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HomeMy WebLinkAbout0018 IPSWICH CIRCLE - Health 18 IPSWICH CIRCLE OSTERVILLE A = 165 121 1 i 1 o � `07 2015 21:04 Jim The Inspector Man 5085349919 IV If page -1 Commonwealth of Massachusetts MIp &J-J/,-,-7l . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ref 18 Ipswich Circle yl Property Address Tom Antkowiak l a, Owner Owner's Name information is = : required for every Osterville ✓ MA 02655 10-7-15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When A. General Information filling out formson the mputer, # /1/�� use only \`� he tab 7/ \jH OF'dyss����i . ,���••• key to move your 1 Inspector: 0 , •,S �; cursor-do not =z JAMES N James D.Sears =�. ;m key,use the return Name of Inspector y' Capewide EnteMrises,LLC Company Name 153 Commercial Street q��i//F 5 I N 9p�C`````�� Company Address Mash pee MA 02649 Citylrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems_ I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-7-15 ' pector's Signature I 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•3I13 a Title 5 Official Inspection Form:Subsurface Sewage Disposal System of 17 I Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 2 IN Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .s< 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or I 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. I Comments: The system is a 1500 Gal. Tank D Box and four chambers. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or'not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old' or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): ,i i t5ins•3113 Title 5 Ofticlal Insaection Farm:Subsurface Sewage Disposal System•Page 2 of 17 i Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with,approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due fo broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will.protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins•3113 Thle 5 Official Inspeclion Form:Subsurface Sewage Disposal System-Page 3 of 17 Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Minmr Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15 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: i ❑ 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: i "This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: i D) System Failure Criteria Applicable to AllSystems 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 tspFffisl is less than 6" below invert or available volume is less than %day flow 1-84 C/x'iA19" t5ins•3/13 Title 5 Official hspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rf 18 Ipswich Circle Property Address .I Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 . 10-7-15 page. Cityrrown state Zip Code Date of Inspection B. Certification (cont.) Yes No ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is.within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flaw of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore,the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure.,, E) Large Systems: To be considered a large system the system must serve a facility with a j design flow of 10,000 gpd to 16,000 gpd. y For large systems, you must indicate either"yes"or"no" to each of the following; in addition to the questions in Section D. t., Yes No ❑. ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a nitrogen sensitive area (Interim'Wellhead Protection Area-IWPA)or a mapped Zone II of a.public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 16.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System,Page 5 of 17� Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15 page. CityrTown State Zip Code Date of Inspection C. Checklist I 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 El available note as NIA) ® ❑ 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): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5lns--Wl3 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System Page 6 of 17 Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15, page. Cityrrown State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal. Tank D Box and four chambers. Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report,) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage 204-79, OO Gal's g ' ( y g (9pd))' 2014-79,000GaI s Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): canons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Irspectlan Form:Subsurface Sewage Disposal System-Page 7 of 17 Oct 07 2015 21:04 Jim The Inspector Man 5085349919 page 8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak I Owner Owners Name information is required for every Osterville MA 02655 10-7-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information i i Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping.- Type of System: ® Septic tank, distribution box, soil absorption system •_ ❑ Single cesspool ❑ Overflow cesspool Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): l5ins•3113+ Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 at 17 fOct 07 2015 21:05 Jim The Inspector Man 5085349919 page 9 • i Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osteryille MA 02655 10-7-15 page. City/Town state Zip Code Date of Inspection i D. System Information (cont.) i Approximate age of all components, date installed (if known) and source of information: 2000 Permit# 2000-589. i i Were sewage odors detected when arriving at the site? ❑ Yes ® No I, Building Sewer(locate on site plan): 30" Depth below grade: 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.): Pipeing is 4"PVC SCH 40. Septic Tank(locate on site plan): Depth below grade: 19"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) I If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal. Precast. H-10 Sludge depth: 211 151ns-3113 Tdle 5 Official Inspeiion Form:Subsurface Sewage Disposal System•Page 9 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 10 I Commonwealth of Massachusetts I a Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak j Owner Owner's Name information is required for every Ostefville MA 02655 10-7-15 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 28 Scum thickness 011 Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? Asbuilt-Tape Sludge Judge 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 at working level. Tank and outlet cover at 19" below grade wlinlet cover 8", In and outlet tee's. No sign of leakage or over loading. 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-3113 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 10 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville MA 02655 10-7-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) I Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage. etc.): I I 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): I 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.): l I I Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 18 Ipswich Circle Property Address Tom Antkowiak Owner owner's Name information is required for every Osterville MA 02655 10-7-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): . Depth of liquid level above outlet invert 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.): D Box is 16"x 16"-26" bellow grade. Box is clean and solid w/two line's out. No sign of over loading or solid carry over. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 13 Commonwealth of Massachusetts e Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 18 Ipswich Circle r Property Address - .. i Tom Antkowiak I Owner Owner's Name information is Osterville MA 02655 .10-7-15 required for every � " page. Cltyrrown State Zip Code Date of Inspection D. System Information (cunt.) Type: ❑ leaching pits Number. ® leaching chambers number, 4 ❑ leaching galleries :' number: ❑ leaching trenches number, length:,' ❑ leaching fields number, dimensions ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is four 500 dry well chamber's 1D'x40'x2'. Chambers are 3' below grade w/cover at 2'. Chambers are clean w/wall's like new. 2"water on bottom. No sign of of over loading or solid carry over. 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 w Depth of scum layer Dimensions of cesspool Materials of construction • Indication of groundwater inflow ❑ Yes ❑ No t5ine-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 or 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 14 Commonwealth of Massachusetts i Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments i 18 Ipswich Circle i Property Address Tom Antkowiak Owner Owner's Name information is required for every Osterville . MA 02655 10-7-15 M1 page. City[Town State 21p Code Date of Inspection D. System Information (cost.) 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 15 (' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Y 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is OStervllle ! required for every MA 02655 10-7-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below.- hand-sketch in the area below ❑ drawing attached separately C 13 -1 i? 3 o t l5ins•31113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Oct 07 2015 21:05 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, 18 Ipswich.Circle Property Address Tom Antkowiak Owner Owner's Name information is Osterville MA 02655 10-7-15 required for every page. CityrFown State Zip Code Date of Inspection i D. System Information (cont.) , i Site Exam: I ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells IVO 37'+ Estimated depth tofhigh 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 reviewed: Date ❑ Observed site (abutting propertylobservation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: on file at B.O.H. ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: On file at B.O.H. Disposal Works Const. Permt 37'+. Bottom of chamber's at 6' below grade. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 16 of 17 Oct 07 2015 21:06 Jim The Inspector Man 5085349919 page 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Ipswich Circle Property Address Tom Antkowiak Owner Owner's Name information is i required for every Osterville MA 02655 10-7-15 page. City/Town State Zip Code Date of Inspection i 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 I i t5ins-3fl3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 -- ---- - ----._. ... ..._.... .... TOWN OF BARNSTABLE LOCATION $ c lW/I GI/�� SEWAGE # ��—✓� 9 VILLAGE ��71L' j/f�/�i ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ,�ZVZOoO i 425,7 77l-�� SEPTIC TANK CAPACITY l67.'D 61 LEACHING FACILITY: (type) )od C.i Z yef (size) ld'�x yo k.2 NO. OF BEDROOMS BUILDER OR( WN // ntz-474y ele PERMITDATE: le /Z!� COMPLIANCE DATE: n (� i Separation Distance Between the: _ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S 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 6�t e o ,Q , b Op i 9 Cd' b-S O f NOTICE: This Form Is To Betsed For the Repair Of Failed Se "tic Systems. Only. CERTIFICATION OF SKETCH AND APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) nn�� L / r7— + r i�PAereby certify that the application for disP oral works construction permit signed by me dated concerninia the property located at f s f�/G� Gll G��. a5 j�1�a/��� meets all of the following criteria: V- The failed system.is connected to a residential dwelling only. T'nere,are no comrne:cal or business es associated with the dwelling.V/s a • The soil is classified as CLASS I and the percoiation rate is less than or equal :o minutes per inciL' 41/711e.-e are no wetlands within 100 feet or due'ronosed septic s✓stem i//Mer e are no private wells within 1.-0 feet of the proposed septic r"stem st V/Ther e is no increase in flow and/or change in use proposed /There are no variances.requested or needed ' /The bottom of the proposed leaching facility will not be located less than five feet above the, ma.,amum adjusted groundwater table elevation. (Adjust the groundwater table.using the crimptor' method when applicable). lif the S.A.S. will be located with 250 feet of arty vegetated wetlands, the bottom of theproposed' 5 leaching facility will not be located less than fourteen(14)f=t above the maximum adjusted _ groundwater table elevation, Please.complete the following A) Top of,Ground Surface Elevation(using GIS information) Cd B) G.W.Elevation +the MAX.High G.W. Adjustment. DIFFERENCE BETWEEN A and B ,7 SIGNED: DATE: [Skech proposed plan of system on ba*]- T he M folder:art TOWN OF BARNSTABLE LOCATION �" 37 5a,-,1e4 cwre/e SEWAGE # Z42"W;79 J � VILLAGE �� � /� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. /7'�dC� / ZUiS_ ;771'�✓� SEPTIC TANK CAPACITY - / D 614(- LEACHING FACILITY: (type) 5-go Co!Lroc f e%goye-J 1`d (size) «'- 1/0 kZ NO.OF BEDROOMS BUILDER O�/ eWl ' PERMITDATE: IV!Z1� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility J 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 6C T Rea S� 3S� 31 g�G OO sla' v� io' No. lJ / r ` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for 30igotal *pgtem Con!truction Permit Application for a Permit to Construct( )Repair(✓ )Upgrade( )Abandon( ) IJ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel og J�(.o�y 4ip 7-010 Installer's Name,Address,and Tel.No. !)v Designer's Name,Address and Tel.No. ,�o��Go��Gor�sj Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(10 Other Type of Building aQ�i1Ge?No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /lf> gallons per day. Calculated daily flow Vy40 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank ISO / /O Type of S.A.S. Description of Soil ld.YypeX 2- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued Signed Date q/Z �!©� Application Approved by Date #0 Application Disapproved for the following reasons Permit No. ZU_ry �S� Date Issued /U 2' S/Z No Fee . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(pprication for Oiopogal *pgtem Construction Permit Application for a Permit to Construct( )Repair(►/)Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot N-I,,( C�rG le Owner's Name,Address and Tel.No. Assessor's Map/Parcel �' rem " if 1 "dT wry dd Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �l�i Go�IsT 7 r/- Type of Building: Dwelling No.of Bedrooms y Lot Size sq.ft. Garbage Grinder Other Type of BuildingWe`,J/ eee,e No. of Persons Showers( ) Cafeteria( ) Other Fixtures 'J/J Design Flow gallons per day. Calculated daily flow 7 7 gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank /5 Oa / `/D Type of S.A.S. Description of Soil /d X04/Z I' Nature of Repairs or Alterations(Answer when applicable) "6 b Date last inspected: Agreement: The undersigned ajtegs to ensure the construction and maintenance oft he afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code acid not to place the system in operation until a Certifi- cate of Compliance has been issued by s Bo He h. Signed Date Application Approved by Cr- Date ** Application Disapproved for the following reasons y Permit No.?.Cl Date Issued Z -------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ! �' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ) Upgraded( ) Abandoned( )b �I' OZ19 i Ce4S11_ at / `l!r/IG G e ©3'&11 e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 7.«U`r 7� dated /U—Z Installer Designer /-\ The issuance of this p!t t's�alI of be construed as a guarantee that the systf-Wil,�l function as designed. Date Inspector44 No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 'igpooal *potem Construction Permit Permission is hereby granted to Construct( )Re air(/)Upgrade( )Abandon( ) System located at 511(I'/G os ry. /e 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 Pe completed within three years of the date of this it. /� Q Date: l Z �� Approved by i peo - c c 00. 0 amp 1le,4 e e�y��e�s L �. -l('lo- G� Commonwealth of Massachusetts ' Executive Office of Environmental Affairs Department of Environmental Protection ' Southeast Regional Office Wllllam F. Weld 0"mor Daniel S.Greenbaum CommNsk"r May 11, 1993 11 �� Mr. Wayne Kurker RE: BARNSTAB_LE--Solid Waste Hyannis Marina Lots 22 & 23 1 ated om• Arlington Street Ipswi NEch�Circle, Ds� Hyannis, Massachusetts 02601 BEFICIAI;USE- DETERMINATION- APPROVAL, 310 CMR 19.000 Dear Mr. Kurker: The Department of Environmental Protection, Division of Solid Waste Management (the "Department") , has conducted a review of your (the "Applicant") request for authorization to utilize approximately 1000 cubic yards of clean sand dredged from Hyannis Inner Harbor as fill material on Lots 22 and 23 on Ipswich Circle, Osterville, Massachusetts. Review of information provided by the Applicant indicates that the dredged material is a clean sand mixture which conforms to the Department's Division of Water Pollution Control ("DWPC") Category I, Type A material . The material was dredged from an area adjacent to the Hyannis Marina's main dock and its most northerly floating dock: The dredged material has been dewatered on the Applicant's property-Hyannis Marina, located at Arlington Street, Hyannis, Massachusetts. The Applicant indicates that the dredged material could be beneficially utilized on the above-referenced lots to fill an existing depression on the property to an elevation of 24 ft. The Applicant states that since the deposition site does not constitute a wetland resource area, does not fall within 100 feet to a wetland resource, is not located within an area subject to flooding, and is not located within a Zone II for a public drinking water supply, there will not be any adverse health or environmental impacts from utilization of the material on the above-referenced lots. Based on the above and the chemical analyses provided by the Applicant, the Department is of the opinion that the Applicant may beneficially utilize the dredged material as fill material on Lots 22 and 23 on Ipswich Circle, osterville, Massachusetts subject to the following condition: The described beneficial use shall be a "one-time" event. Should there be a need for the reuse of additional dredged material, application shall be made to the Department in accordance with 310 CMR 19. 060. The Department will accept comments from the Barnstable Board of Health (the "Board") regarding this request for a period of fourteen (14) days from 20 Riverside Drive a Lakeville,Massachusetts 02347 a FAX(508)947-6557 0 Telephone (508) 946-2700 -2- ate of this approval. Accordingly, the Applicant shall not utilize the fged material until the Board has had the opportunity to comment. Should fourteen (14) days elapse without comment to the Department, the subject ,athorization shall take effect. In addition to the above, please be advised that should any activity on your property take place within a wetlands resource area or within the 100 foot buffer zone (refer to 310 CMR 10.00) , you will need to contact the local conservation commission and obtain any necessary approvals. Any questions regarding this matter should be directed to either Cynthia DeRosa at (508) 946-2761 or myself at (508) 946-2833 or at the letterhead address. my y s, 1 David E is, ief E/CAD/rr Solid Waste Management Section CERTIFIED MAIL #P808 785 255 RETURN RECEIPT REQUESTED cc: Barnstable Health Department Barnstable Town Hall 367 Main Street Hyannis, MA 02601 ATTN: Thomas A. McKean, Director Barnstable Board of Selectmen Barnstable Town Hall 367 Main Street Hyannis, MA 02601 ATTN: Warren J. Rutherford, Town Manager DEP-DSWM-BOSTON ATTN: Philip Weinberg DEP-SERO ATTN: G. Crombie A. Papadopoulos , r no rr BDi= 1 �O���.Tyl�� Y t'/ .,CYJ''• �',� .�� R it <.'. �.;.{•^ /] � IV o.�,..�. � , •• '� o" a��J,�© ••o. urnl fsf: fe •C; • ;, 1 dish f .•\.': .\ n. s. 1. Hatchery.i e; 11, 'a' d o. Pon e �•II ltChw IT 126 i 9L�' ,pCl�a n� ~!�". V ~ ••f ra! • `• ly-1v1 ::� ,v I �" �� - �� �. �'':1 lanoerry_�• 'ti' � I l "� a�/6��o r..�aviet�:t�_ it ,)`•ems\./•u �� ,'In`1���" / '� �� a •�1'�•,Wi1��a� �� �v�yi�•-`� %0/IC �C' •;'i�/ `^�• ^�s-O ,/'! 'Vn�',1)•!., ;-I�• cis /l� sJr':��-�'�. ' /l.^1: 7t.✓ ✓�✓, R,:::; .f!.. -. � �'�I R+,.��;1 I��``(•�cuDdder,�\�(I�� — •c: •'`') -� Ovc �- t. .. �. •'•'� 1 ' yam. '' - .'�('�O. •�C\ 1 . _ ..w .� ay�< �••,•Y' 120 41 �:? . ' ;,a,- _ a-}}/�, .7 Craigvill r \ Ji".\ •\n,r\��w. �0 ,� ' �(/ �Ti•.\>..•• ,•�•',•+r'tw" I.,P• � ...�I�LaG�t L •�d IC' a n rt7C 11\OL '=� 0•,i'�i.}.� rba:�.. _ ral villQ ,I Y...- .. .-` (/'b:a�.✓i• Y�.l�r� ..i��' ',,... CraigvilleLancing \ �\VIY�Q q,,,nlp•r •1' 6 ,�r;�-� '. a'leoaari. •a,�, Public Bea @ea 20 Lx M4V^'fTi .e ' • fir°��� �/ .,, Soindle CFNTERVILLE �,__IARfflaR East Bay r '1 I Jo ..� ! ,, I /6 � ,. w is / \ \ F /)Be i •\� . inncya � I \ � � ; Rocks iJ • '�• sr \J N A �,N T U' C K 0 Gannat I/t cc , r \ Laugs ij a A.M.Wilson Associates Inc. ,E}(N/6/7' 7+ �•• ram• �Y( _ •` �'r� •f' �yo i:1.• 1•,j•.4•. .��ti y ''�tk,Zvi t r �••'r� t7J '� i+:-• •`'�`2, '12}• r-.1,���:•�s5c ��+•��. ��j1 �:�+.,►.: +; •6 .v4•,, i��:' +.r, p eY.(,• -r._. :��:. v f1: =�•tv� '.� S••J� :4T .L :t 'sr.�Z'J.h�I�_ �'..+.:�.,Li•� _ :i> x::' Cj \1. .+'i _� r�:,�i r. 5A- .j s_ rg%it+ `- � �;+�3/� 1�. ��f1C'� .y!': X•!'.'• . La. �, :. a �• :�:_ :r!7..vr _ 'wrF:'P. ti:.'.� ':� ::a,+>-:'•P! •' ,•.1.. .: 1. tiY. �i. .. .rt �+ .:f,. ��.yO►�'.vL '<?�. .�=•�. -'+s1-y,_`e P' �k+w:; •� .tti_:: � i"F�e. _:i :i'. •^;f'+ i%�. �;' _ ALL . TL'• _ ..5• .W •�" � :rsti....�:r+ ;hd..nra?� �.vf.: ��'-:e" ..+�`.: .>�� .? '�_� .y` •L•0 + 00-11 C. IrOA i 1r �• �Q �r ' y �: P ��� 1oS o NONrH POND cr L AO r� V. �0 V• e ��,Z • 3.1 a 150 r, 0 55 `IF '7 b \ W c 56 so P a t .63AC• y� ,! ~ 64 t ') .23AC. J 'y 4actMJ1� PO^�G 1 .. 6 3 AC• o i 63 0 o aawr• i AJA Wilson AsSOClates Inc. . E7(N1/3j7 7 ,,��� 411 Ilnln St f1�4ervfll�, Ma. �I r _ -SgAMAN £NGINE£RI"G coMPANY VID . April 12, 1991- Gregg Aunt Re; Hyannis Marine Division of Solid Wital Chpt. 91 license no. 2183 DEp, Lakeville Hosp DEp SE3-1796 Lakeville, MA 02346 Dear Mr. Hunt' - We have a proposed disposal site for dzedge�h spoils te is Sth hown .We Wish to have -you isPiew and designate. as Lots 22 s 23 on the attached plan No. rqkV 31373 I have plotted the location of the site or. the "Barast�Q�1 w . yzrsouth Water Table „ontouhe capeg and oQic Water p:.arningSapa Supply Zones of Contribution by As you can see fror.: the msPr pevelopmcut Co:nmis$Son. 1g8Z • it is outside any zone of influence and :s close to East B ?' a and Centerville Harbor- to place material from the Hyannis marine dredging We propose in Hyannis Harbor at this 6 area - if have included bulk analyse s test results from the dredge If you have any questions or need any additional. information feel free to call. Sincerely, Robert A. Braman Jr. PAB/Ig cc: Hyannis Marino FAXTRAU MMAL ♦apaps 1 Os. &Isl= .00.to. (500)75P$273 DOM Fax 0 *U LWN STREET SUZZMA3 SAY.UASIAC1 •f CZSU Td.(�769�ZT3!t5�17�t�6 fu(5DE17Sf.�2�� - ------------------------- --- ------- 47kHId17_ g4/is/ol 13:44 croa 759 E244 b tuff ENO.tOtT• I3RF.MAN ENGINEERING COMPANY SIEVE ANALYSIS # COMP0511E OF. 5'4MPLF!5 1 � Z Weight of Sieve Weight �� Sieve i Samp:e Net Retaine�a Pacs� Sie sieve# 20 3 -7 97. � , 60 lao i4Q � Pan Weight of Sample •• �j�j�- loom I I If �Alld M W!1 WAMIS LOCI ff L6110of"94f MALTrRIAL SOURCE it1 TV NO ---J 12: 1 I Li:HYAt JN 15 MAP.I!'t ;I tic Y GA orbunr,aVAL Ifs* yUOO t��i��(� �N. i Ij , � '.' ;` } �• L L, top1 j ;,r: � M/ C� •i' � .fir-irt !Fe {r T. ar ZONE C Y Ilh+�''� >. ':i '1:r,.! w3'r.�iti� �• .t-�;--� `�,�. �, •�� 7J�J �+ mil. 4� �,,.Y.�l�ti�' � NE "kN q� 1 '!' .r ice' •tX'•f �i �• j.�� {��� `Y� � �` i�,. '" •i,~••,•, ; .tit •'• ONE 5j •♦ �• �ONL v .% .. rM'�•``�•. �-\ � 'i r ,eta► 0(dE 8 �. ZONE 9 ItE ` w, ONE QNil- B ,•r; WAN Z(;NE Q A VSwo, _ —1 Loc 1) fiN�7 ZONE ZONE C ZQf:� Al •i'1 I r \ Or r�,;;., a GROUNDWATER = - ANALYTICAL . INORGANIC CHEMISTRY Field ID: North Pond Lab ID: 2625-08 Project: Fowler/91-015 Sampled: 01-30-92 Client: Hyannis Marine Received: 01-30-92 Cont/Prsv: 40ml VOA Vial Matrix: Aqueous REPORTING DATE EPA PARAMETER RESULT UNITS LIMIT ANALYZED METHOD Conductance 80 umhos/cm 1.0 01-31-92 120.1 Chloride 10.6 mg/L 1.0 02-04-92 325.3 BRL - Below Reporting Limit. Method References: Methods for Chemical Analysis of water and Wastes, US EPA EPA-600/4-19-020. Revised (1983). - GROUNDWATER ANALYTICAL, INC. _ CHAIN OF CUSTODY RECORD hej N0. � Pvejed Maen+ V Samplers > Ld c. a� (OU N y Field Type of s. Analysis Requested . • No. Dart. Time E U t7 Station Location Containrre• �• """Wks I-3o ;3o e-j LASS pzes 4) FQ Relkwhtwd by: Mr evl Date Tkm Received by: IS•ew•erwrl Relkowwivi+ed by: (Xww wrl Oate Time Rtwived by: rS;er.ew.el er Relingwhived by: Mp iiv.vl Date Time Received by: IS:wwowm! RelinqursAed by: rS•w.•rvrrl Oate Tfeno Rbaiwd Fry: r3l�were.+/ Relin"we d by: r3;r new # Oete TMno Received for Laoorarory nv: Rarwk• rSgwrww/ f 4 A Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Southeast Regional Office Wllllam F. Weld aovsmw ' Daniel S.Greenbaum CommW w»f May 11, 1993 Mr. Wayne Kurker RE: BARNSTABLE--Solid Waste [Hyannis Marina` Lots 22 & 22 located on . rlington Street �g Ipswich Circle, US-�' Hyannis Massachusetts 02601 BENEFICIAL USE DETERMINATION 1 APPROVAL, 310 CMR 19.000 Dear Mr. Kurker: 4/11J; A2/ The Department of Environmental Protection, Division of Solid Waste Management (the "Department") , has conducted a review of your (the "Applicant") request for authorization to utilize approximately 1000 cubic. yards of clean sand dredged from Hyannis Inner Harbor as fill material on Lots 22 and 23 on Ipswich Circle, Osterville, Massachusetts. Review of information provided by the Applicant indicates that the dredged material is a clean sand mixture which conforms to the Department's Division of Water Pollution Control ("DWPC") Category I, Type A material . The material was dredged from an area adjacent to the Hyannis Marina's main dock and its most northerly floating dock: The dredged material has been dewatered on the Applicant's property-Hyannis Marina, located at Arlington Street, Hyannis, Massachusetts. The Applicant indicates that the dredged material could be beneficially utilized on the above-referenced lots to fill an existing depression on the property to an elevation of 24 ft. The Applicant states that since the deposition site does not constitute a wetland resource area, does not fall within 100 feet to a wetland resource, is not located within an area subject to flooding, and is not located within a Zone II for a public drinking water supply, there will not be any adverse health or environmental impacts from utilization of the material on the above-referenced lots. Based on the above and the chemical analyses provided by the Applicant, the Department is of the opinion that the Applicant may beneficially utilize the dredged material as fill material on Lots 22 and 23 on Ipswich Circle, Osterville, Massachusetts subject to the following condition: The described beneficial use shall be a "one-time" event. Should there be a need for the reuse of additional dredged material, application shall be made to the Department in accordance with 310 CMR 19. 060. The Department will accept comments from the Barnstable Board of Health (the "Board") regarding this request for a period of fourteen (14) days from 20 Riverside Drive • Lakeville,Massachusetts 02347 • FAX(508)947.6557 • Telephone (508) 946-2700 Fr THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / �C(�J LI DATA q -2- ,ate of this approval. Accordingly, the Applicant shall not utilize the fged material until the Board has had the opportunity to comment. Should e fourteen (14) days elapse without comment to the Department, the subject ,athorization shall take effect. In addition to the above, please be advised that should any activity on your property take place within a wetlands resource area or within the 100 foot buffer zone (refer to 310 CMR 10.00) , you will need to contact the local conservation commission and obtain any necessary approvals. Any questions regarding this matter should be directed to either Cynthia DeRosa at (508) 946-2761 or myself at (508) 946-2833 or at the letterhead address. my y s, David E is, ief E/CAD/rr Solid Waste Management Section CERTIFIED MAIL #P808 785 255 RETURN RECEIPT REQUESTED cc: Barnstable Health Department Barnstable Town Hall 367 Main Street Hyannis, MA .02601 ATTN: Thomas A. McKean, Director P Barnstable Board of Selectmen Barnstable Town Hall 367 Main Street Hyannis, MA 02601 ATTN: Warren J. Rutherford, Town Manager DEP-DSWM-BOSTON ATTN: Philip Weinberg DEP-SERO ATTN: G. Crombie A. Papadopoulos , f i �rsnDeuye r.:,.. IK:Y. -/I �� --„1.•�i•[/ •�� :O/ r•nb rry Ya••7S•;' ..'Ti.Does :✓ r.• `p .a ,r�... .•• �..Q '�• ;�..• 'r PA`^� ^ �•r � J2• CCYY�, .i.•'I ./�0 �O 1.✓ ar)� 'S••.• to •. 1 0 •• •'1•, •1 V •` -47 am 60� .•►: •. ., .. .5 p Pon C. eectw -1126 0 1 ice, ,.` Oaf rr- Ctan �I• �nDerr I \�t�� Fn atvret i �• �, -- �. ::; y;,�','.•,'.�•'�•"a�•;� ash`.. �'�• �J It i r��!` J 1!T 1. l ••�r yl���- I::Q•C •'�,`�p I �� ' - //:v„�,�'_ lo �+ �.� �/� !.Ir"/ ,.`mot' �O 1. �i�.I�•fA�i�' v \ i i v�••M^'.•� �.t. JETUALUCT Bay '°=i�i\ r i.1�_ ci�• c /� //?�f; ~i a v I- ( Oi(4 ..� _� •,�*1� f v [ Y T �• !%%�*\�,,'' ��- �•��9 ov~ —T Cralgvillir, ,n.,. 1. Y•11 \�.:•�O,Z °z i ti a ��� ��`� :: - ` IG►lubd�l rpJC j\n,/-1�.;r :.1'^'. o�i'gtr;�j�•, b'J.!.. rat Ville en..•:•°"?! .. ,, rr, •_` .o � " CL31t3V1).�12�` 6\V:'rc z�.n; iRp•� °.r�V �. Be - Public a-%an �. '-Ia,tn:� = K✓,R --Qr Z;.: ,L - $Dindle,- LVI CFNTERVILLE <-HARB-1-a-R East Bay.:;' 20 \ r y '' :• \w \ <•��' `�, •.Beach �c ra ..\ r3 •1,�J Qv.ik ._ Gannet I Rocks tJ a • �� it 10 , ! 131 Ate'\N T U C K 0 I I 0Gannet ,r1 co ! G f Leoee 3 Ij E A.M.Wilson Associates Inc. ,EXH/Q/T t ,�r•.-,-by ..�c. «, •; :a'r � `� �.' �. _. � �'�.���' p_ + * T x•.�•f::�.y` •''�l :i'•.c. 'L"i} i .��+11l• �C�+e .��+:: - �,� %1�, I ��� '«:�i'i��+..� . .,i:.� •: :: .� , O *.;.at,''.•r. ...I .�.ti�+ -=•�3;?. 25.' ,+. •O•'YA: .:: f .Cl: '�.iy'43 ,�••! X :i .`'�•♦!.{.. ."`. •.. a?ti � . L _ •firv� ^.t�J..' t'• •1'4:•-3 �`•ll`' Ji; .C. / • ... Jxl��/�� .�_y�.�.� .f ..a. �I _z� .iy• .:rt..ry '^!'tiA... t,1.'.� :a+f� • •+" •��.'�i• �t.l�. {!F� y.Y..: AL :i:n:f _h.n •..r-. ,S~' �? �• 6%. uh fit • l Pi [ �� NORTH POND 34'` t.01 A� G • 3.1 l o' • °35AI Oi col . 'L '�� I C' a4 150 r 0 55 1 .A6AC• .� s '7 Dd •` I `• a+ 56 �tO v a T .63AC• y� o a 64 ,J e '? .2 3AC. '� !,LYEMA�! PO rjC 57 .6 3 AC• o 63 0 o aAwr o A.M. Wilson s: ASSOClates A, Inc. ' �� Q11 ►Inln S4 flAlervltlA. Ma. - BRAMAf1 ENGINEERING COMPANY LTD . April 12, 1991. Gregg Runt Re; Hyannis M'a_ine Division of Solid Waste Chpt. 91 licensi no. 2183 DEp, Lakeville Hospital DRP SE3-1796 . Lakeville, MA 02346 Dear Mr. Hunts - osal site for dredged spoils which We have a proposed dill' ngte. The gi'te is shown ..wQ wish to have -you review and desig- as Lots 22 & 23 on the attached plan No. 31373 . I have plotted the location of the Psit sic ite Saupply ell w yarrouth Water Table Cobtouza an Zones of. Contribction" by the Cape Cod Planning a^-a Economic :rsnis$ pevelopment Co Jon, 1982 • As you can see fror. the maps it is outside any zone of influence and is close to East B }•a 'and Centerville Harbor. i�.Le dredging ' terial we propose to place materom t 3h�vehe y includannis ed r bulk analysis i in Hyannis Harbor at this s test results from the dredge e area. have an questions or need any additional, information if you y feel free to call. Sincerely, . Robert A. Braman Jr. ImB/Ig cc: Hyannis Marine FAXTRAMSMnTAL FO ofpap�s l Dom .- d>L ,DNS�n tic ,�� �. �nms.� .�•�- ' wtm STREET 6UnAM SAY.WSIA�CMV$tt`•S C2= �t 4rmcmTd•( '76987T3r(S�1Tfi9d119 pax.(5W)7S0 2AA ---------------- - - ---- ------------------- ------------ _ �aCN/a�T S '� F 94/18/91 13:44 C508 159 E241 FsA.AFUIti ENO.COff• ��a ORMAN ENGINEERING CONSYANY • SIEVE ANJkLYSIS ! 4COMP0611E. OF. `57QMPt-Ft 1• ALL Weight of • Sieve HSieve eight OffSieve i Sample Net Retained% Pats% 10 60 • 44 loo � 'o f ''-- "' • y j zoo Pan Weight of Sample •• �j�?- s� TEL NO:►_1'w,►i`_� 51`� +o^ 12:21 ID:H'Y'At4N1S MAF?Ir•;t Ip;i. • ��. .w tilt�•..•}{ ': ., —�}�1�� �•�.. �% .; 7.• .. , t �� •1•:I. °t .�" :r..r • ZONE C •� �'•:.,' -.' *� W10�^it ,st; •(I�l ! L J �'��JIVi• . IL �ON� 9 It zo Is ZONE e ZONE C -} - ZONE 9 ;ZONE ONE 6 + •- "�i► ram'• / '°' '�t ',�'''. f �'. 100 ZGNti �, bp ti , { � �VSN,, L►GrC>J S Ile MN.l7 ZONE ZO+` ZONE C A�1 20t+E � �i i 1 & S GROUNDWATER -ANALYTICAL . INORGANIC CHEMISTRY Field ID: North Pond Lab ID: 2625-08 Project: Fowler/91-015 Sampled: 01-30-92 Client: Hyannis Marine Received: 01-30-92 Cont/Prsv: 40ml VOA Vial Matrix: Aqueous REPORTING DATE EPA PARAMETER RESULT UNITS LIMIT ANALYZED METHOD Conductance 80 umhos/cm 1.0 01-31-92 120.1 Chloride 10.6 mg/L 1.0 02-04-92 325.3 BRL - Below Reporting Limit. Method References: Methods for Chemical Analysis of eater and Pastes. US EPA EPA-600/4-19-020. Revised (1983). - GROUNDWATER ANALYTICAL, INC. CHAIN OF CUSTODY RECORD noj Me. PteiM meow q(-OIS � � e a� s.rev+..+ wel > ype of Analysis Requested Field e o Rernrka No. D.te v. . ° f7 Station ltrutiorr Cat.f�iner u 13 e. •3o hlo ►� ��..� �'+�q's ;. SP►•t, oa, �2E✓SE�r w � t=Q ''� Relinqulalve by: f rwtwrl Drte Tkm Received by: Mw•arwrl Relir.00itf+ed by: fS.w.rw.r/ Data Tine Received by: 1S:wwrarrl Relinquislrad by: / rwrl Date Tlme Received by, /S wmewrvl Relir.gvnl.ed b�: l�.w••rrrr/ Oafe Time ReaiwM by: Tw.an.+/ Rellnoehfwd by: m;pwtwa/ Date Tines R►cei.rd for laooraforr 11- Ra.warka i9L,e LOCATION Oe �� �� ` SEWAGE PERMIT- ,NO. kq —I ocr o VILLAGE INSTA LLE 'S ,,41AME i ADDRESS lee r e U I L D E R OR OWNER � DQ Pi" DATE PERMIT ISSUED DATE COMPLIANCE ISSUED s :' c t+ F ix • C No.............. ��n � '�s. Fizs......J..(............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,- ...................................------..OF.............................. Application for DiipnsFal Works Tomitrnrtinn ami# Application is hereby made for a Permit to Construct ( ) or Repair ( &<an Individual Sewage Disposal System at: ...] ......�,S!�IT�1A._....4 1 CL ..--•1•-...(%7......... Location-Address or Lot No. ......................................... ................................................................................................. ner Address ................................. •.- .• •- - -----------••-...........-----• � Inst er Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) ~ Other—Type T e of Building ............................ No. of ersons............................ Showers — p,, yp g p ( ) Cafeteria ( ) a' Other fixtures ............................ . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity....---.....gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-------.------------ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. 1................minutes per inch Depth of Test Pit.-----.............. Depth to ground water........................ �Tq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..................-----. a ............................................................. ...... .•------------ ----------------------- •......... ............. ----•-•---- -----•--------- 0 Description of Soil----•-----------------------•----•------••---•-•-------•-•----•-....-----------•----------------------------------•.................................................... 44 U -••.....-•----•-••••••••-•••••••-•-••-.....-•-•------•••••••-----•-••-•-••---•••••-•......•--•••-•----•......--•--•-••••-••-••••-•-••-••••••---•-•••••-•-•-•••-•-••••••••......•........--•--•......••-- W U Nature of Repairs or Alterations—Answer when applicable...--.1 ST7tJ,.11...........G.KR........1. N................... W�------..%t.....----s-�°��•-•-----------------------------------•----------------------------------------------•-------------................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.j 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 of health. 6 Signed------ Date Application Approved By.................... . ....... AI. . ........................... ' Date ` Application Disapproved for the following reasons:------•-------------•------...------.....----------.....------------------------•-------•-.--------------------- --••••-----•---••-•----•-•-•--•-•-----••••-••-•-•---••••-••------•••...•••--•-•---•....--••--•-•---•.. .................................... Date PermitNo......................................................... Issued........................................................ Date ------ -- - - - _ ----- --- .W---- ---------------------------- a No.-••-•-----••.` =/9 f'o FEs......I_(................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH,, ............ .........................O F.............................._......... ......_... Applira#ion for Disposal Works Tunstratr#ion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (rim an Individual Sewage Disposal System at: i • -- Location-Address or Lot No. � N.h_.... C -C� .......................................... ..........-------------....----....-:-.......-----................................................ Owner Address W Installer Address Type of Building Size Lot............................Sq. feet .—I Dwelling—No.`of Bedrooms...................................:........Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin No. of persons........................... Showers — Cafeteria Otherfixtures ..................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width......._........ Diameter................ Depth......,-_----__. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area...................sq:-,ft.,,„ Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 -------------••-•-----•-•-----......----...................•-----..........-----•---•••-••---•-•---•......................................................... 0 Description of Soil....................................................................................................................................................................... x W x --- ----------------------------------•-••_.... U Nature of Repairs or Alterations—Answer when applicable..._..t� s721.�,_ ..........A_C .y...._...4C g"M.................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of. "LITLE 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 of health. Signed....... ...... .................................. .....1.1 Date ApplicationApproved By........................... ........ ..................................... Date Application Disapproved for the following reasons:................................ .__......_.._ .........-•------------------•--------....---------------•--------------•--•----------......---------•--.-----------------------------•------•------•----------------•---•----•--•------•---------_..... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF......... .............................................................I......... Tntifirate of ToutpliFanrr Tlys IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired AAMby !. ... -�e !--•------------------------ ' at---Us....... f..............(5.m...................er................................................................................ has been installed in accordance with the provisions of TTTILy 5 of The. State Sanitary Code as described in the application for Disposal Works Construction Permit No.ff-.Z"'rU,`, ........ dated.........:.....................::............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATIS ACT/ORY. ,�• }'� DATE............................................�l jQ . �.--------. . Inspector....-----._......L�—=---�--•--••-•------•---------•----•-----••-------•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A,...................................................................... ('. No. 3 r�.:r��., .6) OF.............. FEE...IL........... iu o al Works Tunu#rurtion ierutit Permission is hereby granted.-- r .-- ..5 - -----------------•--......---------------•-----------•-••--------.................... to Construct ( ) or Repair (;' Oran Individual Sewage Disp System at No....I(&.........t.J?S W-q.-. .k.....heof-A-k:2................::.: Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... DATE_ -----•---•----•-•-•-•----•----•-----------------•......•••.................... 2-,ar-,�d�of Health FORM 1255 A. M. SULKIN, INC., BOSTON -