HomeMy WebLinkAbout26, 28 FRESH HOLES ROAD - Health 26&28 FRESH HOLF&RD., HYANNIS
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Town of Barnstable
Regulatory Services
OF THE Tp�
o Richard V. Scali,Director
Building Division
■ �sxsrasc.E. « .
Paul Roma,Building Commissioner
1639.
°TEo a 200 Main Street,Hyannis,MA 02601
www.town.barnstable ma.us
Office: 508-862-403 8 Fax:. 508-790-623 0
Approved:
Fee: _
Permit#: - -
HOME OCCUPATION REGISTRATION
Date: r i
Name: 4-4p Phone#:_,i Z� 02-1
' - V -r TT
Address: Village:
Name of Business: �4�A ecl
Type of Business: ("A Map/Lot:
EV IT,NT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling, there shall be no increase in noise or odor,no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential vohmmes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carved on by the permanent resident of a single family residential dwelling unit,located
within that dwelling rmit'
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there
is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involvefhe production of offensive noise,vibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat,.glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such-use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of.materials or equipment.
• There are no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included-
` • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.
Applicant fIS(o Date:
Mrneoc.dor Rev.06/20116
TOWN OF BARNSTABLE
LOCATION a 6 t,Z S C-f,?L S JJ /J O LES SEWAGE#
VILLAGE I_Ic c,n n is ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. o 1) 17 e-f4 J�_'j �-
SEPTIC TANK CAPACITY /5-d
LEACHING FACILITY:(type) 3 - ro ia 6r �,,y� size)
NO.OF BEDROOMS
OWNER +
PERMIT DATE: COMPLIANCE DATE: 1D
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
C
f`t r3
a .
Li
oO �
`moo
Al -336 C3 � << � 3 .
-3 3, S a.
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A3 -!k-Z 3 L9L
Gk No. �D 1Q l�y �J �1. 1n) �Ic��` 1. IT/CJ�'" / Fee 1
THE COMMQNWEALTH OF MASSACHUSETTS Entered in computer:_�,Z
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ,k 40
RppliLatlon for Bisposal 6pstem Construction Permit (0, [9& k.
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) El Complete System ❑Individual Components 1 Ae
Location Address or Lot No. Owner's Name,Address,and Tel.No. QL
Assessor's Map/Parcel 242_ TAIAAAI)
,e✓(&, + EA jq Sj1V,4
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No..1[6
S`os — 9 t�t'i21? ZX)C Y77-531
Type of 'ding:
Dwelling No.of Bedrooms y Lot Size �`.�� sq.ft. Garbage Grinder( )
Other Type of Building 471//Q/,,e- 3< No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) yyo gpd Design flow provided �S S/. ,S gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank . �, d Type of S.A.S. —9D7)A W-
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Akb 4"K 12 o.& e— fel�e-4 t'O�
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 Environpontal Code not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health
Signed �A �v Date —-�— I
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
AA
�, . 1 ✓u t,. 1�_l� ►N�``� fin/ t C�� �--^ �^)���.
No. &D I IQ � <'
Fee- `
THE C,OMMgJWEA•LTH OF MASSACHUSETTS Entered in computer: Yes C,✓
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4,,,
2pplitation for'bisp08aY 6pstrtn Construction 3pPrmit �� NoM:�e
�.'
Application for a Permit to Construct( ) Repair•(�) Upgrade,( ) Abandon( ) ❑Complete System ❑Individual Compon is
na £
Location Address or Lot No: /� S , ,9/ej /l.f Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel a g2, t Aedj t/rf
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
fg,,711tv--a �S`0� - W v4g `/77-531
Type of B 'ding:
. 4
Dwelling No.of Bedrooms Lot Size 7 I D5_7 sq.ft. Garbage Grinder( )
Other Type of Building 1 y V 1,,e X No.of Persons Showers( ) Cafeteria
Other Fixtures ?
Design•Flow(min.required) gpd gpd Design flow provided 3 ' gpd�jy,
Plan Date Number of sheets Revision Date
Title
Size ofS'eptic Tank Type of S.A.S. 7, SDZ) 1� ra2�fC.��l
Description of Soil
Nature of Repairs or Alterations Answer when applicable)
f
Date last inspected: 1 TT " 1
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
.s
accordance with the provisions of Title 5 of the Enviro ental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of H�eealth.:•,
Signed //. Date '
Application Approved by "�(1�Y�(�� ,L� / ICE Date
Application Disapproved by Date
for the following reasons
Permit No. to- Date Issued *q;,
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
_. BARNSTABLE,MASSACHUSETTS ,
(Certificate of Compliance
THIS IS TO CERTIFY,that the On- ite Seswage Disposal system Constructed( ) Repaired( Upgraded( )
Abandoned( )by vj� b UC.
at 7 6 ,o has been constructed in accordance
with the provisions of Title S dd tth�ee for Disposal System Construction Permit No. �I � ' �"1 dated
Installer �tsrl Designer ��') (�1 �1✓t W
1 ; a
#bedrooms Approved design ow n y5 3 gpd
The issuance of thil perm' hall not be construed as a guarantee that the system will ctio �J'designed.
Date v! � Inspector _ (ti% r ,
-----------------------------------------------------------------------------------------------------------------------------------------
No. oC�I b'" Fee uo, `
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposat 6pstem4onstruction Permit
Permission is hereby granted to Construct
)"; Repair( Upgrade( ) Abandon( )
System located at �O a�0 �/:�5� �o I�S L)
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:Construction must be completed within three years of•the-date ofthis permit.
Date ApP roved by ► '
f
Town of Barnstable
Regulatory Services
1Rkhard V. Scaii,interbu IUireetor
Rua
Public Health Division
Thomas McKean,Director
200 MQR Strict,Dyannie,MA 02601
Office, 508-862-4644 Fax: 508-790-6304
r do Des ertl Form
Date: 27 ��6 �e 1�'elct►�llt#R 'La_B b-32.`I AtS�StOr'6 MaµlParcell ' � ��1 � �-
Desiper: .. :ort .: 6 r-kAs 1 r. �.. Installer: Ra
Address; F Z t+v B Address: 4qc (ACx:,ems
Actin, c.l-, A
On 8(date)j ) �
6 was m ued a permit to instrall a
mstaller)
septic system at �_ F 4 Vo(-p3 r2A based ona design drawn(address)
by
Fe wr 0 L lre%1-et 6 dated. (l bo 15 �w!s-^ r d 5`6 a% A 3 � _ CJ�
( esrgnerl an A%_CeA t 1 - 'fit 4w
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. SOP out (if nquired) was,inspected and the soils
were found satisfactory.
I certify that the septic s stem 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 ReguMons*Plan revision or
certified as-built by designer to follow. Strip out(if required) - inspected and the soils
were found satisfactory- u n .c, l-%e ,a ra v�s za--r Ali- Lac"U pt &ePr V*1
I certify that the system referenced above was constructed in ca hance with the tam
Of tie AA appr letters(if applicable)
PETER
( taller' mature) .� McEN7
CIVqL
Na 35109 z
(Designer s Signadnre) (A I1es1 ere)
PLZ&SIL RETLWTO 13A1I NST PUBL HEALTH D1V ON. CE F. TE
OF C IPL ANCE L NOT BE -ISSUED UNTIL BOTH THIS IFORM AND S-
MN1i; HARD ARE
. 1VE D BY THE BARNSTAIALE IPI"M H��1LTffR RMSION.
Q.1Sq*jcV)e8i8na Certification Fam Rev 8-14-13.dm
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Town of Barnstable
'moo Regulatory Services
Richard V. Scali,Interim Director
MAW
•. R�R7u4TeT q�r • .
�, ' Public Health Division.
Thomas McKean,Director
200 Main Street,Hyannis,IVIA 02601
Office: 508-86246411 Fax- SM79.0-6304
Installer&.Designer Certification Form
Date: It 7-7 t L 4 Sewage Permit# 20 16-3Z N Assessor's Map\Parcel 2`t Z—1 Z-
Designer: �?:v,�.e tvc rins iv, ` Installer: R04 toe..{ FPA e✓-
Address: ►Z., W, �411�\� tc'e1 Address: 4 q 0 f AQ v. S tv-,�L--
On 'fl T I L 6 ytN V.`r k e.--
was issued a
permit to install a
(date) (installer)
septic system at 2!0 2 1'�es Leo L-es rZA based on a design drawn by
(address).
Ft L l✓,n t--,E 15 dated 111101 ( .57 w i 4-�% C'l. J:5 ka v, 4,5
ra cJl
(designer)
I certify that the septic system referenced above was installed substantially according to
the.design, which may include minor approved changes: such as lateral relocationof the
distribution box. and/or septic tank. Strip out (if required).was inspected and the soils
were found.satisfactory.
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) burin accordance with State &Local Regulations-*Plan-revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory. u 44� �� Yo re v,s Z6 nx aP La cAi 0 Pb 21cU &eer*v*,
I certify that the system referenced above was constructed in co liance with the terms
of the.I\A approval letters(if applicable)
r P�t� OF �1gs3�c
o PETER T:
Installer's Signature) o Mc CIVIL
Ln
(Installer's, � ) �. civet_
No. 35109
(Designer's Signature) (Affix Desi ere)
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.
QASeptic\D6signer Certification Form Rev 8-14-13.doc.
��� ;Dl?IVEWAY •:
28'00,. w'; R=26` V18.. ADJACENT
15 3' DUPLEX
LOT 9 00
B 292-182
�! 9,057 S.F.t
o
O o N
s�b8
�
(#24) Z EXISTING DUPLEX
ADJACENT
Q� DUPLEX SLAB 0 �GRADE
(#22) a� / WITH 2E`ASTONE
EXISTING SEPTIC —
ti R,2B2 BUILDING 26128
8
_ NEW SOLID
9' O � CATCH BASIN
o
co PETER T.
N McENTEE
Za
D '� co O . ^ o CIVIL
RlvEjyAY `� M No. 35109
f101 �l ,S': o PSI
sS IN�
�- 1
SEPTIC SYSTEM FOR BUILDING 22/24 (APPROXIMATE ;.` ':' .• ` :. '.,,.. :: c: °. ::;.:..`..: �2�
LOCATION SHOWN) WAS DISCOVERED ON PROPERTY OF:: :>..' .:.: `,. ;...:.: ::`...:'N 77.8028=.0$' :;'.,:.`... —
BUILDING 26/28. � 0p„..
• `•• ' ` � ' • APPROVED AS BUILT LOCATION OF
`' ;` OF S.A.S., APPROVED BY B.O.H. AS
AN EMERGANCY DUE TO ADJACENT
S.A.S. SERVING BUILDING 22/24. ALSO,
PAVED PARKING . TANK IN SERIES ELIMINATED FOR SAME
REASON.
SEPTIC SYSTEM AS-BUILT PLAN
26 & 28 FRESH HOLES ROAD, HYANNIS, MA ORIGINAL LOCATION OF PROPOSED
Engineering Works, Inc. S.A.S. FOR BUILDING 26/28.
12 West Crossfield Road, Forestdole, MA 02644
(508) 477-5313 DATE: 9/27/16.. SCALE: 1"=20'
I
i
Ft l Town of Barnstable P
Department of Regulatory Services GI
r BARNSTABLE, * Public Health Division Date u (`-1,
9�A M6 q. `0� 200 Main Street,Hyannis MA 02601
rEU MAN t`
t ex)
Date Scheduled Time L� Fee Pd.-At 0 6 uj- I ,1
I T:.
Soil Suitabili f Sewage Assessment for S Disposal t'7
00
l n
I Performed By: k,, $ (St}Q_ S —F ik \St-,Z, Witnessed By: u�
1 LOCATION & GENERAL INFORMATION _
Location Address Owner's Name r e
26 ` <_,e_s� V- a LeS V•n er.'1� tnc. S<
Address Pa- &K 1 6�v
1 et"vt%5, MA 040k
Assessor's Map/Parcel: Zct 2^1 8 Z Engineer's Nam`*r 4-2,A,�`
___(' n e
NEW CONSTRUCTION REPAIR Telephone# N `-
Land Use P'eSr !00t CL Slopes(%) Surface Stones_IJdA—A
Distances from: Open Water Body7U ft Possible Wet Area71(-�'j ft Drinking Water Well>l� ft
Drainage Way Njllr�— ft Property Line 1-� ft Other _ it
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
e I Lki d`�Vl/l�
I �
QL
I C, j
Parent material(geologic) (:3L) -_ j Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: P - Weeping from Pit Pace_ �r1
Estimated Seasonal High Groundwater > T6
DETERMINATION FOR SEASONAL HIGH WATER TABLE
i Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottles:_ _in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
jIndex Well# Reading Date: Index Well level _ Adj.Factor_ _ Adj.Groundwater Level
PERCOLATION TEST Date Time
Observation C
Hole# Time at 9"
Depth of Pere Time at 6"
I Start Pre-soak Time @ t®� Time(9"-6") Zze` a
qq i
I End Pre-soak
Rate Min./Inch ?/ `K b S-�
jSite Suitability Assessment: Sitc Passcd t)e_ Site Failed: Additional Testing Necdcd(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
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l
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
_ C.Onsis tegy.%Gravefl
L M—C 54v,. 1 -?'5`C(' , ,fir"-Ll Cd to
DEEP OBSERVATION HOLE LOG Hole:#
Depth from s Soil Horizon Soil Texture Soil Color -Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones,Boulders.
_ Cons' e;ncv,_96 Grav_et
Sg lrrak• l 0\(t 4k
Z.—I Za C- M—e SqV-CA 21 S-(6(y 20`L t�.x( .� 4•eJ
—
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsiste;ncv.%(,iravel)
I_.
I DEEP OBSERVATION HOLE LOG Hole#_
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling—(Structure,Stones,Boulders.
ro isrs' tgncv.96 Oravel3,T,,,,_
i
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Flood Insurance Rate Map:
i
iAbove 500 year flood boundary No_ Yes
Within 500 year boundary No Yes _
Within 100 year flood boundary No Yes .
Dlenth of Naturally Occurring Pervious Material
DI'ces at least-four feet of naturall-y occurring pervious material exist in all areas observed throughout the
at<ea proposed for the soil absorption system?
Iti not,what is the depth of baturally occurring pervious material?
I
Certification l
I certify that on L (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent:with .
�e required ai ' g,expertise and experience described in 3 10 CMR 15.017.
tl
S}Ignattu'e Date . f ��
I
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Q\SEPTIC\PERCFORM.DOC
Engineering Works, Inc.
12 West Crossfield Road, Forestdale, MA 02644
Tel/Fax(508)477-5313
September 27, 2016
Mr. Thomas Mckean - Director
Town of Barnstable
Board of Health
200 Main Street
Barnstable, MA 02601
Re: 26 & 28 fresh Holes Rd, Hyannis (Parcel ID: 292-182)
Dear Mr. Mckean,
On September 14, 2016, 1 was informed by Rodney Fisher, the Contractor hired to
install the new leaching system at the subject site, that an unrecorded structure had
been encountered during excavation. It was later discovered that the septic system
serving Bldg. no. 22 & 24 was installed on the property of building no. 26 & 28. Since
extensive excavation had already taken and to avoid damage to the system for Bldg.
no. 22 & 24, a decision was made in the field by this engineer and approved by both
you and David Stanton RS, to eliminate the proposed 1000 gallon septic tank in series
to allow room to relocate the proposed S.A.S. to the location where the existing S.A.S.
for Bldg. no. 26 & 28 resided. The proposed drainage structures were relocated, in as
much as possible, to allow for the S.A.S. relocation.
The Installer & Designer Certification Form has been submitted and a Septic System
As-built Plan prepared noting that the new S.A.S. has. been installed as allowed under
the provisions of Local Upgrade Approval
Please let me know if you have any questions.
cnerelyy,,
Peter T. McEntee P.E.
PAVED coti� oiv
(132)
N 8'00 u �,�,-: .y ADJACENT
.1 A, ��. DUPLEX
OT 91
8 L2 2-182
_ 9,057 S.E. , y
l� l
24 EXIS NG DUPLEX%
it
ADJACENT o.F.a51.Of /
DUPLEX Seas 0 GRADE/
�(g+ z Q4y ItNEW Lf,ACH PIT
#22) i WITH 2 STONE.
? EXIS77NG SEPTIC T K �It
BUILDING 26126 II 1
!! J NEW SOLID
G'sy O r4 CATCH BASIN
j 1 3
iL
f o fl EF
.:s ap o ETER T. G�
f'` AA GEiV
O I` ~s ti R' CiNAL
_ . No 35109
�-
ro
SEPTIC SYSTEM FOR BUILDING 22/24t APPROXIMATE 8Q `��� .. ���•�
LOCATION SHOWN} WAS DISCOVERED ON PROPERTY OF OS'
BUILD{NG 26/28. j 7T2$'0O.. APPROVED AS-BUILT LOCATION OF
J W OF S.A.S.. APPROVED BY B.O.H. AS
+ AN EMERGANCY DUE TO ADJACENT
PAVED PARKIN-. : S.A.S. SERVING BUILDING 22/24. ALSO,
TANK IN SERIES ELIMINATED FOR SAME
77 REASON.
SEPTIC SYSTEM AS—BUILT PLAN
26 do 28 FRESH HOLES ROAD, HYANNIS. MA ORIGINAL LOCATION OF PROPOSED
S.A.S. FOR BUILDING 26/28.
Engineering Works, Inc. ;
12 West Crassfield Road, Forestdole. MA 02644
(508) 477-5313 DATE. 9/27/16 SCALE: 1"=20' j
i ,
Town of Barnstable Barnstable o
.� Regulatory Services Department ' �'
sAerrs"U& 1 I
. I
��6 ��' Public b c Health Division m
A
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#7014 1200 0001 0358 7528
August 18, 2015
Vicente D. &Edna M Silva
PO Box 1691
Hyannis,MA 02601
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 26-28 Fresh Holes Road, Hyannis, MA was last inspected
• on August 5,2015 by Michael DiBuono, a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Failed" under the guidelines
of 1995 TITLE 5 (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.
• Distribution box is rotted and needs to be replaced.
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
Thomas McKean,
Agent of the Board of Health
QASEPTIC\I.etters Septic Inspection Failures or Future Evl\26-28 FreshHoles Rd Hy Aug 2015.doc
r
8/18/2015 Parcel Detail
44 T HE
IF 11
'r
ht45g J
Logged In As: Parcel Detail Tuesday, August 18 2015
Parcel Lookup
Parcel Info
Parcel ID 292-182 Developer Lot LOT 9 y
Location 26 FRESH HOLES ROAd Pri Frontage
Sec Road '_ I Sec Frontage w
Village HYANNIS I Fire District HYANNISm
Town sewer exists at this address NO I Road Index 0576
Asbuilt Septic Scan:
2921821 Interactive Map
#�
Owner Info
owner SILVA, VICENTE D& ED CO
Owner
Streets PO BOX 1691 _ Streetz
city HYANNIS State MA zip 02601 country I
Land Info
- . Acres 0.21 ' -- -_ -�use TWO Family� �-� � _I zoning `RB Nghbd �0104�
Topography Level Road 'Paved f
utilities All Publlc,Gas I Location I
Construction Info
Building 1 of 1
Year,1945 Roof 1 able/Hip Ext Wood Shin le J Built Struct Wall g
Living p1440 4 Roof AC GIs/Cmp� Ac None
A rea Cover Type
style Duplex ~� wali:Drywall Rooms4 Bedrooms
Model Residential Floor Carpet y f R oms�2 Full-0 Half
Grade rage Minus Type;Hot Aire Rooms 8 Rooms
Heat Found- I
Story Stories;1 St J Fuel Gas ation Conc. Slab
Grass J
Area 1440
Permit History
Issue Date _JPurpose Permit# Amount linspDate Comments
Visit History
Date Who Purpose
http:/fissq I2fi ntranet/propdata/Parcei Detail.asp)PID=23048 113
Town of Barnstable
. i t
♦ BARNSCABL&
PMAn Regulatory Services Department
rfp Mp•'i�
Public Health Division
200 Main Street, Hyannis MA 02601
J
Office: 508-8624644 Richard Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Feb 6, 2007
Rev. 7/6/15
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)
OTHER
Repair deadline: V e(Ar
Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc
r .
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessme_nts
26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name ----_—_ — ----.-------- --..---- — ----
information is H nnis Ma 02601 8/5/15 _
required for every —y --.__----_ __ -
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:when filling out forms A. General Information
'
on the computer, �!0 /cvn 7
use only the tab 1. Inspector: /
key to move your
cursor-do not Michael DiBuono _ _
use the return T ----——_-- --_— ____---_—___.— --_—
key. Name of Inspector
DiB_uon_o_S_ewer and Drain
,aa Company Name ------ --- --- ------- — -
8 Johns path-- -- —- -------- ----- — ---
Company Address
S Yarmouth --� _-_— _MA _ _ 02_6_6_4_
City/Town State Zip Code
508-364-9587 S113522
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
❑ Needs Further Evaluation by the Local Approving Authority
-- 8/5/15 —-- - - —
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 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' Officia'I Inspection Form
Subsurface•Sewage Disposal System Form - Not for Voluntary Assessments
Ae / 26-28 Fresh Holes Rd
Property Address --
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma_ 02601 8/5/15
required for every —y _ ___. ___ _ _page. City/Town State Zip Code Date of Inspection __
B. Certification (cont.) r
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any'informatioh'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
"s indicated below.
Comments:
The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles
j. are in place. The Distribution box is totted and decayed. The leaching is holding approximately 18" of
water and no longer has enough room to support design flow._
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•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 2 of 17
l
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
26-28 Fresh Holes Rd _
Property Address
Vincente And Edna Silva_
Owner Owner's Name
information is
required His Ma 02601 8/5/15 _
—y _
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•3/73 - Title 5 Official Inspection Form,Subsurface Sewage Disposal System•Page 3 of 17
t.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
\a 26-28 Fresh Holes Rd
Property Address 'r
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 8/5/15 _required for every Hy _. _ _
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within.a Zone 1 of a public water
F supply.
.❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
;:supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
`.;more from a private water supply well`*.
Method used to determine distance:
*' This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No" to each of the following for all inspections:
Yes No
® ❑ Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
® Liquid depth in cesspool is less than 6" below invert or available volume is less
than 'Y2 day flow
t5ins•3/13 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 4 of 17
i
I
. Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 8/5/15
required for every � — _
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.
El ® 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
ET ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area — IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes" to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 .Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form*
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
a
26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 _ 8/5/15
required for every � ,
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate "yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components; excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
❑ ® Was the facility owner (and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 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
"p 26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 8/5/15
required for every —Y
page. CityFrown State Zip Code Date of Inspection
D. System Information
Description:
The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles
are in place. The Distribution box is totted and decayed. The leaching is holding approximately 18" of
water and no longer has enough room to support design flow_
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ® Yes ❑ No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 228 GPD
9 ( Y 9 (gp ))�
Detail:
Sump pump? J ❑ Yes ® No
Last date of occupancy: 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:
t51ns•3/13 -Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
JSubsurface Sewage Disposal System Form - Not for Voluntary Assessments
8 26-2
.� Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner . Owner's Name
information is H required for every nnis _Ma 02601 8/5/15 _
_ Y _
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Occupied
Date
Other(describe below):
General Information
Pumping Records:
Source of information:
2015
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons --
How was quantity pumped determined? -- ---
Reason for pumping: — -- --
Type of System:
Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
?� 8 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
ep 26-28 Fresh Holes Rd _
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is required for every H—y nnis Ma 02601 8/5/15
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:
19 years
Were sewage odors detected when arriving at the site? ❑ Yes ❑ No
Building Sewer(locate on site plan):
Depth below grade: 18" —
feet
Material of construction:
® cast iron ® 40 PVC ❑ other (explain): — —
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.).
System is vented throught the roof.
Septic Tank (locate on site plan):
Depth below grade: 1 ft
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
1500 gallon
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1500 Gallon
- --
Sludge depth: 3
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
— Subsurface Sewage Disposal System Form - Not for Voluntary,Assessments
26-28 Fresh Holes Rd
Property Address --
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 8/5/15
required for every _Y _ _
page. City/Town State Zip Code Date of inspection-
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle 24
Scum thickness 3"—
Distance from top of scum to top of outlet tee or baffle
42"
Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick
Ta e Measure
How were dimensions determined? —�-- —
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid Levels as related to outlet invert, evidence of leakage, etc.):
No evidence of Ieaking,Tees and or baffles in place at time of inspection.
Grease Trap (locate on site plan):
Depth below grade: NA —
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•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
\tea /f 26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is required for every �H nnis Ma 02601 8/5/15
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.):
Tees are in place and levels are normal.
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
151ns•3113 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
_ w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
t 26-28 Fresh Holes Rd _
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is
required for every Hynnis Ma 02601 8/5/15
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 Rootted and decayed
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.):
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why: .
15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
26-28 Fresh Holes Rd
Property Address T
Vincente And Edna Silva
Owner Owner's Name
information is required for every �H nnis Ma 02601 8/5/15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
® leaching galleries number:
4
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology: 4 Coltex
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Cultex are holding water
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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary;Assessments
a
26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 _
required for every Y 8/5/15
page. City/Town 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.):
No ponding as of yet.
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.):
t51ns•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 14 of 17
i
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
26-28 Fresh Holes Rd
Property Address
Vincente And Edna Silva _
Owner Owner's Name
information is required for every Hy nnis Ma 02601 8/5/15
-
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
® drawing attached separately
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts R
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
26-28 Fresh Holes Rd
Property Address --
Vincente And Edna Silva
Owner Owner's Name —
information is
required for every Hynnis Ma 02601 8/5/15
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 18+ ft
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date ----
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers - (attach documentation)
❑ Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
Ground water to be established at time of perk test
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5tns•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 16 of 17
LOCATION OU /fDX Af Ea_SEWAGE#
VILLAGE A�Z /VAI/,S ASSESSOR'S MAP&LOTS'29
INSTALLER'S NAME&PHONE NO. X402,E. a O/Al�nak-979- '97 7 G
SEPTIC TANK CAPACITY /ram
LEACHING FACIIJTY: (type) ;:E -ea 4-TE,)e1 (size) 14) a
NO.OF BEDROOMS_ G 0 1 T
BUILDER OR OWNER
PERMITDATE: 7,6 d- COMPLLANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wedand and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furttished by '� ✓%�' �'%'�
0
GJ
� J
- 13aA
� o �S�PTl� Trf�✓K
QQ
Commonwealth of Massachusetts
g Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
XV
�a
26-28 Fresh Holes Rd_
Property Address
Vincente And Edna Silva
Owner Owner's Name
information is H nnis Ma 02601 8/5/15
required for every y _ _
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Op SHE TQ�
Town of Barnstable Barnstable
ADAm
Regulatory Services Department m;cac I
7* I3A R'11 BLE. + O D
" '
iO4
Public Health Division
r 679 ���
AlFD MAt A' 200 Main Street, Hyannis MA 02601 2007
i
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A..McKean,CHO
CERTIFIED MAIL #7014 1200 0001 0358 7528
August 18, 2015
Vicente D. & Edna M Silva
PO Box 1691
Hyannis, MA 02601
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 26-28 Fresh Holes Road, Hyannis, MA was last inspected
on August 5, 2015 by Michael DiBuono, a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Failed" under the guidelines
of 1995 TITLE 5 (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.
• Distribution box is rotted and needs to be replaced.
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
Thomas McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\26-28 FreshHoles Rd Hy Aug 2015.doc
FORM3o HOBBS&.W-.ARREN,INC. THE COMMONWEALTH OF MASSACHUSETTS
` BOAR OF HEALTH
A,,
�'n_ I� FAA1h�
CITY/TOWN
r-A 1,rH MA DEPARTMENT
#60119
ADDRESS r
TELEPHONE J p ,,/
Address r&063H• HOLO—Ral-Poccupant, �/V j6 � o11
floor Apartment No. No.of Occupants
No.of Habitable Rooms No.Sleeping Rooms
No.dwelling.or rooming,units a No.Stories
Name and address of owner /V���� l�
Remarks Reg. Vlo. 'Odb
YARD Out Bld s.: Fences: _
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress:and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting:
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows: p
HEATING Chimneys:
-Central ❑ Y ❑ N Equip. Repair - `r ='
TYPE: Stacks,Flues,Vents:
PLUMBING: Supply Line: � Jj
❑ MS ❑ ST ❑ P Waste Line: �7 8
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1
Bedroom 2
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.:
Stacks, Flues,Vents,Safeties:
Kitchen Facilities Sink
Stove
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.:
Wash Basin,Shower or Tub: v _ 'j�
Infestation Rats, Mice, Roaches or Other: E /Q O ( .,�. �JC'.�Sl ®� )�Ci'1/
Egress Dual and Obst'n: I t
General Building Posted �\
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL--BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
THIS INSPECTION REPORT IS .SI NED AND CERTIFIED UNDER THE PAINS AND
PENALTIE -OF PERJURY." o
1 c �
INSPECTOR / n TITLE
y
30
.DATE TIME P.M.
/ A.M.
THE NEXT SCHEDULED REINSPECTION- �/�-�2� JI/ P.M.
t,
410 750: Conditions Deemed ,to Endanger or Impair Health or Safety
The following conditions, when found to exist in residential premises,
shall be deemed conditions which may endanger or impair the health, or safety
and well-being of a person or persons occupying the premises. This listing
is composed of these items which are deemed to always have the potential to
endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.490
state minimum requirements of fitness for human habitation, any violation has
the potential to fall within this category in any given situation but may not
do so in every case and therefore cannot be included in this listing. Failure
to include shall in no way be construed as.a determination that other
violations may not be found to fall within this category. Nor shall failure'
to include affect the duty of the local health official to order repair or
correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833
nor shall it affect the legal obligation of the person to whom,the•order is
- issued to comply with such order.
(A) --Failure to provide• a supply of water sufficient in'quantity, pressure
1-And temperature, both hot and cold, to meet the ordinary. needs of the occupant
" in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or
i longer.
(B) Failure to provide-heat as required by 105 CMR 410.201 of improper -
venting or-use of a space heater or water heater- as prohibited by 105 CMR
410.200(B) and 410.202.
(C) Shut-off and/or failure to restore electricity or gas.
(D) Failure to supply the electrical facilities required by 105 CMR 410.250(B);
-- 410.251(A), 410.253(A), -410.253(B) and the lighting in common area required
by 105 CMR 410.254. '
(8) Failure to provide a safe supply of water.
_(F) . Failure to provide a toilet and maintain a sewage system in operable
_ .. condition as required by 105 CMR 410.150(A)(1) and 410.300.
(G) Failure to provide adequate exits, or the obstruction of any exit,
passageway or common area caused by an object,- including garbage or; trash,
which prevents egress in case of an emergency 105 CMR 410.450 and .410.451.
(fl)- Failure to comply with the security requirements of 105 CMR.4110.480(D).
(I)-. Failure to comply with any provisions of 105 CMR 410.600 through 410.602
:,_i&ieh"results in any accumulation of garbage, rubbish, filth or other causes s
`df sickness which may provide a food source or harborage for rodents, insects
Dior other pests or otherwise contribute'to•acciden.ts or to the creation or
` :"apiead of disease.` _
(J)- The-presence of lead-based paint- on a dwelling or dwelling unit in `
-vialation-of the Massachusetts Department of Public Health Regualtions for
-' Lesd Poisoning Prevention and Control 105 CMR 460.000.
(K) -.Roof, foundation, or other structural' defects that may expose the
v.oecupant or anyone else to fire, burns, shock, accident or other dangers or
#"g!t to health -or dafety.
(t;)" Failure to install electrical, plumbing, heating and gas-burning
-facilities in accordance with accepted plumbing, heating, gas-fitting and
electrical wiring standards or failure to maintain such facilities as
-r are required by-105 CMR 410.351 and 410.352 so as-to expose the occupant
or anyone else to-fire, burns, shock, accident or other danger or impairment.
_ _.'to:health or safety. -
� _ (�Q Any of--the following conditions.which remain uncorrected for a period .
�.. of five or more days following- the notice to-or knowledge of the owner
of said condition or conditions:
lack of a kitchen sink of sufficient size and capacity for
washing dishes and kitchen utensils or lack 'of a.,stove and oven
or any defect that renders either operable. -
-(2) failure to provide a washbasin-and a 'shower or bathtub as required
in-105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect .which _... .
-- renders them inoperable.
Q) any defect in the electrical, plumbing, or heating system which makes. -
_ such system or any part thereof" in violation-of generally accepted
_ plumbing heating,, gas-fitting, or electrical wiring.standards_
� - that do not create an immediate hazard.
;.(r) failure to maintain a safe handrail or .protective railing for every
stairway, porch balcony, roof or similar place as required by
`105 CMR 410.503(A) and 410.503(B).
(5) failure to eliminate dents, cockioachea,*insect 'infestations and
ro
' other pests-as required by. 105' CMR 410.550.
(N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A)
through (H) shall be deemed to be a condition which may endanger or materially
Im"Itr the health or safety and well-being of an occupant upon the failure' of
the owner to remedy said condition within the time so ordered by the board
of health..'
TOWN OFfBBARNSTABLE
LOCATION a� f � /I/J�� / -SEWAGE #
w
VILLAGE d ASSESSOR'S MAP & LOT_ _
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)4,417Z1,e,) (size)
"NO.OF BEDROOMS
BUILDER OR OWNER. G:
PERMUDATE: COMPLIANCE DATE:
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 we lands exist
within 300 fee oo ea g facility) Feet
Furnished b /" ��
.� -� � T--- +i
f, ;,� i
r
�, f
���/ / �/
- t, �U
��� � � ��
� �\ �
� Q-
\\ � �
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� � I
d�--
f -
• a DATE:_6-- /00____ .v
PROPERTY ____________
_2'2 &_ 24 Fresh Holes Road_ ERECEIVEDHyannis ________On the above date, I Inspected the eeptio system at theThis system consists of the following:
1 1 -1 500 gallon septic tank a� � �� , a �
2 . 1 -distribution box o
3 .. 4-flo-diffusors 0d- 44d'lts �
Based on my Inapectlon, I certify the following oondltlons:
4 . This is a title five septic system. ( 78 Code ) ,
5 . The septic system appears .to be in working order
at the present time.
6. The tank is at operating level. The leaching area
is under the asphalt parking lot. .
Covers should be located and `�IGNATURE:,/cast iron ring & cover
brought to grade.
Na me:_,La,-.2j-C.QM .a.r.,�___---
Company: Joa��h_P � Nacomb.r_b Son , Inc ,
Address:_ Box-66
-_Centerville t- Ha__02632-0066
Phone:___508_)75_3338_______
THIS CERTIFICATION OOES NOT CONSTITUT2 A CIVARANTY OR WARRANTY
a I
JOSEPH P, MACOMBER & SON, INC.
Tink>i•C�:><pools•L�ichll�lds
Pumplid & In:tillod
Town Sswir Connoctlons
P,O, eox 6y75.3J38e�77, MA 02632.0066
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON MA 02108 (617) 292.6600
TRUDY COKE
Secretary
ARCEO PAUL CELLUCCI DAVM B. STRUHS
Commissioner
Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM
PART A
CERTIFICATION
Pmpwty Addrw :2 2 & 24 Fresh Holes R d. U me of OwnafR1 5 Blue Limited
Hyannis Addrsof Owner:Box�- yannisport, Ma.
Data of hsp.ctSon: .s
N&rr.*fkm6p*CW:1MUiPVtMsePh P. Macomber Jr.
I am a DEP approved systam Inspector pursuant to Section 15.W of Th3e 5(310 CMR 15.000)
Comp",Name: Jose h P. Macomber & Son Inc.
IAei6,gAda,as: ox en ervi e M 632-0066
Telaprwna Nurttbar' — —
3338
CERTIFlCATION STATEMF?!T
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 Inspection. The Inspection was performed based on my training and experience In the proper function and
maintenance of on. It e se. sge disposal systems. The system:
Passes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
_ Falls
Inapecta'a Sign tun: A.'jj )*""6jtz1 Dow
G
The System Inspector all submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)whhin thirty (30) days of
complsting 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
fish submit the report to the appropriate regional office+ of the Department oN£nvlronmertttd f otection. The original shouid'be sent to VW
system owner and copies sent to the buyer. If applicable, and the approving authority.
NOTES AND COh1MENTS
revised 9/2/98 page iorii
" Primed on 0."led Paper
Sv93VAYAC9 SEWAGE 01SI0&kL SYSTEM WSI£CTVON FORM
PART A
CEKTViCAMN (ooffd-Wdl
Proq..tyAdar..,: 22 & 24 Fres.h Holes Road, Hyannis
o"'""' Big Blue Limited
Dww or V%A e • 6/21 /00
►43recr,oN sva4mAAYi ch---< A. B, C, oI 1>
A. SYSTEM PASSES:
I have not fovn4 my Information wNeh tr CM64 that any of the Wufo oortd)dom deeertbed In 310 CMR 14,303 srlat. Any t k
041
1 us Indlcstsd below
CO UIU M3
T Aq 44 9glg04) S&P✓rke ji6er i f *ccesS
s. SYSTFJJ CONDmOKkUY ►AUES;
Ono w ma• eyotem sompononu sa dossrtbod In the 'Coftdldor►aJ /sea• soodon need to be roplso*d of rspaJfed. The •yaum, VP
cornplodon of No roplosomont w rop&!r, w &ppfovod by the board of HsaJth, will paaa,
v4col• ye iA or not detormJned IY. N. w NO). 096cAbe bawls of de%wnJnadon to &ll 4utafwea, If 'not dotermJnod', sx J&Jn why rwt.
Lf� Tho aepd• tank 1• moral, urJoss the er own a operator hew pfov(dsd the oystem 4upestw whh a copy of a Gervrcei• o
CompLsnce (ertoched)tndJssdnp that the tank w&.s Inatasd wlWn twenty(20) yews prow to ttte data of taw 6nap4ct7on
nal. shows
/s Imrrdnent. The ystom wW passs orinspo do �XJs�0pd v oo tank la lth r•pl sed a somprytnp
IaJlvro o 4 LA"
approved by the Board of Health,
39wa9e bockvp or breakovt or high ludo water level obaorved In the dlsutbvdon box Is dve to bfokon of ooewcud OP
or dvs to o brokon, oerded or vneven dJaviWiJon box. Tho system Will pass Inapsotlon If (watt &pproval of VW soaro of
Hoo1N).
broken pipe(e) we replaced
obstrt+cdon la fomovod
dlsv(bvdon box la lovellod w replaced
• The Byrum rsaAred p-. D�;r*v+tltan•lour*nos v"&rdva vo broken v obstrooted pip*(*). the vywv m wW-P%w^
Inapoc0on It(with spprovd of the soul Of He+lth)t
broken pipe(#) ode roplacid
obovvcdon Is removed
revised 9/2/98 ncelerlt
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (corttiruied)
Prop"Add e": 22 & 24 Fresh Holes Road, Hyannis
Own«: Big Blue Limited
Data of kuPecti°n: 6/21 /0 0
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 fa)Ung to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CUR 15.303(1)(b)THAT THE SYSTIEM
IS NOT FUNCTIONING IN A MANNER WH1CH..YALL.PRQIEC'T THE PUBUC HEALTRAND SAFETY AND THE Br%WONJ14ENL•
Cesspool or privy Is within 60 feet of surface water
Cesspool or privy Is within 60 test of a bordering vegetated wetland or a salt marsh,
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBUC WATER SUPPLER,IF ANY)DIETERIVRNFS THAT THE SYSTEM IS
FUNCTIONING IN A MANNER THAT PROTECTS THE PUSUC HEALSii AND SAFETY AND THE ENWONMIEENT:
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 soil absorption system and the SAS Is within a Zone I of a public water supply well.
The system has a septic tank and-*all absorption system and the SAS Is within 60 feet of a privet*water supply wou.
The system has a septic tank and soil absorption system and the SAS Is less than 100 feet but 60 feet or mwe trom a
private water supply well, unless a well wets(analysis for coliform bacteria and volatile organJc compounds Indicates that the
well Is free from pollution from that facility and the presence of smmonia nitrogen end nitrate nitrogen is equal to of less
than 5 ppm. Method used to determine distance._ (approximation not veUd).-
3) OTHER
revised 9/2/98 Page 3orit
I
SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM >
PART A
CERTIFICATION (continued)
PropwtyAddress: 22 & 24 Fresh Holes Road, Hyannis
Owner: Big Blue Limited
Date of Inspection: 6/21 /0 0
D. SYSTEM FAILS:
You must.,indlcate either 'Yes' or 'No' to each of the following:
_Ji IP I have determined that one or more of the following failure conditions exist as described In 310 CMR 15.303. The basis for this
determination Is Identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure
Yes No >
Backup 04 sewage IntoieclH"v/stsnt con'tponortt'due'to an overloaded orclvggedS,ASor-eeaspool, •�--'" . '
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 dlstribu bo a ova out( t I vert u to an verloadod or clogged SAS or cesspool.
�P.15 �,�' a Asp ',�.e�- .laT
"ClZd/ Liquid depth In oaasaeeEis less than 6' below Invert or available volume Is less than 1/2 day flow.
Required pumping more than 4 times In the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped Q.
Any portion of the Soil Absorption System, cesspool or privy Is below the high groundwater elevation.
Any portion of a 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 I of a public well.
Any portion of a cesspool or privy Is within 60 feet of a private water supply wall.
_ Any portion of a cesspool or privy Is less then 100 feet but greater then 60 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen•ond nitrate nitrogen.
E. LARGE SYSTEM FAILS:
You must Indicate either 'Yes' or 'No" to each of the following:
The following criteria apply to large systems In addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system Is a significant threat to put
health and safety and the environment because one or more of the following conditions exist:
Yes No i
the system Is within 400 feet of a surface drinking water supply
the system lawltWn 200 teat eurfeo"rink4"p-** -*uplY - -- ••
the system Is located In a nitrogen sensitive area(interim Wellhead Protection Area a IWPA) or a mapped Zone II of a public
water supply well)
The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 16.304(2). Please consult the local region+
office of the Department for further Infognation.
revised 9/2/98 Paee4ofII
SUBSURFACE SEWAGE DISPOSAL SYSTEM;INSPEC-PON FORM �. .,
PART B
CHECKLIST
P►op"Addrese: 22 & 24 Fresh Holes Road, Hyannis
owner: Big Blue Limited
Date of i upection: 6/21 /0 0
Check If the following have been done:You must Indicate either'Yes' or 'No' as to each of the following:
Yes No
_Y Pumping Information was provided by the owner, occupant, or Board of Health.
None of the systemcorssPoaanis 6amajAw pampod4opsstJeast,two•w&&W and-sAs*vystem haabaeowcalaiagwsal flow
rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this
Inspection.
_ As built plans have been obtained and examined. Note if they are not available with N/A.
_ The facility or dwelling was Inspected for signs of sewage back-up.
The system does not receive non-sanitary or Industrial waste flow.
_ The site was Inspected for'sicy+s of bre ou .
— l,�aq►er Rap i•�,�r.fl'Pr?i ,CDT
jelAll system components, excluding the Soil Absorption Systems have been located on the site.
ael _ The septic tank manholes were uncovered, opened, and the Interior of the septic tank was Inspected for condition of baffles
or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System orrthe site has been determined based on:-
4 _ Existing information, For example, Plan at B.O.H.
_ Determined In the field (if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
115.302(3)(b)I
_ The facility owner land.n^�*=.Jf dMaraoi froul awnar).w&r&4wamLdad with lo+nrmAtioaDn ih&pjn.:Walat f
SubSurface Disposal Systems.
revised 9/2/98 Psgesoru
SUBSURFACE SEWAGE DISPOSAL SYST1W INSPECTION FORMA
• PART C
SYSTEM INFORMATION
PropwtyAddress: 22 & 24 Fresh Holes Road, Hyannis
Owrw: Big Blue Limited
Deft of irmpectlon: 6/21 /0 0
FLOW CONDMONS
RESI ENT1AL:
Design flow:_LlQ g.p.d./bedroom.
Number of bedrooms(d sig 1' Number of bedroom+(actual):2 '
Total DESIGN flow.
Number of current residents:
Garbage grinder(yes or nol:
Laundry(separate system) s or�,_7 If yes, sepasaLaJnapacdon•requlred —.
laundry system Inspected�y�r no) ��/,
Seasonal use(yes or nol: !� (� - l��� z y n +�
Water meter readings,If evr*Ilable Ilost two year's usage(gpo): 9 � T u-4 �1C1- / 1 -*f N
Sump Pump(Yes or no): ,{J �16�= A14
,M J'u+ea 4� -We, e6= /j D i1
Last date of occupancy: 7 ,� /
COMMEACtAVWDVSTRIAL: />7
Type of establishment:
Design now: d ( Based on 16.203)
Basis of design now
Greese trap present: lye+ or no)
Industrial Waste Holding Tank present: (yes or no)A&
Non-sanitary waste discharged to the Title 6 system:(yes or no)J/� _
Water motor readings,If available.
Last date of occupsncy:_A�d
OTHER:IDescribs)
lest date of occupancy:
' GENERAL INFORMATION
PUMPING RECORDS and urce o Information:
v.�12,4 o
System pumped as part of Inspection: (yes or no) //
If yes, volume pumped: gallons
Reason for pumping:
TYPE 0 SYSTEM
Septic tank/distribution boxlsoll absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) (If yes, attach previous Inspection records,If any)
0I/A Technology etc. Attach copy of up to date operation and maintenance conuact
Tight Tank _Copy of DEP Approval
Other
T'E!� g} all compon
ents, date IMta{ledilf known)end
2LUUPE L�f."_ sours*of•iwforeewtion:
Sewage odors detected when arriving at the site: (Yes or not 1
revised 9/2/98 Page 4ofII
SUBSURFACE SEWAGE DISPOSAL'SYSTEIM INSPEICTION FORM '
. PART C
SYSTEM INFORMATION(continued)
Prop"Addre": 22 & 24 Fresh Holes Road, Hyannis
Owner: Big Blue Limited
Date of Inspection: 6/21 /0 0
BUILDING SEWER:
(Locate on site plan)
N
Depth below grade:
Material of construction: cast iron V 40 PVC&19other(explain)
AI
Distance from private water supply well or suction line
Diameter q_
Comments: (condition of joints,venting, evidence of leakage,-etc.) -
Joints agAear tight Nn Pvir9PnnA of leakage
Syc
SEPTIC TANK: D
(locate on site plan)
11
Depth below grader
Material of construction: / concrete4!Lmetal4!&Fiberglass V?Polyethylene other(explain)
If tank is (petal,list age 13.age.confwmed by Certificate of Compliance VJ (Yes/No)
Dimensions: 0 ' 6"X5 ' 8" X5 ' 7" T4i gam_
Sludge depth:
Distance from top of?judge to bottom of outlet tee orbaffle: 2 9 1'
Scum thickness: 10 •
Distance from top of scum to top of outlet tee or baffle.r baffle: 4"
Distance from bottom of scum to bottom of outle tee o
How dimensions were determined:
Comments:
(recommendation for pumpin con itjon of inlet and outlet tees or-baffles, depth of liquid level In relation to outlet invert,fistructural4ntegrity,
vide :e f leaks etc.) tep is tank should be um ed annual! � High c�ic`�a�esehis. n e ou a ees are in 1
S-T—
ructurally sound and shnwg nn Azridence of lQa-kage.
GREASE TRAP: e_
(locate on site plan)
Depth below grade:
Material of construction:.concretaoVAmeteL AFiberglassARPolyethylene.4!t?other(explain)
Dimensions: IVA
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:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level In relation to outlet invert, structural integrity,
evidence of leakage, etc.)
-Grease trap is not present
revised 9/2/98 Page 7of11
r
SUBSURFACE SEWAGE D13POSAL BYSTEM INSPECTION FOP-M
PART C a •',>. .,
SYSTE>LI WFOR"TiON(corAL-&wd)
Property A6&*": 22 & 24 Fresh Holes Road, Hyannis
OwTMr: Big Blue Limited
Dva of tup.c don` 6 21 0 0
TIGHT OR HOLDING TINKAhe- .(Tank must be pumped prior to, or at time of, Inspection)
(locals on she plan)
Depth below grad.:-&1f
Meted&) of cone trvction:4yConcretoametal /&I Flborglasso+lPolyethylono*Aothsr(explaln)
,flA
Dimensions: AM
Capacity: gallons
Design flow: g&llonslday
Alarm present
Alarm level: Alarm In working order:Yos'12 NC
Dote of previous pumping: A�
Comments:
,condition of Inlet tee, condition of&farm and flout switches, etc.)
Tight
OtSnisvnoN BOX:
I,ocote on site plan)
Depth of liquid level above ovtlel Invert:__
Commonu: _
(note It level and dlstrlbvtion Is equal, evldenoe of solid&ca(ryover, dance of leakage Into or out of►ox etc.)
Dis i ere is evidence R som
er UP intn nr not n
-the box,
Puµp CMMBot-4'&le
ifocate on she plan)
Pumps In working order:(Yos or No)-42d
Alarms In working order (Yes or No)_-Za
Comments:
(note condition of pump chamber,condition of pumps and appunenonces, etc.)
UmA P i c not +,resant.
revised 9/2/96 hill Iorli
I
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPEC-hON FORM
r PART C
SYSTEM INFORMATION(corrdrxHd)
PmpertyAddress: 22 & 24 Fresh Holes Road, Hyannis
D` TW: Big Blue Limited
Data of hspection: 11
2 1 /0 0
SOIL ABSORPTION SYSTEM(SAS):
(locate on site plan, If possible: excavation not required,location may be approximated by non-Intrusive methods)
If not I ated, explain:
G
7' o r
-cove
Type: iron ring & cover.Pumping access and inspection.
leaching pits, number:Q
leaching chambers, number: �.
lesching galleries, number:=
leaching trenches,number, length:
leeching fields, number, dimensions
overflow cesspool, number:
Alternative system: L/
Name of Technology:
Comments:
Inots condition of soil, signs of hydraulic failure, level of pon damp soli, cond on of t
egetation, etc,11 �"
it si ns of hydraulic a'ilure. This
sn u in
area is unffe-
CESSPOOLS:1WVP1
(locate on site plan)
Number and configuration:
Depth-top of liquid to Inlst Invert:
Depth of solids layer:
Depth of scum layer: Awy
Dimensions of cesspool:
Materials of construction:_
Indication of groundwater:
inflow Icesspool must be pumped as part of Inspection)
i
CPS4nnn1S arp not nrccente
Comments:
Inote condition of soil, signs of hydraulic failure, level of ponding,condition of,vegetation, etc.)
essoo0 s arp nni- =recent -
PRIVY:4&le
(locate on site plan)
Materials of constru don: �� Dimensions:
Depth of solids:
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation;etc.)
revised 9/2/98 Paac9ofII
3U&3UR/ACL S WAC1 DISPOSAL 5Y9TVA WSP£CTION FORJA
o /ARTrC
SYiT M WFOKJdAT{ON(oontirn+�1
P,op.MAadreoy; 22 & 24 Fresh Holes Road, Hyannis
Owrw, Big Blue Limited
D ou of V"D"d°`1 6/21 /0 0
SKETCH OF SEWAGE DISPOSAL SYSTEM:
Include deer to at least two permanent reference landmarks or bsnchmuks
locate NI wells within 100' (locate where publlo water supply Ooma$lnto house)
i
P \
l
revised 9/2/98 hill 10of11
f
SUBSURFACE SEWAGE DtSPQSAL SYSTDA INSPECTION FORM
PART C ! r
SYSTE)A 1PFORMATION (.Mk..d)
Property Addraaa: 22 & 24 Fresh Holes Road, Hyannis
Own*(: Big Blue Limited
Dou of trup.c ion: 6/21 /0 0
NRCS Report name
Soil Type_
Typical depth to groundwater
USOS Date webalte visited
Observation Wells checked
Groundwater depth: Shallow Moderate Deep
SITE EXAM Slope
Surface water
Check Cellar
Shallow wells
,
Estimated Depth to Groundwater, Feet
Plesse Indicate all the methods used to determine High Groundwater Elevation:
1 0 twined trom Design Plans on record
Observed Site (Abutting propert bservatlon hole, basemeat sump etc.)
20etermined from local condWons
�hecked with local Board of health
ecked FEMA Maps
_Checksd pumping records
2Checked local excavators, installers
Used USGS Oat&
Describe how you established the High Groundwater Elevedon. (&Z be completed)
Used water contours map.
Gahrety & Miller Model
12/16/94
revised 9/2/98 Page It of11
,.•ran r.�nIT1�T."'\.1/:Inr•r.Rwl►TAen7.rARM11.+1.�►/�wwn'I f.�.'♦1Y/A-�n�w win .rRRT-1+1e— ...r...'
TURN OF BARNSTABLE BOARD OF HEALTH
R_SUBSURFACE 9EH�A(;R DISPOSAL SY9TF,M INSPECTION FORM - PART D •- CERTIFICATION
-TYPE OR PRINT CLEARLY- 1
PROPERTY INSPECTED
STREET ADDRESS 22 & 24 Fresh Holes Road. Hvannis
ASSESSORS MAP, BLOCK AND PARCEL 0
OWNER' s NAME Big Blue -Limited
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P. Macomber Jr,
COMPANY NAME Joseph P. Macomber &r'`Son, Inc.
COMPANY ADDRESS Box 66 Centerville MA. 02632-0066
Street Tovn or C ty state LIP
COMPANY TELEPHONE ( 508 ) 775 3338 FAX ( ) -
CER'rIFICATION STATEMENT
I certify that I have personally inspected the sewage dieposa7 system nt
this address and that the information reported is true , accurate , and
omplete as of the time of �inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems .
Check one :
t/!/ System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
healLh or Llle environment as defined in 310 CMR 16 . 303 . Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form ,
System FAILED*
The inspection which I have con acted has found that the system fails to
Protect the },)ublic health and the environment in accordance with Title
5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this Inspection form ,
t
Inspector SignatureY Date o �✓�'`��
77 WMM
copy of this tification must be provided to the OWNER, the BUYER
( where applicable ) and the I30ARD OF HEAL'I'lle
If the inspection FAILED, We owner or operator shall upgrade ' the system
within one year of the date of the inspection, unless allowed or required
otherwise as provided in 3.10 CMR 16 . 306 .
partd .doc
} y tT
11000
COMMONWEALTH OF MASACHUSETTS r
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET BOSTON MA 02108(617)292-3500
TRUDY COXE
Secretary
ARGEO PAUL CELLUCCI DAVID B. STRUHS
Govemor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 26& 28 FRESH HOLE RD HYANNIS, MA 0260,
Name of Owner JEFF LYONS
Address of Owner: BOX 64 HYANNISPORT MA.02647
Date of Inspection: 9/25100
Name of Inspector: JOHN GRACI
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536
Telephone Number: 508-564-6813 FAX 508-564-7270
CERTIFICATION STATEMENT
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 inspection.The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems..The system:
X Passes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: Date: 10/2/00
The System Inspector shall jIbmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
"The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.M,.
inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life."
THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING NOW AND EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL
LIFE.
revised 9/2/98 Paoe 1 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 26&28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/25/00
INSPECTION SUMMARY: Check A, B, C, or D:
A. SYSTEM PASSES:
X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not
evaluated are indicated below.
a
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 o
the replacement or repair,as approved by the Board of Health,will pass.
Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all insta.,ces. If"not determined",explain why not.
Wa The septic tank is metal,unless the owner or operator has prov*.ded the system inspector with a copy of a Certificate of
Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the
septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure
is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved
by the Board of Health.
n1a Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)o
due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
_broken pipe(s)are replaced
_obstruction is removed
_distribution box is levelled or replaced
Wa The system required pumping more than four 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
_obstruction is removed
revised 9/2/98 Paoe 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 26& 28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/25/00
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 the public health,
safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM I.-
NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
_ Cesspool or privy is within 50 feet of surface water
_ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well,
_ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the
well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less
than 5 ppm,Method,used to determine distance nla (approximation not valid).
3) OTHER
n/a
r
I
revised 9/2/98 Paoe 3 of 11
4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 26&28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/25100
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
- X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
- X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
- X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
- X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Na.
- X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
- X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
- X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic
compounds,ammonia nitrogen and nitrate nitrogen.
E. LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
The following criteria apply to large systems in addition,to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health
and safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
- X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412). Please consult the local regional office of
the Department for further information. .
E
revised 9/2/98 Paoe 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
` PART B
CHECKLIST
Property Address: 26&28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner: JEFF LYONS
Date of Inspection: 9126/00
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
Yes No
X Pumping information was provided by the owner,occupant,or Board of Health.
X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that
period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X - As built plans have been obtained and examined.Note if they are not available with N/A.
X - The facility or dwelling was inspected for signs of sewage back-up.
X _ The system does not receive non-sanitary or industrial waste flow.
3
X - The site was inspected for signs of breakout.
X _ All system components,excluding the Soil Absorption System,have been located on the site.
X - The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material
of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site
has been determined based on:
X - Existing information,For example,Plan,at B4O,H,
X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 1 5.302(3)(b)]
X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal
Systems.
tti
�s
revised 9/2/98 Paoe 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 26&28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/25100
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 110 g.p.d./bedroom
Number of bedrooms(design): 4 Number of bedrooms(actual): n/a
Total DESIGN flow: 440 gpd
Number of current residents:2
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): NO If yes,separate inspection required
Laundry system inspected(yes or no): NO
Seasonal use(yes or no): NO
Water meter readings,if available(last two year's usage): n/a gpd
Sump Pump(yes or no): NO
Last date of occupancy: n/a
COMMERCIAL/INDUSTRIAL
Type of establishment: n/a
Design flow: n/a gpd(Based on 15.203)
Basis of design flow:n/a
Grease trap present:(yes or no): NO
Industrial Waste Holding Tank present:(yes or no): NO
Non-sanitary waste discharged to the Title 5 system:(yes or no): NO
Water meter readings. if available: n/a
Last date of occupancy:n/a
OTHER: (Describe)
n/a
GENERAL INFORMATION
PUMPING RECORDS and source of information:
nla
System pumped as part of inspection: (yes or no):NO
If yes,volume pumped n/a gallons
Reason for pumping: n/a
TYPE OF SYSTEM
X 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)
_ I/A Technology etc.Attach copy of up to date operation and maintenance contract
_ Tight Tank Copy of DEP Approval
Other:n/a
APPROXIMATE AGE of all components,date installed(if known)and source of information:
1996-PERMIT 96-484
Sewage odors detected when arriving at the site:(yes or no): NO
revised 9/2/98 Paoe 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26&28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9125/00
BUILDING SEWER:X
(Locate on site plan)
'Depth below grade: 30"
Material of construction: _ cast iron X 40 Pvc _ other(explain)
Distance from private water supply well or suction line: n/a
Diameter: n/a
Comments: (condition of joints,venting,evidence of leakage,etc.)
TOWN WATER
SEPTIC TANK: X
(locate on site plan)
Depth below grade: 24"
Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other
explain: n/a
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO
Age: n/a
Dimensions: 150OG L 10'6"H 5'7"W 5'8""
Sludge depth: 4"
Distance from top of sludge to bottom of outlet tee or baffle: 30"
Scum thickness: 3"
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: n/a
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of
leakage,etc.)
THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING THE SYSTEM NOW AND EVERY TWO
YEARS.
GREASE TRAP: _
(locate on site plan)
Depth below grade: n/a
Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other
Explain: n/a
Dimensions:n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle n/a
Date of last pumping: n/a
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of
leakage,etc.)
n/a
revised 9/2/98 Paoe 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26 &28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9125/00
TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
v .
Depth below grade: n/a ",;,
Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other
Explain: n/a
Dimensions: n/a
Capacity: n/a gallons
Design flow: n/a gallons/day
Alarm present: NO
Alarm level: N/A Alarm in working order:NO
Date of previous pumping: n/a
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
nla
DISTRIBUTION BOX:X
(locate on site plan) °.
Depth of liquid level above outlet invert: n/a
Comments:
(note if level and distribution is equal;!evidence.of solids carryover,evidence of leakage into or out of box,etc.)
UNDER ASPHAULT
PUMP CHAMBER: _
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): NO
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
n/a
revised 9/2/98 Paae 8 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26& 28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/26100
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
n/a
Type:
leaching pits,number:(nla)n/a
leaching chambers,number: (4)INFULTRATORS
leaching galleries,number: (n/a)n/a
leaching trenches,number,length: (n/a)n/a
leaching fields,number,dimensions: (n/a)n/a
overflow cesspool,number: (n/a)n/a
Alternative system: n/a
Name of Technology: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY.THE SYSTEM SHOWS NO SIGNS OF FAILURE.
CESSPOOLS: _
(locate on site plan) i
Number and configuration: nla
Depth-top of liquid to inlet invert: n/a
Depth of solids layer: n/a
Depth of scum layer. n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nla
PRIVY:
(locate on site plan)
Materials of construction: n/a Dimensions: nla
Depth of solids: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n/a
� i
revised 9/2/98 Paae 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26 & 28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/26/00
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
a
o 614f-
revised 9/2/98 Pape 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 26 &28 FRESH HOLE RD HYANNIS, MA 02601
Name of Owner JEFF LYONS
Date of Inspection: 9/25/00
NRCS Report name: n/a
Soil Type: n/a
Typical depth to groundwater: n/a
USGS Date website visited: n/a
Observation Wells checked: NO
Groundwater depth: Shallow_ Moderate_ Deep_
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
Shallow wells
Estimated Depth to Groundwater 10 Feet+
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observed Site(Abutting property,observation hole,basement sump etc.)
_ Determined from local conditions
Checked with local Board of health
_ Checked FEMA Maps
Checked pumping records
Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
UGSS MAPS AND CHARTS-10+FEET
revised 9/2198 Paae 11 of 11
4 r
TOWN OF BARNSTABLE
LOCATION O�� -r,Z�"b"iP�S'�., 4.0 FS � SEWAGE # &
VP�L E ASSESSOR'S MAP & LOT:�—�-L
INSTALLER'S NAME&PHONE NO. "- o 0/Al,&Al- 2-7 7 G
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size) -1f7" 3 Q
NO.OF BEDROOMS _
BUILDER OR OWNER
PERMTTDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by 7 '�%IV --7�°''f
V
vV� �
0
. c
,. v
No. Fee $4 0 .0 0
r
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pprication for �Digaai bpotem Cott!trurtiott permit
Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No. 7 71 —2 0 0 8
esso2r8Map/Pa�e9h Holes Road, Hyannis Jeff Lyons
724 Main Street, Hyannis, MA 0260
Installer's Name,Address;and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.
Wm.E.Robinson Sr. Septic Srv.
P.O.Box .1089 , Centerville, MA 02632
Type of Building: Duplex
Dwelling No.of Bedrooms 2 Pa nh Garbage Grinder(nd
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil graVEL
i
Nature of Repairs or Alterations(Answer when applicable) Fill in old cesspool, Install
Title 5 system-1500gal . tank, D-Box and 4 heavy duty, high capacity,
stonepacked Cultex #330 infiltrators .
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 Certifi-
cate of Compliance has been issued by this B and of Hea
Signed 4 )�e ^-`� Date f�a
Application Approved by Ad Date C
Application Disapproved for the llowing reasons
Permit No. Date Issued
Fee $4 0.0 0
THE COMMONWEALTH OF.MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
ZIpprication for Miopaar Opotem Con!6tructfon hermit
Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at:
= Location Address or Lot-No. Owner's Name,Address and Tel.No. 7 71 —2 0 0 8 3
' 26-2�Fr eelh =Holes Road, 'Hyannis Jeff Lyons`
Assessors ap/farce 724 Main Street, Hyannis MA 0260
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.
i
Wm.E.Robinson Sr. Septic Srv.
P.O.Box 1089, Centerville, MAi026 2
I
Type of Building: Duplex 'd 1
Dwelling - No.of Bedrooms 9 `cia Ch Garbage Grinder(nd ;
Other Type of Building No.of Persons %Showers( ) Cafeteria( )
I` Other Fixtures
f a
t Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
L ` Description of Soil graVEL
k Nature of Repairs or Alterations(Answer when applicable) Fill in old cesspool, Install
Title 5 system-1500gal. tank, D-Box and 4 heavy duty, high capacity,
stoneyacked Cultex #330 infiltrators
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 Certifi-
cate of Compliance has been issued by this Board of Heal n
Signed_/��� Date
Application Approved by Date S-
Application Disapproved for the UlowingAeasons
Permit No. ! G, - � Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
Lyons BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( x)on
by Installer Wm.E.Robinson Septic Srv.
at 28-28 Fresh Holes Road, Hyannis has been constiM ted in accord °ce
with the provisions of Title 5 and the for Disposal System�Construction P rmit No, r, Q dated t'l Z'5-
Date=JI .. ? Inspector . '
v
THE ISSUANCE OF`THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A`GUARANTEE THAT TOP SYS-
TEM WILL FUNCTION SATISFACTORY.
No. - 1. Fee $4 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS r-
Lyons PUBLIC HEALTH DIVISION -BARNSTABLES MASSACHUSETTS
&!9 poe ar *p!6tem Cougtruction Permit ,
Permission is hereby granted to Wm.E.Robinson Sr. ., Septic Sry
to construct( )repair( x)an On-site Sewage System located at No.# 26-98 Fresh Holes Rd. , Hyanni s
Street
and as described in the above Application for Disposal System Construction Permit. 9 l -- $Y
No. T Date
The'applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions.
All construction must be completed within three years of the date below.
Date: ` - �/ Approved by
t Board of Health
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
j Wm.E.Robinson,Sr. , hereby certify that the application for disposal works
construction permit signed by me dated 9-2 4-9 6 , concerning the
property located at 26-28 Fresh Holes Road, Hyannis, MA meets all ofthe
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED: DATE: l
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
4
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L 0 CA TION SEWAGE PERMIT NO.
14)fl ?.6'l F94551A i-wLe �� 04 - 744
VILLAGE
14 i.ems a t S
INST A LLER'S NAME i ADDRESS
�3s 6 . Ove Co lktc-.
&(A .
BUILDER OR OWNER
Guus-t�Ir V I LA-&C-rg T;.
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
a_
ems, � ��
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f
7..
+a. -. - ,i
,.
i
— 100—-EXISTING CONTOUR N 6P
x 100.98 EXISTING SPOT GRADE ® °'ss, LOCUS
W EXISTING WATER SERVICE ROUTE 28 s
G EXISTING GAS SERVICE �°y ea
--&.H.bl —OVERHEAD WIRES A\�`o Rd H1"mop o�
TEST PIT F��y
BENCHMARK =
LEGEND 3 ; �D
U a C N
j a
Y� 4 a
`, o
fide,d9 potton
C� pve-
LOCUS MAP
NOT TO SCALE
O :. `PAVED COMMON'` .`,49.23`, (132)
N 77-O,DRIVEWAY: >11
ADJACENT
0 �y.: .:.
BENCHMARK 15. R=26`: " DUPLEX
L T. CORNER/STOOP 83'; L=23:.AA 9, �•
EL.=50.40 49.5` �j 61, (#30)
49.34 I LVT 9
'\ W 49.51 B 292-182
O G) O X 50,0 9,057 S.F.t �\
N o � 6
M 50.02
Z 49.5L���'9 ' w
I�1 (#24) EXISTING DUPLEX
�1 (#26) (#28)
ADJACENT 49,6 3 TO.F.=51.Of" �j48, -
DUPLEX + SLAB O/'GRADE �" l
`! (#22) 49. l/ : UTILITY
POLE I
\ PqV 49.4 .40 49,3/4 �/! x
b ti. 2 EO k'4Lk 48.77 I
+ 49.32
EXISTING SEPTIC TANK
TOP OF TANK, EL.=47.38f 9'• 0
INV.(OUT)=45.88t(VERIFY) 9 8 �L g g q4K
+
- 49,317
`2` O __
EXISTING S A.S�T `�
47,76 N
(APPROX.-FROM ASBUIL T) �N• ( _..: �. :. : :: .•. ... ., <...• . .,
TO BE REMOVED UTILI�fy =�
SEE NOTE 11 .26
POLE O
48.93
O:. Z.,
PROPOSE 1000
GAL. LEACH PIT
4`8,55 r� Opp.
:. � WITH 2' ,STONE
?..e '9-S,. PROP. 12 INTLET
PROPOSED SEPTIC TANK w
;3
1000 GALLON-IN SERIES : ',�3 I INV.=44�85
8880.0 ...: I 1
`N 5 .�. VENT o5
.. '.
STRIPOUT BOUDARY ..A %i` :_.:W_ :•�` I PROPOSED 12"
SEE NOTE 11 DONE"O' :48
CUT PAVEMENT . P
AeAN ,61 .:. rr DIA. HD PE PIPE
OOL;CESSP >.... 1:'.., :.`..
REPAVE :PAVED' PARKIN:` !
' EXISTING!LCB
REMOVE 4 REPLACE
! WITH SOLID CATCH
BASIN -
RIM=47.6
( / • EX. 12" 1, V.-45.17
C� •')� !hr �� rr PROP. 1 �MOUTLET)
d C��� .. 0 0 � :49.04 - ?
INV.=45.00
'1
�N
0 '-
ADJACENT vi
DUPLEX
(#14) (#16) ► 0-
� 1
OF
44s�9��G � J
PETER T. I
MCENTEE
Clvl�No. 09
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
351
£c�S1 26 & 28 FRESH HOLES ROAD, HYANNIS, MA
�oF \ P.O. Box 1691, Hyannis, MA 02601
/ Prepared for: Vincente & Edna Silva, y
t / OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
SILVA, VINCENTE D & EDNA M Engineering Works, Inc. 1"=20' P.T.M. 258-15
P.O. BOX 1691 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 1
HYANNIS, MA 02601 (508) 477-5313 11/10/15 P.T.M. 1 of 2
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:45.5
FOR A DISTANCE OF 15' AROUND THE
SEPTIC TANK PERIMETER OF THE S.A.S.
INSTALL RISERS & COVERS OVER THE PROPOSED D-BOX PROPOSED S.A.S.
INLET & OUTLET AS REQUIRED SET TO INSTALL RISER & WATERTIGHT FRAME INSTALL RISER, FRAME & COVER OVER ONE
6" OF FINISH GRADE. AND COVER SET TO FINISH GRADE CHAMBER AND SET TO FINISH GRADE
TO SERVE AS INSPECTION PORT.
F.G. EL.=49.3t F.G. EL.=48.85t F.G. EL.=48.4t F.G. EL.-48.5t
CHARCOAL VENT
MANIFOLD ALL CHAMBERS
L 9' L = 14'
S=1% (MIN.) ® S=1� (MIN.) L = 13'
4"SCH40 PVC 4"SCH40 PVC �4"SCH 0(PVC) 2" LAYER OF 1/8" TO 1/2"
6" DOUBLE WASHED STONE
10"I " 6 aaaSa®a (OR APPROVED FILTER FABRIC)
INV.=45.69 14 INV.=45.30 aeaaaaa
48" LIQUID �-3/4" TO 1-1/2" DOUBLE
ADD LEVEL PROPOSED 4' 4.8' 4' WASHED STONE
GAS BAFFLE GAS BAFFLE -BOX INV.=45.13
INV.=45.88: EFFECTIVE WIDTH = 12.8'
VERIFY H-20
E I TING INV.=45.44 �' INV.=45.00
SEPTIC PROPOSED SEPTIC TANK 3-500 GALLON LEACHING CHAMBERS
TANK 1000 GALLON, H-20 SURROUNDED WLTW-ZE0NE AS SHOWN
H- 0
TOP CONC. ELEV.=46.1 t
NOTES: BREAKOUT ELEV.=45.50
INV. ELEV.=45.00 a66a
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE aaaaa aaaaa
INVERTS, PRIOR TO INSTALLATION. mama mamma
BOTTOM ELEV.=43.00
2) D-BOX SHALL BE SET LEVEL AND TRUE TO 4' 3 X 8.5'=25.5' 4'
GRADE ON A MECHANICALLY COMPACTED SIX 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 33.5'
INCH CRUSHED STONE BASE, AS SPECIFIED PERVIOUS MATERIAL
IN 310 CMR 15.221(2). / 4' (MIN.) ABOVE G.W.
3) INSTALL INLET & OUTLET TEES AS REQUIRED. / LEACHING SYSTEM SECTION
BOTTOM OF TP, EL.=39.0
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE = -
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL.
SEPTIC SYSTEM PROFILE
SOIL LOG
GENERAL NOTES: DATE: NOVEMBER 3, 2015 (REF#14,878)
SOIL EVALUATOR: PETER McENTEE PE(SE#1542)
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL WITNESS: DAVID STANTON R.S. HEALTH AGENT
BOARD OF HEALTH AND THE DESIGN ENGINEER. ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 49 0 0" 49.2 0"
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE FILL FILL
LOCAL RULES AND REGULATIONS. 46.0 36" 45.9 40"
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR A A
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE SANDY LOAM SANDY LOAM
DESIGN ENGINEER. 10YR 4/2 10YR 4/2
-..:.. _ 45.7 _ 40"_ 45.6. 44_.'..
47ANY CONDITIONS ENCOUNTERED`DURING-CONSTRUCTION-DIFFERING SANDY LOAM BSANDY LOAM
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
ENGINEER BEFORE CONSTRUCTION CONTINUES. 10YR 5/6 10YR 5/6
43.3 68" 43.2 72"
5. ALL ELEVATIONS BASED ON ASSUMED DATUM. C C PERC
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 66"/84"
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. M-C SAND M-C SAND
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 2.5Y 6/4 2.5Y 6/4
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
DIRECTED BY THE APPROVING AUTHORITIES.
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 39.0 120" 39.2 120"
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING NO GROUNDWATER, PERC RATE: 2 MIN. 10 SEC./IN.
CONSTRUCTION.
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS /
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND EXISTING/DUPLEX
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). (f26��
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 7!
INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL.
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
NOT CONSIDERED TO BE A PROPERTY LINE SURVEY.
14. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH
PERMIT FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING
PERFORMED. S9
DESIGN CRITERIA 9�`s• o
4
NUMBER OF BEDROOMS: 4 .0
SOIL TEXTURAL CLASS: CLASS I
DESIGN PERCOLATION RATE: <5 MIN/INS
(0.74 GPD/SF LOADING RATE) N
DAILY FLOW: 440 GPD "I PROPOSED S•A.S
DESIGN FLOW: 440 GPD ��
GARBAGE GRINDER: NO MAGETIC 42.2
LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF
.74 GPD/SF NAIL SET ---73.9'
EXISTING SEPTIC TANK: 1500 GALLON CAPACITY S.A.S. LAYOUT
PROPOSED SEPTIC TANK: 1000 GALLON H-20 CAPACITY
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS PROPOSED SEPTIC SYSTEM UPGRADE PLAN
USE 3-500 GALLON LEACHING CHAMBERS IN SERIES ZG & Z8 FRESH HOLES ROAD, HYANNIS, MA
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES
SIDEWALL AREA: 2(12.8' + 33.5') X 2 = 185.2 S.F. Prepared for: Vincente & Edna Silva, P.O. Box 1691, Hyannis, MA 02601
BOTTOM AREA: 12.8' x 33.5' = 428.8 S.F. Engineering by: SCALE DRAWN JOB. NO.
TOTAL AREA:............................................................... 614.0 S.F. Engineering Forks, Inc. N.T.S. P.T.M. 258-15
12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
DESIGN FLOW PROVIDED: 0.74 GPD/SF(614.0 SF) = 454.3 GPD (508) 477-5313 11/10/1.5 P.T.M. 2 of 2
d