HomeMy WebLinkAbout0105 UNCLE WILLIES WAY - Health 105 Uncle Willies Way
A=292292-003-015
i
P
i
s
e P.
I.
> T3 WN OlF R ARNSTAB LE
.Al 0 <
V [.AGir n 3 SSE5SOR'S lvf.4d'&.1LOT
LNST �R'S NAND P�t4I�iE Nd
SF1EslIC TA1 K C". X;.
L AG'IItNG AACIJ TY (eye$)
�UIL09R R OWhI��
FJE;P.N�gTA�+` CO1b�IbCIATt .. ._.-
SopttradonisPxznoe T3stvieea ate '' Feet
Maxitr►rcn/� just rl.G�ppradwaterTaaletothe pttomokX.-,8qb! �CsuiUty M
PilvBe1�d4r S �!' Vdc�l adlc9 Y.ea4hing pacikta► mny w,tls exist
! y Fctet
tia sgtG oe'wlthii►:20a fetst`oR i�ec tag fttG bdY) ._._. .
Ec1L o��i f�t4ant, and l•cacdti�g Fac f¢y tY z3uiy wetlands exist
J
xu �>t� wy
4
Its
0,7
► 1 � 1 ,
t
Commonwealth of Massachusetts
Tine 5 Official Inspection Form
."I. Subsurface Sewage,Disposal System,Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey ,
Owner Owner's Name
information is y Hyannis:: ��J` �, t'' MA 02601 10-12-16
required for ever y
page. City/Town State Zip Code Date of Inspection
t fU
Inspection results must be submitted on this form. Inspection forms may not be altered in any f-:
way. Please see completeness checklist.at the end of the form. 'Q
A. General Information
1. Inspector:
Shawn Mcelroy `
Name of Inspector
Upper Cape Septic Services
Company Name ,
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
Telephone Number License Number
f
B. Certification ,x
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. lam a DEP approved system inspector pursuant to Section 15.340 of
Title 5 (310 CMR 16.000).The system: ' '
®• Passes a; ,_ EIN Conditionally Passes ❑ Fails
❑. Needs Further Ev on by the Local Approving Authority
F
10-12-16
In'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
r
Commonwealth of Massachusetts
a=1 Title 5 Official Inspection Form
wA Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
� a
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
;.information is Hyannis
required for every y MA 02601 10-12-16
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
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.
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 o,exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
la Tide 5 Official Inspection Fora
-'fl-I Subsurface Sewage Disposal System Form Not for Voluntary Assessments
105 Uncle Willies Way
Property Address .
Pamela Tobey 1 �,,•;
Owner Owner's Name
information is r
required for every Hyannis'S s 4 MA 02601 10-12-16
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
' pumps/alarmsIare repaired. `
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or,break'outtor high static water level in the distribution box due
d to broken or obstructed pipe(s)-or' ue to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipes) are replaced ❑ Y ❑ N: ❑ ND (Explain below):
El obstruction is removed'' El ,❑'N T El ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
0.
'f t . .k•,. .k? •x. d y -a .. r ry,>:a'..+- ,..« ..;i 1 "^} i .t r.i ._ r., . ..
❑ 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 thd'environinent: " ` rL', .i !
❑" Cesspool or privy is within 50'feet ofa 'surface water
El Cesspool or privy is within'50 feet of a`bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Commonwealth of Massachusetts
al Title 5 Official Inspection Form
it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
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
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 feca'
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
El ® or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
40*1
Commonwealth of Massachusetts "
,a=1 Title 5 Official Inspection form
.�1i;.1 Subsurface Sewage DisposaLSystem Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address ,1a
Pamela Tobey
Owner Owner's Name
information is ,
required for every Hyannis MA 02601 10-12-16,%�r
page. City/Town r•: _ State Zip Code Date of Inspection
B. Certification (cont.)
Yes. No;:, ti i. r. k �, ;;.:c.r, t
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
El ® • -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" ® T`tributary to a surface water supply.
•t. _ ;�: .v ❑ , ® ,t,it Any;portion,of a.cesspool or privy is within a Zone 1 of a public well.
0 ® ' Any'portion of'a cesspool or privy is within 50 feet of a private water supply well.
r Ej 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-
❑s t ® � The'system fails. I have determined that one or more of the above failure
criteria exist as describedin 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
f design flow of 10,000 gpd to 15,000 gpd.
_:- For large systems, you must indicate-either"yes"or"no"to each of the following, in addition to the
questions in Section•D!
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a.tributary to a surface drinking water supply
the system is located'in a nitrogen sensitive area (Interim Wellhead Protection
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.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System r Page 5 of 17
Commonwealth of Massachusetts
�a=1 Title 5 Official Inspection Form
'I?;.I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
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
la Title 5 Official Inspection Forte
1'.1 Subsurface Sewage Disposal System,Form.-Not for Voluntary Assessments
105 Uncle Willies Way
r
Property Address
Pamela Tobey
Owner Owner's Name
information is
required for every Hyannis MA 02601 10-12-16
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
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
Seasonal use? ,} , ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)): ,
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 10-2016
Date
Commercial/Industrial Flow Conditions: .
Type of Establishment:
i + Design flow (based on 310.CMR:15.203):
Gallons per day(gpd)
c Basis of,design flow(seats/persons/sq.ft., etc.):. .
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? A ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
a=1 Title 5 Official Inspection Form
R! �A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
page_ City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use:
Date
Other(describe below):
General Information
Pumping Records:
Source of information: Owner--pumped 9-2016
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping: Maintenance
Type of System:
❑ Septic tank, distribution hox, 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
a=1 Title 5 Official I nspection Form
Subsurface Sewage Disposal.System'Form -Not for.Voluntary Assessments
105 Uncle Willies Way
Property Address y-
Pamela Tobey
Owner Owner's Name Y4.
information is
required for every Hyannis "-�y :.`i} ,P", MA 02601 10-12-16
page. City/Town , , State Zip Code Date of Inspection
D. System Information (cont.) , . . ' .
Approximate age of all components, date installed (if known) and source of information:
2001
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site.plan): is w
Depth below grade: .. _, . •. - � s� N- .,. - , .,,- 20" ,
feet
Material of construction:
❑ cast'iron •® 46PVC ❑'other(explain):.'
Distance from private'Water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Good condition.
Septic Tank(locate on site plan):
Depth below grade: 14"feet
Material of construction: _
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: . . .f 1500 gal
Sludge depth: 61.1
-
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
�a l .p Title 5 Official Inspection Form
i-1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
t 1��
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every H annis MA 02601 10-12-16
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
26"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom cf outlet tee or baffle
15"
How were dimensions determined? Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins-W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
�a Title 5 Official Inspection Form
-.l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address ;
Pamela Tobey -
Owner Owner's Name
information is ,Q•F ;.1
required for every HyannlS , MA 02601 10-12-16 �t
page. City/Town State Zip Code Date of Inspection
D. System Information (cont,)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, eVidence'of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
- # Dimensions:
Capacity:
gallons
Design Flow: . ... .,
+' ` • gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes• ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
l Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
page, City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
Good condition with water at working level and no sign of back-up from field.
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:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
l
Commonwealth of Massachusetts
Title 5 Official Inspection Form
�; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey tf
Owner Owner's Name "
information is required for every Hyannis I MA 02601 10-12-16' : f y
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.) _
f' a t� r .. itl ant „y,t- 3•.d" �� r r
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
® leaching fields number, dimensions:
1-13x48
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
- Comments.(note condition'of soil;signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach field in good working order with no sign of back-up into d-box or surrounding stone.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
i
Commonwealth of Massachusetts
a=1 Title 5 Official Inspection Form
r,
' 11.1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
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.):
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.):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
:a= Title 5 Official Inspection Form
� I Subsurface Sewage Disposal System Forme-Not for Voluntary Assessments
°I r
105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is
E required for every Hyannis i MA 02601 10-12-16'
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
G
C.
3 � - _ �
~C�? ,
t
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
6-
Commonwealth of Massachusetts
Title 5 Official Inspection Form
f
x' .�� Subsurface Sewage Disposal System Form Not for Voluntary Assessments
p,f! 105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
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: 20'
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health - explain:
® Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database- explain:
You must describe how you established the high ground water elevation:
Original design plans show no groundwater at 12'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
e
� Commonwealth of Massachusetts
+^ T f Title 5 Official Inspection Form
�'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1W 105 Uncle Willies Way
Property Address
Pamela Tobey
Owner Owner's Name
information is required for every Hyannis MA 02601 10-12-16
i
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
7 TOWN OF BARNSTABLE
Ln,,ATION 10-5 f'.°lt;/lt (A9a SEWAGE # 673
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S.NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) Ca /tk C S (size) i� bSe 4/8
NO. OF BEDROOMS
BUILDER OR OWNER f e3 ear
PERMITDATE: 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 wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
i
i
d
tY
M
.y IQJ
9
No. �W, �(J / O i r ? FO'e 5 0 V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
0(pplication for ;Diopooar Opotem Conotructfon Permit
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System D Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
105J1D%clg Willy' s Way, Hyannis Pam Tobey
Assessor s ap arse
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service Ronald Cadillac
P O Box 1089, Centerville P O Box 258, W Yarmouth
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building RP G i d Pn t i a 1No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 gallons per day. Calculated daily flow gallons.
Plan Date 9—2 5—01 Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil X OTC_f1 ��f �2 X y r j
Nature of Repairs or Alterations(Answer when applicable) 'New Title-5 septic system to
the plans of Ron Cadillac, dated 9-25-01 ,
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 issuud by thisBo d of Heal
Signed ^✓�' Date
Application Approved by 4A � � Date
Application Disapproved for the following reasons
Permit No. 1 Date Issued
g
V
AI ZIA. 4%
—;rg
Mi
M LOCATION - it,� "Ifl,
0 . ......
0
V .AGE I L OV:,
77-75-
INSTALLER'S
76
SEPTIC TANK CAPACITY
V
si ie)
LEACfENG.TAC!rr"Y:.(typ-e). bivd
R `0"NO.OF BEDROOMS -MS li!
%
,BUILDER OR OWNERTed
/h 6'
OMPLIANCE DATE:
PSWIT- D'ATE' d,;-, 0.V
77. 7
Separati6ri-DistAfic,p't.e'.vween.th e-.
,�,
-F eet:-
�6--dwateitabld to the Bottom of Leaching Facility
Maiimum Adj4s�t6drd�66
Trivate Water y W611 inid'Uicl�*ng"tac r anyve s exist',
Feet o eac fik faci, rYY,
onsite or widilfi1oof i fl W b
ac
WetlandEdge of
an .*Lc dii C.
,
Y 4"w5t.44,--PAIS
Fee-If- e
urlushed-b
10' f I e`dc'hi ng: acl�,ty.
3,
...........
&
D
..........
J
-17.
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE} MASSACHUSETTS
Application for Miopoar *proem Congtruction Permit
w Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System El Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
105 UnU Willy- s Way, Hyannis Pam Tobey
Assessor's Map/Pazce
," .
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm. E. Robinson Septic Service Ronald Cadillac
P O box 10889 Centerville P O Box 258, W Yarmouth
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Res i dent-i a 3No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 440 gallons per day. Calculated daily flow gallons.
Plan Date 9—2 5—01 Number of sheets Revision Date
Title
Size of Septic.Tank Type of S.A.S.
Description of Soil ,� 4"1 ��ix �2' X
Nature of Repairs or Alterations(Answer when applicable) New Title-5 septic system to
the plans of Ron Cadillac, dated 9-25-01 ,
Date last inspected: 19
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 issu d by thi o of Healt
Signed / Date ���� z
Application Approved by Date j b 1 `?rJ c) l
Application Disapproved for the following reasons
Permit)No. 'Dr , Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
Tobey BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( X )Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Service
at 105 Uncle Willys Way, Hyannis has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. Gkl)\-Vj&dated 1�� -w�2 C
Installer Wm. E. Robinson Sr. Designer Rana l d C'a d i 1 1 a n
The issuance of this permit s all not be construed as a guarantee that the system"will functions as�yd�esigned:
Date /l b Inspector = V`cL�� t E
No. Fee Fee $50
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS
Tobey 41
- mi!5po5ar *P!5tern Construction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 105 Uncle Willys Way, Hyannis
s
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 e this permit.
Date: C t c Approved by
ti ,
Town of Barnstable
°^ Regulatory Services
Mass. Thomas F.Geiler,Director Q _
9�ATE0
3
9.�A�O� Public Health Division � a
Thomas McKean,Director
367 Main Street, Hyannis,MA 02601
a
Office: 508-862-4644 Fax: 508-790-6304
June 4,2001
Pamela Tobey&Joseph H.Lomax
105 Uncle Willies Way
Hyannis,MA 02601
NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE
ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE
SUBSURFACE DISPOSAL OF SANITARY SEWAGE, AND 105 CMR 410.00 STATE
SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN .
HABITATION.
The property owned by you located at 105 Uncle Willies Way, Hyannis, listed as Parcel 3-15 on
Assessor's Map 292 was inspected on May 25, 2001 by Glen Harrington, R. S., Health Inspector
for the Town of Barnstable, because of a complaint. The following violation of310 CMR 15.00,
the State Environmental Code, Minimum Requirements for the Subsurface Disposal of
Sanitary Sewage and 105 CMR 410.00 State. Sanitary Code H - Minimum Standards of
Fitness for Human Habitation was observed:
REGULATION 310 CMR 15.02 (207)AND 105 CMR 410.300:
Overflowing sewage onto the ground. This violation is a serious public health hazard.
1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within
twenty-four(24) hours of receipt of this letter.
2) You are also directed to keep the on-site sewage disposal system pumped as many times as
necessary to keep from overflowing onto the ground.
3) You-are further directed to contact and hire a licensed Disposal Works Installer withinseven
(7) days of receipt of this letter in order to repair this system or connect to town sewer.
You may request a hearing before the Board of Health if written petition requesting same is
received within seven (7) days after the date the order is served. -
Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an
4PER
all constitu a separate violation.
DER OF T BOARD OF HEALTH
cKean
Director of Public Health
TOWN OF BARNSTABLE
4or C
LQCATION ® G 1/ LCJ/�.(��S SEWAGE # ?29 -;?0,'-2-
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY l(?19040!-4�
LEACHING FACILITY:(type) AlX$SO4. (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER A40tj � (O D/J
DATE PERMIT ISSUED: '—
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
ASSESSORS MAP NO:
PARCEL NO:
No. 's . - F .: _. Fss..............f........
i THE COMMONWEALTH OF MASSACHUSETTS
BOAR® 6F I=HEALTH
TOWN OF BARNSTABLE
A, ppliratilan for Disposal Works Tnnstrnrtion Frrmit
Application is hereby made for a Permit to Construct ( ) or.Repair ( ) an Individual Sewage.Disposal
System at:
4 ................�..�....----- ........ ... ��...:.1_ ..----- .
a, ation- ress o;74ot Nye
- ...._ . .. ... -•---- - --------------- 1a1..0_...u-! � /►(� -� ..................
ne Address
W
Install r Address
Type o u ing Size Lot-----------------------------Sq. feet
U Dwelling—No. of Bedroom ._•?'Vj6Y
._ Expansion Attic ( ) Garbage Grinder (
Other—Type of Buildin ._ -_. No, of persons............................ Showers ( ) — Cafeteria ( )
Pa Other fixtures --------- ..........................................
Design Flow......................................•-_-:_gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity___- --_-__gallons Length................ Width................ Diameter__-____--____-_• Depth................
x Disposal Trench—No.------�___..._. Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--_--------------------
D ameter....._..._.._._._... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
,-4 Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------------------------------------------•--=--------------------------•••-----.._...-•-•-----•------••-•-----••-----•••------•------------------------
0 Description of Soil........................................................................................................................................................................
x
-•--===- ---------------------------------------------------------------------------------------------•-----------------------....------•-
A
U Nature of Repairs or"-Alterations—Answer`when applicable...............................................................................................
.................................................................................
Agreement: I
The undersigned agrees to instal e afol edescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of th aveEnvironmental e—The undersigne rther agrees not to place the
s st in opera i nrunt)a Certi i of Complian e s een iss d, f ealth.
----/: te
---.
Signed . 1
A at on Ap ove By -- �Q
- =
Application Disapproved for the following reasons: _----------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------
Date
Permit No. . �,� ---------------- Issued -----------�� .�1.. y--lCe_4
Date
THE'COMMONWEALTH OF MASSACHUSETTS - �a
-' BOARD OF HEALTH
TOWN OF BARNSTABLE 1 `
A pliration for Disposal Works Toustrnrtiun "ami#
Application is hereby made for a'Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: i
oeation-A dres 1_/1t {1 or Lot Nosy-
..,{ � rr°"; ' " ..-GI•'.!�j_____E '� .rye ......: .f......... � ......•-...-.... ./��
...................
AddressC /
` P /
W
------------- ------nst a a
ins er Address '
d Type of Building Size Lot............................Sq. feet
aDwelling—No. of Bedrooms_______________________________ Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Buildings`--. � 1Cj41/.. No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures
=.••----•--------•-----------•---------------------------------------------
w Design Flow............................:...............gallons pear person per day. Total daily flow............................................gallons.
WSeptic Tank,'—', Liquid capacity............gallons /Length................ Width................ Diameter________________ Depth................
x Disposal Trench—No..................... Width.................... Total Length................. . Total leaching area-----------_........sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY.......................................................................... Date........................................
a Test Pit No. 1................minutes per inch Depth of Test Pit--------__ __`Depth to ground water_-_____-__•-_-_--_--,-.-
f1 Test Pit No. 2................minutesper inch Depth of Test Pit...... Depih�to gto d waterer:•..__..._._._.
ODescription of Soil---------------------------......................................................-----------------` 1 'r! 7
--------------------.................................
U -----•--------------•--•--------•--•------------...--------•-------•-----------------.._......------------------------•-•---•-•--------------•.....---------------------•--------------------•--•---••--
w
VNature of Repairs or Alterations—Answer when applicable___--` ........................................................................... `
Agreement:
The undersigned agrees to inst l the aforedescribed Individual Sewage Disposal System in accordance with
the provisions q TIT-LE 5 of the'.tate Environmental C de—The undersigned further agrees not to place the
sy to in operau n(un il a Cer Tate of Compliance been issueA by the boa-.d of`health. i
Signed .; ----. � ...f..1 . - 19-/741,1 1 --�1.. .
Application A roved B .... 1� ---�'<-
Application Disapproved r the following reasons: .............................................- ------------------- - ----- ------------------------ g' --E-f--t---%-- --
-----------
------ ------------------------ ---------------------------------------------------------- ---- ------------------------------------- ------------------------------------------------ --------...--------------
Q� ,. D — Dale
< Permit No. lT/w�� ----------------------- Issued ..: . .
Date /
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C�er#t�tctt#P � C�um}�ltttrc.cP
THIS IS TO CkRVFFYY That the Individual Sewage Disposal System constructed ( / or Repaired ( )
by...................... ..........------------------------------- ._ ../.:. '- .-a . �-.............------....------------ ------. --....------....-------------------
• Ins[aller
at --...4�mr---- ...... �� G�[1/CL� ct /r!C G S---------------------------------- wr.....................................
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. />....-_ t ... dated ,... ,t3�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT
SYSTEM WILL FUNCTION SATISFACTORY.
DATE--------- Z Inspector .............
R
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF, HEALTH
TOWN OF BARNSTABLE
Disposal Works Tnnstr uan rani#
a.
Permission is hereby granted..............................................•----•-------•-•--...---------•----••----------------•-.............----------•---••-•••--_----
to Construct ( ) or Repair ( ) an I�d�vidual Sewage Disposal System
Gti(
at No........�! ,`� ,lXr /l�C G-� / ra
-v-------._--;,---••----------------------------------•--�--- k
Street i �-,
as shown on the application for��Disposal Works Construction Permit Ni Dated.._6 -���'
-9^. .......................•.V•• .....................................................
e Board of Health
DATE................................................................................
FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS
s r l 3 G L L E e u T h4 .. + _. i. '. r
sue„[io
T
File 877 . 3A continued from page 1
1 . The septic tank was relocated to the rear of Lhw
dwelling; however , sufficient slope was provid-_a for the
exterior pipes ,
2 , The drop in the D-box was 1 . 3 inches , or 0 .7 ,riches less.
than the design plan specified. This should not af ;r�ct:
the proper functioning of the system ,
3 . The Diffusors were installed approximately 2 .5 inches
lower than the plan specified; -however , the design plan
allowed an additional 1 .0 ft , of separation between the
water table. and bottom of system beyond thie r: eguired .1 0
ft ,
----GENERAL EXCEPTIONS---
A. No excavations were made beneath the surface at the
leaching area or into the material surrounding the
leaching area, thus , there is z,o iritormation
regarding the amount of ors gina i material r�rnoved , ox
quantity and quality of fill materia� utilizzc.d .
B. No inopectiott was made of the int Rr roz p?uml. ; ,g .
C , 140 expr szed ,)r implied Warrant_ js c;i �lnrZ ��s Lu i:lif
cu. 1,i;. t4° or- life exnectanc:y L1F .he ;,,:• te,n 1n L:'t e,
_Res.p(- L ru11.y y,iL.ir. :. _
Koxtn.etI P . I'P,r,-r i r a
.x
Willi-am F, Sraj.Lh P. E.
Senior Engineer
OCT 22 190 a15: 06 OLDE BOSTON, p 05
AD
t
01de Boston Engineering Co., Inc.
()�URVCYMG cave, :AN T4RY,Ar,C)[tjV;AC1j?f,0ENTAL r0N Ui.IANT.,'
William StrCet 14eA Bedfo d Massacnusetts o274r)
Tel; (508)997-6410 Fax (508')997 96;6
July 17 1990
Thomas A. McKean , Director
Barnstable Health Department
Barnstable Town Hall
Barnstable, Massachusetts
RE: FILE # 877 CLIENT Braintxes -,o-op
Subsurface Sewage Disposal Syst _,m
Au-built Verification
PARCEL "C" -STREET-Uncle Wi I I i k-s Way
Dear Mr , McKean ,
At the request of our client , We have CheGht:d t h E. septic
system components' invert elevations , their location and the
foundation grade of the above-referenced septic system design
-plan . Attached and made a part: of this Ietter , as a r, as-built
plan dated July 19, 1990 and given drawing # 977 . 3A
Based 011 our knowledge, information and belief , the
following facts were determined: ,
1 . locations of septic tank, d-box , and. lenchinq taci I it.,
relative to prGperty lines and the existing llr)undatlon ;
2 -_, nvert elevation-o of all outside sePEJI.C; nyst(�.�w 1,19
lines and that were expo, &d at the, time of
3 . valculations of all P1.U.Iftbing 11rie
S I-op e s
Based on the facts above , it is oux o-pin*;on that a.,i of this
dat o;� the zysterr, ap-pi.z t-�,a r s `Lo ha-�ie 1)o e n b ii i I t in uh-1�;U a r, 41 t .n,l
accordance with. thc! de-, isto plan dated 3/ 11 6/9 0 P,Alld is 111
general conformance with the Commonweal0i of MaRsachu;eLts ,,La L e
Sanitary Code, Title V, and the requirement:; of the board
of Health governing or. site zubsurfac� sewacre dispos,,Al OYUL---�111
installations , at the time of dositj , wj L h f-h e_ followihg
exceptions :
continued on .to page 2
'OLT`-_'L s 1c-o-3,3 ULDE .BU:;Tniirl F• ., ,. � ^ ; r 1 F'. =ii
r� f
rq
Fq xUNCLE
y
=n rtsn 4tiA1' (s t•K ' gf s
TL
v '
f �N
C!� vi
Ioo.au
O
0
#Ilk it
vp
s
/ � l
M 1
Mr �� t
cn
>rn + O ,fir
ti� 1 -4
7 a m
ref1i�_ I 4
a
J108 NO. B01_10
BENCH MARK--TOP WOOD STAKE HOTE:j ToIzey.,-jwg
SET FLUSH= 39-02 ASS.IGNEDS N/F 1. L00V.)S IS A.M, 2!,?2, PARCEL 3-15.
C1 e26'-10" OFF HOUSE,E CORNER'i BRYANT 2. ELEVATIONS SHOWN ARE ASSIGNED AND CLOSE TO TOWN C-1;:), ELEVATIONS.
3. LOCUS IS IN FLOOD ZONE C ON FIRM E,,ATEE,, AI!GUST
IGUST 19, if-m.
4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4' PER 1`007. (UNLESS NOTED;
5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN loo' ARE ON TOWN WATER,
D 32.3 6. �'OMPCNENTS TO BE AASHTO H-1C'.-, UNLESS NOTED.
7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14".
8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR ECUAL FLC)W
WE_�11\111 36.7 4.78 D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. W
1 --.-389 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. NOT TO
x 7 40.8 44.4 4.80 4.81 SCALE
BUILD UP COVERS TO WITHIN V OF GRADE. MORTAR CHIMNEYS IN PLACE.
ONE COVER OF TANK TO BE WITHIN 6" OF GRADE.
ED.1E S E35 W33" W
10. STONE TO BE DOUBLE WASHED 3/4 TO 1 112" WITH 2" MIN. 1/8 TO 1/2" PEA STONE
2 11.67' ON Tt P.
11. IF !,1INSUITABLE SOILS, OR �z.,OILS DIFFERING FROM THE '_,0,IL LOG ARE FOUND, LOCATION MAP
4L 39-02 CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC.
12. IF AN rVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5- AROUND AND UNDER LEACHING
N/F x 40.6 43-12 IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310, '-MR 15.25,513). TEST HOLE I
$41) BENCH MARK--S.W, CORN. CONC. x 37.3 WORK LIMIT x 42.5 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN
STOOP 4t.;.,15 ASSIGNEE) LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT.
GUARINO 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. DEPTH 'inches! ELEV-'feet'�
r- 4191 61 i
15 0 36.5
I TE`�.T HOLE DATE: July 25, 1
. ........
OVERGROWN LOAM PILE dec/, REF'LVMB SEWER LINE AND INSTALL PERFORMED BY: Ron Cadillac, Soil Evaluator Fill
41.3
2-1 NEW 1500 GALLON TANK. WITNESSED BY: Glen Harrington, R�>
41,62 0*0"/inc i- ayer*%i
IF POSSIBLE KEEP SEWER LINE LINDER <5'_. J I
REMOTE WATER METER PERC RATE: i h I
SLAB FOR FUTURE BATHROOM. SOIL SURVEY11993%. Sand & Gravel pit
3 BOX--WATER SERVICE
4C 37. GEOLOGIC MAFI(19655•): Barnstable plain deposits '72* 30.5
C NOT MARKE() AT TIME
10, Pere attempted--Fill layer above caved 3 tirnes.
9.9 Z OF FIERC TESTING. assumed 10 < 5 rnin./inch.
gf: 13, 41.1 Invert 37.35 1"- my coarse sand as
C layer 10yr 6/6
x 38 REPLUMS Invert 36.90[V7
x 4 .80 5--C4 UNITS loamy coarse sand
Baffle W/4' STONE
3 11
Invert 36.1 observed water
37.4� Pr Provide 1' cover 10 27.5
.48
EDGE OF DENSE WOODS ni S=1/4"/ft Use 9" cover. 36.71
0� q .7eJ 39.27 GRADE WILL RISE BY 1 1/2' Filter Cloth 120"E:__
CU ArO T."',
ON WEST END OF LEACHING. Flropc�sed S=1 /fi TOD Store &
16.5
x 36A 9.6
N/F Invert .37.15
7
GUARINO 4
39.13 Proposed T
38.59
Invert 36.52 In
vert nvert 36.33 36.0
3' DEEP IMPERVIOUS
C'M P3 Ct Proposed BARRIER--75 L.F. OF 38.27 Proposed I Bottom
POLYETHYLENE
40 MIL PO 4wi
(MILLER BREAKOUT**) a 2' El. 31.r,;
TOP BARRIER=TOP 3.5 8 Out of 10�r. Adjjstrnent
STONE=36.71,GRADE < Barn. 23(`j--Zone
ABOVE BARRIER=37 2 MIN ze 10)
CC) Jul 1001
BARRIER IS STIFF 36.7 DESIGN DATA Observed Woter=27.5
OBTAINABLE FROM 6,85 ONSTR
MILLER ENVIRONMENTAL 36.4 36.8 37.33 CA, 1(P',,J10N N-7.)TE."'. BEUROIOMS: 4
E,0 8-6 9 7-3 710. - 36.82 _Ij a GARBAGE GRINDER: No
P7.27 1. INSTALL WORK LIMIT BARRIER, LEACH AREA
I U REO'k.11RED CAPACITY: 440 GPID
AS SHOWN, FROM DE T MIDDILL USE 5 'CULTEC C-4 UNITS, SET IN A
EXISTING F-.�EFITIC' TANK: 1000 GAL.
OF LOAM PILE. ROW AND 4' OF STONE ALL AROUND,
2. USE LOAM FRCIM UPLANE) SdUE BOTTOM LEACHING AREA: 576 SF FOR A 48' X 12' X 4" DEEP LEACH
to . I
Cj OF PILE NLY FOR TOPSOIL OVER (48* X 12') AREA. RUN PERFORATEE') PIPE LEVEL
36.4 Y',-',.T E M. 'I D E L E A C H' DOWN '--ENTER OF C-4 UNITS BETWEEN
5.; LEACHING AREA: 39.6 5,F I
7.08 TWr. r,
37.1 ,ENTER HI_'MPS. (SEE DETAIL COVER
13. REPL111MB SEWER LINE. ALLOW [21"12'4 48 , X 1).,33' DEEP) WITH FILTER FABRIC, hAS)TONE NOT NEEDED.
co TH 1 36.57
FC-,R FUTI)RE BATHROOM ON LOWER
36.2 FLOC�R, IF POSr..','IBLE. DE-SIGN CAPACITY: GP(,
[!',3,9.(3 SF + 576 S F X .74 GFI[)/cF) 5' REMOVAL WITH IMPERVIOUS BARRIER
t4J
36,5 [".0 5' ALL AROL.IND. AND UNDER REMOVAL
T
6'-! t-- LOAMY COARSE ''BAN[:'. U, E
PARCEL -OWN
IMPERVIOUS BARRIER ON WEST 1/2 OF (,'.IG.
Lay perforc.ifec pipt., level clown, ..;eniter of -4 1.)n i t. cjs shown, c.clp enc].
3 91 010 S. F. SfC1:l`,)E'._1
- - k -) - -41( filtei 1.1 n'00r"
.54
36.00
8.5-F
36.4 36.4 36,6 . ......
121
LEACHING CROSS SECTION
36 x 36.2 1 = 2"'
ON Cl� -Q5.76 35.9� SITE PLAN
0•
0 %
)35,32 FOR
• � . 3 A VALID, CC)PY ONLY IF IT PwEAR*-','
35.6 - 3529 THI� FLAN A N I P" A M E L A J. TOBEY
3515 •
5,12
A N INAL REL' TAMP ANC `-d GN A T�J RE.
35.25 R I
OF AM4,,4
is PARCEL C, 10155 UNCLE WILLIES WAY, HYANNIS, MA
yG
Niq �kAOF A4D,18,
LE ID AM D cn AUGUST 8, 2001 SCALE: 1 "=,30'
TH I TEST HOLE LOCATION, NI..1IMBER # 1060 #35779
-W- WATER LINE MARKINGS S 5\0
E IS U R\J
"-_;VERHEA[*, ELECTRh- WIRES (IF SHOWN) 84NITARO,
11"X MARKF P INT" 035.35 RONALD J. CADILLAC, PLS, RS
9.5 x 8.7 EXISTING FIR 'POSEE �,ELEVATIC)N
-6 - EXISTINGC, -%I PROFESSIONAL LANE) SURVEYOR & REGISTERED SANITARIAN
,nNT(,%IR
_8....�- PROP(_%,'_ED CO-INT01JR P.O. BOX 258
0 I)TILITY POLE (IF SHOWN WEST YARMOUTH, MA 02673
0 EXISTING ERAINAGE CIATICH BASIN HEALTH AGENT APPROVAL DATE (508) 775-9700
REV. --LOAM ACCESS- SH(AN �20X(J1 BY R.J. CADILLAC P A G E "I
REV. FILE &. (_.eC_.;N!'.'-.JR I.) TI..,.jN NOTP-3
----------
T.P.o ExisT. GIRD. 51.2
50.5 FIN.,Gfto�)
The sanitary sewage disposal system shown hereon
t �&IIATERIAL shall be constructed in accordance
M
SeF NOTE *00
with the
requirements of Title V of the state environmental
RA 19F�;Flo q)c 1) C�VICR 4 1?
code and local Board of Health regulations.
-1. A
FINISHED GARAGE FLOOR, NIA FINISHED GRADE 52.0(AVG.)
W. FIN'51tl F.L., 2. Any verification or modificatins to this dles ign
FINISHED FIRST FLOOR 8.qO wffostA UN'is must be approved in writing by :he engineer and
59.8 SEE NOTE COVER
4897
the Board of liealth prior to implementation.,
I MIN.
TOP OF FOUNDATION 55.8 S.2%
13.0' .7
61
7, LIQUID LF-V r L_ MU4. 3. Notify the local Board of llealth when the system
FINISHED BASEMENT FLOOR 51.8
NN, is ready for inspection, prior to backfilling.
49.3d
INVERT AT FOUNDATION 49.60
If confirmation of construction is required by an
5_8"
INVERT INTO SEPTIC TANK 49.35 49.10 48.75 47.60 engineer, notify this office prior to backfill of
Ir
M j,4. TTE T-F the system.
ADJUSTED WATER TAr! L
INVERT OUT OF SEPTIC TANK 49.10 Q)
4 8-0 5. Contractor shall verify and check bench mark as
49.160 J,-
INVERT INTO D-BOX 48.97 4" SCHEDULE 40 PVC SOLID 4" SDR 35
OR APPROVED shown on this plan prior to construction of the
PIPE-OR APPROVED EQUAL EL.- . .......
INVERT OUT OF D-BOX 48.8C EQUAL ENCOUTERED WATER TABLE (91, proposed system.
INVERT AT INLET OF DIFFUSOR 48.7!
6. Soil logs indicate soil condition, percolation
rate, and water table elevation found at the time
INVERT AT END OF DIFFUSOR 48.60 LEACHING DIFFUSOR, SECTION and location of actual testing and should be
SYSTEM PROFILE verified at the time of construction.
ELEVATION OF BOT. OF SYSTEIV 47.7 N OT TO SCALE NOT'TO SCALE 7. The septic I tank shall be a 10 1 00 1 gallon
ELEVATION OF G.W.T.(ACUUSTF-DI 43 Linhares
PRECIIQT '1000 GALL014 SEPTIC TANK i Precast, Rotondo, or equivalent unless otherwise
specified. The inlet and. outlet pipes are to be
NOT TO SCALE fitted with tees of proper length. Concrete
COVER B I UI,L,T UP TO WITHIN' strength . is to be 4000 psi , 28 days, and
reinforced with 6 x 6 - 10 x 10 wire mesh and
OF,FINISHED GRADE SEALED END , conform to all ASSHTO 11-10 loading requirements
QUESTED unless otherwise specified.
A VARIANCE IS RE__
" REGULATION. 2" DEEP LAYER OF 118 VASH z 8. If any nt I s of t.lie p I roposed 4;ystem are
FROM THE LOCAL "330 s-roNE COVERING COARSE STONE compone
,oVERNING MAXIMUM ALLOWABLE BASIS OF SANITARY DESIGN specified as heavy duty, those comporonts shall
conform to all State and Local requirements for
3/4 PED -ONE
I I-I&- WAS S7 1>
WASTEWATER DISCHARGE. TOM I OF DIFFUSOR AS�SHTO H-20 loading.
(FROM
w OF WLET)
TO � I-' I i - - NUMBER OF BEDROOMS 3
01
0 9. Septic tank, distribution box, and leaching pit
GARBAGE GRINDER NONE
2.0.
if any) access manhole covers are to be builtup
ESTIMATED SEWAGE FLOW 400 .G.P.D. (TOWN REQUIREMENT) to within 12" of finished grade unless otherwise
La
D-BOX SIZE OF SEPTIC TANK 1000 GAL. specified.
'N' OUTLET, FLOW61FFUSORS
FD4XB-L
PRECAST LEACHING CHAMBER PERCOLATION RATE < 2 MINJINCH
FROM 10. The distribution box and septic tank shall be
DESIGN RATE'2 MKIINCH
\T� placed on a minimum 6" compacted gravel base to
FLOWDIFFUSOR9 prevent heaving or settling.
FD4X8-D
ST LEACHING CHAMBER LEACHING AREA PROVIDED
PRECA
SIDE: (2 SIDES X 36' LENGTH X,,0.9' DEPTH)*(?FNDSX 9'WIDTH X 0.9*DEPTH) -79.2 S.1r.1 1. The pip(i between the house and the septic tank
BOTTOAt 36' LENGTH X 8' WIDTH 2813.0 SF.�" shall be 4" extra heavy cast iron, Sciliedule 40
PVC, asbestos cement or other material acceptable
36
FLOWDIFFUSORO 0 TOTAL SYSTEM CAPACITY
,SEALED to the approving authority. The slop(-' of this
F04 X8-L
60-� -60 IS.A.IDAY /DAY pipe must be a minimum of 0.01 (0.12 'liches per
PRECAST LEACHING CHAMER
END IDE: 7.9.2 S.F. X 2.5 GAL f-98.6 GAL.
SOTTOM. 288.0 S.F. X LO GALIsF.IDAY - 288.0 GALIDAY foot).
CATCH
00-0-00
BASIN 59
1`OTA L a 486.0 GAL.10AY
8.0, FLOWDIFFUSOR6 59� EXISTING 12. The distribution pipe shall have a slope of 0.005
FD4XB-L
PRECAST LEACHING CHAMBER (6" per 100 ft. length).
LEACHING
PIT 13. All j9ints must be watertight, sealed with asphalt
DEEP , TEST HOLE INFORMATION-
LEACHING FACILITY BRFA 1 WN 57, cement or equivalent.
57
NOT TO SCALE 53 1556 -PERFORMED BY CAPE COD SURVEYORS 14. If leaching facility and septic tank are located
152 �41 WITNESSED BY J.C. at least 25' . 'from the house foundation, a
foundation drain may be installed at the owner's
50 0
491
DATE : 7-15-85 discretion.
481
TEST NO P4701 15. Excavate all unsuitable soil in the area of the
T.P.#2 leaching system to the limits specified in Reg.
LLI T.P. # 1 2.17 of Title V and replace with clean, coarse
46 46 56 LOT 14 0-7' SAND,GRAVELFILL 0-7' FILL.SAND, GRAVEL sand and gravel.
ly 56 7'-S' SILT,SUBSOIL 7*-S' SILT, SUBSOIL
55
OWNER: BRAINTREE COOPERATIVE BANK 81-13, SAND.TRACE OF GRAVEL 8*-12' SAND, TRACE OF GRAVEL 16. Any fill material required around the system,
48 4� 53 beyond the washed stone, shall be clean coarse
49 \ 11 AREA: 39,010t S.F.
-Z GROUNDWATER AT 13.0 FT. NO GROUNDWATER AT 1.2.0 FT. washed san4, with a perc rate of less than 2
0 m nutes, fre� ,�rom fines, clay, organics, stumps
4, 55 and stones.
17. Graide of the first floor of the house is
�4' 'd
approximate; it may be r,7ised but not lowered
W _.. � __-I I \ --
TILITY-1- without the consent of the engineer.
xT U
POLE
18. S this
Unles 4ecified in the design analysis,
50-- system is not designed for use of a garbage
30" 54
tD4RCEL "C" ON A RESUBDIVISION OF A grinder'.
PORTION OF "BERTHA CARL ACRES" IN 30'
MA. pREPARED,FOR 19. r?..4Qy leaching a concrete retaining w
--- _,t, _.gJAW
v __1 N re s on T1 s plan, theywak!117 be
HYANNIS, BARNSTABLE, -A GNP EXISTING
W DATED 3-16-90 151i - 11
BRAINTREE COOPERATIVE BA mom construct�d ht, 7we-epholes or
other perviot C
0 LEACHING 7---
0. 4z � z const �Jna cordance with
00' . \53 tMt
PIT, all� local b Lg depar -�reg�u lat ions..
F t Oe'm enlargement may e the
IV I I _� these retaining walls.
a sion o
DO 20. Top 8" of fill to be topsoil.
r
7 21. No heavy equipment shall be run over the disposal
system.
FORMALLY LOTS 15, 16 AND 17 28, Ln
22. For proper performance, septic tank should be
UNCLE WILLIES WAY ON A SUBDIVISION inspected annually and when the total depth of
i scum and solids exceeds 1/3, the liquid depth of
ENTITLED "BERTHA CARL ACRES" r A I so
LOT, 13 the tank should be pumped.
IN HYANNIS, BARNSTABLE, MA.
PREPARED FOR AL-BERT TRUST
23. Plumbing in the basement shall be limited to a
washing machine if the invert of the outgoing pipe
DATED NOV. 1978
147 51 J! is higher than the finished basement floor, unless
49'-j 49
X othe rwise ind icated.
51
(j 40 < NOTE. 214. ?ffta**.jLaybale checkdams or silt fences
.0�t JFV on plan, o b( k
e sta ed .1&o#Awet" prior to
e
any construc
WATER LINE LOCATIONS ARE APPROXIMATE -C !7?i o-rr and shall remain in
AND MUST BE FIELD LOCATED THROUGH place const uct 0 rading,
,Now
V) "DIG SAFE" PR6cEEDuREs PRIOR TO ANY Ito , Nsr1rffrFing, and inspections are completed.
C4
LU EXCAVATIONS.
C; 1 7'
25. The excavator shall notify the 'local Board of
NATURAL GAS LINES ARE NOT SHOWN FOR
Health if groundwater or perched water is
CLARITY AND MUST BE FIELD LOCATED encountered at a higher elevation than
THROUGH "DIG SAFE" PRIOR TO ANY I.�vl I rj indicated on plan.
EXCAVATIONS.
411 L'T.
LOT 18 tA A"
LEGEND
DWELLING IS TO BE SERVICED BY TOWN
SEE NOTE(S) EXISTING PROPOSED
EXCAVATE ALL UNSUITABLE MATERIA� WATER. INSTALLATION TO CONFORM TO I z
r 1 15 \N
HORIZONTALLY OF �THE LOCAL DPW REQUIREMENTS. W 'C'
co.�11 too----
WITHIN 10' AIN P CONTOURS
ITY, FROM 'THE PEA
LEACHING FACIL )(9 SPOT ELEVATIONS
NCHMARK: HYDRANT STONE COVE WN TO APPROXIMATELY., IS TO BE ON-SITE DURING PROPERTY LINE
BE R DO
LEACHING AREA EXCAVATION TO VERIFY - EDGE OF PAVEMENT
#614 EL. 4Z7 , 8 BELOW ORIGINAL .0 DIE E?
TAGGED HEADE30LT
EL.=52.07 GRADE) VERC RATE.AND SOIL ,CONDITIONS. �9LLA STONE WALL
WELL
ITOWELLS�OBSERVED WITHIN 100' OF _4� DEEP TEST HOLE
E.7 LEACHING TRENCH' i.
PR,0POSE&,LEACHING AREA. LOCUS MAP
LOCATED BETWEEN LOTS 19 AND 20 50 NOT TO SCALE ' PLUMBING PIPE
H
77�GO'
IN
W TOWN USE ONLY
Q) SumMURFACE SEWAGE DISPOSAL
W
DV (E)RAINAGE
UNCLE EASEMENT 'BRAINTREE COOPERATIVE BANK
A LS WA Y
CAMH
PARCEL . 16C" UNCLE WILLIES WAY
HYANNIS, BARNSTABLE. MAftec
H W 0
IN
a: 172 Aillizint �$L We� 29ebfarb, �T� U274a
JOB NUMBER:OBE 877 DRAWN BY: K.M.T.
SCALE- 1"-30' DESIGNED BY:K.E.F
DATE:3-19-90 CHECKED By:
NO S,47?00
CONTACT PERSON: KENNETH E. FORTIER
DRAWING NO.
S
_y,
ADDRESS: 172 WILLIAM STREET
TELEPHONE NUMBER: 997-6410
877.3