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2, 4 FRESH HOLES ROAD - Health
2&4 Fresh'Hold.R d — - -- -- -- Hyannis o t b 1 1� o a TOWN ABLE.. LO A'li'IGN: 'SEWAGE 0-__-_._-__-- VILLAGE ����✓��S ASSFSSOWS-MAP INSTULBR'S NAND 8i I'ItQNE N0. $E'Pllc TAN. LSACi G—PAC.R=- ( e) C. ccr t�ef'�: . (5ixe). �4 lre c IVO: i 3SYTA: 1PIt.OR OAR: �t'BRNIITIDATE � .CpPJQ't..lArICE 1pA'�'E• „�„„� Sep6ti6a Dlstanca Batwee#Stoi blaxlmumljgstetl Cnauitdwptec,TabtBto ilie BnitamnfLs �;hln�Fic;iliEy. .. ,,.,:.., eal Private-wai s. Oly►' Jc;91 W Ue ohiag atiry gf-imly welfs.exist a�alto ae:wi!th,n�Op Beet-of lenstu�ig fuicllny)... l�aaa Ed�ri:6twetlani)aid Leaching eclllEy.(L@smy.vuetlupQs exist ivltlals100 feet bf leaching loci Fwrnlshad bye I J GJ i i i Tz> n, w Commonwealth of Massachusetts �9a ./gg Tov--t- Title 5 Official Inspection Form } i of Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd Property Address Tony Aliberti ' Owner Owner's Name U-' information is u required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 45'1 :99 1a301�_ 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 S13971 Telephone Number License Number B. Certification I certify that:l 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 theproperty 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 5-29-19 I spector'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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts . Title 5 Official Inspection Form i-.I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r „/ 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 " page. City(rown 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: System is in good working order with no sign of failure. Recommend pumping every two years for maintenance and to prolong life. 2) System Conditionally Passes: ❑ One or more system components as described in the "ConditionalPass" 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. I " 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 ON '❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i; hi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e•' !K 2-4 Fresh Holes Rd J Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 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 El ❑ 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): 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 Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface'Sewage Disposal System Form -Not for Voluntary Assessments 4+fn 2-4 Fresh Holes Rd "mot Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspec*ion 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: . r ❑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 nitrale 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 El ® 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 Foam:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form ? hl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments :r 2-4 Fresh Holes Rd z11r•T, > Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 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 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— IWPA) or a mapped Zone II 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 ? ri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town 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? ❑ ® 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? ' ® ❑ Wasthe 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. I +' 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systen-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ti 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 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 flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Description: Number of current residents: 7 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: 5-2019 Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 r . Commonwealth of Massachusetts Title 5 Official Inspection -Form Ni Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c%e �f� wJ ` � ' 2-4 Fresh Holes Rd �J r tom.,'� J Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspect on 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 i Water meter readings, if available: Last date of occupancy/use: pate Other(describe below): 3. Pumping Records: Source of information: Owner-----pumped 2018 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts ,, Title 5 Official Inspection Form of Subsurface Sewage Disposal System Form -Not for Voluntary Assessments >• ;ir', 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town 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/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2006 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24"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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts fw Title 5 Official Inspection Form 1.4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 18"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: 6" Distance from top of sludge to bottom of outlet tee or baffle 26" . 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts ,5 Title 5 Official Inspection Form !� taHi Subsurface Sewage Disposal System Form-Not for Voluntary Assessments • • °% 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 - 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 1 nspecti on)(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 Inspection 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 } A'h' 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) : 8. Tight or Holding Tank (cont) 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 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. 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 of Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments in r /r7 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town 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: 4-3050's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official . Inspection Form r r4 Subsurface Sewage'Disposal System Form.-Not for Voluntary Assessments KI 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 I page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach field is split into two parts. Half of leach field marked "4"was filled to capacity at inspection. Half of field marked "3"was about half full at inspection. Recommend access ports for pumping, and pumping every two years for maintenance and to prolong life. I 12. Cesspools (cesspool must Ce 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.): r ' t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systerr:-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .r 2-4 Fresh Holes Rd r�T•Tty Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis annis MA 02601 5-29-19 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 l 4N, Commonwealth of Massachusetts Title 5 Official Inspection. Form >i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd J Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 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 0.Ic 3 jr C. x t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systerr•Page 16 of 18 Commonwealth of Massachusetts a ,y Title 5 Official Inspection Form Ai Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar i ❑ Shallow wells Estimated depth to high ground water: 20 feet I 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: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 c ° Commonwealth of Massachusetts .� Title 5 Official Inspection Form ial Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 2-4 Fresh Holes Rd J' Property Address Tony Aliberti Owner Owner's Name information is required for every Hyannis MA 02601 5-29-19 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist - Complete all applicable sectiorts of this form 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: TighVHolding 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 i t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 t a TOWN 0 I,JCATION �,�—� �jt` �B� STABLE t SEWAGE# 6"7 VWLAGE v►vit ASSESSOR' MAP&PARCEL �� I INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY. (type) (size) NO.OF BEDROOMS L/ Yc -),I r 2 I c OWNER PERMIT DATE: COMPLIANCE DATE: �P 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 N . { I�L No.��/,, ` , ._ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ..PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for �BigozaY �bpztem Conztrurtiun Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(') ❑ Complete System ❑Individual Components Location Address or Lot No. a—F I(�S d�Q Owner's Name,A dress,and Tel.N Assessor's Map/Parcel r� '2 ki Ins� Napes,Gddress T�� Designer's Name,Address and Tel.No. f4g V ef Z__V Type of Building: L/ Dwelling No.of Bedrooms Lot Size (4 3, 1 i 0 sq.ft. Garbage Grinder ( ) Other Type of Building yc No.of Persons Showers( ) CafeteriaIs ( ) Other Fixtures ` t Design Flow(min.required) L "�t/ gpd Design flow provided gpd Plan Date Of--.Z?f-(�)(D Number of sheets Revision Date Title C�t ` Size of Septic Tank 1 W-- Type of S.A.S. 5,0 ,>0 Description of Soil 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 the system in operation until a Certificate of Compliance has been issued by this Board of S ned Date 7 p t?'e& Application Approved b Date o -Application`.Disapproved.by: Date for the°following reasons Permit No. © Date Issued N ..... -. _� ':iC �.., �,...ti„r �;.•-� Y-i:i. `_..' -G.'s'�{.:,y;�„i-" •�-•r"'v✓°4-n.+>.•'q.•'i�.r.""nl''„'l�yf"`""'y''"wy."""". .y: .`/`„�//1 +, No. � ",. y Fee THE COMMPN ALTH OF M'ASSACHUSETTS Entered in computer: Yes .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplication for �igpogaY`)�pgtem CongtrUction permit w. r Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Irt"S r/1 Owner's Name, dress,and Tel.N�pr - 1 ! - � IA- !S 14 v`Tln�v� (a �I Assessor's Map/Parcel• IpaH N ,Addres Tel.No� Designer's Name,Address and Tel.No. Type of Building: L/ LJ Dwelling -No.of Bedrooms Lot Size Y� ' sq. ft. Garbage Grinder Other Type of Building � No.of Persons Showers( ) Cafeteria( ) } Other Fixtures Design Flow(min.required) L4 LA y gpd Design flow provided gpd Plan Date ���Z"1!)�O Number of sheets Revision Date Title 1C t Size of Septic Tank 1 Uv vim--- Type of S.A.S. 3�So ZO Description of Soil N - --ro -e e r w, A'\- —'t vvL_ O F- I h- 0;-11A j Nature of Repairs or Alterations(Answer when applicable) i Date last inspected: y 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 gf 44ealth. ' fined . i , late D--Q Application Approved b 4 ,. V. Date ce Application Disapproved by: Date ! for the following reasons ` .. - Permit No. Cam"- '' © Date Issued ( T, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY the 1On-site Sewage Disposes 1'System Constructed ( ) Repaired ( ) Upgraded Abandoned( )by O pe S ��` `I C— at � 4 �'Y'Ps 141 has//bb�een constructed in accordance 1 with the provisions Title 5 d the for Disposal System Construction Permit No. C ^y�dated r J� Installer r� � S � Designer � #bedrooms Approved design"flew !_ — q '1 gpd 1 The issuance of this permit shall not co struedIa guarantee that the system will function as e i d. Date ��� � Inspector ——— ————— No. � � � �!J � — Fee /OV THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS ligogal �&pgtem CongtrUction Permit Permission is hereby granted to Construct ( ); j +epa r I( '-I)' t Upgrade (Abandon ( ) System located at Z-i-� 5 -- 14.o a 0 CAL V,._LA N G 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. f Provided: Construc•'on must be completed within three years of therrdat�his permit. Date ` Appro•C4 by —`� Town of Barnstable t"E T°`�. Regulatory Services Thomas F. Geiler, Director • MAJMW eet.e, 9� HAS& ' Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer & Designer Certification Form Q i Date: 1 Designer: Shay Environmental Services, Inc. Installer: q( � LA:=,�- i Address: P.O. Box 627 Address: East Falmouth, MA 02536r' On was issued a permit to install a ate) 1 (installer). i septic system at based on a design drawn by (address) Shay Environmental Services Inc. dated (designer) , I certify that the septic system referenced above was installed substantially according to i the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. . i I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. ,AOFhgSS�C`. , CARMEN ti�N (Installer's nature) E. 4i U : SHAY N No. 1181 0 01STeS S N signer's Signature) (Affix De > p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- ; BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form i (I F L07 T ION2-�� S EW A G.E;. PERMIT �� 6� /fie -/2b " & T VILLAGE INSTA Ll"E NAME •A+ AD!D 2 E S 4 GUILDER.: P' ll SOWN ER f �G DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 0 t - N r90 'el THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................OF.......................................................:::............................... Appliration for Uhipaii al Works Tomitrnrtiun itamit Application is hereby made for a Permit to Construct ( ) or Repair 00 an Individual Sewage Disposal System at: ..... - �. .�.Lo.a!'o- .................. n-Addre r No.. • -------- - --- ....:... ..... • —�..�..".w-er._ ..... �.._ ....................+(` Ot Address Installer �J Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No. of persons............................ Showers — Cafeteria a YP g P ( ) ( ) Otherfixtures .................................-`-...................------•••-•--•----••-•--------------•---••-•--•-•-----•.......•-••-••---------•.........------ W Design Flow............... -.:._..__.___.___._..gallons per person per day. Total daily flow...... 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........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' ------------------------------- ••----•------------------•---••---.._...........................................-.......................................... 0 Description of Soil........................................................................................................................................................................ x W ••-•---------------•••---•-----------------•----•••----------••-••••-••-•-•••••-•-•---•-----------------•--- --------•------- ----------- UNature of Rep irs or Alterations—Annsswsr whg>} p icable_ .................................. r............. ------ ---------� '`'r........... .... ------S ............................................................ Agreement: The undersigned agrees to install the afo edescribed Individual age Disposal System in accordance with the provisions of iiTLi±. 5 of the State Sanit' Code—The undersi ed agrees not to place the system in operation until a Certificate of Compliance has n issued b the bo d iealth. g ined............... --7............................... --- f rf 3...... ..._ /�Application Approved By...... =--- --- - -- .,r...��,. ----------------•------- '. ;. Application Disapproved for the f oll i reasons---------------------------------=•-•--------------------------•-------------•--••............--••--------•••--- ------•------•...._....•--•-----•----••---•---•••---•••------...-•--••---••••-----•-----------------••••.•----•-•••--•-••-----------•-••-•--•••---•-•••--•-------•----•--------•----•••••••••----•-••-•- Date PermitNo......................................................... Issued....................................................... Fizz............................ THE COMMONWEALTH OF MASSACHUSETTS'� BOARD -OF .HEALTH ......... .. . . ..........:..:.....OF-..,,...- .......-........-...........-------- •------------._..........::....... AVVItration fur 1tsposa -Works TvnstfttdW4'�VrrrAft . ' Application is hereby made for a Permit to Construct ( )` or Repair. (4-) an Individual' Sewage Disposal System at i't .......... _ .... .. -- .........- ...:...:... L �t ocation-Address f /J or Lot No / 1��1 ter �L k:_ • 4C '......................— ................................................................ .................................... .... . -71 -- Awner Address L7 ........................................................ ���-_r2t P ) '. Installer Address pq Type,of Building Size Lot.:--- •-•••...........Sq feet. V Dwelling—INo. of Bedrooms.__... Expansion Attic Garba a Grinder Other—Type of Building, ..I No. of pers6ns7............................Showers — Cafeteria Otherfixtures ..................................................• .................................................... ........ Design Flow............. �j::..;:.. gallons per person per day. Total daily flow___. ` ,,... ` ...._ ......_gallons. W Septic posal Trel I iquid capacity_._.:.____.. lions Length _.__. ._.__. Width Diameter _:.: Depth i Tank Trench—•No_____________________ Width.................... Total Length....................... Total<leachmg area...................sq. ft. Seepage' Pit No._..:_.�............. Diameter ..................... Depth below inlet..................... Total.leachin'g area.:.;. ..........sq:'ft. z Other Distribution box ( .,.) Dosing.tank ( ) '~ Percolation'Test Results. Performed by=--------------- -----=-----.......................................................... Date................................... 1.4 Test;Pit No.. 1_:..............minutes per inch Depth of Test Pit.....................Depth to ground Water......................... . L>`I °.Test Pit No: 2................minutes per inch Depth.of Test Pit.................... Depth to ground water......................... ...........--•-•-••------------- ..__.....................--•------•- D�escription of Soil.................................•---.....-- ----_... -•-••---._....::--•-=----•---------•--•------ ------ ........................ x W -- -- --•- -- ---- --------- --- -------- ---- ----- x Nature-of p _ PPS . ---� ........0 e of Re airs or Alterations Answer when a (cable.__?_.�'_ L!r ! 1 1 11 r<(S ��L.(_ i� L L)Z (�. LU/ '? S Agreement: 1 �7 The 'Undersigned agrees to install the aforedescribed Individual Sewage-,Disposal System in accordance .with the provisions of T.iTLS 5 of the State Sanitary Code—'The undersigneurther agrees not to.•place'the system in. operation:until a Certificate of Compliance has, een Issued by the boatd\o health Ic- Signed......:. v ..._ Application Approved B f - �1��_. ��,/� � --•------... ._��%f% /_.... r PP. Y = ` /` date Application'Disapproved for the follozvmg"-reasons__ ............... '--:•-................................. -, - -� ....................................•---....------------------------------- _-_.. - Date PermitNo.........................................._..___......... Issued. `• '.......................................... Date:- THE,COMMONWEALTH OF MASSACHUSETTS' BOARD .:OF HEALTH OF... %�� v..�✓,�i/f . . ...,. ....... . C�rr�tif�rtt�r ,af �unt�li��crr - . THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ;(- ) or Repaired :- � by ,/... nst al has been installed in�accordance with the provisions of:TITLP, 5 of The State Sanitary Code as described m the application for Disposal Works Construction Permit No _ .._. ......... _......__. .__.___. dated THE'-ISSUiWCE`OF THIS CERTIFICATE''SHALL NOT BE CONSTRUED AS'A GUARANTEE THAT-THE, 'SYSTEK WILL` FUNCTION SATISFACTORY �,�v �, DATE:... .__---•- ...... . 1 ....... .-•----- .....---- Inspector.....- �' .. THE.COMMONWEALTH, OF MASSACHUSETTS BOARD -:OF-HEALTH / ... OF � .... . �... -- EE ) FSNo.. ....... Drier tY1tt P - Permission is hereby grant .................................................... ---- ' to Constiuct 7( ) or,Repair ( ) an Individual Sea,age Disposal System at No: ....�� .... _ee --- fir-..i s /i.1 /l _ Street n Permit Nas.shown onthe a llcation for Disposal WorksConstructio -- T Dated,_- ........ ...... Z`3oard of Health. DATE-=-----------F �-�, :'FORM 12551...H6BBS'& WARREN,' INC., PUBLISHERS'— Tovwn of Brnstable P# Department of.Regulatory Services Public Health Division Date Mesa 200 Main Street,Hyannis MA 02601 C(I (Q P��v 'Time Fee Pd. Date Scheduled _.—.—.-r- • i ,foil Suitability Assessment for SpwdQe Disposal C Witnessed By:. Performed By: LOCATION & GENERAL INFORMATION Owner's Name R C4c�tatl Location Address a 4 F-IeC—hO\2S '� C �e���S,�•� I Address Engineer's Name Assessor's Mapmarrcel: R9,�), 1188 3� —�� I REPAIR I Telephone# ie NEW CONSTRU�`P(ON 11 � Slopes(%) �b Surface Stones • Land Use i ��_ft Drinking Water Well _fr Distances from: Open Water Body� ft Possible Wet!Area nI) ,�f 8 1 ft Other Drainage Way ` ' A ft. Property Line SKETCH:($treat name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands in proximity to holes) h,�,tf ngr Depth to Bedrock Parent mateiial(gedlogic) act�7 . lH ! Weeping Prom Plt Face Depth to GroundwaWr. Standing Water in Hole:' i I Estimated Seasonal I}igh Groundwater DtTERNIINATION FOR SEASONAL HIGH WA'Y'� TABLE Method Used: �. Itl. In. Depth to sail motucs: � Depth Observed standing in obs.hole: , in, oroundwater Adjustment Depth toiweeping from side of obs.hole: p�,{actor• �— Adj.aeoundwater Leval Index Well# Reading Date: Index Well Icve PERCOLATION TEST Data ___ TImeLa3D Observation L_ f Time at Hole# ; a t' Tltne at 6" Depth of Pere 'lime(91'•61 Start Pre-soak Tttne.19 -- i End Pre-soak ` �aMP . Rate MinJlnch Site Suitability Ass0sment: Site Passed Site Failed; Additional Testing Needed(Y/N) original: Public He'�Ith Division Observation Hole Data To Be Completed on Back-------- You must first notify the ***If percola#6n test is to be conducted within loo, of wetland, Barnstable C411j servation Division at least one(I)wedk prior to beginning• , 'DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Stru4-,Stones,Boulders. iConsistencv.%Gravel) oZ 5'c)o Cobb1� . I W4 - 5 YI 1:3613?o DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture So1l Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consittencv.%Cravel) -tag a.s � �I-3 C s /C&bk!� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Sol Texture Soil Color Soil Other Surface(in.) {USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi t c Gravel) i r ;DEEP OBSERVATION HOLE LOG Hole# ' Depth from Soil Horizon Soil T-..xture Soil Color Soil Other Surface(in.) ' (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConsisLency.%Qrmyel) Flood Insmrite Rate Map: Above 500 year flood boundary No— Yes Within$00 year boundary No—L-1, Yes Within 100 year flood boundary No v Yes Depth of Nafidaffy Occurring Pervious Material Does at least fo feet of naturally occurring pervto s material exist in all areas observed throughout the area proposed Or the soil absorption system? If not,what-is the depth of naturally occurring pervious material? Certification I certify that on, (date)I have passed the soil evaluator examination approved by the Department of. nviro en 1 ec ' a at the above analysis was performed by Me consistent with . 'the required training xpe pe ' ee described in 310 CMR 15.017. r Signature Date i Q:1SEP71C1PERCMj RM.DOC SECTION A -A s�rr�.itcr,Tiar9�4b11M° a. ,` �' VENT PIPE (O Least 24 inches tall) ;` `�F ems""` s Bdrrr�stasyw 'NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. Schedule 40 PVC w/Charcod Odor Filter, �house 10' min. from PROFILE VIEW OF LEACHING SYSTEMExisting Foundation to septic tank D_9Dx ewer must be l �° It TOP OF FOUNDATION s ELEV. 100.00 (Assumed) Septic tank covers must nrRinin 6 in. of finished grade Not to Scalewith `� Septa Bin. of finished �" VN • Mods over Septic Tank-99.00 tirade over D-8m- 99.00 over SAS 99- .00 3" Of 1/8" - 1/2" Washed Peastor t l; s s 0.02 3/4" to f f/2 " Washed Crushed Stops 3 HOLE H-20 To of SAS-Elev.=94.75 _ 10' EXIST. y"0,01 or treater sT. eox 3' Maximum Cove P 4" PVC (CAPPED) INSPECTION PORT TO BE 4+ m u�i 1,500 GAL s< o.ol• INSTALLED AND TO BE WITHIN 6" OF GRADE ' _ F ds r FROM EXIST. fOlil/DATI[!1 w m SEPTIC TANK N 5' Per foot rn 00 50• Effective Depth CONCRETE SLAB FOIINOYL > 1 H-10 N SYSTEM PROFILE 6 In.�/da• r o o o `� N .+ ab�,wMo»s.R�». a».., n.►".�..ao.:„,.� Not to scale ` carp = -�- 4' - , ' - C, 24 Effective - - 4 4 Sidewatt GENERAL NOTES II II 6 in.of 3/4•-1 1M y 2+ 2 Units @ 7' = 14' 1. Contractor is responsible for Digsafe notification, Verification of Utilities NOTE: ALL COMPONENTS MUST HAVE RISERS TO NATHIN 6" BELOW GRADE mmpoctea Effective Width w 5' 4' ,5.. and protection of all underground utilities and pipes. -.1 2. The septic tank and distribution box shall be set t w • , Effective Length level on 6" of 3/4"-1 1/2" stone. 7' 3. Backfill should be clean sand or gravel with no E stones over 3" in size. 1 4. This system is subject to inspection during installation PERCOLATION TEST II �� , 15 m S❑IL ABS❑RPTI❑N SYSTEM (SAS) by Carmen E. Shay - Environmental Services, Inc. w 1 5. The contractor shall install this system in accordance `► ``' (OR EQUIVALENT) with Title V of the Massachusetts state code, the approved plan wet Date of Percolation Test: Grour w observed - NOW OBSERVED and Local Regulations. Test Performed By. CARMEN E. SHAY, R.S., C.S.E. NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30 /EFFECTIVE HEIGHT IS 24 6. If, during installation the contractor encounters any Results Witnessed By. Donald Desmarais/Roger Roberts soil conditions or site conditions that are different EXCAVATOR: Roberts Septic Service Au ounEr Pm nwm THE from those shown on the soil log or in our design Percolation Rate: Q MPI DIST11118U71011 SET LENSL FM� BE ,2'LEAST 2 Fr. oaaE,E oovER installation must halt do immediate notification be �� ,� 1. Contractor is responsible,for Digsafe notification, LOCATION VERIFICATION made to Carmen E. Shay - Environmental Services, Inc. Test Hole Test Hole aaao s • ' and .protection of all underground utilities and pipes. 7. No vehicle or heavy machinery shall drive over the No. 1 No. 2 - as• ouTiFT i2• "LET septic system unless noted as H-20 septic components. DEPTH soles ELEV DEPTH SOILS ELEv. s I1 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. 0 99.00 o 99.00 - µ• r 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. �,my Sandy lay- 4• - SCH 40 T• ,'/s• 40 POLYETHYLENE LINER FROM ELEV. 10. All solid piping, tees do fittings shall be 4" diameter ,o o 3/2 ,o�3/2 PLAN SECTION CROSS-SECTION 98.00 to 92.00 AND TO EXTEND 10 BEYOND FOUNDATION Schedule 40 NSF PVC pipes with water tight joints. 0•_g• Ae 98.25 0"-9" As 98.25 11. Municipal Water is Connected to ALL OF The Residence and Abutting S°ndy Sandy 3 HOLE H-20 DISTRIBUTION BOX Properties within 150 Feet. 10 TR 5/6 10 TR 5,M NOT TO SCALE THE _ 9"- 42" Be 5.50 9"- 42" Be 95.50 � �' COMPILED FROM LITHE SUNES RRVEY PLAN XIGENERATED BY Med, Med. O i i BARNSTABLE, MA ENTITLED Sand _ BEARSE n3i: KELLOG, z r 7/3 25 Y d NOTE: LOCATION OF NATURAL ` f� "SUBDMSION PLAN OF LAND IN BARNSTABLE, MA" LC 17786-C 3s 144 G 87.00 42'- 12o G es.00 GAS LINES NOT VERIFIED DATED MAY 21, 1954. IT SHOULD BE USED FOR NO PURPOSE P, OTHER THAN THE SEPTIC SYSTEM INSTALLATION. r` 03� ASPHALT EXISTING CESSPOOLS TO BE PUMPED OUT AND REMOVED PROJECT BENCH MARK A � ' �� DRIVEWAY i 6o NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE TOP OF FOUNDATION 'v � �� �! OO O " ` z�, ELEV._= 100.00 (Assumed) ,A , , O• O 4 F'06 - 5' FROM THE EXISTING CESSPOOLS TO BE DISPOSED , HOLE1 _ OF.AS PER BOARD-OF HEALTH SPECIFICATIONS. O i r(+h �' Veo Pipe \ ELEV - 9.00 _ Perc #1 L � , �� �F�.x• � THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Depth to Perc: ENE LINER ,� i' _ • �.'� ASSESSORS MAP 292, PARCEL 188 40 POLYETHYLENE Perc Rate= <2 MPI \ _ Groundwater Not observed FROM ELEV. 98.00 to 92.00 � No Observed ESHWT i/ '�i . �' \ ry's 5 --___. _, LEGEND ADJUSTED H2O Elev. = None AND TO EXTEND Gj tea/ \ 4' 10 FT. BEYOND TANK FND. r s. DENOTES PROPOSED 3-24•EXAM. ACCESS MAMHOU3 �y i`� 12 & #4 SPOT GRADE ' xy DENOTES EXISTING �- • -:. �'-e� -.• `` x 104.46 SPOT GRADE EXISTING 4 BEDROOM PL PROPERTY LINE MET1 1 ; o �' HOUSE PROPOSED CONTOUR OLM ET INLET00 THE ACCESS COVERS FOR THE SEPTIC TANK. j ' DISTRIBUTION BOX AND LEACHING COMPONENT 1 O D-Box ------97 EXISTING CONTOUR SHALL BE RAISED TO "THIN 6" OF -^r--=z- - --.-r-- I (Z CONCRETE SLAB a•t•i� `' z' •: ::y- a •�::..., FINISHED GRADE I O �4 PVC STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS I i FOUNDATION p K Vent Pipe i cod DEEP TEST HOLE & PLAN VIEW ON ALL OUTLET TEE ENDS 0) d' \ h' ® PERCOLATION TEST LOCATION REM OVABLE 6 FOOT STOCKADE FENCE 4• MOVABLE COVERS I N a I � � f ' `t-rR':.�t \ ��• EXIST. •4%;�- 1500 • 4 >_ T Failed 3•mh�daunanw -� Y - - . IeEr \�,ELEV H 99 00 .� � `! \ Septic ank Leach Pit INLET- rein 2•rain,rret to Outlet I.M, \ 0 =% • ---- _ aunET 3��, - ,o•vine► � +� `� fry' sti _ V -r _ ��rain s-r �`. - - P 0 T P LAN j bs 0.Own* i• Liquid depth OF PROPOSED SEPTIC SYSTEM UPGRADE ,D'-a• tr-6' _ `\` PREPARED FOR CROSS SECTION END-SECTION r5ro ANTHONY J . ALB I ERTI -10 LOADING 1500 GALLON SEPTIC TANK �00 a AT TYPICAL (FI , #362 #364 NOT TO SCALE ##2 #4 FRESH HOLES ROAD � � � HYANNIS, MA Design Calculations ASS Number of Bedrooms: 4 Equivalent to 440 Gal./Day \` `�\ ��` q`y� PREPARED BY: Garbage Grinder No `� `� `�` r tr �, SHAY Leaching Capacity Proposed: 440 Gol./Day `� `� o CA R�1�'N E. S Septic Tank 2 550 Gal. Da = 1100 USE EXIST. 1,500 GAL. Septic Tank. ` ` �� " � : - x / y �. `. ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of Q min.,Iinch Bottom Area: 0.74 gal/sq. ft. x 204sq. ft. = 151 gallons ` ` STER�o P.O. BOX 627 Sidewall Area: 0.74 gal./sq. ft. x 116 sq. ft. = 85.84 gallons VARIANCE REQUESTED: �� `� `�` 0 20 40 5 SANITAP-I" EAST FALMOUTH, MA 02536 Providing: = 236.8 gallons/TRENCH x 2 TRENCHES TOTAL = 473.6 GPD 1. REQUEST AVARIANCE TO INSTALL SAS 5' FROM SIDE LOT LINE `� �� TEL/FAX : 508-539-7966 2. REQUEST AVARIANCE TO INSTALL SAS 5' FROM FRONT REAR LINE Use: (2) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH, (PER TRENCH) `. `� `. SCALE: 1"=20' DRAWN BY: CES DATE: SEPT. 22, 2006 (4' W x 7' L) TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND 3. REQUEST AVARIANCE TO INSTALL AN SAS 6.4 dt 9 FEET FROM 1.5' OF WASHED STONE ON THE ENDS. EACH TRENCH 12'W x 1TL x VD - 2 TRENCHES TOTAL A SLAB FOUNDATION (40 MIL RUBBER LINER PROADED. _ `.� SCALE: 1 =20 PROJECT#SD968 FILENAME: SD968PP.DWG SHEET 1 OF 1 r,>t�1&,� SECTION A -A skiwa - ;�, �` " VENT PIPE (0 Least 24 Inches tall) M1` °� �Mwr~itcryFr *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. Schedule 40 PVC w/Charcoal Odor FAter t f `" H ' Existing Foundation �house'to nptic tank PROFILE VIEW OF LEACHING SYSTEM , Septic tank covers must be D-BOX ewer must b. TOP OF FOUNDATION s ELEV. 100.00 (Assumed) within 8 in. of finished grade Not t0 Scale 1 Y e within 8 in. of if grader lirode war Septic Tank- 99.00 f?ad*wen D-Sm-".00 war SAS-99.00 r2s 7 ..• -7r` +� i;• l 3' of 1/8" - 1/2" Washed Peaatawte - l ' r, 2 F ra s Ih 3/4" to 1 1/2 ' hashed Crushed Stara l ;` ' +' ,• ,: `` - ,, S 0.02 3 HOLE H-20 �. EXIST. s-o.ot or Greater sr. BOX 3' Maximum Cove Top of SAS-Etev.=94.75 4" PVC (CAPPED) INSPECTION PORT TO BE EKIST-raE � to 0 1,500 GAL s• s" oar'per foot INSTALLED AND TO BE WITHIN 6" OF GRADE to "' SEPTIC TANK N r._ �. •.•r ,; , FROM EXIST. Fpl1NDATn?t rn rn g m 50• ' Effective Depth ra', '' ,r _ x s -`•. I _? > 1 H-10 ` N rc wens •- tp3 - `s$t CONCRETE SUB o 1 c 2 O SYSTEM PROFILE o 8 In.of 3/4'-t 1/2• o > o ,-- 24 Effectiveh Mao:..��e» �6 compacted atone 5 a -� 4> Not to sale S - a� 4 4 i SidewaZt II II GENERAL NOTES 2 units @ 7' = 14' 8 In of 3/4'-1 1/2" > 1 2' 1. Contractor is responsible for Digsafe notification, Verification of Utilities NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE carrtpocted done Effective Width W 4 and protection of all underground utilities and pipes. � S' 'S�� 2. The septic tank and distrl ution box shall be set Ld Effective Length level on 6 of 3/4'-1 1/2" stone. 3. Backfill should be clean sand or gravel with no o E 7' stones over 3" in size. p� 0 4. This system is subject to inspection during installation PERCOLATION TEST w o SOIL ABSORPTION SYSTEM (SAS) by Carmen E. Shay - Environmental Services, Inc. .� m 5. The contractor shall install this system in accordance Dote of Percolation Test: cYastdwater Observed NOW OBSERVED (OR EQUIVALENT) with Title V of the Massachusetts state code, the approved plan - „ and Local Regulations. Test Performed By. CARMEN E. SHAY, R.S., C.S.E. - NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30„ /EFFECTIVE HEIGHT IS 24 Results Witnessed By: Donald Desmarais/Roger Roberts 6. s during installation the contractor encounters any soil conditions or site conditions that are different EXCAVATOR: Roberts Septic Service ALL OUTLET PM FROM THE Percolation Rate: <2 MPI DISTaBUTON BOX SHALL BE Le ATE COVER from those shown on the soil log or in our design SET LEVM FOR AT LEAST 2 Fr. installation must halt at immediate notification be , 1. Contractor is responsible for Digsafe notification, LOCATION VERIFICATION made to Carmen E. Shay - Environmental Services, Inc. Test Hole Test Hole 13HMOUTS _ and protection of all underground utilities and pipes. 7. No vehicle or heavy machinery shall drive over the No. 1 No. 2 _ s ' aunFT tz• LNLET septic system unless noted as H-20 septic components. DEPTH ELEv DEPTH SOILS ELEV t _ B. Install Tuf-rite gas baffles or equals on all outlet tee ends. 0 99.00 O 99 __ i9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. LoamyLoarndy tas 4' - scH 4o T ,.Ts• 40 POLYETHYLENE LINER FROM ELEV. 10. All solid piping, tees d1: fittings shall be 4" diameter to rs1 y to Ta 3/2 PLAN SECTION CROSS-SECTION 98.00 to 92.00 AND TO EXTEND 10 BEYOND FOUNDATION Schedule 40 NSF PVC pipes with water tight joints. 0. 10 Ae 8.25 0"-9' As 98.25 11. Municipal Water is Connected to ALL OF The Residence and Abutting oarny s°Oomy 3 HOLE H-20 DISTRIBUTION BOX 9 Properties Within 15o Feet. to rR 5/0 to YR s/b NOT TO SCALE / THE PROPERTY LINES ARE APPROXIMATE AND 9'- 42' Be 95.50 9'- 42' Be 95.50 / Med. Med. O COMPILED FROM THE SURVEY PLAN GENERATED BY BEARSE & KELLOG, BARNSTABLE, MA ENTITLED Sand sand as T 7/3 28 r 7/3 NOTE: LOCATION OF NATURAL *SUBDIVISION PLAN OF LAND IN BARNSTABLE, MA" LC 17786-C GAS LINES NOT VERIFIED DATED MAY 21. 1954. IT SHOULD BE USED FOR NO PURPOSE 36"_ 144 C, 87.00 42'- 126 G 89.00 , OTHER THAN THE SEPTIC SYSTEM INSTALLATION. �P PIS AY EXISTING CESSPOOLS TO BE PUMPED OUT AND REMOVED PROJECT BENCH MARK �) NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE TOP OF FOUNDATION r �V �' p� O .�,� 5�ZT' FROM THE EXISTING CESSPOOLS TO BE DISPOSED ELEV. = 100.00_ (Assumed) s' �., ..�. ., ra i+.c1r� Tit., r O' _4 _ P�c ,._ R_ �• _, _ �,. HOLE- 1 _ _.- --__ _: =-. � - _.__._.__-- -._ _ _ - - e __(Assumed) ___ �` Veraf Pipe � EL.EV 9 00 yr -AS Fcr� ov.,w i!'r HwLT'ri �P�.,�� � ��., .,A TvS. / •' �\ THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Perc � Depth to Perc: ASSESSORS MAP 292, PARCEL 188 / Perc Rate= <2 MPI 40 POLYETHYLENE LINER �� i _ Groundwater Not observed FROM ELEV. 98.00 to 92.00 �4it / =w s g - LEGEND No observed ESHWT AND TO EXTEND / '. -- ADJUSTED H2O Elev. = None i i g4' 10 FT. BEYOND TANK FND. , �, , b DENOTES PROPOSED / #z & #4 104X1 SPOT GRADE 3-2e IMAM. ACCESS MANHOLES Y �`� tiX , X 104.46 DENOTES EXISTING SPOT GRADE EXISTING 4 BEDROOM PL PROPERTY LINE INLET HOUSE 96 PROPOSED CONTOUR- l O oo, INLET = �� `� `� THE ACCESS COVERS FOR THE SEPTIC TANK. ' DISTRIBUTION BOX AND LEACHING COMPONENT D-Box - -----97 EXISTING CONTOUR _ = SHALL BE RA TO WITHIN 6" OF , _ ISED I � � CONCRETE SLAB FINISHED GRADE. I O �4" PVC ` STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS K Vent Pipe j FOUNDATION O 60 ® DEEP TEST HOLE & ON ALL OUTLET TEE ENDS PLAN VIEW �y' PERCOLATION TEST LOCATION 3-24•REMOVABLE carats EXIST. �1500 gal. �, 'r 6 FOOT STOCKADE FENCE -ram. TEST H LE 2 .� = Failed =- • . � � i \ .y; � Septic ink Leach Pit 3'mh~dearance tY ..� \ELEV = 99.00 INLETg mh r 2'min. fist to Outlet e. \ 0 ='•:}1 ---- OUI ET 10•mH. ��'"'•"w ti '\ �" 9 LAN s -r a•-o-min 's•_ ~ \ \ 9P LOT P bo "" Liquid depth ' \\ '\. \\ 1 • ' ��� a '\\ OF PROPOSED SEPTIC SYSTEM UPGRADE `i 't�-o• 5-W \\\ PREPARED FOR CROSS SECTION END-SECTION \ \` ANTHONY J . ALB I ERTI \ AT TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK ooT \\ #362 #364 ##2 & #4 FRESH HOLES ROAD NOT TO SCALE IP/1 o, �, HYANNIS, MA Design Calculations �qJ Number of Bedrooms: 4 Equivalent to 440 Gal./Day �\\`\\\\\\`\` '\ °' �� `� s PREPARED BY: Garbage Grinder: No \` \` `\' C M �G`n CARMEN E. SHAY Leaching Capacity Proposed: 440 Gal./Day `\\ • o Septic Tank - 2 x 550 Gal./Day = 1100 USE EXIST. 1.500 GAL. Septic Tank. `\ `� \ " S, y \� ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch `\ `\ \ N`\ F �� P.O. BOX 627 Bottom Area: 0.74 gal/sq. ft. x 204sq. ft. = 151 gallons VARIANCE REQUESTED: '\ \\�`\ N`\ 0 20 40 50 STER EAST FALMOUTH, MA 02536 Sidewall Area: 0.74 gal./sq. ft. x 116 sq. ft. = 85.84 gallons \ N1. \ `iNt/TAP.?P� Providing: = 236.8 gallons/TRENCH x 2 TRENCHES TOTAL 473.6 GPD 1. REQUEST AVARIANCE TO INSTALL SAS 5' FROM SIDE LOT LINE `\ \ ` TEL/FAX 508-539-7966 Use: (2) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH, (PER TRENCH) 2• REQUEST AVARIANCE TO INSTALL SAS 5' FROM FRONT REAR LINE '\ �\ �` \` `� SCALE: 1"=20' DRAWN BY: CES DATE: SEPT. 22, 2006 (4' W x 7' L) TO BE USED WITH 4' OF WASHED STONE ON THE SIDES AND 3. REQUEST AVARIANCE TO INSTALL AN SAS 6.4 do 9 FEET FROM '\ \ , 1.5' OF WASHED STONE ON THE ENDS. EACH TRENCH 12'W x 1TL x 2'D - 2 TRENCHES TOTAL A SLAB FOUNDATION (40 MIL RUBBER LINER PROVIDED. `\� SCALE: 1 =20 PROJECTSD968 FILENAME: SD968PP.DWG SHEET 1 OF 1