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HomeMy WebLinkAbout181-183 SEABROOK ROAD - Health 1 81-183 Seabrook Road Hyannis . _ A = 307 040 o < r�A e I it o II 1� ' aw HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM 30 C BOARD OF HEAL H Rol n44 CITY TOWN- P RTMENT r Qc� - ADDRESS TELEPHONE Address_ �0 1 _ Occupant_. Floor Apartment o. No. of Occn No.of Habitable Rooms No.Sleeping Roomsupa No. dwelling or rooming units No.St ries Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fence . Garbage and Rubbish An,0108d: Containers: _ with, (:Prt: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: 1z � ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: 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.: ks, Flues PIP ties: Kitchen Facilities ink ve Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: 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 P T S IQNED AND CERTIFIED UN D R THE PAINS AND PENALTIES PE J FtY " I� INSPECTOR TITLE DATE 1 ® TIME A.M. THE NEXT SCHEDULED REINSPECTION P.M. r 6 410.750: Conditions Deemed to Endanger o, Impair Health or Safety The following conditions,when found to ex'st 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 those items which are deemed to always have the pDtential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the Dotential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions 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 cf such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the perso-i to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure 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 longer. (B) Failure to provide heat as,required by 105 CMRr4110.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. ­­u (C) Shutoff and/or failure to restore electricit,/or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal 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 any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600,410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safe':y. (L) 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 facilties as 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. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the re ease of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) 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: (1) 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 inoperable. (2) Failure to provide a washbasin and s-iower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumb no or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gas`itting, or electrical wiring standards that do not create an immediate hazard. (4) 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 rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair 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. - _.. .q+ . . ,-_ .- -.9.. -�.....-..ar.r.r`^DTP^_...+r.'T'..••'�..1-.+.....Mw:,.+w•. .r.c'�}n[.*r �'•' MIM+n"wix�M1-.�-r...�nv.....,,.�..,,.Z„�._,,.,,,.y,e.,.,,,-.�,�_�..Y FORM30 HAW HoessaWaRaeNTM THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEAR44 rim LTH t CITY/TOWN- PARTMENT r ,r ADDRESS GBH SVBy`ow TELEPHONE Address l — Occupant_ Floor Apartment o. No. of Occupants No.of Habitable Rooms No:Sleeping Rooms r_ No.dwelling or rooming units No.Stories Name and address of owner 1 Remarks Reg. Vio. YARD Out Bld s.: Fences3 -Oct Garbage and Rubbish Containers: / ' d.` U Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: r _...., ❑ B ❑ F ❑ M Doors,Windows: 1 Roof A AT V Gutters, Drains: {{ Walls: Foundation: A W/j Chimney: BASEMENT Gen.Sanitation: i Dampness: Stairs: f Li htin : n `' STRUCTURE INT. Hall,Stairway: / Obst'n.: ( 'i Hall, Floor,Wall,Ceiling: i Hall Lighting: n Hall Windows: ,..�' - V HEATING • Chimneys: Central ❑ Y~ :❑ N Equip. Repair a TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: - - r -HW:=Tanks.Safet .arldVents ELECTRICAL Panels, Meters,Cir.: ❑ 110 11220 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 IMA'r Bedroom(1). Bedroom 2 � e-1 -) Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: St�a-ks, Flues,Ve s, feties: i Kitchen'Facilities __7;oink __1-141 __ Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: S / General Building Posted Jr Locks on Doors: r 'v ` w� 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 REP© T IS SIG ED AND CERTIFIED UNDER THE PAINS AND b PENALTIES 0 F,PE JURY. ' INSPECTOR TITLE n .M. DATE �" O TIME (P.M. A.M. THE NEXT SCHEDULED REINSPECTION kA P.M. 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 those 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 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in.his listing. Failure to include shall in no way be construed as a determination that other violations or conditions 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 such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include 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 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 longer. (B) Failure to provide heat as required by 10.3 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal 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 any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 135 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities'in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards o•failure to maintain such facilties as 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. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) 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: (1) 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 inoperable. (2) Failure to provide a washbasin and slower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) 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 rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair 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. �...�p-�;i.-•��..._ � _..,.h,--�,....-..-.,,._. ,..�..._.-......, r ,+ww,,r..w.rrrNno'.r"„"'e.�..;.....aFa'.reaY* - irxa:�ix�•ycsl�r [a.7'q..'"'',"°°°" *' `.`""""+r},**w"Rt� �. FORM30 C&w HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C,h CITY/TOW N- iEPARTMENT 'p ADDRESS i GSM svey`oW TELEPHONE Address Occupant_ Floor Apartment o. No. of Occu an No.of Habitable RoomsNo.Sleeping Rooms No.dwelling or rooming units No.Stories , Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences= `' AN "5 C7 Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: fJv Roof AN A k Gutters, Drains: il Walls: Foundation: {j w Chimney: BASEMENT Gen.Sanitation: °` �.✓' Dampness: V Stairs: Li htin STRUCTURE INT. Hall,Stairway: E / / ► ul Obst'n.: Hall, Floor,Wall,Ceilin Hall Lighting: Hall Windows: HEATING Chimneys: �.✓ Central ❑ Y ID N E ui . Repair TYPE: Stacks, Flues,Vents.- PLUMBING: - Supply Line: 4' ❑ MS ❑ ST ❑ P Waste Line: k. �-HW=Tank s -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 Livin 'Room rr Bedroom 1 I 17t , Bedroom 2 ( } C Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: - Stalks, Flues,,VentsjSafeties: Kitchen Facilities i ink) - " Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: �-, General Building Posted 1'( -� 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 REP lT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES O,F PERJ RY? 1 INSPECTOR '\.J� TITLE 1 -- ,r� A.M. DATE J TIME = r A.M. THE NEXT SCHEDULED REINSPECTION F k. 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 those 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 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions 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 such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include 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 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 longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electr city or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal 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 any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department•f Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) 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 facilties as 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. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) 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: (1) 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 inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) 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 rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair 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. I TOWN OF BARNSTABLE BOARD OF HEALTH r / ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date ID �C? Time: In Out Owner Tenant �✓ Q Address Address Complian Remarks or Regulation# Yes AO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities : 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18. Driveway Widthj�.._ 19. Number of Tenants Observed PART II - 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here . TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date r0 3 Time: In Out Owner dA Tenant Address Address f �- ri Pi- Compli ce Remarks or Regulation# Yes NO Recommendatio 2. Kitchen Facilities �pV 1 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed l 6� PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition , Number of Bedrooms Number of Vehicles Allo ed (max) l Number of Persons Allowed (max) Persons Interviewed Inspector f If Public Building such as Store or Hotel/Motel specify here V , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage disposal System Form--Not for Voluntary Assessments 181-183 Seabrook Rd - Property Address /� Horne Ec, NC4796 qU 0 -SPI DqQ 006 Owner Owner's game information is required for Hyannis MA -02601 2-20-08 every page. CitylTown State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. A. General Information f 1. Inspector: Shawn Mcelroy Name of Inspector Shawn Mcelroy Enterprises Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number e B.-Certification I certify that I have personally inspected the sewage disposal system at this ad�}`ess ancMat ttie information reported below is true,accurate and complete as of the time of the��tnspection jhe Rspection was performed based on my training and experience in the proper function ancaintenaiee of--on site sewage disposal systems. I am a DEP approved system:inspector pursuant t" Sectiofe-15.34®of Title 5(M CMR 15.000).The system:Passes- Conditionally, { ❑ Conditionally Passes ❑ Fa Is y ❑ Needs Further Evaluation by the Local Approving Authority 2-21-08 Inspector's signature €fie 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 flour of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DER_The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approWng atrthori!ty. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not aridness how the systent will perform in the future under the same or different conditions of use. 6insp•08/06 TOJe 5 Officral hr p Form Subsurface Sewage Disposal System-Page I of 15 Commonwealth of Massachusetts ugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection B. Certification (coat.) Inspection Summary: Check A,B,C,D or E/always complete all of Section 0 R A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more systefri 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. Answer yes, no or not determined (Y, N, ND) in the❑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. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstruc ted'pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipets) are replaced ❑ obstruction is removed t5insp-08106 Title 5 Official tnspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 SLAabrook Rd v Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E l always complete all of Section D e A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. 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. Answer yes, no or not determined (Y, N, ND) in the❑ for the following statements. If"not determined,"please explain. ❑ The septic taWis 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. ND Explain: r � ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed"pipe(s) or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed t5insp•08/06( - _z Title 5 Official Inspection Foam:Subsurface Sewage Disposal System•Page 2 of 15 u Commonwealth of Massachusetts Title 5 Official Inspection. Farm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is y required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.):-4 ❑' distribution box is leveled or replaced ND Explain: 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): El broken pipe(s) are replaced' ❑ obstruction is removed ND Explain: 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 2. -System will fail unless the Board of Health,(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5insp•0&06 Titte 5 Official Inspection Form:.Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cons.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 coliforTn 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 '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. t5insp-08/06 Tile 5 Official Impection Form.Suhsudwe Sev a Disposal System-Page 4 of 15 Commonwealth of Massachusetts W Title 5 Officia-1 Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 O ® 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 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is.below high ground water elevation. El ® Any portion--of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. t5insp-08/06 True 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts . Tile 5 Official Inspection Form" Subsurface Sewage Disposal System Form-Not-for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is r�wi red for Hyannis '. MA 02601 2-20-08 every page. City/Town . s.r` State. Zip Code Date of Inspection B. Certification (cost.) D) System Failure Criteria Applicable to All Systems (cost): Yes No ❑ . ® Any portion of a cesspool,or privy is within a Zone 1 of a public well. ® Any portion ofa 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 welt,with.,no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bactena 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 mast be attached to this form.] The system is a cesspool serving.a facility with a design flow of 2000gpd- 10,000gpd. F a 0 ® 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 ` r t "necessary to correct the failure. . ' E) Large Systems:'Ta be cons dered'a large system the*sy'stem must serve a facility with a design flow of 10,d00 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 "� ,' .. s 41. ❑t- 0 t r, the system is within 400,feet of a surface drinking water supply 0 , ' ❑ 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 n El 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. t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 N Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 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)] t5insp-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,v 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is Hyannis MA 02601 2-20-08 required for y 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)] t5insp-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Farm Subsurface Sewage Disposal System Form,-Not for Voluntary Assessments . r 181-183 Seabrook Rd Property Address Home Eq,, NC4796 Owner Owner's Name information Hyannis MA 02601 2-20-08 required for y ' every page. Cityrrown State Zip Code,, Date of Inspection 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 Number of current residents: 2 Does residence have a'garbage grinder? - SAS WI ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ®• No Seasonal use? ❑ Yes ® No Water meter readings, if;available°(last 2 years usage(gpd)) :,Y :� _ Sump pump? El Yes ® No 2-20-08 Last date of occupancy: + " Date Commercial/Industrial Flow Conditions: . Type of Establishment:. Design flow,(based on,310 CMR 15 M): ' ., p Gallons per day(gpd) Basis of design flow(seatslpersorisfsq.ft., etc.): 4,, ' Grease trap present? ❑ Yes ❑ No - industrial waste holding tank present?_ ❑ Yes ❑ No Non'sanitary waste discharged to the Title.5 system?',,, .:E.: ❑ Yes ❑ No Water meter readings, if available: Last date of occupancyluse: Date Other(describe): t5insp•0a/06 Title 5 Official inspection Forth.Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments as ,� 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) General Information Pumping Records: Source of information: N/A 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) (f yes,attach previous inspection records, if any) ❑ innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed(f known)and source of information: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp-08/06 Title 5 Official Inspection:Form;Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official In pecflon For Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address HomeEq, NC4796 Owner Owner's Name information is Hyannis re wired for y MA 02601 2-20-08 every page. City/Town State Zip Code Date of inspection Q. System Information (cunt.) General Information Pumping Records: Source of information: N/A 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) (f yes, attach previous inspection records, if any) Q Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): ; • r _ I Approximate age of all components, date installed (f known),and source of information: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp•08106 - - .Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 15 f Commonwealth of Massachusetts a ; . 0 Title 5 Official Inspection For Subsurface Sewage Disposal System Form=Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 . . Owner Owner's Name informati for on is required Hyannis . MA 02601 2-20-08 every page. City/Town - State Zip Code Date of Inspection D. System Information (cunt.) Building Sewer(locate on site plan); Depth below grade: 36"feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water,supply well or suction line: " ,feet Comments(on condition of joints,venting,evidence of leakage,etc.): , Good condition. Septic Tank(locate on site plan): "A ' r -Depth below grade: 30"feet Material of construction: ® concrete El metal' El fibergiass ❑ polyethylene . . El other(explain) v , If tank is metal, list age: - years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No ---- ------- --- ---=-------- ---- ---- ---- --- ------------------------------------------ Dimensions: 1000 Gal Sludge depth: ' ` ^ Distance from top of sludge to bottom of outlettee or baffle '. 22" Scum thickness �. 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 16" How were dimensions determined? Tape t5insp•W06 We 5 OlfficrA Inspection Form:Subsurface Sewage Deposal System•Page 9 of 15. Commonwealth of Massachusetts W Title 5 Official lnspectaon form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. Cityfrown 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.): Tank in good condition with all baffles in place. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑metal ❑fiberglass ❑polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) pocate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): t5insp-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (coat.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural,integrity, liquid levels as related to outlet invert, evidence of leakage,,etc.): Tank in good condition with all baffles in place. Grease Trap (locate on site plan)` Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related, outlet invert, evidence of leakage, etc.): I , 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): t5insp•08/06 Title.5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Tile 5 Official Inspection Form . Subsurface Sewage Disposal System Form Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 3a Tight or Holding Tank (cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert U Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition. . Pump Chamber(locate on site plan):* Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5insp•08/06 Title 5 Official Inspection Form:Subsurface SLwage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official lnspec$oon Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. Cityr town State Zip Code Date of Inspection D. System Information (cunt.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® r:leaching chambers number 3-500's ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovativelaftemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers in good condition with no signs of failure. t5insp-08106 TWe 5 official Inspection Form:Subsurface Sewage Disposal gSystem-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is y required for Hyannis MA D2601 2-20-08 every p9 a e. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3-500's ❑ leaching galleries number. I ❑ leaching trenches number, length: El leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/aftemative system Type/name of technology: Comments.(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach hambers in good condition with no signs of failure. t5insp•08/06 -Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 i f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is - °1 A 0260j 2-2Q-t)8 required for Hyannis � -- every page. Cityfrown state Zip Code Date of Inspection Da System Information (coat.) ` Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration ' Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil,_signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy(locate on site plan): u Materials of construction: M Dimensions Depth of solids Comments(note condition of sail.signs of hydraulic fOure, level of ponding,condition of vegetation, etc.): t5insp-08/06 ��tfe 5 OffieW hispecbon Farm_Subsurface Sewage llsposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 0 cial Inspection Form Subsurface Sewage disposal System Form -Not for Voluntary Assessments 181-1€3 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis MA 02601 2-20-08 every page. City/Town State Zip Code Date of Inspection D. System Information (coat.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. ��•111 �J J 0 v i t5insp-08M Tft 5 fk5ctat 6zspecti;on Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts Title 5 Official InspecUon Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I v 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name information is required for Hyannis PEA 02601 2-20-08 every page. City/Town State Zip Code Date of inspection D. System Information {coat.} Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 4 A ✓F "f El.tF '`raj (,� LJ t5insp•08106 Title 5 Orna,af Sns pr"�an Fo.:m:SuGsis-lacP Savage C'spasal System•Page 14 of 15 Commonwealth of Massachusetts _ u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 181-183 Seabrook Rd Property Address Home Eq, NC4796 Owner Owner's Name informationis required for Hyannis MA 02601 2-20-08 every page. Cityrrown State_ Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: 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 reviewers: Date ® Observed site abutting property/observation ho le within 150 feet of SAS) ® ' Checked with local Board of Health-explain: ® Checked with local excavators, installers-(attach documentation) r: ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: Original design plans show no water at 12'. t5insp•08106 Tdle 5 Official Irwspection Form:Subsurface Sewage Disposal System•Page 15 of 15 YOU WISH TO OPEN A BUSINESS? For Your.Information: Business certificates (cost$30.00 for 4 years). A business"certificate ONLY REGISTERS YOUR NAME in town (which ' you must do by M.G.L.-it does not give you permission to operate.) Eusiness Certificates are available at the Town Clerk's Office; 1' FL., 367 Main Street, Hyannis, MA.02801 (Town Hall) 0._77 - r � ` L Fill in please: a APPLiGANT•S YOUR NAME: ` .BUSINESS "TOUR HOME ADDRESS: c QcloanK gay71 _ a6 bo AS TELEPHONE # Home Telephone Number NAME OF NEW BU 1I ESS OA1S-r 17sZC;n r) TYPE OF 6USINESS: C OA),S IS T141S A HOME OCCUPATION? YES, T, NO . Have you been given ap,proval�frot�rtFre 6uilCldj sio ?YES _. ..NO ADDRESS OF BU'SINESSr 4A IVLAP/PARCEL NUMBE When starting a new business there are several things you must do in order-to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information.you may need'. You MUST GO TO 200 Main St. - (corner of Yarmou`h Rd. & IVlairi Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. -.7. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to.this type of business, Authorized Signature COMMENTS: 2. BOARD OF HEALTH This individual h infor e the p it reclIcrements that pertain to this type of business. Authorized Si ature* COMMENTS: . 3: CONSUMER AFFAIRS LICENSING AUTHORITY This individual ha n infor `ed of e lice n req ments that pertain to this type of business. L Authorized Signature.* COMMENTS: , - TOWN OF BARNSTABLE LOCATION f _ I R 3 5&A hta0o k- CiQA F) SEWAGE # aw3—L(.(.o VILLACE ASSESSOR'S MAP& LOT J0'q'J) f 4) INSTALLER'S NAME dt PHONE NO. u SEPTIC TANK CAPACITY I ai oo o LEACHING FACIUN: (type) 3 DP-V V-36(1 S (size) I'7 X -3 4 K Z - NO.OF BEDROOMS BUILDER OR OWNER lu t),I A PERMTTDATE: �1 0 3 COMPLIANCE DATE: 9/1 S Lo 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 �i . ® 2N G.�, � � �. � �` � � � TOWN OF//��BARNSTABLE LOCAnc-N ���-`�3 -'5-?c roy k ke SEWAGE # VILLAGE I7VG n v►�S ASSESSOR'S MAP & LOTJO7""'T" �— INSTAdER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I D06 LEACHING FACILITY: (type) L 1PAc SribPr (size) 3 >SDO 3 NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: CON 1.PLIANCE DATE: Separation Distance Between the: ' Maximum Adjusted Groundwater Table to the Bod.6 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) y S� CB Feet Furnished bk�^'�► `El��st7 ��� n C O as � o S,oc SC -0 9 -o£ -0 �� 7 8IM J- No. 90 V Fees , / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: !� Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zlppiication for Mtgool 6pgtem Conotruction Permit Application for a Permit to Construct( )Repair()()Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot Ngg. Owner's N e,Address d Tg1.No. I)q/S 64 a /'�1G 01,4 5 Assessor's Ma /Parcel : 'a A(v Installer's Name Address,and Tel No. Desig is N Add s and Tel.No. �n�vn � 5�ar-�` i6 9 C'en S 1J.zn �l� S � Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder(/la 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 Size of Septic Tank k.. .i , Type of S.A.S. Description of Soil, Nature of Repairs or Alter tions(Answer when applicable) //7 5;A411 4 /)� Ii Z�� SVn,_t - /- Q� 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 ttooaVof Health. Signed v Date Application Approved by Date Application Disapproved for the following reasons Permit No.rXQ0 3 F 40 Date Issued ( "/ 9-0 7 :,.....-•-..�.yc,..w...w^��..ti......-�--�r.,a*�.�._.... ,.i.. ..`r..-.-..X.-'....w-rt.�. i... -.._.v �- t. -_ - .. ..... .. A - . f' �r lvo. V U �V �>�_ .� __ _ Fe� d" y / THE.COMMONWEALTH OF MASSACHUSETTS Entered in computer: i Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS t ZppYication for-Migo ar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. Owner's N e,Address and Ty 1.No. /83 secc,b�a9 R� ,tr�An�'S tio6A 7 nic,fio/�s Assessor's f0,71 M y0 Installer's Name,Address,and Tel.No. Desig er's N e,Address and Tel.No. ltJM C /j,001nsan S�of,e. S.ery C , Z Sao!► S . ►J,c n �t! S Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder(/)(,)' Other Type of Building No.of Persons Showers( ) Cafeteria( ) Ott er Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date ,Title Size of Septic Tank .t xcj,,, I t1JD [7 Type f S.A.S Ud b. f .t r Description of Soil Nature of Repairs or Alterations(Answer when applica le) /P fly 5^ �40,aGl1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage-disposal system t> 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 thi o d'of Health. Signed Date I.d,. )� p J v�. ,,/ y Application Approved by 1 - Date c-1^-/h- 3 f` Application Disapproved for the following reasons Permit No. o o 3 - h Date Issued 9" y-Cl T r —_. —————————---— ----- ————— -------- . fi j e,46 0 S' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the/�On-site Sewage Disposal S stem Constructed( )Repaired(X)Upgraded( ) Abandoned( )by UM .� Oh l r Son 5i;h e- 5z!v/e-k-- at /Ff3 5_eg_hPaOk R -go/S has been constructed in accordance with the provisions of Ti 5 and the for Disposal System Construction Permit No. 00 ^ 6 dated 9-1 - UJ Installer Designer ` �� The issuance of thi a n't shal not be construed as a guarantee that the syste w'. c o as i r /, Date f,� 7 Inspector !/ /( 0 _5 - f-, No. 00------------------------------------------ LV Fee •52�,40 Ic CIA S THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migogal *p!6tem Construction Permit Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( ) System located at 5?-3 T and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of�hishis p Date:_ ! _ Approved by TOWN OF BARNSTABLE LOCATION �R'1 SEWAGE # � -L((00 ' VII,LAGE (� d`��'i S ASSESSOR'S MAP &.LOT • �,,.� �Ar•�ti t. S d�P 77S�g7 7�_ I INSTALLER'S NAME&PHONE NO. 46V2 Oi, ) u SEPTIC TANK CAPACITY 3 LEACHING FACILITY: (type) DEZV�C-I I S (size) � � �+y x Z NO.OF BEDROOMS A BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: q ' 5 fd Separation Distance Between the: Feet Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wend and Leaching Facility(If any wetlands exist Feet / Furnished by I - I i I TOWN OF BARNSTABLE LOCATION 1?11,lp3 564 A' RQ SEWAGE VILLAGE ASSESSOR'S MAP & LOT� Ya j INSTALLER'S NAME & PRONE NO. a(ZI,g,J C. -1,L) SEPTIC TANK CAPACITY /.foci Gs7- —_ LE-ACHING FACILITY:(type) _cgs (size) X /00061-P NO. OF BEDROOMS 4/- PRIVATE WELL OR PUBLIC VNATER PWS 13UILDER OR OPl 1ER ��A L 4 tJ I o DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_�� V;IRIANCE GRAFTED: Yes_ �_r No� 1 -11 `93,l� Jo .f►'9h � Q� W a. i o � Q a No. d THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 'HEALTH . .: .................OF.......1 r�. .s . .l . ... Appliration for Disposal 10orks Tonstrudion 1hrnttt Application is hereby made for a Permit to Construct. ( ) or Repair (X) an Individual Sewage Disposal system at: ....... ................ ..................... Locaton-Address • or Lot No. • ............:.--•.....................•-•--.......---•- 1f11_��..,f�i �e .tY, Y. 2:...... R(� 1 owner Ayd�dr ss t• Cr--l�-s., lLig................. �!1.....�L�.Yw ...lN .,�.Q Ar w--�........................ ( . Installer _ .Address •• Type of Building ®op €X Size Lot....2 j:.Ya_�?..___..Sq. feet 1.4 Dwelling—No. of Bedrooms........../�_.�................................Expansion'Attic ( ) Garbage Grinder ( ) � Other—T e of Building ..........................Other—Type P ---- ( . ) _ Cafeteria ( ) d Other fixtures -----•------•-•---------•.......................---•--..----•-------------......------------- ------------------------ W Design Flow.........11.0...........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity../.499®gallons Length..-/Q`Z.O'Width.S' _P:"Diameter................ Depth................. xDisposal Trench—No..................... Width...... Total,Length...........`...... Total leaching area....................sq. ft. 3 Seepage Pit No._ .....A........... Diameter..__...6._........ Depth below inlet............... Total leaching area...AJA,......sq. ft. Z Other Distribution box (x) Dosing tank ( ) Percolation Test Results Performed by.. lU. .,._� 5e4` _, ................. Date......f_.S_ __ l.....-_... Test Pit No. 1______ minutes per inch Depth.of Test Pit.....1-.et..' Depth to ground water... f=. Test Pit No. 2-- AM....-minutes per'inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------------•....-----------.....------...---=--....----=--------------------------------.........................__..._....•••---....•. o - Description of Soil...............MZ X1�t.......To......CDACS-'...�� O.--------- W ..•------------- -----•----•---•-•-------••••---------•---•-------•-----•---�•-----. •-----......----...---••----.....---.....--•---•-------•-------.........--••--•-- ._...........-----••--- U Nature of Repairs or Alteration Answer when applicable ...��`/-�w�'._._,+�'oliry...... � � � ..........._. x �5 V-4C4---.�`o.....b.�'._A;0Ps*r,6........0.5... ................................................................................................... Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f health. .� Signed..--- . . .....C . ........................... .... 1A, ..el Application Approved B G1.: ................................................ ----•• ' ^T • Date Application Disapproved for the following reasons---------------•-------------•-••--- - •-•-•-•-•--••-•--••-----•--------------------•--------•-------•--••----------•---•----.....--------•--------............---------------•----•_...................................................... / Date PermitNo.......................�.-•--•--•-•••--•-- Issued.............•-------------.....................--...... Date Mo. ...l . � � 4 Fxs......��p............ oo THE COMMONWEALTH OF MASSACHUSETTS t • BOARD OF HEALTH ..................OF.........Pa.,AA,,J.Aj-A. .4. .......................................... Appliratiun for Diupuuttl` urku Tunutrnriiun,thrutit Application is hereby made fora Permit to Construct ( ) or Repair (X) an Individual Sewage'`Disposal System at: �• a,:-.. ..\ Location-Address l .. ................... ^•..........or Lot No.._........ .....--....._........--••-- ....._ a W -� , Ow r ner Add r ss � a .......... s�L ......................................... --- m 92 t ,� ?---- .Qae ,R�..- ............................ Installer Address ress Type of Building b op LFx Size Lot.... .......Sq. feet 1 4 Dwelling—No. of Bedrooms.........#...............................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other'fixtures -----•-•--------••-••---•-----•............ . W Design Flow.........J1.®...........................gallons per person per day. Total daily flow............................................gallon s. W Septic Tank—Liquid capacity../-]oogallons Length---/!!.'.K! Width. '_Ejv Diameter__ -------------- Depth.............. -- x Disposal Trench—No..................... Width...........r........ Total Length...................f Total leaching area....................sq. ft. 3 Seepage Pit No.......`R........ Diameter....... *__..... Depth below inlet..... :........ Total leaching area....#),0.......sq. ft. Z Other Distribution box (X) Dosing tank a Percolation.Test Results Performed ................ Date...... 9 14 Test Pit No. I................minutes per inch Depth of Test Depth to ground water...OkIn '-._.F7h1Q. Li, Test Pit No. 2----4 .4----.minutes per inch Depth of Test Pit.................... Depth to ground water........................ RS ------------------------------------•------....................................................... ......................................................... O Description of Soil............... fAXIAA.......Tb........ '_...SAT. ---•......................••----•...........•••..•---• W U Nature of Repairs or Alterations—Answer when applicable..____..!��CIST�?r .._., ?/�'�!�:.__.._r. Sw' ?s� ............. --------z-Q r .... 1 nrlx.....-........ ........................................._.......................................... Agreement: 14. The undersigned agrees to install the aforedescribed Jndividual Sewage Disposal System-in accordance with the provisions of TILE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board ofhealth. ,�J Signed.. J l l:_. � -k� 1- Q ` 9 _ ••....r .Date Application Approved By- . .�. ''� = -� -- /-r���t Date Application Disapproved for the following reasons----------------•----------------------------------------------......------------•-------•-•-......---......---•- ....................•----...-•----.................------......------•-••----------......------....--==----•---......---•--••-•-•-•-•-•-•...---•••••--•••------•-•••-•••-••--•••------•----............ /q Date Permit No..............•..•....— .. / Issued-....•.........--------------------•--•-•--•---......L Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r. A.:? ..................oF.......R6k}.tr 1.:<'T k.s.Jj�7....................................... ` Trrtifiratr of Tuntplianre THIS IS TO CERTIFY, That:the Individual Sewage Disposal System constructed ( ) or Repaired (V bY----------------------------------------------------------------------------------------------------------------------:.....-.-.......-...-.-......--••-----•--.....•..-------------•--•--------••-- Installer at................•--•----------...-•----••-•--------•---------...-------------------•-------_----_---_------------------------------- has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----------------------------------------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. •--- [........................................... Inspector.----------.....---- ....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD 'OF HEALTH �; ... .qua.. ...................O F.... �_. t?�1. 1. .. o0 Now_ ..�1 .. FEE....��,.....................--• Diupuuc�l Works Tons#r ion '"rrntit Permission is herebyranted.......f�_>"� ! `x'._.._. .L.`v� _: g to Construct ( ) or epair (A) an Individual Sewage Dispo9l System I �G��r_Iv `�---------Ff -----------------------•--•-----------•---------••--•---•.......•--•-- at No............... -••-•-- S eet ✓` . G� as shown on the application for Disposal Works Construction Permit-No.—............... Dated........._..:�' .................... ll,>ard of Health DATE................. .......--............................... ,. BENCHKARK SOIL TEST FOUNDATION $ TOP OF FOTION 20 FT. MINIMUM FROM CELLAR ELEV. UNDA_ 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST f 3/Q3 120-00 CLEAN SAND SOIL TEST DONE BY (ASSUMED) CONCRETE WITNESSED BY _1E`g461Nso>' Si3�_ COVERS 4MAX. SEED 4" SCHEDULE 40 PVC PIPE OBSERVATION HOLE 1 ELEV.= 97.12 MIN, PITCH 1/8" PER FT. 2" LAYER OF PERCOLATION RATE _< ?_ MIN./INCH AT _ 3�48 INCHES 981 1/8" TO 1/2" LEGEND: DEPTH HORIZ TEXTURE COLOR MOTT. OTHER MAL 97. WASf'ED STONE EXISTING SPOT ELEVATION 00,�0 N/A 4" CAST IRON PIPE 7.25 MIN. EXISTING CONTOUR ----00---- (OR EQUAL) MINIMUM EL 96.0 x FINAL SPOT ELEVATION PITCH 1/4" PER FT. \ aZ FINAL CONTOUR A Y 1 YR 3DDZABEL FILTER \ SOIL TEST LOCATION9FLOW LINE UTILITY POLE -4- TOWN WATER =Wa+riW ELEV. � _ _N,LA _ 1 ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ [3 / � 12-24 LOAMY 10YR8 NO MINN ❑. 2 o o ° CATCH BASIN ��� EXIST. ELEV. _ _94_5O LEVOEL ° ° ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o ° GAS LINE ELEV. _ _94.7� GAS _ 6" SUMP _ ° ° CLEAN OUT C v ELEV. = 9Q ELEV. = 94_QQ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o 2' o CESSPOOL C.P 0 24- BAFFLE o MEDIUM TO DISTRIBUTION ELEV. _ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ° C COARSE SAND 1 OYRd/6 NO LI UID OUTLET BOX °° ° ° ° ELEV. _ _91.75_ 4 FEET 14 INCHES 1500 GALLON TO BE WATER TESTED -1 5 FEET 19 INCHES IF MORE THAN ONE OUTLET 4 500 GALLON DRYWFLLS WITH STONE 6 FEET 24 INCHES 7 FEET 29 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) IN A 1.3' X JJ.5' X 2'TRENCH FORMATION ? 613� WELL N/A NO WATER ENCOUNTERED AT 138_ ELEV. ZONE N/A 8 FEET 34 INCHES EX/STING 3/4" TO 1 1/2" CLEAN SOIL ABSORPTION u) INDEX DREG WASHED &SSIOLNE SYSTEM (SAS) ADJUS i DESIGN CALCULATIONS 4 C / NUMBER OF BEDROOMS USGS PROBABLE WATER TABLE ELEV. = _ILIA_ GARBAGE DISPOSAL UNIT NO, NQT 6U_OWED SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. = _ A�_ TOTAL ESTIMATED FLOW NOT TO SCALE BOTTOM OF TEST HOLE ELEV. = S2Z- ( 110 GAL./BR./DAY X _4 BR.) _40 GAL./DAY REQUIRED SEPTIC TANK CAPACITY RM._ GAL. ACTUAL SIZE OF SEPTIC TANK _1�74� GAL. SOIL CLASSIFICATION DESIGN PERCOLATION RATE Ste_ MIN./IN. EFFLUENT LOADING RATE -.D GAL/DAY/S.F. LEACHING AREA SO. FT. (13'x33.5')+(97'x2') LEACHING CAPACITY (AREA X RATE) _09- GAL./DAY 621.5 X 0.74 RESERVE LEACHING CAPACITY _bVd_ GAL/DAY NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT, OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. BSoo 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE, 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE NTH DEEDED OR ZONING REGULATIONS. ONMER / APPLICANT IS TO SA.S OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. - 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. x 0 0 �¢?" 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS !! LOT 2 ® 95.5 SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION �97.12 """�" •97•7 IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER 9, 406 f S. F, _ - C EX/STING �.rf. - 8. PARCEL IS IN FLOOD ZONE _ __. 1000 GAL 9. LOT IS SHOWN ON ASSESSORS MAP _ � AS PARCEL _40 1 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND SEPTIC TANK FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM, d I AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. O' SIZ-'�'SBVZ t 11. EXISTING LEACH PITS TO BE PUMPED AND FILLED WITH SAND /97.9 �, OR REMOVED 97.8 SIFPS I , 977 97.7 U I �� ' APPROVED: BOARD OF HEALTH 100.0 o EXIST/NG DWELLING °97.5 ` ! /t'� DATE AGENT g97.5 srFPs 97.5 TH MA PROPOSED SEPTIC DESIGN I •97.4 97.5 FOR a • 97.4 WM. E. ROBINSON, SR. 97.2 _J U_ 4 97.0 a T�'Q�'UL LAN SRN LN • 96.8 LOC.181 183 SEABROOK RD LOT 2 97.2 cusBARNSTABLE MASS 96.8 gSp0LO t •96.8 - ------ �'alU1U1�S' SEABROOK c .96.9 CRAIG P. SHORT, P.X SE�B�oO 235 GREAT WESTERN ROAD 96.7 .96.7 i 508- SOUTH DENNIS,MASS. • 96.7 1 398-8311 02660 i GOSNOLO DATE SEPT. 9, 2003� SCALE = 20' o REV JOB NO. 1-986 L_ LOCATION MAP RED. SHEET 1 OF 1 01-0986 Robinson SP-OO.dwg 02003 CRAIG R. SHORT, P.E. ,