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416, 418 BEARSE'S WAY - Health
rt .416 &.418 Bearses Way Hyannis � 1 t A = 292 - 030 9 ?I o 0 1 i e I o rlF 1� e i 0 7 1 I i i i Town of BarnstableP# �g,Y•t��L�cor'ti �pgaar gnt�ofI=i tlt% Safetty4,� d$Env e tlal�Sj eesY l;s ,,,e Public°Htealth D�><vy�isi`tin Date: lip. �41 . .: �, ., s, 367 Main S'tieet,Hyannis MAr02601s ArA8.4 °rfnta�� Date Scheduled Time �U �4VI_ Fee Pal• Soil Sudiability Assess Ment j'ur Se age Disposal - t Performed By: 1�it l d Witnessed BY Location Address fie - Owner's Name 0— 0 r Assessor's Map/Parcel: o29"L�3 o Engigeei''s'Name e /9��' // NEW CONSTRUCTIONREPAIR Telephone# W U 3Ind Land Use f�sl� �,� ` Slopes(0/0) �� Surface-Stones /V Distances from: Open Water Body tic2_ft Possible Wet Area 50 ft Drinking Water Well ft - Drainage Way ' ¢. ft Property Line _to_ _ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) f 3 77R� P 1 r� - Z -t Parent material(geologic) l(CC.t i a( Depth.to Bedrock CMJ ' n' ^� , Pit Face Depth to Groundwater: Standing Water in Hole: rV� --- Weeping-from n s Estimated Seasonal High Groundwater_ �•, - .................::.:.:::.::...:••.:•:.••:.:••;;;.......:::::;.....:;....:....:::.....::':'•.:.:':':":'>'.:'•:.:::':"::<:::::> iEz<;>z:>i:':{s: ;<:. . IyJGi:; ill: .:;;:.;::.;:.:.;:.;:.:;.>;:;;..:::;:.:::;:,::• .:.::: :. :.xc :...: :.: Aso :::::::.::::.::.::::.:::.::.:: Method Used: !. es: in. Depth Observed standing in obs.hole: in. Depth toosoiPmott l Depth to weeping from side of obs.hole: in. Groundwater Adjustment RT _ Index Well#_.�_._._ -Reading Date:`•__-Index Well level...— ' Adj!Jfactor "'"''"Adj:•Groundwater Level .z 7 hidg .'-:::�.,:-'`�•.::��:>'> ...........................................................................................................................:......................................... ... , Observation Time.at9�� ,iy� Hole#' s / i Time ai`6 Depth of Perc Timej(9,'.-6") r Start Pre-soak Time Q C� End Pre-soak Rate Min./Inch '� r Site--Suitability Assessment.. 'Site'Passed._'. X�` ,SiteFailed: la •-Additiot-ialaTe%sting_Needed:(Y/�N); Original: Public Health Division Observation Hole"Data'To 11e;Q;.ompleted'O'W a C k Copy: Applicant N, I� Depth from Soil Horizon S'oil�Tezfu"reK M !' 1 fSdil;Color'}:+'4 Soil Other Sui "`� race(in.) (USDA (Munsell). Mottling (Structure,Stones,Boulderes. HUI.t .. ::::::;:>:.>::::::::.:«:;:;:::;:<.;:.::;.::.::::.::.:::.;•:.;:.::.;:•.:•....:..::....: . . jD'epth from Soil IIorizon Soil,Texture Soil Color Soil Other 9 Mottling (Structure,Stones,Boulderes. Consiste`Surface(in.) (USDAj' (Munsell) n °°Gravel) I6 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consisten2y.°o r el .:.....::::::::::::::::::::::::.....:.:::::::::::::::......::::::::::::::::..::.:>:::...... ..::...:... D'eplh from Soil Horizon Soil Texture Soil Color Soil tier USDA (Munsell) Mottling (Structure,Stones,Boulderes. Sufface(in.) (USDA) onsistency.°o Gravel) r- iPlo'odalnsuu•ance�Rate�lVlan - ' -��/ � - ` " ' ld Above 500 year rlood?boundary.No. Yes I� -Wm itha560.year.boundary No I Yes V✓iihin;100•.year flood'�b'6ndary'Nor_. `Yes- Depth of Naturally®ccurring�Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _ Yf:not,what is the depth ofttatural`ly occurring pervious material? Certification I�rcertify�that on S cj (date)I lice passed the soil evaluator examination approved by the Departmt'ntdf'Envi on"mentalLProtection_and,that the'above analysis was:per•'folmed by,me.consistent.with 4Eh'e required training,expertise and.experience described in 310 CMR 15.017. Signature Date*0'64 T WN:OF BARNSTABLE- -: LOCA'II O �Cu, �S SEW�t3E V irA�fi s ASSESS6k.1v1AP k Lf INS'TA . . It'S N 'FIC?NE NO sic TA1�lI{c �cz car ' LEACIaI1+iG j�f' .' ) � l3Y:TSLL1BTt 0R©4�1N1�It �' . 1RA/�TIDA'I� �pii'U.1P►I1ltE T3A' ...._ �: op on�9tsEa�naa Bstv�een t��a MtiximumAd}u8leil,Gtavu�wate�Ts�te ga tlic H�ttom of Leaching Nudity � ���' l�lyate 'dUaicr Sapply i7J4�1 acid d. ic�it�g pacitlty : f ►Y �el9s cx4stcr�9 °oo alto or uvlttim 7AQ feet oEleoc[uQ�g Fttciuty) '; slur cyf V�Iet4anr�and l caeltto$�acaltey(lf my wetlands exist riith��i;3QQ feat f leabli,ag�'agltrry) � .. F r k A �A3-30" B3:3- /V _ _ R�✓lsE� = TOWN OF BARNSTABLE ,r..-<t:LOCATION � l� sit t C��i L�,�`�SEWAGE#' 0-0/.4 - �ILLAGE ASSESSOR'S MAP&PARCELS -gip INSTALLER'S NAME&PHONE NO. —t 71-�399 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) —y t c;7j%(L bP— (size) -!T3-�� Ia• .NO.OF BEDROOMS � �—�0�� G +�1-31 L— OWNER C�SI•(r �_ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ---6 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) N 1,4r Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /1 Feet FURNISHED BY a s m ►� 1 n NQ vo �C rn � S z �J No. Fee *. fTHE COMMONWEALTH OF MASSACHUSETTS Entered in co toPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpUtation for Misposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair(k� Upgrade( ) Abandon( ) PrComplete System ❑Individual Components Location Address or Lot No. /(, - y/g p� ii� cy Owner's Name,Address,and Tel.No. gn—/V-23 l4ya,_ni' /�(' ✓,� zaC 1'u' 3 �e. hee{-en A., Assessor's Map/Parcel a 1 U Q n o----4 Installer's Name,Address,and�Tel.No, Z18_W�f—19ga2Ca Designer's Name,Address,and Tel.No. yS� 't" . 17 �4 �Z,S�lj r)gWjf5 93`? v S is O�(o hC5 Type of Building: Dwelling No.of Bedrooms q "��a Lot Size '� 9'$$ — sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) y yy gpd Design flow provided 4 SS gpd Plan Date Dec"? aoi(o Number of sheets / Revision Date Title T-. e. G Size of Septic Tank 1,13en C_ � 4AZ) Type of S.A.S. Sca Description of Soils 5%o Q 123 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 a not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si Pi Date 1 Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. Fee IQ THE COMMONWEALTH OF MASSACHUSETTS Entered coiq ute Yes PUBLIC HEALTH DIVISION - TOWN OF,,,BARNSTABLE, MASSACHUSETTS N#ication for -Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) Complete System El Individual Components Location Address or Lot No. C�/(, - y/� , ,�( c� Ownerjs Name,Address,and Tel.No. !'F Ccn/►i 4g !�`""`y Ce�uu, a 1 Assessor's Map/Parcel a 91 U y !f-k l n o t S Installer's Name,Address,and Tel No.' ,Sa8-ya 8- S1S.12G Designer's Name,Address,and Tel.No. '(_z��kolo�iCat�s�ru�{�•oV� ,-.L„c !�$'?,d'�(-�yf�) �c��C�j�.e. �r����t� �3�t r�-t�r:.c� �-• i s Ia oa(OUS 03&-)s Type of Building: Dwelling .No.of Bedrooms y leY, o1�a Lot Size '� /`'$g — sq.ft. Garbage Grinder( ) i Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) V VU gpd Design flow provided S gpd Plan Date,�)e C,7 f a�1(o Number of sheets / Revision Date r). Title Size of Septic Tank l,13dnR;efl �rNYlryrn�itkrr f N aU Type of S.A.S.I!3 Sc,5 -nJ_'1 .viwo.�l .,S hrn�.(��. 33 S X r✓�r�i3 •Descnption of Soil;4o , 5%c,,C Its i t Nature of Repairs or Alterations(Answer when applicable) Date last inspected: f' Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental C-o a not to place the system in operation until a Certificate of t Compliance has been issued by this Board of Health. ��. S E //C Date Application Approved by Date Application Disapproved by -Date l for the followinreasons Permit No. i , �2 7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance j . THIS IS TO CERTIFY,that the On-siteSewage Disposal system Constructed( ) Repaired Upgraded( ) �! Abandoned( )by Afayl c-st. L.Dns�i'cx f!/no,40 C at'116 �-V19 6m,✓�SA5 � ),IV has been coWeic rwith the provisions of Title 5 and the for Disposal System Construction Permit No �d eInstaller t�-��„�r �„�g�t�� �� ,�L Designer A W m �� Q �n^ne.nxQn.c�rc #bedrooms: Approved design flow c�/%((i' J gpd The issuance of is 71-A it shall not be construed as a guarantee that the system will f m ton d gsigned. Date Inspector \� �, --- No. f ------- -------------------------------------- ------------------ -------------F ee THE COMMONWEALTH OF MASSACHUSETTS Y 0 5 (1�UBLIC TH DIVISION-BARNSTABLE,MASSACHUSETTS O is osal stem Constructiot ,- ermit Permission is hereby grante to Construct( RepairA) Upgrade( ) Abandon( ) System-located-at---4/ f' n u .!r r// /7,oi,' and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. < Provided:Constructio u ;be co p t d ithin three years of the date of this permit. Date Approved by Town of Barnstable Regulatory Services i RAIN� Thomas F. Geiler,Director lsl'A81,�, : Public Health Division . " Thomas McKean, Director 200 Main,Street,Hyaanis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Fortin Date: �7 r Sewage Permit# Assessor's Map\Parceltr4c�^- Designer: V J D W V% �' �+tAnstalle�r: 601r]a10 Address: p r , I � � Adcii•ess: / 'p Q&x 7�Y•. On I G �-� �y�c�li;=bras issued a pen-nit to install a (date) (installer) septic system at �6 ' �t'^Jell � based on a design drawn by (address) lr\c elt o— IIE" &S dated . re V. 9 4 (de ' er) 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 and/or septic tank. r , I certify that the septic system referenced above was installed with major changes (Le. greater than 10' lateral relocation of the §AS or any vertical relocation of any component of the septic s . ) but in accordance with State & .Local Regulations. plan revision or certified. uilt designer to follow. Aa r. ,n (Installer's Signature) OVII. No 4650", (Designer's Signature) (Affix Designer's Stam .Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTii THIS FORM AND AS-PjJjLT`CAI�L?_�I-,E RECEIVED BY THE BARNSTABLE PUBLIC HEALTI•i DIVISION. THANK YOU. Q:Heaitb/Septic/DesiBaer Cez4ificatiotl form 3-26-04.doe --------------- r.VIA S14E Tp� Town of Barnstable Barnstable .�� Regulatory Services Department SAMSPASM I I `";9. ,0� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8001 -_ - - October-14, 2016 Alcorn, Harry R& Barbara H 416-418 Bearses Way Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 416-418 Bearse's Way, Hyannis,MA was inspected on 09/09/2016 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE ARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\416418 Bearses Way Hyannis.doc QjMFT°� kylbd Town of Barnstable Barnstable Regulatory Services Department A&AffWWaC j iARNSTABM I 16 9. ,0� Public Health Division �f0"AP�p 200 Main Street, Hyannis MA 02601 2007 Office: 508-8624644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8995 October 4, 2016 Alcorn, Harry R& Barbara H 321 Great Road Maynard, MA 01754 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 416-418 Bearse's Way, Hyannis, MA was inspected on 09/09/2016 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH. d� Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\416418 Bearses Way Hyannis.doc i ' • 1�✓iSE� TOWN OF BARNSTABLE LOCATION 411.- � Cil Q.+, J SEWAGE# "VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C,f_ job' -t d0,399 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) i (size) 33.Sk- jd.�3 NO.OF BEDROOMS f -3-Soo 44-( C_0.4_,LV, L ' OWNER CL►-tLc= PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -4--19D Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) DPI Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) KFeet FURNISHED BYur�vlyUi �Lf•-t� � �'z}-1� OCRN Owr to 3 3 .33. r-,V+,l Liti4- 'Q-Dk 3-4 �3 0 C t� c��-(c L.) For N c-� = � A..5 Revises #CL-0tzfi�l,b GIN-Oa 5 Town of Barnstable MAM • aaRrrsrns�e, 039. h Regulatory Services Department QED MIS Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 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 ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water 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 pit or cesspool with high liquid level, <12" below inlet(per Town Code §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts :a Title 5 Official. Inspection Form r Subsurface Sewage Disposal System Form Not for Voluntary Assessments 416-418 Bearse's Way m —4 Property Address N Debra Cence V Owner Owner's Name F+ information is / required for every Hyannis ✓ MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection 5.71 Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S 13971 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 ❑ Conditionally Passes ® Fails- El , Needs Further Evalua• In by the Local Approving Authority 9-9-16,- Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form hI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 416-418 Bearse's Way Property Address C.r Debra Cence ! Owner Owner's Name t, information is Hyannis MA 02601 9-9-16 required for every y page. City/Town state Zip Code Date of Inspection r B. Certification (cont.) Inspection Summary: Check A,B,C,D or E!always complete all of Section D A) System Passes:,, ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): , t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form rd Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Qb. 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or.break out or high static water level in the distribution box due to broken or obstructed pipe(s) or'due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ 'N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ 'N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. { 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 I ,1 Commonwealth of Massachusetts f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments o�! 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection i 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: t I ' ** 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 alU 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® . Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis 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 117 1 f 1 Commonwealth of Massachusetts Title 5 Official Inspection Form (z-� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments o %67 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® 0 Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection D. System Information - Description: I Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 9-2016 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form. x+ WI Subsurface Sewage Disposal System Form --Not for Voluntary Assessments r 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 r page. Cityfrown ; State Zip Code Date of Inspection D. System Information (cont.) . Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: .a ' Owner--pumped 2010 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: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool . ❑ Privy f ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Altemative 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 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts }r Title 5 Official Inspection Form VI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name - information is required for every Hyannis MA 02601 9-9-16 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: 1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 16"feet Material of construction: ❑ cast iron ® 40'PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank (locate on site plan): Depth below grade: 8"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: 1500 gal Sludge depth: 12" t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection-.-Form . �+ "1 Subsurface Sewage Disposal System Form =Not for Voluntary Assessments r fib% 416-418 Bearse's Way t - Property Address + Debra Cence - Owner Owner's Name information is H annis MA 02601 9-9-16 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) .. Septic-Tank(cont.) 11 Distance from top of sludge to bottom of outlet tee or baffle 20 Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" - Distance from bottom of scum to bottom of outlet tee or baffle 15" 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.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap,(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ 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 Title 5 Official Inspection Form WI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � ro% 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town 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 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form W Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �•,£%✓ 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA ' 02601 9-9-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) +. { Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 3" 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.): D-box show signs of failure with water at 3" above outlet invert. 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.): i I * 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 Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 4--4'x4'x4' ❑ 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.): Leach galleries show signs of failure with water level above inlet invert and into soils above tank. 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 hi Title 5 Official Inspection Form . A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� �•;, 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 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.): 1 - , t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official* Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 01 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name information is required for every Hyannis MA 02601 9-9-16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately n A Imo, . 48-0) &4 A-3.- 30 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts i Title 5 Official Inspection .Form , 1 Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments KIWI 416-418 Bearse's Way Property Address - Debra Cence Owner Owner's Name Information is required for every Hyannis MA 02601 9-9-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . `- Site ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells , Estimated depth to high ground water: 20 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: . t You must describe how you established the high.ground water elevation: USGS and town maps show,groundwater at about 20'. i t 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f 416-418 Bearse's Way Property Address Debra Cence Owner Owner's Name- information is Hyannis MA 02601 9-9-16 required for every page, City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 C✓ TOWN OF BARNSTABLE 1 � n C OPy LOCATION SB WAGE # VILLAGBl�i?i!/'$ ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) e Iz /5 (size) "IX q X NO. OF BEDROOMS PRIVATE WELL OR UBLIC ATER BUILDER OR OWNER )Mo TRo S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No sips aoFr �� 3d�r Nd IVAr Y'8c/o d4f<ys THE COMMONWEALTH OF MASSACHUSETTS (9VF F,R........3 ...... BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Dirivntiul li urkg Towitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( L, an Individual Sewage Disposal System at: / ,(� .... ................y................................................................................................. --ii � // Lo,.,Iion•:�ddress or�ot No. U? _....._Y_/'D..fPis-------------------------------------------------- 3i....��ct�c�e��t�- c� r- �!f1�1?�►�i?Y�a. Owner Address a /v�Q Installer Address UType of Building L/ / U Size Lot............................Sq. feet Dwelling— No. of Bedrooms..................[___......................Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a Other fixtures ............................... .. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench— No. .................... Width.................... "Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by...........................•-----......_...-------------------•----------. Date........................................ Test Pit No. I......:.........minutes per inch Depth of Test Pit.................... Depth to ground water..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •---•---••-------------------------------••••-----•••..._-••---••---------•..........------.................:................................................ ODescription of Soil......................................................................................................................................................................... x U ------------------------•---...-•-•._.....------•-----------------------------------•..............--------........••-•-----•...---•-•---•--------•••---•---••-----.......--••••--..............._...... w ..... -----•----------------•----•-•--•••---------..._..-----....---.......... ------------•-------- U Nature of Re air or Alt e ations— nswer when applicable_. _ I�...............................sd0 / �. e� �� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issu by board � . ....... .... ... of health. .................. ......... . . . .Signed ......................... ' Dace Application Approved By .................... ..... ....... Application Disapproved for the following reasons: ... ................................................................................................................................. ................... ........................................................................ Permit No. ............. ...-.. �yr. Issued Dare No.. .: �7. F$s....... d...`' THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di!jpniul Works Tomitrnrtiun frrutit Application is hereby made fora Permit to Construct ( ) or Repair ( L,),"an Individual Sewage Disposal System at: /�.. `���..I.---..f�2a,rles Li/�4,/ e ------------------------------------------------------------------=---• ...... - -•............ .... Location-Address / or�of No. J I 3/ 6ACf9P5Cr �i r /1 fl�i,/9iy! � Installer 60') Address Type of Building `/ /` Size Lot............................Sq. feet Dwelling— No. of Bedrooms..................{.................___.-_-__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) Cafeteria ( ) 04 Other fixtures -----•------------------------------------------ kW Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. W Septic Tank—Liquid capacity............gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length......__.__......... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching Area...................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......................•-•-•----------•--------......---••----••-•-••••---- Date.......:................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... GZ4 Test Pit No. 2...........:....minutes per inch Depth of Test Pit.................... Depth to ground water........................ OG 0 Description of Soil..............................................................................•.......................................................................................... W --------------------------------------------------------------------------------------------------••-- --- ..................................................... ......................... U Nature of Re airs or Alterations—Answer when applicable_. !7,v!!�P.__..��...�,SdO----- F ;.._. R�/ ................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has .i.s..s.u..e b e f health. Signed ......................... n ...................... ...................................... i Dare Application Approved By .................... . . ...- ..:�.. 5— Application Disapproved for the fol owing reasons: ...........................................:............................................................................................ ................................................................................................................................................................................................................ ........................................ Dare Permit No. - �..............._ Issued ............../........ .......... ........................Dare....................................... u�r�ai---Prima w oo THE COMMONWEALTH OF MASSACHUSETTS 4 BOARD OF HEALTH TOWN OF BARNSTABLE C�Er#ifirate Of C�IIraplian e THIS IS TO CE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by . fAl e'o ................................................................................................................................................................................................................ • '• �tn.niuer at ... .16.....".... / ...............90&.Z..X-C' ...............1�../.�................/��Y.......................................................................................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..... ....... �....... dated ..-.�,.. .... g..r.��'S.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ... ...-...4 . ........................... Inspector-..... .......'�.. ...... THE COMMONWEALTH OF MASSACHUSETTS m. BOARD OF HEALTH TOWN OF BARNSTABLE No...75-- FEE.......: d... ... Biflpoiial Workii Tonotrurtinn "Prmit Permission is hereby granted A! ...------------------------------------------------------------------------------------------- to Constr c- ) o epair (✓ an Individual Sewage Disposal System y}� L R strce �,,/� as shown on the application for Disposal Works Construction Permit No.7�Jam—;, . Dated......_._.:.-�.r�i.'.� ..... (y Board of Health DATE.................. ....--� 5......................... v FORM 36508 HOBBS A WARREN.INC..PUBLISHERS S71�-- NOTES 4" SCH40 VENT WITH 1. DATUM IS NAVD 88 a w PROVIDE MIN. 20" DIAM. WATERTIGHT SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE CHARCOAL FILTER AS o° C Pov ACCESS COVERS TO WITHIN 6' OF FIN. GRADE MARKED WITH MAGNETIC TAPE OR SHOWN PLAN VIEW 2, MUNICIPAL WATER IS EXISTING OR COMPARABLE MEANS FOR FUTURE LOCATION. PITCH BACK TO SAS, ti (NOT TO SCALE) o v 2'0 H-20 CAST IRON COVERS TO GRADE NO LOW POINTS. C> o c a BED IN CONCRETE UP TO BINDER COAT PAVEMENT 2' CAST IRON COVERS TO GRADE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 2" PEASTONE OR GEOTEXTILE BED IN CONCRETE UP TO BINDER COAT PAVEMENT SLAB EL. 50.7 FILTER FABRIC OVER STONE 4. DESIGN LOADING FOR ALL PROPOSED PRECAST 04 • ' � UNITS TO BE AASHO H-2_Q o' � 50.0 MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 50.0' ��� Rout 28 -`" "--`----'` 6" MIN. SUMP NOTE: 2" MIN. WALL BLO 5. PIPE JOINTS TO BE MADE WATE GHT. � Q\r Locus R TI �' MIN. INT. DIM. �*47.6' THICKNESS REQUIRED MORTAR ALL PRE ST RISERS s : :.,...,. 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE o 4"0SCH40 PVC COMPONENTS H- 0 WITH 310 CMR 15.000 (TITLE 5.) PIPES LEVEL 1 ST 2' ENDS SIDES 47.0' 10• 4 (TYP,) INV'S EL 46.0'- 4' *47.4' TEE Pogo o�°� oSIDEoo 0 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 24" 24" ° ° ° ° 0��0 p ���0 ���� _���� > ° ° ° ° NOT TO BE USED FOR LOT LINE STAKING OR ANY a i TEE :. o ° ° o OTHER PURPOSE. o TEE 46.46 °°°°°°°° oo�000�aoao a®oo��a�000 ° ° ° °0 0 0 0 0 0 0 0 0 >°o •o 0 0 0 0 0 �o°o°o°o° O 46.7 'j GAS BAFFLE GAS BAFFLE ° ° ° ° ° ° ° ° ° ° ��®0000®®O® 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. o�o�o°o,�o_ nj Io°o°o°o° 000°o°o° �� O 916 GAL COMP. 534 GAL COMP. 46.12 '.°o..°.° ®���������� ������®�®®� °�°�°�� 44.0 Q o o 0 0 0 o 0 0 o f L •.:.. ,.. 6.0' 3.5' 46.29 0000 9 COMPONENTS NOT TO BE BACKFILLED OR Hya. E et WATER TEST D'BOX FOR LEVELNESS CONCEALED WITHOUT INSPECTION BY BOARD OF E/em. Sch. tt °' " u LH-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. HEALTH AND PERMISSION OBTAINED FROM BOARD girls J 0 0 0 0 0 0 -O--O- O O O-0-O O O O O (. • 0 0 0 0 0 0 0 0 0 0 0 0O O b 0 0 0 0 0 0 0 (^teV 0000000000000000000°000000000-0 000000000°0°0° 3/4'-1-1/2" DOUBLE WASHED STONE 4' MIN. OF HEALTH. o o_�_� n_�_� 0 0 0 0 0 V.0_�_n_0?o.o o (3) UNITS REQUIRED ALL AROUND PRECAST STRUCTURES *THE INSTALLER SHALL VERIFY THE 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 33.50' X 12.83' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCATIONS OF ALL UTILITIES AND ALL COMPACTION. (15.221 [2]) CALLING DIGSAFE (1-888-344-7233) AND BUILDING SEWER OUTLETS AND ELEVATIONS VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS MAP PRIOR TO INSTALLING ANY PORTION OF OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SEPTIC SYSTEM WORK. SCALE 1"=2000'f ( 3.5% SLOPE) 1 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 292 PARCEL 30 2% MIN. ( % SLOPE) ( 1 % SLOPE) SHALL BE REMOVED 5' BENEATH AND AROUND THE H-20 H-20 38.0' BOTTOM TH-1 PROPOSED LEACHING FACILITY. FOUNDATION- 25' SEPTIC TANK 17' D' BOX 14' LEACHING NO GROUNDWATER FOUND FACILITY 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND SAND. 13. VERIFY SOILS AT TIME OF INSTILLATION 99- EXISTING CONTOUR SYSTEM DESIGN. X 99•1 EXIST. SPOT ELEV. -[99]- PROPOSED CONTOUR GARBAGE DISPOSER IS NOT ALLOWED 198.41 PROPOSED SPOT EL EXISTING 4 BEDROOM DUPLEX TH 1 DESIGN FLOW: 4 BEDROOMS © 110 GPD = 440 GPD TEST HOLE USE A 440 GPD DESIGN FLOW 2� SLOPE OF GROUND MULTI-FAMILY HOUSING UTILITY POLE SEPTIC TANK: 440 GPD (2) = 880 FIRST COMPARTMENT 20 FIRE HYDRANT \ SEPTIC TANK: 440 GPD (1) = 440 SECOND COMPARTMENT �� \ - NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING \) 880 + 440 = 1320 GAL. O� USE A 1500 GAL. DUAL COMPARTMENT SEPTIC TANK LEACHING: TEST HOLE LOGS c SIDES: 2(33.5 + 12.83) 2 (.74) = 137 GPD BOTTOM ENGINEER: CRAIG J. FERRARI, SE #13871 ■ �°'� c CAUTION TOTAL: 33.5 x 12.83 (.74) = 318 GPD WITNESS: DAVID W. STANTON RS �� 0 GAS LINE 615 S.F. 455 GPD DATE: 1 1/1/2016 ° Tv v / PAVED VERIFY SOILS AT TIME USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) 2 MIN/INCH ��' AS � PARKING OF INSTILLATION WITH 4 STONE ALL AROUND PERC. RATE - CLASS I SOILS P# 15186 \ c 2 ELEV. ELEV. j �y,; ,' c� 5F MA 0„ 4 49, o„ 4 49' O ;\ �' �� ��'J �,Z\\ O SAWCUT AND PATCH APPROVED DATE BOARD OF HEALTH PAVEMENT AS REQUIRED SSL � TH2 -� TITLE 5 SITE PLAN 12" 10YR 2/1 10 10YR 2/1 BENCHMARK: TH1`D #418 s OF CBDH ELEVATION C/0 B B =49.0 NAVD88 0 / #416 & 418 BEARSES WAY SL SL ° OAL FILTER EXISTING 'DUPLEX AND PB GSCREEN (FINAL. VENT WITH CPLACEMENT HYANNIS, MA 40" 10YR 5/6 45 7, 36„ 10YR 5/6 46' SLAB EL 50.7 BY CONTRACTOR WITH HOMEOWNER #416 CONSULTATION) PREPARED FOR BORTOLOTTI CONSTRUCTION/ PERC C �� ass �� ALCORN •V � MS MS �� 49 T DATE: DEC. 7, 2016 7,9 8 SFt REV.. DEC. 19, 2016 (BOH COMMENTS) 10YR 7/4 1 OYR 7/4 `7 !' �0HOF4igss NOFMgssq �NofM. of S0„ off 508-362-4541 g sg� �r oC'� DAn i� �� :� fax 508-362-9880 o DANIELA. oyG o DANIEi__ �' " OJALA DANIELA. A `- . downcape.com CIVIL N o OJALA F' OJALA v CIVIL C� 'j No.40980 i down cape engineering inc. 132" 38' 132" 38' q No.46502 4,u _ , .1 r No.46502 � N� .,, 60 e- °�F�c�sTER`` `�, �o��F t F - < F ss�o �4//' civil engineers Scale: 1"= 20' `\CNAL ENG s FSS STe NG�� {q ss '40 land surveyors NO GROUNDWATER ENCOUNTERED NAL E _ SUR ! r �" 939 Main Street ( Rte 6A) 7�/�L� # ' 6_3 ,1� 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 ll l�L `t 16-349