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Home My WebLink About0024 WEST HYANNISPORT CIRCLE - Health 24 West nHyanns..Port Circle 11 ,t yannis - . z A = 267 y7-132 -3., . a i e { f n� ti 0 t Q J i! 11)g IJ d I t TOWN ,OOF�B�A.RNSTABLE LO CATION o�7 W* �I c/�s�t�►o/'+'+ti at. SEWAGE # JILLAG &V&XX-o ASSESSOR'S MAP & LOTA/07 115a INSTALLER'S NAME&PHONE NO a V-iOr 17• Oe C<4L 1 e �� SEPTIC TANK CAPACITY �DDD �j 6tUorZ� LEACHING FACILITY: (type) (size) NO.OF BEDROOMS ' B1 OWNER 6- - I U -- PERMITDATE: COMPLIANCE DATE: l6 a� 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 Commonwealth of Massachusetts SWUTitle 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C.System Information(cunt.) 24 West Hyannisport Circle PrepeM Atltlresa Hyannis MA 02601 CllyRown stets Zip Code Boyle 8/16/05 OwneYs Neme Dete or Inspettlon Sketch Of Sewage Disposal System:Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet Locate where public water supply enters the building. _ 1�0 1 0 0 6 } TOWN OF BARNSTABLE LOC .ATIOi U k,eS f f 1UA0nil jeor� c,"/c. SEWAGE # VILLAGE ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. iJ kb Son S401i� SEPTIC TANK CAPACITY l oo o LEACHING FACILITY: (type) Kok' 8 cPSSPOa (size) NO.OF BEDROOMS 14 BUILDER OR OWNER ►��I� PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 fac�} 'S .Feet Furnished by I S 0 _ r CP/ I J ' b1 if Town of Barnstable Inspectional Services Department BA MASS.BLL ~ Public Health Division y MASS. 1639. �0 & 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 8227 April 13, 2021 SECRETARY OF HOUSING &URBAN DEVELOPMENT 451 7TH STREET SW WASHINGTON, DC 20410 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 24 West Hyannisport Circle,Hyannis, MA was inspected on 03/31/2021 by Patrick Rutledge, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • The outlet cover is damaged. You are ordered to repair or replace the outlet cover within sixty (60) days from the date you receive this notification. Failure to repair/replace the outlet cover within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mai ling\Conditionally Passes Letters\24 West Hyannisport Circle Hyannis.doc lima rpm Town of Barnstable BAR149TABM M^9 Inspectional Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Off ice: 508-862-4644 FAX: 508-790-6304 Thomas A. McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the eater analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems'' (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Lmr'jej OL/P-e l cove y- Repair deadline: 0 c 0:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts al04' 13 a-- W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 ' i.t 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 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 y' way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 51 15a---a-- on the computer, e Patrick Rutledge use only the tab 9 key to move your Name of Inspector cursor-do not Title Five Specialists use the return Company Name key. 22 Taft Co � Company Address Dorchester MA 02125 City/Town State Zip Code r 5082374628 S114198 Telephone Number License Number B. Certification 1 certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true,accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ® Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 3/31/2021 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information equir at'r ore Barnstable MA 02601 3/31/2021 required for every page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2,3, or 5 and all of 4 and 6. 1) 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: 2) 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): Damaged cap at septic tank outlet-Recommend replacement of cap t5insp.doc•rev.7/26/2018 Trde 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): Damaged cap at septic tank outlet-Recommend replacement of cap ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Swage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other. 4) 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 ` t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 ❑ ® 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 a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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—1WPA) or a mapped Zone 11 of a public water supply well t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4" 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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? El ® 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 CMR 15.302(5)] t5insp.doc•rev.7262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name requiratifor a Barnstable MA 02601 3/31/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. 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 Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NA Date t5ins.doc• v.p re 7f26Y2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w MV 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityffown State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Disposal Sewage Dis 9 P System•Page 8 of18 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 4. 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/Aftemative 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): Approximate age of all components,date installed (if known) and source of information: Permit from 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2'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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 5 feet Material of construction: ® concrete ❑metal ❑ fiberglass ❑polyethylene ❑other(explain) If tank is metal, list age: yeas Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle 25" Scum thickness >1" Distance from top of scum to top of outlet tee or baffle 811 Distance from bottom of scum to bottom of outlet tee or baffle 14" 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.): Inlet and outlet tees are in good condition, No leaks noted, Recommend pumping now and every two years t5insp.doc•rev.7/26/2018 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form k�t.vww Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Ins pection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cunt.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level 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.): Equal, No carryover noted, No leakage noted, Some roots noted in d-box t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number,dimensions: 14'x31' ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: t5insp.doc-rev.7/2 M18 Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 13 of 18 c � Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cunt.) Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): No signs of hydraulic failure, Dry soil, Normal grass ve , 6W' pits 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts vi Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is Barnstable MA 02601 3/31/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Tide 5 Official Inspeclion Form:Subsurface Disposal Sewage Dis g p System•Page 15 of 18 Commonwealth of Massachusetts l Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 West Hyannisport Cir Tank Inlet A=24' 13=14.5' #24 Tank Outlet A=18.5' B=20.5' A D-Box A=48' B=23.5' Tank B d-Box t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments IWMI 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >61 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: 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: Permit on record Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5insp.doc-rev.7/260018 Tile 5 Official Inspedon Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 West Hyannisport Cir Property Address HUD Owner Owner's Name information is required for every Barnstable MA 02601 3/31/2021 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this fort inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed& Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-my MA12018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 18 of 18 TOWN OF BARNSTABLE LOCATIONz-"o ni C�iJ- C EWAGE# a VILLAGE ASSESSOR'S MAP&PARCEL 247-(3 2 INSTALLER'S NAME&PHONE NO. (_1 I .S CchfA. Co SEPTIC TANK CAPACITY 6 0 O LEACHING FACILITY.(type) Oks bQ //6 0 (size)%T S X t NO.OF BEDROOMS OWNER 7akwi C inn L PERMIT DATE: , 1 1 D COMPLIANCE DATE: S y 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 Ok o . 1 o4 �: No. _ V ' N Fee 'to THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for �hgpoal *pgtem Co gtruction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ar.+ �a�hn f P,//'C/ -Owner's Name,Address,a Tel.No. Assessor's Map/Parcel �`7hh'�f Installer's Name,Address,and Tel.No. ,_ I�S /:'17 ty)��r'1S'J Designer's Name,Address and Tel.No. '� ICJ 61 L 3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures n 2 Design Flow(min.required) V gpd Design flow provided J gpd Plan Date Dec, op-1 dkoo Number of sheets v7. Revision Date Title 5/'�j -} � rVifAi -u / Size of Septic Tank 1000 S}i Type of S.A.S. Description of Soil See So,j tcA 1'I � Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place he system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed _� t . I Date 311gho Application Approved by 4 Ll(.it/In L� �iCj Date ct/;). 0 Application Disapproved by: Date for the following reasons Permit No. 0_D) (l/ ———Date Issued s — +'! r :ate Fee "14. ' 0 4 - t Entered in computer: 1 THE COMMONWEALTH OF MASSACHUSETTS p PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 'Yes + ZIpplication for lbigpoga l �&pgtem Construction Permit Application for a Permit to Construct( ) Repair( )'Upgrade( ) Abandon O ❑ Complete System O Individual Components Location Address or Lot No. R H �s .�1,9�n J 06/ (�t-Owner's Name,Address,and Tel.No. v Tohn � 7•�in �.3�d/�! Assessor's Map/ParcelAgo 9 3 n Installer's Name,Address,and Tel.No. �- 115 tJrcJ N/f�cnS)y; Designer's Name,Address and Tel.No. 3 b ��,�� l hh '" rr�lilef i I�S U� � �I L Type of Building: . Dwelling No.of Bedrooms (fi Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures *, Design Flow(min.required) I Ll V gpd Design flow provided - gpd //an Date pP� � �> 4, JV Number of sheets vZ Revision Date � Title �j I I`Ci -f- T�i ►� / j��G✓1� Size of Septic Tank I coo .A I Si, Type of S.A.S. Description of Soil S p{ SC j ]n� C2 �} r Nature of Repairs or Alterations(Answer when applicable) S_�P.p C Date last inspected: t_ ` 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. Signed I I A pn , Date 3�IJ/IG Application Approved by {M fN�Z -S Date j Application Disapproved by: Date for the following reasons s t Permit No. ((/ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed (' ) Repaited ( ✓) Upgraded ( ) ' Abandoned( )by lilt t S 63ac Ae,S Cc— S)' � 7 h-, JTvj P`_s,,-L e at �L4 kA/?S)- C i)r I ..inntf has been constructed in accordance V 1 with the provisions of Title 5 and the for Disposal System Construction Permit No. D!U —(b h dated L -,2 [� j Installer )y N l*S(3cc j-;4 r (-C,v) Designer } #bedrooms, Ll Approved desj�gn,floJ U r gpd The issuance of this permit shall not be construed as a guarantee that the system wi fun i n as des ed. Date N 0 Inspector 44 IL?, No. s tom'd 0 �tr —_——._---—_. _ -Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migogal 6pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair (� Upgrade ( ) Abandon ( ) System located at t Lt/PS} 14,,g2 nn �ne-s/" C,C and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Co ruction must be completed within three years of the date of this permit. Date L ns l/V Approved by 05/0,4/2010 09:08 5083621590 - FES PAGE 01 Town of Barnstable Regulatory Services 41 1bomaa F.Geller,Director RAW 1= Public Health Division Thumars McKesz,Director 200 Main Street, Hyanab,MA 02601 Wfce: 30+6t-862.6644. Fax: 508-740-6304 Dater `1 IC _ Sewage Permit#a610 l U(� Aftessor's Map/Parcel lnstaller dt Designer Certification Forth l Resigner: ! Installer: eu- CC S� Address; ►�j _ _ Address: a3 fZtip�c On f'd�3�� _ _(�l L. (32 I^�-v rJ Co#1 44ts issued a permit to install a ( ate) (installer) septic system at �J-. li3 based on a design drawn by (ad res dated —_/2A/ (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box andlor septic tank. Strihout (if required) was inspected and the soils were found satisfactory. 1 certify that the septic system referenced above was installed with major changes (i.e_ greater than 1 Q' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Loea s. Plan revision or certified as-built by designer to follow. Stripout (if re ted and the soils were found satisfactory. DAVID ctic D. ` FLAHERTY' JR. Cr -- _— No. 1211 ]M al �-er's aature p a �a/STIS SgNrtARIP' J lU ( esigncr'c _ (Affix Designers Sta He ' ) PLEAS RETURN TO BARN AB PGB1L C HEALTH D . CERTIFICATE nF , .[ANCE WILL NOT B ISSiTED UNTIL, BOTH FORM Al AS- BUILT CARD ARE RECEWED BY THE RN BASTABLE PLIALI.0 HEALTA DIVISION. THANK lr QL- e^u[fire::erns �.+rgrereernfirai forMAUL _..J _ ...... .... .., J. . .... ... ... L.... NOW, THEREFORE, does hereby place the (OW is name) following restriction orn his above-referenced land in accordance with his agreement.wittithe-.Tawn-of Barnsta-bleZowd--cfHeakh wNe- es;t�-ietton-shalt run with the andand be binding upon all successors in title: 1 AZ tb- IW ay have constructed- (address) upon the lotja house conta'ning no more thank ( bedrooms. Ji�e agrees that this shall be permanent deed (owners name) restriction affecting located on MA and being shown on the plan recorded in Plan Book , 9 Pa ed Or on Land Court Plan For title of (PU-�n e -5 see the following deed: Book , Page a5 Or Land Court Certificate of Title Number Executed as ealed instr nt ( day of / wn s signature - Oval is signature Owner's signature COMMONWEALTH OF MASSACHUSETTS . ss 2Q_ Then personally appeared the above-named known to me to be the person who executed the foregoing instrument and acknowledged the same to be free act and deed, before me, Notary Public My commission expires: / t - (date) .a deedr BARNSTABLE REGISTRY OF DEEDS \ f 0 To be used as a Guideline NOTICE: The Town of Barnstable recommends that tbe_applicant seek legal advice to prepare a properly worded deed restriction document. DEED RESTRICTION WHEREA L i4ty z 3 11np . of(owners name) MA (address) is the o ne of v 10 ¢ located • d s at 1p c MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in 1-s, �i S r MA, Property of et al, duly recorded in Barnstable County Registry of q K t 3 1Li3 Deeds in Plan Books r-1 1,�, L.6.1 , Page T Or on Land Court Plan Number WHEREAS, -k:D "�YL/ as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Dis posal osal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms,in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr oE� Town of Barnstable P# Department of Regulatory Services MAMRARNSTARLr, = Public Health Division c Fn ��`b� 200 Main Stree t,Hyannis Date MA 02601 Date S(rheduled ?3 Q // Time l Fee Pd. Soil Suitability Assessment for Sewage Perfoc .�y; Disposal By�U Location Address LOCATION & GENERAL INFORMATION' 1 �j� ��0 C�, Owner's Name /� 1 �7 H IA( Address S'✓�Asscssor's`Map/Parcel: .' _l 9,4j. ? > ,32. Engineer's Name �. 5 NEW CONSTRUCTION REPAi1t Telephone#,5e�-3,w Land Use �S f /�� Sl es 90) S }�/�/� / Surface Stones �4- Distances from:' Open Water Body _ft possible Wet Area A/,4 ft Drinking Water Well44 1_ft Draihage Way j1� /� 7�y v/ PropertyLine Ft Other rro ft ILG� l-��yt . SKETCH: (Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands i'n proximi f'ty to holes) Gv �#,Wvl� T CIS. � Parent material(geologic) `�✓ Gj,�� Ct/f/$Vyt �/� /. Depth to Bedrock Depth to Groundwater. Standing Water in Hole: v Weeping from Pit Zac Estimated Seasonal High Groundwater. > �z �� /1ivy10�✓-��,, � t �A�Kx DETE. NATION FOR SEASONAL HIGH WATER TABLE Method Used: /l/ Depth O served standing in obs.hole: Depth to wee ' m side of obs.hole: �1,vm in. Depth to soil mot ; Index Well# n, GroundwaterAdJustm Reading Ind ft. - - Adj,factor. �_ Ad),dr dwutcrLeveI FDcpthofperc PERCOLATION TEST bate > j[ime lU ,yj 1 Time at 9" / Time at 6" � Start Pre-soak Time @ Time(9°•6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed ,�/u Site Failed: Additional Testing Needed(Y/N) /t/ Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation testis to be conducted within 1003 of wetland, you must first noti-jy the Barnstable Conservation Division at least one (1) week prior to beginning. Q:\.SEPTIC\PERCF0 RM.D OC Depth from DEL,P-OBSERVATION HOLE LOG Hole# _ Soil Horizon Soil Texture Surface(in.) (USDA) Sdil Color Soil Other r ) (MunselI) Mottling (structure,Stones;Boulders, on i to c % ravel la 2 3/ DEEP OB Depth from SERVATION HOLE LOG Soil Horizon Hole# Surface(in.) Soil Texture Soil Color (USDA) Soil Other (Munsell) Mottling (Structure,Stones,Boulders. onsisten I Graver_ -Z'Z'-1 ' cU z.s DEEP OBSERVATION HOLE LOG Hole# Depth from! Soil Horizon Soil Texture ' Surface(iu.) Soil Color Soil other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Co i to c 9 Gravel DEEP OBSERVATION HOLE LOG _ Depth from Soil Horizon Soil Texture Hole# Surface(in.) Soil Color Soll Other (USDA) Soil Mottling (Structure,Stones,Boulders, Consi ten l ELJ Insurance Rate Map; ,'above 500 year flood boundary No_ Yes �! Within:)30 year boundary No Yes Wituin 100 year flood boundary No y es Dept�Nalurally Occurring Pervious Material lly Does at least -our feet of natura occurring pervio m aerial exist in all areas observed throughout the area proposer for the soil absorption system? s If not,what is the depth of naturally occurring pervious material? Certification I certify that ort4(liZ-/ 9 (date)I have passed the soil evaluator examination approved by the . Department of.Environmental Protection and that the above analysis was performed by me consistent with . the required.trainin ex p tis ndPRIlence described in 10 CMR 15.017. Signature /� Z3 /o� Date 4 / Q:\SBPTIC'\PI RCFORM.DOC To be used as a Guideline NOTICE: The Town of Barnstable ..recommends that-the nj3DI*C:ant seek legal advice to prepare a properly worded deed restriction document. DEED RESTRICTION WHEREAS,, 6 fl t� I�-`.* �1 l�� l� . of (owne's name) �� C2 S M F;—, � )s .0 L )'1 S MA (address). is the owner of c2 to, - _S &kl o I.k o located at !. s MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in1-5 � MA, Property of :70 44. e et al, duly recorded in Barnstable County Registry of q K t l L} 3 Deeds in Plan Books r3 14. l , Page P ; Or on Land Court Plan Number WHEREAS, 'TOR ? in, r)U! as the owner of said lot has (owner's name) i agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum F Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board.of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, dinar '-sr pits NOW, THEREFORE, does hereby place the (oyv is name) following restriction on his above-referenced land in accordance with his agreetneat.with-the..Towa.af Barnstaab a-�r-d-of-H-eattb-whieli�rest-r4otiofl-si*t run with the and nd be binding upon all,successors in title: '(address) T�nay have constructed. pon the lot house containing no more than cLi- (0 bedrooms. .� agrees that this shall be permanent deed (owner's name) restriction affecting located or. MA, and being shown on the plan recorded in Plan Book - , Paged Or on Land Court Plan For title of 0L%_9 n ef-- S seethe following deed: Book 3 , Page Or Land Court Certificate of Title Number ExecuteVas ealed ins nt ( day of wn s signature t Ov�y is signature Owner's signature COMMONWEALTH OF MASSACHUSETTS , ss ' 20_ Then personally appeared the above-named known to me to be the person who executed the foregoing instrument and acknowledged the same to be free act and deed, before me, Notary Public My commission expires: ?� (date) deedr BARNSTABLE REGISTRY OF DEEDS ;. . Commonwealth of Massachusetts Title 5 Official Inspection Form ;`_111 Not for Voluntary Assessments H Subsurface Sewage Disposal System Form ,. r ,W,` Inspection results must be submitted on this form or on the official Title 5 Inspection Form dated 6/1512000. Inspection forms may not be altered in any way. A. Certification Important: When filling out 1. Property Information: forms on the L computer,use 24 West Hyannisport Circle �— only the tab key Property Address to move your John and Jean Boyle cursor-do not use the return Owner's Name key. same Owner's Address tab Hyannis MA 02601 City/Town State Zip Code Date of Inspection: August 16, 2005 Date 2. Inspector: David D. Flaherty Jr., R.S. Name of Inspector Flaherty Environmental Services Company Name P.O. Box 19 Company Address Wellfleet MA 02667 City/Town State Zip Code 508-362-1657 Telephone Number Certification Statement: 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 ❑ Conditionally Passes ❑ Fails ❑ N Pads:/tF rth Eval ati n b the LoGal Approving Authority 8/17/05 Insp tor's Signat re 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. t5insp.doc• 11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 1 of 16 i Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection 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 des ed in the"Conditional Pass" section need to be replaced or repaired. The system, upo completion of the replacement or repair, as approved by the Bo/ea d f Health, will pass. Answer yr not determined , N, ND) in the ❑ for the following statements. If"not determinease explain. ❑ The snk is metal nd over 20 years old* or the septic tank (whether metal or not) is structnsound, hibits substantial infiltration or exfiltration or tank failure is imminent. Systepass in ection if the existing tank is replaced with a compiiying septic tank as appro the and of Health.A mp ' tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Coa indicating that the tank is less than 20 years old is available. ND Expla t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M A. Certification (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection 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 ❑ obstruction is removed ❑ distribution box is leveled or replaced ND Explain: ❑ The system required/Pa an 4 times a year due to broken-or obstructed pipe(s). The system will pass insproval of the Board of Health): ❑ broken pipe❑ obstruction i ND Explain: C) Further Eva ation is Required by the Board of Health: ❑ Condition exist which require further evaluation by the Board of Health in order to determine if the syst is failing to protect public health, safety or the environment. 1. Sy tem will pass unless Board of Health determines in accordance with 310 CMR 15.3 (1)(b)that the system is not functioning in a manner which will protect public health, saf ty 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 t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 3 of 16 f Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments 01 Subsurface Sewage Disposal System Form M A. Certification (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection C) Further Evaluation is Required by the Board of Health (cont.): 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a ma ner that protects the public health, safety and environment: ❑ The system has a septic tank and soil sorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary/fo a surface water supply. ❑ The system has a sept/tankK d SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a sep nd SAS and the SAS is within 50 feet of a private water supply well. ❑ The system ha a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private ter supply well**. Method us d to determine distance: ** This system asses if the well water analysis, performed at a DEP certified laboratory, for coliform bacte la and volatile organic compounds indicates that the well is free from pollution from that facility a d the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provi d that no other failure criteria are triggered. A copy of the analysis must be attached to this for 3. O er: I t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 16 i Commonwealth of Massachusetts Title 5 Official Inspection Form o Not for Voluntary Assessments Subsurface Sewage Disposal System Form M A. Certification (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State ZipCode Boyle 8/16/05 Owner's Name Date of Inspection 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 '/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] Yes No ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 7M A. Certification (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 Cityrrown State Zip Code Boyle 8116/05 Owner's Name Date of Inspection E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 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�o 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 apped Zone II of a public water supply well If you have answered "yes"to any q stion in Section E the system is considered a significant threat, or answered "yes" in Section D ab ve the large system has failed. The owner or operator of any large system considered a significant reat under Section E or failed under Section D shall upgrade the system in accordance with 31 CMR 15.304. The system owner should contact the appropriate regional office of the Depart ent. t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 16 Commonwealth of Massachusetts Title 5 official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 4� B. Checklist 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection 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(3)(b)] t5insp.doc• 11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form } X Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection 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 Number of current residents: 2 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 ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): '03: 263 gpd; '04:267 gpd Sump pump? ❑ Yes ® No Last date of occupancy: present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 1 . 03): Gallons per day(gpd) Basis of design flow(seats/pe ons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holdi tank present? ❑ Yes ❑ No Non-sanitary was discharged to the Title 5 system? ❑ Yes ❑ No Water meter r adings, if available: Last date f occupancy/use: Date Other describe): t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 16 i Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection General Information Pumping Records: Source of information: 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 16 Commonwealth of Massachusetts Title 5 official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 Cityrrown State Zip erode Boyle 8/16/05 Owner's Name Date of Inspection Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >50 feet Comments (on condition of joints, venting, evidence of leakage, etc.): joints good, venting adequate, no evidence of leakage. Septic Tank(locate on site plan): Depth below grade: 2.5 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 ❑ Yes ❑ No certificate) Dimensions: 1000 gallon Sludge depth: 2 inches Distance from top of sludge to bottom of outlet tee or baffle 32 inches Scum thickness 1 inch Distance from top of scum to top of outlet tee or baffle 5 inches Distance from bottom of scum to bottom of outlet tee or baffle 13 inches How were dimensions determined? tape measure t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments 51 Subsurface Sewage Disposal System Form H C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): no evidence of leakage, baffles o.k. j 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 o top of outlet tee or baffle Distance from bottom scum to bottom of outlet tee or baffle Date of last pumpi Date Comments (on mping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as elated to outlet invert, evidence of leakage, etc.): Tigh r Holding Tank(tank must be pumped at time of inspection) (locate on site plan): D th below grade: aterial of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form ° Not for Voluntary Assessments ,M Subsurface Sewage Disposal System Form C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection Tight or Holding Tank(cont.) Dimensions: Capacity: Zi—gallons Design Flow: llons per day Alarm present: Yes ElNo Alarm level: armn working order: ❑ Yes❑ No Date of last pumping: Date Comments (conditio of alarm and.float switches, etc.): Distribution Box (if present must be opened).(locate on site plan): Depth of liquid level above outlet invert n/a 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.): no sign of carryover, dbox under patio but located with detector and viewed with mirror and light. Pump Chamber(locate on site an): Pumps in working order: ❑ Yes ❑ No Alarms in workin rder: ❑ Yes ❑ No t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1, 6'X 8' ❑ 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.): no sign of hydraulic failure, soil dry, vegetation normal. I t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ^M y Subsurface Sewage Disposal System Form C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of 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 Comments (note condition of soil, signs o/aulic , level of ponding, condition of vegetation, etc.): Privy (locat/condition Materials of Dimensions Depth of sol Comments ( ns of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 7N SV � C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 City/Town State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. nc 6 i i /4 Z. - Zs 6 Zq t5insp.doc• 11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 16 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form 41y C. System Information (cont.) 24 West Hyannisport Circle Property Address Hyannis MA 02601 Cityrrown State Zip Code Boyle 8/16/05 Owner's Name Date of Inspection Site Exam: Slope Surface water Check cellar Shallow wells Estimated depth to ground water: 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: 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: no ground water at 15 feet (see last as built) t5insp.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 16 LOCUS DATA N/F BACIGALVPO PLAN REFERENCE 173/143 261/54 I MAP 267 PARCEL 131 DEED REFERENCE 5369/251 _ H 2475/105 5.7' 133.34 ZONING DISTRICT RB ,.2-06'40'�E SHED OVERLAY DIST. WP - ZONE II L� _ — Lo TBM CORNER DECK 0 \ 1.19 , FLOOD ZONE 250001 I I EXISTING t BULKHEAD BOX w "C" II I = DRIVEWAY EL=29.00 o N/F I TOWN OF BARNSTABLE ASSESSORS MAP 267 MAP 267 PARCEL 132 I Z Ln I 32.6' PARCEL 177 I o I I #24 Ln crcvlk LOT AREA 10,001 f S.F. I I 4 BEDROOM DTA#1 o DWELLING $� \ EXISTING LEACHING AREAS I � — o PATIO / TO BE PUMPED, CRUSHED SITE & SEWAGE `-I t;n I DTH #2 AND REMOVED IN r I \ LA 0' ACCORDANCE WITH TITLE 5. REPAIR PLAN , � I � II _ . o t #24 I I I rn 28 4' OBSERVATION liV. H )IANNISPOR T CIR. I I I / 19.0, a 11.0' PORT ?8 N qg ,GAS I --- GAS H YA N N I S I `n/ I\ o�� NB2°06140"E I I I \ 133.34' 1 DATE: DEC. 21 , 2009 I _ N OWNER/APPLICANT: \� N/F PATIO AREA OVER SEPTIC O 20 30 40 MAP 267, JOHN & JEAN BOYLE ��, DERAS BE REMOVED MOVED TO 24 W. HYANNISPORT CIR. PARCEL 133 GRAPHIC SCALE: H YAN N I S 1 INCH = 20 FEET MA 02601 SHEET 1 OF 2 SHED FIRST FLOOR ' SECOND FLOOR NOFM,yss9 o P N ��°`� DVI D c� N PREPARED BY: OF�� 49,9 F RTY, R. EAS SURVEY INC. °a EDWARD tic T211 � �� A � OFFICE LH LBH KITCHENFAMILY BED #1 BED #2 �° b OLD � E N � ' 141 R T. 6 A STON N 26 BO HALL Sq N�AR R I SCHOOLHOUSE RD• P. O. BOX 1729 °�F ;� /ST s l�, z( LOCUS CD SANDWICH , MA 0.2563 O A DINING LIVING BED #4 BED #3 CRAIGVtLLE SMiTH ST• PH. (508) 888-3619 �� BEACH ROAD FAX (508) 888-2496 NOT To SCALE: r REMOVE CONCRETE PATIO SYSTEM D E S I G N OVER SEPTIC TANK �- RAISE COVERS TO WITHIN ®" OF FINISH GRIADE ' SILL 29.87 OBSERVATION DESIGN FLOW FINISH GRADE PORT TO GRADE _4_ BEDROOMS AT 11.Q GPB/D iCL GPD F.G. ELEV. 28.2 ELEV. 28.68 FINISH GRADE ELEV. 27.7 REQUIRED SEPTIC TANK 2.3' OF COVER ___440 x_2__ _ _ ___880 GAL. " 26'®S=0.015 TOP ELEV 25.42 SEPTIC TANK PROVIDED = 1000 _GAL. SCH 40 INV.= 4" PVC SCH 40 6'®S= 0.01 - :: NV= 6.1 25.83 10"TEE 14"TEE INV.= :V--'2 _ SIZE OF LEACHING FACILITY REQUIRED �,. 1 " 25.66 6" .. 5'-7" 6 / GAS BAFFLE 5 OUTLET DESIGN PERC RATE __< ____MIN./INCH TWENTY FIVE 34' x 76 x 11 CHAMBERS LONG TERM APPL. RATE_0•_74_GPD/S.F. 2 4'-1" LIQUID LEVEL D-BOX H-10 1100 BD ADS t: , 4-4" INV.=25.27 INV.=25.04 / o L SIZE OF LEACHING SYSTEM PROVIDED: I5.10 0:31.25' -I a24.50 LBOT. 5 ROWS OF 5 TRENCHES ® 6.25' EACH 0 440 _ 0.74 SF/GPD = 595 S.F. MIN. REQ. EXISTING 1,000 GAL TANK TO REMAIN OBSERVATION PORT ELEV. 15.8 USING 25 CHAMBERS WITH NO STONE AROUND DATUM: I / SCREW CAP ADS - 1100 BIODIFFUSERS H-10 CONSTRUCTION NOTES: 4.7 SF / LF X (6.25 x 25) = 734 S.F VERTICAL DATUM: BARN. GIS MSLf SAND FILL = 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 734 x 0.74 G/SF 543 GPD BENCH MARK USED: CORNER OF BULKHEAD ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING iv - ELEVATION 29.00 WORK ON THE SITE. o 0 543 GPD PROV > 440 GPD REQ. =103GPD RES. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE x ;. WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT ,IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. --2.83'-- --2.83'--- --2.83' -2.83'-►�--2.83'-�-I NO (GARBAGE DISPOSAL GRINDER ALLOWED) V SITE & SEWAGE 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND REPAIR PLAN S.A.S. AREA IS PROHIBITED 14.15' GENERAL NOTES: tt SIDE VIEW #24 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P.I I CERTIFY THAT I AM CURRENTLY APPROVED BY THE D.T.H. #1 0 D.T.H. #2 -0 '^/ TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT DATE: 11-23-09 DATE: 11-23-09 = , l�V. H YA NNISPOR T CIR. FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL GROUND ELEV. 27.6 GROUND ELEV. 27.8 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE EVALUATION ARE ACCURATE AND IN ACCORDANCE WITH 310 NO GROUNDWATER NO GROUNDWATER N ACCESSIBLE WITHIN 6 OF FINISH GRADE, WITH ANY REMAINING CMR 15.100,TIROU H 15 07. ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. `+ H YA N N I S 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE ---- - - -- - -------- A A CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE'i EDWAR STO E, CERTIFIED SOIL EV ATOR LOAMY SAND LOAMY SAND DATE: DEC. 21 , 2009 UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEY 10YR 3/2 10YR 3/2 MUST WITHSTAND H-20 LOADING. 6" 8" OWNER/APPLICANT: 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION I DTH #1 ib INDICATES DEEP B B OF ALL UTILITIES PRIOR TO ANY EXCAVATION. VjµOFJW4 TEST HOLE LOAMY SAND LOAMY SAND J 0 H N & JEAN B 0 YLE 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE I �� Ss9c 11 7.5YR 5/6 .. 7.5YR 5/6 OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. o� DA D ti 24 22" � ELEV =25.6 ELEV =26.0 24 W. H YA N N I S P 0 R T CIR. 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER a FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. FLAHE JR N INDICATES H YAN N I S 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF 0. if P-1 54 PERC TEST C C SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE MEDIUM MEDIUM MA 02601 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND TF NO MOTTLING COARSE SAND COARSE SAND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. SApil7 R .2.5Y 7/6 2.5Y 7/6 SHEET 2 OF 2 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN , 7 NO WEEPING 10% GRAVEL 54„ 10% GRAVEL 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT PREPARED BY: 9. THEVATION SEPTICOTANKESHALLEHAVEEA MINIMUM COVER OF 9 INCHES NO G. WATER NO G. WATER E A S SURVEY, INC. 10. THE OUTLET BAFFLE, 4 INCHES INRY TEE DIAMETER SHALL AND CONSTIPPED WITH A RUCTED OF 4"GAS PVC 1H OF ELEV =17.6 120 ELEV =15.8 144 141 R T. 6 A " SHAL ALL LIBES SHALL BE SLOPED 11/4S NCEDULE H PER 40 PVC FOOT MIN.N XCEPTEFORDTHE 1 �� OWARps9cyG SOIL EN DESMARIAS N SOIL EVALUATOR FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL o A. n+ P. O. BOX 1729 � � GROUNDWATER ADJUSTMENT ED. STONE � BE LEVEL STON SOIL EV. LIC. APRIL, 1995 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION �a 289 a DEPTH TO BOTTOM OF HOLE 12.0 BACKHOE OPERATOR. SANDWICH MA M A 0 2 5 6 3 AND APPROVAL.TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW �F F I/S ` VARIANCE REQUESTED REID ELLIS � `�ip �' SOIL TYPE: �_ PH. (508) 888-3619 13. MAGNETIC TAPE OVER ALL COMPONENTS. N c AN �' TO ALLOW THE EXISTING 1,000 GALLON PERC RATE: <2 MIN. PER INCH FAX (508) 888-2496 SEPTIC TANK TO REMAIN. LOADING RATE: O_74 GAL/SF/MIN