pit.l+/.A.......... Depth to ground water___, -/a__._._...._. eu rZo Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---- a — Description of Soil.........:...... t.__r. la ......me-d-i-m--ye?',1-ow--sand---------------------------------------------------------------------- - -----lfl-jL--�---1-2.------mec :...�rhite---sand/tra.-ced---o f--- vefifnd--wt0je:_at 12' W --------------------------------- .......--•--••-- VNature of Repairs or Alterations—Answer when applicable__________________________________________________________________ ----------------------------------------••-----------••••••---------•----•-••-•-••............-----•--•------------------•-•------------------------------------•-•---••------_._........._•-----•.._. Agreement: The undersigned agrees to install the aforedescribed Individual.Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. r, gned_. ...................'� . . , ..�.. ....�....... / '�Date ApplicationApproved By............................................... ................................................. ---.................................... Date Application Disapproved for the following reasons:------•-----•------•----------------•-----------------••----....-----------------------------------------..._._ -------------------------•--------...------------...-•-----•....-•----------------------------------•-----•-•----------.....•--•-----•--•--••--•---•-----••---•------••---•---------•---•-----•--•---••- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ................OF.................................................................................... Trtifirab of f omplianrr TIffief§eTq,1 'W 'IFY, That the Individual Sewage Disposal System constructed (X ) or Repaired ( ) by______ °....................................................Installer ............`-.._....^.. ...-. ..,..i--Installer-•-----......._..._-._..__...........------•--..........rt......._..............----...__.._ LOt # ,` Hyannis, . ` f has been installed in accordance with the provisions of TI —Sq,��De State Sanitary Code as described in the application for Disposal Works Construction Permit No.................... .......... d................................................ a THE ISSIJANC OF THIS CERTIFICATE SHALT. NOT BE A GUARANTEE THAT THE SYSTEM ill F CTION SATISFACTORY._ �- DATE...1? l... Inspector. -•........................................... DATE... COMMONWEALTH OF MASSACHUSETTS BOARD PF HEALTH Town Barnstable ' ........OF...:...................... ......_.:.._.._-,__...._......-_......-..._.--...._.... ��-•• FEE-_2s...:........ t e ie beln�.��nr�#Uan rrnti� Permissin is hereby granted............................................................................................................................................. to Constru�t0 or Repair. ( ) an Individual Sewage Disposal System at No '? Hyari1isp MA Street %// ................. "'""` 7-' --__•. $ __ -- ••••---------------------•----•---•---• of -Iealth DATE.......................................................................... .... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - - a 37 -rr n C a-/pad v EL- 91.'1 o �'! . j, so (V I �d4 7 ;.. I L T 3 . N QQppd✓ P N Min, FIST o3 x ( M < ,z IGS� "�. eJ c( lira �� 6'xdn ems. . o:�. 2 Q' 0 . • `� L ACN.�a 3 '�J. 3fr v PiT a f aAl WATd l> ^ _ ;\ �SN OF M p i t o,aoo S F w. ('3:. y M74 � N� SUR�Fy LEGEND 1 • '^"' "< �@\�NO.FiM4`PS,. 0CE��irlw4 �L'G-T PLAN EXISTING SPOT ELEVATION ; 0x�i ., o EXISTING CONTOUR 0 ALa % o, T 3 6 WAy4�t w FINISHED SPOT ELEVATION a r` FINISHED CONTOUR 0 . sE g No 10951 Q,� IN APPROVED BOARD ,OF HEALTH o�o sGFST�a�\��`� SIONAI.E I AA S TAS LAo ld ASS' OAT E AGENT . - SCALE,' / "- 30 ' GATE LDREDGE. ENGINEERING C IN CI.fENT 2 CERTIFY THAT THE PROPOSED EOISTERE REGISTERED jO® NO ;Fr/ BUILDINO SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE XONING, LAWS DR.BY= MIN EER RVE OF BARNSTAB E, ASS. 712 MAIN STREET CH. BY Ile:L HYANNIS MASS 9282 ems. . i ' SHEET 1 OF ? DATE R G. LAND SURVEYOR SEPT/ A O R/lOTF rNER N/ 1/ /2"BEt0 lVCgloVC O/T AVe 110RE !o f7•'M/N. < BRA OE, 24 /A M E TER CONC•R E TE CO;Y-,r SWALL BE 0R004SR7- TO 4J;AOE. --;N EXTRA CGNCRCTC 9'PYC P/PL l-6,4 V Y CAST /•PO/Y G o IiER ShI�4 4 L L3- U S EO C'OYE/CS W/N FN Y . P/TCN / / L7R/v4iFW.4 �B QE�Q►FT - 2 Af 1�tAOE • CCd ✓ER E A. G CLEAN .SA/V O /- &ACJI F/L L 2 LAYER 4"GIST� •: �' ..zr�. _ /RON P/PE [9 y o. p e o 314E ST, o • BO s I ♦ • . • . • • • • p O + WASHED S72?NE /4+PER fT. SEPTIC TAAIX X o • t 8 • • • • • � .•• • e I a t • •EFFECT/V�' • y 14 ._ • • ♦ • p PT Ta f,i • • ; • v . WASNEO SNE • E AV •. : • ' • • • • • • • ♦ • o o PREC:4S T SEEPAGE 2. O • • • • • • r • o P/7 OR EQU/V. r - !NI/GrS'T.CLEYAT/DNS . a tc-cam. S3.o _� /NYERT.AT QL/!LD/NG U• FT 6 f7 D/AJ6'7. 89.E C E J INLET. SEhT/C /O T. �SE TA 4,,"r OAN) Ot/TLET SEPT/C`7��i1NK AFT r � y •. INLET 0157R/8117/O/V Box 6 9•`7 FT L. " E GROUND W.4TER TAdLE .S CTION OF "" OC/TlETD/.STR/BllTf6N BQXz FT SEJ�AGE` O/SPASA L SYSTEM lNL6T IZACN/HG /?iT &9•a FT 7iiBUL.4T/ON L'EACHIlVa PI T SCALE �4~ a :/=o' aIMENS/ON A 3 FT. DES/GN CRlTERI/t o/M.eNs/aw 8 -Fr. NClMdER OF,BEGRGOMS �" . : . , ,GyI NS N C�_FT. G.•Ra46AFo%sP05ac Uw/r SOIL LOG SD/l TEST rO7' E.?T/MATED, FLON/ 3 3 v GAL.�DAY SO/L TEST At/. S014 7ES7'*2 ivu;4,4 R04OW 4oAcM/NG P/r3_ J S �Z 4//Ir ' S/DE L.G'ACH/NG PER P/T J B &- .SQ RT• � �+. ELEY, DATE OF SOIL, 'TEST BOTTOM LF�G'N/NG PER P/T 7 $Q. T. L��t y► PERCOLA'T/Olt► RATE,*/ M/Nt/INCK 7-or ,LEAGN/N6 AREA ZG.d _SQ FT Tom 5 v/L. AE.tCO3 AT/ON RATE A � s4 N MJN,�lNGN RESERYEGEACNIN6AREA z�509. FT ,t10 P�(N�FMf.4 7 �- �Z L DT3b ` ' AIr✓ y :. o RSE . in S�V✓!.7 1—10951 O E/-D RED4SE ENG/NAER/NG CO JMC. \ F6I g��O� Po�FG.�5TEQ �\�k. FLIP V 79, 7/2 M/1✓jv ST. , HYAN.viS, /N.gsS- ho SURD FsryO AL Na GRO[JNt� yYATER ENCOC/NTEREO C.L/ENT:.I` AN'CU DRTE 9 / T. c ` �] `GM U/VO WATER AT EL4EN — JOB ND.• �/z U S SHEET�OF z. 3/19/2021 ShowAsbuilt(1700x2800) LOCATION SEWACE PERMIT NO. VILLAOI, I N Sl A tv R's NAME ADDRESS sY �_a•9 �9c5�p r� BUILDER OR OWN— c T >" O DATE PERMIT ISSUED -- 9_ 7_�y DATE COMPLIANCE ISSUED )w �I z 2 zq 33 39 35' https://itsgldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=271223&sq=1 1/1